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Thursday 15 March 2012

The new cases at the clinic

I was on clinic duty again yesterday, this time with a trainee volunteer. And this time I didn’t have to wait long. The moment I went to the doctor’s room to inform the nurses that I was already there, the senior nurse immediately instructed the junior nurse to bring over a new case to see me at the counselling room.

The first case to be brought in was a lady in her early 50’s, accompanied by her husband. She was supposed to have undergone surgery at a private hospital (am not too sure for what ailment though, she couldn’t think of the proper term in Malay or English, so she mentioned it in Chinese but I believe it was something gynae-related), and during the pre-op tests done, she was found to be HIV+ and so the surgery was postponed and her case was referred to Ipoh GH. Her husband had yet to be tested but was likely sent for testing after they saw the doctor yesterday.

Anyway, they asked if her surgery could be arranged at Ipoh GH instead of at the private hospital since they now have to come to Ipoh GH anyway for her HIV treatment. I told them to just inform the doctor at the ID clinic so she could arrange for a referral letter.

The next case brought to us was a 40-something guy, married, and has 4 schooling kids. According to him, his wife had been tested negative. Although this was a new case, he had actually been tested positive since 2007. He was working in another state then, and had undergone a surgery. Then he moved back to Ipoh, and 3 months after that, he received a call from the doctor who handled his surgery, telling him that he was HIV+. However, since it was just a phone call, this guy was somewhat blur and it didn’t really register in his mind the implications of what the doctor told him.

That was until recently when he went to a private hospital in Ipoh for a medical check-up and had a blood test done. His case was then referred to Ipoh GH where another blood test was done and from the medical report in the file given to me, I noticed that his CD4 was only 15. He definitely would have to start on HAART immediately. I told him about our coming Family Day in July, and with 4 schooling children, he seemed quite interested to join.

The 3rd case referred to us was that of a 58 year old lady. Ah, someone I can call kak instead of the other way round. Another new case in Ipoh GH, although she had been diagnosed HIV+ for quite some time already. This lady is quite knowledgeable. Having seen herself her husband taking drugs, sharing needles with someone else, she had asked her husband straight in the face if he had HIV. The husband denied. But apparently the husband had already been going for treatments without informing his wife. It was only after the husband died was this lady informed about it and immediately she went for blood tests and the results came out positive. Her CD4 was just about 50 or so. She started on HAART immediately. However, this was in another state, where she then was staying with her daughter and son-in-law. Initially the SIL seemed to have accepted his MIL’s HIV, but after about 2 months, his attitude towards her changed. He wouldn’t eat if his MIL cooked, and he even advised his young daughter not to go too near the grandma.

The lady, let’s just call her Kak Mar, decided to find a job at a workplace which would provide accommodation as well. She did manage to get a job as a cook and the place offered hostel accommodation for its workers. Nobody else other than her children knew about this though. Then one fine day, Kak Mar’s younger sister went to visit her at the daughter’s house and became furious when told that Kak Mar was staying at the hostel. She told Kak Mar to come back to Perak & stay at their mother’s house.

So yes, Kak Mar went back to Perak where she now stays with her mother, sister and youngest daughter who is now in form 5. However, due to some miscommunication with the nurse at the ID clinic she used to frequent, no referrals were obtained and Kak Mar stopped taking her HAART, until recently when she decided to go to the district hospital near her place and asked around where she could get supply of the ARV drugs. Unlike most HIV+ women who’d feel embarrassed to admit they have HIV, Kak Mar was so positive thinking, she couldn’t care less what others would think of her. She finally got to see a doctor there who immediately referred her to Ipoh GH so she could continue treatment.

I decided to assign myself as Kak Mar’s buddy – not so much because she needed a buddy, but because I felt she’d be good for peer support. In fact, she immediately agreed when I asked her if she’d mind it if I referred anyone to her should there be any cases around her area who may need to talk to someone in the same boat.

The last case referred to us was a guy who just got back from overseas. He and a few other family members had been staying overseas for quite some time. According to him, he had been diagnosed HIV+ since he was 20 years old, but at that time, he didn’t really understand the implications and decided to ignore it. That was untll last year when he was hospitalised and tests showed that his CD4 was only 2! Since he wasn’t a citizen of that country, they told him they couldn’t keep him long in the hospital and the other choice would be to send him to a specific home. This guy figured he might as well come back to Malaysia to get the necessary treatment.

So came back he did. In fact, his younger brother, who was also overseas with him, decided to come back as well so he could take care of his brother. Now they are a renting a house together, with the younger brother working to support his older brother. This guy sure is lucky to get that kind of family support!

Those were the 4 new cases yesterday. 3 assigned buddies, while the last one didn’t seem to need our service, although I still gave him our brochure with our hotline number in case he needed our help.

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