photo taken from: https://www.worldnetsales.org/yourmemorystick/p/6/male-nurse-3003

I have worked my ass off for more than three years as a nurse. And being a nurse here in the Philippines is no joke. Nurses are underpaid. Well, not necessarily overworked since the hospital I worked for have fewer patients compared to government hospitals. But some, if not most patients that we have expects the best service from us to get their money’s worth. And even if that best service includes feeding them even when they are able, massaging their backs and feet to induce sleep, and putting their TV on or off even when the remote control is within their reach. And these are still mild nursing activities. I, myself, have experienced worse, that I believe is not even part of my job description. Harassment, sexual and nonsexual, I didn’t mind. I needed the clinical experience. At the back of my mind, I was telling myself I’ll leave this country and be richer than my patients.

I didn’t harm anyone. I believe I gave my best, at least most of the time. I was up for promotion last February as assistant manager in our unit, but I turned it down because my agency wanted me to resign since my visa has already arrived.

I was supposed to leave Philippines last April 12, but I was diagnosed as HIV positive last March 29. My dreams of providing my family a generally comfortable life suddenly shattered. My mother is a nurse too, but she’ll be in her retirement age next year. I was supposed to replace her as the breadwinner of the family. Now I don’t know how our family will be when she returns; she’s our sole breadwinner.

I have lots of dreams. Most of them, I know I would not be able to fulfill. Reality check here: I know I wouldn’t be able to work abroad.

I was offered a monthly average income of 100,000 pesos, tax free! I was supposed to have my own pad in a building with a centralized A/C system. No electricity or water bills to pay. There’s even food and transportation allowance. All I needed to do there is work.

And look at me now. I am currently unemployed. Not only did I lose my nursing job abroad, but I also lost my nursing job here in the Philippines.

Thank God for my ex-boyfriend, I am still holding on to this online news writing job he referred me to.

So how do all these make me currently hate facebook?

In my facebook account, I see my colleagues travelling around the world. They have been buying gadgets and other things that I dreamed of having, that I dreamed of buying for my Mom, aunts, brothers, and sister. I was supposed to help finance the college education of my siblings. I was supposed to help fix our house, pay the bills, and in general, provide good living to my family.

I remember in one of the seminars in the hospital, I told the facilitator that one of my dreams is to bring my aunts to Bohol, make them see firsthand the Chocolate Hills. My aunts were grade school teachers and they taught about the different tourist spots here in the Philippines, yet they haven’t been to one.

Yes, I feel regretful because I, too, could have provided for my family. I do not want to have HIV, but I invited temptation.

I have always been the supportive workmate, always telling my colleagues how lucky we are to belong to a really big hospital with high-tech equipment. I encouraged them to take foreign exams so that they will have better opportunities abroad.

In my heart, I know I’m happy for workmates’ successes. For more than three years, they served as my siblings in Manila. I’m just not ready to view their successes that could have been mine as well. I know that the problem is with me, but maybe I still need more time to recover.


Hence, I’ll say good bye to facebook for now.

So here’s the timeline of my life with HIV:

March 27 - medical exam for my work abroad

March 29 - HIV positive via ELISA (screening test)

May 8 - HIV positive via Western blot (confirmatory test)

May 28 - first visit to an HIV hub

May 29 - baseline labs

     I had my blood drawn; submitted three samples of sputum; and had my X-Ray. I was told that the CD4 machine is under repair. It has been broken for a month or two, as said by a fellow pozzie.

June 7 - consultation with the hub’s HIV specialist

     He said that all my lab results are good, but I was prescribed with Isoniazid as prophylaxis; just something to prevent me from developing TB. He also explained about possible side effects such as rashes and tremors. I can take antihistamines if rashes and itchiness are not tolerable, and I also opted to take Vitamin B complex in order to counteract the possible tremors side effect. I was also given the clearance of taking my daily supplementation of multivitamins, Vitamins C and E, Selenium, grape seed extract, and garlic oil.

June 22 - CD4 test

June 26 - CD4 result: 518!

Someone who read my blog sent me an email and asked why I worry a lot about my CD4, what its importance is, and how I would be able to get a significantly good result. Here’s a brief summary from several online sources:

What is CD4?

T-cells or T-lymphocytes are white blood cells that play important roles in the immune system. There are two main types of T-cells:

• CD4 organize the response of the immune system to bacteria, fungi, and viruses.
• CD8 destroy cells that are infected, and produce antiviral substances.

The relationship of HIV and CD4

HIV targets CD4 cells by binding to its surface, and eventually becoming a part of them. Early in the course of the disease, the body can make more CD4 cells to replace the ones that have been damaged by HIV. This is the period when the person with HIV still feels well and has no symptoms.

