New Twitter Handle.

Hello dear readers and followers of my blog! Did you miss me? I know it's been a while since the last time I updated my blog, and I would like everyone to know that I'm all good and well. Buhay pa po ako. Hehe.

I've been quite busy this year, with work mostly. So what's happened to me since my last update? Hmmm, let's see...

First, my primary doctor, Dr. Mark Pasayan, is finishing his fellowship at RITM soon and he said he won't be putting up clinic in Metro Manila. So with heavy heart (*sob*), I transferred to Dr. Manolito Chua. Dr. Chua is one of the most senior consultants at RITM so I know I'm in good hands.

Second, my cocktail was changed back to the original Nevirapine-Lamivudine-Zidovudine combo. Yes, zidovudine. The one the we suspect caused my anemia. How did this happen? Well there was a big issue about ARV supplies early this year, and there was a shortage of Tenofivir. It was so bad that medicine refills were done weekly in RITM, and even daily in Makati Med! Since I'm out of the country most of the time (yes, my work requires me to travel a lot), getting my meds on a weekly basis was not an option. So Dr. Chua put me back on trial with zidovudine, which started on May 10, 2014. And guess what? My hemoglobin was steady, even up to this day after 6 months. So perhaps it wasn't really zidovudine that caused my anemia, huh?

Third, my CD4 count last June 1, 2014 went down again from 329 to 260. Big drop. So I had my viral load taken. The result took almost three months to be released, but thankfully my viral load was still at undetectable levels. Baka stress lang sa work kaya bumaba. Or maybe it's an effect of changing meds? Definitely I look forward to seeing my count move up next January, because if it drops some more, I'd be worried.

Lastly, I changed my twitter name, in case you want to follow me. It's now @ako_si_mister_B. So add me up!

Happy holidays!

It's New Year's eve, and in less than 12 hours, it will be 2013! How time flies...

Around this time last year, I was sick. I was having signs of HIV infection, and what should've been a season of parties, get-togethers, movie-watching and shopping was spent mostly at home in bed or at the clinic where the doctor couldn't tell exactly what's wrong except that what I have is something viral and that it was viral and it will go away on its own. (Of course she was right that it was viral, but how I wish she was right on her second remark.)

This year, I'm still sick. But I'm not ridden in bed anymore: I was able to attend christmas parties, I spent noche buena with a guy I'm dating, I treated my parents to a buffet dinner on Christmas Day, and I went to watch Sisterakas with S and my date last Saturday. Everything seem normal and I'm quite happy...

You read that right: I'm dating!

Let's call him J. I met him in RITM on December 12, the same day I got admitted for another blood transfusion. I went to RITM that day for another CBC to see how my hemoglobin count is doing. I went down to ARG to register, and there I saw him: a guy with cute smile chatting with another guy.

I kept looking at him not only because he had a cute smile, but I can't help but notice how clear his skin was. He's not artista-flawless, he's actually moreno. But if you visit RITM as often as I do, you'd observe that having clear skin is uncommon for HIV patients, either as a result of various HIV-related skin disorders or as a side effect of ARVs. (I myself have marks left by herpes zoster on my left arm, but it's barely visible now).

I bumped into him several times, but I wasn't the type who would initiate a conversation. There was one time I was sitting on a bench along the hallway when he passed by on the way to the clinic. I gave him a smile, and he smiled back! I thought that would be the start of a conversation, but he went past me and headed straight to the clinic. I thought, di siguro ako type.

When he got out of the clinic he was with two other guys. They sat in the same bench I was in, and started talking. It seemed to me the three of them knew each other for a long time already. The noise made me feel uncomfortable so I decided to go inside the clinic to ask if my CBC result is already in. Unfortunately it wasn't yet. The staff nurses noticed that my lips were very pale and hinted, I might need another blood transfusion. But that's something I was already prepared for.

When I got out of the clinic, one guy was just outside the door. I recognized him as J's friend. He asked for my number. I didn't know if it was him asking for my number or if it was J, pero di na ko nagpakipot pa, bigay agad! :)

The rest was history. A few moments later we were texting. I found out they've already left and having lunch at SM Southmall. I told him I was still waiting for my CBC and that if worse came to worst, I'd be there longer for the blood transfusion. He told me he'd go back to RITM later that day to meet other friends and see me also.

