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PostPosted: Mon Jul 26, 2010 2:01 pm 

Joined: Wed Jul 21, 2010 3:09 pm
Posts: 9
Location: saint louis
I was diagnosed with genital herpes in 2006, and have taken Valtrex off and on since. As I am currently in a new relationship with an uninfected man, I am taking Valtrex every day as suppressive therapy.

I began having itching and burning in the vaginal area a couple of weeks ago and, being in a new relationship, promptly went to my OBGYN to be tested for STDs. (The irritation was more like a yeast infection than a herpes ob, but didn't seem to be a yeast infection either. It was not a typical ob, so I was concerned.) I am still waiting on the blood work, but the only culture that came back positive was for a bacterial infection. My doctor gave Flagyl, which I am almost done taking. The irritation, however, is not completely gone and I still have an abnormal discharge.

Here's the thing- a day or so after I saw my doctor, I got a bump on my genitalia. I assumed I was having an outbreak, and bumped up the Valtrex to two a day. Over the course of a week, I continued to take the Flagyl and the Valtrex (double dose), but the bump never 'scabbed', in fact more bumps appeared even with the increased dosage but none ever really became much more than bumps, and they are just this morning finally starting to go away... Does an outbreak worsen over the course of a week even with increased meds?

I should also say that this assumed outbreak was not like others in that it was not painful in any way. It makes sense to me that the ob could have worsened even with increased medication, but if so, why was it not typical of any other outbreak (ie painful, scabbing)?

Is is possible that the Flagyl and Valtrex counteract each other to some degree? I'm planning to try to get back into my doctor's office to discuss and have another culture done for the bacterial infection, since that seems to be only marginally better and my treatment is pretty much over. Just wondering any thoughts in the meantime. Still uncomfortable and not sure what gives!

Thanks for reading my huge post, hope it's not too confusing!


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PostPosted: Mon Jul 26, 2010 3:20 pm 

Joined: Mon Feb 05, 2007 11:47 am
Posts: 5443
Location: PA
wait at least a week or two before going back for another vaginal culture.

was it the vaginal flagyl you used?

betsy

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PostPosted: Tue Jul 27, 2010 9:55 am 

Joined: Wed Jul 21, 2010 3:09 pm
Posts: 9
Location: saint louis
Thank you for the prompt reply and advice, Betsy!

I was on the oral Flagyl, not the vaginal suppository. My doctor prescribed twice a day, for 7 days. I've now taken all of the medicine, so it has been over a week since my first vaginal culture (in which the bacterial infection was diagnosed). I'm not sure if you mean waiting a week or so since the diagnosis, or after the treatment has ended. I guess I expected it to clear up in a couple of days really. Now that the medicine is gone and I'm still have symptoms, am a little concerned.

I already have an appointment to see another physician today and suppose I will see if they suggest having cultures done again, because I am still experiencing discomfort! The itching is gone, but not the vaginal irritation. Something is just not quite right... :?

On a side note, what I described as painless bumps before have finally developed 'scabs' of sorts. The bumps were never the open, painful lesions that I've experienced before though during an outbreak. They really didn't seem like a ob, but since they have scabbed sort of, I'm supposing it was in fact?

Anxious to see what this doc says. I am wondering if I could have taken a full seven days of Flagyl and still have a bacterial infection, or is this something that was not previously found?

Again, thank you Betsy!!


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PostPosted: Tue Jul 27, 2010 10:55 am 

Joined: Mon Feb 05, 2007 11:47 am
Posts: 5443
Location: PA
good luck - let us know how your appointment goes today and if they came up with anything else going on!

betsy

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PostPosted: Tue Jul 27, 2010 2:11 pm 

Joined: Wed Jul 21, 2010 3:09 pm
Posts: 9
Location: saint louis
The doctor examined me. When I undressed, I noticed a new 'bump' which actually had a red top to it (the others did not) and showed it to her. She said it was not herpetic (sp?) and that an ob would consist not of bumps necessarily, but more depressed lesions on the skin. Which was not at all what the bumps looked like that I had before, that increased in spite of my doubling the dosage of Valtrex, and only somewhat scabbed. The doc also said that the Valtrex usually knocks the ob out pretty much, and she wouldn't think that herpes would continue to present (become more bumps) after I doubled the dose. Ultimately, she gave me the impression that what I thought was an ob just recently may not have been at all. Unfortunately, because I assumed it was and didn't immediately go back into the doc to be examined, it's too late to tell now...

