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i am so tired/diarrhea we spoke when you spoke in slo
Oct 2, 2002

/i was at the slo conf. last week i am going on a cruise oct21 i feel so tired have no hiv md in our area, made appoint with dr. tony mills can not see me untill oct 18 should i cancel cruise wbc 2.2 rbc 3.37 hgb 11.8 hct33.7

Response from Dr. Frascino

Hi,

Canceling the cruise would certainly be disappointing at this late date, but going on the cruise and spending the whole time in bed or running to the loo might be even more frustrating. As I mentioned to you last week, I do think you need a thorough evaluation by a competent and compassionate HIV specialist. I believe you mentioned your CD4 counts were in the range of 25-75, which puts you at great risk for opportunistic infections. You've had significant weight loss, diarrhea, fatigue, and perhaps other symptoms. Opportunistic infections, including CMV, MAC, etc. need to be ruled out. Depending on insurance coverage perhaps you could visit an AIDS specialist in LA or the San Francisco Bay Area to get an earlier appointment.

Would I suggest you cancel the cruise? No, just postpone it for 6 months or so, so you can focus on your health. Let the cruise be your reward for getting on top of these problems and regaining your weight, strength, and vitality. I'll expect a postcard from somewhere exotic in 6 months, OK?

Good luck.

Dr. Bob


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