Quantcast

Subscribe to:
POZ magazine
E-newsletters
Join POZ: Facebook MySpace Twitter Pinterest
Tumblr Google+ Flickr MySpace
POZ Personals
Sign In / Join
Username:
Password:
Welcome, Guest. Please login or register.
April 17, 2014, 10:13:23 PM

Login with username, password and session length


Members
Stats
  • Total Posts: 620096
  • Total Topics: 46721
  • Online Today: 282
  • Online Ever: 585
  • (January 07, 2014, 02:31:47 PM)
Users Online

Welcome


Welcome to the POZ/AIDSmeds Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ/AIDSmeds community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Author Topic: Semi-Good News, I Guess..  (Read 2134 times)

0 Members and 1 Guest are viewing this topic.

Offline RobbyR

  • Member
  • Posts: 239
Semi-Good News, I Guess..
« on: December 16, 2013, 07:38:49 PM »
Wondering if anyone else has had a similar experience as me. Since October, 2 months ago, I began having sharp pain when passing stools. At times worse than others, but basically it's been with me since then. Saw my doc, she thought she saw a fissure, she gave me Nifedipine/Lidocaine creams, been using them for 3 weeks now. Didn't seem to help much. Was tested for std's and all were negative. I did have a low grade HPV result a year ago, but have been told numerous times that I don't need to have another pap yet. Had a small polyp removed earlier this year, but it was benign.

So today I went back to my colorectal surgeon, he scoped me. Said I have an external lateral fissure, in the 3oclock position. He said surgery would not be a good option because the lateral fissures are more difficult & that basically I just need to up my fiber, and he gave me a different kind of Lidocaine ointment, the 5%. He said emphatically that I do not have cancer. Which is a huge relief.

He said my fissure is probably due to HIV. Not sure how, because my numbers have been excellent for many years, and have had no receptive anal sex in over 3 years, but that's what he said. Maybe it's just back luck. I'm wondering if anyone else has dealt with a lateral fissure, and if Lidocaine helps. I've had this one for 2 months now, he told me they can take 3 months or even a year to heal. Guess it just varies. But mainly I'm relieved that it's not cancer, and my CRS deals with many HIV patients and said he's seen this before. Thanks for any comments. Needless to say, I'm going to try and take excellent care of my butt, no big insertions for me for awhile  ;)
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline Jeff G

  • Global Moderator
  • Member
  • Posts: 9,229
  • How am I doing Beren ?
Re: Semi-Good News, I Guess..
« Reply #1 on: December 16, 2013, 07:49:41 PM »
I had a fissure and was prescribed topical meds and antibiotics but it did not help . I had it for almost two years and took surgery to clear it up . I would try what your doctor is advising, I'm not going to lie to you but all I will say is you do not want to have that surgery except as a last resort .

If you don't get better and your doctor still doesn't think surgery is an option then I would seek another opinion .

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #2 on: December 16, 2013, 08:55:51 PM »
Thanks Jeff for the advice, I will try the ointment & just give it more time. Maybe it will help, maybe it just needs more time. My CRS told me the same thing you did, that the surgery might even make it worse or that it could recur, since I have HIV. Not sure how having HIV would have caused a fissure, since I have no infection, stds or recent anal sex, maybe it's just a freak thing? My numbers have been excellent too. Could you shed any light on that? I did have the HPV result that was low grade for dysplasia, but again my CRS seemed very unconcerned and said my fissure given it's lateral position was due to HIV  since I don't have Chron's or syphillis or any other health issue. (He didn't specify beyond that).

He basically just told me to keep eating fiber & try the ointments & to come back in a few months if nothing improves. He did say that I should stop the sitz baths that they could exacerbate the issue potentially. So I'll take his advice. If I have to have surgery sometime, I'll do it, but I'm just relieved that I can not worry about cancer so that's a load off my mind.

With your fissure were you able to eat what you wanted as long as you had lots of fiber, etc?

Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline buginme2

  • Member
  • Posts: 2,744
  • Certified Life Coach
Re: Semi-Good News, I Guess..
« Reply #3 on: December 16, 2013, 09:10:07 PM »
I had one.  My doctor gave me a prescription for nitroglycerin in a cream form (the same thing they give to people having a heart attack but in a cream).  Anyway, you can't just buy it you have to take it to a specialty pharmacy and they have to make it.  Rub it on twice a day.  Gives you a pretty big headache (which is weird considering where you rub it on).  But....it cleared up the fissure in two weeks.
"All I need are some tasty waves, a cool buzz, and I'm fine."

http://www.youtube.com/watch?v=6e0gcEC1TWE

Offline Jeff G

  • Global Moderator
  • Member
  • Posts: 9,229
  • How am I doing Beren ?
Re: Semi-Good News, I Guess..
« Reply #4 on: December 16, 2013, 09:14:17 PM »
I would think the addition of fiber is to help prevent constipation and difficult bowel movements that may make healing a fissure problematic .

