in her office. Five minutes later, I was sitting across from Dr. Vandoren’s desk again, my dads at my side.
“So, the next step is to determine treatment,” Dr. Vandoren said after introducing herself to my dads and explaining the test results to them. “I would like to see you once a month initially, to monitor the decrease in your RNA viral load. Does that sound reasonable?”
I nodded, although the thought of getting eight vials of blood taken every single month wasn’t exactly appealing.
“And after the first few months, if everything is going well, we can reduce our meetings to once every three months.”
“That sounds good,” I said, and meant it. I liked Dr. Vandoren, and I trusted her. I would do whatever she said.
“The last thing I want to discuss with you today, Lucy, is medication. There is a lot of debate throughout the medical community on the best time to begin drug therapy. Some physicians believe it is best to wait until the CD4 count dips below three-fifty, because the side effects of the drugs can be tricky and they want to give their patients as much time as possible without having to deal with them. I, on the other hand, am of the ‘hit hard, hit early’ school of thought.”
“What does that mean?” Dad asked.
“It means that even though Lucy’s CD4 count is high, I think it’s beneficial to begin medication immediately. We’re only thirty or so years into researching this virus, but studies thus far have shown that the death rate is almost twice as high when medication is deferred. If we start Lucy on a therapeutic regimen now, she could live a very long life,” Dr. Vandoren said firmly. “However, I can only recommend what I think is best. The decision ultimately lies with you.”
“What kind of side effects are we talking about, exactly?” Papa asked.
“As with any drug, they vary from person to person and are difficult to predict, but the more common side effects include rash, headache, fatigue, drowsiness, dizziness, strange dreams, trouble sleeping, diarrhea, and vomiting. But these usually go away after a few weeks. Other more serious possibilities can include loss of fat in your arms, legs, or face, shortness of breath, pancreatic inflammation, and skin discolorations,” Dr. Vandoren stated matter-of-factly, without even consulting a cheat sheet.
Dad sucked in his breath. “That doesn’t seem very pleasant.”
“Which is why many patients decide to defer treatment. However, think of it this way: as unappealing as these possible side effects may seem, for individuals with HIV and AIDS, the ultimate side effect of no medication is death.” Her last word echoed around the room.
Oddly, even though she was throwing around words like “death,” I felt safe in her hands. I looked to my dads. “What do you think?”
“I think we should start the meds,” Dad said, nodding with conviction. “Seth?”
“I agree,” Papa said. “But what do you think, Lucy?”
I thought about Roxie—nineteen years and still no sign of AIDS. I nodded. “Hit hard, hit early.”
31
There’s a Fine, Fine Line
Alone again. Naturally.
Wasn’t there a song about that? I should have learned to play it—it was my theme song lately.
I didn’t hear a single peep from Ty all weekend.
And even though there was so much other stuff—more important stuff—going on, my brainwaves were consumed by him.
Saturday night, I began my medication. I had to take it on an empty stomach, and Dr. Vandoren made it clear that because it could make me feel sick, it was best to take it before bed rather than in the morning. So, starting now, ostensibly for the rest of my life, I would have to stop eating by eight p.m. in order to take the pill at ten.
As I took that first pill, I wasn’t thinking about the side effects or what this meant for my life. All I could think about was Ty. Would he notice if I started feeling sick all the time? If he asked me out to dinner, would he think it was weird when I told him I had to go on the early side? Maybe I should keep the prescription bottle hidden, in case he saw it the next time he was in my room…
The pill slid down my throat, and for an instant, everything remained still.
My dads and I looked at each other. It was like we were waiting for something to happen, like I would immediately look healthier or something. Or sicker. But everything was the same.
Papa spoke first.
“All right, then,” he said,