How to Make the Most of Your Doctor Visit

How to Make the Most of Your Doctor Visit

If you are HIV-positive, you need a doctor. And not just any doctor-you need an infectious disease specialist who focuses on HIV. HIV is a complex disease with complex treatments, and only a doctor who specializes in its treatment can really keep up with the latest information. Your first visit to an HIV doctor is the hardest. You may be so overwhelmed by your diagnosis that you can't even begin to think about what you should be asking. But you need to get off on the right foot. The point of this article is to help you get organized before you see your HIV doctor, so you can make the most out of the visit. Here's a checklist of important tips: LEARN AS MUCH AS YOU CAN ABOUT HIV BEFORE YOUR APPOINTMENT. Don't expect your doctor to educate you about HIV during your visit-there just isn't enough time! The more you know in advance, the more efficient and productive your visit will be. You can learn about HIV from magazines like this one, on the Internet, or by picking up informative pamphlets at your local ASO (AIDS Service Organization), health clinic or doctor's office. The more you know, the easier it will be to understand what your doctor tells you. It also helps you ask better questions. BRING A NOTEBOOK AND A PEN. Before your visit, write down the questions you have in a notebook. Take the notebook to your appointment, and also write down the doctor's answers! A doctor's appointment is a stressful experience-especially if it is your first as a patient with HIV! This is no time to rely on your memory. Rely on pen and paper instead. You might also bring a trusted, level-headed friend or family member to the appointment with you. That way, the two of you can compare notes later on. BE HONEST. You know it's not healthy to smoke, do drugs, drink to excess, or have promiscuous sex. So you're tempted to "forget" things you don't think your doctor wants to hear. Don't do it! Your doctor is not there to judge you. He's there to help you. But he can only help you if he knows what is really going on. So tell the truth-the whole truth. Answer every question honestly, and don't even think about leaving anything out! ASK FOR CLARIFICATION. If you don't ask questions, your doctor will assume you understand everything perfectly and don't want any more information. So, by all means, speak up when you don't know the meaning of a word or when instructions aren't clear! Say, "I'm not sure I understand, could you explain that a little further?" It also helps to repeat what you think the doctor means in your own words, and ask if that's correct. WHAT YOU CAN EXPECT AT THE DOCTOR'S OFFICE. On your first visit to an HIV doctor, he will ask you questions about your health and life style, conduct a physical exam, and order blood tests. Women should also have a pregnancy test and a gynecologic examination with a Pap smear. The tests your doctor orders will almost certainly include a CD4 count and a viral load test. You should also have drug resistance testing. The results will provide a baseline measurement for future tests. The CD4 count, (also called "CD4+T cell" count, or simply "T-cell" count) measures a type of white blood cell that fights infection. HIV destroys CD4 cells, weakening your body's immune system. A CD4 count is the number of CD4 cells (or "T-cells") in a sample of blood. The more CD4 cells you have, the better. The viral load test measures the amount of HIV-the number of copies of the virus-you have in a sample of blood. This test shows how well your immune system is controlling the virus. The smaller your viral load, the better. Ultimately, with treatment, you will try to get your viral load below 50 copies, which is known as "undetectable." Drug resistance testing determines if your HIV strain is resistant to any anti-HIV medications. HIV can mutate (change form), resulting in HIV that cannot be controlled with certain medications. Your doctor may also order: Complete blood count Blood chemistry profile (including liver and kidney function tests) Urinalysis Tests for other sexually transmitted diseases (STDs) Tests for other infections, such as hepatitis, tuberculosis, or toxoplasmosis Depending on the results of your initial tests, you and your doctor may decide that you don't need to go on medications right away. But you still need to see your doctor regularly. HIV-positive people who have not started taking medications should have a viral load test every 3 to 4 months and a CD4 count every 3 to 6 months. You and your doctor will use the test results to monitor your infection and to decide when to start treatment. Once you begin taking anti-HIV medications, you will continue taking them for the rest of your life. So make sure you and your doctor discuss exactly what your regimen will consist of-how many pills, how often a day-as well as strategies to help you stick to your treatment. Take heart! Everyone goes through a whole series of wrenching emotions when they learn they are infected with HIV. But listen: It's not going to be as bad as you think! HIV is not a death sentence any more. But it is a serious chronic disease that you have to keep under control! The first step is to make that first appointment with a doctor who specializes in HIV. Find out exactly where you stand, and what you need to do. And take it from there, one step at a time. You can do it! Copyright 2011, Positive Health Publications, Inc. This magazine is intended to enhance your relationship with your doctor - not replace it! Medical treatments and products should always be discussed with a licensed physician who has experience treating HIV and AIDS!