New to Forum: Very Scared & Confused (Hepatitis Symptoms/Testing/Advice)

[jp111482]

Good morning, everyone. I apologize for the length of this post, but I would really like to not be a burden on this forum and only post once with all of the relevant information needed for you to provide meaningful insight. I am hoping to get some feedback on symptoms I am experiencing, clarity on hepatitis testing, and just friendly/concrete advice from people that have experience with hepatitis or situations like mine and understand what you would do if you were (God forbid) in my shoes.

But first, the back story...

I am happily married w/ two amazing kids. My whole life is consumed in my family and I spend every waking moment (when I'm not working) with them. I have never been intimate with anyone besides my wife, nor have I ever had the urge to do so. Unfortunately, 9 weeks ago while traveling for work, I had protected oral and vaginal sex w/ a sex worker. She removed the condom towards the end for a hand job. I try not to think about the night, because quite honestly, it disgusts me. But I’m fearful that I recall seeing some blood/discharge on a towel she used to clean up. I don’t remember seeing blood/discharge on the condom. Hopefully this detail isn't offensive to anyone, just want you to understand my exposure. Acknowledging this is not an excuse for what I did, I was heavily intoxicated at the time. When I woke up and came to my senses, I was in complete panic and disarray. I have experienced a ton of anxiety/stress/regret from what I had done and it is a burden that I will carry every day for the rest of my life. I know the right thing to do is to be honest with my wife, but I am blindly hoping and fearfully praying that I have not contracted anything, and I can just put this all behind me so I can go back to the amazing life I had with my family before indulging in such a stupid act. The thought of hurting my wife with this news and losing her (and her trust), losing my kids, and the embarrassment I would cause my family, is unbearable.

Onto my symptoms...

While I acknowledge some of this can be anxiety/stress related, that blanket statement is just creating more anxiety/stress for me. I also don't believe that these symptoms just coincidentally appeared after my encounter when I had a clean bill of health before.  But in the days following my regrettable act, I experienced pain and burning in my upper abdomen area followed by diarrhea a few times a day for a few days thereafter. The pain in my abdomen subsided within the next week, but my stools have not been the same since then. They are either choppy/grainy/light brown or green/thin, but regardless, in the toilet my bowels decompose into a sand/dust-like substance. I now have two BMs daily, one in the morning like clockwork and another a little later (always looser). I lost ~10 lbs within the first week after my encounter. Also, I noticed my tongue was white a few days after the act. My tongue is still coated today; however, its mainly in the back. Around the 2/3 week mark, I started getting temporary redness/itchiness as well as persistent blue veins on the back and palm of my hands. This is still there today, although the red blotches/spots and itching has reduced somewhat, it is still happening and veins are very visible. Also I am experiencing severely dry skin and blurry vision/dry eye on occasion. At week 3, I got a burning sensation on my upper lip followed by 4-5 needle thin white bumps that are still there today (can't see it unless you are really close). Around week 4/5/6 mark, I felt irritation at the tip of my penis and slight burn after urination (mostly gone now) as well as some tiny pimple-like bumps and enlarged veins appeared on my foreskin (it doesn't hurt, but this wasn't there before).

Other things of note…

I have altered my diet since the first week. I have been consuming little to no carbs/sweets and no alcohol. I don’t smoke or do drugs. I have been drinking a lot of water, eating grilled chicken/fish, eggs, vegetables, fruits, yogurt, nuts. I have been eating a spoonful of coconut oil (as well as oil pulling), eating a clove of garlic, drinking apple cider vinegar with water every day. I should also note that preventatively, I have taken a variety of prescription meds to try and clear any treatable STDs as well as my white tongue.

Blood work to date...

I am doing all of this anonymously as I don’t want this to show up in any insurance reports or charts. But I have taken numerous rounds of STD tests at 3 days, 14 days, 34 days, and 45 days after the incident. Everything came back normal (except HSV1 was 0.90 equivalent at 45 days). There are some things that show up in my normal blood work that are of concern. I ran CBCs at 4 weeks which were normal, except my WBC was 4.8. At 6 weeks, my WBC increased to 5.4 (but my lymphocytes were 53.9% 2900). Also, I noticed my MCV 79.8 and MCH 26.6 were low at 6 weeks. My ALT went from 14 to 29 and Glucose from 75 to 99 (I was fasting both times), respectively. AST remained flat 20/21 and Bilirubin flat at 0.7/0.6, respectively. Cholesterol was slightly elevated at both readings (but I've always had cholesterol in the 220 range - genetic) even though I am fit, exercise regularly, etc.

Now my questions…

1)   I know this is a hepatitis forum (and the rest of my questions will be specific to this topic), but given some STD tests aren't conclusive until 12-16 weeks or even thereafter, (in your experience) do my symptoms signal anything along the lines of longer developing diseases, such as HIV (white tongue, red spots), Hepatitis B or C (white tongue, change in bowels, body itch/dry skin, redness/veins on palm of hands), Syphilis (white tongue, change in vision), or Herpes (red spots, body itch, bumps on penis)? Anything else that you can think of that could be causing my symptoms (non-STD related)?

