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re: What, me worry? Pshaw.
May 17, 2006

Hey doc, just wanted to ask a follow up question to your response. I will keep it short and simple: you indicate that I have no need of further testing. Just want to to make sure you know all of my testing was over a 5.2 week period. The way my post was written, I was afraid you got the idea that I had tested out to 11/12 weeks. Not the case - last test I took was 5 weeks, 2 days past possible exposure.

Hey, just because I have a sense of humor doesn't mean I'm not as crazy as the next guy.

Response from Dr. Frascino

Hello,

Based on everything in your original post (reprinted below), my advice remains unchanged. However, as always, if you are worried, a single HIV-antibody test at the three-month mark will give you a conclusive and definitive result, which may once and for all get you away from fears of the severed-horse-head experience and your subsequent cozy relationship with anti-anxiety pills.

Should you still be worrying? Pshaw! No.

Should you keep your sense of humor? Absofrickinlutely!

Dr. Bob

What, me worry? Pshaw! Apr 25, 2006

Hola Doc!

Have a question that I hope will be of use to the other readers about testing.

First, a little background. Approximately 6 weeks ago, I performed unprotected oral on a woman I had just met in a bar. It wasn't actually *in* the bar: I do have some modesty. I was drunk, and do not remember unprotected intercourse (vaginal), but let's assume that also happened, though probably didn't. But, just hypothetically, let's say it did (because, of course it makes me feel much, much worse!). Woke up the next morning, she was laying next to me, and I realized that she had been menstruating fairly heavily. Blood on my tshirt, on covers, on pillowcase. Yuck. Looks like scene from Godfather where movie producer wakes up with horse's head in bed.

Typically, I am not a worrier, but, maybe due to the blood, I went off the deep end. Was extremely worried about all sorts of things: hep c & b, gonorrhea, chlamydia, and, most importantly, HIV. So, in classic me fashion once I start to worry about something, I went into overdrive to alleviate my concern. This is what I did:

1. Prayed a lot. 2. Prayed some more. 3. Got chlamydia and gonorrhea urine test, approx. 30 hours after exposure. Came back negative. Got sore throat with exudants on tonsils a day after that (approx. 50 hours post exposure - to what, who knows?), but not sure if that might be pharyngeal gonorrhea or chlamydia. Doctor didn't bother to do a throat swab. He just had me gargle with salt water and, a week later, it went away.

4. Started reading about STDs and HIV on the Internet. Worst mistake of my young life. Soon after, started checking temperature every hour and waiting for the night sweats to start.

5. Talked to doctor again about possible HIV exposure. He said forget testing. Suggested I go see psychotherapist instead. Gave me pills for anxiety. Downward spiral proceeding nicely: now I am not only worried about STD/HIV, I am worried about sanity as well. Lovely combination. Gobble anxiety pills copiously.

6. Doctor, in same visit where he told me not to worry about HIV mentions that my sore throat may have been a fungal infection. Chuckles and says that , of course, thrush is a sign of HIV infection. I fall off stool. Doctor says to keep taking anxiety pills. I say: screw that and head to free HIV testing clinic to get baseline test for HIV, knowing at this point that I am in for a long few months. Baseline test performed using Oraquik saliva testing, comes back negative. Nurse who administers test, after listening to my possible exposure, suggests I do not return for testing.

7. Over next 2 weeks, I comb the internet for all things ARS/HIV related. I become the world's foremost expert on all matters AIDS and HIV. I start lecturing friends about safe sex. Friends begin to avoid me. Anxiety gnaws at my innards like vultures. When I can take it no longer, I call an HIV certified specialist located in Dupont Circle, DC. Speak to a wonderful and caring PA who tells me not to get tested. I feel better for approximately 10 minutes, then call back and say: I want a test.

8. 2 weeks and 1 day post exposure (to what, who knows?), PA for HIV specialist draws blood and sends it to LabCorp for HIV DNA PCR test. 3 days later, he calls me with the good news: negative. He tells me that I now have 100% peace of mind - no more tests are necessary. I listen to him on my cell phone while driving to work. Nearly drive off overpass as relief courses through my body.

9. Relief lasts until I read somewhere on the Internet that the DNA PCR test from LabCorp is only conclusive after 28 days. Worry begins anew. Consider checking into a psychiatric hospital, but worry that they won't HIV test me at 28 days, so decide to wait. Anxiety pills consumed in ever greater numbers.

10. At 29 days post exposure, contact LabSafe, affiliated with LabCorp, for another ProViral PCR DNA HIV test. 3 days later, test comes back: negative. I am happy again. Am told that test is 99.9% conclusive, which is conclusive enough for me. Decide no more HIV testing. Feel good for about 2 whole days. Then, start thinking about other STDs. Wonder why I hadn't thought of that before. Look for anxiety pills I had thrown in trash after latest HIV test result.

11. 4 weeks post exposure, come down with sinusitis and ear infection. Urgent care doc gives me Amoxicillin, 500 mg. , 2 pills a day, 10 day course of treatment. Realize amox pills, when combined with anxiety pills and diet cola, have a nice fruity, sulfurous flavor. Also given steroidal nose spray, which I think is really most tabasco sauce. Spray into my nose and quickly begin to pray for death due to pain. Decide nose spray cure is worse than disease and stop using it.

12. 5 weeks, 2 days post exposure (to what, who knows? could be anything!): get full STD panel from LabCorp: tests for herpes 1 and 2, hep c & b, hiv (antibody), gonorrhea and chlamydia. Results as follows:

HIV - Negative Herpes 1 & 2 - Negative Hep B - Negative Hep C - Negative Gonorrhea and Chlamyida - don't know yet, will know tomorrow.

12. Testing fatigue starts to set in. Most veins have begun to collapse from all the blood taken in past weeks. Cubicle mate looks at arms and wonders aloud when I started doing heroin. I find no humor in this. Begin to wonder if I really need anymore tests at all. Decide to post on the Body to get an answer, and perhaps sweet release from my testing anxiety, which I thought I had left behind when I dropped out of college.

So, the question is: do I need any more tests, for anything?

Response from Dr. Frascino

Hello,

The short answer is no.

The long answer is also no.

But I do have a question about the woman you picked up in the bar. In the light of morning, did she really look like a severed horse head?

Thanks for your amusing post! Now step away from the anxiety pills and get on with your life, OK?

Stay well.

Dr. Bob



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