Eventually, the body can’t keep up, and the number of functioning CD4 cells decreases. As more and more CD4 cells become damaged, the immune system becomes more and more weakened. The weakened immune system leaves the body at risk for illness and infections.

Uses of CD4 Count

CD4 counts are reported as the number of cells in a cubic millimeter of blood. The normal CD4 count is 500 to 1000. Other sources indicate that normal range is 600 to 1200. It is also more important to pay attention to the pattern of results than to any one test result.

It is useful to have CD4 count regularly measured for two main reasons:

• To monitor the immune system, and decide whether and when to start to take HIV treatment and other treatments to prevent infections.
• To help monitor the effectiveness of the HIV treatment.

Personal note:

My baseline CD4 count is 518. For me, my result falls short from the normal range, but it is fairly high that it is still not recommended for me to start with ARVs. I somehow consider myself to be in a critical state because for a period of just around three months starting from the time I was first diagnosed, I developed mild swelling of the lymph nodes and seborrheic dermatitis.

The next schedule for my CD4 is on December, but in my case, I would like to take another one after only three months (September), even if it's not free anymore, just so to know how my health is doing. For now, I just have to focus on improving my lifestyle, so that everything I do is for the improvement of my overall health condition.

References:
aidsmap.com
aids.about.com
webmd.com

I was diagnosed last March 29, received my confirmatory result on the first week of May, and had myself checked at a local HIV hub last May 28. Until now, I still do not have my CD4 count because the machine in our hub is under repair. But I was informed by a fellow pozzie that it is currently being fixed, and might be available before June ends (fingers crossed).

Starting from the time I was diagnosed, I had excision biopsy of lymph nodes (my family insisted to doing it because they fear I have cancer). The result came back, and it indicated that I have reactive follicular hyperplasia (in simple terms, I have an infection). If they only researched about it extensively over the internet, they should have found out that common causes include rheumatoid arthritis and HIV/AIDS. But good thing they didn't, because I have no plan of disclosing my status to them as of the moment.

At one time, I had severe headache (the most excruciating migraine I ever had), fever of 38.6 Celsius, and body malaise which went on for a couple of days. Initially, I thought I’m already having the early signs of HIV infection, but when I saw petechiae in my arms (tiny spots of blood on the skin), I was alarmed that I might have dengue fever. Through prayers, and perhaps 1gram of Panadol, I became fine the day after. There were still morning headaches, but it only lasted for a few more days.

Since I do not have my CD4 yet, I decided to purchase supplements which will help maintain, sustain, and improve my immune system.

NOTE: Just a disclaimer, I am in no way endorsing or selling any of the products presented here. It is still best to consult and seek medical advice from your HIV specialist with regards to consumption of vitamins, supplements (herbal or not), especially when you are already taking ARVs.

First, I got myself the multivitamins that is complete from A to Zinc: Centrum!

Since it only contains 60mg of Vit. C, I decided to buy Poten-Cee, which contains 500mg of Vit. C in each tablet. The recommended daily allowance (RDA) is 90mg for males and 75mg for females. If you are a smoker, add 35mg more.

Php104.75 for 20 tablets

Its role in immunity includes stimulating the production and function of leukocytes (white blood cells). Researches suggest that neutrophils seem to be the primary cell type stimulated by Vit. C, and these neutrophils attack foreign bacteria and viruses. Ultimately, it is a general fact that Vitamin C boosts the function of the immune system.

I also bought Vitamin E (400mg) with Selenium (50mcg). Basically, it is an antioxidant, and has anti-inflammatory properties, and it is often lacking in HIV positive people. I am not on ARVs yet, but Vit. E is said to improve the viral effects of AZT (zidovudine, Retrovir).  It is also stated that  Vit. E functions best with Selenium, and vice versa.

Php 427.50 for 30 tablets

I also bought myself Grape Seed Extract or GSE (I first read about it in the blog of a good friend, (Iam H. Positive). Upon further research, it is said GSE may effectively reduce or prevent the impact of HIV infection. Studies also show possible antiviral activity against HIV. It interferes with viral growth preventing viral attachment to host cells. It is also thought to interfere with viral multiplication.

Php 350 for 100 soft gels

And while I was on a kiosk checking grapeseed extract soft gels, I came across another product: Garlic Oil softgels. I gave in to the brochure indicating that it has anti-inflammatory and anti-infection properties. But further research over the internet reveals that it reduces the effectiveness of nevirapine and efavirenz.

