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First, kudos to you...
Sep 3, 2003

First, kudos to you for a profanely witty and brusque handling of a question similar to mine. Second, my question, which I shall put to you in two prongs, as simply as I can:

1. Until 2 months and 10 days ago, I was using both public and home toilet water to clean myself anally after defecation. This was due to intense hemorrhoids, which made using normal toilet paper very painful. Believe me, suffer through that and you'll be desperate for any solution. Anyway, I would dip my hand in the toilet water, and insert it an inch or two into my anus to lave it clean. I did this for about a year, using K-Mart toilets, college toilets, toilets at home. I do not do this anymore. I use medicated TP. I tested myself in February and came out clean. I was tested 2 months and 10 days ago and came out clean again, yet still am worried, as they say you should be tested every 3-6 months. Should I bother? Am I wasting my time? What if someone used a public toilet before me and I forgot to flush a couple times?

2. Even though I'm using medicated toilet paper, I still have to wrap it round my fingers and insert it an inch or two in. I re-use each paper 2 or 3 times. If, I brush, say, the underside of the toilet bowl, am I still at risk?

Thank you very much for your time. Cordially...

Response from Dr. Frascino

Hello,

A two-pronged question deserves a two-pronged response. Although I don't know how "profanely witty" it will be, I will try to be "brusque."

1. Toilet bowls are not bidets and should not be used as such. You found toilet paper very painful, but didn't mind sticking your fingers "an inch or two" up your butt? OK, if you say so, but I'm glad you have abandoned this technique. Medicated toilet paper is an improvement, but do you really reuse each one 2 or 3 times? Oh, that's the second prong of your question, so I'll get back to that. Are you at risk for HVI from your tidy-bowel-water-finger-douche activities? No, even though it's a most unappealing concept, it does not place you at risk for HIV. If you "forgot to flush" (an even more unappealing concept), you still are not at risk for HIV, but other STD's (parasites or hepatitis, for instance) could theoretically be transmitted. You've had 2 negative HIV tests, one of which was 2 months and 10 days since you last splish-splashed. Should you have additional HIV tests for this potential exposure? No, they are not warranted or necessary. 2. You reuse each medicated piece of toilet paper 2 or 3 times? This is not a good idea, and I don't even want to hear about where you keep the used sheets in between uses. I don't even like the concept of handkerchiefs, where folks blow gobs of goopy snot into monogrammed squares of cotton and then fold them up and stuff them into their pockets. So, you can just imagine what I think of your saving used pooh-pooh papers! As for brushing the underside of the toilet bowel while trying to wipe your hemorrhoids, well, just how bad is your aim? How could you mistake the underside of the toilet bowel for your butt? Assuming your aim really is that bad, are you at risk for HIV? No, review my response to "prong one."

Last, why are you suffering so and coming up with such crappy(pardon my French) ideas? Have you spoken to your physician about your hemorrhoids? Treatment is readily available and highly effective.

Get the help you need, but first, go wash your hands!

Dr. Bob



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