AIDS is a life threatening, painful disease with no current vaccine or cure. In 1981 AIDS was identified as a disease and in 1984 the virus that causes AIDS was identified. In the mid-1990s, AIDS was a leading cause of death. However, newer treatments have cut the AIDS death rate significantly. The journey from diagnosis to treatment is long with many inherent hardships. In the case of a 35 year old Native American contracting AIDS from a blood transfusion, there will be many tests, medications, therapy, health care costs and possible cultural issues and litigation involved.
AIDS stands for Acquired Immune Deficiency Syndrome. Acquired means you can get infected with it. Immune Deficiency means a weakness in the body’s system that fights diseases. Immune Deficiency means a weakness in the body’s system that fights diseases. Syndrome means a group of health problems that make up a disease. AIDS is caused by a virus called HIV, the Human Immunodeficiency Virus and is considered a pathogen. The pathogenesis of HIV begins with a profound depletion of CD4+ T cells in the gut followed by a long period of dynamic virus replication and diversification. Most healthy people have between 500 and 1,500 CD4 cells in a milliliter of blood.
The development of AIDS from HIV occurs when you have less than 200 CD4 cells. There are numerous ways one can contract AIDS some are, having sex with an infected person, sharing a needle (shooting drugs) with someone who’s infected, being born when their mother is infected, or drinking the breast milk of an infected woman and getting a blood transfusion with infected blood. The Centers for Disease Control and Prevention (CDC) estimates that 1 to 1.2 million U.S. residents are living with HIV infection or AIDS; about a quarter of them do not know they have it. This number has consistently risen over the years and will most likely continue to rise without a vaccine or cure.
Fortunately donated blood today is screened very carefully and the risk is of contracting AIDS from a blood transfusion is extremely low. A blood transfusion involves transferring blood or blood-based products from one person into another. Early transfusions used whole blood, but modern medical practice commonly uses only components of the blood. Blood transfusions are usually meant to be life-saving. Some situations, such as blood lost during surgery or when massive blood is lost due to trauma, a blood transfusion will be used to replace the blood. Blood transfusions may also be used to treat a severe anemia or thrombocytopenia caused by a blood disease.
People suffering from sickle-cell anemia or hemophilia may require frequent blood transfusions. It is possible that some of these reasons to get a blood transfusion could be avoided if one has a healthy lifestyle, practices proper nutrition, exercises and practices stress relieving techniques. Unfortunately for the Native American and his wife there is no cure for AIDS and any native Indian traditional cultural remedies attempted or visiting their Shaman would be considered quackery. But the physician will have to encourage him to talk about his health care beliefs and respect the values, attitude, beliefs, culture and autonomy of his patient and be sure to express clear communication. Communication will be especially important in treatment because in Indian culture pharmaceuticals may be stopped when he feels better, and “saved” to self-medicate if the problem recurs. Hopefully he has some type of health care service such as an HMO, IPO, or PPO to supplement high health care costs.
Health care costs have been on the rise mostly due to the rise in professional malpractice insurance, advanced technological developments, malpractice litigation, and increase in longevity and disaster relief expenses. The cost of health care in the U.S continues to increase much faster than any other factors in the cost of living. Some hospitals meet challenges of high health care cost by becoming large corporate facilities and by forming partnerships with physicians for things such as extended care. Insurance companies also established options designed to lower costs, including managed care models, increased deductibles, coinsurance, co-pay, and preventative care.
A patient receiving news of contracting AIDS from a blood transfusion would most likely cause many feelings of stress and mistrust since it was nosocomial. He may even question the medical asepsis of his primary physician and may fear going to the physician’s office after initially going in for a cough and finding out he has full blown AIDS. There will be a lot of visits to the physician for basic health assessments and tests to check for virus progression, tests will include an interview, checking vital signs, checking weight, temperature, pulse, respiration, blood tests, blood pressure and a physical assessment of appearance, cardiovascular, neurological, skin for rashes auscultation, palpation, and percussion. All of this will be recorded into a computer data base for reference. Changes in his health may require changes in treatment. The medicine prescribed for AIDS is called antiretroviral medication and is used to control the reproduction of the virus and to slow the progression of HIV-related disease.
Antiretroviral medication is usually used in combinations, and is then termed Highly Active Antiretroviral Therapy (HAART). HAART combines three or more anti-HIV medications in a daily regimen, sometimes referred to as a “cocktail”. Anti-HIV medications do not cure HIV infection and individuals taking these medications can still transmit HIV to others. So his virus will also greatly affect his wife, they will need to be cautious for the rest of their life together. This situation may include a malpractice lawsuit due to negligence. Proper medical asepsis and blood screening could have prevented this unfortunate situation, and in turn could help to keep health care costs lower as well.
In conclusion, although today the chance of contracting AIDS from a blood transfusion is very low, the Native American did contract AIDS this way. Healthy lifestyle, and proper nutrition and exercise could have prevented the need for the blood transfusion. He will need to visit his physician frequently for checkups and physical assessments and follow a strict medication regiment to reduce pain and prolong his life. Hopefully he has a health care service since costs today are very high. And he may file lawsuit for malpractice and negligence which will actually help to make health care continue to rise. Hopefully one day malpractice, nosocomial infection and AIDS will be a thing of the past, but for now it will be virtually impossible for him to obtain optimal wellness. Even with the many stress management techniques practiced today, his body, mind, and spirit will most likely be stressed for the rest of his life.
