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Jul 22, 2006

Hey Dr. Bob, again let me start by thanking you for all the wonderful support and wisdom u bestow upon these desperate souls. You're work here is imperative. You may recall me, I was that young italian one time model who wrote you back about 6 months ago in a desperate situation. To refresh, I have been struggling with an immune disorder that strongly resembles HIV for about 2.5 years now. In early 2004 after a series of unprotected sex with men involving swallowing i came across Fungal infections on the face, huge boils on the neck, fever, loss of weight, constant headaches, diarrhea, floaters, blurry vision, and abdominal pain. The symptoms never went away and persist today with clinical proof of lypodystophy. Temporal, periorbital, cheek fat loss, along with truncal obesity, and loss of much fat on limps, thighs and buttocks. Yes my model physique is disippating. I have been examined by specialists at John Hopkins and fail to show a reactive antibody test to the "standard" HIV test. I have never tested for rare strains, or even Culture Assays/Pcrs (even though the man i believe infected me was from outside North America).As of recent, my CD4 count and ratios are noticeably declining and are of concern to me and my primary physician. My question today is, you had mentioned in the previous email about infectious disease testing for complex diseases in California, i think particularly University of Stanford if im correct. Can you advise me of the services i may benefit from at this hospital or any other teaching hospital, facility that specializes in rare testing for complex infectious diseases and HIV. I guess i need to know how where these places are and how i can arange a consultation or appointment as I've run out of options in Toronto. If you can provide phone numbers or locations for me id be truly grateful. My primary Physician is currently researching this too and is in total support of my quest (thank God). I truly appreciate any advice you can shed, and only want to come across some answers. GOD BLESS :)

ps. I do have those speedo pics on the beach if u so desire :)

xoxo GINO

Response from Dr. Frascino

Buon Giorno Gino,

I'm sorry to hear you are still having such a difficult time sorting out the cause of your problem! The good news is that it does not appear to be HIV related.

Regarding a second opinion, if you've "run out of options in Toronto," it seems that California is a great distance to travel; although, of course, it's a wonderful place to vacation . . . . Certainly John Hopkins Medical Center has an excellent reputation as a tertiary referral facility. And Baltimore is certainly geographically closer to you (but scores quite low on the Vacation Paradise Scale). I'm concerned that you were "examined by specialists" there, but apparently are still completely flummoxed as to what's going on! What type of specialists did you see there? (I'd recommend Joel Gallant, M.D. He's in the Department of Infectious Diseases and director of their HIV clinic.) What did they say was going on? When you say your "CD4 count and ratios are noticeably declining and are of concern to you and your primary physician," exactly how much are they declining and over what period of time? The reason I'm asking is to determine whether it would be better for you to see a clinical immunologist (to assess your immune system) or an infectious disease specialist (to look for rare infectious processes). Once I have that information I'll try to steer you in the right direction. As for the Italian Model Speedo Beach pics, you can send them at your earliest convenience or personally deliver and sign them if you come to Stanford!

Dr. Bob

Occupational Exposure- Your Friend Me Again Please
Comment on honesty and insults (follow up, rec. by Dr. Bob)

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