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AIDS patient warns others.

It is better to light one small candle than to curse the darkness.-Chinese proverb AIDS Patient Warns Others

If you are planning major surgery, Dorothy Polikoff has advice for you. Ask your doctor about predonating blood or about Autologous intraoperative transfusion.

We applaud her courage in trying to prevent others from suffering her fate. She removed tissue to blot her eyes while telling her tragic story -its impact moved some in the audience to tears. "She reminded me of my grandmother," one said. Mrs. Polikoff has three grandchildren.

Her story as she presented it to the AIDS commission:

"My name is Dorothy Polikoff. My husband, William Polikoff was a World War 11 veteran. He survived the Bataan Death March and was a POW for 3-1/2 years, but he did not survive AIDS. He died December 9, 1987. His death was unnecessary, and I will explain to you how his death from AIDS and my infection with the AIDS virus could have been avoided.

"I am 63 years old and was infected with the AIDS virus from my husband, who died several months ago from the complications of transfusion-related AIDS. He was transfused in 1984 during cardiac bypass surgery while under the care of the Veterans Administration Hospital in San Diego. His surgery was performed under their auspices at University Hospital in San Diego, where he received three units of blood. At that time, University Hospital had available the equipment to perform intraoperative transfusion, but it was not used for my husband. If this technique had been applied, he would not have needed to receive someone else's blood, and neither of us would have become infected.

"Unfortunately, none of our doctors ever mentioned that there were alternatives to homologous transfusion. The possibility of AIDS infection was never discussed.

"My husband never fully recovered from that surgery, and at that time neither of us understood why. He was hospitalized on various occasions since then. In June of 1986, I became seriously ill and was diagnosed as having hepatitis B. Bill was tested two days later and was told he was a carrier. I spent the rest of that year fighting for my survival, still unaware that both of us were infected with the AIDS virus.

"A few months after my release from the hospital, after reading articles about AIDS being transmitted by blood transfusions, both Bill and I asked our doctors if we could be tested for AIDS. They told us that there was no need to worry or that it was not necessary, but neither of us was completely reassured.

"One day, we passed by a health fair that was distributing condoms and information about AIDS at the VA Hospital. They advised us to go to the county health department to be tested for the AIDS antibodies, which we did on March 12, 1987. In the meantime, Bill had developed a tender lump under his arm and had gone to the VA emergency room, where he was treated with antibiotics. Since the lump did not disappear, he was scheduled for a biopsy on April 2, which coincidentally was the same day we were scheduled to return to the health department to learn about our AIDS-antibody test results. On the day that Bill was admitted for his biopsy, we learned from the health department that we had both tested positive for the AIDS virus. We brought the slips to our doctor and told him the results. We were both upset. I was almost hysterical. I couldn't believe what I was hearing, and Bill was furious.

"Not only had the doctors at the VA hospital refused to test us for the AIDS infection when we requested it, but they made the diagnosis even more upsetting by implying that I had been unfaithful rather than acknowledging that the transfusion was responsible for both of us having hepatitis B and AIDS. The doctors later apologized for these remarks.

"Bill got sicker and sicker. His disease progressed rapidly, and during the last months of his life, there was extensive central-nervous-system involvement, resulting in AIDS dementia-a very difficult death.

"I have symptoms now and the disease frightens me, but what frightens me even more is how I will manage when I get sick and need medical treatment. I will not receive care for AIDS from the Veterans Administration unless I pay for it, even though I have this disease as a result of the treatment my husband received through the VA. He became infected through transfusion, but my infection could have been prevented if any of the many doctors we saw had cautioned us not to have sex. As we became aware of the possibility of AIDS through the media, we stopped having sex, but by then it was too late. As it was, we had sex infrequently, perhaps five times after his transfusion. It would not have been a great deal to give up had we only known.

"Although nothing can be done to bring my husband back to life or to restore my health, I hope our experience doesn't go to waste and can be used to prevent situations like this from ever having to happen again. That is why I am telling our story. There are things to be learned from our experience. The whole unnecessary tragedy could have been avoided if intraoperative transfusion had been used instead of homologous blood. I feel that we should have been tested as early as possible after the transfusion was given and advised not to have sex until the results were known. This would not have saved Bill's life but could have saved mine. Instead, no one would deal with the issue, and we had to make the diagnosis by ourselves.

"Because the Veterans Administration will not take financial responsibility for my medical care, my resources will eventually be exhausted as this disease runs its course. Without help, I will die indigent and without proper medical care under circumstances that seem to me worse even than the disease itself. My fear of this robs my peace of mind and drains my strength. I try to be strong and face this disease with courage and determination, but I am haunted by remembering how my husband died and live in dread of the same fate for myself. I hope you will take steps to prevent this from happening to anyone else."