I got the CBC result a few hours later -- it was 62, the lowest I ever got. No wonder my head was throbbing like crazy and everywhere looks so bright! I called up S and told him about the result. He offered to be my bantay that night. How sweet. :)

Before the clinic closed, J, true to his words, arrived. He introduced me to L and to K, his newbie friends. I was already in the emergency room that time, waiting for a room to be vacated. J, K and L all stayed with me throughout and watched as the nurses and doctors tried to stick pink-gauge needle into veins. After 5 unsuccessful attempts, they thought I needed a break. J, K and L had to leave because J had to work, but he said if he has time he will come back to become my bantay.

I've only known J for a few hours, yet I felt like I've know him for a long time already. Magaan ang loob ko sa kanya, and I felt like he's a guy worth dating. When S arrived, I told him about J and he said he's happy for me. (Yey, may approval na agad si J! Hehe)

We continued to text while I was in the hospital. After I got discharged, we saw each other again for a movie date in Trinoma on December 19th. We saw each other again on Christmas Eve and I spent noche buena with his family. We watched Sisterakas with S last Saturday, and we stayed at S place for the night.

I feel good. I never felt this good in such a long time. Sometimes I even forget that I'm sick.

We'll see each other again in January 3. Haay, I can feel that 2013 will be good to me. Please, be good to me! :)

Happy New Year everyone! :)

A blessed Sunday.

Today, I woke up early to go to church, as many others did. But while many woke up to take part of a traditional Simbang Gabi, I woke up with a stronger purpose: to give thanks to Him.

Yesterday, I was discharged from the hospital. It has been my third hospitalization in two months. I was there since wednesday. It was the usual story: my hemoglobin got low to 62 so I would need blood transfusion. On thursday the week before it was 74. I was transfused with three bags of blood, it should've been four if not for the constrain in blood supply at DOH. I left the hospital with a hemoglobin count of 88 -- still low, but i'd rather not wait indefinitely for bags of blood that may or may not be available.

So what am I thanking Him for? I'm obviously in bad shape. I look awfully pale. My social life, love life and sex life, they are in a complete hiatus. I can't work. I can't do the things I would normally do.

But there are lots to be thankful for.

I thank Him for RITM, its doctors, nurses and staff. They are a true blessing to me. I have never received such level of service, compassion and genuine care from any other health service provider, public or private. The service I receive is such a pleasure that it's very easy to forget that RITM is a public hospital.

I thank Him for the numerous free health services. Compared to other chronic illnesses like diabetes, hypertension, renal failure, etc., HIV is easy on the wallet in the Philippines because of the availability of free drugs, free lab tests, and free doctor consultation.

I thank Him for new friends, both virtual and real-life, who give me the support and inspiration I need. I thank Him especially for S, my adorable friend who has been there for me all the time. He has no idea how much inspiration he gives me.

I thank Him for taking care of my family. I'm thankful that my family is intact, and despite some difficult times, we continue to be a happy family.

I thank Him for giving me the courage and strength to live on, for without it I would've faltered and dwindled to depression.

And finally, I thank Him for this second chance in life. I have not been a perfect son, and I've succumbed to my weaknesses. With His help, may I become a better person.

Home.

Finally discharged yesterday afternoon after finishing my fourth bag in the morning. My post-BT hemoglobin count is 98. (Ugh, when will it reach 3-digits? Hehe.)

My next visit to RITM will be on December 10, which coincides with my ARV refill schedule. S, who also got a CBC last Tuesday with me and was finally normal after 3 months of anemia, told me to rest. That's what he did, so I will. I promise I won't be stubborn anymore and will follow everyone's advise, the sane ones at least. I don't want to get a third booking at the hospital.

Not done yet.

I've been confined at the hospital since Wednesday. It's Sunday. I've been transfused with three bags of blood as of Friday morning, and in afternoon I found out I still need one more. That means we have to do the entire process of blood transporting and crossmatching all over again. I guess that means I'd stay here a few more days than expected... And more movies and tv series.

The Big Bang Theory, anyone?

HPV exam.

What's more embarassing than a doctor examining your arse? It's when five of them start peeking and poking at your arse trying to look for signs of HPV.

