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Author: thewriterlyroad_2o62in

Always Flight

(This post is from several months ago).

I’ve slept twelve hours a night since arriving in San Luis Obispo. This has happened before when I feel under great emotional strain, I retreat into sleep as an escape. I find it quite satisfying to hide out from my day-to-day responsibilities. In slumber, no one can call or email and make demands. While I sleep, my brain can process all the drama I’ve endured under sunlight. Resting more seems a perfect remedy for all that ails me psychologically. I lost so many hours of sleep over the past ten years to insomnia that I am constantly playing catch-up.

The past few days, I have been in a bad mental state, one of catastrophizing the situation and thinking of the worst-case scenario(s). My mind has made that leap so many times that it knows the exact number of steps to the ledge and how far the drop-off is below. My psyche naturally wants to go to the other landing, where doom and gloom live because that terrain is familiar if unsettling. It seems I must go through this elaborate charade before returning to more solid ground and formulating a plan based on hope rather than despair. Once I complete this exercise, my brain can find new, more uplifting perspectives on the situation. When I awoke this morning, I was back on the good ground. I can see possibility instead of every terrifying thing that can occur. 

I consider it a mark in the win column every time I can recalibrate my thinking away from despondency. There were periods of my life where I remained on that far shore for months or even years. I took that leap, and it paralyzed me with fear. I was unable to return to the land of light and hope. I stayed in the darkness, skulking around like someone devoid of the bright spirit that usually buoys me along. I’ve written before about how seductive and dangerous it can be to stay in that particular blackness, and it can swallow you whole. There were so many times when I thought I would lose the battle, that I wasn’t equipped to handle everything the darkness held over me. I wallowed in self-pity and resignation, unable to get back on my feet and wield a sword against the forces aligning to destroy me. I had told myself I didn’t possess the emotional and psychological strength to defeat depression.

But all of those suppositions are lies. They are forged in the part of my mind that looks for easy answers and the path of least resistance. That is the base, simple brain that only seeks survival and not any higher self-actualization. It automatically decides that retreating is always a better option than fighting. Fighting can get messy. Running away is a tried and true method for avoiding most people and animals that want to kill or eat you. I’ve become a master at checking out quickly and silently when the current situation turns sour or intolerable. But I’m not sure this is the best way to build a different, less stressful life.

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Education By Incineration

A friend recently gifted me an air fryer. Like many people, I had heard the hype surrounding this supposed miracle kitchen appliance. I told my friend I was considering buying one to see what all the fuss was about.

“I have three,” he said. “I’ll give you one of mine.”

After insisting I pay for it and him refusing, we set a time to rendezvous so I could pick it up. I brought it home and perused the user’s manual. It was true that it could cook various foods without excess oil or other fats. The air fryer option also had instructions for cooking all kinds of vegetables. 

I chose tofu with a soy teriyaki glaze and broccoli with a drizzle of olive oil, salt and pepper, and chili flakes for my first official air fryer meal. The tofu cooked perfectly: it was crispy on the outside and soft on the inside. The broccoli was another matter. Even though I followed the directions to the letter, most of the stuff came out black and charred beyond being edible. A few stalks here and there were okay, but the rest was a burnt-up mess. I have tried to cook vegetables several other times with a similar result. 

The experience brings to mind relationships, or more specifically, relationships that don’t end well. Whether it’s a friendship or a romantic interest, we invest ourselves and our trust in others. As we get to know the person, we learn whether we can count on them when times get tough. We discern how loyal they are and if we share enough common ground to march together through the world. 

When the dynamic works, it’s magical. When it doesn’t, it is education by incineration.

Sometimes the feeling sneaks up on you. You know something has changed, but you can’t quite put your finger on the problem. Then you discover your partner is having an affair or your friend lied about being vaccinated for Covid, intentionally putting your health and life at risk. This person you told your deepest secrets to, who laughed and cried with you, has burned you. 

You pull away as quickly as if you had put your hand on a hot stove. And you have: your former confidante has become a crematorium furnace, fired up to 1,800 degrees and ready to turn you to ash.

