I’m Coming Out
After the battles quieted, there was still the smoke
by John Francis Leonard
I’ve fought many a personal battle in the past fourteen or so years. I was diagnosed positive for HIV in 2003; that was tough. Just as tough was a soon to follow diagnosis as Bipolar I. There were dangerous and reckless episodes of mania (uncontrollable elevated mood), deep wells of depression, three suicide attempts, and subsequent hospitalizations. I’m medicated and well treated now, but it’s not perfect. I still struggle some days. I also had a long history of partying with excessive recreational drug use. Once I put that behind me there was a new demon, the many addictive drugs prescribed by psychiatrists and my heavy dependence and abuse. I put that behind me as well but again, I still struggle. To top off this rather gothic medical history, four years ago, I suffered a major bursting of a brain aneurysm that my highly experienced neurosurgeon says brought me closer to death than he’d ever seen. Don’t feel sorry for me though, I’ve come out the other side, stronger and tougher. These things have cost me much, a successful career in business, relationships, and a great deal of income. What I have done, slowly but surely, is build a new life for myself. There’s a new career in writing, which I love and hope to take further. I have a new relationship, new friendships. I’m a very lucky man.
But, as if that all weren’t enough, I’ve chosen a dangerous path. This one could end up negating all the hard fought battles I’ve won. I would have liked to have kept it a secret, but I couldn’t hide it completely to begin with. In writing this month’s column, I hope to sound its death knell. This past summer I’ve been struggling with a dangerous habit, smoking. Sometimes a lot, sometimes a little, stopping completely for brief periods, but picking it up again. They say that we’re only as sick as our secrets, so I’m putting this out there. I’m not proud of it, I’m literally mortified as I type this. But, I haven’t come this far, and been through so much to be down for the count now. I will win this battle as well.
It started slowly and insidiously, borrowing a cigarette here and there. I don’t know why I did it. I hardly enjoyed it—I was too ashamed. I did smoke for a brief period in my mid-twenties but gave it up more because of vanity than anything else. It was the late nineties and, suddenly, it just wasn’t socially acceptable any longer. I admit, that’s still a big motivation for me, embarrassment, but there are more important factors at play now. First, my health, I’m living with HIV after all.
Overall, tobacco use is the leading cause of preventable deaths in the United States. I think we all know the dangers. When you combine HIV with smoking, you’re adding gasoline to a fire. When a person who is positive smokes, they are many more times more likely to suffer from smoking-related, deadly diseases such as chronic obstructive pulmonary disease, or COPD, heart disease, and stroke (oh, remember that aneurysm?), as well as lung cancer, head and neck cancer, and cervical and anal cancer. HIV-positive individuals are already at higher risk for anal and other cancers. Then there are the HIV-related diseases such as thrush, hairy leukoplakia (white mouth sores), bacterial pneumonia, and Pneumocystis pneumonia, just to name a few. The risks are greatly increased. Overall, smokers with HIV lose more years of life to cigarettes than the disease itself, even when their HIV is under control and undetectable through medication. It’s the perfect storm.
What’s really troubling? The rate of smoking is two to three times higher for individuals with HIV. That’s a startling statistic, one I was shocked to learn when researching for this piece. But I can do it. We can do it. What I won’t do is be motivated by a sense of shame. As a younger man, I let shame and a sense of inferiority motivate me far too often. I strove for the perfect body, the great career, the perfect boyfriend, all because I never thought I was good enough. Not anymore. I’m going to let common sense drive me this time as well as a healthy desire to keep living and survive. I knew and witnessed too many people whom I loved go far too soon. They didn’t have the luxury of choosing to live. It just wasn’t an option in the earlier days of the plague. I’ve overcome a lot so far, and I’m not going to give up now.
Individuals with HIV are under more stress, making it harder to quit, but we can do this. Here are some resources:
• The CDC has a helpline: 1800-QUIT-NOW
Or, simply Google ‘HIV smoking’ for more information and help. Better yet, have a conversation with your healthcare provider or social worker.
John Francis Leonard is an advocate and writer, as well as a voracious reader of literature, which helps to feed his love of the English language. He has been living with HIV for thirteen years and he is currently at work on his first novel, Fools Rush In. Follow him on Twitter @JohnFrancisleo2.