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Fatigue and AnemiaFatigue and Anemia
           
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Your the best
Sep 14, 2001

Dear Doctor: I know that you should already be infected when someone writes to you but I am having a really hard time. I had a high risk esposure 4 months ago got tested by pcr rna, 2 elisa, p24 antigen all within a 15 week period. No testing prior to 10 weeks after exposure. Tested for stds all fine. Doctor I can't stop from sleeping, my fatigue is so bad I don't get out of bed and I am a mother. I go to work come home don't take care of my children, don't cook, laundry or clean all I do is have extreme fatigue and can't seem to function normally. I will probably lose my job soon as I have no energy for that either. I know I need to wait 6 months for my final test but what can I do to relieve these signs of such severe fatigue. Do you think I should see another infectious diease doctor all doctors seem to be making a jerk out of me but there is truly something wrong. Is there anyother test I can take maybe a PCR DNA. I'm sorry I know your not the person I should write to for this but I am very tired and have no strength if you could please just send me a brief answer I would gladly appreciate it. You always make me laugh. Thanks and my god bless you.

Response from Dr. Frascino

Hi,

Certainly sounds like you have something that must be causing your extreme fatigue, but it's not HIV. The 6-month final test is for the Elisa. If your PCR RNA was negative, 2 Elisas were negative, and p24 antigen was negative, you can rest assured that your problem is not HIV, even with that high-risk exposure 4 months ago. Remember, not every high-risk exposure leads to infection. In fact, most don't! For instance, my "exposure" was very high-risk. I sustained a needle stick and laceration with a hollow-bore needle as I performed a procedure on a patient with advanced stage AIDS. Even with that kind of exposure, the risk of actually contracting the virus is 1 in 300 to 400! Unfortunately, I was that 1 who seroconverted. (Hmmm . . . so how come I can't win the lottery?) I write this to point out that every high-risk exposure (occupational or non-occupational) is "risky" but does not mean you will (or are even likely) to contract the virus. So, your problem is fatigue, not HIV. You probably don't need an infectious disease doctor. See your general practitioner for an evaluation of your fatigue. Anemia, low thyroid hormone production, stress, depression, etc. can all cause fatigue. There are many causes to consider. Perhaps the psychological stress of worrying about that high-risk exposure is the cause of the fatigue. Doctors who make you out to be a "jerk" should find a different profession. Radio talk show host? "Weakest Link" questioner? At any rate, I'm confident that if you find a compassionate physician, you'll soon find the cause of your problem. And then, you'll have all that dirty laundry that's been backing up to wash!

Good luck. I'm hoping your zapped zip soon returns.

Dr. Bob


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