AIDS treatment making progress

By Ed Koch

Saturday, Sept. 3, 2005 | 2:47 a.m.

WEEKEND EDITION

September 3-5, 2005

Nine years ago, AIDS patient Lane Olson lay in his bed at the University Medical Center on the verge of death from pneumonia.

Family and other friends gathered around him to say goodbye. As Olson went into convulsions after his fever hit 105 degrees, the last thing the then-32-year-old Las Vegan saw was the wide-eyed, open-mouthed fearful expressions on the faces of his loved ones. Then everything was dark and quiet.

But that wasn't the end for Lane Olson, thanks to the dedication of the doctors of the UMC Wellness Center, which last week observed its 20th anniversary.

Olson awoke days after blacking out to find at his bedside the directors of the UMC Wellness Center Dr. Jerry Cade and Dr. Jim Christensen, whose experience in early AIDS treatment helped save Olson -- albeit with a radical treatment.

They pulled him from the throes of death by using small doses of an antibiotic to which Olson was allergic to desensitize his condition and clear up his pneumonia.

It was a risky, last-ditch effort that hospitals in other communities that do not have a dedicated AIDS center like the one at UMC, might not have had the knowledge or fortitude to try, Cade said.

Olson, 41, who today takes modern AIDS drugs that keep his disease in check and allow him to live an active life, simply says the center "was my lifesaver."

Seventeen years after being diagnosed with HIV, the virus that causes AIDS, and 10 years after being diagnosed with AIDS, Olson is an outpatient of the UMC Wellness Center. He has not been hospitalized since his near-death ordeal.

Cade, who in 1994 co-founded with Christensen the Nevada AIDS Research and Education Society, says Olson's story is not uncommon for people living with AIDS today.

"Twenty years ago, we were hospice doctors, helping patients die as comfortably as possible," said Cade, a general practitioner who in the early 1980s decided to focus his career on AIDS treatment after "seeing too many friends die and too little being done to help them."

"Fortunately, with the drugs that have come along since 1995, we have had to switch gears. Today, 99 percent of our HIV/AIDS patients are outpatients. They are living longer lives. AIDS is no longer a death sentence."

About 8,000 Nevadans are HIV-positive, with 80 percent of them living in Southern Nevada, said Caroline Ciocca, executive director of the advocacy organization Aid For AIDS of Nevada (AFAN), which shares the same building at Rancho Drive and Sahara Avenue that houses the UMC Wellness Center.

Ciocca and Cade noted that, of the estimated 6,000 HIV-positive Southern Nevadans, only about half have been diagnosed and are receiving treatment. The other half have not been tested and are unaware they are infected, they said.

Nearly two thirds of the people diagnosed with AIDS in Southern Nevada are treated at the Wellness Center, Cade said.

"The UMC Wellness Center has done an amazing job keeping up with the growth and treatment of HIV and AIDS patients here," Ciocca said.

As part of the center's services, it provides, with the help of federal and state grants, the lifesaving drugs at a discounted price or free to those patients who cannot afford them.

Olson well remembers the time when he needed such financial help.

"I had just lost my job after my boss found out I had AIDS, and I had to go on disability," Olson said, recalling how, before his insurance ran out, he got $1,000 worth of the drugs per month for a $30 co-pay. "The center's AIDS Drug Assistance Program got me the drugs for free."

Today, Olson maintains two part-time jobs, including working as a coffee maker in a coffee shop, and pays $200 a month in co-pays for his anti-AIDS drugs.

But, despite the medical improvements, Olson says life is not a cakewalk when you have AIDS.

"I recently had to change some of my medication and, because of that, I've had diarrhea, night sweats and other complications," he said. "It is a hassle living with AIDS."

Olson, who also does volunteer work for AFAN that includes handing out condoms at bars and other locations to promote safe sex, takes seven pills a night, down from the 20 pills he had to take throughout the day a few years ago.

