Just my Fu_king Luck

[MysteriousStud]

Good afternoon/evening Room Mediators

     I’ve recently come across this site while seeking out some HIV information; perhaps it’s the correct place for me to post both my concern and question.

    I am a BSN nursing student that experienced not 1 but 2 needle sticks last semester from the same client diagnosed with PCP Pneumonia.  I was injecting my client with …, as I went to recap the needle correctly it slipped sticking my finger, I then suddenly jerked back & hit the damn bed thus sticking myself once again on the side of my hand!  Pondering to myself; “Just my Fu_king Luck”.  I immediately took care of my client, removed my gloves, milked both sticks, and washed my hands.  I didn’t learn about Peep until this semester, my last.  Yea I know, I’m thinking the same thing.  Anyways, I tried to follow up the client’s test results that following week however he had been transferred to another facility.

- What I knew about my Client that may be relevant: gay male, past history of drugs, and HIV test results pending do to the PCP diagnosis.  (Not that this means anything, however the reality is Possible) 

- My situation: 7 days later I got an ear ach, 9 days later I got a sore throat, and 11 days later I started off with swollen lymph nodes just below my ear lobes, 2 day low grade fever, and swollen gums.  I treated this symptoms right away thinking I caught some kind of bug from work/school or from sleeping in front of the fan. (This was over the summer)  Nonetheless, I then felt generalized swollen lymph nodes from head to behind my knees that inflamed so fast they hurt like hell.

- Treatment:
- 21 days later I saw I saw my doctor, my typical blood labs were normal, Mono Spot Neg, and my Strep Neg as well.  I was told it’s probably a Virus infection that I got from work/school, treated with NSAID’s, heating pad, Motrin 800mg TIB.   
- 29 days later I still had generalized swollen painful lymph nodes just not to the degree as before.  I again was tested for typical blood labs (HIV non specific) and those came back with flying colors and was told not to worry, my nodes inflamed so fast that’s what caused the pain and I could possible feel them anywhere from 6 to 8 months after the initial inflammation.  Damn they are so uncomfortable!  Doctor felt that HIV wasn’t an issue after the 1st negative test.
- 30 days later and now I’m starting to think “What if I’m Poz”.  Depression had been around to visit here and there for the 1st time, so I snatched up my B.F. and the both of us got the HIV OraQuick Rapid test and both tested Negative.  (I had to rule him out too of the what if’s)
- 3 months later, October: I could still palpate my lymph nodes under my ears and decided to have my blood checked again and an MRI was ordered, thinking Cancer as a “What if”.  Blood test (non HIV specific) was perfect and the MRI showed Post swollen lymph nodes Anterior/Posterior Neck Region, Post swollen Sinus, and Cervical swollen lymph nodes.  While I was there I got the H1N1 shot.  3 days later my lymph node issue came back and again caused some pain and even a bit of depression. 
- 6 day’s later I went back to the doctor because of my generalized lymph nodes swelling and was told that my body is making antibodies and this could last happen up to 6 to 8 weeks.  She then tested me for Hep A,B, C, D and those came back negative. (now 5 weeks later)
- To date: I still have generalized lymph node issues, however  the ones below my ears are starting decrease and become sponge like but the ones in my neck (both sides) and cervical still cause a great deal of being uncomfortable.

     I do apologize for the short novel however I wanted to fill you in on my past history.   Do I have a need to get HIV tested once again and what can you tell me about lymph nodes pertaining to a recent HIV infection. 

Sincerely,
Mysterious Stud

[Andy Velez]

Several things are not clear. Firstly, did you report these accidents to the appropriate person(s) at the hospital where you were working? There is a standard procedure to follow when a needlestick accident happens.

Secondly, it's not clear to me if and when you have actually been tested for HIV. Please clarify.

None of your symptoms are in anyway HIV specific. And symptoms or the lack of same will never tell you anything accurately about your HIV status. Only an HIV test can give you that answer.

I will just mention that needlestick accidents are very common and it is also rare for them to result in transmission.

[MysteriousStud]

Dear Mr. Velez
     
     No sir, I didn’t report the incident to neither my college nor the hospital that I was doing my internship at.  I was scared of getting kicked out school because I didn’t have health insurance any longer and that was a part of our college’s rule/stipulation.  I  now have regrets regardless!

     Yes, both my boyfriend and I were tested 30 days after my initial needle stick.

     11 days since the initial needle stick I’ve been dealing with swollen lymph nodes.

[Andy Velez]

You need to test at 13 weeks/3 months after the incident in order to get a conclusively final result.

