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Just need to say this...

Dec 1, 2006

Hi Dr. Bob!

I'm not posting a question, just simply writing down some thoughts I need to get out of my head.

There was a post from a nurse a couple of days ago that really hit the proverbial nail on the head for me. I too am a nurse and I love my job (90% of the time!). Being a nurse I have witnessed so much of the good, bad and ugly; I have been present in some of the most important moments in my patients lives. I have seen people walk through our doors with a mild pain only to find out they will be lucky to make it through the next 30 days. I have cried with them, sat with them through the night and comforted their families afterward.

I know there are much worse things in this world than an HIV diagnosis. But that doesn't stop me from being terrified. In 2 weeks I will have my first HIV test and I have good reason to be worried (unprotected sex with boyfriends in the past). I have been married for 5 1/2 years and thinking about children, but of course when your blood work is taken in the first trimester they request an HIV test and I would prefer to do it on my own terms. So that means making the appointment and getting tested before I become pregnant (You know taking responsibility for my own body..yada, yada, yada).

Long story short...I am worried and scared and dealing with this by myself. I'd love a few words of encouragement and maybe some of that 'good-luck karma' of yours Dr. Bob:)

Thanks for reading.


Response from Dr. Frascino

Hello K,

The most encouraging comment would be to remind you that HIV is actually quite difficult to contract. For instance, the estimated per-act risk for acquiring HIV from unprotected receptive penile-vaginal intercourse with a partner confirmed to be HIV positive is 1 per 1,000 exposures. The estimated risk when the partner's HIV status is unknown is obviously much lower than that. Consequently the odds are all in your favor that you are HIV negative. However, only an HIV test can confirm this fact.

Dr. Bob's good-luck karma? Sure, signed, sealed and sent with a kiss for good luck. However, I should point out your being a compassionate nurse and helping those in need has already garnered you a healthy supply of excellent cosmic karma from the higher powers.

I'll reprint the nurse's comments you referenced below and I'm looking forward to your WOO-HOO very soon.

Good luck!

Dr. Bob

HIV: Life or Death? Nov 24, 2006

I'm not sure whether to post under the "Am I Infected?" forum or rather "Comments/Thanks," but here goes. . .

I am a 37-year old heterosexual, female nurse who has, heretofore been negligent in practising safe sex. "Condoms-shmondoms," I'd say, usually with a cocktail or two (no pun intended) under my belt, and with luck, all of my HIV tests have come back negative.

So why am I posting? Two reasons: a change in specialities (ER to Hematology/Oncology), and an epiphany gone wrong.

Sixteen months ago, I left my Emergency Medicine practice and began specializing in blood disorders and cancer treatment. Since then, I've met ten young, straight women and one heterosexual man who were diagnosed with AIDS only upon ending up in hospital with serious and, in three cases, life-ening illnesses.

Primary gut reaction? "That's _awful_! Just like the early eighties, when no treatment was available!"

My second thought?

"Sh#t, that could be me!"

The immediate upshot of my reality check is that, for the first time in my sexual life, I used a condom the next time I had sex with someone. Unfortunately, it broke.

And here I type, ten and a half weeks later, scared of acquiring a condition I have 0.1% of acquiring, assuming my partner was HIV+.

Assured that I'd test positive at 12 weeks, I'd begun uconsidering the myriad ways in which, as a registered nurse working in hospital, I could stockpile medications in order to end it around, oh, say New Years Day or so.

Until tonight. Honestly. I was assigned two female patients in their late forties who are dying of terminal cancers, both of whom have less than three months left to live.

"God," I thought, "I bet both of these women would rather have had new HIV diagnoses. . .at least they'd have years, decades even, to experience rather than just months."

I wrote earlier of my safe sex "epiphany gone wrong." I tried to be responsible and the damn condom broke. In writing this, I've started to reconsider.

HIV+ or not, we've all got to die sometime and, with early diagnosis and expert treatment, HIV can usually be managed as well as any other chronic medical condition, like diabetes, for instance.

If you're a "worried well," be WELL damn it, and direct your angst outward to help educate others and prevent the spread of HIV.

If you've been diagnosed with HIV, as I well may, be glad that you have access to first rate medical care and remember. . .it could always be worse.

I know that the patients I cared for tonight would envy your, and maybe our, position.

Sidebar: Dr. Bob, I've sent a donation to your website. Aside from my personal research, I've directed ALL of my AIDS patients to your website and, for those without internet access, to local libraries where they are able to access the wealth of information provided herein.

I've also given them my home telephone number in case they need outside assistance. . .I've always had a hard time with the professional boundary thing.

And BTW, thanks for the tireless efort and amazing work that you do. I'm floored!

Response from Dr. Frascino

Hello Epiphanized Nurse!

Thank you for taking the time to write and share your enlightenment from "condoms-schmondoms" to HIV/AIDS activist! BRAVO! BRAVISSIMO!!!

It's personal stories like yours that make other "condoms-schmondoms" folks stop and think. I have no doubt that you will save a number of lives just by personally relating your heartwarming story here.

Thank you for your donation and your compassion toward those in need. I, too, have always had difficulty with the professional boundary thing. A number of years ago many physician friends thought I was totally insane when I told them I was making home visits for AIDS patients too ill to travel to the office!

In return for your good deeds, I'm sending you my very best good-luck/good-health karma that your definitive three-month HIV test is negative. (I should also mention my good-luck karma has never failed so far!!!)

I'm honored and delighted to have you as a professional colleague in battling the pandemic.

Be well. Stay well. (And that's a doctor's order!!!)

Dr. Bob


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