So much stress, even livesavers squirm

There are times when University Medical Center nurse Robin Parks wants to leave her patient's room and howl in frustration.

It doesn't happen as much now, but it still happens.

Mothers and fathers, sisters and brothers, ask her why their loved one is so ill, but her patient has told her that if she shares the truth he will be disowned, and his family will stop visiting him.

So she respects his privacy and talks instead about an infection the patient is often battling.

Pneumocystis jiroveci is an organism that rarely causes problems in people with healthy immune systems. But in people living with HIV, the virus that causes AIDS, it causes a dangerous opportunistic infection called pmeumocystis pneumonia.

"Some families just can't handle the stigma of someone close to them having HIV, but pneumonia's OK," Parks said recently as she sat in a bookstore and talked about her work. "HIV would fracture a family. You hate to think there are families who can't express their love to someone with the disease, but it's still happening. When I'm in this situation, I want to go into another room and scream, but I can't."

In November in Maryland, the 48-year-old Parks, a licensed practical nurse, received the highest award for a nurse who cares for HIV and AIDS patients, the Distinguished Service Award presented by the National Association of Nurses in AIDS Care.

Her knowledge of how to care for AIDS patients surpasses that of many physicians, according to Dr. Jerry Cade, co-director of UMC's HIV Program.

In August, the federal government issued a report that estimated 1.2 million in the United States have the disease, with 42 million people living with HIV or AIDS worldwide. Three million die yearly from AIDS-related illnesses.

As clinicians learn more about how HIV, or the human immunodeficiency virus, works, researchers have developed new drugs to slow progress of the disease into AIDS, or acquired immunodeficiency syndrome, which is always fatal. Many patients must be hospitalized to fight off infections. In Las Vegas, UMC sees the majority of cases.

More than 290,000 U.S. women have the disease, infected largely through heterosexual sex and injection drug use.

Men who have sex with men are most at risk of HIV, with 61 percent of new cases in 2009 affecting 29,300 of these men.

One gay man who has been in Parks' care said he has been moved by her devotion to HIV patients.

"She makes you feel you're still a good person," he said.

Afraid his parents would ostracize him, he has never told them that he is gay or HIV positive.

That kind of secrecy, Parks believes, causes an unnecessary stress in patients that may make it more difficult to fight off the disease. One of her patients, she said, shot himself rather than reveal to his wife that he had the disease.

Despite that, she said the days of people being paralyzed by fear of the disease seem largely over. Eighteen years ago, as she worked to save the life of a patient vomiting blood, other doctors and nurses wouldn't help her.

"They wouldn't help because they were scared about how you could get the disease," she said. "That patient died in my arms. The response by our medical team would be different today."

The virus is basically spread through high-risk behaviors, including unprotected oral, vaginal or anal intercourse and by sharing needles to inject drugs or to create tattoos.

It is not always a good thing, Parks said, that people have less concern for HIV. She frequently sees prostitutes with the disease, both men and women, who say they get paid more not to use condoms.

"If you're going to have sex with someone you don't know in this town, you better use condoms," she said.

According to government statistics, more than 10,000 people in Nevada, the vast majority in Las Vegas, are known to be living with HIV or AIDS.

About 16 years ago, a needle that Parks used on an HIV patient ricocheted off the man and into her finger.

"At first, I freaked," Parks says. "I took medications to fight it off and luckily I didn't get it."

A grandmother now studying to be a registered nurse, Parks says she loves her work.

"There's always new medications, new treatments to learn," she said. "I'm now seeing patients live 20 years or longer. And they're living long enough to die of something like heart disease."

Paul Harasim is the medical reporter for the Las Vegas Review-Journal. His column appears Mondays. Harasim can be reached at pharasim@reviewjournal.com or 702-387-2908.