I'm Only Human

October 1, 2004, is indelibly burned into my memory. It was that day, toward the end of a five-day hospital visit for for gastroenteritis (which a doctor friend of mine referred to as 'stomach issues when they don't know the true diagnosis') that I learned I was HIV-positive. Every year in the autumn days leading up to my HIV anniversary I become reflective about where I am in my life and what the virus means to me. Here is what I've come to realize this year.I've grown to a point where I am mostly accepting of and calm about being HIV-positive. My CD4 cells number around 500. My viral load is undetectable. I have notdeveloped any opportunistic infections. And so it is understandable that for the most part I treat my HIV as I treat mydepression or allergies'mindful of it, seeing physicians when I need to, and taking my medications on time. However, to say that I am totally at ease with my diagnosis is a bit like saying 'life is great' when everything is going my way. It's too easy. It would be too simple to claim complete serenity and acceptance when there are no obvious problems or reminders of the virus I carry'and of the potential danger it poses. And it would be untrue. Each year as I approach my HIV anniversary'and, for that matter, any time I become ill'I'm acutely reminded of that danger, and my serenity and acceptancerapidly devolve into fear and agitation. And this year, even a bit of hypochondria. A few weeks ago I noticed developed skin irritation, at first thinking it was nothing more serious than an ingrown hair. I was wrong. When I saw my HIV specialist for our quarterly visit, she recognized the condition as methicillin-resistant Staphylococcus aureus'better known as MRSA or drug-resistant staph. And suddenly, I was certain that my HIV was gaining the upper hand. I started to ruminate on my steady decline of CD4 cells at my check-ups'748, 632, 521, 498. I began to dwell on the fact that I had been extremely fatigued lately, and finding myself needing to get up in the night more often to use the restroom. I wouldn't say I was panicking. Panic is a strong word. Anxious concern is probably a better term. My doctor knows me well. Recognizing the look of 'anxious concern' on my face, she calmly reminded me anyone'HIVers and non-HIVers alike'can get MRSA. She explained how the bacteria is transmitted and how it would be successfully treated with the antibiotics she was prescribing for me. Regarding my more grave concerns about fatigue and my falling CD4-cell count'and my fear that the two together were a sign of something more ominous'she again put my mind at ease with a 'chicken and egg' scenario. Yes, the two could be related, she said, but it's just as possible for fatigue to cause a drop in CD4 cells as is the drop in CD4 cells to cause the fatigue. And then she asked what turned out to be the million-dollar question: 'How much caffeine do you drink?' I answered: 'A lot.' Well, a lot actually is a gross understatement. Friends joke that I should cut out the middleman and start taking caffeine through an IV. There it was. My doctor believed my fatigue was due to the fact that I drink too many caffeine-laden drinks that not only affect the quality of my sleep but force me to wake up during the night to go to the bathroom. She urged me to see what would happen if I stopped drinking beverages with caffeine in them at 4 p.m. each day. It was like magic. I don't get up as much in the middle of the night to use the bathroom and I feel much more rested during the day. I'm hoping my next doctor visit shows a similar rebound in my CD4-cell count. That cloud of 'anxious concern' was lifted. And I began to realize that while some of my worries may be unfounded, they're also understandable. People my age 'rapidly approaching 40'worry about their health a bit. And when you're HIV-positive too, it's perfectly natural to worry a little bit more and a little more often. We just do. It's human. I'm human. That's the biggest lesson I've learned this year as I mark my HIV anniversary. While I'm OK with my diagnosis most of the time, I'm also terribly afraid at others. And that's simply human. Fransen is a licensed clinical social worker who is in private therapy practice in Chicago. He welcomes feedback at stillpoint4003@yahoo.com.