2)   At 6 weeks, I took the Hep A IGM Antibody, Hep B Surface Antigen w/ Reflex Confirmation, and Hep C Viral RNA, all of which were non-reactive. But given the high Lymphocytes, changes in ALT, etc. plus symptoms, I am very concerned about Hepatitis. Are any of these tests at 45 days good markers for conclusiveness (if this was you, would you be comfortable)? I am planning to take another round of tests next week (10 week mark). This also includes the same tests I just described plus the Hep B Core Antibody Total w/ Reflex to IGM and Hep B Immunity Panel as well as Hep C Antibody w/ Reflex to HCV Quantitative. Would any of these be conclusive or close it at that point in time (70 days)? Given what you know now, do you expect any of these to turn positive (more of a curiosity question, not holding you to it)? What else would you test for if you were in my shoes?

3)   I noticed that I was vaccinated for Hep B in 1997/1998 3 shots over 6 months. It’s been ~20 years. Obviously, I don’t know if I’m immune because I have never taken the immunity test, but if I am immune, could that be the reason for the increase in Lymphocytes (body recognizing a virus it has come across before and it is building WBC to fight it) or is that not how vaccines work? Should I be taking another dose of vaccines, immunoglobulin, booster, etc. given the time lapsed?

4)   If I go see a GI (who presumably has expertise in examining the liver as well), and I don't share the incident with the sex worker, can they identify any STDs from their testing (blood work, stool sample, ultrasounds, scans, etc.)? Is there a chance they can identify Hepatitis and it is not being found in the blood work I’ve already done? Are there any other specialists that you recommend I should see given my symptoms? I'm trying to avoid surprises (given my wife will likely want to accompany me to the doctor) and be realistic about expectations, but time out my visits appropriately (if and when STDs are ruled out/tests conclusive).

5)   At what point is it safe for me to resume sexual activity with my wife? I by no means want to transmit anything to her (which is why I am so zeroed in on finding an answer / conclusive testing). But given where I am in my exposure/testing lifecycle what, if any, forms of sex can I engage in at this point (unprotected oral, protected vaginal, etc.)? If none, that’s fine. Just want to know.

6)   Do you all know of any platforms where I can discuss any of this with doctors anonymously either on a forum like this or through some type of service. Cost is not the issue, but discretion is very important.

It looks like there are a lot of knowledgeable individuals responding on this forum. I spent a good bit of time articulating my background and questions. I really appreciate your experienced feedback and want to thank you in advance for your advice.

[gnatcatcher]

jp, from what you describe, the odds of your having gotten HCV are extremely low. There are others here better at estimating how low the odds are, and when you would take a final test. As for symptoms, it would be highly unusual for HCV to be producing any of those you describe until much more time (typically decades) had elapsed.

Please note: we're not doctors, just people who have, or have had, hepatitis C. As for web sites where doctors answer questions, I've bumped into a few when doing a search for something, and IMO, they're nowhere near as helpful as a caring, in-person doctor.

You wrote, "I have taken a variety of prescription meds to try and clear any treatable STDs as well as my white tongue." You have managed to get prescriptions without your wife along, so can you see that doctor again by yourself? The doctor should have to abide by HIPAA regulations, so you should be able to tell the crucial parts of your story in confidence. Given that you have introduced new variables (e.g., a different diet), and that anxiety is probably contributing to your symptoms, it is unfair to any doctor not to disclose the key event that took place right before all of your symptoms suddenly appeared. If you would prefer a specialist at this stage, an infectious disease specialist is probably the most likely to have expertise in all the candidate diseases.

May you continue your new, improved life.

Gnatty

[jp111482]

Thank you for your response, gnatcatcher. I really appreciate your feedback. In reference to your question about the doctor. He is a friend of mine that lives in another state. He knows the full story as well, but has not been able to clinically visit with me given the geography between us. Your point about HIPAA is valid; however, if I disclose any of this it could end up in my insurance records, which could be mailed to my home. That is one of my (many) fears. Also, as I am new to this site I am still getting used to all of the sections of the forum. I didn't realize the Am I Infected? portion of the site was specific to Hep C. Do individuals knowledgeable about Hep B also read/post here as well, or will I have to post something (again) in the Hep B section. I guess I could just wait and see...

[gnatcatcher]

jp, I've been trying to put myself into your shoes, and your wife's as well, and realize:
(1) You'd have to go out of network, self-pay 100%, and probably need for some doctor to see you after hours in order to prevent a paper/computer trail.
(2) Your wife may already be wondering about all the "New Year's Resolutions" behavior you've been exhibiting, and she may already be worrying privately as you lose weight and interact with her differently.
(3) Keeping this secret from your wife even this long has clearly taken its toll on you. Given (2), your wife might experience some measure of relief if told what happened with enough contriteness on your part (there was plenty of contriteness in your original post).

While the circumstances are somewhat different, I also once did something I greatly regretted that I feared could destroy my marriage. Rebuilding trust did take some doing, but we are still married more than four decades later -- happily so! Perhaps another specialist you might consider is someone in the psychology/couples communication field who can guide you on how best to approach telling your wife. Then the medical aspects would be much easier to resolve.

All the best to both of you,

Gnatty