September #116 : Doctor's Diary - September 2005 - by Neal Rzepkowski, MD

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Table of Contents

Charles King Has a Dream

Cross-Country Crusaders

Quoth the Raven

A Trip to Bountiful

Doctor's Diary - September 2005

Combo Vision

Hearts and Chocolate

The New HIV Bouncers

Foreign Agents

Positively Fit

Fitness 101

Weep No More

Ask the Sexpert - September 2005

Antibody Snatcher

The DL Deal

Legal Eye - September 2005

Medicaid Watch

Savings and Moan

Freedom to Worship

Spirit Guide

Teenage Wasteland

Shooting Gallery

HIV Hot Spots for Injections

Buzz Kill

Run for the Border

Mentors - September 2005

I Say a Little Prayer

Easy Come, Easy Go

Forever a Fighter

Founder's Letter - September 2005

Mailbox - September 2005

Most Popular Lessons

The HIV Life Cycle


Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV

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September 2005

Doctor's Diary - September 2005

by Neal Rzepkowski, MD

Prescribing Disclosure—by his own example

I’m HIV positive and an HIV doctor, so I tell my new patients: “I’ve had HIV for 23 years—my virus is old enough to vote.” This gives them confidence in what I say. If I insist, “You have to take those meds every time,” they know I take my doses as well. Sometimes my revelation does more than put them at ease—it helps them disclose, too. And that can be good medicine.

Take Claire, a blue-eyed 43-year-old with three kids—and a messy cocaine history. For four years, I’d urged her to tell her kids she’s got HIV, because I knew it would help her stay healthy. When I raised it, she’d stare at the wall, refusing to confront her secrecy.

Recently, I told her more of my own story—how hard it had been for me to tell my parents I had HIV. How I’d hemmed and hawed until they’d saved me by just coming out and asking. And how much easier my life has been since, how much healthier I am without the extra stress of such a big secret.

At our next visit, Claire told me she’d fessed up to her kids and that they were relieved to learn why she sees the doctor so much. Then, having opened up to her kids, Claire suddenly opened up to me about something her urine and low weight had already suggested: She was still using coke.

Once she admitted it, she could find the support to stop using. Her lab numbers look a lot better now, and so does she.

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