But you don’t have to stay near the heat. Instead, you can learn from the flames. Like my poor, scorched broccoli, not all of you is singed. With time and compassion, your burns will heal. You may have scars, and that skin will never look or feel the same, but it is still yours. You have earned it. You escaped that burning building and survived the fire. With the memory of the inferno blazing in your mind, you will move forward.

Education by incineration teaches us tenacity and reminds us that we can be harmed, but we aren’t ruined. Wear your burn like a badge of honor.

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A Lot of Oysters But No Pearls

I was visited last night in my sleep by Adam Duritz, lead singer of the Counting Crows. He was crooning verses from their song “Long December.”

A long December and there’s reason to believe

Maybe this year will be better than the last

I can’t remember the last thing that you said as you were leaving

Now the days go by so fast

And it’s one more day up in the canyons

And it’s one more night in Hollywood

If you think that I could be forgiven

I wish you would

The smell of hospitals in winter

And the feeling that it’s all a lot of oysters

But no pearls

A lot of oysters but no pearls. Yes, I feel that way a lot. I keep waiting for something to knock me out of my lethargy and light a fire under my ass. But as I’ve said before, I’m the only one who can do that. Waiting is futile. Hanging in there has done nothing but leave me hanging. Perhaps there is something else in those lyrics that I can learn from: “If you think that I could be forgiven/I wish you would.”

Maybe I need to forgive myself for the mistakes of my past and the things outside my control. I may have been berating myself, hoping to make myself a better person. But I don’t think it works that way; it certainly hasn’t for me. The berating has only diminished my capacity to feel loving toward myself. The criticism kept me stuck in a place where I was unhappy and unfulfilled. There is no reason to remain there anymore. There is nothing that requires my continued punishment and repentance. The only one asking for my head on a pike is that mean-spirited voice who always tries to run my life, and that fucker is never on my side.

It all comes down to me. It all comes down to forgiveness.

If I want a life that speaks to me, a life that sings, I have to forgive my ignorance and blindness. I must realize that in particular circumstances, I wasn’t evolved enough to make smarter, self-loving choices. I was doing the best I could with the skill set I had. More often than not, my toolbox was lacking essential components that I needed to help myself. I was lost, trying to find my way without a map or a GPS. 

Now I am looking for the pearls. I may have to work through many oysters to find them, but I know they exist. I am not only my past and my fuck-ups; I am my present and the future. I am a compassionate and passionate person. I am a creative force for good. I am the reason I’m still here, despite all the tragedy and grief. I am also the reason that I will find other ways to interact with myself and the world. If something isn’t working, then I can change it. I must point my compass in a new direction if I want to reach a different destination.

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A Hold on Hope, Part Three

Why is this piece of writing labeled ‘part three’? Because I have used the same title twice before. I am repeating myself within these pages, and I don’t know whether that’s good or bad. It could be that in my unhappiness, I keep running over the same ground to dissipate the sadness. Alternatively, I could choose to see these repetitions as a meditation, a clearing out of all that no longer serves my spirit and moving me closer to the bliss I seek. 

I like the second idea better.

Not to point out the obvious, but if I’m moving toward something I want, then I have hope. I have written before about Emily Dickinson and her poem about hope, and I have paraphrased Vladimir Nabokov: let the shadows fall behind you and all that. I have even Googled the definition of hope as a guidepost or waypoint to know where to turn at the next juncture or when to stop, rest, and recalibrate. 

Now I look to music which has saved my life more times than I can count. I did another Google search and found site after site with lists of songs about hope and perseverance. Many of the sites lean Christian, which doesn’t interest me. But I am intrigued by how humans continue cultivating hope in some of the worst circumstances. Music is one avenue, but I also lean on my friends, books, movies, and nature. 

Perhaps it’s a hodgepodge of many things that combine to give us a sense of possibility. We must believe that our situation will improve, or else why go on? I know people who are confirmed pessimists or call themselves “idealists” to make it seem that their negativity is based on some rational argument with verifiable data. But I don’t think hope is a measurable and quantifiable thing that can be pinned down with charts and clinical trials. Its origins and manifestations don’t reside in one place; they are everywhere. I have conjured up hope in the darkest moments as if I were an alchemist creating a new magical potion to save me from my demons. 

