E. Winter Tashlin

Seeking Answers [Picture Tells A Story]

Filed By E. Winter Tashlin | May 17, 2014 4:00 PM | comments

Filed in: Living
Tags: advocacy, discrimination, health care, LGBT medical care, PTAS, respiratory illness, tunnel vision

CT_scanner_PTAS.jpg

Not an artistic photo today, sorry. I've actually done some recent photography work I'm super proud of, but I can only write so many PTAS pieces based on photos of sunsets and sunrises.

For those of you unfamiliar, today's photo (taken on my cell phone) is of an x-ray CT scanner, which uses computer compiled x-ray images to created a three dimensional model of a person's insides. In this case, me, and my chest to be specific.

My respiratory health is not what one would call optimal. Between my first serious respiratory infection at age three till today, I've had well over sixty cases of bronchitis, and pneumonia at least five times (that number would be higher if not for the advent of the pneumonia vaccine).

I don't know that I've ever had "just a cold" in my life, almost any illness turns into a respiratory infection eventually. Despite working a job that allows me to set my own hours and work from home, I miss around two months of work a year due to being too sick to function, and often times once I get sick it can take weeks or months to recover fully, even with medical intervention.

This begs the question, why the hell did it take until I'm 34 years old to get to the point where a pulmonologist is ordering diagnostic imaging of my lungs?

The most simple answer is that I'm a gay man. A gay man who gets sick all the time.

As of my last test about eight months ago, I was HIV negative (Yes, I know I'm overdue). But when a doctor sees a gay man who is incredibly vulnerable to infection and can't seem to get better once he does get sick, HIV is not unreasonably the first place their mind is going to go.

Thus, for most of my adult life, doctors have looked at how I present medically, ordered HIV tests, and when they came back negative, let the matter drop. The fact that I've moved frequently and rarely had the same doctor more than a few years hasn't helped things.

That LGBTQ people face unique obstacles in accessing healthcare is hardly a secret, but my experience points to a more subtle and insidious challenge than simply being denied care or encountering doctors unfamiliar with some of our unique medical needs.

We've made real progress in the last couple of decades when it comes to getting the medical community to acknowledge the reality of our lives as people with minority sexual orientations and/or gender identities and histories. As LGBTQ people, many of us have learned to advocate for ourselves around the issues related to our identities.

For instance, several months ago I found myself explaining to my doctor just why it was important that I receive the meningitis vaccine as a sexually active gay man who regularly traveled to the New York area. There was no reason to expect her to know about the recent meningitis troubles seven states away, but she was receptive to my explanation and had no qualms about authorizing the treatment.

At the same time however, we have to remain vigilant that medical professionals don't develop tunnel vision, seeing everything in our lives through the lens of our sexuality or gender identity/history.

What finally lead me to yesterday's CT scan, began in the winter/spring of 2013, when my immune system utterly cratered. I became very ill on February 15th with what turned into extensive and hard to treat infections of my respiratory system, with secondary infections in my sinuses, eyes, and ears. It took until mid-April before I began to really get my feet under me again. In that time I had at least three HIV tests, including a comprehensive T-cell workup. In the end, my doctor was convinced that I wasn't throwing false-negatives, and that my health issues weren't sero-status related, particularly in light of my lifelong history of respiratory illness.

When I next became ill, she began the process of figuring out just what is going on. The pulmonologist's office was not my first stop, but with any luck it'll be my last. Although none of the top contenders from his differential are particularly fun.

So while I'm hopeful that yesterday's tests will yield productive results, it's hard to ignore the possibility that answers might have come along a long time ago if I was a straight guy; for all that I haven't encountered discrimination per se in my medical care over the 21 years since I came out.

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