Anyone wishing to reach Mrs. Polikoff may do so by writing to her c/o The Saturday Evening Post.

Traveling Toothpick

Dear Dr. SerVaas:

We thought you might be interested in hearing about my husband's "high-Aber diet"-a large round wooden toothpick.

I imagine medical history is full of people who suffered various results from swallowing toothpicks, but I don't believe many of them have reappeared in the leg!

The toothpick was removed on March 11 by Dr. Charles Schafer. It had exited the colon through a diverticulitis pocket that had herniated into the hole in the pelvic bone (where the nerve leads to the thigh).

It was lying on the femur next to the nerve. This has left a large open wound which we change bandages on three times a day after flushing out with water. Fortunately, as a biology teacher I'm not squeamish!

Dr. Schafer plans to write this up for a medical journal as he first spotted this toothpick last fall while doing a colonoscopy for removal of polyps. At that time it was wedged tight across the colon, and his biopsy tool wasn't heavy enough to loosen it.

A few days later he set up the video camera to remove it with another tool only to find it was gone! Naturally, we thought it had passed rectally, and none of the many doctors ever thought my husband's continuing abdominal and leg pains were due to a toothpick.

There are a lot more strange details to the toothpick story, but I won't elaborate. (This is almost like hauling out the pictures of the grandchildren to display to the stranger in the elevator.)

If you are interested in this, you could contact Dr. Schafer. He was as excited about Finding that toothpick again as a first-time father!

Helen Boertje

Pella, Iowa

Bad Eggs

Dear Dr. SerVaas:

How long do you have to cook eggs to be sure there isn't any salmonella food poisoning in them? We heard there was an outbreak, and we live in the Northeast.

Janice Wilson Boston, Massachusetts

One study has suggested that boiling for at least seven minutes, poaching for five minutes, or frying on each side for at least three minutes is sufficient to kill the salmonella. It isn't possible to ensure there's no salmonella if you prefer your eggs sunny-side up. Since the salmonella outbreak in the Northeast, we haven't been ordering Caesar salad, because it's made with raw egg whites. Other foods to avoid if you are concerned about salmonella are ice creams, hollandaise sauces, eggnogs, and pies with meringue.

The Centers for Disease Control isn't sure why there has been an outbreak of salmonella in the Northeast. Eggs are suspect (even clean grade A), but not for all the salmonella in the outbreak.

Retin-A: Its Promise and Pitfalls

The topically applied drug Retin-A is one of the most talked-about developments in the war on aging, Approved by the FDA in 1971 for the treatment of acne, it was recently found to be effective in reducing age spots and wrinkling caused by overexposure to the sun. Not everyone, however, should be using it, and those who choose to should do so only under the care of a dermatologist.

Retin-A is a substrate of vitamin A. Its exact mode of operation is not known, but it is able to effect changes through the two layers of the skin. It is believed that Retin-A stimulates the growth of new collagen in the papillary dermis layer. The epidermis above it thickens slightly, and it accelerates the sloughing of the outer dead cells. Moreover, capillary blood vessels in the treated areas dilate and new ones are formed, thus giving the skin a rosy appearance. This renewed vigor of the skin helps fade age spots, fill out small wrinkles, and smooth the skin's texture.

Results may begin to appear within a month, and the skin may continue to improve for one to two years. Retin-A's renewing action is more effective on fine wrinkles than on deep lines.

Qualified medical supervision is important because overuse of the drug can cause redness, swelling, and even blistering of the skin. Heightened sensitivity to certain cosmetics and to the ultraviolet rays of the sun is a complication that needs to be considered. It is stressed that Retin-A is not a sunscreen and does not prevent sunburn. In fact, exposure to the sun should be avoided; it can be minimized by the use of sunscreens. As the skin becomes more sensitive to drying, proper use of soaps and moisturizers is also necessary. The adverse effects of Retin-A, however, have been reversible upon discontinuation of therapy.

Avoid using someone else's supply of Retin-A, because usage levels that can be safely tolerated vary widely from person to person. Women who are considering pregnancy or who are nursing should avoid using this drug because pregnancy studies have not yet been done to determine its safety.

Remember, many wrinkles and age spots can be avoided simply by protecting yourself from too much sunlight.

Answering the Call

Dear Dr. SerVaas:

When I phoned the AIDS hotline for specific answers about AIDS, they told me that they did not have the information I wanted and referred me to my local county health department, who didn't know the answers either. I then tried state health officials and in desperation called the National Healthline in D.C., and they didn't know! So I wrote to CDC in Atlanta, and they either ignored or circular-filed my letter. All that took about three months.

While reading The Saturday Evening Post, I noticed that a) there have been many articles about AIDS over the past year, and b) that you are indeed a medical society. I phoned and was immediately put through to a counselor who answered all my questions in laymen's language (which I deeply appreciated).