Its almost certain that since you have a rectal tear that there is some kind of infection involved and those kinds of anaerobic, Anaerobic bacteria, or anaerobes, are bacteria that do not need oxygen to live. In humans, these bacteria generally live in the gastrointestinal tract and they can be hard to treat in a rectal fissure .

That's about what I remember from my butt - tastrophe days . I cant be sure what your doctor is thinking but if it does not respond to his treatment go see another doc or this could rock on for some time if you don't .


Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #5 on: December 16, 2013, 09:29:16 PM »
I have heard a lot about nitro glycerin, isn't it basically the same as Nifedipine? They had to mix it for me too. I have been using Nifedipine for 3 weeks now. Hasn't done much. The CRS gave me a new script for Lidocaine ointment (not gel) and told me to stop the Nifed. Maybe I'll call my primary and ask him if I can try nitro too. But I had thought it was essentially the same as Nifedipine (Nifedipine having fewer side effects). But my CRS indicated that Nifedipine might actually have made the fissure more painful for me. Anyway, I'll try the new Lidocaine ointment for a bit & try it out. I don't think I have any infection, I've kept the area totally clean, no toys in a long time, etc..My recent blood tests appeared fine.
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline oksikoko

  • Member
  • Posts: 672
  • Writing the congressman again
    • the treatment cascade
Re: Semi-Good News, I Guess..
« Reply #6 on: December 17, 2013, 12:29:55 AM »
Did this happen before or after you started treatment for bipolar? I don't recall which you were on, but some of those drugs, like risperidone, can cause stool hardening and constipation, especially in the beginning as you adjust, which, possibly, could have been responsible for the fissure.

But I guess your doctors are aware of all your prescriptions?

Note: I'm still not a doctor. I base this off things I've read on crazymeds.com etc.
Code: [Select]
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #7 on: December 20, 2013, 02:08:03 PM »
This happened two months ago, shortly after I started treatment for bipolar. I had been on Atripla for several years before, and my numbers are excellent, cd4 over 650, vl undetectable. So it puzzles me why the colorectal surgeon would say the fissure is due to HIV.

He examined me with scope, said it was a lateral, on right side, which usually are due to other factors like TB, stds, trauma, or HIV. Didn't explain how though. And I've had no anal trauma or anal sex for years, and my recent colonoscopies earlier this year were fine.

Basically the CRS just said that surgery would not be a good course of action now because it could recur. He said emphatically that it was NOT cancer, which was a relief to hear.

He just told me to stop the sitz baths, the Nifedipine/Lidocaine & gave me a higher strength Lidocaine, with peppermint oil.

The pain is a bit better the last couple days, but still having bleeding. The CRS said he has seen HIV-related fissures like mine before, and that some take a few months to heal, others take up to a year (ugh).

So what do I do now, just deal with it? I can't go to another CRS because I can't afford it, unless my clinic can get me a referral through Ryan White to another private CRS.

But since my CRS didn't seem to concerned, guess all I can do is deal with it. But I'd still like to try Nitroglycerin or something in the meantime.

One thing I wonder is, all my recent labs have come back negative for all stds.

Would this rule out all stds, even in rectal area?
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline darryaz

  • Member
  • Posts: 450
Re: Semi-Good News, I Guess..
« Reply #8 on: December 20, 2013, 04:12:02 PM »
I had one a couple of years ago.  Had the surgery - under sedation and it wasn't bad at all.  It cleared the problem up FAST.

So in case that's the route you have to go, don't stress too much about it.

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #9 on: December 20, 2013, 04:34:02 PM »
My CRS said that surgery wasn't a good option because it might recur. But I thought that the surgery permanently cured fissures. Just puzzled. I'd like to just have the surgery and be done with it if that would cure it.

But my CRS said since mine is a lateral fissure on the side, surgery might not fix the issue.
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline oksikoko

  • Member
  • Posts: 672
  • Writing the congressman again
    • the treatment cascade
Re: Semi-Good News, I Guess..
« Reply #10 on: December 21, 2013, 01:45:36 AM »
And I've had no anal trauma or anal sex for years, and my recent colonoscopies earlier this year were fine.

...

Would this rule out all stds, even in rectal area?

