While I have not yet verified that I actually have HSV,
I do have a couple of genital lesions and the partner
(one time only!!! AARRRGGGHHH) who alerted me to the possibility
of my getting it has had an outbreak. She's currently waiting
for her test results.
It's unfortunate for me that I first realized the lesions on
a Sunday right before MLK's holiday; it's made it impossible
to see my regular physician. However, on day two I went to
an emergency room to get checked out, and here's what they've
done and told me thus far. I have a few more questions for the group
interspersed in the text below...
They first checked my urine for any infections and that was cleared,
A-Okay. Second, they took a culture to test me for gonorrhea and
chlamydia, which as I now understand it these can be eradicated with
treatment (was my emergency room physician correct?). I get that
test result in a couple of days. Part three of my exam will take
place tomorrow at a dermatological clinic where they'll do a culture
on a genital lesion to (presumably) determine whether I have HSV
and, if I do, whether it's HSV1 or HSV2.
The first person I saw at the emergency room, probably a resident or
something, thought I had HSV and was about to prescribe an anti-viral
medication. I was glad to hear that I could begin some sort of treatment
immediately. However, he asked that I wait until another more senior
physician come in to have a look as well. The senior guy preferred that I first
verify the HSV before getting the anti-viral medication. When I asked
why he said that he wasn't entirely certain from the nature of the lesions
that I actually had HSV. I asked him whether my sores were relatively
minor HSV lesions, if in fact it was HSV, and he said yes, that my lesions
seemed pretty low down on the totem pole. I guess this is one small piece
of good news, although I don't hold out much hope that I don't actually have
HSV.
This brings me to a couple of questions. First, if I indeed do have HSV,
does it make much of a difference if I begin taking the anti-viral medication
immediately, as opposed to waiting a couple of days after the first outbreak?
Am I wasting a valuable 24 hours in the suppression of my initial outbreak?
Or is it really no big deal whether I get on the meds 48 hours after noticing
lesions or 72 hours afterward?
Also, if my initial outbreak is relatively minor (meaning...my sores are
not in excess of two or three, they aren't terribly large, and they aren't
especially painful), does this mean it's more likely that any future
outbreaks will also be relatively minor, and diminishing in severity as
the months and years roll by (this diminishment with time happens for
pretty much everyone, I guess)?
Next, if indeed my speculation that a minor initial outbreak likely means
at worst minor future outbreaks, then does this mean that I am less likely
to transmit HSV to a female partner (let's assume I have genital HSV2) than
someone who exhibits larger (in size and number) and more painful outbreaks?
Is there a correlation here? I ask this not under the delusion that minor
outbreaks mean that I can go ahead and have condom-less sex during lull periods.
I just want to know where I stand in the greatest detail I can possibly obtain.
After the HSV test, the final thing I'll do is see my primary physician
and have him redo the suite of AIDS, hepatitis, etc. tests that I had just
a few months ago, since if I can get HSV I'm certainly more at risk for these
others, suddenly....
All of this really sucks. There's the understatement of the year for you.
The worst part is going to be when I inform my current girlfriend of this.
I wasn't entirely forthright in my initial post to this group because I
wanted to probe some very general issues about likelihood of transmission
to future partners, etc....without biasing any of your responses toward
how to break the news to a serious partner (who in my case is a serious
girlfriend who I'd like to marry one day, who would certainly not be pleased
to hear that in a moment of weakness I cheated on her, with dire consequences).
So, I didn't mention before that I have a committed girlfriend, who up until
now I've had condomless intercourse with. We haven't had sex in a couple of
weeks, thankfully, which is long before my exposure to HSV last week.