The negative at 30 days is encouraging but not final. The average time to seroconversion is 22 days. All but the smallest number of those who are going to seroconvert will have done so within 4-6 weeks after a risk. So if you test negative at 6 weeks the likelihood is that you are going to continue to test negative.

If you and your boyfriend are having anal intercourse it would be prudent idea to use condoms until your HIV status is confirmed to be negative. I think the odds are in your favor that you will test negative.

Good luck and keep us posted. Meantime you can discuss your symptoms with your doctor if they persist.

[Ann]

MS,

I have to say I find it most unusual that your college would let you loose to give patients injections without first drilling their needle stick injury protocol -including PEP - into your heads. Even if you were AWOL during those lessons, you should have been required to complete those lessons before being allowed anywhere near a patient - let alone a patient suffering from PCP - with a needle.

Unless there's something else you're not telling us, or I've misunderstood, this is something you need to raise with your school. It's a major procedural breech, if what you're telling us is accurate.

Hiv infection due to occupational needle stick is actually quite rare - and that's not just down to PEP. In this case, as you were giving an injection as opposed to taking blood, I fully expect you to continue to test negative for hiv. You do, however, need to test again at the three month point.

And speak up about not being given lessons on needle stick protocol and PEP BEFORE being allowed near a patient with a needle! That's really bad practice on the part of the school and I would be questioning their entire programme as a result of this gaff.

And by the way, since you're here and since you mention a boyfriend, let me give you some further advice so you can protect yourself against hiv infection in future:

You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together. To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex without a condom lasts only a matter of minutes, but hiv is forever.

Have a look through all three condom and lube links in my signature line so you can use condoms with confidence.

Anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs.

If you aren't already having regular, routine check-ups, now is the time to start. As long as you make sure condoms are being used for intercourse, you can fully expect your routine hiv tests to return with negative results. Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than hiv.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid hiv infection. It really is that simple!

Ann

[RapidRod]

Just to add to what Ann said incase you missed the class.

https://fpm-www3.fpm.wisc.edu/safety/occupationalHealth/LinkClick.aspx?fileticket=goC7hkAydzg%3D&tabid=64&mid=609

[Ann]

Just to add to what Ann said incase you missed the class.

https://fpm-www3.fpm.wisc.edu/safety/occupationalHealth/LinkClick.aspx?fileticket=goC7hkAydzg%3D&tabid=64&mid=609

Very good point, Rodney. I missed the part where the OP stated "as I went to recap the needle correctly...". Needles are NEVER re-capped, they're ALWAYS immediately placed in a sharps-bin. Re-capping a needle is about as INCORRECT as you can get!

MS, you're either 1) having us on, or 2) you don't pay one iota of attention in class or other teaching situations, or 3) the school you attend and its instructors are of the lowest quality ever.

If it's the first, grow up and tell us what really happened to make you concerned about hiv infection.

If it's the second, you need to get your act together before you either injure yourself or cause a patient unnecessary suffering or even death. Or better yet, go train for a non-healthcare profession where you're not going to have people's lives in your hands.

If it's the third, ask for your tuition fees back and find a new school - and become a freshman again.

Ann

[MysteriousStud]

     I’m a bit lost and confused and I almost feel as if this is a personal attach or a bit of a spanking.  However it’s typing and can sometimes be hard to identify with.

     Both my B.F. and I took our HIV test August 3rd at a local testing center, 30 days after my initial needle stick.  (We both tested negative)  I’ve included and informed my boyfriend in every way possible pertaining to this situation.  I turned to him to be my rock and strength.  My/our HIV counselor never advised me to get another check up; it seemed as if I was educating him at the time on some levels.  I/we went on feeling reassured after thinking what could have happen, more so me.  Nonetheless, since then we’ve participated in unprotected sexual activities due to the fact that we’ve been in a 5 year MONOGAMOUS relationship.  We never had anything to think twice about.

    It wasn’t until after my H1N1; in late October, injection and the reoccurrence of my lymph nodes swelling did I think anymore into the needle stick situation or the “what if’s”.  I returned to my physician and requested to checked for Hepatitis since all my lab panels had been normal and I/we already tested HIV -.  My boyfriend has been aware of all this and say’s it’s all in my head.  I tell him its reality and I need to keep an open mind due to my “what if” situation and it’s my health.  Since my 2nd thoughts about a possible infection of some sort, I’ve not par tacked in any anal intercourse and I thank you for your support and education regarding the situation and his health.

