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Follow-up: I'm sorry doc but I know whats going on with my body, you dont !!
Nov 5, 2010

Hi Dr.Bob;

K with you. At 12 weeks post now, havent tested yet as testing not available where i live/work. Travelling back to my home country to test in a couple of weeks.

Developed itchy eosinophilic folloculitis cluster of 4 or 5 pimples aorund 2-3mm dia on side of face. Ocassional skin/skin layer peeling from palms and finers.

Intermittent diahrrea continues. Chronic cough continues. Lymph node pain/lymph vessel pain in neck intermittently continues out to 12 weeks. Muscle fluttering/twitching continues. Muscle pain/fatigue also there. Sometimes arm/leg muscles feel exhausted/overworked even without any exertion. Unbelievable.

My issue is simple. I picked up something, i say this from actual significant physical shift and changes i have SEEN & FELT over last 3 months and they continue. An average person can tell reasonably when there is something significant/continuous/progressive going on in the body.

MY question is WHAT..if not HIV? as nothing else i know can cause this as mentioned in previous posts.

This is why i know you're dead wrong. I do not understand you confidence, given that there are possibly hundereds of ways besides penetrative intercourse in which infected body fluids can enter you if your partner is a carrier.

Neck node pains going on off and on as i type this as well.

Anyway...I know you wont budge from your stand once taken.

Hope you are doing well.

P.S. I'd like to work for your foundation..

Regards; K

Response from Dr. Frascino

Hello K,

Unfortunately I cannot diagnose your condition over the Internet; however, I'm extremely doubtful HIV is the cause. You are not qualified to self diagnose. Just because there is "nothing else you know that can cause this" doesn't mean HIV is the cause by default. The more likely explanation is that it's caused by something that indeed you don't know! (Remember you haven't been to medical school and so there may be a few thousand or so ailments you know absolutely nothing about!!) Consequently, we'll just have to wait for the HIV test results.

Dr. Bob

Follow-up: Easy to know HIV infection from symptoms if you know whats going on & what to look for! Nov 2, 2010

Hi.Dr.Bob;

Hope you are doing good.

Just a quick comment, i have since infection 12 weeks ago, actually, physically felt rapid viral replication in my blood (via pathogenic irriation, whether or not you believe in it), followed by infection spreading to brain, testicles, the thymus gland area, followed by week or two of "bone-deep" pathogenic irriation, specifically in ribs/arms/skull/legs when infection was establising itself in the bone marrow.

All of this happened well before the body was able to produce antibodies when i felt slow and significant reduction of HIV plasma viral load at around 7-8 week post exposure mark, which is why i am sure as can be that my 14 week post test a couple of weeks from now will be positive as opposed to my 5 and half weeks post test which was negative.

And since reduction in plasma viral load, have felt active intermittent ugly pains/discomfort in neck/armpit lymph nodes and thymus, which have persisted throughout anyway. Indicating infection not eliminated from there.

Best Regards; K.

Response from Dr. Frascino

Hello K,

You have a very vivid and overactive imagination. Have you considered a career as a science fiction writer?

Dr. Bob

Follow up: Not Psycosomatic, Just trying to save my life. I somehow had accidental exposure for sure.. Nov 2, 2010

Hi dr.bob;

You're a great man dr.bob and I deeply appreciate your continued effort to put up with my follow up posts! You are the only person i have to guide me through this. I'm very calm and collected, rationally thinking so there is nothing psychosomatic about my symptoms. I have increasing dizziness on daily basis, sort of brain fog.

As i mentioned in my first post, i got violently ill about 5 years ago after acquiring an unknown viral infection. This happened after i used a possibly contaminated sex toy. STD screening out to 4 months was negative for all STD's. Took me almost a year to fully recover from that infection. developed shotty submental, axillary and submandibular nodes and chronic throat inflammation after recovery. Was perfectly healthy and fine since then, got married, been happily married for 5 years till now when suddenly my life comes to a standstill! The agony is unbearable.

Now, as a result of my recent HIV infection, these normally not so hard shotty nodes intermittently get rock hard, then recede to a size less than my previous chronic shotty node size. The slow but inevitable recession towards zero node size is allowing my old infection to take hold, chronic throat inflammation dying out slowly and HIV forced shotty node size reduction are inducing a sort of brain fog which is getting worse day by day.

This along with permanent atropy of subcutaneous fat from areas of my soles, arms, legs, head, development of recent eosinophilic folliculitis on arms/abdomen, loss of scalp folliculutis infmallation and itching, continued severe to moderate discomfort in thymus area, bouts of node and lymph vessel pains make for a perfect HIV diagnosis. yet you wrongly pass me off as a case of anxiety and mania! You couldnt be more wrong, i cannot think up any of my numerous symptoms!

