My doctor's (irresponsible?!) position on genital herpes

[SunnyFlorida]

There is a chance that I have been infected with HSV-2 genital herpes. I'm fairly certain that I have had two outbreaks: the first one 2-3 weeks after suspected infection in early February. My mouth went dry, lymph nodes swelled up, I had no appetite and had extreme exhaustion. I also had difficulty urinating and a slightly red area developed near the base of my penis. That was when I first freaked out and thought I had gotten HIV from oral contact. (Many thanks to Rod, Ann and Andy for the no-nonsense talk they gave me, by the way!) The symptoms went away.

In mid-March, the lymph nodes in my neck and groin area swelled up again. Certain spots started to itch, my lower back started hurting, I had tingles down one leg but once again, no blisters. After some time, they went away but I now have had chronic fatigue and diarrhea for two weeks and one node in my neck is still swollen. This past Sunday I went to the ER and pretty much explained that I might have had been exposed to herpes. They ran bloodwork but didn't test for herpes at all. Eventually they just assumed I had a stomach virus and let me go home.

On Tuesday I went to see my PCP. I essentially came out to him as gay, described my sexual encounter and the possibility of having contracted genital herpes. And here's the point of this thread:

He told me that it's not worth testing because most people have it, so it's a waste of money.

Whiskey Tango Foxtrot!!!!!

He refuses to order a screening for me. I ended up having to go to the county clinic to get a prescription to take to a local lab for the test. My thinking was that I wanted to know if I had it, so I could protect whoever I come into sexual contact with and to mitigate my symptoms if my diarrhea/chronic fatigue is actually related to the herpes. I did research and the symptoms I mentioned have been attributed to HSV-2. And now I'm considering replacing my doctor with someone who's not so "past it".

Has anyone ever experienced anything like that? What did you do?

[Matty the Damned]

Well he's sorta right.

Testing for HSV is a bit pointless and a bit difficult. There are blood tests which can detect the antibodies for both types 1 and 2 but given either can cause cold sores as well as genital herpes these don't really tell us a lot.

The preferred method is to culture the virus from an existing lesion. But it has to be an unruptured vesicle (ie the blister stage of the infection) and usually these rupture pretty much soon after appearing. Swabbing a ruptured lesion generally won't yield sufficient active virus to produce a useful culture.

So the easiest option is a presumptive diagnosis based on patient report and possible examination of extant lesions and then presumptive treatment.

Not perfect but it works.

For the record I have teh anal herpes.

MtD

[Ann]

Sunny, you know, in the real world, there's not much difference between HSV1 and HSV2. I have herpes in the genital region, but I got it through oral when my bf had a "cold sore". We had no idea at the time (early '80s) what we were really dealing with.

I'll tell you something right now - if you have herpes in your genital region, mate, you're gonna know about it. You're going to get blisters and boy oh boy are they a muthafucka, excuse my language. From what you've told us, you haven't had a single blister.

I really doubt that your "diarrhea/chronic fatigue" would have anything to do with HSV even if you do have it. Herpes isn't known for causing either, aside from maybe during the acute phase, and you cannot possibly be in the acute phase this far into it.

If you start getting actual herpes blisters on your dick or anywhere else on your junk, it may be worth you taking acyclovir as a prophylactic but what you're describing does not sound like you have genital herpes.

[SunnyFlorida]

Sunny, you know, in the real world, there's not much difference between HSV1 and HSV2. I have herpes in the genital region, but I got it through oral when my bf had a "cold sore". We had no idea at the time (early '80s) what we were really dealing with.

I'll tell you something right now - if you have herpes in your genital region, mate, you're gonna know about it. You're going to get blisters and boy oh boy are they a muthafucka, excuse my language. From what you've told us, you haven't had a single blister.

I really doubt that your "diarrhea/chronic fatigue" would have anything to do with HSV even if you do have it. Herpes isn't known for causing either, aside from maybe during the acute phase, and you cannot possibly be in the acute phase this far into it.

If you start getting actual herpes blisters on your dick or anywhere else on your junk, it may be worth you taking acyclovir as a prophylactic but what you're describing does not sound like you have genital herpes.

