Saturday, February 25, 2012

The AIDS Alphabet: P is for PCP, PICC Lines and PIs

The AIDS Alphabet: P is for PCP, Pentamidine. PICC Lines and PIs

PCP: Pneumocystis carinii pneumonia (most recent name is pneumonia jiroveci) is a lung infection commonly seen in people with compromised immune system. PCP, otherwise known as AIDS pneumonia, usually occurs in patients with a T cell count below 200. As in the case of CMV (cytomegalovirus), the organism that causes PCP can enter the healthy human body and live peacefully in it for the rest of its life, not causing any damages. Only when the immune system weakens or deteriorates, the organism activates and can cause pneumonia. In the early days of AIDS, PCP was too often a regular cause of AIDS related death for AIDS patients. Medications used for treatment of PCP include: Bactrim, Pentamidine, Mepron (Atovaquone), and Primaquine.

Pentamidine: It is used to prevent and treat PCP usually when the patient becomes allergic to the more commonly used antibiotic, Bactrim. Pentamidine is available in inhalation (for PCP prevention) and injection, or intravenous (for PCP treatment). 

Protease Inhibitors: Protease Inhibitors, or PIs, inhibit replication of HIV protease, which is an enzyme needed for formation and assembly of HIV proteins. An example of PI is indinavir (Crixivan).

PCP, aka pneumocystic carinii pneumonia, pneumonia jiroveci or just AIDS pneumonia, made its presents in the U.S. in a handful of young male individuals who died in a matter of days. PCP was the first sign that AIDS had arrived to the States. As with other AIDS-related opportunistic infections (OIs), the life-extending HAART medications can prevent patients' immune system to weaken to the point where OIs like PCP, KS, CMV can become active. Still, lately it seems that KS and PCP have resurfaced.

AIDS pneumonia, an opportunistic infection associated with a depressed immune system (like in patients with AIDS) has become a focus point and main "character" in photographs, playwrights, books and movies featuring the pandemic. One example is Angels in America, the HBO movie.
Angel in Central Park:Lensbaby Photography, part of the AIDS Museum collection

What it's like to live with (or better said to survive) PCP? Just ask Kurt Weston. He survived three bouts of PCP and is still here to tell the story. And he does, in Journeys Through Darkness--A Biography of AIDS.

Award-winning photographer Kurt Weston's first bout of AIDS pneumonia: excerpt from Journeys third chapter--Dark Angel, named after one of my favorite Kurt Weston images.

As always,  thanks for visiting,
Alina Oswald
Author of Journeys Through Darkness: A Biography of AIDS

with Dark Angel
During his first hospitalization with pneumonia, doctors placed Weston in an isolation ward, which was a common procedure for dealing with AIDS patients, to prevent the disease from being spread, because at the time experts were not sure of all the ways it could be transmitted. When it came to HIV/AIDS, in order to follow hospital rules, both medical professionals and visitors had to go through two separate doors and a ventilation system to enter the patient’s room.
    Kurt Weston woke up hooked to tubes and machines, not sure what was happening to him. He opened his eyes only to realize that people wearing masks, gloves and suits were staring down at him.

Sunday, February 19, 2012

Is it all well with your soul? To find out, check out Well With My Soul, by Gregory G. Allen. Book review published in A&U Magazine

Is it all well with your soul? To find out, check out Well With My Soul, by Gregory G. Allen. Book review published in A&U Magazine.

Happy Sunday!

I'll keep this post short. I just want to share with everybody a book, a read I totally enjoyed.

The book is: Well With My Soul.
The author is: Gregory G. Allen
I had the honor to review it for A&U Magazine.

Check it out, below.

Thanks for visiting,
Alina Oswald
Author of Journeys Through Darkness

Well With My Soul
By Gregory G. Allen
Reviewed by Alina Oswald
Originally published in A&U Magazine--America's AIDS Magazine February, 2012

      “Is it all well with my soul?” is the question that comes to mind upon finishing Gregory G. Allen’s latest novel, Well With My Soul. Inspired in part by Horatio Spafford’s hymn with a similar name, Well With My Soul intrigues and surprises not only by the questions it forces us to answer, but mostly by the answers we reach and the journeys of self-discovery we have to embark on in order to find these answers. 
      In that sense Well With My Soul proves that sometimes it is, indeed, about the journey and not the destination; that life doesn’t play by the rules; and that, too often, unconventional elements define the reality surrounding us.

Monday, February 13, 2012

The AIDS Alphabet: O is for Opportunistic Infections (OIs)

The AIDS Alphabet: O is for Opportunistic Infections (OIs)

"Identity" by Alina Oswald

While learning about HIV/AIDS, we also learn to use letters rather than words, letters that stand for one or more words. It starts with AIDS itself:

AIDS: Acquired Immune Deficiency Syndrome

As the studying continues, we also becomes familiar with terms like PCP, KS, CMV, and many others:
"Black Skies" Copyright 2010 by Alina Oswald. All Rights Reserved.

