Tuesday, April 3, 2012

The AIDS Alphabet: X, Y, Z

The AIDS Alphabet: X, Y, Z

Now that we've almost reached the end of the AIDS alphabet, let's review all its letters. This is only a snapshot of the larger, more comprehensive AIDS Alphabet, the subject of my upcoming book with the same name.

A is for AIDS, AZT, Atripla, ARV, (AIDS) awareness, abstinence, ART [AntiRetroviral Therapy] (see HAART), amfAR, ADAP, ACT-UP, AIDS museum
AIDS Museum Opening. Seton Hall University, South Orange, NJ, 2006. Photo by Alina Oswald

B is for Bactrim, Buffalo hump, (AIDS related) Blindness, (AIDS) Bracelet

C is for Candidiasis, Cidofovir, crypto, cocktail, CD4, CMV (Cytomegalovirus), Crixivan (see PIs), (AIDS) complacency, (AIDS) Conspiracy theory, (AIDS) Cure

D is for ddI, d4T, (AIDS) Dementia, Drug interaction, Death, Duality of AIDS, December 1st (See World AIDS Day), (AIDS) Denialism

E is for Entry Inhibitors, AIDS education, epidemic, ELISA 

F is for Foscarnet, Fuzeon (see Entry Inhibitors), the Face of AIDS, FDA

G is for Ganciclovir, GRID (Gay Related Immune Deficiency), gay cancer, AIDS-related Gingivitis

H is for HIV, HAART (see ART) [Highly Active AntiRetroviral Therapy], Dr. Ho, Hope

I is for Immunomodulators, Immune System, Infection

J is for (pneumonia) Jiroveci (see PCP)

K is for Kaposi's sarcoma (KS)

L is for (AIDS) Lymphoma, Lazarus effect

M is for (HIV) Mirror test, Mono-therapy, MCV, Maraviroc, Molluscum Contagiosum Virus

N is for NNRTIs, NRTs, Norvir, Neuropathy

O is for Opportunistic Infections (OIs), ozone therapy, Orasure, (AIDS) Origins

P is for PCP [Pneumocystis carinii pneumonia], (AIDS) Pneumonia, PICC (Peripherally Inserted Central Catheter) line, Protease Inhibitors (PIs), Pentamidine, (AIDS) pandemic, (AIDS) prevention

Q is for (AIDS) Quilt

R is for Ryan White CARE Act, Reverse transcriptase, (CMV) Retinitis, Retrovirus, (AIDS Red) Ribbon

S is for SIV, SIDA, Sustiva, symptoms, side-effects, Syndrome, skin cancer, survivor, sunken cheek syndrome, safer sex, SLIM

T is for T-cell, T-cell count, T20 (see Fuzeon), (AIDS) Treatment, Therapy

U is for Until There's A Cure, Urine therapy, Undetectable (VL)

V is for Viral Load (VL), Visual AIDS

Empire State Building in red lights for December 1st, World AIDS Day
Empire State Red Lights on World AIDS Day
W is for (AIDS) Warrior, (AIDS) Walk, Western Blot Test, World AIDS Day

Y is for Yeast infection, (AIDS early) Years and 30 Years of AIDS

X is for X-ray

Z is for Zerit

Journeys Through Darkness: A Biography of AIDS bookmark
Here are a few excerpts from Journeys Through Darkness:A Biography of AIDS, which reflect the last three letters of the AIDS alphabet:

X is for X-ray

By 1991 the number of AIDS-related deaths skyrocketed. Many of Kurt’s friends and people he knew in his community became infected with HIV. But Kurt didn’t really worry. He had been feeling fine and hadn’t been sick at all, so there hadn’t been any reason for him to go to the doctor for his annual physical.  As a matter of fact, Kurt hadn’t been to a doctor in over a decade. He’d been healthy… at least up until the end of October 1991, when he started coughing. It was a persistent cough, exhausting, draining him of energy.
    Not knowing what to make of it, Kurt tried to self-diagnose, thinking he had an allergy. So, he decided to put to good use the health insurance he had through his work and flipped through the provider books with their endless lists of physicians, searching for an allergist. He found one and called his office to make an appointment. A few days later the doctor gave Kurt several shots of different allergens under his skin to determine just what he was allergic to, and then sent him home, advising him to return in a few days.
    Once at home, Kurt started feeling much worse. He went to bed only to wake up in the middle of the night soaked in his own sweat. That’s when he realized that something was seriously wrong with him and it wasn’t allergies. He started to think that whatever was wrong had something to do with HIV. 
    Only a week earlier Kurt had taken his date to a gay bar, where he first noticed an AIDS magazine. He picked it up and flipped through its pages and he came upon a list of various opportunistic infections associated with AIDS. One of them was Pneumocystis carinii pneumonia, or PCP, otherwise known as “the AIDS pneumonia.” Kurt mentioned his suspicion regarding his HIV status, but the other guy brushed him away, saying that Kurt was probably overreacting.
    But after waking up several nights covered in sweat and feeling sicker and weaker by the minute, Kurt decided to call a doctor—a general practitioner this time—and make an appointment. He got in a few days later and by then he was coughing constantly and had mild fever.
    The doctor X-rayed Kurt’s lungs and drew blood to send out for fast testing. It turned out that the photographer had pneumonia, but the doctor needed more time to determine what kind of pneumonia it was.
    Kurt’s blood test results were back in no time. The physician studied them and noticed that his patient’s white cell count was way out of the normal range. That was reason enough to ask permission to perform an HIV test. Permission granted, the doctor drew more blood from Kurt’s arm and sent it out for more testing, and then he sent his patient home with a prescription for antibiotics to treat his pneumonia. Kurt was to return in a week for a follow-up visit.
    During the following days, despite the doctor’s treatment, he started feeling even worse and by the end of the week Kurt became certain of his HIV status. When it was time for him to return to the doctor’s office, his sister insisted on going with him. “You can’t go in there without some emotional support,” she said and drove him and stood by his side as he received the news.
    According to the new blood test results, Kurt not only had HIV. He had AIDS. He was also experiencing his first bout of PCP—two more were to follow in less than a year. His T cell count was fifteen. [In comparison, the T cell count for a healthy person is approximately one thousand or more, measured per unit of blood.]
    Being a general practitioner, the physician thought it was time to turn his patient to an HIV specialist, and so he sent Kurt immediately to the hospital. There, although doctors didn’t tell Kurt much else at the time, they told the photographer’s mother that her son might not make it through the night.

A PICC line, or Peripherally Inserted Central Catheter line, is a thin flexible silicone tube that medical professionals insert into patient’s vein and through which they administer intravenous medications, transfusions or chemotherapy for long periods of time. This way, the patient doesn’t have to make frequent hospital visits to receive necessary treatment or to be given multiple injections. For optimal results, the PICC line has to reach the large veins in the patient’s chest. This allows medical professionals to administer large amounts of medication directly into the bloodstream. Therefore, the medications can work fast and most efficiently.
    Nurses are usually the ones to start the PICC line. They can insert the tubing straight in the patient’s chest using general or local anesthetic. In this case they call the line a central line. Nurses can also insert the tubing in the patient’s arm, usually near the bend of the elbow, and in this case the line is called a peripheral inserted central catheter line, or PICC line. After starting the PICC line, nurses then use an X-ray machine to help them guide the tubing all the way up into the patient’s large veins in order to make sure it is in the right position (close to the heart). Only then can they begin administering the medication through the PICC line. The entire procedure requires only local anesthesia of the skin where the line is inserted and it generally takes about thirty to forty minutes.