Revoke my medical license?
Dec 4, 2003
Dear Dr. Bob! Of course my license will not be revoked, but I read that you are a great sucker about catchy titles,..and I do need to catch your attention! J Well, I might receive a bollocking at from you, as I am a medic myself and yet, am likely to be asking you silly questions. But let me appease you a little by expressing my admiration for so much effort, competence and great sense of humour of yours. However, I have only just started as an equivalent to an intern working on a paeds unit and dont really know anything yet. So do be lenient on me! :-) I'll give you a brief history now, in good hope you will be supportive as you seem to be. I gather that it by the many positive responses you get here on this forum! I (circumcised) had protected, vaginal sex using polyurethane (Avanti) condoms with a positive women. She is on HAART, very compliant, has a none detectable virus load and a CD4 count around 560, although I don't know her ratio regarding her total lymphocytes. Anyhow, 3 weeks and 4 days after first exposure, I felt a little "fluish" and I had a shingles-like stingy pain without any visible skin symptoms (I recognized the -very slight- shingle-pain, as I have had shingles many years before and am also prone to herpes simplex) That day I felt a bit shiverish too. Two days later, I got cold/flu-like symptoms: sore throat, lots of sneezing and runny nose, temperature with the shivers at night (didn't recall any particular sweating) developed a productive cough, yet no glands palpable and no rashes. It took me nearly three weeks to recover. But not to forget: I work on a paeds unit, in the wheezy/bronchiolitic season and there was an Influenza A, and I understand another strain from China, going around. I think that some people came down with the flu at the same time as I did, but in average, most were affected 7-10 days later. Now my concerns are: Do you think coincidence, or did I blow it the 3 1/2 weeks earlier? Presently, I do bilaterally palpate non-tender inguinal nodes, but I have noticed this too quite a while ago. In fact, I asked somebody to ultrasound scan it ruling out any malignancy. It know it sounds ridiculous, but I have been literally worried sick since; feeling all these funny little aches and pains. Organisational problems have been preventing me from undergoing a test (confidentiality problems require me doing it in an other town) which I want to do ASAP just to get some kind of relief and not hanging in suspension.
And just to give you some good feedback: Should I manage to get an Elisa test done as from now (8 weeks post exposure), and it turns out negative, then I know I am negative and will jubilantly inform you!
Many, many thanks in advance, a UK bloke!
Response from Dr. Frascino
Hello there UK bloke,
How could I "bollock" a "shiverish" pediatric intern? Interns are supposed to ask dumb-ass questions. That's how they grow up to be smart-ass pediatric residents and then cocky pediatric fellows and finally know-it-all attending physicians. Did you know before I specialized in adult/pediatric immunology, I was a pediatrician? I do remember vividly what it feels like to be a pediatric intern, so I'll be very lenient with your dumb-ass question, OK?
"Protected sex" is protected! HIV cannot mambo across latex or polyurethane. So, assuming you used the condom properly (which I'm sure you did, because they teach that prior to letting you loose on the wards, right?), then you should have no great worries about HIV transmission. Remember, most "cold and flu symptoms" are due to colds and flues, not HIV, the plague, malaria or Ebola! If you do decide to get an HIV test, wait at least three months. Otherwise, the results are not considered definitive, OK? Was that kind and lenient enough?
Oh, one more thing: You asked "somebody" to do an ultrasound scan to rule out malignancy, because you self-palpated non-tender inguinal nodes??? OK, now it's time to bollock you! No more Mr. Nice Guy! Trying to self-diagnose is never, ever a wise idea. Didn't they teach you the saying, "A doctor who diagnoses and/or treats himself has an idiot for a doctor and a fool for a patient?" It sounds like it came from a fortune cookie (and maybe it did originally), but it's wise advice. Knock it off or they're likely to send you back to medical school!!!
Stay well, bollocked bloke!
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