[ConcernedConfused]

Dear Terri-

That sounds good. I am sorry I missed my video consultation with you today. I was confused by the Westover Heights portion of the website where it says “all appointments are in Pacific timezone” — but they actually are not in Pacific time on the E-Visit system, as that system updated to my timezone.

Anyways, I take responsibility for the mixup. I scheduled another appt with you next week.

[ConcernedConfused]

You can do the western blot now – are you trying to eliminate HSV 2 infection through this test?

Yes I would like to do the WB. Should we schedule a video consultation? Please let me know how one does that. Although I live in NYC & currently only have catastrophic health insurance, I am prepared and able to drive to PA & pay out of pocket for the WB if you can help me set it up. Thank you, deeply and sincerely.

Herpes simply does not cause constant pain as your describe it.

I want to clarify a bit: it is not intense pain constantly. The pain is rarely very intense. It is more like persistent itching throughout my anogenital region & mild and occasional twinges of pain in my genital region and in my feet. Both my past doctor, and a urologist and infectious disease doctor, did not know what it might be besides HSV.

For me, a couple of the things that make me think it is HSV:
-Horrible episode that began immediately upon ceasing to take antivirals in the first months of infection. This was a violent outbreak inside my urethra that made my genitals burn horribly to touch, or to pee.
-Pain in feet, as described by some HSV sufferers, potentially caused by HSV affecting the same nerves that innervate the feet.

And since I had confirmed HSV1 years before these symptoms began, I feel as if it is likely I have HSV2. If I don’t, I have a mysterious disease contracted (& theoretically transmissible) by sex that causes my constant symptoms. Maybe that’s worse than HSV2.

I am horrified that my conclusive HSV2 diagnosis will come from infecting another person with HSV2.

I hope you can understand how difficult it is to have daily genital itching and be unable to receive a diagnosis or effective treatment, and how hard this makes it to pursue any sort of romantic relationship. And, to be clear, I have no shame about sex & had quite a few risky sexual partners before the one that has led to these symptoms.

Thank you Nurse Warren.

[ConcernedConfused]

Hi Nurse Warren:

I realized I likely did not have additional questions on my account. I just purchased an additional 3 questions and appreciate your advice. I am interested in getting a WB done and in your thoughts.

[ConcernedConfused]

Well I was editing my previous post so aggressively for length I realized I left out some crucial info so I need to use one of my follow-up replies here:

-I have constant genital pain and itching, through the tip of my penis into my testicles, around my anus and in my inner thighs. I also have twinges of pain in my feet that I generally feel simultaneously with the twinges of pain in my genitals. These symptoms have been present every hour of every day since Nov 2014 when symptoms began. Acyclovir reduces but does not eliminate these symptoms. They are worsened by masturbation, and often aggravated by exercise or tight pants.

Thank you again for providing this service. I would like to seek a definitive answer here. It is very depressing to have an incurable infectious & stigmatized disease that has permanently scarred my genitals and causes me seemingly permanent genital pain and itching. I don’t know how I would discuss this with a potential romantic partner. I guess it would be easier if I were to know that I had GHSV1 as opposed to HSV2, although it wouldn’t change how the disease affects me every day.

[ConcernedConfused]

I have not taken antibiotics or antifungals.

I have had a small amount of discharge on only two days out of the 80+ days I have had symptoms, and not within the first 45 days of having symptoms.

I think I’ve taken acyclovir for at least 55 out of 85 days since potential infection. Can that amount of antivirals delay seroconversion significantly beyond the 3-month range?

It would be great for this to not be HSV-2, but some symptoms are just so troubling–acyclovir seems to have some positive affect on symptoms, the red spots inside my urethra that persist/reoccur in exactly the same places (perhaps the place of viral entry, which would explain not having had sores on the penis shaft), the significant tingling/numbness in legs & feet that is often most acute at same time symptoms in genitals are most severe, the severe pain in urethra during initial “outbreak” that has since subsided with subsequent symptoms more like itching/pinching in urethra.

How should I go around looking for other possible diagnoses? Should I seek out an STD specialist/private STD clinic?

If it’s possible that I

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