Please note, my random muscle or fat (i cant quite tell which) flutters continue, even though i am not anxious and am perfectly calm.

P.S. There should be a way for patients/potential patients to post photographs along with posts on this site to help them and the experts guiding them.

At 11 weeks, 2 days post incident. Regards. K

Response from Dr. Frascino

Hello K,

Your post did not pose any additional questions or provide any new information. My assessment and recommendations remain unchanged. See below.

Please note I'm not denying you have symptoms; I'm merely advising HIV is not the cause. What you consider a "perfect HIV diagnosis" makes absolutely no sense whatsoever from a medical perspective. Your problem is anxiety, irrational fears surrounding HIV, depression and guilt. I continue to urge you to seek the help of a psychiatrist. Show your therapist your many posts and my responses. It will help focus your treatment and speed your recovery.

I have no doubt your definitive three-month HIV test will be negative. I also have no doubt you will have difficulty accepting the result.

Dr. Bob

Follow up question: Why wont you admit you could be wrong Dr.Bob? Process of simple elimination! Oct 18, 2010 Hi dr.bob;

K here with you. Just a quick follow up, at 10 weeks post exposure, have had chronic dry cough since 6 weeks post exposure. Developed vomitting and diahrrea at 7 weeks post, vomitted twice on that same day, but it ceased after that. had fever/fatigue that evening that resolved within 36 to 48 hours. Could this be ARS? No rash observed. The diahrrea is intermittent now since that day 3 weeks ago. the dry unproductive cough continues.

I do not know of any infections that can induce such sickness or cause such widespread symptoms as i mentoned in previous posts. CMV/HBV/XMRV seem to be the only other STI's i can think of. By simple elimination, HIV is the only explanation. Arm/leg thinning continues slowly but my weight has remanied stable throughout since incident. Heel pad thinned significantly, shoulders and knees also thinned.

Please note my chronic scalp folliculitis is pretty much gone now! Impossible without antibiotics! which i havent taken! I've had it for 6 plus years on daily basis! no more imflammation on my head, no more pimples! classic loss of inflammation associated with HIV!. also slowly losing my chronic throat inflammation with reduction of shotty neck nodes after bouts of pain in those nodes over last 2 months, same thing hapenning all over body in different nodes. though my neck and armpit nodes were the only nodes i could feel shotty for years since before incident.

You're making a diagnostic mistake in my case and its only a matter of time before i prove you wrong.

Wishing you all the best.

K.

Response from Dr. Frascino

Hello K,

As I have stated before, no matter how many times you write in or how absolutely certain you are that you are HIV positive and that I am wrong, my assessment and advice will not change. I again ask you to hold off on sending more posts until you get a definitive HIV test result at the three-month mark. I'm extremely confident it will be negative. In the interim you can follow up with your general medicine doctor for all of your various symptoms (many of which may be anxiety related or psychosomatic in nature). You would also benefit from psychiatric/psychological counseling to help with your anxiety and irrational fears.

Dr. Bob

RE:Infected after "protected" hand/boob-job. Laying out why i know what is going on & why you're wrong yet again.!Oct 4, 2010

Dear Dr.Bob;

Thanks for your reply to my 37 day test question. I can understand it is difficult to reach a conclusion or get an idea over a post without actually seeing or feeling the changes i describe below. I'll lay out why i know you are wrong.

2 months post incident now and following has actually happened during this long incubation period, whether you believe it or not.

1. Significant Loss of adipose fat tissue from soles of feet, wrists, hands, forearms and head. Visible thinning of arms, legs & upperbody along with reduction in waist size by 3 inches over last 2 months..losing body fat used to be a near impossibility for me before incident and now i dont have to do anything for it.

2. Random "fluttering" in various parts of body (legs, arms, neck, back, hands, feet) at random intervals for random durations of time. has started only AFTER incident 8 and half weeks ago and continues till this day

3. I've had diagnosed eczema on hands since i was a kid, never completely went away, but did so completely within i think a week or two post infection, without any treatment for it, never to return.

4. I've had diagnosed scalp folliculitis since past 6 or 7 years and used to get many pus filled pimples on head as a result regularly. Pus has now, since infection, largely dissapeared from any pimples on my body, including head. I now get pus-less pimples. which has never happened with me before in my life. Pus used to be abundant in my facial and head pimples. I now get pusless pimples that take too long to heal. Pus is largely GONE and any pimples i get are healing so slow as if they will never go away! First time in my life. What a coincidence these things all hapenning since AFTER incident!

