[Question #3426] Dr. HH follow up - please help !!!

35 months ago
Hi Dr. HH

I have a business trip coming up near Seattle. Since, it is near Seattle I wanted to come and visit you in person with my test results and the swollen bump I had mentioned in my previous question. I am trying to call the contact number I found on the internet but no response. Request if you can please share your office contact or mail id or the reception where someone will help me with an appointment with you next week. I’m not from that part of the world so this guidance would really help and I need  to accordingly book my flights and hotel. Just any means of booking an appointment related to my exposure. That’s it. Thank you !!
35 months ago
Even an online booking method is fine which just gives me confirmation on the date, time and charges. 
35 months ago
Sorry for breaking this up in parts but even if no contact number or mail id you can let me know which organisation or medical centre to get in touch with, I will google it and get the number and seek an appointment and other details. Just guide me how ... please !!!
Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago

Welcome back to the Forum.  All questions regarding herpes go to Ms. Warren and Dr. Handsfield and I split all other questions.  As it happened, today I happened to pick up your question.  As an FYI, having worked closely for more than 35 years, Dr. Handsfield and I never disagree on the content of our replies although our verbal styles vary.  I will be addressing this question.


Dr. Handsfield has retired and no longer works regularly at the Seattle-King County STD Clinic and is actually traveling away from Seattle at this time.  There are many other superb providers who work there.  If you are in the area you can phone the clinic for an appointment (206-744-3590) or walk in and typically be seen. 

I hope that his information is helpful to you.  EWH

p.s.  I have discussed this response with Dr. Handsfield. EWH


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35 months ago
Hello Dr. Hook and Thank you for replying. I’m here for the next 3 weeks and hence I thought if it’s possible it would be great to seek an appointment. It’s a brilliant chance for me to meet him since it would be impossible to travel so far again this side. Is there a chance of him being back in the next 3 weeks ? I understand that he doesn’t visit the clinic regularly but for an apppintment does he visit? 

Going through a situation that I’m going through and having a chance to meet him and discuss this with him would be great. I would really appreciate if I were given a chance to see him, I can make some amends to my Travel back if it’s close to his dates of arriving back into Seattle if need be. Please let me know if it’s possible given my flexibility?  From my point of view this is like a rare opportunity I have so please consider my request 
Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago
Dr. Handsfield has indicated that he will be away from Seattle for several months and, as I mentioned, he no longer works regularly in the clinic.  I think you should see another provider.  EWH
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35 months ago
Sir,

Thanks for that quick reply again. I guess it’s not possible to meet him and see Seattle. I already asked for Dr. Handsfield’s opinion on my testing and symptoms which worry me till now and will take this opportunity to check with you so that you can guide me appropriately.

For an unprotected  vaginal and anal exposure with a CSW female (I’m male) and 10 days symptoms started post that exposure. This exposure was in Thailand. Severe flu and a rash post 10 days. Today it’s been almost 4 months now and all other symptoms disappeared in a week I’m left with a swollen lymph node under my left arm and a swelling behind my left knee. In addition I have slight abdominal pain. I’m really scared and worried. The timing of the symptoms ?? 
Testing as below : 
10 day PCR RNA fo HIV 1 - not detected
30 day DUO - non reactive CMIA method
65 day DUO 1 - non reactive 
82 day DUO - non reactive CMIA method.
82 day PCR RNA fo HIV 1 - not detected.
The reason you see two tests on day 82 because I asked the clinic for both these tests while giving the blood sample.

