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Medication sensitivity question
I was diagnosed with HSV2 via culture swab at a non-emergent clinic 2 and a half months ago. I was given 1g Valtrex 3x/day for 7 days. It was another week before I was able to get in to see my gyn so I was off Valtrex during that time. The Valtrex cleared up the lesions from the initial outbreak and I had some pinching sensation when I went in to see my GYN the following week. I mentioned that I had the pinching/tingling feeling. She did a silver pap to see if I responded to the Valtrex and if there was any viral shedding at that time. It was negative. I went on 500 mg Valtrex daily for suppression. I was also diagnosed and treated for BV and a yeast infection. I went back to my doctor over a week ago because not a day goes by that I don't have pinching. When it is really bad, I take 1g of Valtrex per her instructions. No visible signs of an OB, just constantly pinching feeling. Upping to 1g of Valtrex from the 500mg makes no difference. The BV has never resolved. The doctor feels one is just constantly keeping the other flared up and I'm in a bad cycle. She also thinks I could be having a reaction to the Valtrex. I'm waiting results to see if the BV is still present (99% sure it is). Her suggestion is to go with Boric Acid suppositories to "reset" my system. I'm a little nervous about that for one, but secondly, she is emphatic that she does not prescribe acylovir (sp?) and is considering switching me to the medication for those with compromised immune systems (I cannot recall the name at the moment). Has anyone else had this kind of reaction of being unable to resolve BV with HSV2 or Valtrex causing problems? Any insight would be appreciated. I've come to terms with the diagnosis but just want one day of feeling normal.
Finally got call from doctor, no BV or yeast present, so this is all a medication issue.
Hi, tingling is associated with a pending outbreak but should not last more than a few days before a sore appears. Do you shave down there?
I do. I have for years but have never had this problem. Possibly I'm just more sensitive with the HSV? They called in Famvir for me to start but I think I might take a medication vacation for a few days. If I start showing sx of an outbreak, I'll go get the Famvir. I've read that Famvir isn't as effective at suppressing viral shedding as Valtrex. I'm not in a relationship right now, so that's not a pressing issue, I just like being informed. Interested to know if anyone else experienced anything similar on Valtrex. I have the worst luck, lol.
not sure why your provider doesn't prescribe acyclovir. It works just as well as valtrex and is way cheaper.
Having bv actually sets you up for being more susceptible to contracting hsv2. Hard to tell at this point which came first for you. It can be hard to break the cycle of bv but sounds like at this point you might have. I'm not a fan of the boric acid suppositories myself for many reasons including the pain they can cause. When you already have a bunch of stuff going on down yonder, adding acid to the mix isn't always the best idea :(
so what do you do now? Well yes, you can have pain from valtrex. If this provider isn't willing to prescribe acyclovir instead to see if you do better on that, perhaps time to find a different gyn unfortunately. Even though famvir is a generic now, it's still higher priced and you have to take it more often than valtrex so not really worth it unless you are one of the folks who just seems to do better on it. Even though valtrex is an acyclovir prodrug ( the body converts it to acyclovir), you get less active acyclovir in the actual acyclovir pill which is why you take it more often. Some folks do have pain from valtrex and getting less acyclovir in the actual acyclovir pill controls your herpes without causing you as many side effects. You were given a higher dose of valtrex than you needed to initially treat your herpes and if you are sensitive to it, might take you a bit to get past the side effects. You only ever needed 1 gm twice a day initially. recurrences are treated with 500mg twice a day for 3 days.
so what do you do now? well the choice is yours. You never, ever, EVER have to treat your herpes if you don't want to. It's doubtful this pinching sensation is due to herpes so no reason to up your medication when you feel it. Perhaps waiting a full two weeks before taking any antivirals is a good idea at this point. Let them all wash out of your system before you try a new one. Decide if you want to try suppressive therapy or just wait and see how often you get recurrences and take daily suppressive therapy then with acyclovir ( 400mg 2x/day ). why pay for famvir if you don't have to?
keep asking questions!
Having bv actually sets you up for being more susceptible to contracting hsv2. Hard to tell at this point which came first for you. It can be hard to break the cycle of bv but sounds like at this point you might have. I'm not a fan of the boric acid suppositories myself for many reasons including the pain they can cause. When you already have a bunch of stuff going on down yonder, adding acid to the mix isn't always the best idea :(
so what do you do now? Well yes, you can have pain from valtrex. If this provider isn't willing to prescribe acyclovir instead to see if you do better on that, perhaps time to find a different gyn unfortunately. Even though famvir is a generic now, it's still higher priced and you have to take it more often than valtrex so not really worth it unless you are one of the folks who just seems to do better on it. Even though valtrex is an acyclovir prodrug ( the body converts it to acyclovir), you get less active acyclovir in the actual acyclovir pill which is why you take it more often. Some folks do have pain from valtrex and getting less acyclovir in the actual acyclovir pill controls your herpes without causing you as many side effects. You were given a higher dose of valtrex than you needed to initially treat your herpes and if you are sensitive to it, might take you a bit to get past the side effects. You only ever needed 1 gm twice a day initially. recurrences are treated with 500mg twice a day for 3 days.
