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Why do doctors not look at the big picture? Tell me that my attitude and outlook are an inspiration
Jul 19, 2001

Doctor Dezube;Thank you for your compassion and sharing your knowledge with us.This is my history. I tested pos/aids april 2000;numbers CD4 235/8 VL 5000.I had lasted tested neg March 1999.I know when I was exposed.Started meds june 2000 epivir,ziagen,viracept.Stopped Viracept due to severe diarrhea in August and replaced it with both sustiva/viramune.My viral load was undectable and has remained that way.However,my health was declining and never improved. My Doctor says it takes time for the body to recover. My symptoms where a very enlarged spleen. In fact the ER doctor said he'd never seen a spleen so large,and my primary care Doctor actually told medical students in front of me that he never palpated aspleen as big as mine,I had developed a chronic dry cough for 3 months and SOB and my HR was running between 120 to 140;my lymph nodes where enlarged and my skin was extremely itchy.I was also anemic and he allowed my hemoglobin and hematocrit to get 8/14. Finally in sept he ordered biopsies and scans which took another 4 weeks. Then I was diagnosed with an advanced lymphoma. My oncologist believes tht it's been cooking at least 6-8 months.Completed m-BACOD chemotherapy end of January and March lymphoma returns and currently still undergoing chemo VP16,Cytoxin,BCNU IV.My last numbers CD4 280/22 VL undectable,dropped the Sustiva due to dreams.My Primary care keeps telling me that my HDL/LDL are so low that they cannot be calulated and my total is 79.That if i don't workout i'll die of a heart attack. I'm working full time,doing chemotherapy.Between the constant fatigue,the stress and worry that he is putting on me is terrible.I'm doing the best i can and use all my energy just to get through my daily living.Why do doctors not look at the big picture before they cause stress to patients by telling my chances of a heart are 10 times that of anyone else,may be if he knew what he was doing he would have realised sooner than 7 months that something else was going on with me,so Dr Dezube I'm walking each day and looking towards a bright future,is my HDL/LDL at this point a danger to my health? I just can't go to the gym and run a treadmill and do weights. After I'm done with chemo in Nov i can start,what do you think? I just don't trust my MD and right now I'm stuck with him.Thank you. P.S people tell me that my attitude and outlook are an inspiration,so I'm not depressed just trying to get well.

Response from Dr. Dezube

That's quite some saga! I was debating whether to shorten your question or not, but I decided that your story needs to be told. It's a story of courage and inspiration-- you are doing the best you can, trying to hold your life together, working full time, doing chemotherapy and so on. I would NOT worry about the HDL/LDL cholesterol values at this time. You need to focus on getting well and getting through the chemo. As the old proverb go, there's a time for everything, and now is not the time to worry about your cholesterol levels. AIDS can be totally overwhelming. I work with my patients to focus on one or two issues at a time. No one, no matter how strong they are, can deal with all the issues at once. Dealing with too many issues can lead to mental exhaustion, depression, and withdrawal. Keep on doing exactly what you are doing. You got a great attitude. My very best. BD.


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