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Deep, deep depression continues
Dec 15, 2007

Dr Frascino, I wrote to you a while back (can't take this hell anymore). Since then, I have battled every day to put this behind me and move on. And then I read something new, or discover something worrying. I cannot shake this Dr Bob. I know you will tell me to see a counsellor and that negative tests are conclusive, but I have recently been reading about indivudals who have HIV but never ever test antibody pos (HiPS). Before my exposure, I was relatively healthy. I now suffer from sebborheic dermatitis, constantly cold feet, severe rheumatoid arthritis in my fingers, dark urine, brain fog, and a prominent spleen (my Gp confirmed this). I have tried to get this sorted, and recent blood tests were normal apart from a WBC count slightly below the margin (suggestive of HIV).

Dr Bob, I cannot continue like this. I am 20 and I have so many things planned next year, but I cannot enjoy them with this hanging over my head. And to add on top of my worries, I believe I have infected my mother and brother. My mother applied cream to a fresh wound of mine (mildly bleeding) in 2005 and since then, she had to go to a GUM where she presumably tested neg for HIV and they apparently told her "we don't know what this virus is". (Before you tell me you can't get HIV, I'm sure you know about the other case of transmission like this). I can't ask her more about it because we do not have such an open relationship.

Dr Bob, please be honest with me. Have you ever seen a situation like mine where the patient ultimately ended up in hospital with a HIV/AIDS diagnosis, despite negative antibody tests after 5 years? I am afraid of the damage I am doing to others while I am supposedly HIV -ve. This recent low WBC count is very worrying. Also, I have tested negative for HEP B/C, but I have read about occult seronegative Hepatitis so those tests mean nothing. If I turn out to have Hep B or C, then it means your initial assesment of my exposure as 'almost nonexistent' was wrong, right?

Please respond Dr Bob, I'm counting on you. You're a great man, and you deserve only good things in life.

Scared guy.

Response from Dr. Frascino

Hello,

"Dr. Bob please be honest with me"!!?? Scared Guy, I'm always honest. I absolutely agree with the title of your post, "Deep, deep depression continues." My assessment and advice remain completely unchanged from last time. Why continue to write to me if you don't believe what I have to say and are not willing to accept the advice I offer??? Your HIV fears are completely irrational and unwarranted. Your fears of infecting your family are completely irrational and unwarranted. I really can't say it any more directly than that. You also apparently have not followed the advice I offered. You mention that I recommended you "see a counselor." Actually I recommended you "see a psychiatrist", not just a counselor. There is a difference. A psychiatrist is a medical doctor, most counselors are not. Psychiatrists are consulted for more severe problems and you definitely qualify. My "very strong recommendation" remains unchanged.

I'll reprint your previous post below. The next step toward regaining your health, both mental and physical, is clear; however, it's a step only you can take. I urge you to do so without further delay.

Finally, you ask if I've ever seen a situation like yours before. Yes, many times. The situation is someone who continues to believe he is HIV infected despite incontrovertible evidence to the contrary! Just take a look through the archives and you'll find many similar stories. Note also that 100% of these folks ultimately proved to be HIV negative.

Good luck.

Dr. Bob

Can't take this hell anymore Oct 19, 2007

Hi Dr Bob, I hope you will read and respond to my very long story. For 5 years I have been stuck in an absolute nightmare which I don't think will ever resolve. In 2002, when I was 15, a boy in my class stuck me with a compass which penetrated the skin and caused bleeding. I have reason to believe he stabbd himself with the compass beforehand and that he was a serious drug user. Even at age 15 I was very worried. I didn't tell my parents because I was scared of their reaction, but a month later I developed a fever and had a blood test, where a low WBC was discovered. They told me it was a viral infection. I kept silent about the experience for a couple of years, but then I started notice a few things. I have devloped a swelling (splenomegaly), dull pain below my ribcage, and the most worrying for me was seborrheic dermatitis. This condition persists to this day. A year or two later I devloped 'asthma' and I have a white coated tongue with raised red, painless spots at the back. I could live with this, and I was more than happy to suffer in silence. But In December 2005, I had a fight with my brother which turned violent, and being younger than me he bit me. His bite did cause me to bleed although I doubt the blood penetrated the vest I was wearing. I thought nothing of it, but 6 months later he started devloping dry skin problems where he had none before. Then about a year later I noticed seborrheic dermatitis on my mothers face, aswell as her having recurring thrush and skin infections which I found out. My sister also started devloping dry skin. She had a HIV test in order to get a visa for her emigration and it was negative. I could handle all my problems, but believing I have infected my innocent family is something I cannot handle and I have been at rock bottom for about a year now. In September 07, I finally had enough and went for a rapid test, which was negative. I was happy for a day, but my symptoms have not been explained, so I went for an ELISA the following week, which also came out negative. Bearing in mind my symptoms and my family's, could it type N? I know you will say this strain is rare, but it's still possible. I have a feeling no test will ever dispel my doubts, PCR or antibody. I'm pretty certain I have hepatitis B or C also, which can induce diabetes. Diabetes can cause immunosuppresion, which maybe has diminshed my antibody production for HIV. Please give me some insight. I will donate as much as I can.

Scared guy.

Response from Dr. Frascino

Hello Scared Guy,

I absolutely agree with you! You are indeed "stuck in an absolutely nightmare"!!! However, what you apparently have yet to realize is that "nightmares" aren't real. They are merely fear-inducing bad dreams!

Let's start with your potential exposure a prick from a compass that caused bleeding five years ago. The chances this mishap transmitted HIV are so remote they are essentially nonexistent.

Next, your symptoms are not suggestive of or worrisome for HIV/AIDS. I doubt your pain below the ribcage is "splenomegaly." And even if it were, it's not related to HIV. Why? Because you don't have HIV. That's why! Seborrheic dermatitis is an incredibly common dermatological condition and the vast majority of cases have absolutely nothing to do with HIV/AIDS. "Asthma" and raised red painless spots on your back are not related to or suggestive of HIV/AIDS.

Next, your fears about infecting your "innocent family" are also completely irrational and unwarranted.

Next, your test results a negative rapid test and negative ELISA five years after your compass poke are definitive and conclusive. HIV is not your problem. No way. No how. Subtype N? Nope. No way Jose!

So what is your problem? Anxiety, irrational HIV fear and depression. This is clearly evident from your statement, ". . . I have been at rock bottom for about a year now . . . . I have the feeling no test will ever dispel my doubts . . . . I'm pretty certain I have hepatitis B or C also, which can induce diabetes. Diabetes can cause immunosuppression, which maybe has diminished my antibody production for HIV . . . ." WOW! You certainly have a vivid imagination, somewhat morbid, but vivid nonetheless. However, your impressive stream of consciousness, doom and gloom scenario is total balderdash, drivel and poppycock without a modicum of rational thought or the least shred of common sense evident! No doubt you have a significant problem; however, that problem is not HIV! Scared Guy, your problem is being scared, not being infected!

My very strong recommendation is that you seek the help of a psychiatrist without delay. Bring a copy of your question and my response to your first visit and show it to your psychiatrist. It will help focus your treatment and speed your recovery.

Once you have completely recovered you might consider a career as a bad science fiction writer or a post in Dubya's cabinet where science, truth and common sense are always strictly verboten!

Dr. Bob



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