Russell Fleet Alive and kicking
Hands up everyone who wishes they could just forget all about
HIV and act like it never happened. I don’t mean stop your drugs and
throw away the rubbers, I’m just saying it would be nice not to have
to view every aspect of your life through the prism of HIV.
Of course, not everyone with the catflu does that, but I have a feeling many
of us do. I work in the sector, so I get it from both ends – now, now,
cheeky! I mean the personal and professional ends, and I’m starting
to wonder if it might be time for a change in the next year or so. Mind you,
the question then would be: what do I know as well as I know HIV? When I went
back to work in 2000 I nearly ended up working at London City Airport preparing
aircraft for departure. The work looked interesting and I would have got to
use my languages. The downside was that a large amount of time had to be spent
frightening pigeons with a football klaxon, otherwise they get sucked into
the jet engines and the plane blows up.
But that’s beside the point. I’m begining to realise I don’t
want to spend any more time than necessary thinking about the catflu. I’ve
been on the once-a-day combo for three years now, and as it no longer causes
me to cack my pants when I stand up suddenly, and thankfully has never caused
my face to cave in or my arse to migrate to the back of my neck, I really
don’t spend any time thinking about the drugs at all. In fact, I actually
look forward to them now as I take them just before bed along with an antidepressant
that helps me sleep. I now equate HAACT (Highly Active Anti-Catflu Therapy,
obviously) with a pleasant night in the land of nod, you see, and it’s
done wonders for the old adherence.
So I suppose there’s always that once-a-day reminder of life with an
unwanted lodger, but it’s over in a flash. It’s the other things
like the three-monthly appointments and the pre-visit to get the bloods done
that interfere more. I try to arrange those for before or after work but it’s
not always possible. However, there are discussions about seeing those of
us who are stable on treatment less frequently, and to be honest I find the
idea quite appealing. I’d like to go once a year really, and just treat
it like a yearly medical, with quarterly deliveries of the sweeties to keep
me going, because there just isn’t room in the fridge for a year’s
supply of ritonavir. I’d have to chuck out valuable nutrients like wine,
beer and vodka.
Many others don’t find that idea very comforting, though. I suspect
it’s because there’s the suspicion that it’s really about
saving money, and nobody likes to feel their care might be compromised on
cost grounds. So the question we have to ask ourselves, and we have to be
really honest when answering it, is what need is being met by the three-monthly
appointment status quo? After all, it’s essentially a relic from the
old pre-protease days, but now most of us are in for the long haul do we really
need to have quarterly monitoring?
If your gut reaction is ‘no change please’ it’s worth asking
yourself if it’s just the reassurance you’re after, or if your
situation really is precarious enough to warrant that level of scrutiny. The
numbers were interesting at first - “ooh look, four t-cells! Now they
can play mixed doubles!” – but after a while they stop meaning
so much. Given my experience over the last three years, there’s no reason
to assume that my viral load will suddenly rocket unless I stop taking the
tablets. So I see no need to sit there with the doc exchanging pleasantries
when both of us would rather be doing something else; there might be someone
really ill in the waiting room he could be seeing, and I might be missing
something exciting on telly – Meerkatflu Manor perhaps?
And saving money isn’t such a bad thing. If I had to choose between
getting the drug of choice but with six-monthly monitoring, or the cheap generic
drug with quarterly monitoring I’d rather the first option. Remember,
the NHS funding bonanza will be over very soon, so unfortunately those are
the kinds of choices that we – and the clinics – will have to
make. Time for a bit of honest soul-searching I think, and maybe time to cut
the apron strings and fly. Just watch out for pigeons…