I suppose that is what we do every day: we find ways to inspire ourselves and the motivation to keep on keepin’ on, even though it feels desperately hard. I survived many things from my younger years that had the potential to destroy some people or render them dysfunctional forever.  I know I have issues and flaws that need to be addressed, but those events didn’t warp me.

What happened to me did not become the defining chapter of my life. They have informed my story but will not determine how it ends.

And so I go back to hope, eternally. I rely on it to bolster me. It reminds me of these lyrics from the band Guided By Voices:

Everybody’s gotta hold on hope/It’s the last thing that’s holding me.

I too am holding on to hope, and I won’t let go.

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A Hold On Hope, Part Two

What does it mean to have hope? I know Emily Dickinson’s definition of the bird that perches in the soul, but what about here in the real world? With boots on the ground, I am moving through—or trudging through—this life of mine, surveying the horizon and seeking guidance, a wayward point that will give me something to aim for. 

As a noun, hope is defined as “a feeling of expectation and desire for a certain thing to happen.” As a verb, it’s to “want something to happen or be the case.” Suppose I keep googling while asking myself why hope is essential. In that case, I find this sentiment from the website extern.org: “Hope reduces feelings of helplessness, increases happiness, reduces stress, and improves our quality of life.” So, hope is a valuable tool in my emotional arsenal, one I need to have at the ready when life charges at me and tries to knock me backward. 

Hope should be as easy to cultivate as despair, but it doesn’t always feel that way. Hope feels fleeting, like Dickinson’s bird. It rests in the soul for a time, but it is easily startled and will flutter away if not given the right environment and nourishment. I have to create an internal space where hope can live and flourish. I must not allow my mind to dictate my feelings, especially when I am in a place of self-doubt. In that state, I am susceptible to negative and faulty input. I will believe everything those dark voices tell me, even as I recognize they don’t want what’s best for me. 

If hope is a desire for a particular thing to happen, I must decide what thing or things I want to experience. This means that hope is directly tied to purpose. If I have something to look forward to and work toward, my life feels purposeful. If I lose meaning, I lose hope; they walk arm-in-arm with me. I must accept that I am the only one who can create meaning for my life. I expect some external force or person to show up and give me direction. No one is coming. It’s only me here, figuring out each step along my hero’s journey. 

Joseph Campbell had the right idea. Each of us has to leave home, go on a quest for our unique Holy Grail, and then return with the news of what we learned. During that adventure, we are changed, for good or ill. We must determine how our journey will shape us and what lessons we will take from it. I have to choose optimism over pessimism. I must continue to turn my face toward the light so the shadows fall behind me (I think I’m paraphrasing Nabokov). I must stay on my path and follow my North Star. The journey is all I have; it has to feed my soul and nurture my spirit. Anything less is not worth pursuing.

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A Hold on Hope, Part One

Since leaving my job, I wake up each morning and try to give myself a pep talk. I use the well-worn phrase, “Today’s another day.” I suppose the words are meant to remind me that I still have a life to live, and I shouldn’t get mired down in the present stresses. I cannot change the past, and if I continue to dwell on all of my worries, I will rob myself of a peaceful future.

Intellectually, I know all of this is true. And yet. My heart is aching. I find myself in a state of grief. This grief is not borne out of the loss of someone dear but something dear. I am mourning because I feel I will never teach again, at least not in the settings I’ve been to before. I am profoundly sad because I have lost the opportunity to do something I love: teaching. I thought that teaching would be one of the ways that I give back to the world; it would become a part of my legacy. But now that seems unlikely.

I am trying to separate the voices that do not help me from those who give me honest feedback, which is a challenging task. I am prone to self-deprecation and flogging myself for even the slightest misstep. It is difficult to balance being truthful about my shortcomings and telling myself I am a complete and utter loser. I’ve wasted years of my life berating and belittling myself, only to realize that it never made me a better person. It made me feel small and like a waste of space. If being mean to myself worked, I would be the best person on the planet.