It occurs to me that the questions I was asking are those things that housewives all across the United States need to ask in order to deal with the AIDS problem. Questions about transmission of AIDS through swimming with those who are infected. Questions about the temperatures and mediums necessary for the virus to live. How you kill the AIDS virus, etc., etc., etc. And kissing and what are its dangers with AIDS. The counselor you have should write an article for your magazine which deals with this type of information-and The Saturday Evening Post should carry a column in each issue outlining new information concerning HIV.

Mothers and fathers want to give their teenagers the information they need about AIDS, but most of that information isn't easy to get. All of us who are homemakers need to know how to disinfect against HIV; we need to know just how this beastie acts in order to protect our families.

For the love of God, I beg of you to get this information into the hands of the housewives and mothers of America -help us help and protect our families! I am very assertive and verbal, and I will continue to yell and squawk until I have the proper answers. But most women aren't that verbal or assertive or persistent. They are the majority, and their unanswered questions about AIDS are no different than mine.

You have it in your power to disseminate the information that the general public doesn't have about AIDS. Not to do that would be to take responsibility for a great deal of needless human suffering and death. Please look to your conscience.

If your counselor can write as well as he can explain over the telephone, then you already have on your staff the person who can do the job.

For all you have done concerning HIV, I thank you. For all I hope you will do, the homemakers and mothers of America will bless and remember what you have done long after others less courageous are forgotten,

Jessie L. Burke Tarpon Springs, Florida

Keep on being assertive. Pass information on to "letters to the editor" columns of daily newspapers. Speak out. Ten percent bleach solution kills the AIDS virus. Unfortunately, the most common cause of spread is by sexual transmission.

Foot Sore

Dear Dr. SerVaas:

I want to say I really enjoy all the articles and stories in The Saturday Evening Post. I have been a subscriber for about a year now. I do have a question and I hope you can help me.

I have very flat feet and my ankles are pronating over so bad. Do you know of anything to do for this? If I put shoe inserts or arch supports of any kind in my shoes, it throws them over to the inside even worse. It is hard to find shoes, plus it is getting harder for me to walk because my foot lands on the protruding bone on the inside of my feet.

I keep hoping and praying they will come out with laser surgery to correct this condition.

Your articles are so interesting in your "Medical Mailbox," and I know you help many people.

Name withheld Connersville, Indians

I am enclosing the names of two good board-certified orthopedic physicians who are not far from your area. I am sure either of them could give you some good advice on the best strategy for minimizing your problem. I have also enclosed the names of two good podiatrists. Either of them might also help.

Hair Fallout

Dear Dr. SerVaas:

I am writing to ask your opinion concerning the treatment of alopecia areata. For about the last three months my 18-year-old daughter has been losing hair above her left ear. She has approximately a 2-1/2- to 3-inch in circumference bald spot. Our family doctor said there was no treatment-the hair would grow back. We decided to get a second opinion as we were seeing no growth and the spot was getting larger. We drove " miles to see a dermatologist. He immediately said she would need a series of at least four injections (around the bald spot) of cortisone. I felt rather uneasy about getting this treatment without doing some investigation. The doctor assured me that the injections contained only a little more cortisone than the body produces by itself every day. He also said there would be no side effects. 1 was not totally convinced, so he gave my daughter some Elocon ointment to apply to the spot but said he didn't think it would be enough to stimulate hair growth in such a large spot. He said if we didn't see new growth in a month she would need the injections.

I asked for an explanation of why cortisone would make the hair grow back but didn't completely understand all that the doctor said.

My daughter is quite concerned as you can imagine. So far she has been able to hide the bald spot but is getting worried about going completely bald.

I would appreciate any information you could give me concerning this procedure. Other than this my daughter is in excellent health. I should also tell you that the dermatologist took a culture to rule out ringworm.

Thank you in advance for any help you can give me in making a decision about whether to pursue the cortisone injections or not. God bless you!

Leta Kobielusz Wright, Wyoming

Alopecia areata is a disease that is difficult to treat because the cause is not clearly understood. You made a good decision to see a dermatologist. The treatment he recommended agrees with the findings of Dr. David Whiting, the director of Baylor Hair Research and Treatment Center, Dallas, Texas. Dr. Whiting states that for localized patches of alopecia areata in adults and older children, treatment with steroid injections into the area of hair loss is best. I would encourage you to return to the dermatologist for injections if the ointment doesn't help your daughter to grow hair.
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Title Annotation:Dorothy Polikoff's story, as given to presidential AIDS commission
Author:SerVaas, Cory
Publication:Saturday Evening Post
Article Type:Biography
Date:Jul 1, 1988
Previous Article:All work but all play.
Next Article:Hip, hip, but no hooray: fat can sneak up on its victims in a number of subtle ways - and places.

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