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re: Shingles 3 weeks afterward
Jul 9, 2004

Dear Dr. Bob,

Please read. (re: "Shingles 3 weeks afterwards" 06/08/04) I'm sorry to call upon you again but things have gotten worse. I saw a doctor about my symptoms particularly the aches and pains that I have been experiencing but he didn't say much about them and tested me for HIV at 6 weeks which was negative.

The episodic pains have continued in my thighs, legs, feet and particularly in my hands and fingers which are aching and sore in nature. But the worst thing I am worried about is now (10 weeks since the unprotected oral sex) I have palpable enlarged lymph nodes in several places (upper arms, elbows, groin and behind the knee. My left upper arm is swollen. This started a couple of days ago. Do you think I'm infected with HIV with these new symptoms.

I'm very scared and depressed. I still haven't told my wife yet but I will. I can't even enjoy the anticipated birth of our child in the next couple of weeks. Thank you for your time.

Dan

PS I sent the $100 donation that I promised a couple weeks late. sorry.

Response from Dr. Frascino

Hello Don,

The only thing that has gotten worse is your OCD and irrational fears of a disease that you do not have. Dan, your risk was essentially nonexistent. In addition, you now have a negative HIV test. I fully realize that HIV tests are not conclusive until at least three months, but Dan, I see nothing but good news here.

I agree you are very scared and depressed. I do not believe you are infected with HIV. My advice has not changed from my 6/8/04 response:

1. Be honest with your wife. It is the best way to confront your guilt and anxiety. 2. Ask your doctor for a referral for counseling to help you cope with your OCD and irrational fears of being HIV positive. 3. Test again at three months, but only for peace of mind, as there is not significant HIV risk from the activities you described.

Dan, thank you for your generous donation to my foundation. It will be used to provide crucial services to men, women, and children coping with HIV/AIDS. In additional, it will help our HIV/AIDS awareness and educations programs. I'm hopeful that scientifically sound HIV education will decrease the stigma and misinformation surrounding HIV. This in turn should eventually decrease irrational fears such as those currently causing you so much distress.

Feel better, Dan, and please realize that fear of HIV, not HIV itself, is your real problem

Dr. Bob

Shingles 3 weeks afterwards. Posted: Jun 8, 2004

Dear Dr. Bob

Please read. I'm a 37 y/o married man. I went to asian massage parlor. At the end of the massage I told the woman to only wanted a hand job. However, her back was to me and I'm pretty sure she used her mouth on me for 5-10 sec. Since then I've had an extreme amount of distress and anxiety (I have OCD). It's all I think about. I took doxycycline for about 2 weeks starting the same day of the incident.

1. I developed a mild sore throat several days afterward the incident which lasted for about a week. (side effect of doxycycline?)

2. The following week later I had an episode of night sweats and awoke with a rash (due to sweating?) which disappeared within 20-30 min. in the morning. Then exactly 1 week later I developed shingles (2 reddish linear crops/blisters on my abdomen 0.5in x 2.0 in). They did not hurt though. They healed within a week. But since the shingles were healing/healed I've been having episodic minor muscle aches and pains (thigh, leg, ankle, back and hand) . could this be from the Herpes Zoster or HIV? I had a varicella titer done about 15 years ago and it was low.

It's been almost 6 weeks now and I haven't had any other symptoms. I've been taking my temp. since the incident and it's never been higher than 98 degrees. I had an HIV test several years ago which was negative. My wife and I have been together for last 5 years. I've always used condoms in the past and I never had any intercourse with a sex worker before this. To make matters more complicated my wife is pregnant and our first child is to be born in 2 months. She is HIV negative. We haven't had any sexual relations since she been pregnant but she often asks what's the matter. I haven't told her b/c I don't want to worry her with baby due soon.

Could you please give me you thoughts on the following symptoms I had the past 6 weeks. Particularly the etiology of the muscle aches and pains. Do you think also do I have a cause for concern for HIV infection? Thank you for your time. I will make a $100 donation to the foundation later this week.

Dan

Response:

Hi Dan,

Do I think you have a cause for concern about HIV infection? No, absolutely not.

Hand jobs carry no HIV risk. Even if your Asian rub-a-dub-dub gal decided "to use her mouth for the 5-10 secs," as you mentioned, the HIV risk would be essentially nonexistent. If you remain worried, get HIV tested at three months. In my opinion, this would be only for your own peace of mind.

Your muscle aches and pains may be due to your anxiety and guilt over this episode. Have your doctor check you over, if symptoms persist. Also, considering you have OCD, some counseling may be helpful, if no medical cause can be found for your symptoms.

I also suggest discussing the whole situation honestly with your wife as the best way to confront your anxiety over this whole issue.

Thank you for your donation. It's warmly appreciated. Congratulations on soon becoming a Dad!

Dr. Bob



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