So now I find myself ruminating on my grief at what I have lost and how I played a role in bringing it about. I am terrified that I am what some people have said I am, and I can’t see it; I won’t see it. I fear I am blind to the true nature of my intentions, and because of all the tragic events that have occurred, I am becoming bitter.

I don’t want to become bitter. 

I want to retain some of the wonder and innocence I once had before so many bad things happened. I want to remember that girl who loved to sing, read, and climb trees and whose imagination was boundless. She was the world through a particular lens, and that perspective contained hope. I need to hold on to hope; it has carried me through tough times like the one I’m in now. I think of a quote from Emily Dickinson. “Hope is the thing with feathers that perches in the soul—and sings the tunes without the words—and never stops at all.”

I need that hope now. I need it as much as the air I breathe. If I can hold on, I know hope will save me.

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The Dark Well

For the past few months, I have been depressed. If I’m being honest, my despair extends beyond the past few months. The negative, persistent thoughts that lead me to the edge of the dark well of depression have hounded me mercilessly since childhood. Any attempt to flee from them is futile.

I have been diagnosed with clinical depression three times in my life. Traumatic events seem to thwart my brain’s ability to regulate the neurotransmitters that keep my mood and emotions in balance. Each time, I fell into the dark well. Each time, it took medications and months of therapy to push the reset button on my mind’s circuitry.

This time feels different (do I say this to myself every time I get depressed?). Before, I had youth on my side and enough naivete to convince myself that things always get better eventually. Now I’m on the other side of forty and have less of an emotional support system. I do have a small circle of close friends I’ve known since my late teens and early twenties. They are a consistent and solid foundation that keeps me from losing my sense of security in a world where sometimes I cannot find my way. But I am also alone now more than ever. I find it hard to make new friends even though I think of myself as outgoing and gregarious. I find that I want to isolate myself at home and avoid people.

I know the desire to retreat is because of those voices that tell me I am not enough, not worthy, and why would anyone want to interact with you anyway? They are insidious and relentless, and it becomes impossible to discern whether or not they are helping or hurting me. If I pull back the lens to take an aerial view, I can see they want to take me down and are actively planning my destruction. But my vision is blurry and unfocused when I’m back here on the ground. That’s the fucked up thing about depression: I know the voices are lying, but I keep listening to them.

Even if I can’t stop them, I try to quiet them down. Amid my sadness, I looked out my window and saw that some of the trees near my building were changing colors in response to the Fall. Several of them are primarily green, but the tops are brilliant red. Why does that happen? I ask myself. I stare in wonder and realize that I am looking for hope. I want to be hopeful.

Today, this reality is enough to keep me going. I will step away from the dark well.

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What Are HIV and AIDS?

What is HIV?

Human immunodeficiency virus (HIV) is a blood-borne virus transmitted through body fluids (i.e., blood, semen, and vaginal secretions). As the name states, HIV infects the cells that help keep our immune system strong. Without a healthy immune system, our bodies are susceptible to a whole host of infections we wouldn’t usually get. It is important to remember that HIV doesn’t only affect a specific segment of society. Anyone can be infected with HIV regardless of their age, sex, race, ethnicity, or sexual orientation (AIDS Healthcare Foundation).

There are only a handful of ways to spread HIV. The first is through anal or vaginal sex. The second is by sharing infected needles or syringes to inject drugs or cookers used to make drugs. Lastly, babies can contract HIV during pregnancy, birth, or if they are breastfed by a mother who has HIV. In rare cases, patients can contract HIV from an organ donation or blood transfusion. This scenario is highly unlikely in the United States because of the thorough testing of organ and blood donors. Regardless of the route of transmission, the disease progression is the same. Many people don’t recognize the initial symptoms of HIV infection because they can be similar to the flu. 

Symptoms can include:

 * Sore throat 

  • Swollen glands 
  • Muscle aches
  • Skin rash
  • Nausea, vomiting, and diarrhea
  • Night sweats

It is not uncommon for patients to experience weight loss with a new HIV infection. If a patient presents with any of these symptoms, the clinician should complete a physical assessment, order blood tests, and obtain a complete medical and sexual history. Blood work would reveal HIV in the blood and a decrease in the white blood cell count. These findings are significant and different from other kinds of infection. 

