[Question #7698] Question

1 months ago
This question is for Terri Warren.   I just noticed that you added some comments to my prior closed question (7680).  Thank you so much for taking the time to do so.    I agree I am not going to do any testing because there is a very large part of me that thinks I couldn't have it based on information I provided.   
Would you mind answering a few more questions?
1. Both you and the other Dr. do not think I had it.  Would you mind giving me your reasons why you think that?   Do you think I would have had other symptoms/OB each decade?   Can you give an estimate how many OB a person would have had this many years?  Based on what you've seen. 

2. I know you've seen people not have anything for decades but is that really the norm or the exception?   

3. What even is an OB? I've read about them, but what do you see in practice?

4. I think what if there was a blister and I missed it when I was having a possible yeast infection years ago?  Again people in their teens and 20s have many OB.  What would be special with my immune system all these years that it could be contained?

5. I've read that alot of people ignore minor little symptoms.  I honestly can't think of any.   Let's just say there were ever so minor ones I didn't recognize, what do you think my chances of waking up some day in menopause and having a huge OB out of nowhere? Is that normal?   

6. There is one more thing.  My husband has never had anything on his private parts.  2 days after intercourse, 2 small pimple like appeared. They were spread apart.  No itching or pain.  They remained unchanged for 2 weeks.  Third week they disappeared after using fungal cream.  Do you think that's anything to worry about or can a man just get a pimple every once in a while? 
That's really all the questions I have.  I just wanted to say thanks and see what you think about those questions. 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
1 months ago
1. Both you and the other Dr. do not think I had it.  Would you mind giving me your reasons why you think that?   Do you think I would have had other symptoms/OB each decade?   Can you give an estimate how many OB a person would have had this many years?  Based on what you've seen.
Generally speaking, people with HSV 2 have about 4-6 outbreaks per year, fewer as time goes by.

2. I know you've seen people not have anything for decades but is that really the norm or the exception?  
You know, it's difficult to say for sure.  Research shows that 85% of people with HSV 2 don't know they have it so it couldn't be that everyone has 4-6 outbreaks a year.  And I have patients who test positive accurately for HSV 2 with no symptoms that they recognize, and they are looking!  But I can't say which is more normal - having that number of outbreaks or having very few.  I think our research just can't say that for sure.

3. What even is an OB? I've read about them, but what do you see in practice?
Blisters, sores, ulcerations, red areas that look like abrasions, that kind of thing

4. I think what if there was a blister and I missed it when I was having a possible yeast infection years ago?  Again people in their teens and 20s have many OB.  What would be special with my immune system all these years that it could be contained?
I don't know that it is true that people in their teens and 20's have many outbreaks.  Again, most people who are infected (as documented by good blood antibody tests) don't know it so it's very difficult to know

5. I've read that alot of people ignore minor little symptoms.  I honestly can't think of any.   Let's just say there were ever so minor ones I didn't recognize, what do you think my chances of waking up some day in menopause and having a huge OB out of nowhere? Is that normal?  
If you are infected, I think it is extremely unlikely that you will someday wake up with a horrible outbreak.  If you have to undergo major chemotherapy, that is a small possibility but I don't believe ever it will just come out of the blue.

6. There is one more thing.  My husband has never had anything on his private parts.  2 days after intercourse, 2 small pimple like appeared. They were spread apart.  No itching or pain.  They remained unchanged for 2 weeks.  Third week they disappeared after using fungal cream.  Do you think that's anything to worry about or can a man just get a pimple every once in a while?

I think men do sometimes get a pimple on their penis now and then, yes.  And herpes lesions really do start as blisters, break open and become an ulcer, scab over and disappear.
If this continues to worry you, you could get the herpes western blot.  But what would you do differently in your life if you were positive?  Or would it just greatly disturb you with nothing really changing?

Terri
That's really all the questions I have.  I just wanted to say thanks and see what you think about those questions.
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1 months ago
Thank you for your quick response.  I just have 4 more questions.  Meant to ask them in my first thread so I don't have to keep bothering you. 

1. About 6 years ago, my husband had a bright red streak (about an inch or so wide) appear on his lower leg almost above his ankle but front part of leg.  It didn't blister.  Maybe had a little blood? Was outside all day so assumed came in contact with something.  I think it lasted about 3 days then went away.   Read in some previous questions with experts that hsv can go down the nerve and impact legs?   
Could he just have atypical signs or could that have been an OB?    Wouldn't there be an OB in boxer area first?   You think this was just a coincidence ?

2.  If would have it and didn't know when pregnant, could it be dormant and show up later for children?  Would they always show antibodies since some would have been passed at birth from mother?   Would those just be temporary antibodies and then disappear?   Is Eczema or any other common skin condition associated with HSV?   Is it usually obvious at birth or shortly after?

3. I try to work out 2-3 times a week.  Do you think if I started working out 7 days a week, it could activate something that was there.   
Throughout the years, I've been in the sun, been stressed at times, and haven't gotten 8 hours of sleep every night.  I'm sure something would have triggered it by now if it was there.

