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Fatigue and AnemiaFatigue and Anemia
           
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Scared!
Jun 24, 2002

Dr. Frascino- I am a 24 year old man. I lost my job about 2 months ago, and for the last month I have been fatigued. I am generally healthy; I have been training for my 2nd triathlon (up until about 3 weeks ago). I just started feeling tired. I actually wake up tired sometimes. I just got done with an HIV section in a health class I was taking and started thinking about fatigue and HIV. I have since noticed what I think may be blood in my stool. I actually picked it apart (with a pencil) and it seems to be "pasty" kind of like undigested tomato (please forgive the extra detail). I've been in an abstinent relationship for a year and a half, I was tested for HIV (was neg.) just before the previous girlfriend (5 years ago) I have contacted my ex and she is healthy (but she hasn't been tested) I just want to know about the blood and fatigue, and if I should be loosing the amount of sleep that I have been. Thank you so much!

Response from Dr. Frascino

Hello Triathlete,

You've been in an abstinent relationship for a year and a half?? Wow! Why? It's no wonder you exercise so much! OK, never mind about that.

You tested negative before your previous girlfriend, so we know things were fine then. Did you place yourself at any risk with your ex? If so, and you want to be HIV tested, go ahead. Your symptoms are not really suggestive of HIV and the odds are still overwhelmingly in your favor for being negative. But if anyone has been sexually active and at risk and wants to put their mind at ease, I always recommend getting tested.

Now, exactly what kind of homework are they giving you in that health class? Picking apart pasty pooh-pooh with a pencil sounds a bit extreme. Yes, there are well known causes for having blood in the stool - bright red for bleeding hemorrhoids or anal fissures; black, tarry stool for bleeding ulcers, etc. The undigested tomato-like stuff you found may well have been undigested tomato. It really doesn't sound like blood. There are some very simple tests that can be done by your doctor to see if you are loosing blood through your gastrointestinal tract, i.e. a stool hemoccult test. It's far more accurate than the "let's pick it apart with the pencil" method. If you are losing blood in the G.I. tract, your doctor will help treat whatever is causing it and also see if you've lost enough blood to become anemic. Anemia can be associated with fatigue. Then again, so can a lot of other things like stress/anxiety/depression, medication side effects, inadequate rest/sleep, and loads of other causes as well. For instance, I get tired just thinking about a triathlon, let alone participating in one.

So, see your doctor. I think you are fine from an HIV standpoint, and I doubt you're losing blood in your stool. I also think you should be given some extra credit for that health class and don't you dare start complaining about headaches when they teach you about brain tumors. OK?

Stay well. Keep exercising and, for heaven's sake, throw that pencil away!

Dr. Bob


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