But it begs the question in my mind, because I've only ever had red bumps that I've considered an ob- Do I even know what an ob really looks like? I think I left more confused than I was going in. If it wasn't an ob, what the heck was it?!

She checked under the microscope for remnants of the bacterial infection, and came back to say that the BV was gone entirely but that I have yeast growing. Terrific. Traded one for the other it seems! (I don't know that that's the case or even possible, I'm really just making a joke. Sure seems like it though.)

So now I've got a prescription for Diflucan (one day pill) and we'll see if I feel better I suppose.

Thanks again Betsy. Please let me know if you have any further thoughts. I will continue to research and try to learn more on this board. Eager to see the results of my blood work, since I've read up some on it here...


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PostPosted: Tue Jul 27, 2010 4:25 pm 

Joined: Mon Feb 05, 2007 11:47 am
Posts: 5443
Location: PA
so she didn't give you antibiotics for a bacterial skin infection ( which is what your bumps sound like )???

it's not unusual to treat for bv and then end up with yeast either though typically that occurs more with vaginal flagyl than oral flagyl.

anytime you have anything going on genitally you should be avoiding sex until it's healed. so even if you are thinking something is herpes and it isn't, you are still doing the right thing. sometimes it is hard figuring out what is and isn't herpes.

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PostPosted: Tue Jul 27, 2010 5:25 pm 

Joined: Wed Jul 21, 2010 3:09 pm
Posts: 9
Location: saint louis
No, she did not give any antibiotics for it. Said only that she believed it to be an ingrown hair or some other irritation that I may have scratched over or something, but not a herpes sore. ? Which is a little bizarre to me, because it's actually closer to what I always considered to be a herpes outbreak (which I've only had twice maybe since I was visually diagnosed with herpes in 2006) than the bumps that I just had (which she essentially said may not have been an outbreak because an outbreak is not a bump, it's a depression in the skin more like a broken blister). This particular bump that we are talking about now is not painful, just as the other bumps that recently came and went away without getting red tops on them, were not painful either.

Yes, I abstained from sex immediately when I felt itchy and irritable down there (the beginning of the BV, I believe) and developed the unexplained bumps afterwards, whether they were herpetic or not I definitely erred on the side of caution!

Thanks again for listening, and any thoughts. Much appreciated!


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PostPosted: Wed Jul 28, 2010 7:32 am 

Joined: Mon Feb 05, 2007 11:47 am
Posts: 5443
Location: PA
you were only visually diagnosed as having herpes? did you ever follow up on that with type specific herpes igg blood testing?

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PostPosted: Wed Jul 28, 2010 10:03 am 

Joined: Wed Jul 21, 2010 3:09 pm
Posts: 9
Location: saint louis
Yes, I was only visually diagnosed as I recall. The doctor didn't recommend additional testing because it wouldn't be in my system yet (?) or something to that effect. And he was pretty confident in his visual diagnosis, I'd say was the greater reason. From what I've read, I can't imagine what else it could have been either. I had an outbreak of many, very painful red sores on my genital area (the doc said inside and out).

However, I requested to be tested with the blood work I just had done, and had to be adamant even then with the nurse. She said that it's going to come back positive anyway, so it doesn't need to be done. I persisted though. Unfortunately, I'm not entirely clear on the different testing methods and am unsure which test they did, it was all sent electronically to the lab.

We will see. I am going to try to call back by the end of the week and see what the results are and what test was done. Will post!

Any thoughts in the meantime? I realize that I sound like an uniformed idiot. I am. The truth of the matter is, until now I believed that I had herpes, from my husband who gave it to me, and with us both being positive, didn't really need to know any additional information beyond what the doc said initially- this is what you have, and to take this medicine if you have an ob. However, since my marriage is over and I am having to actually confront this issue in my life, I am just NOW really finding out what's what...

Thanks for your patience.