From what I understand, only 20% of herpes sufferers show symptoms, and not all develop blisters. Some only develop a red area that can itch and is sensitive to the touch but is still shedding the virus. My friend whom I might have contracted it from has been confirmed to have HSV-2 and is completely asymptomatic. That's my concern, really. I've read personal accounts of people having diarrhea and chronic fatigue in between herpes outbreaks... so... *shrugs* I'll at least find out if I have it on Monday. While I hope I didn't catch it, it'd be comforting to know what's been keeping me absolutely exhausted with the screaming shits for the past fortnight.

What do you think of my doctor's response, though?

[SunnyFlorida]

For the record I have teh anal herpes.

MtD

*looks at your avatar* Oh, really? Trying to show it off? Heheh...

[thunter34]

I love Matty's avatar, but the one about fisting sheep was the best.

[Ann]

Sunny, I'd say that your doctor's response was totally typical. Herpes is not life-threatening - it's just a pain in the ass. (Matty and I know that first hand, boy oh boy do we...)

You'll live, lad, you'll live. Don't expect to get tons of sympathy around here over HSV 1`or 2. You'll live.

As far as you infecting any partners, the trick is to not let your bits come into contact with another person's body when you either have an outbreak or can feel one coming on. If you have it, you'll know when this is happening. I've had genital herpes since 1980 and not one of my partners ever got it from me.

[thunter34]

As far as you infecting any partners, the trick is to not let your bits come into contact with another person's body when you either have an outbreak or can feel one coming on. If you have it, you'll know when this is happening. I've had genital herpes since 1980 and not one of my partners ever got it from me.

Actually, I was about to ask this question a few minutes ago.

[SunnyFlorida]

Sunny, I'd say that your doctor's response was totally typical. Herpes is not life-threatening - it's just a pain in the ass. (Matty and I know that first hand, boy oh boy do we...)

You'll live, lad, you'll live. Don't expect to get tons of sympathy around here over HSV 1`or 2. You'll live.

As far as you infecting any partners, the trick is to not let your bits come into contact with another person's body when you either have an outbreak or can feel one coming on. If you have it, you'll know when this is happening. I've had genital herpes since 1980 and not one of my partners ever got it from me.

Thanks, guys. Wasn't looking for sympathy, I just took it to be something more serious than it actually is. It's comforting to hear personal accounts from rational people such as yourselves. I hated browsing the herpes forums because everyone, and I mean everyone, were hysterical about it. :/ Bottom line, it's not a big deal, it's an annoyance, and just watch for the outbreaks, right?

[Ann]

Thanks, guys. Wasn't looking for sympathy, I just took it to be something more serious than it actually is. It's comforting to hear personal accounts from rational people such as yourselves. I hated browsing the herpes forums because everyone, and I mean everyone, were hysterical about it. :/ Bottom line, it's not a big deal, it's an annoyance, and just watch for the outbreaks, right?

Yep.

And if you do start to get actual blisters (which is doesn't sound like you have so far), you can get a script for acyclovir. You'll know when you're starting to get an outbreak and if you start the acyclovir right away, sometimes you won't even get the blister. You need to talk to a knowledgeable doctor about this.

[thunter34]

Yep.

And if you do start to get actual blisters (which is doesn't sound like you have so far), you can get a script for acyclovir. You'll know when you're starting to get an outbreak and if you start the acyclovir right away, sometimes you won't even get the blister. You need to talk to a knowledgeable doctor about this.

Are these blisters - like, say...Matty's ass blisters - are they painful like in a shingles sort of way?  Is that what we're talking about here?  I've always known about the outbreaks, but I never thought about what those would feel like.

[Ann]

Are these blisters - like, say...Matty's ass blisters - are they painful like in a shingles sort of way?  Is that what we're talking about here?  I've always known about the outbreaks, but I never thought about what those would feel like.

Oh yeah. They're painful in a shingles kinda way. And when one is coming on, you get that horrible, itchy/tingly feeling that you just know isn't going to end well.

Shingles and herpes are both caused by the same family of viruses and they do behave in a very similar way. Herpes lives in nerve cells in your spine and travel down the nerve cells to the site of the outbreak, so nerves are very much involved. And it is painful as fuck being bitten by a cat on your nipple. Bitten very hard. And not in a nice S&M way either. It just fucking hurts.

