Personal Views

Breathless uncertainty

BMJ 1995; 310 doi: (Published 21 January 1995) Cite this as: BMJ 1995;310:199

Pneumocystis carinii pneumonia creeps up on you slowly. Although I had known that I was HIV positive for nearly 10 years, I did not recognise the signs of gradual deterioration in my health in early 1993. Repeated bouts of genital herpes were painful and I noted a slight reduction in my appetite and energy. I lost my enthusiasm for working out in the gym and was irritable and bad tempered at work. Dismissing the way that I was feeling as due to pressure of work, I did not mention any of these things to my consultant when I saw him for my regular six monthly check up. We had not kept a very close eye on my T cell count, but on that occasion we discussed it as the last count had been around the 200 level. I did not appreciate the importance of this and thought that I would like to carry on as before. We did not discuss prophylaxis against pneumocystis carinii pneumonia, something I was unaware of.

In May I began to notice that I was slightly breathless but put this down to air pollution. The dyspnoea was inspiratory and slight but gradually increased over the next three weeks. I particularly noticed it when I yawned; my breath would come in staccato gasps. Laughing became a strain but I had no pain in my chest. …

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