Php 200 for 100 soft gels

Currently, I am still waiting for the repair of the CD4 machine in my hub. But just like when I was still negative, I just have to lead and live a healthy lifestyle: exercise, enough sleep, eat healthy, and have a stress-free and peaceful mind.

                                                              image taken from http://momfog.com/2012/03/29/mom-guilt/

I had a relationship three years ago, and I learned that he died this January 2012 due to liver abscess. He was in his early 30s. As I’ve mentioned in my earlier blog entry, I kind of assumed that it may be caused by Hepatitis B. I got myself tested, and the result was negative. But now that I have HIV, I have a strong suspicion that I may have gotten the virus from him. We had unprotected sex.

When I learned that he died, I felt sorry for him. I even posted in my facebook account a video of his favorite song, “Somewhere over the Rainbow” by  Israel “IZ” Kamakawiwo’ole. We had a good relationship. I took care of him when he had fever; he helped me when I transferred to my apartment in Quezon City. I remember him helping me carry the chairs and the refrigerator to my room at the 3^rd floor of the building where I live. I was waiting for my deployment date in the hospital back then, and to avoid boredom, he gave me an online writing job; the kind of job which paid for my apartment rental, utilities, and internet bill. He was the first one who brought me to Malate, and he insisted that we hold hands all the time when we were there. Combined with my income from my nursing job, the online writing work gave me the opportunity to tour to different tourist spots in the country. So how can I ever hate the person who gave me life while I was still a struggling nurse in Manila?

Just yesterday, I don’t know what came to me, but I searched over facebook a person who I once dated for several months around mid-2009. I was shocked to learn that he too, has already passed away last October 2011. He was 25 years old. It was due to meningitis. And research tells me that meningitis is one of the defining conditions of AIDS. Right now, if I think about it, maybe he really had AIDS. It’s just that it was undiagnosed. He always wanted to do bareback sex. He doesn’t want me to use condom, and whenever I do, he removes it moments before I would cum, so that I could cum inside him. And right now, I feel so stupid for indulging in that practice. True, it felt better without condom, but look what it got me.

I also learned that he knew he had meningitis all along. If he ever consulted a doctor about that, HIV screening test must have been suggested for him to take. And if he ever took one, and turned out positive, did he intentionally pass it to me? I don’t know. I really don’t know. And perhaps, I wouldn’t ever know.

I have to admit, I got angry with these two abovementioned people. But then I realized, what if I passed the virus to others? These two are the most possible people from whom I may have acquired the virus, and I had encounters with them two to three years ago. So after them, what happened to the succeeding partners I had?

That is the problem with HIV. Whether your CD4 is high or low, that doesn’t necessarily conclude that your infection is recent or acquired years ago. More than that, it is asymptomatic. You may have it for years already, yet the symptoms do not show.

It is a struggle living with HIV. There’s that temptation to blame past relationships and encounters, and there’s that condemnation towards oneself. I carry around fear; I carry around loathing; and I carry around guilt.

Again, it is a struggle. And I’m dealing with it every single day.

                                                                                            

my pre-HIV pic

I created Pinoy Positive in facebook, twitter, and blogspot with the purpose of having support system as I start living as an HIV-positive individual. Since I haven’t disclosed my status to my family and close friends, I find it best to ventilate my thoughts and feelings in these social networking sites, and at the same time, get to interact with my fellow pozzies and share about our experiences. And I’m thankful for all the heads up, encouragement, and care.

It has only been one week, but I have “cybermet” several pozzies already. It’s also helpful to read their blogs as well. There’s one from the same province where I live, so we basically share information about our hub, the census in our province, etc. He has been living with HIV for more than two years, AND still without ARVs (galling, di ba?). And there’s another one I have known three years ago. Small world we are in, really.

I have been melodramatic in my blog entries, and others that have read asked for my background. There are several others from twitter who asked as well.

So here are bits and pieces of me…

• I watch Friends, Sex and the City, Coupling, Queer as Folk, and Desperate Housewives over and over and over again (No life, di ba?).
• I was supposed to take Med. Tech. as a pre-med course, but my older brother took Med. Tech. so I thought of settling with Biology. Almost all the courses in UP are quota courses, so when I passed their Psychology program, I decided to pursue with it instead.
• I was a member of a fraternity and a theater group back in college (an early battle between my masculine and not-so-masculine side. Hehehe!).
• I have three siblings: two brothers and a sister. I have four older stepbrothers, and two younger stepbrothers (masyadong masipag father namin. Hehehe!).
• I love travelling around the country. Whenever I have travel plans, I would work six days straight, travel for three days, then back to work again. There were also times that I go straight to the airport after my night duty, spend two days in the province, then fly back to Manila just in time for another night duty (patayan!).
• Standing at 5’9, there was a time when I weighed more than 200lbs. I got into gym and a diet program, my lightest was 150+. But now, since I’m still a little bit depressed, my weight went up (haha! Bwisit!).
• I dabbled into running to lose weight. I started with 5km on my first try. Before my 2^nd year, the farthest I’ve ran is 32km. I have participated in trail runs in Rizal (Merrel), and Tagaytay (Xterra).
• Because of group buying sites, I got to eat buffet in several different restaurants/hotels. Hence, the weight gain. 

