Leg pain/twitching and when to get IgG?

[luzon23]

Hi Terri,

I’ve had symptoms from a primary outreak for two weeks now. (I was infected on April 10.) Sores are healing, peeing is getting easier though still painful. I got a yeast infection. It’s a doozy.

I’m here to ask about the ongoing pain and numbness in my buttocks, upper thighs and down to my ankles. I’m taking ibuprofen and tylenol 2x/day to manage it. Is this typical? Can I expect this to go away soon? Should I do anything else to help?

I am also experiencing intense nerve tingles and twitching when I lie down to sleep and have had to take meds to go to sleep nightly. Is this related to the virus taking up residence in my sacral ganglia? Do you think it will get better/is there anything I should be doing to help? I had this symptom before occasionally, but it’s so much worse right now.

I got an IgM test from my primary care a week after symptoms started. It said positive for HSV-1. My number was 4.23. I have no idea what this means, except I know from the handbook I should get an IgG test – should I wait for 3 months to do that to confirm the type?

If I disclose my status, is it okay to have sex in the first year even if I’m shedding more than I will later?

Thank you so much.

[Terri Warren]

So are you saying that your sores were never swab tested and typed if positive? That’s an error. The IgM test should never be done due to high levels of false positives.
Are you taking antiviral medicine and if yes, how much and how often?
You should wait another month or so to do an IgG test and see where things stand. It would have been very useful to get a baseline IgG test but that time has passed.
If you disclose, then the decision to have sex or not is between you and a partner. Condoms would be helpful
It is likely that the nerve pain will reduce over time, yes

Terri

• This reply was modified 4 weeks ago by Terri Warren.

[luzon23]

They were swabbed and the result says NOT ISOLATED, reference range, negative.

I will get an igG test in a month.

Nerve pain is slowly easing. I’ll be at 4 weeks on Monday. Vaginal itching continues and the skin around my anus is still red and inflamed. Any advice for supporting this healing would be great (I also booked a consult with you for Tuesday 5/16 so no need to answer here.)

[Terri Warren]

you can do an IgG test in one month yes.
But that may be too soon to get an accurate result. Have you been taking antiviral meds? If yes, if taken daily, your IgG test may not be accurate.
The IgM test is unreliable – was an IgG test never done?

Terri

[luzon23]

Hi Terri, I met with you last Tuesday (Lauren, though I’m sure we all blur together.) We decided I would get off antivirals for 8 weeks then do an IgG test, which has not been done.

New concern – I think I am having prodrome 6 weeks after my primary outbreak. I’m horrified. Does this mean I will have monthly outbreaks??? Could it be lingering symptoms from the primary outbreak that resurfaced after I stopped Valtrex? See timeline:

April 10 – contracted virus anally
April 13-16 small sores inside mouth
April 17 full symptoms – anal sores, urination problems, fever, etc
April 25 started Valtrex
May 17 stopped Valtex
May 19 felt basically normal/recovered
May 20 nerve pain started again – prodrome!?
May 21 started Valtrex again

More importantly, how much Valtrex should I take now and for how long? I took 1g this morning to try to prevent or shrink this 2nd outbreak if that’s what it is, but I don’t know how long I can keep taking that amount.

Thanks so much,
Lauren

[Terri Warren]

Are you back on Valtrex because you are trying to reduce transmission or to deal with an outbreak? I think if you are trying to reduce transmission to an uninfected partner, you probably shouldn’t stop Valtrex. If you are trying to prevent an outbreak, you could just not be on Valtrex, see if the symptoms of nerve pain turn into anything, and if they present an outbreak, take episodic Valtrex, maybe 1 gram twice a day or even three times a day, for a few days only.

Terri

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