All above test are blood drawn from vien.  What are the chances for HIV ? Can I be sure about HIV 1 and HIV 2 ? Are these tests missing some strain of HIV ? Do I need to test again now at 4 months post exposure ? I t dyed for other STD’s at 65 days and they were negative? Can I be 100% certain with this testing ? Is CMIA method reliable or do I need ELISA or western blot method ? Should I do PCR for  HIV 2 ? I’m just really confused. Please help me and request if this can be tested as the first follow up question just in case. 
Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago
I agree with the assessment that Dr. Handsfield provided you earlier.  There are many possible causes of symptoms such as those you report and the majority of them are not STIs.  Your HIV tests conclusively PROVE that you did not get HIV from the exposure that you describe and further testing related to that exposure is a waste of time, energy and money.  The methods you tested with are highly reliable, including the CMIA test.  EWH
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35 months ago
Sir,

It is hard to make myself believe that suddenly post that exposure I got symptoms like flu, rash and swollen lymph nodes under my arm and a pain/discomfort under both my arms. 

But since you and Dr.Handsfield who are both known experts and have so many years of experience have assured me that my tests prove that I didn’t catch HIV, I’m just going to try and tell myself this all the time when I’m anxious. The abdominal pain although not strong but causes discomfort. Another thing that I noticed today and freaked out was in the panel test I did at 65 days that included something called the TORCH panel. I noticed there my two test results were positive. Rubella IGG was  39.70 and Rubella IGM was 0.09 & Cutomegalovirus IGG was 91.60 and IGM was 0.13. 
I immediately called my testing clinic and they said these are nothing to worry as these are past infections that have been resolved probably during my childhood. 
What is your opinion on this? Could these be the cause of my symptoms ? 

One important question have you or Dr. Handsfield or any other doctors you know have heard or know of someone who had a fourth generation test at 82 days negative that later turned positive without any further exposure at all?? Has any such case with a fourth generation test been reported ? 
My PCR tests at 10 days and 82 days had a detection limit of 20 ..... is this good ?? Do other countries have better detection limits ?? Is it possible to have a viral load below 20 which the test can’t detect if your infected ? 
I know post answering, this question shall be closed but I request if you can address my questions I’m detail for my sanity and peace of mind.

Thank you Sir !!! Thank you so much !!

35 months ago
Sorry for the typo I meant cytomegalovirus there. 

Sir, just help me!! I can’t understand this whole situation. I’m really struggling to be honest. If I had no syntptons I would so happily believe all advice and results. It’s really really a difficult time. Trust me I want to get over this and move ... go for a run and have fun but I can’t coz of these symptoms and specially all that I read online.... it’s scary !!!!
35 months ago
When I try making myself believe that it’s stress and anxiety and I need to believe my results. I have my family and friends tell me that I’ve lost so much weight and I look so tired and sick... what happened? What wrong ? It again takes me back thinking about my exposure all the time... hope you can understand my situation.... there are no guarantees in life for anything I know but how confident would you be given my testing history that I don’t have HIV ? Would you go ahead and even say 100%  3 duo tests can’t be wrong at 30,65, and 82 days and there is no chance for both HIV 1&2. Also, the two PCR tests can’t be wrong at 10 and 82 days. 
There has been no exposure WHATSOEVER after that in any form.
Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago
 Your follow up questions are once again, repetitive.   Your multiple tests for HIV are conclusively negative and neither one of us has seen anyone in the home negative tests of the sort you report have gone on to later turn positive.    You need to except and believe your test results and to move forward. Your symptoms are not due to HIV. They are coincidental. 

The TORCH panel  is recommended primarily for a valuation of pregnant women. As you were told the results of your test show that in the past you have had previous infections with rubella and CMV  and these test results do not explain your symptoms either. If the symptoms you mention  worry  you because they could be due to HIV you need to move on, with the assistance  of a counselor or mental health professional if necessary.  On the other hand,  if your current symptoms are truly problematic then you should explore their cause with your own personal physician without concern about HIV or any other STI. 

 This final reply concludes this thread. After I post it, I will close the thread. If you return asking the same or related questions regarding this exposure and the validity of your HIV test results, the repeat questions will be deleted without a formal reply and without return of your payment.  This approach and policy is done  out of concern for you and the fact that repeating the same answers again and again has no benefit to you or other readers on the site. I trust you will understand. 

Take care.  EWH
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