HSV

[pandora9048]

Dear Doctor,
    I am a 30 y/o female.  Six years ago i was diagnosed w/ HSV1 (in the genital area), presumably through oral sex.  At the time of my primary infection, I had a fever, swollen glands in the neck and groin, and blisters (one on the side of my lip and numerous blisters down below) which were very painful, and for some reason, the whole inside of my mouth hurt as well.  The diagnosis was made from a culture of one of the genital sores.  My doctor told me at the time I probably "touched my genitals after touching the one on my lip."  I just let that go as I did not want to go into the oral sex part, but my partner has been prone to cold sores on the lips (he has never had any in the genital area) and had one at about the time this occurred.  since I was pregnant at the time, I did not take any medication for it.  I had one recurrence in October of 1999 which was much milder.  Since then I have had none (that Im aware of anyway). I have not taken any meds for herpes.                                        
     My relationship w/ this man ended 3 years ago and until 4 days ago, I have not been in a sexual relationship w/ anyone.  4 days ago, I had sex and I did use a condom; however, there was a few seconds where my partner's penis was in my vagina without the condom.  I stopped this immediately (as I have not informed anyone of my condition for fear of rejection and all that goes w/ it).  Since that night, I have been panicking that maybe I could have passed this on to him and have been checking myself repeatedly since then, looking for sores or anything suspicious, since Ive read on numerous web sites about asymptomatic shedding and people unaware of outbreaks.  during one of these checkups on myself, I noticed a spot that Im worried about. it did not hurt (until I started fooling around with it, it does not seem to be fluid filled or raised, but it looks a little different than the surrounding skin. i went to a gynocologist who said it could be either a skin abrasion from sex or a herpes lesion.  he said it's 50/50 chance, which neither reassurred or satisfied me.  it doesnt seem to be the same as my other outbreaks, but since im not sure if its been there or what, im very worried for my partner.  My questions are as follows:
1) after four years, can I still have occurrences?
2) is it a given that if it was a herpes lesion, my partner will get it during the unprotected 5 seconds of sex that we had?
3) if he does contract it from me, how long will it take for his symptoms to appear?
4) is a dermotologist a more appropriate doctor to go to for this than a gynecologist?  the gyno who diagnosed was sure it was herpes before the culture even came back (hes no longer around) but the doc I went to the other day said he didnt know if it was, but since i had a history of HSV, to assume that it was an outbreak.
Please help me.  Im am a nervous wreck and will absolutely hang myself if ive passed this on to someelse:(      
thank you

[Alan Rockoff, MD]

Please do not hang yourself.

Yes, you can shed virus between attacks.  The focus of your current concern, however, is the bump you found when you looked.  When herpes appears at all, it appears as a group of blisters, not as a bump.  Then it goes away.

If yours does not go away, then it was probably there all along as a cyst or something similar, only you had no reason to look.

The doctors who saw you sound as though they weren't sure, and were somewhat insensitive to the implications (for you) of speaking from uncertainty.

I advise you to wait for the culture (which I bet will be negative), leave the bump alone, and consult a dermatologist who can diagnose it for you properly.

You needn't consider yourself a leper.  When you're contemplating a serious relationship, you can broach the subject and expect a reasonable and affectionate partner to accept the risks.

Good luck.

Dr. Rockoff

[yoshi2me]

Dr. Rockoff was right on when he said:

"You needn't consider yourself a leper. When you're contemplating a serious relationship, you can broach the subject and expect a reasonable and affectionate partner to accept the risks."

I would hope that you would want to be with somebody that loves you for who you are and *not* what you have. Herpes doesn't define who YOU are ...

One thing though ... you need to tell your partners that you have herpes before you have sex with them. They have a right to know just like you have a right to know if they have an std. If you want to ... you can read about "Our Telling Story" here:

http://members.cox.net/yoshi2me/Telling/Telling.htm

It's an interview that my husband participated in and later had published when we were dating . . . today we are married and about to have a baby. I think you will enjoy the story and it might bring you some hope.

Do not be afraid to tell your potential partners that you have herpes. If they care anything about you as a person they won't care that you have it.

To answer your questions . . . once you have herpes you keep herpes so even after four years it's possible to have a herpes outbreak. For people that don't get outbreaks they probably shed aproximately 2% to 3% of the time which winds up breaking down to a couple of days out of the year. The only problem with that is that we don't know which days those are ... that's why it's always important that you be upfront with your partners. Just like you would expect them to be upfront with you if they had an std ... right?

As for the type of doctor to go to ... I say you should see a professional that knows his or her herpes facts. The only way to determine that is to read up on it and learn everything you can about it so you will be able to discern if the professional knows what they are talking about.

If you need to stay in touch my e-mail address is: ***@****

Hang in there,

Angela

[pandora9049]

Angela,
   you are absolutely right in everything you said.  But I do feel like leper.  I don't think that will ever change.  I am an absolute piece of **** for not telling.  I just hadn't had an outbreak in over 4 years and I did insist on condoms, but as I said in my post, had it not been for that couple seconds of unprotected sex, I probably wouldn't be as worried about passing it.  Also, the person who gave this to me (my ex husband) never got it from me.  I got it from him orally (so he did know of my condition) but I never passed it on to him genitally, even without the use of condoms.  I just kinda know what this current person's reaction would have been (trust me, not supportive. so Ive just made the decision to never let this happen again. (No more sex for me)  
Thank you for your comment, though, and congrats on ur little one:)
Pan

[giraffe7983]

That's a good story Yoshi. Nice picture too. I think the key is education too.

K

[yoshi2me]

Try not to beat yourself up to much. You will have sex again and I know you can be honest with your partners. You are not a leper. Why? Because I'm not one!

Hang in there ...

Angela
***@****

[yoshi2me]

Thanks K! You are right! Education is the key. We are working very hard to squash the negative stigma associated with this virus and to educate as many health care professionals as possible.

Angela
***@****

[Terri Warren, RN, Adult Nurse Practitioner]

I would disagree that herpes is always a group of sores, it can certainly be a single bump.  Remember that you are infrequently infectious from the genital area with HSV 1, less infectious than the person who has HSV 1 orally is, through giving oral sex.  Also remember that most people are still positive for HSV 1 (although that number is steadily decreasing), so you are less likely to infect them since they have the same type of antibody.  It still is essential, I think, to disclose your herpes info, even though it is type 1, but to discuss that in some detail when disclosing.