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I need you now more than ever doc...Please!! (DONOR)
May 26, 2010

Dr. Bob, Again I just wanna say that you are a godsend to many of us!! I wrote to you earlier about an unprotected sexual encounter I had with a woman of unknown status. Two weeks after the encounter I came down with symptoms that I have never felt before in my life. They were extreme muscle spasms in calves and hamstrings, rectal discharge, lymph node swellage all over body and widespread muscle pains and a feeling of being hit in the back of head with a baseball bat! It feels like something is almost attacking my nervous system by the involuntary muscle twitching I am experiencing and the back of my neck is in pain leading into the back of my head. These symtpoms have been dragging on for 4 months almost 5 now. I had a metabolic panic done 11 weeks after encounter which was normal. had cbc done which was also normal, got tested for hep a,b,c neg, ebv, hsv, hiv, and all came back neg at 11 weeks. I had another hsv and HIV test done at 14 weeks which was elisa and came back neg. The only reason I am still on here is because I went to planned parenthood last week and had a 17 week or 4 month rapid test done and was neg but they took a urine sample and said there was an infection present in my urine but could not tell me what it was. I have taken 2 rounds of doxycycline prescribed by a dr. and there is still an infection present 4 months after this encounter. I did what you said and had a urinalysis done and was told there is actually no infection present. This scares me because I have constant muscle twitching in calves still as well as the pain in back of neck and back of head, my scalp is actually sensitive to the touch with sharp pain. I have sharp pains in my feet and hands as well and lower back pain. I am trying to keep a level head but despite all the neg tests I can not get HIV out of mind for lack of explanation of these ongoing symptoms. I plan on going back to test for HIV once again two days from now which will be 20 week mark. Do you recommend further testing? Should having sex with unknown status and HIV+ person be tested same out to 6 months? Can I still woo-hoo despite these symptoms? You told me earlier my tests were conclusive and woo-hooable but its hard to woo-hoo with these ongoing symptoms doc. I just need your help and once again say thank you and you are the MAN!!

Response from Dr. Frascino

Hello,

My assessment has not changed and no matter how many times you ask, my assessment will not change. You are HIV negative. Your symptoms are not consistent with our worrisome for HIV disease. Rather, they are very consistent with anxiety.

You report: "I can not get HIV out of my mind . . . ." BINGO! There is your problem! I urge you to seek psychotherapy to help you confront your irrational and totally unwarranted fears of being HIV infected.

The bottom line is that HIV is not your problem. No way. No how. No additional HIV testing is warranted. However, evaluation and treatment of your anxiety and irrational fears definitely is!

Good luck.

Dr. Bob

Please Help Me (DONOR) May 5, 2010

Dr. Bob,

let me start off by saying that I think what you do is truly amazing!! Could only donate $10 because I am still in college. My story goes like this: Had unprotected vaginal sex with a woman of unknown status on Jan. 6. Two weeks after the encounter I came down with flu like symptoms and had extreme muscle pains in my legs and had muscle twitching in legs as well, mostly in calves, as well as rectal discharge and have never received anything in my rectum. Went to my university wellness center and had temperature of 99.6 so didnt think much of it. 10 weeks 5 days after encounter I got tested for just about everything under the sun including hiv which was elisa test don't know which generation cause it was sent to labcorp and all came back negative. Since the onset of these symtpoms I have had a continuous headache as well as felt lymph nodes in arm pits, groin, back and side of neck,behind ears, as well as jaw flare up and rectal discharge has continued as well. My symptoms seems to get worse when I drink alcohol so I have quit. Now it seems I have this nonstop lower back pain as well as pains in the side of buttox. Have had slight acute pain in abdomen too. Have had no visible symtpoms of any kind which is what scares me. Had HIV test done again 97 days 0r 14 weeks post encounter and was negative as well test was elisa again do not know which generation was sent to labcorp. I have been on some antibiotics as well and do not know if that would affect results such a azythromicin, lexapro, doxycycline. I am worried because symtpoms have been persistent for over 3 months!! I have tested for hiv with 2 blood tests sent to labcorp at 10 weeks and 14 weeks and both were negative also had 4 rapid tests done at various times and all were negative three were oraquick swab hiv 1/2 and one was rapid finger prick. I am a 23 year old college student in Texas who works out and eats healthy on a regualr basis do not know if that matters at all. It does seem that my symtpoms seem to get worse after i workout and i get lightheaded when my heart rate picks up which has never happened before (have been working out for quite some time) I have a few questions which are.. Are these typical symptoms of HIV? Is my 14 week elisa test reliable or should I continue to test at another time? Is it normal for symptoms of hiv to last this long? Would having multiple infections affect hiv results or slow seroconversion? Do you recommend further testing or can I woo-hoo?

