[Question #56] Seriously Worried for Hunter Handsfield

40 months ago

This message is for Dr Hunter Handsfield!,

I am so glad to finally be able to contact you. This has been a very chaotic and to say it’s been extreme would be a ginormous understatement, for me and everyone involved. I recently had an HIV scare and it has turned my life upside down. I’ve even been hospitalized from the anxiety and panic from this, left my life duties and responsibilities for going on 6 weeks now. And I just want it to be over already. Almost much as everyone around me does as well. I’m waiting on blood tests that will be100% definitive, which is so scary to wait for in itself. But more to the point,

 

 

5 weeks ago now I had sex with a young man I don’t really know at all. We used protection the first time and I am sure that condom didn’t break, we had sex again and he was the one who threw the condom away so I’m not sure that it broke or not, though he later said it did not, though I feel like one of us would have noticed and said something. The fact that I wasn’t able to handle it myself leaves a big question open for me. . Furthermore, I began to develop symptoms throughout all of this time. I soon after had extreme muscle pain all throughout my body and joints, diaharrea even up until now, the muscle pain goes in and out still, on and off head ache, one day I couldn’t even see straight, and feeling like memory loss is going on, though I know that’s probably not acute symptom, lots of shortness of breath in the beginning, continued diaharrea, which worries me a lot because one doctor told me most HIV patients he sees in the acute stage have a lot of diaharrea but that he didn’t think I have it because its not common in the NW and mostly gay men and that my lymph nodes and no fever are fine so I’m good. But at the same time this last week my throat began to really act up, my neck and right under my chin got very stiff and things got hard to swallow, like something was blocking it eat nothing would go down well. I am still having constipation and diaharrea, and have been given anxiety medication by one of the MANY ER doctor’s I’ve seen over the last few weeks. Everyone’s telling me I most likely worried myself sick, but all of the symptoms I’ve shared with you, including a big of nausea like feeling here and there and fatigue, clearish vaginal “Water” like discharge coming out, whatever you want to call it coming out of me. Even some sharp pain in my anal area here and there. And there’s been some abdominal pain in the last few days that’s really worried me and that’s what brought me to the doctor the day before yesterday. No Doctor seems to think I have HIV. I’ve checked every day and though I did have the stiffness and the neck problem and throat issue I have yet to feel a swollen lymph node or have a fever, is it possible I would feel any of these symptoms I shared with you and have HIV without having experienced the lymph node swelling or fever? I’m praying I don’t get either. But it seems like all symptoms have pretty much come to stop, I was also prescribed anxiety medication. Again, this has really taken over my life. I’m waiting on the official blood test that will ease my mind for good if its negative next Weds, and it’s been so hard to wait. It’s been hard on me and everyone around me including the professionals. Im even having short term memory loss, It has literally turned my life upside down I have been in a severe panic for 5 weeks straight and I’ve finally come down trying to accept I probably don’t have it though I just CANNOT ignore the physical symptoms I’ve had, how can it be so coincidental. Is 4 weeks long enough for the rapid test to show a positive result if I was? The doc said a month or 30 days should be enough. I did the OraQuick ADVANCE® Rapid HIV-1/2 Antibody Test. I’ve heard its accurate but I’ve also heard that one of of every 12 pack is not accurate... I did it twice. 2 weeks after. And 4 weeks (28 days after) i’ve pretty much tried to accept the reality that things may not go well, and it’s been very hard. Another thing that bothers me is the partner gets frustrated that I keep asking him which is understandable but he’s been defensive from the beginning about me inquiring about his sexual health, which is a normal and good thing, I think. And to make matters worse he just went to the county jail for a month and found out he was in prison for a year, he is 23 years old and has two children who I am sure are healthy, but it doesn’t make feel good that he’s been in there, obviously. I went to visit him and he got upset because I questioned hima gain, but he cannot look me in the eye when I talk about STD’s. he just swears up and down the condom didn’t break. The symptoms have now seemed like they’re disappearing don’t know if it’s from stress lowering or because it would be that the acute symptoms had stopped. Though I am still sneezing and coughing a little bit and feel week, I lost my appetite over this time as well. Nothing can explain how sick I’ve gotten, though some say I have worried myself sick, which I believe is possible, but I don’t know about worrying yourself into a throat that nearly closed up and fatigue, I can believe the nausea and diaharrea and physical pain, feeling hot at night here and there, is it possible for me to catch a fever at night and only night time with acute? im nto sure if im just hot from the mugginess and summer but I feel heat pressing through my body at night sometimes and have been sweaty under the covers when I wake up, I cant tell the differences. this has been on a few occasions. but the throat ant the burning feelings in my palm and feet I cant ignore. And my throat and neck is definitey not back to normal, its still sore. I’m just praying they are not on their way to swollen lymph nodes.   I don’t know Every doctor keeps stressing how unlikely it is, but I cant trust it completely based alone on the symptoms themselves, plus I got tested at the 4 week mark,not the 6th, you know.

