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MIKE FROM BAGHDAD -AGAIN-PLEASE ANSWER
Apr 6, 2004

Dr. BOB, I can only imagine how busy you must be ....but i am glad to see that you have some help now. I will be returning from Baghdad next month and i was wondering-based on my last post -and your response (which I have attached so you will remember who i am)What-if anything should I do next. I know you can not tell me what to do-but in your professional opinion....is any further testing required or even necessary..or can i just relax abd move on with life? Any help you can give this scared Devil Dog...would be greatly appreciated. I have survied over here in Iraq so far - and I am hoping i will beat this scare as well .Thanks again ,Sir. I look forward to your response. Regards.

Mike

Dr. Bob, I have posted several times, and I know you are busy, but I would appreciate your insite/comments before I leave for Baghdad on Sunday. I will give you the short version. On 12/16/03 was with a "pro". Had oral/vag -protected-during vag-condom broke. Felt it break , pulled out. Exposure maybe 10 seconds or so. Before this incident was with another pro on oct.22/03 with protection and no failure. Well i took a home acccess on Jan 1st-17 days past exposure-results neg. I guess this established my baseline since my last episode was Oct 22-with no failure. This was 74 days after that- so guess i am good there. Well contacted girl-she agreed to take a Home ACCESS test -2 days after our trist-her results neg. Since then - a PA that works with me gave me an orasure/oraquick rapid test on Jan 13,2003-27 days past exposure- test was neg-here is confusing part. He left test sitting out-forgot to dispose of it. I saw it a week later on there was a line at the C and T areas. The PA said this is normal due to the test being old...etc and not to worry. The initial neg was the accurate result.

Well since then I crumbled under the guilt of the incident and confessed to my wife. She freaked out needless to say, and insisted I get the pro to test again,. Well the pro agreed to do another home access test. This time at 42 days after /6 weeks. Results -NEG. So this is where I stand, I have mentally manifested all the classic ARS symptoms-but one thing puzzles me. I was diagonosed with genital herpes years ago- but rarely have outbreaks. About two weeks ago I had one and now they just keep coming. About 5 so far in just a few weeks. Well I guess my questions are- 1. What do you feel my initial risk was/and now based on her results 2. Is what my PA told me about the oraquick test accurate? 3. And are herpes outbreaks an indication of ARS or should I chalk them up to stress.

Any help you can give would be greatly appreciated Sir. I really would like to calm down and get my head together before I leave for Baghdad. I need to be on my A game, and I am just so filled with worry and regret. God bless all you do for all of us. I have the utmost respect for you and the other fine Doctors who take the time to answer and entertain thoughts and question from people like me. Please pray for me while I am in Baghdad! I will need it. Thanks again. Dr. BOB. I will have access to the net over there - so I will check back regularly.

Mike

Hello Mike,

Your risk is essentially 10 seconds of insertive vaginal sex with a pro who has tested HIV-negative at two days and six weeks after the tryst. You have tested negative at 17 days and at 27 days. Despite this, you have "mentally manifested all the classic ARS symptoms."

O.K., first off, your risk was extremely small and made essentially nonexistent by the repeatedly negative tests on both you and the pro. The chances of her being in her "window period" with two negative HIV tests out to six weeks and then passing the infection on to you are so miniscule as to be off the radar map.

Next, the PA is correct. The initial negative result is the accurate result.

Next, stress can certainly lead to recurrences of herpes. Talk to your doctor. If you've had five episodes over the past few weeks, you may need suppressive therapy.

Finally, "mentally manifesting" symptoms doesn't mean you have the disease any more than dreaming of $1,000,000.00 makes you a real millionaire!

Thank you for your service in Iraq. Our thoughts and wishes are with you and all the service men and women for a safe and very speedy return home.

Dr. Bob

Response from Dr. Frascino

Hey Devil Dog Baghdad Mike,

Welcome back to the forum. It's always enjoyable when someone in a real uniform calls me "Sir!"

Mike, of course I remember you. We've all been watching the horrors of war on CNN and sending our very best karma for the speedy safe return of all soldiers, as well as for the return of rational thought and world peace.

Mike, my opinion regarding your "essentially nonexistent" risk hasn't changed. No, I don't feel any additional testing is necessary or warranted, based on what you have told me. HIV from that episode should no longer be a concern for you. It was only a scare and yes, you beat it.

Mike, please get home safe and sound.

Dr. Bob



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