Response from Dr. Frascino

Hello College Stud,

Unprotected sex does place you at some degree of risk for STDs, including HIV. However, your repeatedly negative HIV tests out to 97 days are definitive, conclusive, excessive and WOO-HOO-able. HIV is not your problem. No way. No how. No additional HIV testing is warranted. Your antibiotics and antidepressant mediations would not affect HIV test results or the duration of the HIV seroconversion window period.

Unfortunately I can't diagnose the exact cause of your symptoms over the Internet. However, what I can do is advise what's not causing them. It's not HIV. If your symptoms persist, see your private doctor for an evaluation. Stress/anxiety may well be contributing.

Thanks for your donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's very much appreciated.

Be well. Stay well. And no more unprotected nookie, OK?

Dr. Bob

Dr. Bob (College Stud Really Needs Your Help) Please I dont know who else to talk to!! May 11, 2010

Dr. Bob,

I once again would like to say that I admire you and am actually getting my masters in counseling and guidance and am now thinking about specializing in HIV counseling thanks to you! I wrote to you about an unprotected sexual encounter I had with a woman of unknown status(vaginal sex)on Jan 6. Well a couple weeks after the encounter I came down with some symptoms that i have never felt before in my life as far as rectal discharge,lymph node swellage all over body, muscle spasms in calves and hamstrings from time to time and i feel like i got hit in the back of the head with a 2x4!! At 10 weeks 5 days after encounter I had full metabolic panel done, which was normal. Had cbc done and was normal, was tested for Hep a,b,c and was neg. Was tested for HSV, EBV, HIV from a blood sample sent to lab and all came back neg. Was tested for Syph, chlamydia and ghonnorea and all was neg.I had a hiv rapid test done at 12 weeks which came back neg and an elisa test done at 14 weeks which came back neg. I went to planned parenthood last week because symptoms have persisted and had another rapid test done which was unigold finger prick and it came back neg for hiv at 17 weeks or 4 months. The thing is they took a urine sample and told me there was an infection present in my urine and it has now been four months since the encounter.I am scared because I have taken two rounds of doxycycline but there is still an infection present and I have tested negative for everything known to man up to this point! Its the unknown that is killing me Doc! My questions are this: 1.) Is a 17 week unigold rapid finger prick test reliable or should i test with different method? 2.) If the infection in my urine was HIV would I have not tested positive by 17 weeks? 3.) Do ARS symptoms last four months!? 4.) I know you can't diagnose ober internet but does this sound familiar of any infection you may know of? 5.) Would my metabolic panel or cbc had been abnormal at 11 weeks if it was HIV? 6.) Knowing what you know would you Woo-Hoo if you were in my situation? Thanks ahead of time for your response doc I really do appreciate it and God Bless!!

Response from Dr. Frascino

Hey College Stud.,

Welcome back to the forum.

Your repeatedly negative HIV tests out to 17 weeks are definitive, conclusive, excessive, WOO-HOO-able, and move-on-able! HIV is not your problem. No way. No how. No additional HIV tests are warranted.

HIV has absolutely nothing to do with your urinary tract infection.

Nope.

I would suggest you get a urine culture, and also be checked for prostatitis. You could have nonspecific urethritis (NSU).

Not necessarily.

Absofrickenlutely. But I'd still get the urinary tract infection evaluated and treated.

Dr. Bob



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