Chapter 44


Nick

I’d thought I would be better off away from L.A., away from the paparazzi, away from Lauren and Howie, but after I left, my life just got worse.

For the first few days, everything was fine.  I shut off my phone and stayed off social media so I could avoid people and enjoy the peace and quiet of my house in Franklin.  I immersed myself in my favorite hobbies:  video games, movies, music.  I still ran on the treadmill and tried to eat right and took my meds religiously… until I ran out.  That was when everything started to fall apart.

It was my fault for not planning ahead, for leaving town before refilling my prescriptions.  It’s not like I couldn’t have transferred them to a pharmacy in Franklin, but I got a panicky feeling every time I thought about walking into someplace to pick them up, remembering what had happened at Walgreens the last time I’d tried.  I didn’t want to be seen doing anything that would fuel the speculation about my HIV status, so I put it off.  And the longer I procrastinated, the better I felt… for awhile, anyway.  The nausea and stomach pain I usually felt after taking my pills went away, even without Compazine.  My appetite improved, sleep came more easily, and my energy level increased, motivating me to work out more.

Eventually, I thought, Screw the pills.  Maybe I didn’t need to take medication.  Dr. Usako had said I was doing well; my viral load was down, and my immune system was back to normal.  I could stay healthy through diet and exercise, which was much easier to maintain when I wasn’t suffering from the medication’s side effects.  Yay for holistic medicine.

I even went grocery shopping and bought a bunch of the immune-boosting superfoods Lauren had been feeding me before we broke up.  But in the checkout line, I saw something that made my stomach start hurting again:  Howie’s face on the cover of People magazine, along with the headline, HOWIE DOROUGH:  “I’M HIV-POSITIVE.”  The Backstreet Boy opens up about his diagnosis, his divorce, and how he’s dealing with it all.

With a sigh, I snuck a copy into my cart and went through the self-checkout so no one would see me buying it.  On my way home, I stopped by a liquor store and stocked up on booze, knowing it would be easier to read Howie’s interview if I wasn’t sober.  I hadn’t had a drink since starting treatment, but now that I’d stopped taking my medication, I didn’t think it would hurt.

I suppose that was the start of my downward spiral.

I started feeling sick a few days later.  I thought I had the flu; the symptoms were the same:  fatigue, high fever, headache, body aches, and so forth.  But even though I stayed in bed and slept as much as possible, I didn’t get any better.  Days passed, and by the time Lauren and Howie showed up, I was in bad shape.

At the hospital, a nurse took my medical history and asked what medications I was on, so I was forced to admit that I’d stopped taking my HIV meds.  When Lauren heard me say that, she literally gasped.  “Nick!”

“What?” I said flatly.

“Why would you do that??”  She was staring at me incredulously, like she couldn’t believe what an idiot I was.  “Dr. Usako said once you start treatment, you can’t stop.  No wonder you’re sick!”

“It’s just the flu,” I mumbled, closing my eyes as I massaged my temples.  The fluorescent lights in the exam room were too bright, and my head hurt.  Lauren’s shrill voice shouting at me was only making me feel worse.

“Based on your symptoms, it does sound like you have an infection of some sort,” the nurse interjected, “but with a weakened immune system, we can’t be too careful.  I’m sure the doctor will want to do some blood work and get to the bottom of this.”

Sure enough, after examining me, the doctor had her draw my blood and ordered a bunch of tests.  We had to wait a few hours for the results.  I pretended to sleep while Lauren and Howie sat off to one side of the room, whispering about me.  I couldn’t make out what they were saying, but I could tell they were worried.  I felt bad about them coming all that way to deal with my bullshit, but mostly I just felt… bad.  Every part of my body ached.  I’d had the flu before, but this was ten times worse.  As it turned out, that was because it wasn’t the flu at all.

“Well, Mr. Carter, the good news is that your test results came back negative,” said the doctor, when he finally returned to deliver his diagnosis.  “Nothing out of the ordinary showed up on your scans, and there were no signs of a bacterial or fungal infection in your blood cultures.  The bad news is that your blood cell counts are abnormal.  Your platelets and white blood cells are low, and your CD4 count has dropped significantly.  I spoke to your HIV specialist, and she said it was 511 when she last saw you in January.  Today, it came out at 224.  To put that into perspective, a CD4 count lower than 200 is one of the criteria that can be used to diagnose AIDS.”