5. I've had for a few years, a viral skin infection of a scrotum which normally stays under control and flares up sometimes if my immune system get weakened temporarily. This time since a week or so post infection, i have had a major flare up that has not gone away, got so bad that i had trouble walking due to the skin rash. been 8 weeks now..

6. Intermittent pain in various lymph nodes all over body, started with groin, moved up to armpits, and now in neck/head over course of last 8 weeks. Not a single day passes without this node pain.

Make of it what you will.

8 weeks, 3 days and counting...

As always, love & respect.

K

Response from Dr. Frascino

Hello K,

No matter how many times you ask or how certain you are that I am wrong, my assessment and advice will not change. So hold off on writing back until you get a definitive test result at the three-month mark. It will undoubtedly be negative and I will be delighted to WOO-HOO with you at that time. OK?

Dr. Bob

RE:Infected after "protected" hand-job/boob-job, fatigued and suicidal...help me dr.bob! Oct 3, 2010

Hi.Dr.Bob;

I continue to feel overly fatigued and not refreshed after sleep, various lymph node pain and body muscle twitches continue at random. Please help me understand my 37 day post exposure test results:

Patient Value: 0.041 Cut-off value: Positive > 1.0 S/CO Result: Negative.

My question is, do i need further testing? Also i continue to feel overly tired all the time, fatigue, have had considerable loss of lymphatic drainage as evident by permanent thinning of my upper arms/wrists, feet/ankles/lower legs. Is partial or considerable loss of lymphatic drainage ever HIV related at any stage of disease or is it indicative of any systemic viral infection? And what about my all body fasciculations? they dont seem to stop! started a few days after incident and continue till now at 7 & half weeks post exposure! PLease note, i have not yet had HIV rash/fever/lymph node swelling as yey. My question is, since what i have narrated above is physically happening, what could be causing it since it is too much of a coincidence to happen after incident and continue...i feel infected physically! i dont feel the same, dont feel fresh and trust me its not a mental issue! could i haver picked up another, virus instead? like HTLV 1, HTLV 2, XMRV or CMV?

As always, an admirer of your work, looking for your guidance & support!

K.

Response from Dr. Frascino

Hello again K,

You want me to help you understand your 37-day post-exposure test results? OK. Well, it says "Result: Negative." So exactly what aspect of "result negative" are you having difficulty understanding?

As for do you need additional testing, as I've already mentioned (see below), a three-month test would be necessary if you want a definitive result. (HIV-antibody tests taken before the three-month mark are not considered to be conclusive.)

Regarding "loss of lymphatic drainage," I have absolutely no idea what you are referring to, as "loss of lymphatic drainage" makes no sense medically speaking.

Finally, you state, "trust me it's not a medical issue." Sorry K, I disagree. I think you are becoming a worried-wreck fluffernutter. Symptoms such as fatigue, random "body twitches," fasciculations, suicidal thoughts, etc. are very consistent with anxiety, not HIV!

No matter how many times you ask, my assessment (not HIV infected) and advice (see a psychiatrist) will not change!

Dr. Bob

RE: Infected after "protected" hand-job and boob-job - You are wrong dr.bob! Aug 13, 2010

Dear Dr.Bob;

I appreciate your positive comments, but with respect, i firmly believe you are wrong in my particular case. I know you may have heard than a zillion times before.

General statistics do not apply to individual cases. I could have accidentally acquired the infection even though medically i shouldn't have. The condom could have failed without my realising it. I guess abstinence is the only sure way to escape this nightmare!

My testicles are swollen and somewhat enlarged, my thymus area is tender and somewhat enlarged, my throat doesnt hurt at the moment but is inflamed, raw and refuses to heal. I have lost a kilogram of weight before any seroconversion illness has even begun! these are all real points i am experiencing upto day 6 post exposure! Expecting a hellish seroconversion soon!

I remember i also had a small cut on the index finger on the hairy side of my hand, the cut measuring 1cm in length and about 1mm in depth which had dried blood on it when i examined it by chance after the activity. I did not however, use that finger for any insertive purposes.

Anyhow, i will prove it to you after getting an antibody test at the 3 month mark or even an ELISA earlier than that.

Love your work and wishing you the best of health!

K.

Response from Dr. Frascino

Hi K,

You are convinced I'm wrong and that you did acquire HIV from a protected hand-job and blow-job. Hmm. Yes, I have heard similar claims "a zillion times before." Yours makes it a zillion and one!

