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Fatigue and AnemiaFatigue and Anemia
          
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Dr. Bob ---I'll do anything for an answer..
Oct 16, 2002

Bonjorno ! Por favore, I'll do anything for an answer--Instead of spending another 500 on testing scams, I'll donate to the address you keep posting--please oh please just take one moment to shed light-- I'm in pain over this-- I took time to document my history -- please tell me "yeah, you might have a problem" or "stop worrying, this is nothing"

Day 2 (after exposure) Canker sore under tongue, overwhelming fatigue, lack of concentration, general head buzz

Day 3 4 cold sores on lips

Day 7 -By now canker and cold sores have vanished, fatigue and concentration have worsened Had blood work done-- HIV negative [I know --it's way too early] -- and lymphocytes up high [nearly 4200 - -should be 800-3900 according to lab report]

Day 8-20 -- mild sore throat --fatigue persists from mild to extreme--- lots of drowsiness even though i'm getting 7-9 hours of nightly sleep.

Day 21 --sore throat becomes a bit of a cough--mostly at night...fatigue goes back to all-day extreme--- begin to develop occasional "hot fevery" feelings in face--but temperature doesn't seem to rise above 98.3 --at most...some ongoing belly discomfort begins around now..

Day 22--- belly ache after eating; immediate watery diarrhea stool: one time

Day 23-29 ---light cough persists...fatigue goes on...no other symptoms

Day 30 -- that one-time watery diarrhea from last week is no longer one-time-- today, it happened again-- twice-- A little bit less fatigued-- but still no concentration (except when reading about HIV)... no real documentable fever--but daily high temperature has gone up to 98.9 instead of the old 98.3 daily high...

The main ongoing symptoms have been fatigue and mild sore throat-- the MAJOR but RARE ones-- are mouth sores at about 2 days after possible exposure and severe, watery diarrhea once at 22days and twice on day 30.. Is this seroconversion ? or just a guy who had an unrelated sore breakout right after...a cough and fatigue enhanced by worry, guilt, and anxiety...and then sporadic watery diarrhea cuz I uh, ate something bad...uhm...twice ?!?!--

Exposure type: I'm a male who performed unprotected cunnilingus, a bit of analingus, received unprotected oral sex..and did some fingering of vagina and anus. No visible blood present. Female was a caucasian in her mid 20s in a high-risk state, but also in a county w/ a pretty low prevelance of hiv [65 believed cases out of 119,000 residents --BUT* more than 50 of the county are senior citizens and/or children and there are no reported cases in that county in those age groups --so it's like really 65 infections out of about 59,000 people from age 12-65.. .presumably most are age 20-45 ish... But this girl was also SUPER promiscuous-- uncaring...and told stories of her sexual history that would make your skin crawl (im pretty open minded and they shocked me)

Tell me the truth- -if someone came to you w/ these symptoms--spread out over a month's time--w/ this one risk exposure-- would u be thinking "better keep testing this guy for HIV at 3,6 months, etc;" ? --or are you thinking "another worried well... low risk or theoretical risk---he should get on w/ his life--- get tested, sure--but sounds like nothing--and not really "ARSish" ?

THANKS SO MUCH ! --

Response from Dr. Frascino

Hello,

I'm sure you know this forum is dedicated to HIV-positive folks with anemia and fatigue problems. Questions like yours should be posted to our forum on HIV Prevention and Safe Sex. That said; let me at least try to put your problems in perspective for you. Your exposure risk - cunnilingus, analingus, insertive oral sex, and digital manipulation of the vagina and anus - are all relatively low risk. Your partner's serostatus is unknown. Second, your symptoms 2 days after the possible exposure are not due to HIV-ARS. The immune system just doesn't work that way. Your problems with fatigue and difficulty concentrating are most likely due to anxiety and stress. HIV-negative tests at 1 week are meaningless. Your total lymphocyte count of 4200 probably reflects your recent bout of herpes (cold sores). Your mild sore throat and occasional diarrhea are not impressive or suggestive of ARS. Are you seroconverting? I very strongly doubt it. Are you just a guy who happened to get cold sores around the time of your sexual adventure? Yes, I'd bet on that! Are the other symptoms worsened by worry, guilt, and anxiety? Absolutely. For you to be doing epidemiological and statistical analyses of presumed HIV incidence and prevalence in the state and county where you had your adventure, means you're doing a whole lotta worrying! So am I thinking "another worried-well?" Yep! Do I think you should get on with your life? Yep! Does it really not sound "ARSish?" Absolutely. Save your time, money, and sanity. Donate the funds to an AIDS charity and your time to an AIDS clinic or hospice. If you want to get tested, do it at 3 months. Do I think you need it? Nope.

Hope that helps! Thanks in advance for your donation to the Foundation.

Stay well.

Dr. Bob


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