Have you ever wanted something specific to eat, but you didn't know what? Call it an incomplete craving: The desire is strong, but the object is elusive. It's not necessarily even about hunger and food. My therapist would say, "You're looking for some sort of substitute for what's really missing." What's really missing? Love, fulfillment, inner peace, knowing the meaning of life, freedom from HIV -- for starters.
These cravings come during idle time, like when watching TV. Last weekend I was in a particular limbo -- between having decided to restart anti-HIV treatment (Friday when I saw my doctor) and actually starting (Monday when I picked up my prescriptions.) I felt depressed about having to go back on drugs after 10 months. When I stopped HAART, I had 400 CD4 cells. I told myself then that if they went as low as 200, that would be one of three "triggers" to send me back to meds. (The other two: a viral load above 750,000 or some clinical event like thrush.) Well, 209 CD4 cells was close enough -- and 10 months was a longer break than I had hoped for. Still, I was frightened. Part of the fear was the "200 CD4 cells = AIDS" that was stuck in my head. For a few days, I went running around the office like Chicken Little telling people: "I have AIDS! I have AIDS!" (You can do that at POZ.) And part of the fear was about the highly experimental, even risky way I've chosen to manage my HIV. Had I made a mistake?
TV provided a good distraction from all this. I came across an old Batman, a show I loved as a kid. In this episode, Cat Woman, Joker, Penguin and Riddler had formed an evil alliance to take over the world by ambushing the United Nations. Now, the plot wasn't all that different from the terrorism news on CNN, but at least with Batman, I knew that good would prevail over evil. If only I felt that confident about real life.
As thinking, feeling adults (I tell myself), we all have to accept a level of uncertainty in our lives and make peace with more powerful forces -- nature, fate, evil -- that we can't control. For me, current events have only highlighted this inner struggle, just as fighting HIV does every day.
Of course, good TV requires good snacks. Salt-and-vinegar Cape Cod potato chips and a tub of French Onion dip. A dry salami summer sausage and some pepper-jack cheese for "Scooby snacks." Some string cheese and some Little Debbie "Fancy Cakes."
Sound the alarm! My diet will probably send me to the grave before HIV and the drugs do. Like so much of me, my taste in food can be traced back to growing up in the South. When we had "vegetables," it was green beans cooked in pork fat. Or tomatoes and cantaloupe with biscuits in sausage gravy. My mother let me have all the sugar cereal I wanted. My grandmother smoked two packs of cigarettes a day until the day she died at 89. My father drank Jack Daniel's. The general attitude in my family about nutrition and health can be summed up in Aunt Ann's frequent refrain, "Well, something's gotta kill ya!" Translation: Enjoy life, be who you are, accept your mistakes, failings and short-comings -- consequences, be damned!
On Friday, when I sat down with my doctor, about to embark on my fourth cycle of HAART, there was not much to discuss. I wanted something new and exciting -- something permanent. I asked about clinical trials, about IL-2, the immune booster. But in the end I was just going to go back on the same combination I had been on -- it worked before, I think it will again, and I want to keep other options open.
So it's back to that nagging, gnawing "adult" feeling -- that eternal question mark that manifests itself as a snack attack. I am a dissatisfied customer. I want something for my treatment -- and not only do I not know what it is, but it doesn't even exist (yet). At least with food I can try to sate the cravings, with a frozen Sara Lee pound cake, say. Or that new Ben & Jerry's flavor...