[Question #9782] Follow up to question 9717

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29 months ago
Hi again! I received my HSV results as follows: HSV culture and typing; negative, no herpes Simplex virus isolated. My OBGYN thinks there’s no need for an IGG test since this is conclusive, do you agree? The cut did subside that weekend after it bled a bit more. Is there ANY possible chance, despite my Gardasil shots, that this can be anal warts? Can warts manifest internally but not externally? I assume this is not herpes?

My transabdominal and transvaginal ultrasound found a small cyst. My lower right pelvic pain seems to have subsided, we think it was due to a lower back tendon I pulled during lifting. My OBGYN never ordered a CBC or inflammatory marker test, do i need them? I plan to get an std test during my physical tomorrow for piece of mind.
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H. Hunter Handsfield, MD
29 months ago
Welcome back, but I'm not certain why you found it necessary. I see no reason not to trust your ObG's opinion and advice. Although a negative PCR test does not rule out the possibility you have herpes, looking back at your several previous forum questions, there was previous evidence you don't have it. As for HPV and warts, they never cause genital ulcers or sores of any kind. Yes, warts can occur internally, but having had Gardasil, I think you should drop all concerns about HPV.

I'm glad to hear your abdominal pain has resolved and nothing serious was found by ultrasound. As for CBC etc, I see no need -- and in any case, an in-person physician's advice is almost always more valid than anything a distant expert can advise. 

I note this is your eleventh forum question over the last 6 years, which might be the forum record. On quick scan, most or all of them suggest elevated anxieties about STDs in general (and maybe herpes in particular), out of proportion to your risk. Many if not most of your questions have been addressed previously -- if not directly, the answers often should be obvious from those discussions. Of course if entirely new scenarios arise, feel free to ask about them -- but be aware that we discourage repeated questions especially when anxiety driven, and eventually we reject them and do not reply (and do not refund the posting fee).

HHH, MD
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29 months ago
Thanks, doctor. I’ve been misdiagnosed with STDs in the past more than a handful of times, I’ve had doctors refuse to run cultures or tests and dismissed things as they were, when pathology says different because I’ve had to plead for testing. I’ve met doctors who don’t know simple facts on HSV, and like anyone else, we turn to the forum boards not to be nuisances and annoyances but to get second opinions. The clinical advice I’ve received versus what the doctors on this website have differed exponentially. And then there’s google as well. Im just trying to make the right decision not to burden anyone else who I may be sexually actively with. I apologize for the multitude of questions. 
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H. Hunter Handsfield, MD
29 months ago
All understood, and I don't mean to come across as complaining or insensitive to these issues. Unfortunately, your experiences are not uncommon. It certainly is true that many practicing physicians have less understanding of STDs than desirable. HSV might be the most common area of misunderstanding, since diagnosis and best treatment are more complex than most other STDs. That said, it doesn't apply to all of them, and if you're in an urban area of the US, you should be able to find a doctor or clinic with sophisticated understanding. A good option often is the Division of Infectious Diseases at an academic or other large, comprehensive medical center. ID also is an unofficial subspecialty among many gynecologists these days. And in a select few medical centers, there are particular centers of STD expertise. You might be able to find one or more such resources with diligent online investigation.

Don't hesitate to use the forum when there's no other option. But do be aware that a distant forum expert generally can't provide very specific information about diagnosis of particular problems, which was at least partly in evidence in your recent thread before this one. It's one thing to ask whether an STD can explain a certain set of symptoms and how often it does so, but quite another to ask or hope for aid in diagnosing something like abdominal pain. Does that make sense?
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28 months ago

No, youre absolutely right, it makes sense and I don’t think there’s any insensitivity! I’ve had a lot of posts here, and I think the anxiety has to be taken into account, it’s just difficult sometimes based on the lack of knowledge and misdiagnosing. I had a physical this week and mentioned the lower pelvic pressure since it came back just a tiny bit (although I really think it’s due to my lower back discomfort which radiates to the front) and the PCP said “hmmm.. could be an undiagnosed case of chlamydia, we’ll check for all STDs.” And I could not understand for the life of me how that’s possible in the absence of any other symptom and having intercourse 10 weeks ago. I’ve unfortunately had chlamydia before, it took a month to diagnose with an OBGYN who swore it was a yeast infection, but I had symptoms 2 weeks later that included burning. This is not the first time a PCP misdiagnosed me for an STD and ended up dead wrong. It’s just so unhelpful. 
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H. Hunter Handsfield, MD
28 months ago
I'm glad you understand. I don't see any further question here, so that concludes this thread. Please note the forum policy against repeated anxiety driven questions. Having had so many, this should be your last one unless something comes up that wasn't addressed previously, i.e. entirely new symptoms, a unique exposure situation, and so on. The sponsor ASHA is not keen on collecting fees for questions with predictable answers, and repeated questions have limited educational value for other users, one of the forum's main goals. Such questions may be deleted without reply (and without refund of the posting fee. Thank you for your understanding. I do hope the discussions have been helpful. Best wishes and stay safe.---