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6:00 am: TB meds
8:00 am: arv: zido/lami

Yung CD4 ko nun 22... but I started ARV therapy only after 3 weeks...

The new pozzie at twitter got his CD4 count, it was 224... and he is asking if that meant he should be on ARV...?

Una, ano ba ang ARV drug o Antiretroviral drug...?


Currently wala pang gamot sa HIV/AIDS... Pero, there are drugs that can slow down the progress of HIV and thus slow down the damage to your immune system... at ito nga yung antiretrovirals (ARV's). ARV's slow down the reproduction rate of HIV. Once the virus is reproducing at a slower rate, it is less able to harm your immune system. If your immune system is functioning properly, your body is less likely to become sick. 

Antiretroviral combination therapy defends against resistance by suppressing HIV replication as much as possible.


Combinations of antiretrovirals create multiple obstacles to HIV replication to keep the number of offspring low and reduce the possibility of a superior mutation. If a mutation that conveys resistance to one of the drugs being taken arises, the other drugs continue to suppress reproduction of that mutation. With rare exceptions, no individual antiretroviral drug has been demonstrated to suppress an HIV infection for long; these agents must be taken in combinations in order to have a lasting effect. As a result, the standard of care is to use combinations of antiretroviral drugs. Combinations usually comprise two nucleoside-analogue RTIs and one non-nucleoside-analogue RTI or protease inhibitor. This three drug combination is commonly known as a triple cocktail.

Di naman natin kailangan malaman, tipong pampagulo lang kasi pero  for better understanding on how it works... ito yung classes ng ARV:

• Entry inhibitors (or fusion inhibitors) interfere with binding, fusion and entry of HIV-1 to the host cell by blocking one of several targets. Maraviroc and enfuvirtide are the two currently available agents in this class.
• CCR5 receptor antagonists are the first antiretroviral drugs which do not target the virus directly. Instead, they bind to the CCR5 receptor on the surface of the T-Cell and block viral attachment to the cell. Most strains of HIV attach to T-Cells using the CCR5 receptor. If HIV cannot attach to the cell, it cannot gain entry to replicate.
• Non-Nucleoside and nucleotide reverse transcriptase inhibitors (NNRTI) inhibit reverse transcription by being incorporated into the newly synthesized viral DNA strand as a faulty nucleotide. This causes a chemical reaction resulting in DNA chain termination.
• Nucleoside reverse transcriptase inhibitors (NRTI) mimic nucleotides and inhibit reverse transcriptase directly by binding to the enzymes polymerase site and interfering with its function.
• Protease inhibitors (PIs) target viral assembly by inhibiting the activity of protease, an enzyme used by HIV to cleave nascent proteins for the final assembly of new virions.
• Integrase inhibitors inhibit the enzyme integrase, which is responsible for integration of viral DNA into the DNA of the infected cell. There are several integrase inhibitors currently under clinical trial, and raltegravir became the first to receive FDA approval in October 2007.
• Maturation inhibitors inhibit the last step in gag processing in which the viral capsid polyprotein is cleaved, thereby blocking the conversion of the polyprotein into the mature capsid protein (p24). Because these viral particles have a defective core, the virions released consist mainly of non-infectious particles. Alpha interferon is a currently available agent in this class. Two additional inhibitors under investigation are bevirimat and Vivecon.

So, yun, without ARV, the virus would just keep replicating, attacking your CD4, killing it... the lesser CD4 count you have, the weaker your immune system, thus rendering your body more susceptible to infections...

Normal CD4 count would be 600 to 1200... pagnagpaCD4 count ka at lumabas na less ng 200, AIDS na... I was Stage 4 AIDS with my 22 CD4... and must be on ARV alredy... now, 200 to 500 CD4 count, medyo debatable... depende kasi sa doctor, sa recommendation niya... tipong should they wait for the CD4 count to drop to critical level o mabuti na yung habang maaga agapan ng wag bumaba...

Problem is ARV requires commitment to adhere and that ARV side effect should also be taken into consideration... 

