[Question #3825] Last follow up

32 months ago
Hi Terri, 
   I'm sorry to bother again and thankful for all of your help. We have talked here and over eVisitis.
   Summary: 9.5 months ago had protected sex. 3 days later at the base of my penis developed a small linear area if redness. No symptoms. Never developed blisters, sores, ulcers, cuts. Healed within 3 days max. I had also gone for a long, aggressive run on a hot day and the area fit perfectly the shape of my underwear seam. 
    Over the next few months, once every few weeks, I noticed small red spots on my penis. No blisters, sores, or ulcers. No symptoms. They would resolve within a day or two. I was seen by two PCPs and a dermatologist. None thought this was herpes. Possibly folliculitis or just normal changes to the appearance of blood vessels. They did swab once but sent the wrong tube so it was rejected. 
    I had a negative 20 week IgG for HSV1 and 2. With your help, i had two negative Western blots at 4 months and 6 months. But I still couldnt put the recurring red spots out of my head completely. 
    We talked and you said that if it would ease my mind,  I could ask my PCP about home swabbing. You said I could swab a max of three times.  I did and over the last 5 months I have had a negative culture and three negative PCRs. I have over the course of this swabbed on at least 7 different days as well. 
    As I write this, I know its a bit crazy that I still have some lingering fears. I understand I have had the best tests multiple times. But I'm just not sure what I should do now. Today for instance, one of the blood vessels on the surface of my penis is a bit more prominent and I am worried about not swabbing. My plan is to work with my therapist to move past this and to try very hard to ignore completely what is going on on the skin down there unless there are very obvious blisters or sores. What do you think?
32 months ago
Also just to be clear each time a spot has developed, it has been a very small isolated single area. That is what I have swabbed each time. 
My thinking is that my exposure was not 0 risk but low risk. My "rashes" have been atypical and when combined with a 20 week negative IgG, two negative Western blots with one at 6 months (after having had valtrex for a max of 10 days at the very start) and the multiple negative PCRs of areas of concern, my chances of actually having herpes are practically 0. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
32 months ago
You are correct- with all negative PCR tests and two negative western blots,you don't have herpes or a medical problem - what you have right now is a bit of obsessive compulsive disorder.  I would strongly suggest that you see a cognitive behavioral therapist who works with this disorder.  I'm sorry you are still struggling with this but there is no need for further testing of any kind nor do you need to continue observing your penis so closely.  You are fine.

Terri
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31 months ago
Thank you. I have sought behavioral therapy. I did just get a large bill for a PCR test. My insurance said it was because a PCR quant instead of a PCR qualitative test was ordered the last time. Insurance said for swabs it should only be a qualitative test. It was still a PCR test. And it said there were 0 copies of HSV detected. Would the fact that it was a quant and not qual test have any bearing on the result?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
31 months ago
Not at all.  A negative there is a negative.  You can count on this result.  So glad you have sought therapy - I hope it is CBT specifically.

Terri
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