Grace -- A question for you

[lookingforadvice423]

Grace, I've directed this question at you since you seem to be the most knowledgable on here.  On October 9, I did something incredibly stupid.  I performed unprotected oral sex on an anonymous male partner although he DID NOT ejaculate in my mouth.  In addition, we had PROTECTED anal sex with ME AS THE RECEIVING PARTNER.  What I wanted to ask you about is that about four days after the contact I noticed a small bump with a white head on it on my lower lip.  The "lesion" does not hurt.  Two weeks after the contact I reported to the local health department for an STD check up.  I spoke with a counselor and then saw the nurse practicioner who looked at my lips, mouth and genitals.  After looking at the lesion on my lip, she pronounced it was not a chancre and said my genitals appeared clear.  A urine sample was taken to test for gonorhea and chlamydia.  The counselor, who had said the lesion on my lip looked like a chancre then drew blood and sent it for an FTA-ABS and an RPR blood test.  Two days later when I called him and as directed he said both blood tests were negative and that I was clear of syphilis.  All the web sites say syphilis testing is conducted over a 90 period.  What I wanted to ask is who is accurate?  When I check on differring web sites I've seen numbers for a valid FTS-ABS test between four weeks and nintety days.  Merk says the test is valid between four and six weeks.  Can you tell me where I'm at in this?  Should I test again, or is the health department as the "first line of defense" against the spread of STDs a believable resource?  If you don't feel qualified to answer my question, can you direct me to a resource that can?

Thanks

[AB_Gurl]

is there more  then 7 stds out here and do they need

[lookingforadvice423]

First are you the aunt Jessie grace recommended I contact?

If so, in answer to your questions, I've "Googled" for pictures of chancres and you're right those are clearly the "worst case" scenarios, but I've seen nothing in any of the pictures that looked anything like what is on my lip.  The closest was a chancre that was on the inside of the upper lip so far inside that to take the photo they had to "curl the lip" back manually whereas what is on my lip is visible from the outside with a normal view of the lip.  Additionally, in that picture the "white area" is very diffuse spreading across nearly the entire top of the raise red area in an irregular pattern; whereas mine is rather specifically defined near the crest of the raised red area, which is actually a rather dull red only slightly redder than the normal tissue surrounding it and only slightly higher than the tissue around it.  Furthermore, I've read that a chancre is a hard raised papule which to me means it is like a cyst in that it can't be "flattened out" manually.  Mine on the other hand can be "flattened" out by pressing on it with my tongue or fingers.  Also there is no apparent exudate eminating from the lesion which I understand eminates from a chancre.  

At the clinic, the nurse practicioner said the lesion looked more like herpes, which by the way is the picture I found on the internet that looks the most like what I have although from what I understand herpes sores are painful whereas chancres are not.  My lesion is definately not painful.  

One question I have is about the way you framed your suggestion, "If you are concerned, test again at 4 or 6 weeks."  From the way your question is framed, I can read it that I could not test again and that I only need to test again if I am concerned.  Am I reading more into your suggestion than it deserves?  According to the counselor at the health deparment, his materials from the CDC say the FTS-ABS is a valid test at 2-3 weeks, but as I said when I look it up it says 4-6 weeks in the Merk Manual on-line.  

As you can tell, I'm very confused.  First, the health department which is our supposed first line of defense in controlling STDs failed to inspire confidence in their conclusions.  As I have excellent health insurance I only went to the health department because I believed, "Okay, these people do this "all the time" whereas my doctor spends most of his day looking at sore throats and sprained ankles, so I'll go to the "experts."  Then, well as I said, they were less than confidence inspiring.  

Lastly, is there someway that I can contact you directly either through this web site's messaging function or at a board which you visit regularly?  Oh, and is Grace correct that you're a CDC STD counselor?  

If so, could you provide a comment on my risk of HIV infection from the described contact?

Thanks for your time and help

[auntiejessi]

Hi there -

What you are describing doesn't sound like a chancre, but the testing at 2 weeks might not be reliable.  If you are concerned, test again at 4 or 6 weeks.

I don't usually suggest this, but have you googled syphilis to see what a chancre looks like?  Keep in mind that those pics are usually the worst case scenarios.

What did they think it was if not syphilis?

Jess

[gracefromHHP]

I'm not up on my syphillis testing - go to the herpes homepage in the off topic folder or the general health folder and ask aunt jessie- she's a std counselor for the cdc so she's WAY more up to date on this than I am!!! Tell her gracie told you to post it for her :)  I'll tell her to look for it!

grace

[lookingforadvice423]

Grace -- one thing I forgot -- the lesion is still there...it looks much the same as it did two weeks ago and it still doesn't hurt.