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PostPosted: Wed Jul 28, 2010 1:49 pm 

Joined: Mon Feb 05, 2007 11:47 am
Posts: 5443
Location: PA
this is completely normal - you didn't have to worry about it and now suddenly it's a new set of rules for you! I did it the complete opposite way - always had to worry about transmission and now 20+ years later have a partner who also has it so I don't have to worry. It's a nice change I admit. It's one advantage to getting older, more men my age have hsv2 too....he he he

A visual diagnosis is wrong 1/3 of the time which is why we recommend proper follow up testing to confirm. As you are experiencing yourself now, not everything that goes on in the genital area is due to herpes so we recommend treating based on the visual diagnosis but then confirming infection. The longer you are infected, the more you get to recognize patterns to help you figure out what is herpes and what isn't but even then sometimes your herpes throws you for a loop too. we do the best we can with what we know.

If things aren't better by early next week, probably time for a 2nd opinion elsewhere or at least a trip back to your doctor again to try to figure out why it's not clearing up.

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PostPosted: Wed Jul 28, 2010 3:24 pm 

Joined: Wed Jul 21, 2010 3:09 pm
Posts: 9
Location: saint louis
Thank you much!!!


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PostPosted: Thu Jul 29, 2010 9:55 am 

Joined: Wed Jul 21, 2010 3:09 pm
Posts: 9
Location: saint louis
Lab results are- they did a IGG test which was positive for HSV 1 but negative for HSV 2. When I asked for specific numbers, she said only that it was greater than 5, so I am positive for HSV 1.

The nurse explained it as my being exposed (more than 6 weeks ago) and suggested that perhaps someone in my past with cold sores came in contact with me, maybe an aunt kissed me when I was younger. LOL. After I explained that I've never had cold sores but have had genital sores, she said that someone with cold sores gave me oral sex and that's how I came to now have HSV 1 genitally.

What does this mean exactly?! How do I explain this to partners? What is their risk, and how are they most at risk? Can I no longer receive oral sex? Can I transmit by giving oral sex? Can I give them HSV 1 genitally through intercourse without oral sex? :(

I'm going to search on this board for more information on HSV 1, and perhaps my questions related to it should be moved to a new post since this is really under the original BV post still.

Thanks for listening, and sharing any thoughts...
Confused!


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PostPosted: Thu Jul 29, 2010 12:14 pm 

Joined: Mon Feb 05, 2007 11:47 am
Posts: 5443
Location: PA
Unfortunately at this point you still don't have a lot of answers. your prior partner had hsv2 right?

At this point I'd consider stopping the daily suppressive therapy and when you get a return of symptoms you typically think of as being due to your herpes, don't take any herpes antivirals but be seen within 48 hours of their appearance for a lesion culture and typing. You can't really assume it's hsv1 genitally at this point since you don't even have a + herpes culture without typing to go on. You can even talk to your provider about having the supplies at home to do home pcr swabbing of your symptoms and then just drop off the swabs at the clinic or lab.

just keep adding to this post. that way I have all the info available to glance back through quickly when I'm replying - thanks!

betsy

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PostPosted: Thu Jul 29, 2010 4:46 pm 

Joined: Wed Jul 21, 2010 3:09 pm
Posts: 9
Location: saint louis
You bring up a very good point, one that I had overlooked. I am not at all certain that my partner has HSV 2. In fact, when the doc visually diagnosed me and I in turn confronted him, he said that he was unaware of having anything. I didn't entirely believe him, but it seemed rather pointless at the time to pursue or argue over. Nor did I know that there was anything to pursue. I has sores on my genital area, and the doc said I had herpes. End of story in my mind. What was the point of arguing over whether or not he knowingly gave it to me? I was devastated enough without that battle. No discussion of HSV 1 and 2 from my doc when he told me that I had herpes. I thought cold sores were entirely different, and existed only on the mouth. Wow...

Here are my immediate concerns, for purposes of stopping transmission of HSV 1 to anyone else if at all possible. I have two young children, who I kiss frequently of course. I also have a sexual relationship with a man, including oral intercourse. What precautions do I need to be taking to make sure that they do not get the virus from me?


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PostPosted: Thu Jul 29, 2010 5:50 pm 

Joined: Mon Feb 05, 2007 11:47 am
Posts: 5443
Location: PA
http://www.ashastd.org/herpes/herpes_le ... herpes.cfm I always recommend this link that asha has because it's accurate info but down to earth and common sense worthy. You can only control things so much and you certainly don't want to live your life in a bubble and not kiss and share food and drinks with folks - this link I think gives advice how to balance it all :)

your current partner was tested right? not just assuming they are negative?



betsy

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