8:00 pm: arv: zido/lami, efav. Prophylaxis: Cotrimoxazole

I do have a great sense of direction...

I need to find a place... I stumble to it immediately, like I know where exactly it is... I'm lucky that way... I was at RITM, OPD Annex was moved, don't know where, but just walked on a general direction and there I was... the same thing happened actually when I went to RITM the first time... that was May... never been to Alabang before... but when I got there, I was told to look for the new firehouse, literally I stumbled on it... nadapa ako as usual ng walang karason-rason and when I look as I pick myself up, there's the firehouse... galing 'no...

I went kasi last night I notice na kounti na lang yung ARV ko... and indeed for 9 days na lang siya, so tipong 1 weeks na lang... eh ayoko naman mangyari ulit tulad nung huli na naubusan ako at tipong laki ng problema... so I decided to go... long due na rin kasi yung need for me to see a doctor... because of my neuropathy and the blood stain on my sputum...

Good thing pa, I went later... I was planning sana to go really early to avoid traffic... like before 6am early... mabuti na lang natakot ako sa lamig tubig pag naligo ako... so I left around 9 na, and arrived at RITM almost 11 am na... buti na lang, kasi there were no doctors available... the doctor only came after lunch... but even so, I was only able to talk to a doctor around 3 pm na... 

Wait... do you maintain a private doctor? Should I maintain a private doctor and just go to RITM for ARV refills? 

Why am I even asking, as if I could afford it...

O sige, out of curiosity...

So I told the doctor about the neuropathic pain... I told her about the last time when I told about the doctor about it, and was recommended to take Vitamin B Complex... I told her that I was taking Neurogen E... but to no avail... so she decided to put me on Gabapentin, which when I check, according to wikipedia:

 "provides significant pain relief in about a third of people who take it for fibromyalgia or chronic neuropathic pain. It is also effective in reducing narcotic usage post operatively and is helpful in neuropathic pain due to cancer. It has not been shown to be useful for HIV associated sensory neuropathy. When used for neuropathic pain it does not appear superior to carbamazepine. Further evidence is needed to determine if it is effective for migraine prevention. It appears to be equally effective as pregabalin and is of lower cost. It does not appear to be of benefit in treating complex regional pain syndrome." 

Sounds promising... she also recommended a Vitamin B complex brand, as it is more concentrated... Neurobion?

I also mention about the blood streak on my phlegm... explaining that I was a TB patient, recovering, I hope... She was a bit concern... but when I explained the circumstances, like I have no shortness in breathe or difficulty in breathing, no fever, no lost of appetite... she was relieved... she think it is just gasgas sa lalamonan... but just to make sure and anyway it was my fifth month of therapy... she wants me to take sputum test...

And then, maybe she just thought to ask, if the family have a history of diabetes, which, yes we do... and she thinks, though I am too young, high blood sugar can also cause neuropathy... so she also wants me to take blood sugar test, I forgot the right term but basically that is another test...

So, I started on ARV around 2nd week of June... My CD4 was done about a week or so before that... so my 2nd CD4 should be around 1st week of December... the doctor noted that... and educated me na malakas magpapayat ang Stavudine... she explained that perhaps the reason why I was given Stavudine before was because I have low hemoglobin... so she ordered, aside from CD4 count, CBC... she also just gave me just a month supply of ARV, since yun nga, next month, I might be given a different combination of ARV...

On Skins season 4, Episode 5: JJ is in love with Lara Lloyd, a fellow employee at a confectionery shop, but lacks the courage to ask her out. Thomas gets JJ to ask her out and she accepts. He visits Lara’s flat and discovers that she is a single mother with a young child. Lara’s ex-boyfriend, Liam, walks in and threatens JJ, telling him to leave Lara and his child alone. The date goes disastrously as a result, and Lara leaves. JJ finds her and they have sex at Lara’s. JJ returns home but his mother takes him to the clinic for more medication. JJ lets Lara meet Naomi and Emily. Upstairs, Emily tells JJ that Lara is using him to get back at her ex. JJ snaps at Emily and makes remarks on her own relationship, reducing her to tears. JJ’s family also think Lara is a slut and she leaves, offended. JJ becomes angry and beats up Liam when he sees him talking to Lara, who then calls off their relationship. JJ apologises to Liam who tells JJ he loves his child and for JJ to look after Lara. JJ serenades Lara with a ukelele version of 'True' by Spandau Ballet, and she takes him back.