I don't know how HPV got written on my chart, but one of the doctors referred me to derma on reports of HPV. I'm clueless because to know if one has genital warts, you actually have to see the warts. I don't remember any doctor examining my privates, so how did it get reported?

The report said I had peri-anal warts. So they tried and tried to look for warts in an area of my body so private not even I have seen. It didn't end there. They also examined my other private part. After a careful and thorough search, they gave up and said I probably have none because if I have it, I would definitely know. Genital warts are supposedly hard, cauliflower-like growths that can easily be felt when cleaning.

Not that I'm complaining, it was about time somebody examined my privates for signs of anything, but they sure did it with a bang! :)

(For more info on HPV, you can check this article out.)

Going down.

Yesterday I was back in RITM for a follow-up checkup. My CBC is down again to 84 from 97 post-BT.

I'll have another CBC next week. If the trend continues, I might need to see a hematologist, which RITM doesn't have.

Am I worried about my condition? No. S has gone through worse, and he's doing fine. I thank him for showing me that things will be ok. But what I am going through right now is very, very frustrating.

See you again next Monday, RITM.

Going home.

After finishing my blood transfusion on Thursday evening, I had a my blood extracted again on Friday morning for a few tests which include CBC. From 67, my hemoglobin increased to 97. Still way below the normal range, but enough for me to regain some color. I feel stronger as well.

The doctor gave me calcium gluconate intravenously around mid-day to counter the effect of preservatives added to the blood I received. She told me and my parents that they are still studying the lab results and trying to find out the next steps to take. She did mention that a bone marrow biopsy is a possible last resort. So I guess I have to prepare myself mentally and emotionally for that.

The rest of the day was pretty much another waiting game. My parents called for my youngest brother to accompany me so that they can go home.

My youngest brother arrived around 8pm. He got lost. Haha. My parents were already about to leave when the nurse stepped in and told us I'm ready to be discharged in the morning. Yey!

She took away my IV fluid, and after pulling off the needle, I was amazed after I saw how big it was. No wonder they had a hard time looking for a suitable vein the other night!

It's Saturday morning. Today, we need to get hospital clearances signed off. And pay the bills. My brother will take care of that but he's still sleeping.

After spending five evenings at RITM. I'm finally going home. But I won't be gone for long -- I'll be here again next week for another checkup.

Pumping new life into the bloodstream.

It was early morning Wednesday when I was waken by the nurse to tell me that the blood matching was completed and that the blood is ready for pickup. Again, he told us to hurry because the cut-off is at 12 noon.

So I called my parents up, who at that time were already preparing to go to the hospital, and told them the news. By 10am my parents were here. After a few minutes of freshening up, my dad picked up the request from the medical lab and went straight to DOH Tayuman. My mom stayed behind.

While my mom and I were talking, a visitor entered the room and caught me by surprise. Let's call him M. He is a friend I've been talking to online for quite a while now, and a fellow RITM patient. I was surprised because I completely forgot he was visiting. After saying hi's and hello's, M handed me a box of cranberry juice. And then said, "Magpapa-flu vaccine lang ako sa baba." My mom overheard. I panicked, I'll be busted. She asked my if the guy was a friend from college, I told her he was a friend visiting because he lives nearby. And my mom asked no more.

(To M, if you're reading this, I'm very sorry if I was not a very good host to you... I'll make it up to you when I'm better. And thank you very much for the cranberry juice!)

I immediately texted S, my dear friend who was also confined at RITM also for anemia (know more about S in my blog entry "False alarm!"). He was also at RITM for a checkup and asked him not to visit me while my parents were with me. Minutes after, someone knocked at the door, and guess who it was? Handsome S, wearing a face mask.

I introduced him to my mom and this time, I acted coolly. We had a few minutes of chit chat when S looked at his phone and told me, "Ngayon ko lang nabasa." Haha! He immediately excused himself.

(To S, if you're reading this, thank you for the visit. It's a pleasure as always, I'll see you paglabas ko dito.)

After S has left, my mom asked if he was working here. I told him no, he's just a visitor. I know something is already running through my mom's head, and I don't think she's buying my alibis anymore.

Around 1pm, my younger brother arrived. He is a registered nurse, albeit non-practicing. He will accompany me for the next two evenings.