Again, Lauren gasped, as my stomach did a somersault.  I had just barely dodged what, in my mind, sounded like a death sentence:  AIDS.

“In your case, Mr. Carter,” the doctor continued, before any of us could speak, “I believe you are suffering from something called retroviral rebound syndrome, which can occur soon after stopping antiretroviral therapy.  Basically, once you stopped taking your HIV medication, the virus started replicating very rapidly, just like it did right after you were first infected.  Your viral load is up from around 10,000 to almost 1,000,000 copies per milliliter, which explains why you’re experiencing the symptoms of a severe viral infection.”

“Oh my god!” Lauren gasped yet again, looking shocked at the high number.  “How could it have climbed that high so quickly?  Nick said it’s only been a couple of weeks since he stopped taking his meds, and even if that was a lowball estimate, it can’t have been much more than a month.  When we were together, I made sure he took them.”  She shot me a glare, as if to say, See how much you need me?  I looked away, feeling guilty.

“You’d be surprised,” said the doctor.  “I consulted a few similar case studies that found it only takes a week or two for HIV to take advantage of the fact that it has free reign and start wreaking havoc on the immune system.  Fortunately for you, Mr. Carter, the condition is reversible,” he added, “as long as you start your antiretroviral therapy again right away.”  He gave me a stern look over the top of his wire-rimmed glasses.

I swallowed hard.  “So… so you’re saying I don’t have AIDS.”

“Not at this time,” said the doctor.  “Your HIV infection is still in the early stages.  However, without treatment, it will most definitely progress to that point.  That was the problem in the ‘80s, before advances in antiretroviral therapy.  Most people had already developed AIDS by the time they were diagnosed, and it killed them quickly, often in a matter of months.  Nowadays, people with HIV that is properly treated and does not progress to AIDS are predicted to live a normal lifespan.  It’s very important that you adhere to your treatment plan from now on.”

Everyone was watching me, waiting for me to promise I would start taking my pills again like a good boy.  I felt embarrassed and stupid, but the doctor’s little AIDS lecture had done its job of scaring me into submission.  In a small voice, I said, “I will.”

The doctor nodded.  “Good.  Dr. Usako faxed over your prescriptions and said you should continue taking the same drugs and dosages for now.  She’d like to see you for a follow-up appointment as soon as you’re back in Los Angeles to make sure you’re still responding to the treatment.  Sometimes HIV develops drug resistance when treatment is stopped and started again, so she may need to change your medication regimen at some point.”

I groaned to myself, as I imagined what a pain it the ass it would be to have to adjust to whole new set of meds and their side effects.  I hoped it wouldn’t come to that.

“In the meantime,” the doctor added, “I’d like to admit you for observation.  Your symptoms should start to go away within a few days of reinitiating the antiretroviral therapy, but until then, we can manage them here.”

I felt a sinking feeling in my stomach.  “Can’t I manage them at home?  I mean, do I have to stay in the hospital?”

“Of course, I can’t force you to stay against your will, but Dr. Usako and I both agree it would be for the best,” said the doctor.

“Don’t even go there, Nick,” said Lauren, glaring at me again.  “You’re staying.”

“I know it sucks,” Howie spoke up for the first time, looking at me with sympathy instead of judgment.  “Trust me, I’ve been there, bro.  But you have to do what the doctor says.  He knows best.”

I was too tired to argue, so I just nodded and turned my head to the side so they wouldn’t see the tears starting in my eyes.  Even though we weren’t together, I still loved Lauren, and I felt guilty for screwing up and letting her down.  I also felt bad about bringing Howie all the way out here, when he was still recovering from his surgery.  But I hadn’t just hurt them.  More than anyone, I’d hurt myself.

I couldn’t take my health for granted again.  Lauren and Howie were right:  I had to follow the doctor’s orders.

***


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