If you told them you weren't having anal sex, then they probably didn't swab this area to test for, say, Cclamydia. I tell them I've done everything even when I haven't to be sure I get all the swabs. It always seemed to me that if you had chlamydia of, say, the penis, then even if you hadn't had anal sex you could still cross-infect yourself from other the infected area fairly simply, it seems to me. Isn't that how you get ocular chlamydia? By touching your eye after touching your junk? 

Or maybe that's not how it works. But I still want all the swabs.
Code: [Select]
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

Offline Ann

  • Administrator
  • Member
  • Posts: 27,947
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Semi-Good News, I Guess..
« Reply #11 on: December 21, 2013, 07:40:11 AM »
If you told them you weren't having anal sex, then they probably didn't swab this area to test for, say, Cclamydia. I tell them I've done everything even when I haven't to be sure I get all the swabs. It always seemed to me that if you had chlamydia of, say, the penis, then even if you hadn't had anal sex you could still cross-infect yourself from other the infected area fairly simply, it seems to me. Isn't that how you get ocular chlamydia? By touching your eye after touching your junk? 

Or maybe that's not how it works. But I still want all the swabs.

Yep, you can spread several STIs to other places on your own body, notably herpes, chlamydia, and to a lesser extent, gonorrhea.
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #12 on: February 09, 2014, 05:36:00 PM »
I've had a pesky anal fissure since October, at first it was sharp, glass-like pain when going number 2, & some spotting, now maybe thanks to both time, diet, stool softeners, & gels, the pain is less, but still having some spotting. I saw my colorectal doc in December he scoped me, said the fissure is lateral, which would make it tough to operate on. He also said it may or may not be HIV or HPV related, which I have.

Says he wanted me to just do what I'm doing for now. It's frustrating because I had an inflamed rectal polyp removed in March, & did fine, until the fissure occured. I haven't had any anal sex in years or any sex toy insertions, etc.

I'm going back to see my CRS next month, I'm hoping he'll tell me the fissure is better, my regular doc told me last week it looked better. But the continued spotting makes me wonder. Could I have developed another polyp since December, but don't those or tumors take years to form? I had a colonoscsopy last March, so wouldn't they have seen any other issues then? All the doctors tell me that i spite of my anal pap in December 2012 showing low-grade lesion, that I don't need to repeat it anytime soon. Nor will I need another colonoscopy for at least 5 years or so according to my doctors, all of whom regularly treat HIV patients.

Maybe I am worrying too much, but given my issues with my butt I obsess over every little thing & drop of blood back there. If the fissure is indeed improving, why the spotting? I guess my brain tends to assume the worst, & I am thinking I have some massive hidden tumor back there somewhere, but the fact that my recent scope didn't show anything but the fissure makes me feel a bit better I guess. I asked my colorectal doc point blank in December, do I have cancer, he said no. But he told me in future he might want to biopsy the fissure, and that word, biopsy, scares the hell out of me.
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline wolfter

  • Member
  • Posts: 4,028
Re: Semi-Good News, I Guess..
« Reply #13 on: February 09, 2014, 06:57:39 PM »
I'm assuming low grade polyp means low grade neoplasia?  If this is the case, I certainly WOULD NOT wait 5 years.  Polyps can develop quite quickly.  I had some removed and within a relatively short period of time I developed more that quickly became high grade neoplasia that required surgery and was some of the post painful shit I've experienced.

Perhaps it's time for a 2nd opinion.

best of luck
Wolfie
Judging someone does not define them, it defines you. 

True peace is not merely the absence of war, it is the presence of justice.

Online Miss Philicia

  • Member
  • Posts: 23,558
  • celebrity poster, faker & poser
Re: Semi-Good News, I Guess..
« Reply #14 on: February 09, 2014, 07:51:19 PM »
For a colonoscopy my colorectal specialist does the following:

If you have a family history of polyps, benign: colonoscopies every five years -- however if your own colonoscopy results in polyps, even benign then it's every three years

If you have no family history then it's a 10 year cycle beginning at the age of 50.

Obviously if you have a colonoscopy that finds malignant polyps everything is different.

note: none of this should be confused with treatment for dysplasia/HPV/anoscopies etc.

Robby's post is confusing so I can't really understand what he's talking about.
"Iíve slept with enough men to know that Iím not gay"

Offline Jeff G

  • Global Moderator
  • Member
  • Posts: 9,229
  • How am I doing Beren ?
Re: Semi-Good News, I Guess..
« Reply #15 on: February 09, 2014, 08:15:15 PM »
Hi Robby . I merged your old thread with your new one on the same subject .
 
