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Another question from the overly worried healthcare worker!
May 17, 2009

Hi Dr. Frascino

I wanted to reply to your question about why I had to wait 3-4 weeks for my results. The reason being that they send the sample to the state lab instead of a private lab. I actually went to my local health department, and they told me that if I saw a physician that they would do the same thing, and the health department was free. The wait is literally killing me! And I have 2 more weeks (June 1). The day before my 2 year wedding anniversary....great. I didn't want to take the at-home test b/c I didn't feel that I could completely trust the results, so that's why I went the route that I did.

I hope you don't mind if I ask you another question. I've been having this problem since the very month that this possible incident occurred. I started noticing bald red spots on my tongue. I kind of let it go, told myself no big deal. Well over time, the same thing kept happening to my tongue. I get the spots, they heal and new ones begin. I started worrying about it so I googled it (bad idea). When I did I kind of figured out that I had geographic tongue. My tongue also gets this white, furry appearance, again another thing I shouldn't google and I did. Seems both are related to HIV ugg. Seems that neither of my parents have these issues and my mom said that my Grandma once told her that if you have a white tongue you need a laxative lol, and I do seem to have constant issues with constipation. When I went to the health department the NP told me that symptoms don't usually occur unless you're exposed to someone with full blown aids such as leukoplakia (which is not my problem)....and that symptoms don't generally appear during the first 6 months. I asked if she wanted to look at my mouth and she said no =(. I've just become so self-conscious about my tongue that I don't want anyone to see it. Anyways, my question is do you think that I should be worrying about these issues with my tongue, or am I to quick to judge and relate them to HIV? What are your opinions? Should I go see a doctor and have it checked out? I know my husband is right when he says I shouldn't google symptoms.

Thanks for all the comfort you bring. You truly do a wonderful job with this forum, and I am patient waiting on my answers. I also intend to donate to the fund.

Response from Dr. Frascino

Hello Overly Worried Health Care Worker,

Regarding the length of time it takes to get HIV test results back, I don't agree. Certainly the health department may have a long lag period and send their specimens to a state lab to help keep costs down, as this is a free service. However, private physicians routinely have HIV tests done at commercial laboratories and the turnaround time is days, not three to four weeks. Rapid test results are available within 20 minutes. If you don't want to wait and can afford to pay for your test you could get the results very quickly.

Regarding your tongue issues, your description does sound like geographic tongue. Please note the vast, vast majority of cases of geographic tongue have absolutely nothing to do with HIV/AIDS; likewise for "white tongue." The information the NP told you is inaccurate. Symptom development has nothing to do with whether you're exposed to someone newly infected or someone with AIDS. (We don't use the term full-blown AIDS because there is no such thing as partially blown AIDS!).

To address your specific questions:

1. Do I think you should be worrying about your tongue symptoms? No. I think you should see an ENT physician if these symptoms are bothersome. I do not believe they are related to HIV/AIDS.

2. My opinions? These haven't changed from my initial response. See below.

Dr. Bob

Overly worred healthcare worker? May 8, 2009

I have a question. What are the chances of getting HIV from a PEG tube splash where no "visible" blood is seen? I don't know the patient's status but with universal precautions lets pretend she's positive. I am a nurse and when the incident happened (almost 8 months ago)I felt convinced that nothing had gotten into my eyes though a drop got on my lip which I went to the bathroom and washed off. Over time OCD has set in and I'm like well what if it did get it my eyes? and I didn't have my eyes rinsed out?! I didn't even turn the event into occupation health as an exposure. I also just got my HIV test done today, and I have to wait 3 more weeks for results. Am I over-reacting and worrying for nothing?

Response from Dr. Frascino

Hi,

I'll make two quick points:

1. All occupational exposures or potential occupational exposures should be reported, documented and evaluated. Had you done so eight months ago, you wouldn't be freaking out now.

2. From the details given, I would assess your HIV risk as negligible at best. I'm confident your HIV test will be negative. Why do you have to wait three weeks for results? Rapid tests give results within 20 minutes and even routine ELISAs should only take several days at most.

Good luck.

Dr. Bob



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