Right now, I have a patient in the ward, almost blind in both eyes, needing medications to be administered directly INTO his eye ball and intravenously; medications which cost nearly RM 600 per day! Meanwhile his body’s defense system is being ravaged uncontrollably by HIV. His CD4 count (a marker of immunity) has plunged over the years from a healthy high of a few hundred to merely double digits!
You ask, how did this man descend into this abyss of horrors?
Many years ago, when he first got to know he was infected with HIV, he decided to seek treatment from a General Practitioner (GP) instead seeking help in established hospitals with facilities and expertise in treating this disease.
And the GP took it upon himself to treat this patient with anti-HIV medications with little blood tests done to monitor the patient’s immune status. The patient was placed on bizarre regimen of anti-retroviral drugs and each time a new drug emerged in the market, the doctor will switch him to the newer drug. The cost of his treatment escalated.
Because of this unchecked dangerous practice, the viruses in the man developed resistance to almost every single anti-retroviral agent available in Malaysia! The man’s immunity started to plunge despite being on expensive medications taken incorrectly. Soon, a virus named Cytomegalovirus saw the opportunity to invade the patient’s retina, slowly and irreversibly eating away his sight!
And that’s how he eventually landed in the hospital with us.
Now, we frantically fight to save what remains of his sight with exorbitantly expensive medications. Resistance testing of the HIV virus shows it to be resistant (in varying degree) to every single class of medications available. Now we are thinking of placing him on salvage therapy, which may cost him another Rm 2000 -3000 per month on top of what he is already paying daily.
I get angry whenever I think of this patient.
I am angry at the incompetent GP who thought he was clever enough to manage this patient while sucking him dry financially.
I am angry that I can’t put this idiot behind bars.
I am angry that the doctor forgot the principle of medicine: Primum non nocere (First, do no harm)
I am angry that we have to pick up his mess which could have been avoided.
I am angry that this patient, through his ignorance, has landed himself in such a predicament.
I have some advice to HIV + patients who happen to read this rant:
1. Seek help from places with established expertise.
2. GPs, generally, are not trained to handle HIV + patients.
3. Medications are free in government hospitals.
4. Medications outside are obscenely expensive.
5. It’s your life, make the right choice.
Fri, 230710 @ 0700