I am reasonably confident that she'll stay the course with me because our
love is strong (yes, despite my having been a scoundrel), but it's obviously
going to alter our sex life dramatically. I'll now have to use condoms
during intercourse...and she'll be very disappointed at not being able to
perform oral sex on me. Yes, really. HOWEVER, I would like to be armed
with all possible information so that she knows any risks involved if she
chooses to do oral on me during lull periods of outbreaks. Yes, I know there
is always the possibility of "asymptomatic shedding." But, she (as well as I)
will want to be appraised of the risk factors. I still don't have a good
grip on these risks....I understand that there is *A* risk, but I just don't
understand how strong that risk is. I guess it's impossible to address this
because of the asymptomatic shedding issue, which means that one cannot
use visual cues to accurately assess transmission likelihood. (please tell
me if I'm wrong or too pessimistic here) However, it seems that numerous
posters here have successfully had condomless sex with uninfected partners
during lull, no-outbreak periods. There's a lot of variability out there.
Thank you all very much for listening and for your comments.
Best,
J
Grant - 19 Jan 2004 21:26 GMT
Hi Joe,
Comments below:
"Joe" <ccr1633@yahoo.com> wrote in message
> They first checked my urine for any infections and that was cleared,
> A-Okay. Second, they took a culture to test me for gonorrhea and
[quoted text clipped - 4 lines]
> on a genital lesion to (presumably) determine whether I have HSV
> and, if I do, whether it's HSV1 or HSV2.
Yes. All the other stds can be cured. Unfortunately, I believe it may be
too late for the culture. Why they didn't do one immediately is beyond me.
Cultures are notorious for false negatives. The reason is that once the
outbreak has begun, it's possible for the viral load to diminish to the
point where a culture is worthless. I had one culture done, it came back
negative. But I do have herpes. I would not trust the culture if it comes
back negative.
> The first person I saw at the emergency room, probably a resident or
> something, thought I had HSV and was about to prescribe an anti-viral
[quoted text clipped - 8 lines]
> of good news, although I don't hold out much hope that I don't actually have
> HSV.
I don't understand the "low on the totem pole" comment.
> This brings me to a couple of questions. First, if I indeed do have HSV,
> does it make much of a difference if I begin taking the anti-viral medication
> immediately, as opposed to waiting a couple of days after the first outbreak?
> Am I wasting a valuable 24 hours in the suppression of my initial outbreak?
> Or is it really no big deal whether I get on the meds 48 hours after noticing
> lesions or 72 hours afterward?
Taking the meds immediately upon the notice of symptoms will cut down on the
duration of the outbreak. Waiting for as long as you have...I'm not sure
what effect they'll have.
> Also, if my initial outbreak is relatively minor (meaning...my sores are
> not in excess of two or three, they aren't terribly large, and they aren't
> especially painful), does this mean it's more likely that any future
> outbreaks will also be relatively minor, and diminishing in severity as
> the months and years roll by (this diminishment with time happens for
> pretty much everyone, I guess)?
Most everyone will have their herpes outbreaks diminish over time
irregardless of what their first outbreak was like. But remember that there
are no set rules for herpes.
> Next, if indeed my speculation that a minor initial outbreak likely means
> at worst minor future outbreaks, then does this mean that I am less likely
[quoted text clipped - 3 lines]
> outbreaks mean that I can go ahead and have condom-less sex during lull periods.
> I just want to know where I stand in the greatest detail I can possibly obtain.
No. You are incorrect in your assumption. Someone who never has had an
outbreak can still pass it on. And someone who has multiple, horrible
outbreaks might not ever pass it on.
> All of this really sucks. There's the understatement of the year for you.
> The worst part is going to be when I inform my current girlfriend of this.
[quoted text clipped - 4 lines]
> girlfriend who I'd like to marry one day, who would certainly not be pleased
> to hear that in a moment of weakness I cheated on her, with dire consequences).
Tell her the truth.
> but it's obviously
> going to alter our sex life dramatically. I'll now have to use condoms
> during intercourse...and she'll be very disappointed at not being able to
> perform oral sex on me.
Joe, did you read all of our responses to you about oral sex? You should go
back and read them again because you missed the part where we told you that
your misconception was a misconception.
And, quite frankly, there's nothing wrong with condoms. If sex is only in
your genitals, then you're missing the point of love making. Love is in
your head and in your heart. It doesn't matter if you are wearing a condom
or not. And wouldn't you feel better knowing that you are doing whatever
you can to protect the woman you love?
Take care,
ar