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Who to believe... for a friend?
Sep 14, 2005

Hey Doc,

Thanks for all you do... here goes!

One time unprotected oral (receptive partner, fellatio) with someone at very high risk for 30-45 seconds. No real symptoms other than big-time stress-related loss of appetite, achiness, and guilt for 4 weeks and negative for everything at that time. Thought the clear was in sight given the slim chances from brief exposure and negative tests... started having protected (latex condom) sex with a long-term, monogomous partner (exposure above was only non-monogomous action) based on advise from a counselor at a clinic that there was little to worry about.

Towards the end of 5 weeks, lots more protected sex (with same monogomous person) that started with unprotected and intense rubbing between penis and vagina... definitely exchanged some pre-cum and vaginal fluids.

At six weeks, developed obdominal pain and back pain that persisted for 5 days and subsided with Maalox (not taken until the 5th day), but when that happened some feverish/flu-like symptoms and diarhea for two days. At about the same time, partner simultaneously developes vaginal itching and burning with some white discharge that was not easily cured with monistat or flagyl but eventually went away in 10-12 days with continued treatment (counselor at clinic said probably latex irritation). Negative for HIV at the end of 7 weeks.

During week 7 after exposure, some feeling of discomfort under rib cage on either side, mostly right, and some mild back pain which subsided by the end of that week, however, then developed a sore throat.

Week 8, developed a white coating on tongue and some pain on either side of neck under jaw as well as in the face, behind/under ears and toward the back of neck. Neck pain under the jaw went away after a day, but a couple of days later developed some "feelings" not really pain in underarms, which went away after 1-2 days. But a day or two after that, pain in the groin area started and went away after 1-2 days. Between weeks 7-8 dropped about 10 pounds but put most of it back on (obviously very stressed).

Week nine... white coating still there but no other real symptoms other than fatigue and another negative HIV test.

Week 10... sore thoat, mild dry cough began, and white coating still there, all of which continue through week 11. Another negative HIV test at week 10.

Approaching the end of week 11, pain at the base of the neck, slightly to the left side almost under the trap for 1.5 weeks, cough, on and off sore throat, and white coating that could no longer be tolerated and mostly came off when scraped but some spots of white in back slightly raised and won't come off.

Loose stools have been on and off throughout but seem to have gone away at this point. At first thought most of this could be caused by stress, not being healthy due to guilt, and letting body become very vulnerable as well as sudden excessive smoking. But there are just too many coincidences here to have any peace of mind and now the monogomous partner has a heavy feeling of tiredness all the time (although she gets very little sleep lately and constantly stressed by her job).

Everytime a negative result and closer to the end it seems more symptoms arise. Heavy smoking began after feelings of guilt set in... hoping that's the cause of white tongue but it seems very coincidental that started after getting sick. Hope like hell this could all be the stress and the smoking.

Two STD counselors have now said they would bet their jobs that HIV is not the problem, but they're not MD's... then a third said to be very concerned. 90 days comes toward the end of next week (probably the 20 minute oraquick test) and want a "woo-hoo" or at least a "hell-yeah" very badly.

Could you please give some opinion about whether you you think this is ARS, the already conducted testing, the risk from this exposure... some but not all of these were answered by previous threads.

Thanks again... donation in route.

Just plain 'ol sick!

Response from Dr. Frascino

Hello,

You claim "just plain 'ol sick" and I claim "well, well, well . . . ."

Your risk is extremely minimal at best. Your negative tests at four, seven, and ten weeks are extremely encouraging. Your symptoms and those of your monogamous partner are not consistent with ARS; however, stress, anxiety, guilt and "heavy smoking" can indeed cause these and many more problems.

I agree with the two STD counselors, and yes, I am a real MD HIV specialist. (I don't just play one on TV).

You're 90-day test will be a definitive WOO-HOO.

I should mention one worrisome health risk from your post heavy smoking. Should you give it up immediately? "Hell Yeah!"

Thanks for your thoughtful consideration to help those in desperate need (www.concertedeffort.org).

Stay well.

Dr. Bob



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