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Beauce County Boy Needs Some Help
Apr 5, 2010

Doc, Read your blog and was delighted to read you spent time in "the great metropolis of St. Georges" My parents hale from Beauce and I spent lots of time up there as a boy, mostly in St.Victor. But I did some partying in St.Georges as a young man. Small world. Also wanted to say how buff you look on your blog photo .My Dr. Bob what big guns you have.I hope you feel as good as you look.I'm struggling with OCD manifesting itself mostly as an irrational fear of AIDS and the possibility of transmitting it to those around me.It effects intimacy with my wife and how I interact with my 3 sons. I'm in therapy and taking meds but still the battle rages in my head. I was was exposed to a intervenous drug users blood and I had a small open cut on my hand. Sometimes being a Good Samaritan can be dangerous. The individual refused to get tested because he couldn't deal with the results,and ignorant about PEP, I figured I would ride out the window period. Twenty one days after the incident I became ill with a fever, nightsweats and a non itchy macropapular rash on trunk arms and hands. The rash was transient for a few months, I endured red burning skin on chest abdomen and shoulders. I went to an infectious disease Doc who ran HIV 1&2 DNA PCR test and an HIV 1/2/0 ICMA antibody test, all neg. Went out past window period of 6 months retested at 1 year, 1.5 years,2 years,& 2.5 years, even had a negative western blot the Doc reluctantly performed.My anxiety waxes and wanes and I'm working real hard at getting better ,being a good dad, and husband. Recently however I've been suffering from a gaggle of new health problems that reinforce my fears. I have Blepharitis that responds well to morning and evening eye washing,seheroric dermatitis on chin & forehead that responds well to washing with a non moisturizing soap, again morning and evening, I have recurrent jock itch that goes away with use of an OTC antifungal powder. After it abates if I don't powder the boys 3 times a day with regular talc it returns and now I'm getting warts on my damn hands.I'm having problems accepting that these are just coincedences . By the way , these conditions were diagnosed by GP and a dermatologist. I don't want to be infected with a disease that can be treated and not know if I have it. I want to be around to enjoy my family and be there for them.I need some advice.Do I go back to the Infectious Disease Doc and try to get more tests maybe to find out what the statis of my immune system is, or try and get tested for rare subtypes?,or do I just do my best to take real good care of my health and deal with these little annoying conditions? Since turning 40 I feel like I,m falling apart!! I love you Doc!!! Best Wishes, Beauce Boy

Response from Dr. Frascino

Hey Beauce Boy,

Salut! Parles-tu la langue de Molière et Asterix? Peut-être non. Alors, je te réponds dans la langue de Obama!

Thanks for your kind comments. It's amazing how many married guys are impressed by my "big guns!" I take that as a very big compliment!

I absolutely agree with your self diagnosis: "I'm struggling with OCD manifesting itself mostly as an irrational fear of AIDS . . ."! BINGO! Your problem is "irrational fear," not HIV/AIDS.

Your repeatedly negative HIV-1 and HIV-2 antibody tests out to 2.5 years plus your undetectable qualitative HIV-1 and HIV-2 DNA PCR are definitive, conclusive, excessive and WOO-HOO-able. HIV is not your problem. No way. No how. No additional HIV tests are warranted. You've had way too many already!

As for your symptoms, they are indeed "just coincidences." They are not suggestive of or worrisome for HIV. They are just, as you stated, "little annoying conditions."

My advice:

Continue with your treatment of OCD. Psychotherapy (counseling) plus medicament can be very effective in helping you confront and conquer your irrational fears.

Continue to follow up with a dermatologist for your "annoying conditions" (seborrhea, warts, etc.). Rest assured these are not HIV related! A negative HIV test outside the window period trumps "symptoms" each and every time. The vast, vast, vast majority of cases of blepharitis, seborrhea and warts, etc. Have absolutely nothing to do with HIV!

I have many fond memories of my time in St. Georges!

Be well. (You are indeed well.)

Dr. Bob



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