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Fatigue and AnemiaFatigue and Anemia
          
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Worried and anxious PLEASE PLEASE HELP :)
May 3, 2002

Hi there. I sent this message earlier today but have since made a few important changes so please disregard the other one if you do manage to have time to answer this. I have a great deal of respect for the great work you all do on this site. It has been invaluable to me over the last couple of weeks. I have written before but have had no reply. I came across your section on the site today and you come across as being very dedicated and compassionate so im hoping, praying even that you will have time to answer my questions. I have become very concerned over the last 3 weeks following a high risk encounter in thailand where a condom split on 2 separate occasions with 2 different girls. There was also a encounter when i performed oral sex on a different girl. I know I only have myself to blame but what is done is done and I must live by my actions. Since my return I like so many others have been glued to the Internet convincing myself i have been suffering from ars. I have been suffering from very painful muscle aches (mainly in my hands and feet, they are cold all the time. This has never happened to me before and seems to be getting worse, extremely painful). What are the most commonly experienced ars symptoms and is true that there are normally more than one. Ive had some pain under my arms and knees and briefly behind my ears but nothing appears swollen and i don't appear to have any lumps. Ive had no fever or high temperature. My tongue has a white coating on it and what seem to be white spots on the back. I don't believe this to be flush as its not painful and isn't coated like cheese. I can not scrape it off and there has been no bleeding. My main concern is the pain im experiencing. Have u ever known anybody to just have this type of pain and in particular just in the hands and feet?. On a more positive note I visited the clinic a few days after my return (3 weeks ago) and was tested for all the various stds which all came back negative (is this a good sign). I had a hiv test done yesterday. some 38 days from the 1st break and 29 days from the second. I will of course reset nearer the 3 month period but do you think i have a good chance of being negative based on that most people have detectable anti bodies with 3 to 4 weeks of exposure. Im from the uk and the test was carried out at a hospital specializing in gu medicine. One thing I would like to add at this point is that the doctors in to the uk seem to be very uneducated about certain aspects of hiv. None of the doctors or care workers i spoke to at the hospital dept. specializing in gu medicine were aware of ars and the possible symptoms associated. No one including my doctor seemed to be able to competently diagnose the white on my tongue. I asked if they would be able to carry out a pcr and p24 test but they didn't even know what it was (the care workers) one doctor had heard of it. Im sure your aware that here in the uk health care is free so i even tried contacting bupa to see if i could pay for these tests (no joy there). I consider my risk to fairly high hence the extreme concern but help is not very forthcoming here in the uk. I was even contemplating flying to new york to have the tests done there but it does seem a little drastic. Your site really does seem to be the authority on hiv. I have read almost every post going and haven't seen any people writing in with just specific hand and pain problems so maybe thats a good thing. One last question I occasionally take cocaine recreationally and have done a couple of times since my return (mainly due to stress) I am not addicted and only normally do this once a month and in small doses. I understand that recent studies at ucla have found that hiv loves cocaine. if i am infected would my taking this drug increased the re production of hiv in my blood stream. What im trying to ask is would it make it detectable sooner meaner that my test at this stage would be more accurate. I have been extremely stressed since my return and even on my holiday (to a almost extreme). Im hoping, praying even that this is the cause of any symptoms i may be experiencing, Could this be the case in your experience. One thing for sure. I will never be so foolish again and will be making a regular donation to a charity here in the uk regardless of my outcome. I can only hope you answer this question but either way thanks for all the great work you and your colleagues do on this site.

Response from Dr. Frascino

Hello UK Guy,

Just a reminder to all my readers that this forum is dedicated to questions involving HIV-related fatigue and anemia. The "am I infected" questions should be sent to our forum on "Safe Sex and HIV Prevention."

Just briefly, painful muscle aches in the hands and feet is not a symptom related to HIV acute seroconversion reaction. The tongue coating is probably normal. By the way, it's "thrush" not "flush." This is a fungal infection that is seen when the immune system is failing. Having negative STD tests is always a good sign. Your chances of being HIV negative? Probably very good, particularly if the condom didn't fail completely. Cocaine may indeed speed up viral replication. Cocaine and other similar uppers are a particularly bad idea for folks with stress, anxiety, and depression problems, as well as HIV disease. Could all your symptoms be related to stress? Absolutely.

Finally, condoms "split" on 2 separate occasions with 2 different girls??? Check the expiration date on those rubbers! This is highly unusual. Find a brand that fits and is perhaps more durable. In any case, continue to practice safer sex, retest at the 3-month period, and rest assured the odds are in your favor, and that your symptoms are not suggestive of HIV. OK? Tip, tip, and tally ho good chap. Stay well.

Dr. Bob


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