Four Hundred Six

Just like what my previous post was described – deteriorating, so as my new CD4 count. Last week I went to RITM to have my CD4 count and refill of meds. It was quite a busy day for them as the clinic was bombarded by old timers and new patients. They have a new system for those who are due for their CD4 test – to have it scheduled prior to you arrival at the clinic. I have heard this from a friend of mine and immediately sent Ate Beth an  SMS to have my appointment o more than a week before my preferred date.
Come that day, I called in sick to my boss and went straight to Alabang. My home is quite near RITM so there was no need to struggle for an early morning call time – they have a cutoff time for the test which is 10am. I arrived like 9am and it was crowded. They have asked if I had my appointment BUT they cannot seem to find my name on that piece of ‘office desk calendar’ appointment sheet. Just to find out that they mistakenly wrote my code as R11-XXX which should have been R10-XXX, ayaw pa nila ko payagan to take the test kasi wala naman daw sa list yung ‘code’ ko. I insisted that I have called a week before this day and they admit they commit an error. So the mere difference of R10 versus R11 would have put my leave into waste.
This was also the day when I saw an old friend of mine. But I did not pay attention too much to him as he was aslo busy with his anniverasry exams.
My tests were done and I’m now waiting for the prescription of my ARV’s. When this guy came in almost 10am, just before the cutoff time for CD4 testing, he didn’t know about the appointment and schedule setting prior to the test but after  a while they allowed him to take the CD4 test. I was just a mere observer that time and only one thing came into my mind: I have scheduled myself a week before this day to have my CD4 test and almost on the brink of not taking it and wasting my leave to nothing when this guy came on an instant and he was allowed to take it? That was just too unfair. This guy was like a BFF to them. Ok fine, I now know where should I place myself.

Nonetheless, I was still grateful that I had the test and they gave my 3-month supply of ARVs – STILL. Contrart to what others have said a week before that they now only give 1 month supply.
That day was really a frustration, my first time to experience after 2 years of going to them. Everytime I go to RITM, I always wanted to stay even after my appointment as I wanted to mingle with other patients and staffs, now It’s like the opposite. I wanna get myself out the minute I finish my deal. I just hope this won’t take too long to change.
Anyway, my CD4 streamline is now:

1st: 282
2nd: 610
3rd: 608
4th: 406

1st viral load: 110,000+
2nd viral load: 86
The results were just texted to me, so I don’t have any validity whether this tremendous drop is real or not. I’m just worrying why in the world this happened? Am I too stressed and depressed or my ARV’s are no longer working? With the viral load still *NOT* undetectable after taking the potent Efavirenz for almost 2 years… I’m just worrying to much.

My current health status

As of November 2011, my current sero/health status:

CD4 count: 608 units – from 610 units of December 2010

Viral load: 86 units – from 111,000+ units of initial Treatment Hub enrollment (2010),
after more than a year of taking EFV, still not undetectable. But there’s a drastic change, a sign of NO VIROLOGIC FAILURE

Hemoglobin count: 176 units – as per RITM’s CBC vs 124 units of company APE’s CBC, so RITM told me am not Anemic contrary to what was previously diagnosed. 

Cholesterol/Triglyceride level: Borderline high, as per Makati Medical Center’s Blood Chemistry Test, this is an obvious side effect of my ARV’s.

Hepatitis A/B/C: Non – reactive

Pulmunary XRAY: normal

AFB smear and culture: no AFB seen

TB culture sensitivity: No growth seen for 6 weeks, via MMC’s TB BACTEC MGIT test

Cryptococcal Antigen Latex Agglutination test: Negative, as per RITM since 2010

Anniversary CD4

This was supposed to be July but due to uncontrollable weather disturbances, my acute bronchitis and some procrastination this was moved to September… Yes, two months after.
I decided to have it done on a Friday so I can be absent from work and go on a long weekend… which happened to be a boring one. 
I woke up at around 730am, prepared some stuff like my backpack, the disguising bottle of my ARV and the pertinent papers – PhilHeath papers and Makati Med lab results.
Fasting started 12 midnight prior to that morning so I was that hungry, I even opted not to brush my teeth – this will just make me hungrier. LOL
Arrived at RITM at like 830am and as advised, OPD and ARG clinic has been relocated to another location… I got lost, of course am no kiddo so I asked the Kuya and Ate Jaguars to lead the way.
In all fairness, the new office site is more conducive – bigger floor area, a bit separate from the animal bite section and smells like provincial breeze. So, OPD and ARG combined into a bigger room.
When I entered the room, came along a new face – perhaps this was the new nurse in replacement of Ate Ana : Ate Mameng. I heard some stories of her being bitchy or should I say grumpy or masungit to patients. Well, I tried to call her several days before my scheduled test and she sounded nice so no big deal about it.
It was my turn and she was preparing the test requests, I already know what tests should be done but as I scrutinized the request, I wasn’t able to understand some handwriting and asked her what are those…
Unfortunately in a grumpy and masungit manner, she answered – “ano ka ba, buti nga libre na yan”. Knowing me being a reactive person and adding my hungriness I uttered in a respectful but sarcastic manner – “Alam ko  po, gusto ko  lang malaman kung anong klaseng exams to para alam ko” She then explained everything in detail… still in a grumpy manner. 
Haay, alright… I’d try to widen my senses and understand, maybe she’s no longer young and hormones are on the loose. but with all due respect.. I’m still thankful for her since she accepted the job of helping those in need.
Checking my peripheral vision, there was a guy smiling at me… I tried looking at him and to my surprise, he looked familiar. It took several minutes for my brain cells to work – I’m hungry, ok?. Hindi ko siya pinapansin and when I stared at him I said – “kilala kita!” He said the same thing. Ok, another small world instance not knowing a friend of yours is also sero-converted. Not a big issue.
Blood extraction was first in line and it took 4 vials of blood to complete the test. Still a lot! Time to get back to the new clinic and request for medicines, Ate Let and Victoria prepared the needed papers and sent me to the doctor on shift. Got my meds and Ate Mameng told that there was a free Hepatitis booster vaccine, I grabbed the opportunity so I took it. Till now, my shoulder is pain because of that. 
I was making tambay at the clinic and letting time pass by, I can feel Ate Mameng is starting to be friendly in a manner that she makes small talks. 
My intestinal walls can no longer hold the acids and my tummy started to make rumble so I decided to go home and perhaps buy some snacks on the way.
It was a tiring, hunger-full day. 
Four in the afternoon, I texted Ate Let for my cd4 results..
My new cd4 count as of September 09, 2011 = 608  

It went down by 2 points. From 282 to 610 to 608. I was expecting that it will reach like 800+ but to my dismay it went on a semi-plateau behavior. Just steady – whatever happened, I need to change my lifestyle again so next time it will be higher. Oh well, fluctuating numbers.