Despite being diagnosed HIV+ on the afternoon of Thursday, April 17, 1997, I didn’t begin to even consider seeking treatment until around nine-months to a year later.  I suppose equal parts stubbornness, defiance, self-will and denial (not to mention my ever-increasing active crystal-meth addiction) allowed me to believe the fallacy:  If I did not acknowledge the problem then the problem did not exist.

                I eventually ended up at Ward 86, San Francisco General Hospital’s HIV/AIDS clinic.  My case was assigned to Dr. Phoebe Trubowitz who played a huge role in getting me to a place of acceptance as it pertained to my health.  For the most part, I was a pretty cooperative patient, though, there were times when I let the fact that I still had drugs at home, or at a trick’s house, or at the sex-club or bath-house (face it – in San Francisco period!) supersede appointments with Dr. Trubowitz or even taking my meds on a consistent schedule; had it not been for my housemates, Mr. M., Mr. V. & Mr. B, I probably wouldn’t have taken any medication.  To be fair, there were times I would attend 12-step meetings in an attempt to clean up my act, during which my compliance with care substantially increased.

                I continued my care there until my hasty departure from the Bay Area in early March, 2001 when I ended up in Washington, D.C.  The only attempts at finding a health provider there was several half-hearted phone calls.

                A month later I was back in the Philadelphia area living at my Grandmother’s house.  I found a doctor at the Hospital of the University of PA, but lost interest when I realized he had no clue about addiction and recovery issues.  (At that time I was back in recovery since, even though the desire to get high was ever-present, I was not going to do so while living at her house – my uncles are all very large men and believe would have had no issue expressing their disapproval of such behavior in a very physical way.)

                Nine months after moving into her home, I found my own apartment. One month after finding my own apartment, I relapsed.  Back on drugs and off any type of medical care, I naturally became sicker.  So sick that my new friend J. made me promise to call for an appointment at a clinic I had recently heard about.  By the day of my appointment arrived, I became so sick that I was leaning on my mother pretty hard simply to stand, let alone walk.  I remember getting on the train to Philadelphia, I remember getting in the taxi at 30^th Street Station, I remember giving the driver the address to the Partnership Clinic at Drexel University’s Hahnemann Hospital…..after that my memory is disjointed….if you could see it in your head it would look like:  checking in at the clinic, lying on the exam-table in the exam-room, sitting in the ER, lying on a bed in the ER – after that – three days later.

                I spent several years getting better, then getting worse, then better, then worse, then better again – all depending on how compliant I was (or was not) to my med regimen and whether I was (or was not) active in my addiction.

                By the time I started coming back to San Francisco last May, my health was fair to good, closer to good.  Not only did I feel more energetic when here, I found myself walking a lot more; I honestly believe that climbing the famous (or infamous depending on your point of view) hills has begun to increase my lung capacity which had been diminished due to two bouts of PCP Pneumonia.

                After months of being bicoastal, I officially moved back to the city I love August 14!  That’s when I should have also started looking into medical treatment, but I was working on Writing Man Productions West Coast premier Sigh-Fi; An Evening of Science-Fiction Themed Comedic Shorts.  That was excuse #1.

                Excuse #2 was that after the show I was going to have to head back East at the end of September to mid-October and again at the end of November which was originally planned for just a week but ended up being until mid-December.

                About a week before my November flight to PHL, I started feeling, well, the best way to describe it is – funky.  Since it started as a pain in my chest area, it was because I had recently started back at the gym after a decade of no real exercise at all.  I was wrong.  I ended up being hospitalized for the night at Chester County Hospital where they found I had a mild case of pericarditis.  As for the pain, the doctors assumed it was esophogitis which they decided to treat with Fluconozole.  Several days after that stay, I flew back to San Francisco.  I arrived at SFO late-night December 10.  I got to my apartment within the first few hours of December 11, got some sleep, and somehow managed to run some errands that day.  I was in bed – an air mattress at the time – from that point until January 3.  Other than walking down to the deli or to perform unavoidable functions of the body (okay, I did push myself to go see a show a friend of mine wrote and directed – great show, bad idea to go)  I was in bed.

                I also made it to a Christmas party December 19.  I knew I was pushing it again, but something told me to go.  I’m glad I did.  I got a chance to talk to someone who was able to give me a list of resources here in the city that I should call during the next week if not the very next day.  Disguising my procrastination with the excuse, “Oh, I won’t be able to get an appointment over the holidays.” I waited until the first week of January to call.

                My delay turned out to be serendipitous.

                I found myself standing at the check-in desk explaining my situation to the receptionist while telling her I would like to become a new patient.  She told me that she could make an appointment for me for intake, but the earliest appointment for that she had was in a few weeks.  I asked if there was any way I could see someone that day.  Probably because she was so nice or because I was near tears or a little of both, she told me I could be seen in Urgent Care, the clinic’s walk-in clinic.

                I was first seen by a Nurse Practitioner who was impressively thorough in his inquiries about my history as well as his examination of me.  Something must have concerned him because he went to get a doctor.  Dr.  Oliver Bacon came in and within five minutes had built a rapport with me most patients only dream of having.  They ran some tests, told me to continue on the Fluconozole and Bactrim I was already taking.

                When I showed up for my intake, I requested Dr. Bacon as my primary care provider.  His schedule is tight, and he occasionally goes to do his work in Africa, but he agreed to fit me in.  Though our first official appointment was two-weeks from that point, he suggested I come to Urgent Care the next morning as he was the doctor on duty and we would be able to get things started.

                He increased my Fluconozole dosage from 200mg daily to 400mg daily.  Some blood was drawn and at the next (first) appointment, he told me what meds he wanted to put me on, but wanted to talk to the Partnership’s pharmacist as well as my previous doctor.  The next day I received a phone call – from the doctor himself – telling me he had made his final decision and would fax the script to the pharmacy of my choice.  My new regimen is Truvada, Prezista and Norvir.  He also has me on Nexium and Bactrim for the esophogitis which actually seems to be gradually improving and on Valcyte to make sure my CMV doesn’t return.

                He’s had me see the ophthalmologist who had me see a retinal specialist so they can decide how much follow up is needed from my retinal reattachment surgery in 2005 (the silicone gel they used to reattach the retina is still in the eye and is causing some slight swelling).  As of now, they see no immediate need to do anything about it, but will check me again in early-March after my upcoming trip East.  In addition to the eye-doctors, he wants me to see a dermatologist about my molluscum contagiosum.             

I had another appointment with him today (okay, technically yesterday, but not only is the time stamp three-hours ahead of me, it is still today until I go to bed and fall asleep!).  He told my while some numbers in my bloodwork came as a little low, my numbers seem to be okay considering I had been off any type of medication for HIV since around June (not his exact words but that’s how I perceived it).  He seemed to be cautiously optimistic about the small improvements I’ve made and then ordered more blood to be drawn today and gave me a lab slip to get it done again within a few days after returning to San Francisco from Philadelphia; he wants to keep a very close eye on my body’s reaction to a mostly-new course of therapy.  The only thing he said that concerned me was that, though I was successfully treated for Syphilis in the past, he might consider putting me on a two-week course of Penicillin when I return; that means either having to have an access inserted into my arm for that duration so I can give myself the dose from a pack, or, a two-week stay in the hospital.  Since I made a commitment to myself to dedicate the first six-months of 2011 to my healthcare, I will agree to whichever option he thinks is optimal.

                So, as for my HIV/AIDS care, I am right back at SFGH’s Ward 86!  The only difference this time, at least for my part, there will be no fighting, no arguing, complete compliance – whatever it takes to help me live this wonderful life I’ve built!