In most cases, the body will produce more white blood cells to fight a new or growing infection. In the case of HIV, the virus is suppressing the bone marrow’s ability to make white blood cells. Additionally, another cell called a CD4 will also decrease. CD4s are often called “helper cells” because they help the immune system fight various infections; however, HIV prevents the helper cells from doing their job. As the disease progresses, the virus level will rise, and the CD4 cell and white blood cell levels will continue to fall, which further compromises the immune system.

HIV infection has three stages. Stage 1 is known as the acute phase. Some patients may have flu-like symptoms, but others may not have any symptoms at all. Because there is a large amount of HIV virus in the blood during this stage, patients are highly contagious. If a patient has flu-like symptoms with no other explanation, they should have an antigen/antibody test or nucleic acid test (NAT) to determine if they have HIV.

Stage 2 is the chronic phase. Patients still have HIV virus in the blood but at lower levels. However, they are still able to spread the infection to others. “At the end of this phase, the amount of HIV in the blood (called viral load) goes up, and the CD4 cell count goes down. The person may have symptoms as the virus levels increase in the body and the person moves into Stage 3. People who take HIV medicine as prescribed may never move into Stage 3” (Centers for Disease Control). Stage 3 is acquired immunodeficiency syndrome (aids). Although the progression of the disease can vary greatly among patients, stage 2 generally lasts for about ten years.

Clinicians should offer emotional support to a patient newly diagnosed with HIV infection. Significant strides in medications and treatments mean that patients with HIV can live a long and healthy life but there is still no cure, so the diagnosis can be a life-changing event. Clinicians need to be sensitive to the stigma some HIV patients may face with friends, family, and the public, and we should offer other community-based resources if required. These might include referrals to an HIV clinic, a social worker, a therapist, or a support group.

What is AIDS?

Acquired immunodeficiency syndrome (AIDS) is the third stage of HIV infection. At this point, the patient’s immune system is severely compromised, and they are at risk of contracting a variety of illnesses (known as opportunistic infections). 

Some examples of these opportunistic infections are 

*Candidiasis 

  • Cytomegalovirus (CMV) 
  • Herpes simplex virus (HSV) 
  • Lymphoma 
  • Tuberculosis
  • Kaposi’s sarcoma (KS)
  • Invasive cervical cancer 
  • Pneumocystis pneumonia (PCP)

As in the other stages, patients are contagious and can infect their sexual contacts. Even with proper treatment, the general survival period is about two years, although this can vary from patient to patient based on other co-morbidities. Patients are diagnosed with aids when their CD4 count falls below 200 cells per cubic millimeters of blood, or when they develop opportunistic infections.

Patients in the third stage suffer significant disability and physical challenges. The opportunistic infections may also cause multiple emergency room visits and hospital admissions. They may become unable to work, drive a car, or eat enough to maintain their weight. Fungal infections in the mouth may make it difficult to eat. In some cases, parenteral nutrition may be necessary. “Poor nutritional status and HIV infection interact with each other leading to the development of opportunistic infections, malignancies, debilitation and death” (Enwereji et al., 2019). Because patients can also develop a condition called HIV encephalopathy, they can have a cognitive impairment, making it difficult for them to perform their activities of daily living.

Treatment and Medications

As previously stated, there is no cure for HIV and AIDS, but medications and testing are advancing substantially. The main category of drugs currently in use is called antiretroviral therapy (ART). It is not uncommon for patients to be on a multi-drug regimen or “cocktail” of three or more medications to treat the disease. Each category has a different mechanism of action and works on different cells in the body. The multi-drug approach has effectively kept patients free from opportunistic infections, stabilizing or significantly reducing their viral load, and improving their CD4 counts. According to the Mayo Clinic, the classification of drugs is as follows:

  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs) turn off a protein needed by HIV to make copies of itself. Examples include efavirenz (Sustiva), rilpivirine (Edurant), and doravirine (Pifeltro).
  • Nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs) are faulty versions of the building blocks that HIV needs to make copies of itself. Examples include abacavir (Ziagen), tenofovir (Viread), emtricitabine (Emtriva), lamivudine (Epivir) and zidovudine (Retrovir). Combination drugs also are available, such as emtricitabine/tenofovir (Truvada) and emtricitabine/tenofovir alafenamide (Descovy).
  • Protease inhibitors (PIs) inactivate HIV protease, another protein that HIV needs to make copies of itself. Examples include atazanavir (Reyataz), darunavir (Prezista) and lopinavir/ritonavir (Kaletra).
  • Integrase inhibitors work by disabling a protein called integrase, which HIV uses to insert its genetic material into CD4 T cells. Examples include bictegravir sodium/emtricitabine/tenofovir alafenamide fumar (Biktarvy), raltegravir (Isentress) and dolutegravir (Tivicay).
  • Entry or fusion inhibitors block HIV’s entry into CD4 T cells. Examples include enfuvirtide (Fuzeon) and maraviroc (Selzentry).

Like all other medications, side effects are possible. 

Common side effects of ART include: 

  • Bleeding
  • Bone loss 
  • Damage to the kidneys, liver, or pancreas
  • Lactic acidosis 
  • Heart disease
  • Hyperglycemia which can lead to diabetes

Treatment also involves regular blood testing to assess the viral load, white blood cells, and CD4 cells. As much as possible, patients should maintain a strong immune system by avoiding others who are ill, taking medication as prescribed and not missing any doses, eating a well-balanced diet, and minimizing stress.

Another positive step in the treatment and possible prevention of HIV is PrEP, or pre-

exposure prophylaxis. These medications are taken before potential exposure to HIV or if a patient is at high risk of exposure to HIV. PrEP is effective if it is taken regularly. PrEP can reduce the risk of HIV infection from sex up to 90% and in I.V. drug users up to 70% (Medline Plus).

According to the website HIV.gov, there are currently two approved medications for PrEP:

The side effects of PrEP are similar to ART and include:

*Nausea and diarrhea 

*Headache

  • Possible damage to the liver or kidneys
  • Loss of bone density

There is another class of drugs for patients who believe they have been exposed to HIV. These are known as PEP, or post-exposure prophylaxis. PEP may be ordered if a patient feels they were exposed to HIV during sex, after sharing potentially contaminated needles or syringes, and after being sexually assaulted. To be effective, patients must start PEP within 72 hours of exposure, and they must take the drug for 28 days. Just like PrEP, PEP is only effective if taken as prescribed.

Patient Teaching

Like other chronic diseases, patients with HIV and AIDS need ongoing education about the progression, treatment, and management of their illness. Clinicians play a crucial role in helping patients understand symptoms, side effects of medications, the need for regular blood tests, and how to handle and treat opportunistic infections. Teaching should empower the patient in taking their medications as scheduled and report side effects to their provider. Clinicians should strive to build rapport with their patients. In doing so, they stand a good chance of obtaining an accurate and thorough medical and sexual history.

Another critical component of teaching for this patient population is safe sex practices. It cannot be overstated how important it is for patients to understand behaviors that increase their risk of contracting his as well as actions that can decrease their risk. 

Behaviors that increase the risk of contracting HIV are:

 *Sharing needles and syringes 

*Having sexual contact with someone who has a high viral load the presence of another sexually transmitted infection

* Using drugs and alcohol during sexual encounters.

Behaviors that reduce the risk of contracting HIV include:

 *Abstinence 

*Less risky sexual behaviors

*Using condoms and lubricants 

*Reducing the number of sexual partners

*Taking medication to prevent HIV or reduce the viral load 

It is essential that sexual partners have an honest conversation about each other’s sexual practices and whether the relationship will be monogamous. Sexual partners can also agree to only engage in safe sex practices and remain committed to these guidelines during the relationship.

Lastly, partners should always be honest about their HIV status, especially if they plan to engage in sexual activity or become pregnant. Having HIV does not mean that sex or pregnancy is not possible, but extra precautions are needed to reduce the risk of transmission.