PCP: pneumocystis carinii pneumonia a.k.a. AIDS pneumonia, later renamed pneumonia jiroveci, associated with a deteriorated immune system; T-cell count under 200 (per unit of blood)

CMV: cytomegalovirus which can attack the eye (retina), the digestive system or more in patients with a weakened immune system (T-cell count under 50)

KS: Kaposi's sarcoma cancer is usually associated with the late stages of AIDS.

PCP, MAC (macrobacterium avium complex), Toxo (toxoplasmosis), candidiasis (thrush, one of the first signs of a compromised immune system) are also known as opportunistic infections (OIs). OIs are caused by viruses that normally live in the body but do no harm. When the immune system become weakened, deteriorated, depending on the degree of deterioration, certain infections (opportunistic infections) can occur, caused by these viruses. An immune system can become compromised because of HIV or chemotherapy (in patients with cancer, for example).

To learn more about what it's really like to live with (and survive) opportunistic infections, check out books like Hope: A Story of Triumph, by Joel Rothschild, Caregiver, by Rick R. Reed, My Dream to Trample AIDS, by Don Carrel, Journeys Through Darkness by yours truly (photographs by Kurt Weston). In one way or another, they all tell stories of AIDS survivors, AIDS warriors, which, in turn help us survive life, ourselves. 

Hope you'll enjoy the reads. As always, thanks for stopping by.

Alina Oswald
Author of Journeys Through Darkness: A Biography of AIDS

Alina Oswald

Monday, February 6, 2012

The AIDS Alphabet: N is for "NUKES" (NRTIs) and "non-NUKES" (NNRTIs)

The AIDS Alphabet: N is for "NUKES" and "non-NUKES"

An excerpt from life with NUKES, non-NUKES and other medications that fight HIV/AIDS from Journeys Through Darkness: A Biography of AIDS.

NNRTIs: Non-Nucleoside Reverse Transcriptase Inhibitors (a.k.a. Non-NUKES) are medications that inhibit the reverse transcriptase enzyme by binding directly to the enzyme. NNRTIs include: nevirapine (Viramune) and efavirenz (Sustiva).
NRTIs: Nucleoside analogue Reverse Transcriptase Inhibitors (a.k.a. NUKES) represent the earliest antiretroviral drugs. They act by incorporating themselves into the DNA of the virus and blocking an enzyme called reverse transcriptase, which HIV needs in order to replicate. NRTIs include: zidovudine (Novo-AZT, Retrovir), lamivudine (Epivir, 3TC), and stavudine (d4T, Zerit).

Journeys Through Darkness: A Biography of AIDS by Alina Oswald with Photographs by Kurt Weston

Excerpt from Chapter Eight: Modern Crucifixion"

The modern-day face of AIDS is not a face of death anymore, but rather is defined by new terms like “Crixi bellies,” “PI pouches,” “buffalo humps” or “sunken cheeks [syndromes].” It is partly a face of HAART regimens, the very medications vital for patients to sustain a normal life and lifespan. Therefore, especially in North America and Western Europe, the contemporary face of AIDS is associated with physical deformations that sometimes can transform a patient’s appearance beyond recognition.
Due to the new protease inhibitors he was on, called d4T, Kurt Weston was also starting to grow a buffalo hump and a stomach pouch (also known as a P.I. pouch). When he asked his doctor to switch him to a drug that wouldn’t distort his body, his doctor told him about a new medication at the time, an entry inhibitor that was coming up the pipeline and becoming available.
In 2003, FDA approved a medication called Fuzeon (or T20) supposed to fight HIV by not allowing the virus to enter the T cell. Because it is difficult to manufacture, the drug is extremely expensive and available only as an injection. Studies have shown that AIDS patients who are on Fuzeon may get skin rashes where they self-administer the shots, or some may become more prone to developing pneumonia.
Doctors put the photographer on Fuzeon and a combination of other medications. While on Fuzeon, Kurt has experienced very few side effects and he liked that very much. Also, to make best use of the medication and his time, he had no choice but to quickly learn how to integrate his shots into his daily schedule.
Ever since his diagnosis, AIDS has been a constant variable in the equation that describes Kurt Weston’s existence. In time and with the appearance of new treatments, the threat of his disease has turned from immediate to manageable. These days, AIDS has become more of a constant companion in his life rather than a threat, but it continues to influence, at least partly, all decisions, minor and major alike, that he has to make—be they related to his studies, to traveling or eating his meals.

Friday, February 3, 2012

Book Covers and Their Journeys: How to Create Book Covers (and what makes a book cover unconventional)

Book Covers and Their Journeys

Backbone by Alina Oswald
This blog is about unconventional topics. That includes unconventional images and the book covers created/designed with such images. As I just finally reached the finish line for my book, Journeys Through Darkness--A Biography of AIDS, I've gone through a journey (or maybe journeys) of my own. Some of these journeys are related to getting into the story so that I could make sense of it and actually write it; some include lots and lots (think years) of editing and re-editing (I'm not even joking); lately, I've just learned how to convert a book into an e-book (that's a journey of its own); design and create the book cover, bookmarks, posters and much more.

