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DR. BOB (2ND TRY) I KNOW YOU CAN HELP
May 26, 2003

Dr. Bob,

I am married and between 6 and 7 months ago, I had an affair with a married woman of unknown serostatus (I've had two sexual partners, my wife and this woman). The affair had 3 oral and unprotected vaginal intercourse episodes, one of which was during a menstrual period. I found out after the affair was ended that she had had an affair with a known rapist. I have asked her on repeated occassions if she was +, and her response is always "well, I don't have any symptoms...". But, she has lost a lot of weight, literally skin and bones, not healthy looking at all, maybe even minor to moderate hair loss. not what you would expect from a woman in her middle 30's. About 1 month after the affair I starting developing a scrotum that was very itchy, but unresponsive to jock itch medications, and the head became very sensitive and at times itchy. No other symptoms were present. At between 2 and 3 months, I donated blood to the red cross, and didn't receive any phone calls. At between 3 and 4 months I started developing a incredible burning sensation in the groin and tremendous amounts of acid reflux, and flu-like symptoms to boot, and I had strange bowels, and diarrea. I bounced between 3 different doc's who either said it was a stomach bug or in my head. I became suspicious of some sort of STD, possibly HIV, and contacted the CDC and the RED CROSS, who did check the records and indicated that at that time I was negative for all the things they check for, but wanted to know if I thought my blood was unsafe, although I didn't know I said that it is possible my blood has been compromised and they have taken me off the donor list for another 6 months. I do feel that this was the ethical thing to do. I also had an ELISA HIV-1 screening done, and it came back negative. Meanwhile, I went to a general surgeon/gi specialist, who discovered a double inguenal hernia (something my father and brother both had, and something I had 3 previous docs check for, but they looked for it differently). I had the surgery perfomed that week (along with a vasectomy). I quickly recovered from the surgery and felt immensely better, at least that BURNING was gone, but the diarrea and stomach pain did not go away, nor the itchy penis/scrotum, but the testicular soreness was long lasting, even longer than what was considered the normal recovery. At between 5 and 6 months I began to have rashes on my neck and upper chest, some that would come and go within 5 minutes, follucitis (never had before), and then oral thrush on the tongue. Again 3 different doctors, three different diagnoses (some said acid, some said thrush), and my dentist said it was an allergic reaction to something on the tongue. My tongue swelled to twice it's normal size, the tonsil got large, and the lymphnodes under each armpit became extremely painful (swollen and sensitive)(lost 15 pounds in 2 weeks), and I've had periods of numbness/tingling in the hands (not the feet though), as you can imagine, I became scared again like I had been 2-3 months earlier and had another ELISA HIV-1 test done (by quest again (type 3??)), and it came back negative. A day or two after the test, but before the results were back the lymphnodes came back to normal, my surgeon did a colonscopy/endoscope and found a real damaging acid problem (prescribed NEXIUM). He also checked the thyroid (normal), and testosterone (1/2 of what it should be) The intestinal biopsy came back negative for celiac, cancer, etc. With the nexium the diarrea went away, along with the rapid weight loss, but the constipation that is predicted with the med is non-existent, bowels are more like normal, so it's like the constipating effects are just normalizing. A week after the test result was back I ended up with 3 ulcers on the right side of my tongue right at the edge. The ulcers went away two days later, I started feeling better and picked up a lot of energy, got back to yard work, etc. testicles started to feel better, but the exterior itch on the whole genital area did not subside, and the tongue (thrush) has not gotten better. Last week I went for another test, felt that if I was feeling somewhat better that maybe I had built some antibodies, that test also came back negative (I know you aren't suprised). I'm curious if this is a subtype issue, HIV2?, or if although always been healthy that the immune system is slower than the norm to build antibodies???? Nobody around here in my rural area knows what to think... Would a PCR be of any value now??? My wife since the affair has had unusual smelling urine, weird rashes, strange bowels, and tongue ulcers. I've been checked for clymidia/gonnarea as well.

Today, since we live in the woods and have had a flea/tick problem with our animals have had a blood sample drawn for Lyme Disease, but my doc did think it was a waste of time (of course he didn't think i had a hernia either). If you had Lyme Disease would that destroy the immune system enough to have some of these symptoms and/or could it slow the creation of antibodies to the HIV disease? You being an immunologist, would probably be best for this answer. I've read that if you are in the window period, but come up negative and have symptoms, that they are not because of HIV?? The clinics (even though I'm paying for the tests, think I need to stop testing for HIV), I understand why, in that in 6-7 months post-exposure no antibodies have been created. I have had unprotected sex with my wife throughout this period, except lately, and of course am very scared that I may have infected her, if I'm infected, but not showing antibodies yet. Its a reasonable concern, and I certainly would like it to be something else, or obviously nothing at all. I've learned a great deal about this disease, at times a little too much, but I've tried to keep a level held through it all, yes I've been really scared a few times, and there has been a great deal of anxiety, but who wouldn't be stressed over an unknown??? Finally, Dr. you impress the hell out of me, as I'm one of those guys you like to pick on!! Yes, I'm a right-wing conservative, but an unusual one at that as I have many friends, one of my best friends is a 73 year old gay republican, who is probably the most scared of anyone I know about all of my symptoms, and has been the most supportive through it all. I consider myself a very tolerant person (unlike senator santorum) and seldom if ever let my views get in the way of enjoying life with others!! I do believe that my view of life has changed, it's people like yourself that have been given a bad card, but dealt a great hand with the cards left that truly make a difference in the world. Thank you from a Right-winger in NH.

Response from Dr. Frascino

Hey Right-wing Conservative in NH,

Gosh, another right-wing conservative having an affair and then freaking out?!? You are the 5th this week!

OK, so youve been to lots of doctors I think I counted at least 6 in your post and they thought it was "in your head" until they found your inguinal hernia. Your 4-month HIV test was negative. At 6 months, you had another negative ELISA along with some tongue and lymph node symptoms, acid reflux, and low testosterone levels. And you want to know if a PCR test would be of any value. Sure, but only to the company that runs the PCR, because they would have some of your money. And what would you have? You guessed it --another negative HIV test.

So now, even though you are wasting your own money paying for unwarranted tests, the "clinics" think you need to stop testing for HIV. I couldnt agree more. No, Lyme disease would not alter HIV tests.

Well right-winger, its comforting to know you have one gay friend. What you apparently dont have is a lot of common sense. Which part of "you dont have HIV" and "stop testing for an illness you do not have" dont you understand?

So you "live in the woods," have extramarital affairs, freak out with excessive guilt, waste money (unnecessary tests), have many doctors telling you that you are kind of whacked out. Yep, youre a right-wing conservative all right!

All I can do is wish you enlightenment and suggest you get some counseling. Good luck.

Dr. Bob



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