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Now I'm Scared
May 19, 2009
Almost two years ago I was diagnosed as HIV positive. My CD4 at the time was nearly 800, but my viral load was nearly 70,000 copies. Since then I have been in good health until recently. In January I was diagnosed with HPV infection. It had caused me quite a bit of pain and my doctor at the time didn't do much for me realizing that I didn't have insurance and was paying out of pocket. I had just started a new job and thought things would get better soon, but it didn't. Things just got worse, I am still having severe anal pain, itching, and burning, along with the fact that my fingers don't recognize my anus anymore when I go to wipe. I've found the best thing for immediate relief is a bath after defecation. Two months ago I found a lump that lead from my anus to my sacral spine and a week later I found a lump in my inguinal area. Now my docs have given me some pain meds, sending me to a surgeon, and telling me not to worry about the swolen areas that they are related to my HIV. The only problem with this story is that the swolen glandular lumps in my body was the reason I was tested for HIV. I know where those lumps are and they were not where I'm finding lumps now. So they also did a CT scan of my abdomen and pelvis which come back as a negative CT scan all together. What is going on? Why am I in so much pain? Why am I facing the possibility of having to wear depends at twenty-eight due to rectal/anal discharge. Has my HPV advanced to cancer. I'm scared to death, but I deserve these answers. I'm the one paying these guys, so why am I paying them if they're not giving me answers? Seriously, I'm a nurse and I think I know the answer and I can't understand why they haven't figured it out.
Scared
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Response from Dr. Frascino

Hello Scared Nurse,
As a nurse, why is it that you only got HIV tested when you noted swollen lymph nodes? Not only would I hope that health care professionals would know how to protect themselves from HIV, but if they did have an indiscretion or condom failure, I would also hope they would know to get tested at the three-month mark.
To answer your specific questions:
1. What's going on? You have HIV and HPV (genital warts). It appears that the extensive genital warts are causing your discomfort.
2. Has your HPV advanced to cancer? I have no way of knowing over the Internet. It's possible but unlikely statistically speaking. Anal warts can in and of themselves be quite uncomfortable and disfiguring.
3. Why are you paying your doctors but they are not giving you answers? Again, I can't comment on such a hypothetical question. I doubt they are hiding anything from you. You've been referred to a surgeon for definitive treatment of your genital warts and I believe this is an appropriate next step. Discuss with the surgeon your fears of anal cancer as well as your prognosis and recovery time if surgical treatment is indicated.
Good luck.
Dr. Bob
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