[Question #615] Follow up

44 months ago

So I am following up on advice from Dr. Handfields on question 595 .  I am seeking help mental help for an unprotect oral sex exposure with an older woman (late 30s). My concern was that I never had any symptoms, but day nine after my exposure,  I took a 1g zpack for NGU. I panicked about my test results (day 10 urine sample and day 15 took another test) since I read on medhelp that antibiotics can maybe mask the results. Anyways, I sought treatment and received a 250mg rocephine injection and 1g azyro treatment.  Both test results were negative. I was informed that I can move on and continued unprotected sex with my partner by Dr. Hook and Dr. Handsfield.  During the whole incident, I never had symptoms.  I am getting therapy because my mental professional says worry of the test results made me feel like I could have been infected with gonorrhea.  My doctor felt it  would like to clarify a few questions about NAAT testing since my doubts are making physically sick every day.


1. Why would the zpack not interfere with the testing? Is it because cure the gonorrhea or dead DNA would be detected? This is where my problem lies .

2. How confident should I be in the test results? 100%

3. How accurate are the test results 99%? Is a false negative very rare?

4. What are the chances of a failed treatment? I read that CDC says it is 99.95 percent effect and no retesting is needed. Is that correct?

5. Does being with an older woman lower my risk of gonorrhea exposure?

6. How often do you see infections from oral gonorrhea? 

I appreciated concern and patience with my suggestion as this topic. While I understand you are the top professionals in the business, people like  myself don't understand the process.  It is a long road ahead for me, but I am trying to get through one day at a time . 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
You are asking exactly the same questions as last time, using slightly different words. I'm not going to repeat the answers that were provided last time.

1) Re-read the last discussion. At the time you were tested, you were not infected.

2) 100%

3) Re-read my previous reply about your inappropriate focus on the test results. The certainty that you are not infected is based on several other facotrs as well.

4) No chance.

5) Hey -- a question you didn't ask previously (I think)! Chlamydia is rare in women over 30 and gonorrhea rare in those over 35.

6) I see them all the time. So what? The number of patients I have seen doesn't alter your risk.

I hope "I am seeking mental health care" means you are already seeing a mental health professional. If not, please do it now. I'm surprised your therapist and/or doctor has recommended another round of questioning, despite our expertise; I have to suspect this is at your volition, not theirs. They know that simply repeating the facts of the case is not the road to resolving obsessions of any kind. There is always a need for repeat, for clarification, etc (what I call "yes but" questoins). It is not helpful to you. Therefore, this is the last response you will receive. Any future new questions on this forum about these events will be deleted without reply, and without refund of the posting fee. Call it tough love if you like but that's how it will be. (You might consider printing out this thread as a framework for discussion with your doctor and/or therapist. I'm pretty sure they will agree.)

Best wishes to you--  HHH, MD
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44 months ago
Believe  I am getting help. It has not been easy to have physical symptoms and not being able to concentrate. Plus it ain't cheap. Thank you doctor
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
Not sure what you mean that you "believe" you are getting help. "Not able to concentrate" is a BS excuse. The more that and other emotional symptoms are bothering you, the more urgent it is that you get proper care. And as for the expense, my guess is you've spent a lot of money you didn't need to for unnecessary STD exams and tests. In any case, spending on mental health care will be a much wiser investment than on further testing or other medical evaluation. Just do it.


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43 months ago
Dr. H, I truly respect what you do here. I meant to say believe me, I am getting help. They give you breathing exercises and positive thoughts thinking, but they are not experts to explain you doubts in the science of testing or treatment.  But I a bit offended to call me out with a BS excuse. You have no idea what it is like to drag through a day worry about something and how it impacts your focus, even though you receive advice from a top expert like yourself .   I am paying for mental health care and yes an emotional element is playing a part. But as I talked about and stated with my mental health doctor, my lack of confidence in the results played a part in my emotional fears.  My ability to focus on my day to day activities has been impacted because of my dumb decision and spending too much time reading medhelp and getting confused by my lack of medical science.  I understand you only have best wishes for me but at the same time, believe me I don't want to spend more money and time than I have to on any of this. 
43 months ago
All and all, thank you for your advice.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
Thanks for clarifying. Very happy to hear you are in therapy. It wasn't clear -- even re-reading your words before this comment, I don't see confirmation of that, but instead evidence of obfuscation and delay. Hence my assertive wording, which I tend to use when the symptoms that are an obvious sign of needing help being used as an excuse to delay. I have the same response to delaying STD/HIV testing for fear of a positive result, which is common on this forum. Don't take it personally. Our goal on this forum is to educate all readers, not only those posting questions. And over 10+ years of providing online advice, many people seem to beneift from the nudge to "just do it".

Best wishes and stay safe.

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