 

I just have a bad feeling. And I just want to know your thoughts on the information I’ve provided. And the odds. Coming to you here, and doing this, really shows how desperate I am for an opinion that matters more to me than the ones I’ve heard so far. I’d like to know my Odds and here what you have to say in general. Your opinion is much respected and I am glad to have hopefully reached you here. I’m so afraid I have it. I feel hopeless and depressed, but finally calming down. I know to everyone else it isn't as serious as it is to me, I wish I could check into their reality, but with the symptoms and the chances, I can't let it go. especially the symptoms. sorry if this is scrambled message.

This is all I can think of for now, I will update you with further concerns if I remember once you get back to me. I hope to hear from you soon. Can't wait to hear from you.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
This is a very long question, way over the requested limit, but I think I have the gist of it.

Two things are important here. First, you describe an extremely low risk exposure for HIV. The odds a partner like yours would have HIV are under one chance in a thousand. And if he did, the average transmission risk for a single episode of unprotected vaginal sex, male to female, is around 1 in a thousand. Thus, the chance you caught HIV is on the order of one in a million (0.001 x 0.001 = 0.000001). Had you asked ahead of time, I would have told you no HIV testing was needed at all.

Second, your negative Oraquick test at 4 weeks is very strong evidence against HIV. Although it can take 6-8 weeks for antibody to become positive, in the vast majority of cases the resuls are positive by 4 weeks. As for your symptoms, even though your 4 week test is not quite 100% proof against HIV, it IS proof your symptoms are not from HIV. The HIV antibody tests always are positive within a few days after onset of true HIV symptoms. I'll also point out that your symptom are NOT suggestive of a new HIV infection. Not even close!

I won't get into speculation about the true cause of your symptoms, except to agree with your own doctors that they are most typical of the physical manifestations of anxiety, stress, etc. In other words, I tend to agree that anxiety or other psychological origin seems very likely.

Finally, you don't need to wait any longer for a truly conclusive HIV test. Have a duo test, for both HIV antibody and antigen -- also called a combo or 4th generation blood test. These tests are 100% conclusive 4 weeks or more after the last exposure. You definitely can expect a negative result. In the meantime, do your best to stop worrying about it. Don't confuse your anxieties and (perhaps shame and guilt) over a sexual exposure you regret with HIV/STD risk from that event. They aren't the same! Deal with the former as best you can, but you can disregard the latter. For sure you don't have HIV.

I hope this has helped. Best wishes--  HHH, MD
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39 months ago

Hi Dr!

It was so hard to find your response on here

Yes, I am sorry, that last message to you was a bit all over the place wasn’t it. I’m sorry I didn’t know about a requested limit. I will pay more attention to that. I understand that the symptoms I was having around the 4 week mark I didn’t test positive for, but the more serious symptoms were at the 5th week when my whole chin went stiff, and finally for about two days it felt like I was swallowing rocks it was so hard to swallow, and then came the abdominal pain and the uneasy nausea. I’ve heard a sore throat can go with acute HIV symptoms. I just have a few questions for you, Is it possible for me to have gotten all these symptoms including a sore throat and the rest I listed to you in my last message without getting a fever or swollen lymphnodes if it was acute HIV? I also have had a dry mouth and an eye that keeps turning red. And I never ever get diahrrea and gas like that, which they say is a huge indicator of HIV symptom. And in your opinion, which I value more than any of the too many people I’ve spoken to for, hence why I am here, do you believe a person can worry themselves sick into all of the symptoms I have described to you? Including the throat? I know the mind is powerful and they say it can weaken the immunute system, but I’m not sure of how sick it can actually make you, and do you think worrying myself is sick is what I did here. Also, I did not mention, about 7 years ago I caught genital warts as a young girl, they froze them off at the doctor and they never came back, but bumps to appear on the outter skin of my vagina, much like ingrown hair bumps, they come and go and I’ve just gotten used to it, but I read somewhere that someone with HPV if that’s what I tis, and I am going to look into that after this nightmare is hopefully over after my test results Weds that are supposed to be 100% accurate, but I read that having HPV would make increase my risk of catching HIV if I had unprotected sex with a hiv + guy, which he isn’t to my knowledge, but then again I don’t really know him at all much. That worries me and its something I’veplayed into factor. Like maybe it’s that my body would be to busy fighting off the HPV bumps or from cervical damage it wouldn’t have enough to fight of HIV if there was an entry, I also don’t know if brain damage would make it harder to fight off as well. I did have a slight drinking problem I deaded before it became an issue. And am healthy person, I think. I also read somewhere that beign with a man who’s been incarcerated highers the chances, not to mention, we’re African American with keeps us at risk too, do you agree? And is OraQuick ADVANCE® Rapid HIV-1/2 Antibody Test a duo test? I guess not. Is what you were saying. I don’t know the difference between 4th generation and all that, but there’s no point in me taking any more tests because that official lab one is coming in on Weds and it’s been long anticipated. I have been prescribed anxiety medication for the meantime, but I am truly frightened and it’s been hard. Very hard on me emotionally and supposedly physically. I hope I didn’t go over board again, those and the questions I am about to ask you are all I wanted to know from you. I thank you so much. I have great respect for your knowledge. I thank you for your encouragment and assurement, but I’m sure glad I at least got to get your opinion.I guess no oen will be able to convice me but me, it’s just so hard when you feel all these symptoms and then they come to a stop right aroudn the time acute signs are supposed to stop. It wasthat sore throat and abdominal pain and diaharrea, but especially that stiff neck and sore throat that scared me STRAIGHT. I look forward to hearing back from you about these things and the ones I forgot to mention, but that’ll do it after and  I will let it go until Weds after I hopefully hear back from you.

