Tuesday, February 11, 2014

Compliance

In my practice, I always teach my patients about strict compliance to their maintenance medications. Ironically, I don't practice what I preach.

Yes, I know I'm wrong. I should know better. But what can I do?

Currently, I'm on my 10th going 11th month of taking the combination of ARVs Lamivudine, Tenofovir, and Efavirenz. I take them all once daily at 11pm. I still feel dizzy and hot few hours after having my meds. It's what Efavirenz is notoriously known for. That is why taking them before bedtime is very convenient.

My ID doctor told me once that I should have, by now, overcome the dizziness. I don't know why I still haven't.



I have always been religious about taking my meds. I got so used to it that it has been in my system already to have my ARVs on 11pm. I don't even need an alarm anymore.

That is, when I'm not on 24-hour duty.

The problem is, I am always on 24-hour duty after every 3 days. Technically speaking, I'm on 24-hour duty 10 times a month.

I do remember to take my meds even when on duty no matter how toxic the workplace is. However, I deliberately delay taking them so that I don't feel dizzy when I am still expected to be awake and doing my work. I can't concentrate and I feel very unproductive after the dizziness sets in. In deliberately delaying taking the meds (at around 3 or 4am), by the time I feel the side effect, there is already less work to do and all I have to do is endorse all my work to the next duty team.



I know this is wrong. And I've been hearing from everyone that I should prioritize my health rather than my work.

Again, what can I do? Having the privilege of wearing the white coat and putting those 2 letters (MD) at the end of my name, I am expected by my family, by the society to help other people alleviate their physical suffering...



... at the expense of my own health?



P.S.:
I got my CD4 count this morning. Then the flight of ideas, thus this entry. I'll tell na lang about my CD4 count next time.

Aja!


10 comments:

  1. I've been on EFV for more than two years and I still have episodes of mild wooziness, especially if I take the pill after eating or before a hot shower. You're not alone. Just be compliant na lang. I know you know that even before writing this blog. To health!

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    1. two years and still dizzy with efav? tagal na ah.. yeah, compliance talaga..

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  2. Hey! How do you manage to work while experiencing side effects of the ARV's? I might start it and same as your problem is that I am employed as a health worker.

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    1. tiis lang pag anjan na yung hilo... or madalas ginagawan ko ng paraan to minimize the dizziness after taking it.

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    2. Di pa naman ako nagstart. Most likely e mid March ako magstart. Super hectic pa kasi ng sched. Fear ko lang e kapag ng rash ako while on duty. Or if nahilo, e madalas isahan lang kami sa shift. Crap. Btw, what was your CD4 when you started ARV's? Thanks.

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  3. you're a nurse? wag mo lang iisipin mga sie effects, and you won't have them... :)

    my initial cd4 was 173 kaya i was told to start na agad ARVs... ikaw ba?

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    1. Yup. Govt nurse. Crap. Imagine the exposure to almost everything that may affect our immune system.

      CD4 was 388, though napagusapan na namin ni doc na basta below 500 e magstart na ako with ARV's because of my work.

      Sana wag ako magkarash. Baka di ko kayanin yung side effect na bangag e. I can just imagine my patients intoxicated with Phenobarbital, baka maging ganun rin ako haha.

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  4. Yup! Government nurse here (just imagine the exposure to all diseases that may affect our immune system). CD4 is 388 but the doctor decided that I start taking it na since i work in the hospital. What do you think?

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    1. ganun talaga, exposed to all kinds of infectious diseases, kaya dapat doble ingat, or if kaya mo to choose which ward you'll be in, try to be somewhere na controlled ang environment.. like OR, ICU, ganyan... ward nurse ka ba?

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    2. Ward and emergency. Crap. Haha

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