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THIRD TIME WRITING PLEASE HELP!!!
Apr 9, 2004

Doctors,

I really need your help because I cant live with myself. This is the third time writing to your guys. I really scared and need your help. My wife is trying to get pregnant and I was at a bachelor party and got drunk. I dont cheat my wife but that day I was drunk and stupid. I really feel like killing myself but that would not be fair to my wife. I dont blame the drinks but myself. I had my protected exposure on Nov 1, 2004. She was a sex worker and hate that I did this. I started getting fever and sore tongue about four or five weeks after exposure. I just bought a house and was doing a lot of work for three weeks. There was a lot of dust and mold and fever started right after I finished the work, didnt wear mask. The doctor said that I had a upper respiratory infection. I was still scared of my exposure, so I got tested about 6 weeks. The test results were negative. The doctor prescribed me Zithromax and fever went away. My throat was still hurting so I went to my other primary doctor and he prescribed me cipro for ten days. I took this about two weeks later. It was about Mid or end of December. He told me if my throat still hurts that I should go to an Ear, Nose and throat doctor. My tongue still was bothering and my throat after a few weeks. I went to the ENT and she told me to take augmentin for ten days 875 twice a day. My throat got better after a few weeks. My tongue was still hurting and now it was white with lines in front. After reading the web, I learned that antibiotics could cause a white tongue. I went to my primary doctor and he said it could be from all the antibiotics. He told me stay of the antibiotics for a few weeks and it would get better. The tongue got better at times but was still sore and white. The patches would move around the tongue. I went back to the primary doctor and ENT and both took cultures with a swab that came back negative for Canada or thrush. I felt better but anxiety was going through the roof for months. The ENT prescribed me nystain for ten days but it didnt help and my primary doctor prescribed me diflucan for tens days and it didnt help. I started getting scared so I went to another ENT and he said that it was Geographic tongue. He told me to use baking soda and rinse my mouth. This helped but didnt take the problem away. I stared to feel sick and got diarrhea, felt food getting stuck in stomach, headaches when I eat, night sweats, and body pains. I also lost ten to twelve pounds. Now I was really scared so at three months I got tested again for HIV and it was negative. This made me feel better for a few days. My tongue was still bothering me and stomach. I decided to go to a GI doctor and he checked my stomach and esophagus for any abnormal fungus or bacteria and everything came back normal. Now I decided to get a third opinion from another Ear, nose, and throat doctor and he said that the antibiotics could cause the problem and he prescribed me nystain and dexamethasone. He prescribed me nystain again because the other doctor didnt tell me to swish for three minutes and swallow. The medicine didnt help. I went back to him and he said that I have nothing to worry about because it is geographic tongue and it will clear up. I also went to a dentist and she told me that there is nothing to worry about. My wife infertilty doctor told me I had to take a HIV, Hep and a& c test. I was so scared because I felt this was end of wife and I. I love her very much, even though what I did doesnt show it!!!! The test came back negative after three months and 3 weeks. I was relieved and stated to feel better. My stomach was better and my body pains are better but my tongue is still white and sore. I went to the ENT and another primary doctor and they told me that I would be fine. I really want to believe this but my tongue still bother but is better. I have a lot of brothers and they tell me that I will be fine. They have given me comfort and support. It is now five months and 6 days from the stupid mistake. My tongue still white but doesnt hurt as much. From your professional experiences can you tell me if Im over reacting or have a problem? I know you cant see my tongue but you can give me some advice for my anxiety. I feel a lot better but still worried. I really feel that I should take others advice and shouldnt. By the way I also called the CDC and they told me to relax. What do you think and please help, I will donate to the cause.

Thank YOU!!!

Response from Dr. Frascino

Hello,

You are wondering if I think you are overreacting. Well let's review:

1. You had "protected" sex on Nov. 1, 2004. That's already a bit odd, unless you have a time machine. But even if you do (did, or will do), there should be no reason for concern about HIV transmission, as HIV cannot pass through a properly used latex condom that does not break. So in essence, you had no risk.

2. Your six-week HIV test is negative. No surprise there.

3. Doctor #1 prescribes Zithromax for an upper respiratory tract infection. OK. This may or may not have been necessary. Zithromax treats bacterial infections. Many upper respiratory tract infections are caused by common self-limited viral infections against which antibiotics have no effect.

4. Doctor #2 then prescribes Cipro. That's also a bit odd, since Cipro is also an antibiotic, and not one that would normally be chosen for "upper respiratory" or throat problems.

5. Doctor #3 (ENT #1) prescribes Augmentin. I wasn't there, so I can't really comment, but it seems to me that additional antibiotics probably weren't warranted.

6. You develop "white tongue" and are advised that all the antibiotics might be the cause. I agree. You stop the antibiotic, and the tongue "got better," but not completely.

7. So then it's back to both Doctors #1 and #3, who both take cultures, both of which are negative for thrush/Candida (NOT "Canada," by the way).

8. ENT prescribes Nystatin (NOT "nystain," by the way). I don't understand why they gave you a treatment for Candida when you didn't have Candida.

9. Nystatin didn't help. Not surprising, since you didn't have Candida.

10. Doctor #1 then prescribes Diflucan (an even stronger anti-Candida drug). Again, I don't see the rational here and big surprise: it didn't help either!

11. You then visit Doctor #4 (ENT #2), who diagnoses you with geographic tongue.

10. You then feel "sick" have diarrhea, headaches, night sweats, body pains, and fell food getting "stuck in stomach." You lose 12 pounds and are "really scared."

11. Your HIV test at three months is again negative. And again, that certainly is no surprise.

12. Next up, Doctor #5 (G.I. specialist), who checked stomach and esophagus for fungus and bacteria, and everything was "normal." Once again, this is not at all surprising to me.

13. Next, Doctor #5 (ENT #3), who prescribes Nystatin and dexamethasone, because the other guy didn't tell you to swish for three minutes and swallow. Again, I see no medical justification for any of this whatsoever. And again, predictably the "medicine didn't help."

14. Back to Doctor #5, who says nothing to worry about geographic tongue. That sounds familiar.

15. Next to dentist, who also says nothing to worry about.

16. Next, wife's infertility doc says that you need an HIV test and you freak out, but results come back negative. (Wow, what a surprise, eh?)

17. Next, back to ENT and Doctor #6 (another primary care doctor). They both said you would be fine.

Now after reviewing that quite remarkable history, how could I possibly think you are overreacting??? A non-exposure followed by three courses of antibiotics for symptoms that were probably not bacterial, then followed by three courses of antifungals for a condition that was probably non-fungal, followed by three very predictably negative HIV tests, visits to six doctors and one dentist and advice form the CDC, all telling you to "relax."

So after all that, we now know several things:

1. You're HIV negative (non-exposure plus repeatedly negative HIV tests).

2. You have been dramatically and unnecessarily over-treated by multiple physicians.

3. You have significant guilt resulting form your indiscretion.

4. You have irrational fear of HIV.

5. You need counseling to help you cope with #3 and #4 above.

6. The total amount of money you have spent so far on this totally avoidable and unnecessary anxiety merry-go-round equals or exceeds the gross national product of almost all African or former Soviet Block nations.

I do hope that helps put things in perspective. Thanks for your willingness to donate. The funds you give touch the lives of those actually struggling with the disease that you only fear and definitely do not have!

Dr. Bob



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