October #117 : Doctor’s Diary - October 2005 - by Barbara Johnston, MD

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Table of Contents
 

Immuno's Defense

Quick Draw




The Common Touch

Seeking for the Perfect Pill

Three’s the Charm With One-A-Day

No Cure, But A Better Liver

Striking Gold

Doctor’s Diary - October 2005

Home Work

Daring to Diet

Do and Don’t-Do Diets

Flu-Shot Time

Smokin’!

In Sickness and In Health

Buzz Off

A Little off the Top

Buddy Up




Who Will Save Them Next?

Pulse - October 2005

Wait-Lifting Stretches

Charlize in Charge

Miss Congeniality 3:HIV

Rap Sheet

Mentors - October 2005

Sex Toys R Us

Trying Trials

Underexposed




Editor's Letter - October 2005

Mailbox - October 2005



 
Most Popular Lessons

The HIV Life Cycle

Shingles

Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV



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October 2005


Doctor’s Diary - October 2005

by Barbara Johnston, MD

We don’t always agree with our patients’ choices

My patients get the final word on their HIV treatment. Once we’ve discussed the options, the plan they commit to is the one that will work best. Rarely, I feel someone is making risky choices. Then office visits can get heated.

 “Miriam,” 52 and positive since the ’80s, has a strength and serenity derived partly from her church work. For years she was undetectable. But then she had gynecologic surgery with complications, then back surgery, liver disease—and finally an infection, likely resulting from the hospital stays. Not surprisingly, all this seemed to alter her feelings about working within the medical system. She decided to try herbs and prayer instead of HAART. I fretted and argued as her T cells dropped—300, 200, 100. “It will all be OK,” she would say, “I put my faith in God.”

 “Don’t you think God put doctors here for something?” I would plead.

Miriam also had pains that were hard to treat, but she rejected 90% of my suggestions. One day, my patience snapped. “Maybe we should find you another doctor.”

“No, I really want you,” she said. “Let’s keep trying.”

As her T cells hit 49, she agreed to try a new regimen. Wouldn’t you know? She got a rash and had to stop. The combo raised her T cells, and she’s waiting again, not choosing another. But she agrees to keep an open mind, and so will I. At her last visit, I said, “All I can do is be here when you are ready.”


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