Dr. Handsfield, i really need your help

[extremelyafraidman]

Dear Dr. Handsfield. This is my second post.  Four month post exposure I still have a mild headache which is with me most of the day. I also started to have some pencil like feeling or tingling on my feet and hand fingers mostly over the past few days. I should have never read anything on the internet regarding HIV symptoms because usually I got them as soon as i read them on the internet and they just DO NOT go away.
Exposure:  condom breakage during vaginal sex with a girl, not sex worker.
Tests: HIV-1 PCR RNA test after 6 weeks and HIV1/2  antibody test  after 33 days,  8, 12,14,17 weeks post exposure. Chlamydia and mono and Hep B test all negative.  Waiting for Gonorrhea, syphilis and Hep C results.
Symptoms: started 30 days after exposure, 2 days of night sweats and possible fever (didn't check) then ulcer on top of my mouth 4 days after onset of symptoms. Tiredness  for 2 weeks. Then sensation on my body all over like tingling or pencil like feeling on and off for two weeks. For few hours my palms were very hot and sensitive. (same feeling came back on palms after three month this time milder but lasted for three days. each time a tiny peeled off skin located on hand) then again pain in muscles for two weeks with pain in stomach. Then Short of breath for another week or two. Then mild on and off headache started  for almost more than two month. Pain in my lymph node on week 11 and lasted for 3-4 weeks. Same time stiff neck and sore throat . After 3.5 months white coating in tongue mid to back and it's still there.  I have not had swollen lymph node early after onset of symptoms instead i got lymph node pain under my neck which started 11 weeks after. On one side it was swollen.  Questions:  Do you think the fact that i still have headache is because I have not seroconverted yet? I had no medical problems before. I believe PCR DNA Qualitative should rule out HIV now (false positive ok). Do you recommend any tests? Yours,

[Edward W Hook, MD]

Stress may contribute but you need to take the steps you have planned - see a heatlh care provider who can exam and evaluate you.  For me to even guess what might be contributing to your discomfort would not be in your interest.  You need to be examined.  EWH

[extremelyafraidman]

Dear doctor, i am sorry that i am asking you another question again.
the truth is, this needle like feeling is really bothering me and it really hurts. i am really confused about the source of this possible peripheral neuropathy. i am a 26 year old male had no previous illness. i want to know if stress could possibly cause this stinging pain on my nerves now it's everywhere my fingers my feet hand shoulders face. i looked on causes of this neuropathy but couldn't pinpoint any. i have to wait at least till Monday to see any doctor but in the meanwhile i am really suffering from physical and mental pain i am going through. I had whole blood count and everything was normal as well. my std tests are back and they're all negative. please help me doctor. i really need your advice and don't have anyone to go to.

[Edward W Hook, MD]

I am not denying that you have symptoms but I can assure you with complete confidence that they are not due to HIV.  i would advise you to see an internist and to disclose your concerns and prior test results to him/her, as well as your current symptoms. This will all the doctor to assess what role disease is playing here, what sort of process it might be and what role anxiety/guilt is playing..  You may have a neuropathy but it is not an HIV neuropathy. You do not have HIV and neurpathy is a late, not early part of the natural history of HIV.  EWH

[extremelyafraidman]

Thank you so much doctor for your response. I really appreciate that. I actually went to see my school STD doctor one more time after I got my 3 months negative result. The truth is that I felt much better then compared to now after fourth month since I didn’t have white coating on my tongue or this needle like feeling on my skin and foot fingers. Actually now it’s more spread to other parts as well.  This needle like feeling on my skin really makes me nervous. When I do have headache usually I don’t have this feeling, when I don’t have headache this needle like feeling comes back. I really want to know if it could be peripheral neuropathy as a sign of HIV.  I know it’s not usual but it doesn’t mean it doesn’t happen. You have repeatedly told me that I don’t have this HIV but I am really desperate, sick and tired of all this 4 months. I don’t really have anybody to ask for help and I mean it. Please advise me on what to do now. If I am correct you want me to see a doctor now. What kind of doctor do you think I should see? I really lost faith in myself and it’s not really about losing faith in great doctors like you. I really appreciate you help. Regards,

[Edward W Hook, MD]

You got me again.  In addition, nothing has really changed since our interchange in September. The fact is that you do not have HIV or any other STD.  You do not mention seeing a doctor for any reason since our last interaction either.  I cannot help but wonder why not.  The fact of the matter is that you do not have HIV or any of the other STDs you have been tested for following your low risk expsoure.  Nonetheless, you do not believe the tests.  The tests, particularly when you are tested using multiple types of test (i.e. ELISA and PCR) are absolutely reliable.  You need to work through this with a doctor who you have faith in.  I suspect your substantial anxiety is contributing in some part to your difficulties.  Forget about HIV and STD however, that is not part of the problem and your fixation on them appears to be keeping you from dealing with what is really going on.  EWH