It helps to keep all your thoughts and the reply's in one thread . When you want to update a thread you can find it by going to your profile and selecting show own post and it will take you there .

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #16 on: February 09, 2014, 08:28:09 PM »
For a colonoscopy my colorectal specialist does the following:

If you have a family history of polyps, benign: colonoscopies every five years -- however if your own colonoscopy results in polyps, even benign then it's every three years

If you have no family history then it's a 10 year cycle beginning at the age of 50.

Obviously if you have a colonoscopy that finds malignant polyps everything is different.

note: none of this should be confused with treatment for dysplasia/HPV/anoscopies etc.

Robby's post is confusing so I can't really understand what he's talking about.


Miss P, to clarify, the polyp which they removed last year came back showing inflammatory, but they told me when I asked that it was benign, just inflammatory. That was before I developed the fissure, which seems to be a seperate issue. I had an anal pap in 2012, which showed low grade LSIL lesion, but all the doctors told me that I don't need to worry about that for now. I am going to get another opinion, but the polyp which they removed, was not malignant, they just said it was "consistent with inflammatory" or something to that effect. My current CRS doesn't know if the fissure is HIV/HPV related or not.

But yeah the polyp I had removed was not malignant or so they said, & although my pap test showed low grade lesion result.
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline buginme2

  • Member
  • Posts: 2,744
  • Certified Life Coach
Re: Semi-Good News, I Guess..
« Reply #17 on: February 09, 2014, 09:27:06 PM »
A  polyp, an anal fissure,  and hpv  low grade dysplasia are thee separate issues/conditions. 

 

"All I need are some tasty waves, a cool buzz, and I'm fine."

http://www.youtube.com/watch?v=6e0gcEC1TWE

Online Miss Philicia

  • Member
  • Posts: 23,558
  • celebrity poster, faker & poser
Re: Semi-Good News, I Guess..
« Reply #18 on: February 09, 2014, 10:32:18 PM »
So when you say polyp you mean in your colon as a result of your colonoscopy? Why are you conflating this with things going on in your anal canal?

You've started about five threads about your anus and/or colon since registering here it's very difficult to keep track of what is going on.

Bugsy is correct, your anal fissure has nothing to do with anal dysplasia as a result of HPV, nor does a benign polyp found during a colonoscopy. If you have had an anoscopy and/or colonoscopy then the doctor has already done biopsies so why does that word "frighten" you?

It's as if this doctor isn't explaining what he's doing to you during these procedures, which I find dubious.
"Iíve slept with enough men to know that Iím not gay"

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #19 on: February 11, 2014, 05:48:37 PM »
Well I'm not a doctor so naturally I'm confused about all of this.

The HPV thing just scares the hell out of me, it seems nobody can give me a straight answer about it. My last pap was in December 2012 & it showed LSIL & I have asked my doctors & Colorectal Doctor numerous times about having another pap or a HRA but they seem to not see it as necessary. I guess they know what they're talking about. I just don't want to wait & do nothing then be told I have cancer 2 or 5 years from now. But each time I ask for another pap or HRA they don't see it as necessary so I guess they know what they're talking about. I just hope I won't get cancer in the meantime.
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Online Miss Philicia

  • Member
  • Posts: 23,558
  • celebrity poster, faker & poser
Re: Semi-Good News, I Guess..
« Reply #20 on: February 11, 2014, 06:17:49 PM »
You have two choices -- sit and worry or trust your doctor.

I had to look up what LSIL means with a PAP smear (low-grade squamous intraepithelial lesion). First of all you must recognize that treatment for this stuff is fairly recent, so there are no set standards and treatment may vary from doctor to doctor. Some are more conservative than others. They probably analyzed the different types of HPV that showed up on your PAP smear -- then did they do an anoscopy? Is that how they diagnosed the lesion in the first place? I'm sorry, but your posts are often vague on the process you've been through. You seem to have asked both your HIV specialist and your colorectal specialist on what sort of treatment you should have going forward. I would think they'd at least do another anoscopy at some point, but yeah you probably do not need an annual one.

Compare this to me -- my first PAP smear was in 2003 followed quickly by a HR anoscopy. It was of enough concern that I may have had to go back for my second one in 6 months, and I know by the end of 2004 it was high grade and they had to zap it. So my treatment plan after that was to have annual anoscopies, but that's simply because I am at higher risk having had one high grade lesion. Personally I think they'd being too conservative, as since then -- and entire decade -- I've not had another high grade lesion. They've taken many biopsies of places but never had to do anything else.

