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Newly diagnosed and hurting
Sep 5, 2003

Dear Dr. Bob, First I would like to thank you for all your wonderful comments and the time you put into this for us. I was diagnosed July 8th with CD4 23, viral load 300,000. I am on Combivir/Kaletra. Just got my first big update and now have CD4 of 76 and viral load of 1124. Pretty good news, huh? My wife (neg. so far) and I are very happy about that, but I am still experiencing a mysterious pain in my upper left side - just below my rib cage, which is what I went into the hospital for in the first place. My HIV specialist says it is rare but he is going to research it for me. This pain has been going on for about 4 months now with the only odd test being a slightly enlarged spleen on a CT scan. I've had a negative endoscopy (except for the candiadisis) and colonoscopy (completely neg). One nurse suggested the HIV could be just hanging out in one place causing this pain, but another said no. So, I still don't know the reason I went into the hospital, but got to know I have AIDS. Ain't that a kick in the pants? Any ideas? Anything HIV related? My wife(who did her best to proofread this before e-mailing it) and I wanted to ask you 'cause you rock!

Response from Dr. Frascino

Hello Newly Diagnosed and Hurting,

Yes, it may be a "kick in the pants," but you may also be one lucky guy to find out now, before a very serious opportunistic infection really "whips your butt!" (as opposed to just being kicked in the pants). Your HIV viral load is declining nicely (hopefully to undetectable soon), and your CD4 count has more than doubled. That's great news; however, CD4's less than 200 still leave you susceptible to opportunistic infections, such as PCP (pneumocystis carinii pneumonia). Hopefully your HIV specialist has started you on prophylaxis to decrease your risk of developing these complications.

As for the pain in your upper left side, I agree with the "other" nurse: This is not due to "HIV hanging out in one place." HIV doesn't work that way. I can think of multiple potential causes for the discomfort, but they would be merely guesses at this point. Your HIV specialist appears to be evaluating this problem appropriately with a CT scan, endoscopy, colonoscopy, etc. Continue to work with him/her and I'm confident the cause of the problem will be identified.

Finally, I could really use a good proof reader. Can I borrow your wife every now and then? Good luck. And remember, we are all in this together, OK? So let's not only rock, but roll as well!

Dr. Bob


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