AIDSiversary 27 : Existential question

 
My meaningful anniversary date passed over a week ago, and I am again taking the time to write this rather late. Has HIV lost its importance in my life? Not really, considering that it is also the focus of my work. But in my personal life experience it might be true that some other things have asserted their importance as I do accumulate certain signs of decline.

I’m less mobile than I was. Not only problems of psoriatic arthritis and the damage my weight has done to my knees, but I think I will soon be adding a diagnosis of gout to my list of afflictions. That is to say, that my siblings, all of whom have had that diagnosis, seem to agree that what I am describing could be what they have also experienced. In my case, it seems to be most present in the ball of one of my feet, which is not helpful for the mobility thing. We shall see: doctor appointment in February.

My other biggest concern is the psoriasis over which I have lost all control. I have never been good at applying the topical treatment, but now I have it all over my back, which I can’t even reach (best excuse of all to not apply the treatment, no?). I am on the verge of attempting a return to an outpatient dermatology service to explore the possibility of other types of treatment, always a challenge because of the state of my immune system (there’s that HIV!), since those treatments are immune suppressive, and I’ve got that covered.

The next big challenge on the horizon is not really even health related, but there are health considerations that enter into my deliberations. I will turn 65 this year, which I didn’t really expect to happen when I was diagnosed with HIV late, 27 years ago. I’ve always had a certain healthy (or unhealthy) pessimism about my prospects of longevity, certainly not due to just the HIV (I have a robust optimism for people diagnosed with HIV today, and early enough to get treated before it ravages their immune systems), but due to the lateness of my diagnosis and my apparent inability to actually reconstruct my immune system. I’m very good at taking my meds, and have been undetectable, with a blip or two quickly resolved and maybe due to lab error, since my first test after starting treatment, about 6 weeks after I started. But those CD4+ cells remain low.

So what’s my new challenge? Retirement or not. I do enjoy what I am doing for work, even if I am now much more comfortable doing it remotely, so it isn’t a lack of interest, but my advancing age and the idea that one day I might be able to do some of this as a volunteer and not as a job. I have, however, worked most of my life in the community sector, not noted for high wages/salaries, and my internal pessimism didn’t lead me to make a lot of sacrifices along the way to save for eventual retirement. What I will basically have is two public pensions, but if I delay drawing on them I can maximize the amounts (waiting until age 70 tops them up, one of them by 36%). But wouldn’t it be a shame to wait in order to have a somewhat less inadequate income and then never draw on the pensions because I don’t survive that long?

That’s my new existential question.

My most recent results (28 June):
CD4 count: 217
CD4 %: 27
Viral load: "Not detected" (test sensitive to 20 copies/ml)