And yes, lesions go from low to high grade slowly. I think you're over-worrying about all of this. I mean, are they telling you to have another anoscopy in 3 years or what? Nothing?

And you've still not explained what you mean by polyp -- did you have a colonoscopy or are you confusing polyp with lesion? If you're confused about all of this why aren't you asking more question of your doctors, getting it explained to you, and writing down notes?
"Iíve slept with enough men to know that Iím not gay"

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #21 on: February 11, 2014, 07:06:22 PM »
Yes you're right Miss P this whole HPV thing is pretty new, when you think about it, it seems silly that doctors are only just now beginning to actively screen men for HPV rectally, since they've been doing it to women in the cervix for years, but anyway..

Yes, I've had a colonoscopy & a scope (not a high-res) done as recently as December, a year after my pap, & all the mentioned was my fissure. Which probably is a totally separate thing from the LSIL result from the pap.

I do struggle with this mentally, I have a somewhat fragile mental state, I am being treated for anxiety & bipolar, & sometimes my anxiety overwhelms me although it's better than it once was.

To clarify, I had a polyp removed in the lower rectum, it was biopsied, it just came back showing "inflammatory polyp" which they told me basically meant benign. So that would seem to not be related to the HPV. My colorectal doc told me the polyp may have resulted from an infected anal gland.

The actual pap test showed LSIL lesion, which I know is not any huge deal as long as it's monitored. I guess this fissure I've been dealing with has me worrying more about everything down "there".

The colorectal doc told me if the fissure doesn't go away I might need it biopsied to see what the underlying cause is. As far as the HPV, none of them seem to concerned about it though, as far as not rushing to do another pap, or HRA, so guess that's a good sign.

It's just hard for me to process all this, & my anxiety causes me to hyper analyze stuff.

Thanks for the response.
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Online Miss Philicia

  • Member
  • Posts: 23,558
  • celebrity poster, faker & poser
Re: Semi-Good News, I Guess..
« Reply #22 on: February 11, 2014, 07:38:29 PM »
They sound on top of the issues so, as a patient, you should try and relax about. Just have it monitored with the frequency they dictate and I'm sure you will be fine.

I can't speak to the anal fissure issue as I've not had that happen to me. I can only suggest you learn to be a top until that is solved.
"Iíve slept with enough men to know that Iím not gay"

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #23 on: February 11, 2014, 09:17:11 PM »
Thanks I'm going to try & not stress it too much & take it day by day. I'm a complete mess mentally I just started a new medication for the bipolar & some days it's hard for me not to obsess over things.

One thing I wanted to ask you, was, a couple months after the low-grade pap result came back, I asked my doc if I could have the HPV Gardasil vaccine. She said yes, but that it wouldn't make a huge difference at that point. The HPV vaccine is given in like 3 separate injections, over about 6-month intervals. I had the first one, which made me pretty sick, & opted not to have the 2nd & 3rd injections.

If I wanted to have the 2nd & 3rd injections, over a year later, could I do it or would it even do me any good.

I'm just a complete mess emotionally & really don't want to set myself up for the awful nausea & soreness that came from the shot.

And since I already had one positive test for HPV via the pap, I wonder if it would even be worth it. My emotions are on a rollar coaster about this. Like you said I just need to learn to relax & trust my docs.
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Online zach

  • Member
  • Posts: 726
Re: Semi-Good News, I Guess..
« Reply #24 on: February 12, 2014, 01:27:55 AM »
are you taking any opiates? opioid induced constipation can cause fissures and tears, and in general is a real pain in the ass
3/27/14 vl >300k cd4=9... plenty of room to improve

Many rivers to cross
But I can't seem to find my way over
Wandering I am lost
Yes, I've got many rivers to cross
And I merely survive because of my will...

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #25 on: February 27, 2014, 03:43:18 PM »
Got my very first High-Resolution Anoscopy scheduled for a couple of weeks from now with my new CRS. I'm a little nervous about it, but not too bad. I think I have an excellent doctor who understands gay men's health & anal issues. I've been reading up on it, he explained it pretty well to me, basically they go in, shine a light, coat the area with something, & if anything shows up abnormal they biopsy it from my understanding. Not sure if they go ahead & do the infrared thing if it shows something, or if I'd have to wait for a future time for that. I also have a fissure too so there's that, & it's causing me some bleeding now & then. hoping maybe they can do something about it too while I'm sedated. He told me that if my result is still LSIL then they just wait & see for awhile, if it's a higher grade, probably have to do more frequent HRA, or maybe the infrared thing. I'm hoping if they do find a higher grade thing, that they can do whatever they need to do during the procedure so I won't have to turn around & have another procedure shortly after.

