Wednesday, January 5, 2011
JANUARY 5, 2011 THE RED RIBBON
" Often when we are not looking, in the silence of nature's embrace, the miracle of change happens "
What grabs me most in this quote is ' in the silence of nature's embrace.' If you never have been in the midst of nature with just the wind, crackling, frogs, crickets and maybe running water you are missing a unique opportunity. Living in the hustle and bustle of New York City has made me appreciate the stillness of nature. My times in Ithaca among the plants and trees was pure serenity. At first I was not used to the silence, but now I want stillness even more. It is at these times, when my mind is quiet. This is when miracles do happen. Miracles also happen when I have no expectations.
Every single day of my life is a miracle. This is my opinion on life. When was your last miracle ? Enjoy the miracles of your life !
It is hard to imagine that it is 2011. In 1983, my cousin, Anthony died of G R I D. This was Gay Related Immunodeficiency Disease. Today we know it has HIV. For more than 25 years , men, women and children have been affected by this illness. The longevity today is far better than it was in the early 1980's for those infected with HIV. HIV has multiple and devastating effects on the immune system. These were first noted in 1981, with the finding of an altered CD4(helper)/CD8 (suppressor) T cell ratio. The CD4 depletion was associated with opportunistic infections and tumors thus signifying immune dysregulation and dysfunction. During the first five years of this epidemic many men died of pnemonia called PCP (pneumocystsis). Prior to 1996, the life expectancy of HIV infected patients was far below that of the general population. I was in medical school in the early 1980's. During my clerk ships in London I met many gay men infected with HIV. With the help of two doctors, Charles Farthing and Michael Youle I became familiar with the first treatments of HIV.Today Dr. Youle is the Director of the dedicated AIDS hospital, St Stephens in London, England. These medications as AZT was all we had at that time. Many men, women and children died. I witnessed the most devastating decay of the human spirit. It was a difficult time for me. Unfortunately I buried many friends. To this day I think about what if... I do know that if these men had lived until 1996their longevity would have been more secured. Many of these men secured their AZT and DDI from underground sources. Who do we blame for that? The FDA for not swift approval of medication or the Reagan administration ? I can't help but look back with anger at the politics of the FDA. I had to move on and even 'let go' of that anger. The life expectancy of HIV infected patients treated with combination antiviral therapy , (cART) markedly increased between 1996 and 2005. Due to HAART therapy introduction in 1996, the life expectancy was 36 years for people diagnosed at age 20 and 25 years for those diagnosed at age 35. These life expectancies increased further during 2003-2005. I am happy to say that those individuals diagnosed and successfully treated with HAART have life expectancies that nearly approach those of the general population.
Perhaps these statistics allow the younger population not to use safe sex practices. Who knows? I do know that I see more young teenagers diagnosed with HIV than I ever thought I would see in my lifetime.
Education about HIV and the use of safe sexual practices is encouraged. Since longevity is improved my focus among those infected is changing their dietary lifestyle as well as increasing exercise routines. The same lifestyle changes that I adhere to for those with heart disease and diabetes are also applicable to those with HIV on HAART. I have to consider HIV and heart disease, HIV with lipid abnormalities and HIV and aging.
Mike Youle, B Med Sci, MB ChB,
After qualifying at Sheffield Medical School, UK, Dr Mike Youle helped found the world-renowned Kobler Clinic in London in 1986 as Clinical Trials Co-ordinator. Other than a 1-year stint working as a Consultant for the World Health Organization’s Global Programme on AIDS and the National Programme on AIDS in Kampala, Dr Youle has devoted most of his career to the clinical care of HIV patients. Since 1996 he has been the Director of HIV Clinical Research at London’s Royal Free Hospital as well as an Honorary Senior Lecturer in Public Health at its associated medical school. His numerous professional activities currently include a visiting professorship for Belgrade University and board/committee memberships for organizations such as the International Association of Physicians in AIDS Care, the British HIV Association and the MANON Therapeutic Vaccine Programme. Dr Youle also serves as a trustee of the Red Hot AIDS Charitable Trust and the National AIDS Manual, as well as medical advisor to the Elton John AIDS Foundation.
I was blessed to have worked with this gentleman