[Question #6786] Follow up to question # 6599

13 months ago
Dear Dr.Hunter, 

I just remembered a minor detail that I wanted to add to my previous question(#6599)
I remember shaking the massuses hand before she washed her hand to start the massage and I could feel that it was a bit wet or sticky...my hands were a bit chappy and dry because of winter, but I dont remember having any obvious bleeding cuts. If she had any genital secretions on her hands if this place offered any sexual services (such as handjobs) that I was not aware of, could I have been at risk of contracting hiv or any other std through small cuts on my hand? 

Again no sexual activity took place what so ever. Just a fully clothed nonsensual massage with my face, neck and hands exposed.
The reason why I am still over concerned is because of the jelly like layer and reddness still covering my eye after almost 3 month and a small pea sized lymph node above my collar bone that could not be seen but felt when i examin this area (which I have read on the internet could be a sign of serious infections such as hiv or even cancer). Could common cold viruses or allergies cause a lymph node or two above the collar bone to be felt?
(You have kindly mentioned in the closing comment of the last question that my symptoms could be a result of allergy and I just wanted to be sure that the lymph node symtom was included (we have been currently experiencing dusty weather and still are)
Thank you very much for all your help and patience.
Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago

Welcome back to our Forum although I must say that I am saddened that you felt the need.  On this occasion I happened to pick up your question. The questions you are asking are repetitive, particularly given the fact that Dr. Handsfield assured you that the events you described put you at no risk for HIV or other STI whatsoever.  I have reviewed his earlier responses and agree entirely with his assessment and advice.  I would point out that amongst the statements he made to you were - "You're obviously stressed -- perhaps feeling guilty or ashamed over a sexual decision you regret. Deal with that part as you need to, perhaps including professional counseling. But don't confuse this with infection from the event. They aren't the same and there is no chance you have any STD. Do your best to believe it and move on without further worry. I hope this discussion has helped you do that."  This recommendation reains appropriate.  My further responses will be brief.

Shaking the hand of your masseuse, wet or dry, with our without cuts on either or both or your hands, with or without genital secretions on the hands was an entirely no risk event.  HIV cannot be acquired in this way.  As Dr. Handsfield told you, your eye problems and the pea sized possible lymph node that you have detected are neither signs of HIV or STIs, nor things that you are at risk for.  If they concern you, you should work with a health care professional to evaluate them, realizing that they are NOT due to HIV of STI. 

Please do not worry further about HIV or STI from the encounter you describe.  If you cannot, what I recommend, as did Dr. Handsfield, is not testing or therapy but counseling to assist you in moving forward from this unrealistic concern.  EWH

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13 months ago
Dear Dr.Hook,

Thank you very much for the much needed reassurance..I am both honored and grateful to recieve feedback and reassurances from Leading, world respected Experts like you and Dr.Hunter.

I have taken your advice to examine my symptoms with heathcare providers without the concern of an sti (after a video examination of the above collar lymph node, the internal doctor doesn't think it is serious and suspects that it could be from a sinus problem that I am living with).

Due to my severe anxiety over my eye problem and the above collar bone lymph node symptoms, I have been overly aware of any body sensations or changes, and I have noticed that my urine is slighly light lime green in color for the past weeks, and that I could feel a couple of tiny lymph nodes at the end of my inner thighs (where my thighs meet the groin area)..

I have googled the symptoms and and found on a medical website that some kind of urinery tract infection could be the cause, and that among other symptoms of UTIs are conjunctivitis, which made me think that this could somehow be related to my presisting eye problem.

My questions are:
1) do the added symptoms of light lime green urine and tiny lymph nodes that i could feel in the upper thighs area in addition to my presistant eye problem indicate a UTI?

2) I have understood from your and Dr.Hunter's kind reassurances that a nonsexual massage and wet handshake (even with hand cuts) could not possibly result in the transmission of any sti...if my symptoms are because of a UTI, how could I have possibly acquired it? Are there possible non sexual reasons for a UTI?
I have not had any premartial sex and my only partner ever is my wife and vise versa.
3) me and my wife have had our first baby almost a year and a half back, and since then we haven't been practicing sex consistently...foreplay for most of the time without actual sex, which may have resulted in me sleeping with some precum on my penis and occasional masterbation..could this cause some sort of bacterial infection or could the continued sexual excitment without actual sex cause prostate inflammation and bacterial infection that are causing my synptoms?

3) do the new symptoms (light lime green urine and tiny lymph nodes that i could feel at the upper end of my inner thighs) change your previous assesment in anyway? Are they connected to my old symptoms (conjuntivitis and a small lymph node that I could feel above my collar bone?)

4)How do I move forward from a medical prespective from here? A urine analysis? I feel like I am deeply stuck in depression and anxiety that is preventing me from assessing what the next step should be.

Thank you Dear Dr.Hook for all your help.
Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago

let me start this reply with a warning.  GOOGLE is NOT your friend!!!  PLEASE do not search for symptoms or medical knowledge.,  Much of what is there is out of date, misinterpreted, taken out of context or just wrong.  Your searching will only make you unnecessarily more anxious and make more work for your doctors and me.  Your doctor has already told you the things you are concerned about are of no consequence yet you went back to the internet- bad idea!  Your follow-up questions reflect your being misled on the internet.  Therefor my response will be appropriately brief as there is no medical or scientific basis for your concern:

1.  No.  TIny nodes are typically normal and may persist.  They are not pathologic.  Your "lime green urine" is a sign that you are paying entirely too much attention to such things.

