Post-Initial Outbreak Concerns

[concerned and thankful!]

I contracted simplex 1 genitally in late April. For the first three months I dealt with fairly constant discomfort and aborted outbreaks–I would have redness and itchiness without a rash. Heat caused discomfort. Sex was the number one cause, though. Masturbation was practically impossible for me without discomfort. For each outbreak, I was taking Acyclovir 400mg 3xday for 5 days. In June, I decided that the medicine wasn’t doing a good job, and switched briefly to Lysine. In mid-July I switched back to Acyclovir, except now I take it daily 2x 400 mg. I am writing because I have had frequent pain and outbreaks. The number one cause of outbreaks for me currently is sex. Masturbation is especially likely to cause an outbreak/aborted outbreak. Do you have advice on whether my reaction to the virus is typical? Should I wait this out and stay on anti-virals? What options do I have? At what point should I consider additional/alternative treatments? My main concerns are that I am not giving my body the help it needs to fight the virus off. My secondary concern is having a sex life that doesn’t involve frequent soreness/aborted outbreaks.

I didn’t have a primary care physician going into this, and just recently have gotten one. I was relying on Urgent Care following the initial outbreak and felt in need of extra care. I’m now seeing an ANP, and she has been helpful, but isn’t an expert, so I wanted to get extra input.

I have noticed that my symptoms are lessening. I am now able to have sex with only occasional soreness, and rare aborted outbreaks. However, this past week I have had another outbreak. Any advice you have on how to respond to frequent outbreaks from sex is appreciated. I have had the same partner throughout this whole time period, if that is pertinent–she has simplex 1 orally.

Since April, I think I have had 5 full blown outbreaks, and countless aborted outbreaks, which usually consist of redness and tiny bumps that disappear within a day or so, leaving dead skin that looks like the aftermath of a regular herpes sore. Is this an unusual amount for simplex 1 genitally? Are these symptoms likely to continue? What can I do to help my body?

Thanks so much!

[Terri Warren]

This is a very unusual pattern for genital HSV 1, yes. While is it possible that you are just having way more outbreaks than normal, if you were my patient, we would be confirming these symptoms with PCR swabs to be certain that everything that is going on actually is herpes. And we would want you off medicine so that it did not interfere with the accuracy of the swabs. May I ask exactly how you were diagnosed with genital HSV 1 infection?

There really isn’t more you can do except eat and sleep well, exercise adequately and have you life as even as possible, with few extremes.

I’m not at all clear that everything you are having is actually herpes. It would certainly be worth confirming

Terri

[concerned and thankful!]

Terri,

Thanks for the reply! I was diagnosed from a culture taken during my initial outbreak. I also had classic symptoms of a primary outbreak (lymph node sensitivity, feeling sick, more severe outbreak than those that have followed).

Prior to writing you, I went to my ANP to get a culture because I was worried that my partner may have been swapping yeast with me–she suffers from frequent yeast infections. I just got the results back.The results didn’t find yeast, but did find what they described in the test results as “rare acinetobacter species.” Could this be something that is leading to “aborted outbreaks”? I was on acyclovir when I had the culture done, for your information.

I’m still suffering from frequent discomfort (some itchiness/tingling, occasional redness, what looks like almost healed sores). When I have aborted outbreaks, the itchiness is slightly more severe, and I noticed that there are 2 sores that appear almost as ghosts of a sore, always in the same place and shape Two of the last outbreaks I’ve had, these two sores puffed up, and went through the stages of a classic herpes sore. Is this an indication of HSV-1? An indicator of something else?

Given the additional information, do you still think it would be prudent to explore additional testing? If not, would you recommend continuing with anti-viral treatment, moving to something else? Is there another medication commonly used that my body might take better to? Are there effective herbal alternatives, if the medication isn’t effective for my body?

I would also be open to recommendations about where to seek additional medical advice. If this problem is unlikely to resolve itself, or is something in addition to herpes that my body is unlikely to effectively combat, I would like to take steps towards being healthier. Any advice you can give is appreciated. Thank you for your time.

[Terri Warren]

Honestly, I am not at all convinced that everything you report is due to HSV 1 infection – that would be highly unusual. Did your provider treat you with an antibiotic for the bacteria isolated. Again, to find out if these rather constant symptoms are actually due to herpes, I would ask my patient to undergo daily home swabbing for a while when these symptoms are present for HSV. You could talk to your provider about allowing you to take swabs home and gather them when you have symptoms, then return them to her. If you do that, I would not recommend being on daily antiviral therapy because it can really change the picture. Do you get these symptoms even when you are taking 400 mg BID of acyclovir?

Terri

[concerned and thankful!]

Terri,

Thanks for the reply! I am local to your clinic, so I went ahead a made an appointment there. Funny how it takes time to realize the smartest move.

I am getting symptoms even on my daily anti-virals. The latest instance was today. Post-masturbation, I experienced almost immediate discomfort and a series of small, red bumps/sores appeared about 20 minutes after masturbating. There are also what look like the remains of a herpes sore present–those kind of ghost sores I described earlier. It is also tingly/itchy.

In anticipation of a visit to your clinic, I decided to stop taking anti-virals today. My visit is in a little over 10 days, so I think that will give my body time to clear the medicine. I’ll look forward to hearing what the doctors at the clinic say, and hope that they will be able to provide me relief.

I’m also curious: if my symptoms get worse over the next 10 days, should I resume anti-virals?

In the meantime, would it hurt anything for me to use herbal anti-viral supplementation? Specifically, I was thinking of taking elderberry, topical emu oil to aid my skin. Any risks there of interfering with swabs later on??

Thanks so much for all your help so far!

[Terri Warren]

Why is it taking so long for you to be seen at the clinic? Did you request an appointment out that far? Usually, we can see people sooner than that. But probably a good idea to stop the antivirals so we have a better idea about what is going on here. It will be most helpful if you have specific symptoms when you are seen. Without them, it is unlikely that the clinicians there can be of much help honestly. Are you waiting for an appointment with me when I get back?

I wouldn’t recommend putting anything in the area of the skin bumps/lesions at this point because it could certainly confuse matters.

Terri

[Terri Warren]

Why is it taking so long for you to be seen at the clinic? Did you request an appointment out that far? Usually, we can see people sooner than that. But probably a good idea to stop the antivirals so we have a better idea about what is going on here. It will be most helpful if you have specific symptoms when you are seen. Without them, it is unlikely that the clinicians there can be of much help honestly. Are you waiting for an appointment with me when I get back?

I wouldn’t recommend putting anything in the area of the skin bumps/lesions at this point because it could certainly confuse matters.

Terri

[Author]

Posts