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Painful lymph nodes
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Painful lymph nodes

Last week i had a lymph node that hurt when i touched it. now I have three. My throat feels funny but not painful; just like there's something there, and I feel weak. I went to the toilet and my faeces was mushy but not watery, though I've eaten nothing but crepes and Mcdanalds since yesterday evening.

I'm feeling weird, and I'm worried sick. Help.
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239123_tn?1267651214
I'm not sure what you're asking of me.  Your symptoms are extremely nonspecific, potentially due to a giant number of viruses and other infections.  I'm not even sure you have enlarged lymph nodes, unless you are a health professional; not all bumps under the skin are lymph nodes.  Presumably you're worried about HIV, since you posted your question on this forum--but there is nothing about your symptoms that is particularly suspicious for HIV.  In any case, I cannot evaluate that possibility without knowing about your risks for infection.

Bottom line: See a health care provider.  There's nothing more I can suggest or say.

HHH, MD
15 Comments
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Avatar_n_tn
The method of infection does not affect the time to positive test. From what I have read so far of the Doc's responses, the emphasis is on the nature of the sexual event, that is, whether high or low risk exposure. Thus, he tends to be more conservative and go for the conventional 3 month repeat testing(about99% certainity) when the exposure is a higher risk nature,and the somewhat earlier 4-6 wks mark(85-90%accuracy)for those he deems low risk exposures.

I believe he does that to give a measure of certainity and peace of mind to individual posters on a case by case basis.
And he does that in his own way quite remarkably.
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239123_tn?1267651214
It's quite simple and I have explained it before.  Here it is again.

If someone has an extremely low chance of having acquired HIV, the reliability of an earlier HIV test should be sufficient, both for clinical diagnosis by providers and emotional reassurance of the patient.  If the chance someone has HIV is say 1 in 100,000, then a negative test with 95% reliability (e.g., 6 weeks) leaves only 1 chance in 2 million that the person actually is infected.  Statistically, this number is known as the positive predictive value (PPV) of the test.

But if the risk is high, say exposure to a known HIV positive person by receptive anal sex, with a 1 in 500 risk of becoming infected, then after a test with 95% reliability, the chance the person is infected is 1 in 10,000.  That's still low, and will be reassuring to many people.  But most persons at risk want higher reassurance than that, and so do their providers.  So in that case, it's good to have another test at 3 months, when the test is closer to ~99.9% positive.  With that result, the chance someone really has HIV (the PPV) is 2 in a million.  Still higher than in the low-risk scenario, but good enough to keep most patients and providers happy.

Got it?

HHH, MD
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150689_tn?1333993645
I've never had it explained that way before.............but it makes sense. And certainly helps me to understand the risks i was exposed to, such as they were, which in the end wre pretty damn low. Also makes sense of my tests @ 28 & 87 days - 1 & 3 months. Both neg. I guess i can draw a line and move on. Funny how just how a couple of paragraphs can let the light in!

BTW; Keep up the stirling work!
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Avatar_n_tn
I would be. Honestly;

I had  two unprotected sex intercourses in the last year, once in sept last year and on the tewnty ninth of of july. the last one, she called me because she hasn't had sex in a year and I was her first, and she was worried |I might have something, and that was qwhen the lumps appeared under my left armpit.

and my throat feels like there something stuck there, like a bubble. moods fallen, obvoiusly.

Any Ideas?
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Avatar_n_tn
From just those exposures it is very unlikely you have HIV.  Pain in the armpits is a common symptom a worrier of possible HIV infection has along with a funny feeling in the throat.  Stress causes muscle tension, therefore leading to discomfort.  Also individuals going through the window period are extra sensitive to any feeling they might sense going on with their body.  This leads to exaggerated sensations, cuasing more stress for the individual and finally triggering a downward spiral of more actual symptoms such as loose stools, nausea, muscle cramps, etc., etc.  Before you know it, you'll be absolutely convinced your infected.  I see anxiety and what it can do all too often as a mental health therapist in the ARMY.  Try exercising, it will loosen you up!! If that doesn't help, then get tested.
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239123_tn?1267651214
"Any Ideas?"

Your symptoms are not due to HIV or STD, and are not in any way related to your sexual exposures.  You probably caught a cold or some other garden-variety virus.  See a health care provider if the symptoms do not go away.

HHH, MD
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Avatar_n_tn
Even the docs statement of 95 percent accuracy is conservative to mass who claims that the tests are 100% conclusive to the general population.  Exceptions being cancer patients or people with immune diifeciencies which one would know prior to testing.  I still wonder if the post 6 weeks with newer testing is theoretical or reality.  I have yet to hear somone say, "yes, I've seen a 6 week neg turn into pos."  But I have heard a lot of medical doctors and lab workers say they havnt seen it.  With that being said every poster on here believes their symptoms over the 6 week test and low risk possible route of transmission.  Once that happens you know logic has left the buiding.
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Avatar_n_tn
Just to echo what the doc has said, I sent an email to Mark Katz MD along the same lines.  It's on par with the docs approach almost to a tee.  It was almost like the doc was writing it himself.

My question was weather or not I should keep testing after a 4 and a 6 week neg and this was his reply based on my exposure (a condom break during mentuaration)


"If you had said that your partner was a woman
with advanced AIDS and a high viral load, then I
would agree with the need for more testing.
However, your exposure was actually quite low
risk, given the low incidence of HIV in U.S.
women.  Thus, your negative test at 6 weeks is
most likely conclusive.  But some people will
still wish to test all the way out to 12
weeks--and if this is necessary to make you feel
comfortable, then by all means, do it.  I think
most people in your situation would stop after 6-8.

Good luck!
Mark Katz, MD"
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Avatar_n_tn
1. What is the difference between ELISA 4th generation (P24  
   antigen) and ELISA 3rd generation?

2. Which test is more sensitive?

3. Is there any difference at all in detecting the antibodies
   earlier by these 2 tests?
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239123_tn?1267651214
No difference, for practical purposes. I have said many times that persons being tested should not put an eyeblink of energy into worrying about which "generation" ELISA is used to test them.  No labs use older (first, second generation) anymore.  Labs and HIV specialists have totally stopped using the "generation" terminology, which doesn't mean anything anymore.

HHH, MD
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Avatar_n_tn
Thank you doctor for the comments.
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Avatar_n_tn
I know this has probably been addressed, but for those people who do use a first or second generation test (such as one that is often used by people at home, Home Acess), would that be  conclusive after 12 weeks also? Does anyone remember reading about the first or second generation test in the forum (Sorry if I misunderstood you doctor, when you said generation doesn't matter. I didn't know if you were referring to first generation tests as well)
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Avatar_n_tn
I asked mass the same question with their 6 week timeline.  They said it didnt matter if it was home testing.
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