     Ann, I too am thinking the same way you are.  I can’t believe there’s NOT some kind of college needle stick policy nor Peep (spelling) instructions included in that.  It’s something I should have known about before I was even given a damn needle.  The client’s safety is just as important as my own safety and I should have been taught that aspect as well.  I wish I had, I wish I would have known the reality and the what if’s in the very beginning, I wish I had health insurance at the time too.  Those both are my wishes and regrets!  What I’m telling you is accurate and I’m not leaving anything of importance out.  I was truly scared to get kicked out of school due to not any health insurance, it’s mandatory.  I lost my job & I didn’t have any insurance. 

     I’ll be graduating next week and you know something, I’ve had NOT 1 lecture about Peep nor even ½ a lecture!  Deep down that makes me emotional on a negative level.  It wasn’t until this last semester here did I even hear about such a thing with some detail.  Trust me, it sticks in my head.  I actually went to our HIV instructor on campus who has actually participated in HIV vaccines/medications research at the Cleveland Clinic in Florida.  I told him about my situation on a confidential altitude and he’s the one who informed me about Peep and stated that I should be clear with smooth sailing regarding my 1st HIV test and the mind is a powerful tool and not to let it affect me.  (I was a bit emotional when I approached him with my situation) 

    I/you can’t even believe how common it is to have been stuck by a needle and not report it.  I’ve told a ton(many) of class mates about my scare and I’ll bet I had at least 7 ladies tell me they too had been stuck and never reported it, some of them even being LPN’s.  Shocking huh, I too think the same way and then some.
   
      Ann responded with; MS, you're either 1) having us on, or 2) you don't pay one iota of attention in class or other teaching situations, or 3) the school you attend and its instructors are of the lowest quality ever.  1) I don’t understand 2) I’m a smart individual & pay such a great deal of attention 3) the school is good and there no fu_king doubt that some of the instructors are of poor quality or just full of SH_T, just damn lazy, and like to intimidate.  I get that more than ever with both thoughts and regrets, you have no idea.  (With tears in my eyes)

    Again I’ve come here with concerns and questions, I’ve provide truth and accuracy so that “I” could get a valid response not a personal attack nor to defend neither the college that I attend nor those that represent it. 

   Nevertheless, I give good quality patient care, I have a 3.6 GPA in nursing school, and I’m 34 y/o thus growing everyday on all levels.  Another thing, I’ve never recapped another needle again regardless of the situation. 
   
    Feb. 1st is going to be 6 months since my last test.  After graduation, the holiday, and come the 1st of the year I’m gonna get another lab panel done with CD4’s and CD8’s drawn (I’ll need a base line if “what if’s” occur), and I’ll get HIV anonymously tested once again.  I’ve talked with our local AIDS Task Force and well they are here to support me.  By boyfriend say’s I/we don’t need another test and it’s all in my head however it’s my/our health and “my” responsibility to protect my health and not put his at risk. 

Sincerely,
M.S.

[RapidRod]

Really? I don't know of any medical school that doesn't teach safety in using syringes or IV's. That example I posted was from a medical teaching school.

[MysteriousStud]

Seriously!

     Uggg, RapidRod, Yes they teach you how to recap a needle if necessary or at least a way that is safer (pick your language and role with it) and yes they teach you to never recap as well, I could even give you a written procedure as how to perform a puncture correctly of any kind yet you wouldn’t find a: what if I got poked section nor a Peep section.  If you get poked you tell you preceptor, fill out paper work, and well I’ve “heard” other things too but again nothing in writing, testing, nor competency. Yea that’s what I needed; no doubt, hell PEEP could have saved me from pondering the thought of a virus infection of any kind.

    Nonetheless, that’s NOT the issue, concern nor question!  It’s irrelevant as to why I genuinely posted here.  What you posted was appreciated, thank you.  If you’re trying to guide me in answering a specific question, I’m not picking upon it.  If you’re looking to point a finger; I’ve already done that. (Both at myself and my university)  None of that really matters; I was still sitting here with both a concern and a question.

    As I said before, “I’ve recently come across this site while seeking out some HIV information; perhaps it’s the correct place for me to post both my concern and question.”  I genuinely posted a brief history for an assessment.  If this isn’t the place, I’m ok with that.  I’m not interested in what or what my education hasn’t provided for me, I’m in a situation that may or may not be relevant yet I’m open minded to the fact of a possibility and sought out a professional review by Forum team.

    Please, assist me, support, or send me in a different direction and save busting my balls for another time IF THAT’S WHAT I’m DETECTING. 

M.S. 
   

[Andy Velez]

Let's not make this more complicated than it needs to be. A negative test result at 13 weeks will give you the answer you are hoping for. And that is the result I would expect you to get. Everything else is just frabber jabber and doesn't answer the basic question. If you already have that result then great. If you haven't tested at 13 weeks after the most recent incident then that is what you need to do.