And you can spread them around your own body. I didn't get the ass blisters until after I'd had them a little.... um.... further... north? for a while. We women are supposed to wipe from front to back and well, that's how I got the ass blisters. Not much fun at all anywhere, but ass blisters take the proverbial cake.

[thunter34]

Ow.   Just ow.

[SunnyFlorida]

Oh yeah. They're painful in a shingles kinda way. And when one is coming on, you get that horrible, itchy/tingly feeling that you just know isn't going to end well.

Shingles and herpes are both caused by the same family of viruses and they do behave in a very similar way. Herpes lives in nerve cells in your spine and travel down the nerve cells to the site of the outbreak, so nerves are very much involved. And it is painful as fuck being bitten by a cat on your nipple. Bitten very hard. And not in a nice S&M way either. It just fucking hurts.

And you can spread them around your own body. I didn't get the ass blisters until after I'd had them a little.... um.... further... north? for a while. We women are supposed to wipe from front to back and well, that's how I got the ass blisters. Not much fun at all anywhere, but ass blisters take the proverbial cake.

I've had the prodrome symptoms - tingling in certain areas, pain shooting through my leg and pain when trying to urinate. It's all so confusing!

[Ann]

I've had the prodrome symptoms - tingling in certain areas, pain shooting through my leg and pain when trying to urinate. It's all so confusing!

Yeah, well, you thought you had symptoms of hiv infection too, but you didn't.

Stop trying to diagnose yourself. It's getting tedious.

[SunnyFlorida]

Yeah, well, you thought you had symptoms of hiv infection too, but you didn't.

Stop trying to diagnose yourself. It's getting tedious.

Hahaha, I know... I'm TRYING to get professionally diagnosed but my doctor refuses to do it. THAT'S the problem.

[Ann]

Hahaha, I know... I'm TRYING to get professionally diagnosed but my doctor refuses to do it. THAT'S the problem.

Well, re-read Matty's reply to you. As he said, the only really reliable test is to swab a blister before it erupts and that's a difficult feat to accomplish. And the blood test isn't going to tell you much either as somewhere in the region of 80% of people in the developed world will test positive - regardless or whether or not they get outbreaks. Many people do not.

If you're not having outbreaks of blisters - and you'll know if you do - there's not a lot of point in worrying about it.

[SunnyFlorida]

Well, the herpes issue aside, I finally "fired" my doctor.

For the past 3.5 weeks, I've been having diarrhea, fatigue (which I've been handling better lately), brain fog and general malaise as well as swollen lymph nodes in my neck and armpits. I went to a new doctor yesterday morning (April 26th) and he's been nothing but amazing so far. Whereas my previous doctor would only give me immunosuppressant shots to mitigate my symptoms, the new one is actually ordering all sorts of tests to be done, including a CT scan for my neck and mastoid bone. The scan for the mastoid bone is pretty much to check up on the progress of the infection I was fighting last year (mastoiditis) and he commented that my lymph nodes are DEFINITELY swollen, and so is my thyroid.

It's possible that I may have hypothyroidism or Diabetes Type II, according to him. I've definitely been diagnosed with oral thrush, which is something I've had for a few years now, as well as constant dry mouth and frequent urination. He says it has something to do with my immune system, so either my body has been fighting something for a few years now, or the immune system has been compromised somehow.

We've already ruled out HIV (duh) and Hep A, B, C as well as Syphilis, Gonorrhea, Chlamydia and HSV-2. I've gotten a prescription to treat my thrush, so hopefully that'll work out for me. It's called Nystatin, and I'm supposed to swish it in my mouth and then swallow five times a day. I've been fasting since 10pm for the bloodwork in the morning, as well as the CT scan I have at 1:45pm EST.

So far, so good... I'm so happy that I finally have a doctor that will get things done.

It was an interesting birthday for me... At first I didn't really want to do anything, but klouny insisted on taking me out to dinner. We went out for sushi... MMMMMM!!!! Then we went to Starbucks and then my place to watch a movie and cuddle. We saw Eternal Sunshine of the Spotless Mind. Holy crap, what an amazing movie. We talked some more... I don't think I could have asked for a better birthday. Thanks, Danny. <3

[SunnyFlorida]

Had my CT scan this afternoon... I think it makes my head look fat.