Worried Well syndrome


Worried Well syndrome

This syndrome can grip into anyone who became scared of becoming infected with hiv due to some action of their own. Even healthcare workers are sometimes plagued by this syndrome. This can cause severe monetary loss and affect the mental health of the sufferer and family.

Other people get into this syndrome after doing a risky or brothel sex. Majority people experiencing this problem are those who once or few times visited a prostitute. Most of the people visiting brothels or prostitutes are married people and most of them are in the age group of 30 to 45. They ponder an idea of having some extra marital sex for a long time, but stay monogamous and are good husbands. Due to some circumstances like - On a tour to another city or country, wife is away for a vacation, attending a loose party with alcohol etc. they engage in a risky behavior sans their hiv/std knowledge. At that time they may be under the influence of alcohol and having an elevated mood. Their hiv/std knowledge at that time also may be too little. Having done that stupid act, they start surfing web for hiv/std information.

Imagine his shock when he finds that, he need to wait for 3 months for a clean HIV chit. He was thinking, it is like another VDRL test and can be done in the same week to get cleared of the scare. Then some websites write exaggerated stories about HIV and transmission and also lot about other STD's. Especially Hepatitis B, C, Herpes etc.. and he reads all this without sleep, food or rest. Within a week or so he becomes more than a PhD in HIV and other STDs. How HIV originated? What are the hiv genotypes? How is the HIV replication? What is HIV RNA, DNA? Why CD4 counts are important? What are the HIV conspiracy theories? You ask anything, all the answers are ready. Some people becomes a pseudo HIV activist too.

He might have been using a condom or not, his roller coaster ride of hiv scare already begun. Sometimes condom slipped during withdrawal, condom broke, found blood on condom, even if condom intact (but who knows there was some small tear?), he did oral on her, she did oral on him, sucked her nipples, did open mouth kissing (bleeding gums), you name it, there are one hundred reasons for him to worry. He recounts the events again and again after he went with that prostitute. He also starts self diagnosing for hiv ARS (acute retroviral syndrome) and finds usually acne (for him it is hiv rashes), night fever (due to anxiety), oral candidiasis (many reasons), peripheral neuropathy (numbness and pain in legs and hands - either withdrawal symptom of some medicine or just a feeling), diarrhea (food problem), swollen lymph nodes (just a feeling or due to frequently checking whether it is swollen) and things which may be associated with other infections. If this guy is a bachelor, this prostitute-adventure will happen when he is just engaged for marriage or the marriage is fixed. For married people, this will happen when they are just planning to have their first baby. See the misery. For a few months the ISP, Labs, Psychiatrists, MD doctors in the city is going to make a nice money. He visits numerous websites for HIV information. Each one gives different versions of the stories of transmission of HIV. He is the sufferer and within weeks he goes for a ELISA and STD panel and all the results are negative.

By the time his wife returns home or he returns home. The family notices that he is abstaining from sex and taking some extra precautions at home. If he used to drink alcohol occasionally, he drinks now lot more. They wonder why?. The wife starts exerting pressure on him to reveal what really happened to him. At last, he breaks down and tells her the whole story. One of the biggest foolishness, much bigger than he had sex with a prostitute. Depending on the nature of wife, she tells the story to her family or keeps it as a secret, but surely she is not going to believe her husband anymore in sex. The whole family relationship is maligned and if he has children, they too suffers. He also looses his inhibition of telling others and tells this story to some of his friends (another foolishness) hoping to get support from them. These friends instead of treating him as a victim, keep a distance with him, as they believed that he is a friend with good morale, but is not. Friends spread the news across the town and now he becomes an isolated guy. Poor chap. All because of one foolish act of sexual adventure.

Those who are rich enough goes for a PCR test. No viral load. Still he could not convince himself. He makes one hundred calls to CDC hotline if he is in US. CDC guys gets irritated and he gets scolded for his impatience. If he knows the prostitutes phone number, he calls her and plead for a HIV test for her. He offers to pay for the test and even some extra money. What a shame to go back to the poor prostitute and ask her to do a HIV test for his sake. The reaction of the prostitute, most of you can guess. US guys also have another workaround for HIV testing. They go and line-up for donating blood to Red Cross. Free testing for full hiv/std bundle!. If he is working Arab countries he flies backs to his home country for a HIV ELISA test. He keeps on changing MD doctors for not sympathizing with him. The guy used to save every penny by eating two square meals a day or not smoking, can be spending money like a sultan . He also makes overseas calls to HIV/AIDS hotlines umpteen times. But no solace.

He looses his sleep and having insomnia. The testing for HIV goes on and on and all the results are negative. The Lab girl can recognize him from 300 meters far and she pleads him not to come until 3 months are passed. But no avail. Every 15 days he is there. Who knows when the antibodies will suddenly pop up? He may loose interest in his normal activities and can get depression. Or he may become alcoholic. A full blown worried well. At worse he may attempt suicide. He may loose his job. His brain is really screwed up and there is no solution in sight. He may not recover even after 3 month negative ELISA since the feeling of guilt and loss of self esteem is deep rooted in his mind. Psychiatry does not offer much help and only can prescribe benzodiazepine drugs to control his anxiety. Depression or Bi-Polar drugs takes enough time to act or the psychiatrist himself need ample time to experiment with drugs to make this person stable. Worst of all, he may relapse into prostitutes again, the very cause of his distress. Prostitutes - Testing becomes a compulsive behavior. The very fact is, some prostitutes are very service minded and can be addictive as you get much better treatment from them compared to your wife.

But time cures every thing. After about 6 months continuous ELISA test and psychiatry help the person can become normal again. Counseling can reinstall the persons lost self esteem and self confidence in a due course of time. He can be normal again. May be a sum of money is lost or a job is lost, he can start everything from scratch. Those who are religious, can pray regularly and gets god's help to get out of their agony.

All the people who are going to prostitutes are not becoming "worried wells" for that matter. It is generally who are weak in mind gets this syndrome. They may be already having some underlying mental diseases like depression, bi-polar or alcoholism. There are also people who regularly test for hiv and regularly visit prostitutes. But it is always better to be on the safer side and do not involve in any illicit sex adventure for your sake and your family.



This "Worried Well Syndrome" sounds like a personal experience story. Most likely your story, right?

Stay safe to stay well, and avoid worry.

Dr. Bob