Medication Compliance

As researchers and health care providers learn more about antiretroviral therapy, it is clear that strict adherence to the dosing regimen is essential to keep the HIV viral load under control, increase CD4 production, and support the immune system. Clinicians play a pivotal role in ensuring that patients understand their medication regimen and the rationale for strict adherence to its guidelines. As health care providers, we should never assume that patients know what to do to keep themselves healthy. Therefore, assessing the patient’s knowledge level and willingness to follow the medication dosing is crucial to the successful treatment of HIV infection.

Conclusion

The progress made in the battle against HIV and AIDS is nothing short of phenomenal. A disease that at one time would have meant a sure and quick death is now being held at bay by advances in both testing and treatment. If handled properly and conscientiously, HIV patients can expect to live long, quality-filled lives. More than ever, HIV patients can hope that they won’t suffer disability and devastating illness because of the virus. This hope extends to friends, family, and the community as well.

Clinicians can help this patient population by not being afraid to have open conversations about medical and sexual history, medication compliance, and overall health status. Additionally, offering emotional and psychological support will help these patients better navigate their journey of living with the virus. HIV and AIDS once may have been the worst-case scenario for many, but that is not the reality now. We can hope the next phase is a cure.

References

AIDS Healthcare Foundation. What is HIV? HIV Basics. HIV Care. (n.d.). https://HIVcare.org/hiv-basics/?gclid=EAIaIQobChMIgaaX__3x8AIVZz2tBh0WuAUCEAAYASAAEgJ_MvD_BwE

Centers for Disease Control. About HIV. https://www.cdc.gov/HIV/basics/whatisHIV.html

Enwereji, E.E., Ezeama, M.C., Onyemachi, P.E.N. (2019). Basic principles of nutrition, HIV, and aids: making improvements in diet to enhance health. DOI:10.5772/intechopen.84719

HIV: PrEP and PEP. https://medlineplus.gov/HIVprepandpep.html

HIV.gov. What drugs are approved for prEP? https://www.HIVgov/HIV-basics/HIV-prevention/using-HIV-medication-to-reduce-risk/pre-exposure-prophylaxis

Mayo Clinic. HIV/AIDS. https://www.mayoclinic.org/diseases-conditions/HIV-AIDS/diagnosis-treatment/drc-20373531

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Fodder from the Frontlines: Day #7

Although it was a slow day, the pressure and stress are starting to show. We are all a little too quick to question each other and become defensive over the smallest perceived slight. One nurse who has anxiety has developed a constant eye twitch. Over the weekend, one nurse became agitated when another accidentally bumped into her. She screamed, “Don’t touch me! Don’t touch my stuff!”

Today we began random testing of 10% of the staff to look for positive COVID tests. I volunteered as one of the first to be tested. My anxiety about this virulent virus isn’t unfounded. Two of the complications are renal failure and blood clots. Not only do I have one kidney (I became a living donor in 2015) but I also have a clotting disorder. Contracting this virus could mean a potentially devastating outcome for me.

As I wait for the results, I think about what a positive result would mean. I’d be done working, I would have to stay at home and have my groceries delivered. Can I still sit out on my patio, or walk my dog, Harper? So many questions with blurry answers, and such a new and unfathomable world spinning before our eyes. All three of us who tested are negative. I am so relieved I go to the bathroom and cry.

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Fodder from the Frontlines: Day #6

t was a busy day but the team handled the flow like a well-oiled machine. We have a system and it’s working. We are processing everyone’s samples while staying safe. Young people are still clearly hanging out with each other and don’t seem to take the threat of this virus seriously. Part of me understands this. At eighteen, I made some profoundly stupid decisions, and no one could tell me I was wrong.

Human beings do not have a fully developed frontal lobe until about age 25. The frontal lobe controls decision making and impulse control, so it’s not surprising the younger ones don’t get how bad COVID can be for everyone. I did a lot of patient teaching today. Some of these kids were offended but I don’t care. A huge part of nursing is helping people comprehend how their actions affect not only themselves but others. I will not stop talking about the right thing to do.

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