"I encourage people to have safe sex to avoid getting AIDS," he said, quoting estimates that about 78 percent of HIV cases today result from people having unsafe sex. "I feel I should give something back by helping educate people about this disease."

Cade said educating the public remains a priority because there are 40,000 new cases of AIDS each year in the United States -- a number that has remained steady since the mid-1990s when it dropped from a record 70,000 new cases a year.

"Despite all of our education efforts, we have not seen the numbers of new cases go down, and there was even a blip up two years ago," Cade said, noting that either unprotected sex with an infected partner or sharing hypodermic needles during narcotics use account for nearly every new case.

And, he said, the jury is still out on whether Olson and other afflicted people will live a normal life span even though the newer drugs are far superior to the early AIDS drugs such as AZT.

"We are seeing side effects of the modern drugs that could affect longevity, such as more early adult onset diabetes, patients with higher fats and cholesterol (in their blood) and a greater risk of heart attack," Cade said.

However, because of modern drugs, Cade said doctors also are seeing positive signs that show today's AIDS patients are a lot healthier than those of a decade ago.

"Our goal in Las Vegas is to ensure that no person infected with HIV/AIDS goes without the medical care that he or she needs, as well as the love and compassion that he or she deserves."

Cade emphasized "she" because AIDS, initially thought of primarily as a gay men's disease, does not sexually discriminate when it comes to its victims.

Ciocca, quoting statistics from the Centers for Disease Control and Prevention in Atlanta, says a major focus of her group today is on women because new HIV cases for women are up 15 percent compared to a 1 percent hike for men.

When the Wellness Center was founded on Aug. 29, 1985, in the form of an AIDS inpatient treatment unit at UMC, only a few major cities had hospitals that had dedicated HIV units, including San Francisco and New York, UMC officials said.

UMC's inpatient HIV/AIDS unit has grown from 12 to 36 beds over the last 20 years. The hospital's first formal outpatient clinic was established in December 1986, primarily to provide AZT to patients.

"We have come a long way since 1985," Cade said. "Although the fear of HIV/ AIDS still exists, most people understand how HIV is transmitted and, more importantly, how it is not transmitted."

Each of the four times the center has moved, it has gone to a larger facility. Plans are to move in two years from its current site, 2300 S. Rancho Drive, Suite 203, he said.

Cade said the Wellness Center's success can be credited in part to the commitment of the Clark County Commission, which serves as the UMC board, to AIDS care since the early 1980s, and to the center's dedicated staff of doctors, nurses and others.

One employee in particular was Dr. Lisa Bechtel, the center's former medical director, who died in 1994, a year after contracting AIDS from an accidental needle puncture while treating a patient.

Ironically, the first AIDS protease inhibitor -- the protocol for treating people immediately after being exposed to the disease -- was made available in 1995 and would have saved her life, Cade said.

Bechtel, who was credited with revamping the AIDS clinic and making it more responsive to women and children with AIDS, continues to be an inspiration to patients, medical personnel and AIDS activists.

At the 1994 American Civil Liberties Union of Nevada awards ceremony, Bechtel was posthumously given the Humanitarian Services Award. At the ceremony, Cade, then the inpatient AIDS clinic director, urged those in attendance to carry on the fight in Bechtel's memory.

The UMC Wellness Center has carried that torch high, proponents say.

"The Wellness Center serves as a symbol that we have a caring community," Ciocca said. "The center has not just stayed in a bubble treating patients physically, mentally and emotionally, but also has played a major role educating the community about AIDS and removing the stigma of the disease."

Olson long struggled with that stigma before informing his loved ones he was afflicted.

"I was adopted when I was young, and I was ashamed to tell my mom and dad I had AIDS because I felt I had let them down," Olson said.

"But I am a very fortunate person because I have a good family and friends who stood by me. They and the Wellness Center got me over the stigma of having AIDS so I could live a fuller life."