4.  In regards to those 2 pimples for my husband, can you think of anything else it could be? Could they be fungus since fungal cream worked and they disappeared?  So if these were herpetic, they'd look like you described and fungal cream wouldn't absolve them..

So after these other questions, do you still think I probably don't have it?   Do you think there's even a very small chance and it could completely change our lives...go from completely normal to OB every month/year after menopause or just because of age?

In summary, if you could give 2 reasons why you think I don't have it? 

 Again, I just can't believe people can go all their life and not have anything until 60 or 70?  Do you see that alot? 

Sorry if I reasked a question, but wanted to be sure nothing changed after these questions.  That is all the questions I have! Thank you for your patience and being so kind answering my questions.   

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
1 months ago

1. About 6 years ago, my husband had a bright red streak (about an inch or so wide) appear on his lower leg almost above his ankle but front part of leg.  It didn't blister.  Maybe had a little blood? Was outside all day so assumed came in contact with something.  I think it lasted about 3 days then went away.   Read in some previous questions with experts that hsv can go down the nerve and impact legs?   
Could he just have atypical signs or could that have been an OB?    Wouldn't there be an OB in boxer area first?   You think this was just a coincidence ?
This sounds absolutely nothing like a herpes outbreak.


2.  If would have it and didn't know when pregnant, could it be dormant and show up later for children?  Would they always show antibodies since some would have been passed at birth from mother?   Would those just be temporary antibodies and then disappear?   Is Eczema or any other common skin condition associated with HSV?   Is it usually obvious at birth or shortly after?
If your children had acquired herpes at birth, they would have been symptomatic and likely quite sick indeed.  It is not appropriate to test children for antibody as the test has a 50% false positive rate on the test.  Eczema is not related to herpes.

3. I try to work out 2-3 times a week.  Do you think if I started working out 7 days a week, it could activate something that was there.   
Throughout the years, I've been in the sun, been stressed at times, and haven't gotten 8 hours of sleep every night.  I'm sure something would have triggered it by now if it was there.
Working out more wold NOT make herpes come out if you had it.

4.  In regards to those 2 pimples for my husband, can you think of anything else it could be? Could they be fungus since fungal cream worked and they disappeared?  So if these were herpetic, they'd look like you described and fungal cream wouldn't absolve them..
People definitely can get pimples in the genital area  - it happens all the time and antifungal cream would not resolve a herpes lesion.

It is possible for people to have herpes for years and not have symptoms, yes.  But nothing you have described here concerns me.  And if you did an antibody test and it was positive, how would you change what you do?  How would it help you and could it really upset you?  In your particular situation, I would advise against testing.  In general, I am more of an advocate for testing than my colleagues, but not in your case.  You aren't going to have multiple partners that could contract this disease if you didn't know you had it.  You don't have symptoms that we can't sort out and are worrisome for herpes.  None of that is the case for you.  You just seem worried in general that might have herpes.  Is that correct?  I would advise that you work on letting go of this worry rather than testing.

Terri
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1 months ago
Thank you for your responses.   I have never worried about hsv until I did some reading about those pimples and those unexplained yeast infections that seemed to come and go for a while many  years ago.. 
 Those 2 pimples appeared on my husband's private part about midway up.  (About 2 days after intercourse).    They were separated and flattish (mainly clear to white on top?).    If they were hsv, would they have gotten worse over time or been in a cluster? Could this be a primary OB?   Isn't hsv clear? 

 Could they be hpv or would those have showed up way before now? Can hpv cause these flattish pimples?

The only reason I mentioned his leg was because there was a post on another forum where it was mentioned there can be hsv on ankles and the genital nerve runs to the ankle.   What makes his sound different? Again, is it because there would have been more symptoms or took longer to heal?  Do most primary break outs happen in genital area first?

I didn't know if people could just have hsv 2 on other body parts and never in the boxer area.

Was just concerned that maybe he was just starting to show symptoms even if atypical?what do you see with guys?

I guess I'm still looking for a quick few reasons why you think there's a good reason why you think I don't have it?   Is it because I would have had at least a bump or blister or an OB throughout the years... especially if it was type 2? 

Thank you for answering all of my questions.   I know I've had a lot, but you've helped ease my fears. 

I guess someone can just have bad yeast infections that can get worse if they're not checked out.  I just don't remember white discharge?  

It sounds like neither my spouse or I need to worry about having anything take us by surprise with this topic?    Should I be fairly confident? 

I agree no testing.  Don't want to take a chance with false positives. 


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
1 months ago
If the pimples had been herpes, they would opened, made an ulceration, scabbed over and healed. That's not what you are describing
HPV would not go away quickly for sure
A red streak on your husband's leg is not the presentation of HSV at all.  You are not reporting water blisters that broke open, ulcerated and scabbed over.
With men, we mostly see lesions on the shaft of the penis that as I described above.
Neither of you are having herpes symptoms at all.

Terri

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