Today was nothing less than eye opening and interesting. I literally had no idea what I was walking into and there is no way someone could have prepared me for it.
The potent smell of sweat and body odor. The sight of very skinny and frail men and women. The HIV Health Unit has a lot to offer students, employees and patients alike.
Leigh Ann, our preceptor, definitely has a full, well-rounded resume. She is the state specialist in oncology medical nutrition therapy and has traveled the states speaking and presenting her research and scientific based opinions. She is very respected in the field. But her office looks like a tornado passed right through. I could not function to look at her desk. It definitely made me nervous. It was so disorganized but she knew exactly where everything was. I guess that’s what makes her so awesome!
You may be wondering how someone who is living on the streets gets diagnosed with HIV. Well, malnutrition, involuntary weight loss, or a secondary illness is usually the culprit that brings them into the emergency room. Doctors and nurses test for HIV when these symptoms are presented. In comes the clinic for follow ups and labs. Walk ins are allowed because how do you keep a schedule when you don’t have or need one? Some drop in for air condition or to see Leigh Ann for more Ensure or just to chit chat or watch the Today Show in the lobby.
We saw 4 patients today. One homeless, one with no water or electricity (SINCE KATRINA…), one with a home and car and family and somewhat normal-ish looking life, and one who was so young it made me upset. All four with different backgrounds, but all with one debilitating disease. It was so sad, but it is reality. Almost every single patient has a case manager with a social worker trying to help get housing, food, water…anything.
Three of them left with a case of Ensure Plus to help maintain or gain some weight. Leigh Ann says she has a grant which allows her to purchase cases for the patients if BMIs (calculation based on weight and height) are below 20. They can get this once a month and some patients twice a month if the situation is bad enough. And trust me, most of them are that bad.
Food safety is another issue with these patients. If CD4 (glycoprotein found on the surface of T cells that help fight off infections) is below 200 then food should basically be overcooked because a bacteria that wouldn’t normally harm you or me would kill these patients. I saw a patient today with a CD4 of 19. If the patient didn’t finish the Ensure in one sitting, it had to be throw away within the hour. The patient’s immune system, or lack there of, wouldn’t have a clue what to do if bacteria got in.
Tomorrow we are off to the Neuroendocrine unit at Ochsner Kenner location. And back to HIV Wednesday and Friday. Good news: I have Thursday off!
Until next time! Eat Smart and Move More.
And don’t take water or electricity for granted. Just think if you didn’t have the means to pay for it since Katrina. Puts things in perspective.