Desperate for Answers

[whmag]

Dear Doctor(s): Thanks for the opportunity to post this question; I sincerely hope one of you can assist me in gaining absolution.  

To the point: Aug. 2009 - received brief (< 3 seconds) unprotected fellatio from female w/ no visible sores - odd feeling in testicles next day and slight discoloration on glans penis - continues 2 weeks - Sept. 2009 see my GP he says slight balantitis and epididymitis - Azithro + Doxy for 10 days + test for HSV 2 IgG = .03 neg - continues another week - see GP he prescribes Cipro for 10 days + test HSV I/II IgM = neg. - see urologist he says nothing abnormal & tell him my testicles are burning and glans feels itchy / pinching - he tests chlamy. gonn. & syph. = neg. - visit 2 dermatol. they say not herpes and prescribe anti fungal & steroids & diflucan - stays same - back to urologist for HSV I/II IgG @ 6 weeks = negative - pain in testicles and groin (burning in both legs) discoloration still present - back to GP checks prostate says prostate infection and prescr. Levaquin for 2 months - symptoms still present - back to urologist @ 4 months (Dec. 2009) post exposure for HSV I/II IgG = negative & cystoscopy = normal - so back to GP for repeat HSV I/II IgG = .1 negative (wanted to make sure using same lab company)

So here I am in month 5 still having testicle pain, glans itch and pinching, periodic burning in groin down inside both legs and abdomen - just got GP to order HSV I/II western blot or PCR and waiting on results - all the docs (8 in all) say I don't have HSV because of 1) minimal nature of exposure and 2) my IgG results @ 4 months but I am still symptomatic and desperate.  they say it's psychosomatic but I disagree.  

I know my docs have good intentions but I am so frustrated  In your professional opinion(s) - does this sound like HSV? Could I have contracted it with that limited exposure?  If not what could be wrong with my body? thanks so much for helping me.

[Terri Warren, RN, Adult Nurse Practitioner]

In my professional opinion, this sounds absolutely nothing like herpes!  The contact wasn't a risk for HSV 2 anyway, and an extremely minimal risk for HSV 1.  And I mean MINIMAL.  I've got no thoughts about what be causing your testicular pain or itching or pinching.  You've been treated with every possible antibiotic used for STDs plus some, and you've had procedures, like cystoscopy, that would identify underlying issues.  I agree that there is a psychological element here, but perhaps a little different than the others suggest.  

When someone has a sexual experience outside of their normal relationship (and let me guess, but I'm thinking this was that kind of situation for you, though I could certainly be wrong), they start recognizing sensations that they never recognized before, they become aware of things that they never would have given a thought to in the past.  Because now, all of those sensations have MEANING when before, they weren't even noticeable because they had no meaning.  Do you see what I'm saying?  
By the way, the PCR is only to be used when there is a lesion present, not as a screening tool.  The western blot can be used for screening.

Terri

[whmag]

Thanks for your expeditious response and reassurance.  Is it permissible to ask you a follow up?  Thanks

[Terri Warren, RN, Adult Nurse Practitioner]

Yes, it is possible.
Terri

[whmag]

Thanks in advance; I can't tell you how much I want to believe you but the symptoms I am experiencing seem to be all over the web (including this site) as being indicative of HSV - the discoloration area on glans penis, itching, pinching, burning in legs/abdomen, testicular burning - that combined with the fact that it all started after the encounter and I have taken so many antibiotics that would have cured most any bacterial infection - it is difficult to think that it could be anything other than viral.  It is soooo important that I be absolutely certain about this - and you already guessed why in your first reply - you're good.

Thus...1) should I find absolution in the HSV I/II IgG negative results @ 4 months?  2)would you have recommended the western blot?  3) should I wait until 6 months and retest?  4) would HSV symptoms continue virtually unabated for 4 - 5 months? 5) should I take a trip across the country to your clinic and be evaluated by the best (said with sincerity and comedy)?

I will gladly repost this with the requisite fee if I need to.  Thanks,

[Terri Warren, RN, Adult Nurse Practitioner]

1)  Yes, but 2) get the western blot done to reassure yourself.  It is also slightly more sensitive for HSV 1 than the ELISA.
3)  You can test now
4) no
5) thank you very much, but no.  We can do what we need to do this way, or you may wish to become a phone patient of the clinic, we often do that when this gets more extensive, 503-226-6678.