I know some of you have had HRA's, maybe you can offer me some insight on what to expect from the procedure. My CRS will be doing mine under EUA (exam under anesthesia) & said it should only take about 45 minutes. Hoping it goes ok! Seems like a pretty routine thing. I've had colonoscopies before, & they were a piece of cake. Thanks for any insights!

« Last Edit: February 27, 2014, 03:50:54 PM by RobbyR »
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline buginme2

  • Member
  • Posts: 2,744
  • Certified Life Coach
Re: Semi-Good News, I Guess..
« Reply #26 on: February 27, 2014, 04:11:39 PM »
I have an HRA scheduled on Monday. It's prob the tenth one I've had. 

Nothing really to do to prepare except maybe make sure you've gone number two well ahead of time.  Its pretty uneventful.  Even if they do an IRC that's also uneventful (although for me they started with cream therapy first such as aldera then 5-fu then proceeded to IRC).

My clinic does an anal pap, complete std check (since they are in the neighborhood) and a regular booty check when they do an hra.  My clinic does hra's on everyone though.
"All I need are some tasty waves, a cool buzz, and I'm fine."

http://www.youtube.com/watch?v=6e0gcEC1TWE

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #27 on: February 27, 2014, 04:18:52 PM »
Thanks a lot for the comment buginme, HRAs seem remarkably routine, which they are from all I've read. The amazing thing is the research I had to do to find a CRS who was well-enough informed about gay men's butt issues that immediately was willing to do one on me, once he saw my LSIL pap result..HRAs are still sadly not standard of care, which they should be!

My CRS is in Louisville, Ky, I remember tednlou here talking about this once, maybe he & I can compare notes..MY CRS told me that he's thinking about starting an anal dysplasia clinic for gay males, who he said many sadly fall through the cracks because primary & ID docs just don't know as much about the importance of HRA screenings when it comes to gay men or even straight men.

I have the fissure too, which is probably causing the bleeding, so I'm hoping he'll do something about it too while I'm out..Main thing is I'm relieved to be under the care of a doctor who seems to be well-informed about this.

How are you doing now with your HPV issues, btw?

« Last Edit: February 27, 2014, 04:23:11 PM by RobbyR »
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline eric48

  • Member
  • Posts: 1,010
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: Semi-Good News, I Guess..
« Reply #28 on: February 27, 2014, 04:26:16 PM »
post removed by self. (mistake in using mouse) Eric

Offline buginme2

  • Member
  • Posts: 2,744
  • Certified Life Coach
Re: Semi-Good News, I Guess..
« Reply #29 on: February 27, 2014, 04:32:13 PM »
Well, they are pretty routine here.  I go to a large hospital that has an HIV clinic, they do routine hra's on all HIV positive people yearly.  If you have hsil or dysplasia they do them more frequently (4 months ish). 

I started with no symptoms whatsoever.  Went for my first hra years ago and they said I had high grade dysplasia.  Been treated with Aldera, 5-fu, IRC, and was given the hpv vaccine. 

Last check I had they couldn't see anything on the hra but the pap returned ASCUS (atypical of unknown significance).  We will see what Monday brings.

Also, year or so ago during a hra exam the doc said I had a fissure.  She prescribed nytroglycerine cream.  Got rid of the fissure in two weeks.
"All I need are some tasty waves, a cool buzz, and I'm fine."

http://www.youtube.com/watch?v=6e0gcEC1TWE

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #30 on: February 27, 2014, 04:54:18 PM »
Glad to hear you're doing ok buginme. I don't think my actual symptoms are related to hpv, even if I have hsil, because I do have an active fissure which is visible from the outside, my CRS saw it when I bent over, without even scoping me. So the bleeding doesn't worry me as much as if I didn't have the fissure, because that's so common with a fissure. I hope he can do something for the fissure while I'm out though, since it's symptomatic.

I had the first injection of Gardasil, but it made me so sick that I opted not to do the other two installments. But if I can, I'd like to get them.

I've never had a HRA, but I've had many regular scopes, & my most recent one in December didn't seem to show anything beyond the fissure, although it wasn't high-res.

I was on Nifed/Lido, now I'm on Diltiazem/Lido ointment externally for the fissure.

Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #31 on: February 27, 2014, 06:53:41 PM »
One thing I wonder is why my HRA will be done with general anesthesia, it's an exam under anesthesia, thought most HRAs didn't require that. Maybe he wants it under anesthesia so he can do a biopsy or in case he has to fix something else. I'll have to ask them that.
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline buginme2

  • Member
  • Posts: 2,744
  • Certified Life Coach
Re: Semi-Good News, I Guess..
« Reply #32 on: February 27, 2014, 08:06:25 PM »
One thing I wonder is why my HRA will be done with general anesthesia, it's an exam under anesthesia, thought most HRAs didn't require that. Maybe he wants it under anesthesia so he can do a biopsy or in case he has to fix something else. I'll have to ask them that.

WAIT WHAT?

General anesthesia as in they are going to put you to sleep?  Thats a red flag.  There is absolutely no reason to be put to sleep for an HRA and I would seriously consider refusing that and canceling the appointment! 

Anyone else?  Am I wrong with that but I dont think so.
"All I need are some tasty waves, a cool buzz, and I'm fine."

http://www.youtube.com/watch?v=6e0gcEC1TWE

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #33 on: February 27, 2014, 08:23:05 PM »
WAIT WHAT?

General anesthesia as in they are going to put you to sleep?  Thats a red flag.  There is absolutely no reason to be put to sleep for an HRA and I would seriously consider refusing that and canceling the appointment! 

Anyone else?  Am I wrong with that but I dont think so.

I'm assuming that means they'd put me to sleep. On my paper I got after my consultation with the doctor, it says I am going to have a EUA (exam under anesthesia) & a High-res Anoscopy. Maybe they're putting me to sleep because of my anal fissure, not sure but I'll have to ask them about this before the procedure.
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #34 on: February 27, 2014, 08:29:46 PM »
I'd rather not be put totally to sleep..I googled this & some HRAs say they do just local, but I saw others that say they do use general anesthesia, maybe it's because in case they want to take biopsies. I'd prefer to do it under twilight sedation, because I never liked to be put to sleep fully. Maybe I'll see if that's possible, it seems like it would be.

Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #35 on: February 27, 2014, 08:30:46 PM »
I'd rather not be put totally to sleep..I googled this & some HRAs say they do just local, but I saw others that say they do use general anesthesia, maybe it's because in case they want to take biopsies. I'd prefer to do it under twilight sedation, because I never liked to be put to sleep fully. Maybe I'll see if that's possible, it seems like it would be. I have a couple weeks before the procedure, so I'll call the nurse or doctor himself & ask him about this beforehand.
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline buginme2

  • Member
  • Posts: 2,744
  • Certified Life Coach
Re: Semi-Good News, I Guess..
« Reply #36 on: February 27, 2014, 08:45:44 PM »
Ive had like ten HRA's and have never been given anything for anesthesia.  Its just not needed, they are looking at you with a camera and you watch it on tv. 

When they do a biopsy they rub some numbing gel on it...then I inject it with some lidocane..thats it and thats only if they do a biopsy.

I dont see how they could give anesthesia for this, it doesnt sound ethical.  Your not going to be in any pain or discomfort so why?   
"All I need are some tasty waves, a cool buzz, and I'm fine."

http://www.youtube.com/watch?v=6e0gcEC1TWE

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #37 on: February 27, 2014, 08:54:22 PM »
Yea I've had regular anoscopes & of course they use no sedation at all. My CRS seemed to be pretty well informed, maybe the anesthesia is because he wants to look at my fissure in addition to being examined for any lesions, but it seems he could do that with just local too or none at all. Maybe he just wants to make sure I'm comfortable.

Now I'm confused again. I know the procedure is going to be outpatient, but I may request that it be done by twilight sedation or local as opposed to general, if it's at all possible. My CRS is supposed to be one of the best, so I'm sure he knows what he's talking about.
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline aaware72

  • Member
  • Posts: 197
Re: Semi-Good News, I Guess..
« Reply #38 on: February 28, 2014, 02:03:43 AM »
I've have had  two HRA's in the past year.  When they took a biopsy they used Lidocaine to numb the area.  I have never had any type of sedation and I could not really even tell they did anything.
"Yes, knowledge is power. Self-knowledge brings mastery of one's body."