This was not the first time to make photography or design covers. I've done it multiple times before. In the future, I believe that this aspect of book... creation/design will be an intrinsic aspect of the larger, more complex journey through book publishing. Therefore, I'd like to share with you a few things I've learned about book covers. And, even more, unconventional book covers. (In a future post I'll talk about other book covers and also photography for inside the book).

First things first: what makes a book cover?

A book cover may be unconventional because:

* its shape is unconventional (think fancy photo albums, especially wedding albums)
* the image used to create the cover is unconventional
* the book story is unconventional, and, therefore, conveyed, somehow, in the cover

The Awakening... by Alina Oswald
What's not that unconventional about book covers is how they get created. That means, conventional or not, fancy type or not, a book cover designer should follow some rules. That means, usually, publisher's rules. Each publisher has its own guidelines that have to be followed in order for the cover to come out just right (not only to be accepted but also to look great in print and on screen). That applies even when the book cover designer works with the author of that book, not directly with the publisher (I've worked with both, with authors, creating promotional material and covers for their books, and also publishers, usually creating material (book covers) for my own books).

There are several things to consider:

* does the client want a full book cover (back, spine, front) or just the front cover; usually, when working with authors, may just want the front cover; even then, be prepared to design everything based on the publisher's guidelines, which are usually posted online on the publisher's website. If they are not, contact either the author or the publisher (or both) and ask for those guidelines

* work either in Photoshop or InDesign (sometimes combined) but make sure you do use layers, so that if you have to make changes to the cover design (which usually happens), you don't have to start from scratch (save time, aggravation, sleepless nights, stress, migraines and much more)

* have your monitor and printer calibrated, color calibrated, that is (it usually helps tremendously if you work on a big screen (think iMac) rather than a small screen (think MacBookPro). You may have or want to send the author (if you work with an author vs a publisher) a printed version of the author's book cover; you can also check with the publisher and ask about their printer's color profiles; also, print the book cover sample at original size, 100%, to make sure that it looks as close to the original as possible; a 100% size book cover sample, if we talk about front cover only, for example, may be 6x9 inches or 5x8, either way, it's not a large size of paper; the author can further use that sample to autograph it for readers or for promotion...

* especially if you create only the front cover, do save your Photoshop file and its layers, and name those layers something that it makes sense to you and, possibly to someone else... like the publisher; the publisher may ask for it to adjust (or further adjust) the title and byline, etc to fit with the rest of the book cover; this can happen, so be prepared

* in addition, you can use that front book cover file to further create other promotional material for your author client--bookmarks, poster, etc

Here are a few examples of the book covers I created:

Kurt Weston's "Journey Through Darkness" (part of his Blind Vision series) first inspired the title of my book, Journeys Through Darkness, which tells the photographer's story through AIDS and related blindness:

Journeys Through Darkness: A Biography by Alina Oswald with Photographs by Kurt Weston

From an image I took on 9/11/2009 photographing the 9/11 Tribute Lights on a rainy night:
9/11 Tribute Lights 2009. Copyright 2009 by Alina Oswald. All Rights Reserved.

I came up with this cover, which was also published on the cover of a local newspaper:
Infinite Lights: A Collection of 9/11 Photography by Alina Oswald

And talking unconventional, I think writing about and photographing vampires and dark angels qualifies as "unconventional." In September, 2010 I started photographing vampires and dark angels (thanks to some very helpful friends and models). Here are two images from my vampire photography collection (which has been growing ever since):

"I'm Not Afraid" Copyright 2010 by Alina Oswald. All Rights Reserved.
 From Vampire Fantasies photo-books

"Superstitions" Copyright 2010 by Alina Oswald. All Rights Reserved. From Vampire Fantasies photo-book.

I decided to use "Superstitions" as cover for my Vampire Fantasies photography collection. And I came up with this:

Vampire Fantasies: A Collection of Vampire Photography by Alina Oswald

When creating the back cover, make sure you have content to add, be that image (can be an image stretched out over the entire front-spine-back cover), text (praise or blurbs for the book). If you don't have blurbs/testimonials, you should still include something. While I have blurbs for Journeys Through Darkness (thanks to authors, photographers and activists) and while for Backbone (my photography collection "praising queer courage," as Out IN Jersey wrote about the book (thank you!)), I did not have anything like that to include on the back cover of Vampire Fantasies... so I used the available space to talk more about vampires, the subjects of my book. Here's what I came up with:

Vampire Fantasies: A Collection of Vampire Photography by Alina Oswald

One more thing... when creating/designing the cover, you also have to keep in mind the kind of fonts you are going to use. The font should accompany (and even add on to) the image. For Vampire Fantasies I used Lucinda... it does look vampire-ish.

I will write more on book covers and book photography, in general, as I'll also continue my posts on the AIDS alphabet. Until then Happy Book-Cover-Designing! [smile] and, as always, thanks for visiting!

Alina Oswald
Author of Journeys Through Darkness: A Biography