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Fatigue and AnemiaFatigue and Anemia
           
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Fatigue, etc.
Aug 30, 2002

Dr. Bob, I have been following you for months and you are an angel.

Had unprotected vaginal on 6/6/02 and later protected anal and then unprotected insertive oral (with deep throat for a few seconds that hurt)on 6/21/01. 10 days after 6/21, I get a burning just below the tip of my penis, then pain (like sunburn) and warmth in testicles for 5 days (doc says maybe too much coffee or just irritation) Tip and where abrasion was (on left side of penis tip during oral) still tingles and burns (from urine/semen drip) from time to time. Abrasion and penis was warm days after oral. Two weeks after oral, extreme fatigue, took nap, sweat on foreheat, shaky feeling. Had mild fatigue one week later (resolved after a jog and some exercise) Four weeks after oral, a little diarrea (maybe once per week), light colored stool (some floating!), lost 6-7 lbs over 3 weeks (lost 4-5 in one week), very anxious and depressed, never noticed fever but a few sweats (neck and forehead) 3 or 4 nights and feeling hot a few nights, and then wrist pain 4 weeks after oral incident (resolved in two weeks). 8 weeks after oral had shortness of breath that kept me up til 3 am (onset at 5 pm during job through a cemetery to see Stonewall Jackson's grave! Imagine that).... After the first bout of fatigue, it was really mild (the first one was scary as I felt anemic and weak and had to lie down).

Week 5 from oral had negative health dept EIA. (They told me it would pick it up in 4-6 weeks). Then had Home Access negative at 9 weeks (from oral) and 11 weeks (from vaginal intercourse). This Access test was almost 4 weeks after "symptoms" (sweat, wt loss, some chills) ended.

Symptoms were almost always at night, felt fine during the days except slight fatigue.

Lovely wife had UTI (resolved)right when my symptoms started 4 weeks post oral incident, she also had dry cough 3 nights (worst nite was same nite I had my shortness of breath.. maybe something in the air.. I have asthma but was not wheezing) and said she felt anemic (exactly 6 weeks post oral incident) and lay down for an hour then felt better. Also said she had vivid dreams during worst coughing night.

Have had some altered taste a couple times, sore throat (still looks like red patches on sides of entry to throat)

I know I am not out of the woods yet (but I feel no pain today!), but I just wanted to run this by you. I have been a basket case. Don't these symptoms seem scary? I dont think wife and I had any sexual contact after oral incident with other woman, but was worried I gave her something.

Positive or negative, I think I have found my mission in life. I'd like to make a contribution to your foundation right away. This is an important fight!

I have rambled on long enough!

Much gratitude and love to you. I love you man!

Bo

Response from Dr. Frascino

Hi Bo,

Thanks for your kind comments. Your risk is unprotected vaginal insertive intercourse, protected anal intercourse, and brief unprotected insertive oral sex. The anal sex was protected, so that's not really a problem. The brief insertive oral sex carries a very low risk of contracting HIV. That leaves unprotected insertive vaginal intercourse with a partner of unknown serostatus. That does carry some risk, although insertive sex is less risky than receptive sex.

Now what about your symptoms? The burning below the tip of the penis and warm feeling in your testicles are certainly not due to too much coffee! No one drinks more coffee than I do and my equipment feels just fine. There is no medical justification to blame this on coffee. Irritation from the sexual activity is a possibility, perhaps even an STD. Your physician can check you for common STDs - gonorrhea, syphilis, NSU, chlamydia, etc. The fatigue, sweaty forehead, feeling shaky, and mild diarrhea were all transient and not really indicative of HIV seroconversion. You state you felt "very anxious and depressed." Anxiety and depression can be associated with many symptoms, including fatigue, diarrhea, feeling shaky, shortness of breath, etc. You also report that you are asthmatic. Certainly the shortness of breath could have been related to that, even though you weren't actively wheezing. Shortness of breath is not associated with HIV seroconversion. Your negative HIV tests up to 11 weeks after the incident are very encouraging! However, as I've stated before, it's really the 3-month test that really counts.

Your wife's symptoms also do not sound at all alarming to me: Cough, tiredness, and vivid dreams are not suggestive of HIV seroconversion. That you didn't' have sexual contact with her is additional evidence you did not "give her anything." If, per chance, you do test positive for an STD - say chlamydia, etc. - then she should also be tested as well.

So, bottom line: So far, things look encouraging. Take an HIV test at 3 months. The odds are definitely in your favor that you'll be negative. If negative, yell WOO-HOO and write back to let us all know. I'll be definitely expecting that good news very soon.

Thanks in advance for your kind donation to our foundation! Your gift will touch many lives and your halo just got a bit brighter! The Foundation's address is:

The Robert James Frascino AIDS Foundation 779 Altos Oaks Drive, Suite 200 Los Altos, CA 94024

Good luck, Bo. I've got a very strong feeling you are just fine!

Stay well.

Dr. Bob


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