comfortable with, s/he may be able to continue as you primary
physician while consulting with specialists a s necessary -- an es-
pecially good option if you live far from an “AIDS doctor”.

During your first clinic visit after testing positive, the health care
provider will do a thorough physical examination and take an ex-
haustive medical history. S/he will be looking for any signs of ill-
nesses which may be related to immune suppression. One of the
most important parts of the exam will be blood drawing for test-
ing -— the blood work—up will usually include a complete blood
count, testing for other infectious diseases (like syphilis and hep-
atitis), and a basic immunological work—up. Other tests, such as a
chest x-ray, may also be recommended. A number of tests will
help give a picture of how your immune system is working.
While they may seem confusing now, before long you’ll be con-
versing fluently about t—cells and CD4s and CD8s and a host of
other arcane medical terms. The count you may hear most often
is your CD4 level, which is usually above 800 in healthy person,
and below 400 in a person with serious immune suppression. Re-
member that these counts are only a part of the overall picture of
your health status. These measures of the function of your im-
mune system play a key role in decisions about possible treat-
ments. If your immune system shows signs of weakening, your
physician may prescribe medication.

There are two distinct modes of treatment that your provider may
suggest if certain measurements have declined. Anti—viral drugs
(AZT, DDI, DDC) work to prevent replication of HIV in your
system, and are now suggested for consideration when CD4
counts are around 500. Other drugs are used to fight off specific
infections that become life-threatening to a person with a dam-
aged immune system. For example, therapy to prevent pneu-
mocystlcs carinii pneumonia is highly effective, and rec-
ommended for anyone with CD4’ below 200. Perhaps even more
than anti—viral drugs, treatments to prevent specific opportunistic
infections are making a major day-to—day difference in the health
and life of people with HIV and immuno-suppression. Other
drugs may be recommended to prevent tuberculosis, CMV-
related illness, and other serious infections.

The decision to start any of these drugs is ultimately in your
hands. While your physician may suggest or actively encourage
their use, it is your right to decide for yourself. You’ll hear lots of
things, especially for or against AZT, and unfortunately there are
not definitive easy answers; since this is an evolving epidemic,
you’ll be making your decision based on the incomplete in-
formation and studies we have so far. In making decisions of this
magnitude, you’ll need to be a complete partner in your own

health care, developing a relationship that makes the most of your

health care provider’s medical expertise and your expertise as the
person whose body this is all happening to. Establish early on
that you expect your provider to take the time to answer ques-
tions, to explain, to listen, and to discuss you concerns with you.
Virtually everyone working in AIDS agrees on one thing: the
folks who do the best are the ones who aren’t passive about it, but
instead take an involved active role in dealing with their in-
fection. A positive attitude doesn’t guarantee you won’t get sick,
but it can make a difference.

Now that you know you’re HIV positive, it’s up to you to decide
how you’re going to deal with it -- who you’re going to tell, what
kind of attitude you’re going to have, what kind of treatment you
want, and what role it will play in your life. It is hard to think of a
more difficult or important set of decisions you will ever have to
make. But by facing them directly and honestly, you’ll be able to
make the best ones you possibly can. V

November 1991

Janet K. Brown, M A., C. A C
Licensed Psychologist
Certified Alcohol Counselor

Jean Townsend, M.A.
Certified Mental
Health Counselor

- ACOA - IDENTITY ISSUES
- TRAUMA AND LOSS
- DEPRESSION
Individuals Couples Families

Milton VT
’ _ 2 Church Street
(802) 893 4816 Burlington, VT
(802) 863-8162
(802) 447-2110
N / BY APPOINTMENT
/ \ DR. NANCY L. BURNS

CHIROPRACTIC PHYSICIAN
BODY MIND SPIRIT

185 NORTH STREET
(HARSCH ASSOCIATES BUILDING)
BENNINGTON, VT 05201

The Passion of Pearls...

November 8 Women’s Buffet & Dance
Buflet by Dinner to Go
$5.00 5-9 p.m.

November 14 Whole Earth Travel Night
Gay/Lesbian Travel Info — Door
Prize

November 16 Ladies Lounge Dance
$1.00 7-10 p.m.

November 20 Pasta Night - All You Can Eat
$5.95 6-10 p.m.

November 21 Juice Bar - 18 & Older
$3.00 cover 9 p.m.

November 23 M en’s Hunting Season Dance
Sponsored by the Mansfield Buck
$3.00 cover 6 p.m. ’

Pearls

« 135 Pearl St.
Burlington, Vermont

15