On my way home, I pass by Mercury Drug... I took out the prescription for my neuropthy... and have them priced it... Gabapantin is Php29.75 each, a table a day, for 15 days... and the Neurobion is Php17.50 each, a tablet a day, for 30 days... so I was looking at Php446.25, just for the Gabapantin... and if I just get 15 tablets of the neurobion, Php262.50... I only just have Php1500... naiyak ako...


Wala, naawa ako sa sarile ko... wala kasi akong pambili... akala ko kasi matatapos na yung hirap ko... yung sakit... I was so hopeful... pero, yun nga... mahal pala... tapos I started thinking saan ko kukunin yung pambayad dun sa mga test... CD4 alone cost Php3000... as it is hirap na hirap na kami to make things meet... so yun, sa paglabas ko ng Mercury, naiyak na lang ako... try ko pigilan kasi nakakahiya... pero wala... di ko mapigilan... umupo na lang ako sa isang tabi... 


Feeling ko kasi talong talo na ko... and as much as I want to fight back it is either I am starting to believe that it is no use... o pagod na pagod na lang ako...


Syempre drama lang yan... wala naman ako choice but to get up, wipe my tears away, hail a jeep... get home and be crazy again to believe everything is going to be okay...

Apparently, Cook is inlove with this Effy girl...

So, from the previous episode, when he saw her kissing Freddie, he went on a rampage, brutally beating some random guy... He got arrested for it and was made to live with his drunkard artist mother whom he hates... He was also expelled from school because of it...

Also found out, when Freddie visited him to see if he was okay, that he--Freddie--had sex with his mother when they were fifteen...

His baby brother, who idolized him, got into trouble, making their drunk mom throw a fit, blaming him for everything... Cook lashed out of the house with his brother and just did crazy things... 

But at the end of the day, Cook realized, his baby brother looks up to him and wouldn't want to screw his life like his... he went to surrender and accepted the consequences of his actions...

Just realized, it have been 5 months that I have been smoke free...

I have been confined at RITM for a week already before the doctors figured what was causing my fever then... Yes, it was confirmed that I was HIV+ and that my CD4 count was just 22, but what infected me to cause the fever was not clear... 

And that, during that week at RITM, despite it being prohibited, I was smoking in the room... although not as much... I used to have a pack a day... during my stay, I limit it to 3 sticks... and it was just 2-3 puffs and I was done...

The thing was, my x-ray came out clean... so did the skin test--they inject something in the surface of the skin and they see if it swells or not... it didn't... I have no trouble breathing whatsoever... just that I have observed, the only way to bring down the fever was if I was in an upright position... injecting paracetamol on my IV then doesn't help if I remain lying down... 

They only found out what was causing my fever when the result of the sputum test came about... I was positive on 3 counts of tuberculosis... That was June 3, I remember, it was my birthday and thought that it was my birthday gift... I welcomed it as it was frustrating that I was in the hospital for a week already, throwing up everything I forced myself to eat--didn't have appetite for anything, not even for spaghetti--and having fever that almost run 24 hours, and not knowing what was causing it... at least now, we know what it was and that we know how to try and fix it...

and I knew that I have to totally quit smoking...

It was easier than I thought... I think it was because I was too scared, but I didn't crave for it... I think it also help that none of the people around me smokes... I guess I was lucky in that way... I think I went to withdrawal... I remember breaking to cold sweat and trembling and feeling restless... but nothing "I NEED TO SMOKE!!!" I think my mind was that powerful to block the suggestion of smoking to my body... I didn't crave whatsoever... but I was also careful not to trigger it... like I don't want to drink coffee as I always smoke while having coffee... or I immediately go in my room and lock myself there after meal... I tried not to do things I used to do associated with smoking...