PLEASE! I know you're very busy but please help.

Question

Dr. Bob,

First I'd like to say thanks. You seem like a very good person to offer you're time and expertise to those who need help. I've read many of the Body forums and you seem to give straight forward, descriptive answers. I've posted on a lot of other forums where other "internet MDs" like myself try to self diagnose one another (stupid). Here is my story. I went to Thailand on vacation and had vaginal (protected) sex and oral (unprotected) with two female sex workers of unknown status. That was 07-08 March. Upon my return, I started having a slight sore throat on 15 Mar. It lasted about a week but I wasn't too concerned because about a dozen of my co-workers had a "bug" that seemed to be going around. On Mar 28, I started getting sore in the neck and shoulders. This pain has persisted to the present day (today is 07 April in my part of the world). The worst part is that the regions on the side of my neck where my lymph nodes are (I think), are very sore and tender to the touch. I've read a lot on the internet (I know not a good idea) about swollen posterior cervical lymph nodes and HIV and am TERRIFIED. I have no other symptoms whatsoever (fever, rash, fatigue, diarrhea,nothing). I'm still exercising like a fiend with no problems but the lymph node areas in my neck and groin are very tender, although not visible. I went to the Doctor (twice) and was given motrin (and diazepam for anxiety). I had an HIV test as soon as I came back and it was neg, but I know that it is too early to show. I had another on 04 April(hasn't come back yet and I know it's still too early to tell), my CBC was normal, and no mono or strep. Can you PLEASE shed some light on the lymph node problem? If my nodes were actually swelling, should I be able to see them? What is your assessment (I understand that a diagnosis online is impossible) and I'd greatly appreciate some good Karma. I've read tons about ARS but could you also tell me what a "typical" ARS case would look like? I've been in the middle east warzone twice, and I've never been this scared. No problem on a donation.

Answer

Hello,

The HIV risk associated with "protected" vaginal and unprotected oral sex is extremely low, assuming the latex condom was used properly and did not fail.

If you've been to your physician twice and been given Motrin for discomfort and diazepam for anxiety, we can assume your "lymph node problem" really isn't much of a problem! It may be helpful to note that the lymphadenopathy (swollen lymph nodes) associated with HIV disease is generalized (multiple locations simultaneously) and not painful!

Regarding a "typical" ARS case, there really is no such thing. This is a QTND (Question That Never Dies). See below (and check out the archives for more of the same!)

Good karma sent! Thanks for your donation (www.concertedeffort.org).

Be well.

Dr. Bob

What the heck IS consistant doc? Dec 6, 2005

Hello sexy. Love that picture of you. Anyway, I have a quick question.

I often see you telling people that their symptoms are NOT consistant with ARS.

I am wondering if you can explain the most common scenario of someone recently infected with HIV.

thanks beautiful;)

Response from Dr. Frascino

Hello,

Do you really think just calling me "sexy" will increase the chances I'll respond to your question??? Well . . . um . . . OK, here's your response!

This is becoming a QTND (Question That Never Dies), so I'll just repost one of my previous responses.

Stay well.

Dr. Bob

What exactly are the symptoms of ARS?Nov 15, 2005

Dr. Bob,

Hi there. I've been reading through many of the postings in this forum. Most of the people who write-in are labeled "worried wells" and you tell them that their symptoms are not consistent with the true symptoms of ARS.

I was wondering if you could share with us what you believe the true symptoms of ARS to be. I've found lots of websites describing them, but I want to hear it from a reputable and definitive source such as yourself.

Thanks a lot.

Response from Dr. Frascino

Hi,

Sure, just check the archives. I've discussed this many times before. I'll repost below just one of the questions that addresses the signs and symptoms associated with primary HIV infection. Stay well. Be informed, not worried, O.K.?

Dr. Bob

Me again! Aug 14, 2005

Hi DOc,

You responded to my initial question a few weeks back - thank you so much. You also responded to my partner who was recently diagnosed positive - that was so helpful. Incidentally, I think it was the first time he used a computer in his life - so you achieved more than I have with him there!

Anyway, sorry to bother you again - its now 8 / 9 weeks since my last exposure - I think I am imagining swollen glands all the time! Could you kindly answer two small questions. Firstly, how long after infection do people normally get ARS and symptoms? Secondly, what symmptoms are characteristic?

Thankyou for helping. My partner is being really strong - andw e will get through this together, I love that american term worry well - yes I am a british one of those, sorry!! xx

Response from Dr. Frascino

Hi Brit-Boy,

You're welcome!

Chances are you are indeed "imagining" swollen glands all the time. Regarding ARS, symptoms generally appear 1-3 weeks of contracting the virus. Sometimes symptoms may not appear until 4-6 weeks. It is called a syndrome (Acute Retroviral Syndrome), because it is a collection of symptoms that can be extremely variable form person to person. In fact, symptoms alone are notoriously unreliable in predicting HIV infection. It is estimated that 40-90% of acutely infected folks will have some ARS symptoms. But to specifically answer your question, the following is a list of symptoms associated with ARS and the percentage of time the symptoms are present:

Fever 96%

Adenopathy 74%

Pharyngitis 70%

Rash 70%

Myalgias 54%

Headache 32%

Diarrhea 32%

Nausea or vomiting 27%

Hepatosplenomegaly 14%

Thrush 12%

Neurologic symptoms 12%

The duration of symptoms is generally 1-3 weeks.

Regarding your lover's use of the computer, now that he's discovered the wonders of Internet look out!!!! He just may get so hooked that the only way you'll be able to converse with him is via IM-ing!

Good luck!

Dr. Bob