Saturday, January 5, 2013

History of Present Illness

A lot has been asking me what were the symptoms that I experienced which prompted me to take the HIV Antibody Test. And I noticed that I haven’t really written it down here.
This entry will tell my ordeal. One thing, gusto ko sana gawin itong entry nato na parang format ng History of Present Illness (the ones you see in the medical records of patients) kaso it would be too objective. I won’t be able to put some emotions in it.

So, here’s my story.

I do not know the exact date or month when it all began. All I remember is that I started to experience being sick last December 2011, and again in January 2012, but I do not know if that counts. Or both were just isolated cases.

My first bout of ATP (acute tonsillopharyngitis) happened during the Christmas week of 2011. It was torture! I could not eat what I wanted to eat. With all the festive foods at the table, I could only eat a little. I was running with fever, sore throat with swollen tonsils, and I still have to go on duty. Niloloko ako ng mga ka-duty ko na I didn’t have the fever naman daw, because technically fever starts with a temperature more than 37.5oC, and mine’s exactly 37.5oC. Shoot! My body felt warm and I was so weak that time. Still, I went on duty. I call it passion! Hehe! Eventually after a few days of fluid therapy and supportive care, the fever and the sore throat subsided before the year ended. 

Then came January 2012, around 1st or 2nd week, I became sick again. This time, it was worse. I was legitimately having fever (with a temperature of around 38-39oC). Sore throat and swollen tonsils again, but this time, my sore throat was accompanied by a very big mouth sore, the size of a 25 centavo coin located awkwardly in my left tonsil. You could just imagine how painful it is. Just by the mere movement of my tonsils (swallowing of my saliva, talking), it already hurt. I lost a kilo or two in just a week since I really could not eat. It took a toll in me. Wala munang passion-passion. I was very ill. Um-absent ako and I had to rest for a few days. This time, I self-medicated with antibiotics which in the end, afforded relief.
I was apparently well until July 2012 came when I started to notice some multiple, painless, enlarged lymph nodes in my neck and in the groin, with no other accompanying symptoms. By this time, I was already alarmed knowing that this is something serious, a systemic infection probably (involving the whole body). HIV is a systemic infection, and many more. Kasi kung local infection lang yun (limited to a specific part of the body), I wouldn’t have as many lymphadenopathies as I had now. Being a hard-headed doctor, I just took Vitamin C to boost up my immune system. A few enlarged lymph nodes disappear, while some persisted.

My friends also soon started to notice my weight loss, considering that we see each other every day. I’m on a seafood diet naman. I see food, I eat it. Kidding aside, I’m not on a diet. In the medical point of view, weight loss is most likely due to cancer, or an overwhelming infection kasi the infecting organism takes up your nutrients kaya dumadami sila, while you lose weight. Naisip ko na posibleng HIV na naman, na at that point, they are still actively replicating kaya ako nangangayayat. And funny thing, I was praying that I’d rather have cancer than to have HIV.

August 2012, there seemed to have a few pimple-like lesions around my neck sprouting one at a time. The problem is, I pricked it whenever I had an idle hand. Mas nahahalata tuloy ng mga tao, until it reached to a point na my self-esteem went down, below sea level pa. I wore collared shirts (hindi naman kasi pwedeng turtle neck, or lalo naman masagwa ang scarf) to cover it up, kaso lalong nai-irritate.

In addition to that, my skin became itchy (pero not the pimple-like lesions, they are not itchy), usually in the arms, chest, back, and thighs. It was irritating as hell. I’ve been taking antihistamine for the itch from then on (taking it once daily) until now (once every other day). Parang naging maintenance ko na nga. This itch has been my main concern. This 5-month long itchiness is no longer normal. Wala naman ako signs of any gallbladder disease (it could present kasi with itchiness) or any allergies for that matter.

I consulted a dermatologist about the pimple-like lesions in my neck, but I didn’t tell her about the itch. Controlled pa naman yung kati ng antihistamine. Kung sinabi ko kasi, she would subject me to different laboratory tests pa. Dahil yung rashes lang ang pinakita ko and not the itchiness, she just gave me a couple of creams to apply on the affected area around my neck. It was okay during the first week, until parang nagflare-up yung mga rashes with continued use of the cream. Mas dumami pa. Dahil doon, I decided to consult another dermatologist. Yaman! Papalit-palit ng derma!

Well, one of the perks of being a doctor is that you are entitled to a free consultation from your colleagues. Kahit simpleng token of appreciation lang, like J.Co Donuts pwede na. The drawback is that you have to give co-doctors free consultation as well. Pero okay na yun. Thanks to Hippocrates and his Hippocratic Oath. :)

And so the dermatologist prescribed me another cream and an antibiotic which I took for several weeks (more than 3 weeks). The effect was dramatic as the pimples were no longer inflamed. After taking the antibiotic for at least a month, there were still a few persistent pimples in my neck, but they were no longer as inflamed as before. Salamat, doc! Sa uulitin. Pero Krispy Kreme na lang po next time. Haba ng pila sa J.Co eh.

Being in the medical field, I tried to diagnose myself and I could not relate all these symptoms to just one disease entity, except for HIV infection. I cannot simply rule it out because of the vagueness of my symptoms, although I believe mine are milder in presentation. May ilan na rin ako naging HIV patients during my practice, and I’ve seen worse. Plus, my sexual history is a big factor to consider. Pasok na pasok sa high risk group of acquiring the infection.

There have been attempts too, to seek the consult of Internists (doctors who specialize in treating adult diseases) but I was afraid. I know the drill kasi. They’ll run several lab tests and exams, trial-and-error treatment hanggang marule-out na nila lahat ng posibleng sakit. Unless I tell them of course about my sexual history, agad-agad magsususpect yun ng HIV.

Kaya, I decided to take the HIV Antibody test instead.

My thoughts back then:
If I turned out to be negative/non-reactive, I’ll go immediately to an Internist so that I could get checked already. This 5-month long itch is something serious na kasi.

If my result showed that I’m positive/reactive to the test, I’ll have myself checked by an Infectious Disease specialist as soon as possible as well, para maagapan pa.

As of today, I still have the abovementioned symptoms. Nothing has changed. The itchiness is still my major, major concern. I haven’t seen any doctors yet due to time constraints. The soonest time na maging less busy na ako, I’ll surely go to RITM.

Next question: How did I get the infection? Malamang through sex.


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