2.  UTIs are not STIs but arise from bacteria normally on or in the body getting to the wrong place.  In most cases they are a chance event.  Rarely problems such as an enlarged prostate (something that is normal in men over 40) can predisposed a man to a UTI.

3.  No, residual pre-ejaculatory fluid is not a risk factor.  What you perceive as "problems" or "signs" are not

4.  Get a grip on yourself.  Accept, as your doctor appears to have told you, that there is nothing wrong.  Deal with any guilt that you may have.  Get professional mental health assistance (counseling) if you cannot do this yourself and all signs suggest that you are having much trouble moving forward on your own. 

EWH

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13 months ago
Dear Dr. Hook, 

Thank you for your reply..you are helping me tremendously and I will definitely follow your advice and stay away from the internet from now on.
I am doing my best to use the answers that I recieved to put all of this behind me and resume my normal life..
For the closing comments, could you kindly help me understand the following so that I could be better informed and put an end to my worries?

1) I presume from your answer that an eye getting in contact with a contaminated surface in the environment, even if it was contamined 5-10 minutes prior contact is different from getting splashed by fresh contaminated fluid or blood (which is from what I understand a low but possible route of infection)? If so, could you kindly explain the reasons?
Everyday I push myself to mentally put all of this behind then as soon as I see my eye in the morning I start deeply reworrying that I might have been extremely unlucky and contracted something through my eye contact with the massage bedsheet or massage room wall that my eye briefly contacted, especially since I have started feeling that my eye was turning slightly red in the following day, and that I have never had an eye problem like this, nor an eye problem that lasted for 4 month ( tiny pockets of transparent watery fluid in one eye, covered with a jelly like transparent fluid in morning as soon as i wake up on the white side of the eye towards the nose, making it seem as if it is slightly bulging out compared to the retina, then drys out through out the day, general slight redness)
Dr.Hunter kindly mentioned that it could possibly be from a common garden variety virus followed by allergy, but it is the timing of the symptom that is worrying to me..

2) Regarding shaking someone's wet hand with genital secretions and having dry skin cracks from the cold weather (which you kindly reassured provides no route for infection), don't these minor cuts or skin cracks provide access of the virus to the bloodstream?

3) Just to make sure I correctly understood your last answer, There is no scientific bases that my symptoms (a combination of conjunctivitis that is presisting for 4 month now, a small lymph node that I could not see but feel above my colar bone, and possible small bumps (lymph nodes?) that I could feel when i press deeply towards my upper inner thighs near the groin and slightly greenish-yellow urine and now a dry and cracking mouth lip corner) are a sign of a nonsexually aquired uti or anything related to the nonsexual massage that I had?

Could dehydration possibly cause slighly light greenish urine?

5) Is it safe to resume sex with my wife even with my presisting eye symptom?

4) Are my symptoms suggestive of ebv, mono or cmv in any way?


Thank you for all your much appreciated help and your pateince with my misinformed questions..I am just trying to do the responsible thing for my family and to get a grip back on my life after severe anxiety and standstill of the past 4 months. 
My best regards
Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago

Straight to your question.  You are continuing to overthink this:

1. theoretical concerns about acquisition of HIV or other infections through the eye are overstated and largely theoretical.  Hand to eye transmission is not documented and transmission from inanimate objects such as a countertop or other surface to the eye are simply not realistic.  Further, for eye inflammation or irritation to occur due to infection, symptoms would not appear for AT LEAST several days even if it were possible.  Your eye problem is not related to an infection acquired through the interaction you have described.

2.  No, they do not.  If anything, the movement with blood is out of the body, not inward.

3.  Correct

Dehydration can cause urine color to become darker due to the concentration of the urine.  The color of the urine is not indicative of any abnormality.

5..  Yes,

4.  Possibly but if they are, they would not have been sexually acquired. All of these infections, while rarely sexually transmitted through direct, penetrative sexual contact are far more often acquired from community or household contacts through activities of daily living. 

As you note, this will be the final response as part of this thread.  Further and perhaps importantly, I must warn you that further repetitive and/or anxiety-driven questions may be deleted without return of your posting fee. Repetitive questions serve no purpose..  I wish you the best and hope that these final replies will help you to put your fears behind you and to move forward.   EWH


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13 months ago
Thank you Dr.Hook, 
Last point, if this is ebv, cmv or mono, is it better to avoid contact with my wife for a couple of month?
Are these viruses known to cause presisting  eye symptoms like the ones I am experiencing? Can they cause symptoms without experiencing above 105 f fever?
Regarding your answer to n#4, again no sexual contact what so ever, only contact to skin is massaging side of face and forehead..is this possibly enough for transmission of these viruses?
This is my last follow up.
Thank you.
Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago

No need to avoid contact with your wife even if this does happen to be one of the viruses listed (which do not cause persisting eye inflammation). 

End of thread.  EWH

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