At 2:30pm, my dad arrived with the blood, three bags in total, and handed them over to the medical lab. The medical lab will have to prepare the blood first before it can be transfused to me, and I was told it can take a while.

At around 5:30pm, my parents decided to leave. While they were preparing to leave, S popped his head into the room to say goodbye. After he left, my dad said, "Bakit sya naka-mask? May sakit ba sya?" All these naive questions are really making me feel uneasy. If this continues, I'll be busted soon. I told him this is an infectious disease hospital, baka nag-iingat lang.

My parents left a while after and I was left with my brother, who was obviously bored. He only had my laptop to keep him company. Good thing Sun Wireless Broadband was fast in this area. He was streaming movies after movies, occasionally stopping to buy medical supplies needed for my blood transfusion.

At around 12 midnight, I was informed that the blood was ready for transfusion. At around 1am, my nightmare started. They couldn't find a suitable vein to to stick the IV needle. They said I was dehydrated. Three different nurses, five unsuccessful attempts. Both my hands were full of cotton balls, and after a quick glance at the mirror, I swear I looked as pale as a ghost.

It was Doc Mark who successfully stuck a the needle in on the 6th attempt. I thanked him big time.

It was 4am on Thursday when blood started pumping through my veins. After sixteen hours, and three bags of blood, my lips were rosy again.

The blood(y) process.

I had the opportunity to ask the lab technician about the process of getting replacement blood while she was extracting blood samples from me on Tuesday morning.

She told me that after my blood is taken, it will be blood-typed and the staff at the medical lab will look for a suitable blood for me from various sources. I asked if I still need to look for a donor to replace the blood, she said no. She told me that there is an agreement with the bloodbank at DOH and RITM that replacement blood for HIV patients will be for free, and there is no need to replace them. Cool, another freebi! She said all we need to do is to wait for the lab to finish blood typing and if a suitable blood is available at the bloodbank, they will make a request and ask my parents to pick blood 'segments' from DOH Tayuman. The blood segments are basically a sample of the replacement blood stored in the bloodbank and it needs to be matched with my own blood before the entire bag is taken. So although the blood is free, acquiring it is tedious because my parents will have to make two trips from Alabang to Tayuman.

I explained this to my parents, and although free blood is more than welcome, it did prompt another question. Why is my blood free, while other patients they talked to at the hospital told them they bought theirs? I tried to evade the question by saying I don't know.

It's another waiting game on Tuesday afternoon and my parents got bored, so they left and went to nearby Festval Mall for a stroll. I can't blame them, there was nothing to do in my room, and we didn't know when the request will be available.

At 6pm, the nurse informed me that the lab has found a suitable blood for me, and my parents need to pick it up as soon as possible, before 10pm. I quickly called my parents and they were back in half an hour. After my dad got the request, I told him that a nurse informed me we can use the ambulance to transport the blood segment if the ambulance and a driver is available. So my dad asked the nurse station if it was possible. Out of good fortune, the ambulance was available and they agreed to help us transport the segments provided we fill the tank.

At 7:30pm, the ambulance left the hospital with my parents to get the blood segments at DOH in Tayuman. The ambulance was back before midnight, without my parents though. They decided to head back home and return the following morning. The blood segments were handed over to the medical lab to confirm if it is a match for me, and I will be informed as soon as possible if it is.

Meanwhile, I was transferred to a new room -- a much smaller room, with a single bed, with electric fan and its own comfort room.

Again, I slept alone.

(To be continued.)

Waiting for blood.

So here I am at RITM confined since Monday evening. It's now Wednesday afternoon. Allow me to tell you about my experiences so far.

The doctor told me I need to get admitted for blood transfusion around 5pm on Monday. Since I was half-expecting confinement, I already have an overnight bag with me and said ok.

I called my parents and told them that this time, I really have to undergo blood transfusion. But I told them there's no need to go to the hospital that night because there wasn't much to do, and the doctor said she won't put me on IV fluids yet.