 

Thank you Dr. Handsfield


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
I don't know why you found it hard to find a way to find my reply or post a follow-up comment, but you seem to have figured it out. Most forum users don't seem to have any difficulty. However, the forum is new and bug are still being worked out., Uf you have suggestions about how to make it better, please contact ASHA. (The forum moderators have nothing to do with those details.)

Oraquick is a third generation test, not fourth. All the symptoms and other circumstnaces you describe don't change anything, because as I said below, test results always overrule symptoms, no matter how typical (or atypical) the symptoms are for HIV. Therefore, this additional information doesn't change my opinions or advice. As long as you don't have any possible new exposures to HIV, you can continue to expect any and all additional HIV tests, no matter what type and no matter when done, to be negative.

Note that the initial posting fee covers the initial question plus two follow-up questions, so you have one more coming. I would suggest waiting until you have a final HIV test result, then ask any remaining issue on your mind.
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39 months ago

Hi Doctor,

I won’t have any follow up questions after I get my test results. And you're right I figured out how to access the questions.

 

My concerns are with technicalities and what we can eliminate here, things I have read about even, from some of your former forums.

 

See, I understand now that the symptoms I was feelings up until the 4th week were not related til HIV, as you say, it would have tested positive if so. But it wasn’t until the 5th and 6th week that I got one of the more reliable signs of acute symtpoms, which is a sore throat they came out of nowhere, not with a cold, but now a runny nose and abdominal pain. It is extremely irregular for me to get a sore throat, just on the whim like this, without any real cold. I keep feeling things slowly coming on. I just don’t know if worrying myself can cause this, that’s why I asked your opinion. And I don’t know if I could get these symptoms without a fever or swollen lymphnodes and rash? I also read that I could be getting fevers at night and not in the day time, so it can be missed. I have fore sure calmed down now.

 

That’s why the questions I have for you I feel are important to me, and it’s why I paid to inquire about this and your knowledge of it… I know it’s 15-20 days when you begin to get symptoms, and they end shortly after, right now would be in that range of time IF I did have it?

 

I read in one of your forums you mentioned to someone that a reason they shouldn’t have a concern is because they have no knowledge that their partner had been recently incarcerated, as I expressed to you, mine is in jail now and was in prison for a year.  The HPV question I was genially curious about as well, because I have learned that it heightens the risk of contracting HIV if you have it? I had warts a long time ago that were frozen but I still get bumps here and there. I got one weeks ago, it was bare though and hair didn’t cover it like usual.

 

 This throat issue is really confusing me, and it’s why I am still somewhat concerned.

 

I’ve had some of the main symptoms in the beginning, lots of muscle pain, fatigue, diaharrea, and now an unexplained sore throat and pain in the neck and that’s what I’m focused on.

 

I’m still a bit worried and would like to have a better understand to the questions in my mind.

 

Would I be feeling anything at almost 6 weeks in?

 

Please let me know your feedback on these questions and concerns of mine.

 

Much respect,

Nobody Knows

 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
Glad you're more confident about HIV. I didn't notice that your partner had been incarcerated. But it doesn't really matter, since test results overrule exposure history as well as symptoms. The same applies to HPV. In fact, that virus does not significantly increase HIV risk. Some STDs do that, but HPV little if at all. But even if it did, same answer: the test results rule! The test results show you weren't infected, regardless of how high or low the risk of exposure to HIV, whether because of your partner's risks, the nature of the contact, HPV, or anything else.

I hope you're now able to move on. That ends this discussion. Best wishes.
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