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Worried dutch boy follow-up

Jul 30, 2009

Dr bob,

Im writing to you in a follow-up on my question with subject: worried dutchboy from last December.

The facts are as follows: Vaginal, unprotected sex (very clumsy, used a condom, took it off, put it back on the wrong way out) with a Thai prostitute (i was told later). 14 days after I developed fatigue, swollen lymph nodes, sore throat and most important: macopapular rash on my right arm for which I have not found any other cause.

After this I have gone through oral thrush in my mouth (confirmed by GP and specialist) about 3 times in the last 2 years, fatigue for over 2 years now. Also the lymph nodes in my neck and above my collarbone have been enlarged (>2 cm) and are extremely painful. I feel run down all the time. I bruise very easily (weird yellow bruises, never had them before my sexual encounter), have flaky skin on my hands and feet. I have tingling/numbness in my hands and feet pretty much all day. The last couple of months I have been having muscle weakness in my legs as well. Also in the months following my sexual encounter I had severe pharyingitis (also confirmed by GP and specialist). I just finished law school with top grades, Im not a dumb guy. And my analytical mind tells me that I have hiv. However, Ive tested negative out to 10,5 months which would make that unlikely. What should I do? Im sick of HIV-testing, and actually a bit afraid of what the outcome might be too. But if I leave it lingering and wake up with AIDS one day the meds won't be as effective as they can be and a lot of the damage has already been done. I have read some medical literature in the university library the other day which clearly states that some patients remain seronegative despite their HIV-infection. Although I know this is highely, highely unlikely I just cannot think of anything else that is causing me to feel the way I do. I think I know my body. Do you have any suggestions on what I should do or do you think Im ready for the nuthouse? Id love to hear your professional opinion since I highly value yours. Keep up the good work dr.Bob. I really admire the way you handle your life!

Response from Dr. Frascino

Hello Worried Dutch Boy,

You have repeatedly tested HIV-antibody negative out to 10.5 months and yet you state: ". . . my analytical mind tells me that I have HIV . . . ." Hmm . . . that, as Mr. Spock would say, is "illogical!" Your negative HIV tests are definitive and conclusive. HIV is not your problem. No way. No how.

"Symptoms are notoriously unreliable in predicting who is and is not HIV infected. You report: ". . . I just cannot think of anything else that is causing me to feel the way I do . . . ." Well, of course you can't! You just graduated from law school, not medical school!!!! Silly boy! I wouldn't be able to craft a complex legal argument any more effectively than you could diagnose a set of symptoms!

Here is what I would advise:

1. Stop perseverating on HIV. You have overwhelming and incontrovertible evidence you are not HIV infected. Case closed!

2. If your "G.P. and specialist" are stumped as to the cause of your symptoms, get one additional second opinion, preferably from an Internist. If again no physical cause can be identified, I recommend you be evaluated for psychosomatic disease.

3. Stop trying to self diagnose!

Dr. Bob

(AMBUSH) Can u at least test it...
My Woo-Hoo Moment!!

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