And for some serious stuff…

• An ex-partner died January this year because of liver abscess. I easily thought he had Hepa B so I had myself checked; negative! But right now that I’m positive for HIV, I suspect that I might have gotten the virus from him.
• Being a nurse or any healthcare staff does not guarantee compliance to safe sex.
• Co-workers claim that I never looked sick. The past year when I had fever of 39 degrees, I went to the hospital’s clinic and had my check up (I suspected dengue, but turned out negative). I passed by our unit to file my two-day sick leave, my co-workers jokingly said, I was just playing sick.
• The longest period that I was absent from work is 7 days: sore eyes!
• So after discovering that I have HIV, I oftentimes look at myself in the mirror and furiously ask, “Is this the face of HIV? Is this the face of someone sick?” I had no symptoms back then. Now I have swollen lymph nodes (pero hindi naman din kse visible on the outside).
• I had excision biopsy of lymph nodes mid-May because my family fears that I may have cancer. Histopathology result is not yet released (inefficiency of the hospital; it has been more than two weeks as of this writing; they promised 7-10 working days).

No love is ever worth the risk of acquiring the virus. If you love each other, wear protection. If you love each other even more, get tested!

photo taken from: http://staydum93.deviantart.com/art/Crying-Face-171951658

March 29. I went to the diagnostic clinic early to finish whatever it was that needs to be rechecked on me. I wanted everything to be accomplished because I was on PM shift. And yes, it was that day that I knew that I am HIV positive.

After the talk with the head med tech, I decided to proceed to the hospital although it was still early for duty. I was in the MRT station when I texted a workmate that I needed to talk to someone. I was glad with the reply; she’s on PM shift as well.

When I arrived in the hospital, I prepared my things and received endorsement from my manager. I remember texting my Mom that I had my follow up lab earlier, and that I wouldn’t be able to work abroad. I told her I’m sorry for everything, for disappointing her once again. She texted, asking what my problem was. Afraid of disclosing to her that I have HIV, I just told her that there was a problem with my blood exam.

I remember her calling, furious, asking me what happened. I told her that I might have Hepa B, and that blood was extracted from me again, and I have to wait for 3 to 4 weeks for the confirmatory result. I cried telling her how sorry I am. I cried because I lied.

She asked what my plans are. I said I do not know for now. Then I said, I can ask my manager if I can still retract my resignation. With regards to my employment abroad, I can just tell my agency that I have a health problem that may take a while to be resolved. With regards to my siblings visiting me in Manila, we can go on with it since it was already all planned out.

Then the workmate that I texted earlier arrived. She asked me what my problem is. She asked if it’s about my work abroad. I looked at her and nodded. Controlling my tears is such a feat. I couldn’t hold back any longer, tears flow continuously from my eyes. I cried in silence because I was embarrassed that the other staff might see me. My workmate and I agreed to talk after duty.

A few moments later, a guy I recently dated texted me, asking why I wasn’t texting back anymore. I replied that things are complicated with me right now; that currently, I’m in a very very dark place that I do not know my way out. He was worried; he called. I was not comfortable taking the call because I don’t want to lie again, and I don’t want to explain myself to anyone as of the moment. Things are very recent. But out of politeness, and the need, maybe, for someone to listen, I did take the call.

My voice was shaking when I talked to him. I told him I’m sick. Since what I do know about HIV then, is that it might lead to TB, pneumonia, or cancer, I had no choice but to just tell him that I might have cancer. I cried telling him that I did care for different patients in the hospital, patients in critical care conditions. And it’s so hard for me to accept that sooner or later, I may be one of those patients. I see how they suffer, and I will suffer like them as well. We ended our conversation with him saying, that I should just pray, and never forget to seek Him at all times.

After PM shift, my workmate and I talked. I did not disclose to her my real condition, but she listened to all the worries of my heart. Before we parted ways, she held my hand and told me that everything will be fine, and God will always be there for me.

I walked home crying.