Offline Rhaegar

  • Member
  • Posts: 99
Re: Semi-Good News, I Guess..
« Reply #39 on: March 01, 2014, 08:45:58 PM »
I find it unusual that it's under general anesthesia.  Personally, I think that's too much risk for what's a routine outpatient procedure. 
05/19/2011: Diagnosed.  CD4 159   VL 284,000.
04/29/2013:  CD4 789,   VL <20

Offline RobbyR

  • Member
  • Posts: 239
Re: Semi-Good News, I Guess..
« Reply #40 on: March 01, 2014, 09:05:46 PM »
I really want the high-res, to make sure things are okay, but I agree I'd rather not be put to sleep for it. I didn't think to clarify that with the doc on my last office visit. My sheet said "EUA" (exam under anesthesia) & "High Res Anoscopy" so maybe the reason for the general anesethesia is the EUA & not the HRA.. All it said on my sheet for my procedure was that general anesthesia was checked. Again I do have the fissure too, so maybe he wants to check/fix that, but I'm definitely going to call the office Monday & check on this before I go through with this. It seems like I could have the procedure without being put to sleep, I hate that. He's a superb CRS, or so I've heard, & was super nice to me & seemed well informed about gay men's anal issues, so I trust him, but maybe if I request that I not be put totally out he'll be okay with it.  I'll be calling Monday to clarify this! Cause I want to avoid general anesthesia if possible, seems like I'd be able to.
Started Atripla August, 2010.

vl in December, 2013: Undetectable

cd4 in December, 2013: 650

Diagnosed Bipolar I in 2013.

Offline buginme2

  • Member
  • Posts: 2,744
  • Certified Life Coach
Re: Semi-Good News, I Guess..
« Reply #41 on: March 03, 2014, 12:57:12 PM »
OK I was wrong earlier.

I had my HRA appointment this morning.  They ended up doing another biopsy.  Before I said I thought they might give you an injection of lidocaine if they did a biopsy.  So I was wrong.  No lidocaine or anesthesia.  Just a snip. 

I still find it incredibly odd that they would give you anesthesia for an HRA, even a local for that matter. 

You have had sex right? Did you require anesthesia for it?
"All I need are some tasty waves, a cool buzz, and I'm fine."

http://www.youtube.com/watch?v=6e0gcEC1TWE

Online Miss Philicia

  • Member
  • Posts: 23,558
  • celebrity poster, faker & poser
Re: Semi-Good News, I Guess..
« Reply #42 on: March 03, 2014, 02:54:33 PM »
Yes, I was about to say that whenever I have had a biopsy done during a colorectal examination there was nothing more than a snip done, however they do apply numbing cream in there before inserting the anoscope so perhaps that is why. By the time the biopsy is done usually 15 minutes have gone by, and the most you will feel is a quick, harmless pinch.

But as far as RobbyR's posts here much makes no sense (again) -- either he's misunderstanding what procedure is going to be done from previous doctor's appointment or is erroneously communicating it here. The only other option is that his heralded doctor is, in fact, a quack.

I also do not understand why once again RobbyR started an entirely new thread on this subject when he had one going last month. In that thread you stated that your doctor saw no reason for you to have an HRA at this time. Why the change? Every time you disconnect your threads we lose something in translation -- and I believe the last time you did this the moderators merged your thread with yet an even older one on the same topic.

Really, none of this is particularly frightening or confusing if you are communicating with your physician, and if it is confusing then take a notebook and write things down. This is "Being a Patient 101".
"Iíve slept with enough men to know that Iím not gay"

Offline Jeff G

  • Global Moderator
  • Member
  • Posts: 9,229
  • How am I doing Beren ?
Re: Semi-Good News, I Guess..
« Reply #43 on: March 03, 2014, 04:29:09 PM »
I merged your thread Robby... it is a good idea to have all discussions on the same issue in one place so please try and remember this in the future  .


   
« Last Edit: March 03, 2014, 04:36:53 PM by Jeff G »

Offline Jeff G

  • Global Moderator
  • Member
  • Posts: 9,229
  • How am I doing Beren ?
Re: Semi-Good News, I Guess..
« Reply #44 on: March 03, 2014, 04:36:34 PM »
Really, none of this is particularly frightening or confusing if you are communicating with your physician, and if it is confusing then take a notebook and write things down. This is "Being a Patient 101".

Miss P ... this may very well be frightening and confusing to Robby and he is encouraged to seek support if he wants to ... after all that is why we are here . If its important to Robby it is important to us .

Offline Piscean

  • Member
  • Posts: 19
Re: Semi-Good News, I Guess..
« Reply #45 on: March 03, 2014, 08:06:23 PM »
My experience is more as RobbyR describes. I have had two HRA's and both times I was sedated with "Milk of Amnesia" (propofol).  Now, I also had some warts removed along with the HRA so that might have been the reason for the sedation. I didn't mind as the nurse anesthetist was hot and I swear he was flirting with me as I was going under :P

 


Terms of Membership for these forums
 

© 2014 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.