Terri

[whmag]

Thank you so much, Terri - you are the best and I admire your philanthropic efforts through this online service - best to you.

[Terri Warren, RN, Adult Nurse Practitioner]

You're most welcome.

Terri

[whmag]

Terri - thanks for speaking with me this afternoon - I called Quest and made an appt. for tomorrow, hopefully the paperwork you sent got through.  quick and final questions:
1) will you call me with the results or do I call your office?  

2) we discussed my HSV I/II combined IgG reading @ 4 months = .1 and you said that was a combined test and is not the right kind...does that mean the value is wrong?  Or does that mean the value is a combination of both (i.e. HSV I might = .07 and HSV II might = .03 for a combined total of .1? Can I trust that result?

3) any other possibilities that would not have been addressed by the antibiotics (NGU? Trich etc?

Thanks so much again.

[whmag]

Terri - I called Quest and they said they did not receive the fax / order requisition last evening.  Just wanted to let you know.

thanks

[Terri Warren, RN, Adult Nurse Practitioner]

Please call my office tomorrow and we will go over this again, OK?

Terri

[whmag]

Ok - Sorry did I do something wrong?

[Terri Warren, RN, Adult Nurse Practitioner]

Nothing wrong, of course not! I re-faxed, lets see how it goes.  Do contact me again if it doesn't go through, OK?
Terri

[whmag]

Got it - thanks a million -

1) Does quest do the test locally or do all WB's go to the Univ. of Wash?
2) Do you know what the turnaround time is?  
3) Will you call me or should i make an appt. to call your office for results?

Just let me no...have a great weekend.

[Terri Warren, RN, Adult Nurse Practitioner]

1) All go to UW
2) about 2 weeks
3) I will call you with results.

Great, I'm glad they got it, good news.
Terri

[whmag]

Hey Terri - hope you are doing great.  I have a quick question regarding IgG tests that I was hoping you could help me with.  

I read a thread from Dr. Hansfield stating that all HSV IgG tests are not the same (i.e. HSV I/II IgG test is not the same as HSV I / II Glycoprotein IgG).  I am worried because the IgG my doctor ordered back in Dec. just says HSV I/II IgG = 0.1 with no reference to Glycoprotein.  Did he order the wrong test?  If so, even though you ordered the WB for me can we still order another IgG?

Thanks and let me know if I should repost this question with the fee - no problem.

[Terri Warren, RN, Adult Nurse Practitioner]

No, a negative combined test just tells you that you have neither one NOR two.  No, we will go by the western blot as a final result.  He did order the wrong test, because if it had been positive, we would not have known if you had HSV 1 or HSV 2, but since it was negative, I think we are fine.  But the western blot will be the final test.  Did you have the blood drawn yet?
Terri

[whmag]

Ok - Yes, I had the blood drawn last Friday morning and I am anxiously awaiting the results.

Thanks so much for the information - again, I know you here this often but I will reiterate - your knowledge, kindness, support & willingness to aid is a tremendous asset - I can't thank you enough.

Hopefully I will here from you within the next couple of weeks with some good news!

Take care

[whmag]

Quick grammatical correction from previous thread..."again, I know you HEAR this quite often..."

ha ha

thanks

[Terri Warren, RN, Adult Nurse Practitioner]

Good thing you corrected that grammar, not sure we can answer questions without proper grammar!  LOL

Terri

[whmag]

Hey Terri -

Do you mind if I call and schedule a phone appt. tomorrow?

Thanks

[Terri Warren, RN, Adult Nurse Practitioner]

Of course not, go ahead.

Terri

[whmag]

Thanks again for your time and consideration - and thanks for the great news regarding the Wb results - look forward to hearing about the 2nd one.

Have a great evening.

[Terri Warren, RN, Adult Nurse Practitioner]

You too!

Terri

[whmag]

Thanks - hey let me know if you figure out what happened with the duplication - again, I don't want to cancel the lab order (additional reassurance is welcomed) but just curious.

Talk to you later.