so what do you do now? well the choice is yours. You never, ever, EVER have to treat your herpes if you don't want to. It's doubtful this pinching sensation is due to herpes so no reason to up your medication when you feel it. Perhaps waiting a full two weeks before taking any antivirals is a good idea at this point. Let them all wash out of your system before you try a new one. Decide if you want to try suppressive therapy or just wait and see how often you get recurrences and take daily suppressive therapy then with acyclovir ( 400mg 2x/day ). why pay for famvir if you don't have to?
keep asking questions!
Thanks Grace! I was driving home from the store on the first day of my "med holiday" and I started having the burning, papercut sensations. So, I went ahead a grabbed the Famvir (500mg 3x per day 7 days with 6 refills, odd...). The pinching is gone within 24 hours of stopping Valtrex, but now I'm in full OB mode with a few lesions, which thankfully is not nearly the horrendous adventure the initial OB was. This is minor discomfort compared to shear agony. I should have taken my Valtrex when I woke up that morning and by mid afternoon, I was getting to Famvir bc I felt "papercuts". The doctors reasoning behind not prescribing aclyovir is bc of having to take it so often and her patients report higher side effects. Patients miss doses and have difficulty managing symptoms. But honestly, remembering to stop and take Famvir every 8 hours is pretty hard too. This course is only for 7 days so I guess I'll see how I feel after that and may very well be looking for a new doctor. I need to feel like I have some control over this and right now, my lady parts are running my life and about to bankrupt me...
recurrences with multiple lesions is unusual ( though it can happen). I'd recommend following up and being seen again. Perhaps you have more than just herpes going on down yonder. Since you started famvir, might result in a false negative lesion culture to know for sure :(
your provider is once again prescribing you the wrong dose of famvir too. It is 1gm twice a day for 1 day to treat herpes recurrences. They are prescribing you the shingles doses which aren't needed for genital herpes. There is no benefit to treating for 7 days - most recurrences are almost healed on their own during that time.
side effects are the same with all herpes antivirals actually - they aren't higher with acyclovir. Yes, taking it twice a day for suppressive therapy vs once daily with valtrex is harder to remember but they certainly aren't taking it easier on you in general by prescribing the wrong doses of antivirals for you!! They also all work about the same at reducing recurrences when taken suppressively and healing recurrences when taken with each other.
your provider is once again prescribing you the wrong dose of famvir too. It is 1gm twice a day for 1 day to treat herpes recurrences. They are prescribing you the shingles doses which aren't needed for genital herpes. There is no benefit to treating for 7 days - most recurrences are almost healed on their own during that time.
side effects are the same with all herpes antivirals actually - they aren't higher with acyclovir. Yes, taking it twice a day for suppressive therapy vs once daily with valtrex is harder to remember but they certainly aren't taking it easier on you in general by prescribing the wrong doses of antivirals for you!! They also all work about the same at reducing recurrences when taken suppressively and healing recurrences when taken with each other.
Thank you! I will definitely see if I can find someone in my area that specializes in this and can help me figure out what's going on. The lesions I have now are identical to what I had when I was diagnosed but instead of 100+ raw areas/ulcers (probable exaggeration but that's what it felt like) it's about 15 in three different areas (two new areas in last two days!!) She mentioned contact dermatitis as another possibility for my pains (which is interesting if that's what it is bc this is the exact same thing I had when I was tested) and per her recommendations I no longer use any type of soap with bathing, unscented/undyed laundry detergent, plain Jane cotton underwear during day and none at night with plain cotton shorts or pajama pants. I'm really concerned about the doseage of meds not being right. I don't want to fill myself with more meds than I need, especially if it's not the root of my problem. I do believe I have herpes even though initially I questioned it adamantly since the ulcer that was swabbed was about 6 days old, covered in A and D ointment and identical to what I have now. I know false positive on a culture is virtually impossible but if it's possible these aren't herpes lesions, then I really need to find out what it is. Feels like I have glass in my underwear. And another bit of evidence that herpes diagnosis is accurate (even if not causing these current sx) is I got a blister under my fingernail with the initial outbreak that hurt for 4-5 days before becoming visible. This is my third day on the Famvir and no further improvement since the day after I stopped taking valtrex. Would be a miracle to not have herpes after all and a very important and expensive lesson but I can't let myself explore that possibility. I do plan to have IgG done in December (@ 16 weeks) just for final confirmation.
definitely more than herpes going on with the description of your symptoms :(
you can have hsv2 detected via swabs during recurrences that are triggered from other issues. make sense? anything that irritates the genital area can trigger a prior hsv2 infection to shed/reoccur.
you can have hsv2 detected via swabs during recurrences that are triggered from other issues. make sense? anything that irritates the genital area can trigger a prior hsv2 infection to shed/reoccur.
