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Fatigue and AnemiaFatigue and Anemia
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Xmas wish...Dr Bob.
Dec 27, 2001

Dear Dr Bob, my honest view: You and Dr Gallant (JH) are God send. Both of you have giving lots of inspiration and hope to HIV+ and those who fear for testing. I have been living in fear for more than 3 months after my last exposure (which, was having protected vagina and anal sex with a sex worker). My stupid ignorance was not applying any lubricants while having anal sex even though I was using brand new condom and did not check for condom breakage. Had experienced all the classic symptoms of ARS day 31, sore throat for 2 daysday 34, burning tongue for couple of hoursday 36 sore throat again for 3 daysday 40, diarrhea for 1 dayday 42, mild night sweat for 2 daysday 46, persistent swollen lymph nodes (both parotids/front ears, submental, cervical and groin)day 60, severe diarrhea for 2 days which felt like I'm experiencing wasting process! and now I'm experiencing tongue pain/sore, fatigue and possibly anemia as I'm having constant chest pain. I did not consult any doctor even after having so much symptoms and the thought of ending my life is just too strong. I went into great depression and anxiety especially after the first week of exposure whereby one of my niece (months old) got high fever for 5 days and ended with 2 days of rash after coming in contact with me (scratched me on the hand which bled after a while and then putting her finger into her mouth). I'm fearful that he has got infected too and I'm just praying that what he has is ROSEOLA. -Have you seen any individual with such strong symptoms especially accompanied by multiple swollen nodes (INCLUDING CERVICAL!) being tested negative? -Can ARS persist for more than 3 monthsor is it because of my anxiety level that affect my immune system hence making me so prone to minor sickness? -Can a child being infected through the way I described? And is it possible for a child to infect an adult with the HHV6 virus/Roseola and as a result activate the immune system causing the above symptoms? The social stigma on HIV is too strong in this part of the world where one can lose their job, family and friends. As for medication and specialists, all I can say is that it is not as advance and as liberal as it is over in the States. I envy the way it is handled in the States. Spent many hours everyday browsing through nets until I came across your site and Dr Gallant's sitewell now I have decided that it is time to face the reality. I'm ready for a test and I'm planning to do it in couple of week time. At least now I have hopes on: -A more effective medication and longer life span. But can you advise on what is the percentage of people (first timer) that took these meds and have severe side effect? Will the side effects be severe enough that others can know that you are on HIV meds? Can one be on medication and carry on with his normal life/career? I will let you and others know the outcome. No matter what it is, my perspective in life has taken a great change. I have even promised myself to be an AIDS volunteer as now I understand what it is like on the other side. Like many others, I have pledged to do what ever I can within my means to contribute to AIDS/HIV society. Dr Bob, I applaud you for your courage and perspective in life. I wish you and all other HIV+ good health for many years to come. Merry Xmas and my ongoing wishes will be cure for AIDS/HIV.

Response from Dr. Frascino


Thanks for the compliments. First, I must remind readers and potential questioners that this forum is dedicated to HIV-related anemia and fatigue. Questions regarding possible infection are best handled in our Safe Sex and HIV Prevention Forum. Let me at least briefly try to address your major concerns. First of all, you were following the safe sex guidelines by using a condom. When condoms break, usually it's quite obvious - kind of looks like your head sticking through the hold in your sweater, if you know what I mean. It's hard to miss, so if you didn't notice it, chances are the condom remained intact. They are remarkably durable.

Second, your symptoms are not "classic" for ARS. "Wasting," sore tongue, chest pain, and anemia are not seen in ARS. Swollen glands are extremely common and not necessarily related to HIV infection. I'm glad you recognize the fact that you are having difficulty with depression/anxiety, as this condition is most likely the true cause of most, if not all, of your symptoms.

Your chances of infecting your infant niece are non-existent with the type of exposure you described. So, to answer your specific questions:

1. Have I seen "symptoms" like yours in people who test negative? Absolutely. I'm quite sure you'll test negative as well. 2. You don't have ARS; however, anxiety can certainly last longer than 3 months and be the cause of your symptoms. It is not related to your immune system. 3. Can a child be infected by the exposure you described? No. Can a child's roseola cause your symptoms? No.

I'm glad you are planning to get tested. It will be negative. I won't answer the questions about medication side effects, because in all likelihood, you are not HIV-positive. Write back and let me know the results. This is one case where I love being able to say, "See, I told you so."

So, my friend, get tested so you can stop worrying. If you can't stop worrying, get some counseling and treatment for your depression/anxiety.

Stay well and please enjoy the Holidays. And remember to ask Santa for an extra supply of lubricants to avoid such worries in the future.

Happy Holidays.

Dr. Bob


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