So before I actually got admitted, I went to Festival Mall to buy myself some food to eat and toiletries. During my trip, a huge dilemma dawned upon me once more: is it time to tell my parents of my condition? I don't want to tell them because I don't want them to worry, and I didn't want to disappoint them. I want to tell them when I'm strong and normal, not when I'm confined at the hospital. But how can I hide it? The burden was so much, for the first time since finding out about my status, tears fell from my eyes. I felt stupid because tears were falling while I was doing my grocery, while paying at the cashier, ordering food and while having dinner. I guess I wasn't that strong after all.

So after doing my grocery, I went back to RITM. I was interviewed by the pretty doctor, Doc Sheena, who was very cool, and filled out all the forms needed for my admission. Unfortunately that night there was a scarcity of rooms, so they had to put me in a room that looks like it's never been used in a while, with no electric fan and no toilet. But I didn't complain because at least I was alone in the room.

I spent the evening alone. I wasn't able to sleep very well because of the heat, and they won't allow me to turn off the lights.

So far the only tests done with me are ECG and XRay, which were done before I got into the ward. I was instructed to fast so that they can extract blood in the morning and do some more tests.

At 7am, breakfast arrived: 1 piece of hotdog and a cup of rice, with no spoons nor forks. But I couldn't eat my breakfast yet because I'm fasting.

At 8am, it was time to take my ARVs, but I couldn't because my blood hasn't been extracted yet. So I followed up with the nurse. At 8:30am, staff from the clinical lab arrived and took my blood. Soon after the blood was taken, I took my anti-tb medication, isoniazid. After 30mins, I took my breakfast, barehanded, which I found homey, and took my ARVs afterwards. I took my ARVs late for about an hour.

Nothing much happened the entire morning. Around lunch time, a poz friend I met online visited me. He was at RITM for consultation also. After lunch my parents arrived, so my friend had to leave.

The first question my mom popped was, "Anak, paano ka ba nakarating sa pagkalayo-layong ospital na 'to?"

I laughed. Haha. But deep inside, I was uneasy. I told her this is the only public hospital in Metro Manila that is not congested and cheap. I'm not sure if she bought my alibi, but she never asked me again. Whew.

(To be continued.)

Confined.

Yesterday I went back to RITM to check if my hemoglobin count has improved. Sad to say it didn't, and it dropped again to 67. The doctor told me I need to stay in the hospital for a blood transfusion and other tests. Good thing I came prepared, I already have my overnight bag with me.

I'm now confined at RITM. I've had my ecg and xray taken last night, and this morning I had my blood taken for matching. I'm staying in a big room which looks like a ward with many beds, but I'm alone, which is superb. My only complaint is the heat - there's not even an electric fan! But who am I to complain? I'm receiving a virtually free treatment afterall.

The doctors and the nurses are all very nice! I think I'd enjoy my stay here. :)

My meds and drug-induced anemia.

It's been almost two weeks since I confirmed that I am anemic, and my blood count history shows that it could be drug-induced.

I started taking anti-retroviral (ARV) drugs on July 31, 2012. I started trial on nevirapine (Nevipan) one tablet once a day, and lamivudine + zidovudine (Avacomb) combi twice daily for two weeks. I also started taking isoniazid and cotrimaxazole as prophylaxis for TB and pneumonia, respectively. Before I took the meds, I had a CBC, and my hemoglobin was 140.

After two weeks, I passed the trial period for nevirapine without experiencing the usual side effects. I was happy because most people I talked to were allergic to nevirapine, and I'm glad the first set of meds prescribed to me worked without causing any adverse side effects. So the doctor upped my nevirapine dosage to twice daily, and continued with the rest of my other meds.

After another two weeks, or one month after I started taking meds, I had another CBC. My hemoglobin count was lower at 130, but still ok. The nurse told me that the reason I need to take regular CBCs was to ensure my hemoglobin doesn't drop, because zidovudine is known to cause drug-induced anemia.

Fast forward: October 5, 2012. I went to RITM on an emergency case because I developed blisters on my body. I was also very pale. It's been a little more than two months since I started taking ARV drugs. The night before, I stopped taking my evening dose of nevirapine, because I thought the blisters might have been a side effect of nevirapine. But after seeing the doctors at RITM, I learned that what I had was not an allergic reaction to nevirapine, but herpes zoster, which was possibly caused by a combination of stress, and a weak immune system. Again, I was relieved because I didn't want to change my meds. I was afraid of taking efavirenz, which was the usual replacement for nevirapine.