                                                  photo taken from: http://www.added-value.com/source/2010/10/marketing-and-hiv/

January 2012.

After three years of working as a staff nurse, I was informed by my manager that she will process my promotion as assistant manager of our unit. I was ecstatic. After a hate-hate relationship with some managers in the hospital in the early years of my career, it became love-love a few years later. To be fair with the company, I was honest enough to inform them that I have a pending application abroad. I already passed the panel interview, and currently in the process of complying with all the requirements. Although there was no certainty as to the date of my deployment abroad (because of an internal problem in the agency), I still informed her of the possibility of me leaving the hospital any time soon.

Nevertheless, I was assigned as OIC in all my duty days in preparation for my promotion (and I can only feel glee inside; my managers trust me).

February 2012.

My visa arrived. I informed the agency, and they wanted me to finish complying all the requirements (pertinent documents, and my medical exam). Deep inside, I still did not want to resign. I enjoy being OIC. I still want to spend more time with my family in the province. Delaying tactics, done!

March 2012, first week.

The agency kept pressuring me to submit all my documents. They wanted me to be deployed on the last week of March. March 28, to be exact. I told them I wasn't ready yet. I still have to comply with the 30-day-notice of the hospital. They told me I don’t have a choice.

That same afternoon, with a heavy heart, I submitted my resignation letter.

March 2012, third week.

I have already completed all my required documents. And another good news: my deployment date was moved to April 12. Perfect, as it will give me enough time to go to the province to be with my family before flying abroad. Bu there is only one thing left to comply, my medical exam!

March 27, 2012.

I went to the accredited diagnostic clinic. It took me one whole day to finish everything. I felt so happy and productive. I was quite worried about my X-ray result, though, since I had cough during the day of the medical exam. Other than that, the other thing that worries me is how to budget my remaining two weeks: move out of my apartment, Manila tour of my siblings (I bought them airfare tickets already), we all fly back home to the province to spend at least three days with my family, pack my things, and head back to Manila two days before my scheduled flight abroad.

March 28, 2012.

I texted the agency if they already received my medical exam results from the clinic.  Thirty minutes later, I received a reply telling me to go back to the clinic because of a pending exam.

Uhm, I asked myself what went wrong. I checked my medical slip: no signature for the audiometry test. That must be it!

I texted an applicant whom I met in the clinic whose destination abroad is same as mine. She told me that the agency texted her that she is physically fit to work. More than that, she said there was no audiometry test. We were in the same line in all tests during the medical exam, we did not miss any single test.

I know that at the back of my mind, I worried that I might have Hepa B. A past relationship died January this year. I was informed it is because of liver abscess. I researched about Hepatits B over the net. Asymptomatic. Great! So only blood exam will tell. I refuse to think I have it because it will hinder my employment abroad.

Upon closing the windows in my laptop, I glanced upon the “You might also like:” portion of the showbiz site, showbiznest. The title: HIV Positive Wanggo Gallaga Faces Boy Abunda. And I said to myself, “Wow! Another sign!” Although I was convinced that I do not have HIV, a little part of me got worried. I also know for a fact that HIV is asymptomatic.

March 29, 2012.

I came to the clinic early because I was on PM shift that day. Although I arrived at 8AM, I was informed that the doctor arrives at 10AM. I was in the line together with those who have pending results. A few hours later, a staff called each one and assigned us to the units where we need to have ourselves rechecked. Some were assigned to X-ray. I thought I will be belonging to that group. I was not.

I was told to wait for the head med tech because of a pending blood exam.

I waited for what seemed like eternity when the med tech (Sir Roger) told me to come with him in his clinic.

He told me to sit, and then he introduced himself. He asked me where my destination is, the date of my deployment, etc. I answered April 12, and I have already resigned from my current employer for that reason. He then calmly told me that when he "run” my blood in one of the exam kits, there was a reaction. My blood reacted to a test, an HIV test. It was positive.

I was speechless. He asked me if I was alright. I didn't move. I didn’t say anything.

He then continued that what was did to me was just a screening test. What he will do now is to extract blood from me again, “run” it in the same kit, and another portion of the blood will be sent to DOH for confirmation.

He also informed me that he will text me personally if the results come out after around 3 to 4 weeks (added to the fact that Holy Week is approaching).

He then asked me again if I was alright. I said, yes. But to be honest, I was overwhelmed with all the emotions which came crashing down right at that moment. There was that fear of dying. There was that confusion as to what to tell my mother why I cannot go abroad. And there was also fear of unemployment.


And then, in a moment, I remembered during one review class about man's greatest fear: the fear of the UNKNOWN!