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Fatigue and AnemiaFatigue and Anemia
          
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not too tired to see your angel eyes, Dr. Bob
Oct 22, 2002

Dr. Bob- Please read even if you don't post it -- I think it might make you smile along the way...and might help other worried wells.... I will be brief -- I sent your organization a somewhat significant check and truly hope it helps in some way... You answered my quesiton yesterday about my cunnilingus/analingus experience followed by cold sores and a month of fatigue/sore throat..I thank you for taking the time out. I did take an Elisa and PCR DNA test yesterday [day 31 after the encounter or the "adventure" as you called it].. I do have one question that I'm afraid i'm not clear on even though I've read every response you've given in the forum's history--at least twice ! I know .. I know.. an Elisa is only conclusive at 90 days--but I haven't seen your opinion stated on the PCR DNA tests-- they claim to be 95 within 28 days.. so if I [fingers crossed] am negative on both PCR DNA and Elisa at day 31 [I dont know yet] ---am I cleared--- or do you recommend PCR DNA beyond 30 days as well ? Finally, I went to a doctor today without mentioning HIV --just to go over my sore throat, achy neck, fatigue, and burning head sensations.. He looked me over carefully and said my throat doesn't even look soar and my glands certainly aren't swollen despite the neck aches.. He did some blood work to 2check for mono [had it already though] and even lyme's disease to explain my fatigue--but he said -- it seems I'm really depressed and anxious about something...and he doubts I have anything at all -- That visit alone-- made me feel 500X better--and I exercised and got around for the first time in weeks... a negative result on my tests [find out monday] will make me woo-hoo for sure [and then im leaving for a month long vacation!]--- It's really amazing how much the mind can do... I have never been a whiner.. I have never had depression or a mental disorder to my knoweldge.. In fact, I didn't even believe in depression-- but this month of fear has been incredible--and I have wasted my days and nights reading about HIV and practically crying myself to sleep...I was convinced my glands were swollen--dr. said not at all... I couldnt explain my hot flashes and intense face heat-- he said "anxiety" [or unlikley male menopause at a young age, he joked]...I was taking robitussin to ease my sore throat-- he looked in and siad "why? what sore throat"-- I have never been a worry wart-- I have a great life and hope it continues-- Where am I going w/ all this? I know you must be TIRED of hearing from people like me--especialy since we're so worrited about having a disease you've dealt w/ successfully every day for years. Please don't change who you are or your wonderful mannerism in dealing with all of us-- I have worked alot w/ Internet email handling myself and I know how frustrating all these letters can be--Just know that your words..the way you handle us... REALLY shine through and there's people all over the world clinging to your every word but loving you in return--- NO OTHER Dr. on this board comes CLOSE to showing the compassion that you show... If i somehow turn out to be positive on Monday after my cunnilingus "adventure" I will write back to cry on your shoulder and I hope to get a reply.. Otherwise, I'm gone --outta here-- will do a follow up 3 month still if you recommend it... I hope you make some use of the donation and continue to get lots more ! be well and keep managing your disease as well as you manage us whiners !

your fan !

Response from Dr. Frascino

Hello Fan,

You've read all my responses twice? Wow, I can't imagine. How many times have you read the Harry Potter books? They are really much more entertaining.

You do pose an interesting question. Yes, the HIV DNA-PCR is 95% predictive at 28 days by report. Of course, how does one know if they are in that unlucky 5%? A negative ELISA at 31 days may be encouraging and add to the predictive power, but an ELISA in and of itself, is not predictive until 3 months. So can we give someone an "all clear -WOOHOO" if they test ELISA and DNA-PCR negative at 31 days? Nope, not yet. Certainly the odds would be very much in favor of being HIV-negative (probably at least 95 percent based on limited data), but that person would still need the 3-month ELISA test according to current guidelines. Things may change as the tests further improve, but as of today the guidelines still stand.

That said, what about your case? As I previously mentioned, your exposure risk is extremely small - cunnilingus/analingus/digital anal play. Some guidelines would not even recommend testing with this degree of risk. The cold sores and fatigue really are not at all suggestive of an ARV syndrome. Added to that, you now have seen a physician who has reassured you that your lymph glands are not swollen, your throat is normal, etc., etc., etc. He also suggested that you might be anxious or depressed about something. Smart guy, eh? His reassurance alone made you feel "500x better!" And now you are exercising again, which should help with the fatigue, your love handles, and making you look better naked. Your results will be negative on Monday, and I'd suggest you start packing for that month-long vacation right away!

Thanks for writing back and updating me on your progress. I'm not expecting you'll need my shoulder to cry on, on Monday, but if you do, I'll be here. If you are indeed negative, and don't need my shoulder, can I come with you on that month-long vacation???

Thank you for your generous donation. When it arrives, I give you my solemn word it will touch many lives and each one of those lives will return good karma to you for your ongoing health, happiness, and peace.

Live long and prosper! Have a great vacation! We'll expect a posting from some place exotic! Stay well.

Dr. Bob


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