I also took another CBC that day, and the result was alarming. From 130 just a month ago, my hemoglobin count dropped to 86. The doctor immediately removed zidovudine from my meds and replaced it with tenofivir once daily. He also asked me to take ferrous sulfate help combat anemia.

After 10 days, on October 15, I visited RITM for a checkup on my herpes zoster, which has already dried up, and to take another CBC. As I told in a previous blog entry, my hemoglobin count dropped further to 74. Apparently the effect of zidovudine takes time to wane. All I can do now is to rest, wait, and make sure I eat iron-rich food and take iron supplements to combat the anemia.

I'll be going to RITM again on monday for another CBC. Hopefully I hear good news.

False alarm!

Yesterday I went back to RITM (Research Institute for Tropical Medicine) for a follow-up consultation on two cases: first is for the shingles I contracted 2 weeks ago, and second is for my anemia. I arrived there at around 8:30AM, early because if I were to consult the dermatologist in the afternoon, I need to finish the CBC and HIV doctor consultation in the morning. That was the plan.

However, there was no dermatologist available yesterday, because all of them were in Boracay attending a conference. (These doctors sure know how to mix business with pleasure! :)

So I was left with consulting the doctor for my anemia. I had my blood taken at around 9am and I had to wait for a while before I could get the result. I saw the doctor at 10am and after showing her the already dried up blisters, she advised me to take vitamin B complex to help repair damaged nerve cells. She couldn't help me with my anemia until the lab results were in, so it meant that I had to see her again after lunch.

While waiting for the results, a good friend and fellow patient arrived. Let's call him S. S was confined in RITM for 7 days the week before, also for anemia. I was supposed to give him a visit the last time I was there, but since I had herpes zoster at that time, I couldn't.

He was there to complete some paper works related to his confinement, as well as to get a copy of his medical records. He will be seeing a hematologist at a different hospital to consult if there is an underlying condition that causes his hemoglobin count to continously drop: even after changing meds from zidovudine to stavudine to tenofivir, and after 20 bags of blood transfusion. I was listening to his story intently, because if worse came to worst, I might be in the same shoes as he is.

S is a very cheerful guy. I admire how he is able to keep a strong and positive disposition despite the uncertainty surrounding his condition. He's such an adorable guy!

Around lunch time, we got the result of my CBC. My hemoglobin count is 74. My previous count was 86. Two months ago, it was 130. How can this be? I was feeling a lot better now than I did the week before, it's been more than a week since I stopped taking zidovudine, and I've been resting the entire week. Why is my hemoglobin count still dropping?

Ate Ellen, the senior nurse at RITM ARG, suggested that I might need to get a blood transfusion asap. I panicked. My family doesn't know about my status. I left the house for a casual checkup, how would they react if I tell them I'm getting a blood transfusion all of a sudden?

A huge dilemma is in front of me: is it time to disclose to my family?

S knew what was running through my mind. During lunch, he told me I needed someone to look after me while I was getting the blood transfusion. For that reason I have to contact my family. But, he told me that there is no need to disclose my status to my family. He told me that RITM staff respect their patient's privacy, and they do not disclose their patient's status to anyone, not even to relatives. During the time he was confined there, his family knows that he was receiving treatment for anemia, and nothing more.

This encouraged me to call my family and tell them I might be getting a blood transfusion. But I told them prematurely. They were already preparing to go to RITM to bring my things, when the doctor came in after the lunch break. He told me that if I was feeling better, and I had no signs of anemia (such as shortness of breath, exhaustion, etc.), then I don't need a blood transfusion. Yet. He told me that I need to do another CBC for the next week and see if my hemoglobin count has improved or not.

So it was a false alarm after all! Of course I was happy, and S and the rest of the RITM staff were happy. But I feel bad for having given my family something to worry about. In the first place, that's the reason why I've kept my condition a secret from them all along: I don't want them to worry about me.

So I called my family and told them not to go to RITM anymore. My mom told me she will put ampalaya and chicken liver in the menu. It seems to me they're relieved that I'm not getting a blood transfusion anymore.

So I went home like nothing happened. Today, I had adobong atay ng manok with kamote sprouts for lunch, and had ginisang ampalaya for dinner.