Well I guess we'll just have to wait and see if the "hellish seroconversion" you are expecting actually arrives and if you have indeed acquired the virus. But I have to tell you K, the chances are about the same as a virgin birth. (Then again some folks believe this as well!)

I have your WO-HOO on hold and look forward to presenting it to you in three months.

Good luck (although in your case it isn't even necessary!).

Dr. Bob Infected after protected hand & boob-job! Aug 10, 2010

Dear Dr.Bob;

First of all, i'd like to thank you for your invaluable support in providng information and care to those in dire need. I am a regular reader and I apologise for the long description but i hope you can help me with your expertise.

I am K, a married 28 year old south-asian male.

If you can, please include this post in the questions asked section because this should be a very rare case of HIV acquisition i belive, in your opinion. I am so convinced i have acquired the infection (due to very early actual symptoms) that i am no longer worried about "might be or might not be" infected.

4 days ago, i engaged in protected "hand-job" with a hotel prostitute of unknown status. This proceeded to a "boob-job". She used a lubricant which could be anyhing. The total activity lasting for no more than 10 minutes. I did not ejaculate nor was there any anal/vaginal or oral penetration. She did "kiss" the tip of the penis over the condom a couple of times and also rubbed her hand over her vagina and then rubbed it over my already slightly inflamed scrotal skin. She may or may not have been menstruating.

Please note that i have a pre-existing unknown chronic viral infection that has lead to a chronic inflammation of my mucosal membranes. (this may have aided my infection)

Moving on, I have had an elevated metabolic rate (avg bpm 90-100) since the day after the activity, my normal resting rate is 60-70bpm. I am right now having off and on, pain in various lymph nodes in my body. Neck/armpit/groin. And i have started to have intermittent fatigue, hot flashes, night sweat on one ocassion and am unable to fall asleep due to my elevated metabolic rate, probably caused so early in the HIV incubation stage due to my pre-existing unknown infection. I feel a general strong irritating discomfort within my body and my arms/legs are somewhat swollen.

There is no doubt i in my mind i have acquired HIV. Because i feel deathly discomfort and illness.

You might say i am at no risk and the symptoms are too early, but an already supressed or activated immune system can cause early symptoms or incubation symptoms right?, and i have no way of knowing if the condom failed or not. Also i shall prove the risk factors wrong by getting tested after my seroconversion illness which i can truly feel "is in the post" due to my constantly elevated non-stress related metabolic rate as confirmed by a doctor, and my thymus/lymph node intermittent pain.

Again i thank you for your work doctor bob. i can feel how difficult it is living with the disease and managing all these tasks. I myself feel like quitting my job after the extreme fatigue i have been having since 4 days.

Please let me know how in your opinion i should proceed, should i get tested? Could i have been infected with something other than HIV as it is definitely some pathogen, i feel so ill overall that i know a seroconversion illness is just around the corner! Should i refrain from unprotected sexual relations with my wife in the mean time as we were trying to have a child? I have already levelled with her but she is unsure what to do. The consequences can be devestating. I need your kind assitance dr.bob. and if possible please let me know how i can reach you by phone or personal e-mail?

Thanks and regards K.

Response from Dr. Frascino

Hello K,

Even though you are "so convinced" that you acquired HIV from a protected hand-job and boob-job with a hotel prostitute, I'm quite certain you did not! Despite your "pre-existing unknown chronic viral infection," "elevated metabolic rate," and other symptoms, your HIV-acquisition risk was nonexistent and consequently you could not have HIV. Your problem is most likely related to anxiety and guilt. We have an entire chapter of situations similar to yours in the archives devoted to anxious folks who are 100% convinced they have acquired HIV. Check it out! Also, I should point out none of these folks actually turned out to be HIV infected!!! None!

I would advise that you do not quit your job. Your fatigue is most likely related to depression, anxiety and guilt. I suggest you level with your wife. It's not only the best way to confront your guilt; it's also the right thing to do. I also suggest you consult a psychiatrist to help you cope with your anxiety and depression. Although HIV testing is not medically warranted for such a non-risk, a single three-month HIV-antibody test might be helpful psychologically. The results will undoubtedly be negative. Write back with your definitive negative HIV test results and I'll include your follow-up post in our archives to help others in similar situations. Phone or personal e-mail contact is not warranted (or available). I am an HIV specialist and you do not have HIV. I am not a psychiatrist and that is the physician specialist you do need.

Good luck.

Dr. Bob



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