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Dr. Bob, Please help me, I really need your help
Sep 13, 2008

Dear Dr. Bob, You are a great person who shines light of hope on people like me. I desperately ask you to save this desperate stupid soul who lives an hour away from you. I have already donated 100$ to your foundation and will promise to do it again. please reply to me. I had vaginal sex with a girl about 3 months ago and the condom broke. I also had a cut on my finger which touched her body fluids. I will never forget that night. I had undetectable HIV-1 PCR RNA quantitative test on week 6 and negative antibody test on weeks 4,8,11, 12.5. My last antibody test was done 86 days after exposure and it was an HIV1/2 rapid blood test. All the tests where done in the Bay Area California. The reason I am posting this to you is that, still I dont really have the peace of mind after all and I am afraid if all I got is a false negative and I am one of those unlucky guys who mess up the statistic. I am really going through a horrible time and I would have never wasted your precious time if I wasnt in this bad condition. I had a series of HIV related symptoms which started about 2.5 weeks after exposure. I couldnt find a good reason for them and my doctor also didnt help me at all as I visited him a couple of times. Basically he said he can tell me what I dont have (he says I dont have HIV after my negative test on week 8) . But he cant tell me what I do have. I desperately need you to tell me what could or might be the source of my symptoms and if it could be still HIV related. Here is what I went through when first symptom started. First I had night sweat for two days. I guess I had fever but I didnt check it. First I thought its a simple cold or mild flu but then HIV came to my mind as I had flu shot vaccine last October or November. Then I had pain in arms and legs, pain in my stomach after eating for two weeks. I also got an ulcer on the top of my mouth about 4 days after the onset of symptoms and took about 4 days to heal. Then I had a mild, on and off pencil like or needle feeling on my skin (leg, arm, face) for another two weeks. It wasnt like it bothered me much but I had it anyways. Then again 1 or two weeks of tiredness in my muscles arms and legs mostly. Then kind of headache started for two weeks. Then short of breath for 1 week or two. I had still mild on and off headache in that interval as well. Then Pain in stomach after eating again and on and off headache again. Little before week 11 my lymph nodes under my neck started to hurt and lasted for more than one week (not swollen). I could still feel a different feeling on my neck on the week after. Right now after three month, I still get a mild headache on and off close to my eyes. Basically my symptoms followed each other and when previous one ended the new one started. I had also negative mono test and negative Chlamydia. During the last three months I never had swollen lymph nodes or skin rash or diarrhea. But I vomited once. My lymph node started to hurt 2.5 months after exposure. I though its a late seroconversion. But my test after 86 days is still negative. I am really sorry for such a long email. But I wanted to give you my exact situation and tell you whatever I went through. Do you think I am infected with this HIV? I used to be healthy and had a good immune system but why my body is responding this way? What could be the source of my symptoms. Please help me. There are times that I cant stop crying because of all I did and all I am going through. This is changing my life in any aspect you can name it. When should I test again? Yours,

Response from Dr. Frascino

Hello,

Your repeatedly negative HIV-antibody tests out to 12.5 weeks and your undetectable HIV-1 PCR RNA at six weeks are definitive and conclusive. HIV is not your problem. No way. No how. (No McCain. No Palin!) No further tests are warranted!

Unfortunately, I cannot diagnose the cause of your symptoms over the Internet. (I don't have access to your medical file or laboratory tests nor do I have the benefit of a complete medical history and physical examination.) However, what I can do with absolute certainty is advise you what is not causing your symptoms: it's not HIV!

Your symptoms, by the way, are not worrisome for or suggestive of HIV acute retroviral syndrome (ARS). They are, however, quite consistent with stress, anxiety and psychosomatic illness. If your doctor cannot find a physical cause for your symptoms, I suggest you consider a psychosomatic cause. Psychosomatic illness produces very real symptoms! Certainly the stress of this HIV scare and your deep-seated fear of being HIV infected could be the cause of your problems. That you state "there are times I can't stop crying . . ." would indicate you are clinically depressed. Counseling could help you confront and conquer your fears, depression and anxiety. I urge you to seek the help of a psychologist. Bring a copy of your post and my response to your first visit and show it to your therapist. It will help focus your treatment and speed your recovery.

Thank you for your generous donations to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). They are warmly appreciated.

Good luck.

Dr. Bob



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