My insurance changed at the first of November so I'm looking at a $1500 deductible before the $50 specialist copay just to even go back to my GYN. :(. Figure may as well play around with some variables and try to hang on until the first of the year. I'll go to my family doctor and request the confirmation IgG blood test in December since I probably need to fill him in anyway. So, I'm off all meds (even ibuprofen for sinus headaches!). This is day 5. Since yesterday, I have felt 100% normal. No lesions, no burning, no pinching. I'm going to try to ride this out without meds until I have what I think is another OB and see if I can learn my body's warning signs. Knowing what is normal for an OB vs what could be reaction to meds or contact dermatitis or whatever will go a long way in helping me have a normal life and eventually a normal relationship down the road.. I have plenty of 500 mg Valtrex I can start back at any time. Famvir won't be an option as my insurance doesn't cover it at all and I only noticed what seemed to be less pinching, and feeling better overall for about a day or two before then feeling the same/worse. I'd love to go to a specialist tomorrow and get to the bottom of this but it doesn't make sense financially until the first of the year..
because we all keep a couple of thousand lying around the house to pay deductibles don't we? :(
glad you are feeling better :)
glad you are feeling better :)
I think I've got it now! Lol. Want to see if this sounds right. Didn't have anything that stood out to me as warning signs before except maybe 2 days ago, I felt kind of sore as though I'd had a really long night of rough sex (I wish). Wasn't constant, just kind of sore achy feeling on and off. Really didn't think much of it. Last night, came home and was about to wet my pants, ran in bathroom. When wiping I noticed I felt itchy to the left side so I scratched a little with the tissue thinking oh no, not a YI. Then it stung, within a few seconds. Of course I had to look. Right where it itched was 2 little ulcers, one pretty much on top of the other but definitely 2 separate ulcers that I could tell were blisters I just popped with my scratching with tissue. They aren't painful unless I go over the area with tissue, then it just feels tender, not pain. Nothing anywhere else. Still feel kind of sore and achy through the whole area on and off but that's it. I know this might sound silly but I'm keeping log of my symptoms until I get a handle on this! If this sounds correct for an OB, I'm still going to stay off meds since this isn't anything more than a minor annoyance, see how long it takes to heal and how long before I have it again. I really want to get a feel for my "warning signs" to decrease chance of passing this along when the time comes. The sx I had before that I described above was more pimply with a white fluid than what this is. This was visibly clear fluid and now two shallow ulcers from what was clearly blisters. Just wish I had clearer "warning signs".
well it still doesn't mean it's all herpes related but certainly having a diary of symptoms to take with you when you are seen will be helpful. Hopefully you can get in to be seen soon to get to the bottom of this all!!!
It's week 16! If someone sees this prior to my appointment in 3 hours (I know it's possible no one will, I should have asked sooner!). I want to make sure I ask for correct test. I know IGG but I've read no to have the ELISA or immunoblot. Just want to know if there is something reliable and specific I should request. Expecting positive, no doubt but just want best test either way. I doubt WB will be an option. Going to my GP.
I'm not sure what test I had but it was performed by labcorp. I don't have copy of results but nurse told me what I expected to hear!
HSV 1 - Neg < 0.91
HSV 2 - Pos 11.41
I know the result values don't mean much. Was hoping it would be an indicator of if this is what would be expected.
I just really hate that I don't know what a typical recurrent OB is like (not that I'm wishing to experience one because they are wonderful). I want to keep any future potential partners at lowest risk possible. So much else going on down there, I don't know what is HSV2 related and what is just whatever this wackiness is.
Thank you everyone for all of your support and answering my questions! Those of you who volunteer your time to answer questions from people who are newly diagnosed/scared/in denial are truly a Godsend to people like me. While I don't plan to tell the world my status, it will be my goal that I educate those I do share the information with to the best of my ability as I continue to learn more myself.
Now, I'll take my GP's advice and take my meds and not worry about it :)
HSV 1 - Neg < 0.91
HSV 2 - Pos 11.41
I know the result values don't mean much. Was hoping it would be an indicator of if this is what would be expected.
I just really hate that I don't know what a typical recurrent OB is like (not that I'm wishing to experience one because they are wonderful). I want to keep any future potential partners at lowest risk possible. So much else going on down there, I don't know what is HSV2 related and what is just whatever this wackiness is.
Thank you everyone for all of your support and answering my questions! Those of you who volunteer your time to answer questions from people who are newly diagnosed/scared/in denial are truly a Godsend to people like me. While I don't plan to tell the world my status, it will be my goal that I educate those I do share the information with to the best of my ability as I continue to learn more myself.
Now, I'll take my GP's advice and take my meds and not worry about it :)
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Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
