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Please answer this time!

Feb 14, 2007

Dear Doctor, Please! Please help me! I have asked so many times!

A very strange case

On Feb 17, 2006 I had an unprotect sex with an old friend. I know him for many years. He is 69 I am 54. We played a teasing anal sex where he was the insertive. I had never done it before. I could not relax. No ejaculation at all. He says he is ok. Ten days later I was insertive in another unfinished (anal) contact that lasted about 2 minutes. Person of unknown status, but it happened in a very dangerous environment (bath house, Sao Paulo - Brazil).

I started to research over the internet. I found out about primary infection! I read almost 50 articles about it. I start to look for symptoms. No symptom was showing up except I recall that 7 days after the first encounter I had a sore throat that lasted for 3 or 4 days. Never had fever or swallow lymph nodes or anything else I can recall. But I had whitish tongue later on. But, when I thought I was safe After 30 days) , I suddenly start to feel a cold sensations in my members though it was warm. My perception of ambience temperature had changed. Then I start to look over the net to find out what that was. The only thing close to my symptom that I found was sensory pheripheral neuropathy. Fact is that the more I read, the more my symptoms started to change from cold to burning sensation on my feet and legs (mostly at night). Since I dont have diabetes the only thing that could explain my symptom was HIV.

Twenty two weeks after the first risk (which was 20 weeks after the second one) I decided to go to an infections specialist. This person has been working with AIDS patient for 20 years. But I wonder if she has really seen primary infected patients. She said, let me exam you. She touched me all over and said up front that she believed I did not have HIV. I cant detect a single clinical symptom in you. I took and HIV test and others including hepatitis AB and C, liver enzymes, calcium etc. The tests came all negative. HIV Method Meia Axsym ab-ag. (137 days after my later risk, 139 after the first).

I took three blood counts in the six months period. The first one was when I thought I was in the primary infection. My WCBC had always been on the 9,000 range.. This time it was 10,700. The percentual were normal. My lymphocytes were respectively 2.880, 2800 and 2810 (period of 6 months) . For almost six months my CBC remained over 10,000 going down to my normal 9400 afterwards. I had never experienced this change before. My platelets increased from 324 to 394 after 6 months.

My doctor gives too much attention to blood count on diagnosing HIV saying among other things that if I had HIV I probably would have had lower instead of higher counts and lower platelets in addition to lower hemoglobin (It was around 14.3). As the burning feeling in my feet did not stop ( I thought they would) after a negative test, I went back to this doctor 3 additional times. She said my problem were pschycological. I went to two neurologists. They said my reflex and muscle strength were normal (by a test EMG I took). Fact of the matter is that I still have to take 1 mg clozenpam to sleep every night due to the burning. Recently I had a bout of sinus not so strong but enough to bother me. Soon it will be a year ever since it all begun. I do not feel well. I am having either a cold or a sinus problem again. I cannot differentiate.I was a very healthy and strong person. The stress has been overwhelming. Deep inside I feel I have HIV and I was victim of mistakes by the doctor and by the lab. There is no other way to explain my lack of well being.

MY QUESTIONS; a) Is it possible for peripheral neuropathy to be the first symptom in the primary infection and remain for so long b) Is an EMG a reliable diagnose for peripheral neuropathy 5 months after it appeared. c)When a person has a late seroconversion does it mean the p24 also appears later, (my test was ag-ab). d) If a person has symptoms of neuropathy does it mean that the virus is already in his blood stream and therefore that person has already antibodies detectable. e) How much can a doctor tell about a patient based upon a physical exam

Please let me know what you think of all of that. I want to live. Right now I am vegetating. Thank you dearly!

Response from Dr. Frascino


I have not responded to your previous posts, because HIV is not your problem. No way. No how!

Yes, there was a degree of risk, but you conclusively and definitively did not acquire the HIV virus!

You have been repeatedly and thoroughly evaluated by an AIDS specialist with over 20 years of experience! (Yes, I do believe with 20 years of experience she "really has seen primary infected patients.") She advised you she "could not detect a single symptom." Your HIV tests and other studies were completely normal. Your CBC counts are unremarkable and certainly do not indicate HIV! Your symptoms of "peripheral neuropathy" are not peripheral neuropathy, as confirmed by two neurologists.

You correctly identified your problem when you wrote: "The stress has been overwhelming. Deep inside I feel I have HIV . . . ." BINGO! There's your problem: stress and guilt, not HIV! There is a world of difference between feeling you have HIV and actually having HIV. You claim "there is no other way to explain my lack of well being." Why would you say that when the specialists have advised you your problem is psychological? I absolutely agree with them. Until you seek and obtain help for your psychological problems anxiety, stress, guilt, depression, irrational fear of HIV, etc. you will continue to feel unwell.

To address your specific questions:

1. No.

2. Yes.

3. You are not a late seroconverter. You are definitively HIV negative. Period.

4. "Symptoms of neuropathy" and actually having neuropathy are two very different things. You do not have HIV-related peripheral neuropathy. Period.

5. Lots!

You claim you want to get better. Yet you continue to reject the advice of physicians trying to help you. I strongly suggest you seek the help of a psychiatrist/psychologist. Bring a copy of this post and my response to your visit. Get the help you need, rather than continuing to chase an illness (HIV) that you could not possibly have. Your road back to good health is clear. You just need to take the next step.

Dr. Bob

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