New Year’s Eve 2017: my sixty-fifth birthday. As I write this, slightly more than a month before the dreaded day, I wish I could say that I’m eagerly anticipating a lovely fun-filled celebration. But I know better. I will most likely spend the day in bed with the covers pulled over my head, wondering, What the hell happened?!
Not that long ago—although it seems a lifetime away—I was a very active, respected wrestler and amateur MMA fighter—I have a championship belt hanging on my wall that I won in an eight-man MMA tournament in 2001 at age forty-eight. Today, my bones are so brittle and fragile that I cannot lift or carry anything weighing more than a few pounds. I am forced to unlearn decades-old habits, like…bending over. Recently I bent over to tug the corner of a fitted sheet onto my bed’s mattress, and caused a compression fracture in my spine. I cannot even bend over to remove clean dishes from the dishwasher without fear of another compression fracture (and my third very expensive surgery). From ten years ago, when my height was last measured at the DMV, to today, I have shrunk from 5’8” tall to 5’4”. My used-to-be very strong legs—once powerful from thirty years of hiking up and down the hills of San Francisco—have weakened so much that I cannot climb the three steps to get onto one of San Francisco’s light-rail trains; I must utilize the raised platforms designed for wheelchair users and strollers to board a train. Adding to my humiliation, my fiancé Rick has had to take sole responsibility for household chores that, for many years, either I did exclusively or we shared—grocery shopping; laundry; house-cleaning; making the bed. In short, I have become as close to “useless” as a functioning human being can get short of being an invalid.
And it sucks. It sucks big time.
Aging may have brought me some level of wisdom (debatable) and success as a writer (less debatable) but it has also brought me—as it has brought innumerable other survivors—debilitating pain, great expense (nearly $3,000 in insurance co-pays and medications in ten months), and humiliation.
Now, I realize that a lot of this bodily deterioration can be attributed simply to the natural aging process. I get it. But I have to wonder how much the aging process has been exacerbated, accelerated by my having been HIV-positive for twenty-eight years.
The research on aging with HIV is incomplete, of course. It is a field of inquiry that no one ever even imagined until just a handful of years ago when the medical community seemed to awaken to the fact that we HIV-positive folks didn’t all die in the 1980s or ’90s when we were supposed to. But the preliminary results of that fledgling research are indeed scary.
According to the U.S. government’s website HIV.gov, while effective antiretroviral medications have greatly lengthened life expectancy for those of us who are HIV-positive, “HIV appears to increase the risk for several age-associated diseases,” such as cardio-vascular diseases (partially due to changes in lipid profiles caused by some HIV medications), lymphoma, type 2 diabetes, lung diseases, cognitive difficulties (such as memory problems, loss of brain volume), and certain cancers (remember the subject of a previous column of mine, “Tommy, My Tumor”?). People with HIV have a higher-than-average risk of osteoporosis and fractures (oh, really? tell me about it!). Many of us are more prone to kidney failure due to enhanced susceptibility to infections such as hepatitis B and C. Polypathology (a combination of two or more of these conditions) can and does occur in the HIV-negative population, of course, but according to a July 12, 2016 article in VeryWell magazine, it seems to occur in HIV-positive folks some fifteen years earlier than in the general population, with symptoms of polypathology beginning at age forty instead of fifty-five.
According to that article, “It may seem strange to read that an HIV infection can cause premature aging, but it seems to be true. Furthermore, premature aging isn’t simply a matter of HIV causing a series of symptoms that are usually found in older adults. Instead, the overall health of individuals with even well-controlled HIV infections is similar to that of people without HIV who are approximately 15 years older.”
Sixty-five is the new eighty.
Of all the unintended consequences of surviving the Plague, this accelerated aging and its debilitating effects have been the most challenging for me to deal with. I’ve defeated the isolation and loneliness that haunts us survivors by becoming active with social groups here in San Francisco. I have come to grips with my grief over losing dozens of friends, wrestled it to the ground, and pummeled it into submission. And I am certain that the opportunity to revive my writing career has saved me from rapidly losing whatever cognitive ability I can still claim. I am grateful for those things—grateful for the fact that I am not half-crazed with grief and loneliness. And perhaps in future, in whatever time is left me, I will learn to be grateful for that time, no matter how painful and humiliating it promises to become. Perhaps.
Meanwhile, please excuse me if I don’t celebrate turning eighty at the end of my sixty-fifth year.
Hank Trout, Editor at Large, edited Drummer, Malebox, and Folsom magazines in the early 1980s. A long-term survivor of HIV/AIDS (diagnosed in 1989), he is a thirty-seven-year resident of San Francisco, where he lives with his fiancé Rick. Follow him on Twitter @HankTroutWriter.