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When should I return to work?
Dec 30, 2001

HELLO Dr. Bob!

I was diagnosed with AIDS 13 months ago. I had PCP (CD4 was 2, VL 77,000) 2 months later diagnosed with sepsis (or fevers of un know origin) Then 2 months later Anemea.

I had missed 3 out of 6 months of work then, once recovered I went back to work with a CD4 of 56. VL undetectable.

I was only able to work 3 more months be for getting more HIGH fevers of unknown origin. I started seeing a HIV specialist (at your recomendation) Had my enlarged spleen removed, now being treated for enlarged liver and MAC. This time i missed 4 months of work and am on L-T-D.

I'm starting to feel better but still have a CD4 of only 79 after 13 months.

Since my CD4 is still low and I have had alot of O.I.'s, should i wait to go back to work?

My job is retail mgmt with Wal Mart, a demanding job, working 50-60 hours a week.

Should i wait till CD4 is over 200?

I know this is not fatigue and anemia, but i value your opinion very much....

Thanks

Response from Dr. Frascino

Hi,

Retail management at Wal Mart during the Holiday Season, especially now with everyone returning unwanted X-mas gifts like fruitcakes and Chia pets? Oh my! My T-cells are falling just thinking about it!

When and if one should return to work is a personal decision, but yours is a demanding 50-60 hour-per-week position. With your current medical problems, this additional stress is probably not a good idea.

Within the past 13 months, you've been diagnosed with full-blown AIDS, had PCP, sepsis, anemia, removal of an enlarged spleen, and active MAC infection. Your CD4 count has ranged form 2-79. Personally, I would not even consider going back to work for quite a period of time, if at all. You don't need extra stress in your life at this time. Instead, you should be focusing your energies on your health - nutrition, rest, exercise, taking your meds, checking for other OIs, etc.

Check with your HIV specialist. He or she will most likely agree. You should also check an HIV-knowledgeable benefits counselor to help you maximize your benefits - Social Security and other entitlements. MAC can be difficult to treat, and anemia is a frequent consequence of this infection. So remember to keep an eye on your hemoglobin. See how I put that last part in to show that your question really did fit nicely into this forum?

Happy Holidays.

Dr. Bob


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