20 April 2007

Stylin' Friday: PCP and Diagnosis

On finding out I had an AIDS-defining pneumonia, in the style of One By One.

On the 20th I had trouble breathing. The symptoms were : coughing to the point of running out of breath, hard to stay standing, fighting to return to bedroom, falling to bed, breaking glasses on the way down. I woke up later, coughing again.

The woman at Info Santé spoke in difficult English. She offered only two choices of clinics; both were far away for a winter day and open for only short hours. I left her thinking that she had helped me, but I did not intend to go. Two days until I would see my own doctor at his office.

I don't remember the 21st. I imagine it full of coughing and sleeping. Or trying to sleep. The neighbours came and went : I heard them on the stairs and I heard their front door opening and closing. Nobody noticing my difficulties inside my apartment.

Afternoon on the 22nd, I try to imagine taking a bus and metro to my doctor's office. I step outside into the cold and I can't breathe. Nobody sees me go back inside to phone a taxi. Will I remember my doctor's office address? The taxi driver takes me there easily, but I do not remember him. Or her. It is usually a man, so I think that is who it was.

My doctor greets me as he always does. Leads me to his office down the hall, stands aside for me to enter before him. Asks me how I am doing. Breathing is hard, coughing is easy, so I do what is easy and I try to explain. He seems to know what is wrong and writes a long note for me to take outside, up the hill to the hospital emergency. I wait until I am out of his office to read the note and confirm his suspicions for myself. I have the strength to read "PCP" and I understand what it means.

Flashback to all the times my doctor encouraged me to have a test for HIV. I not cooperating, not ready for a result I knew could be positive. Not mentally or emotionally ready for the result I knew could be positive. Back to now with no choice but to accept it. The cold waited for me outside the doctor's office, but the taxi had moved on after I paid. A new taxi stops easily, the driver does not question the close destination. Or I do not have the strength to notice and commit the reaction to memory. I am too busy trying not to cough and trying to breathe to remember the rest of the three minute ride to the hospital emergency room.

I show the note to the person behind the plexiglass. I don't notice her reaction to the note I have already read because I am concentrating again on breathing and on not coughing. I wait my turn in the waiting room.

The doctor is pleasant and businesslike. He asks me questions and listens to my breathing between coughs. He appears to have read the note, which he mentions to me. A simple prescription for antibiotics and an appointment to come back the next day for a test he calls a bronchoscopy. He tells me that this would not have been necessary if I had followed my doctor's advice and been tested for HIV in the past. I don't remember if I am panicking on the inside because most of my energy is taken up trying to breathe and trying not to cough.

The doctor leaves and I go back into the waiting room. I am not aware of whether everyone is looking at me: they are preoccupied with their own miseries. Now I have one more: how to go back home through the cold, how to get my antibiotics prescription filled. Only one thought: my friend who told me about his being HIV positive at least a year before. I know I can count on him and my instinct is right. He comes to the hospital and takes me home in a taxi. Then he goes out and gets my antibiotics and brings them back to me. When I cry and tell him I don't have the strength to deal with this, he reassures me that I will find it. "We make these efforts to be here for the pleasure we will have tomorrow." I know that I will remember this. I feel bad that I can't tolerate his smoking after he has done so much for me.

I am lying on my bed, struggling to breathe when my parents phone me. I have so little energy, so little awareness of breaking news gently, that I tell them what my doctor's note said and that I am too weak to talk. I tell them this means I have HIV. Even in my weakness I know that I will have their support. They were very good to me after my long struggle to come out to them about my homosexuality and I have no doubts about their love and support. They ask me if I am sure about the HIV, and I say I am. I am not thinking about how difficult this news is for them to hear; I am focused on breathing and not coughing and trying not to drop the phone.

On the 23rd, I make my way again to the hospital for my bronchoscopy. I have fasted for this, but I wouldn't have had the energy to cook for myself anyway. I remember taking something to relax my throat, remember the tube going in and some kind of images. These might have been in my unconscious. I still have trouble breathing. After the procedure, I am lying on a bed in a clinic at the hospital, with a something measuring my blood oxygen, which is low. I am weak and I tell the nurse (a man) that I don't think I can go home. He gives me time and check on me every now and then to see if I am less weak.

By the end of his shift, he has found me a bed in a room in the hospital with three other people in it. I have all of my clothes on, but not my boots, and I am in bed with a tube hooked around my ears and under my nose giving me oxygen. I stumble to the bathroom once or twice in the night. I also hear the man in the next bed trying to get more and better drugs from the nurse. She knows what he is trying to do and she does not give him what he wants but does not need. I do not see her face, but I can imagine its impatience. I do my best to avoid any contact with this man, pretending to sleep even when I am not.

I ask several times about my antibiotics, because I do not want to miss a dose. I am confident that the antibiotics will make it easier for me to breathe and end the constant coughing. My back has been sore from coughing for so long. In the morning, after many times hearing the man in the next bed ask for different drugs and hearing him talk to one of the other people in the room many times through the night, they bring me breakfast. I understand the value of hospital food. When I am as weak as I am, as unable to take care of myself, this is the best thing that could happen : a meal placed before me.

I don't know how it happens, but one of my co-workers and friends comes to see me at the hospital on the 24th. It is Christmas Eve and she brings me some food from a Christmas meal. She takes me home in a taxi. I am still weak and I am still struggling to breathe and not to cough. At least now I am home and I have my antibiotics (they were not precisely on time in the hospital, and this bothered me a lot).

I am alone again at home. When my phone rings during the day and I answer it, I am suspicious to hear the doctor I saw in the emergency room. He asks me how I am feeling and if I am taking my antibiotics. When I hang up, I still do not feel like I understand his calling me. The calls continue for almost two weeks. Every day through the holidays: am I feeling better, are the antibiotics working? I feel less suspicious and I am amazed at the doctor's dedication and caring.

We wait for the antibiotics to work before we do a real HIV test.

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