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generalized palpable lymph nodes

Apr 18, 2008

Dr. Bob:

Okay so I've been dealing with these palpable lymph nodes (which have also been) but they have become tender (even w/out touching them) for over a year now. What's most confusing is that they are tender on one side of body (under chin/jaw, armpit, and slight pain around elbow and behind knee but no lymph nodes which are palpable there). I have been to my family doctor, an ear/nose/throat doctor, and a general surgeon who have all confirmed that my lymph nodes are normal but what they fail to understand is that they do bother me whether they think they are within the normal size or not and they don't know that I'm scared about my HIV status. Now-I know the easy answer is 'go get a test' but I sometimes laugh at how easy that comes out of doctor's mouths. HIV is my most feared illness and death is my greatest fear and always has been. I do not see myself walking into a clinic anytime soon-I've already convinced myself that I have HIV. I have had a few unprotected vaginal experiences-I'm not going to lie-most which were 5 years ago or more. Other than the fear of an HIV test, I've always had normal pap tests and all other stds' always come back negative...I also have routine blood tests w/differentials yearly. My doctors are not concerned about HIV but I also haven't been completed honest about my risks to them. This fear is disabling me-I won't even get pregnant and I'm ready to have a child w/my boyfriend but won't because I know I will have to get a test then. I don't know what to do-I feel hopeless. Isn't it true that HIV lymph nodes are non-painful? Mine are all 1 centimeter or less and move around but they are sometimes very tender when touched and they seem to only bother one side of the body or the other but never all at once! I'm at a loss and I'm not crazy-I know my body. I appreciate any insite you can give. Thank you so much.

Response from Dr. Frascino


Sorry, but the insights I can give and advice I can offer clearly you are not ready to accept. Consequently I don't know exactly what you would like from me.

You emphatically state: "I've already convinced myself that I have HIV." If that is truly the case, you should go see an HIV specialist. Personally I doubt you have HIV, but since you also insist you won't get tested I guess we'll never know one way or the other, right?

I find it interesting and quite sad that you've been to many specialists who have "confirmed that (your) lymph nodes are normal," yet you are not satisfied with these very consistent assessments. Once again all we as physicians can do is give you the benefit of our knowledge and expertise. If you choose not to believe us, there is little else we can offer you.

It's bizarre that you state "HIV is my most feared illness" and yet you won't even consider the most likely scenario -- that you might not have it. Rather you've convinced yourself you are HIV positive. To say this is not logical (or rational) is an understatement. It's also quite sad that you report "this fear is disabling me. I won't even get pregnant and I'm ready to have a child with my boyfriend but won't because I know I will have to get a test then." And so you have chosen to trap yourself in your own worried-well hell, a very unhealthy and uncomfortable place to be.

You state you "know the easy answer is to get HIV tested" and I heartily agree. You may "sometimes laugh at how easy that comes out of doctor's mouths," but it happens to be the absolutely correct advice to give. Only an HIV test can bring resolution to your disabling fear.

I will offer one other piece of advice. Go to a psychiatrist. You need help confronting your irrational fear of HIV (and death). Once you have a better perspective on these issues, hopefully you'll reconsider your decision concerning HIV testing. Barring that your condition will only worsen and you will become increasingly paralyzed by fear and worry that each small ailment you develop is HIV related. That is a truly horrible way to live. You may or may not know this, but I've been HIV positive since January 1991. If I denied my illness due to fear and did not get the treatment I needed, I'd be dead now rather than responding to your anxiety-ridden ramblings. There is an excellent chance (distinct probability really) that you are not HIV infected. How you choose to live with this information is up to you. So far you've chosen very unwisely.

Dr. Bob

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