Need advice & questions to ask

[shockedandscared]

I just received positive hsv2 test results (culture & blood) yesterday. I was shocked because I was tested for hsv2 11 years ago (8/99) after seeing a red place on my labia. The first time I ever noticed anything wrong was (2/99), 3 days after a liposuction procedure. Swelling in that area due to thighs & lower stomach being suctioned caused  the compression garment to rub a place on my labia. These "spots" have appeared sporatically for the past 11 years. I never gave hsv2 (or hsv1 via oral sex) a second thought because of the negative test results. I have been with my husband for 12 years and have not been with ANYONE else since we met/married. My husband has never experienced ANY hsv2 (or hsv1) symptoms. We have had 2 children since the test in 1999 and am concerned I have not only exposed my husband, but my children. 1. Both my husband and I are BAFFLED how he hasn't exibited ANY symptoms because we have had roughly 12 years of sex without a condom, etc. Is it possible that he may not have hsv2? 2. We plan on getting him tested next week. What specific test(s) should we ask be performed on him and what specific questions should he ask? 3. Could I have exposed my children to hsv2 by sharing a towel? Bathing in the tub with them when they were little? Wiping diaper cream on them, etc.? 4. Obviously I am concerned about the quality of our sex life going forward (not at the expense of my husband's health). Everything I read indicates Valtrex daily supression & condoms will reduce exposure. If my husband does test positive for hsv2, do we need to use condoms when no lesion is present, going forward? Would condoms keep him symptom-free even if he is hsv2 positive (remember he has never exibited any symptoms in these 12 years)? 5. Are there any topical creams/ointment to help the pain of underwear touching/rubbing a lesion, etc.? I haven't seen any listed in my internet reading.

[Terri Warren, RN, Adult Nurse Practitioner]

the sunburn spray would be fine in that area, yes.  When you look at the frequency of headaches, that is the total number of people who had headaches - what you really need to know is the number of people who had headaches on Valtrex vs. placebo.  My read of those numbers is that the two are very close.

I'm not clear that daily therapy is best for you, that depends upon what the two of you think about transmission and outbreaks.  What's good for one situation and couple might not necessarily to be good for another.  

Let me know how the tests turn out.

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

Thanks for your kind words.  It is possible that the liposuction irritated the surrounding nerves enough to cause an outbreak.  We see a fair number of people who have never had a recognized outbreak, and then they have back surgery or some procedure involving the abdomen or uterine area, and they get their first recognized outbreak.  But they haven't had sex for years.  I suspect this may well have been the case with you.  

The bikini waxes are fine in terms of safety for both you and the waxer.  But again, its possible that the physical stress, the irritation of that set of nerves,  of having the waxing may bring on an outbreak.  If you are on daily therapy, this should not be much of an issue.  

How often are you getting outbreaks, do you think?

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

It seems likely that you've had this for quite a while.  I'm wondering what sort of testing you had done that was negative 11 years ago.  Perhaps a culture?  There are frequent false negative cultures for herpes.  

You can certainly get your husband tested and see what's up with him.  Either of you could have been infected with HSV 2 before you met.  And transmission doesn't have to happen, even between long term partners, such as you and your husband.  If he is positive for HSV 2 through a type specific IgG antibody test, then there is nothing at all that you need to do about your sexual relationship.  If your husband tests negative for HSV 2, then you have some decisions to make.  Clearly, you haven't transmitted so far, so you could continue to be sexual as you always have.  I think we automatically assume that everyone should do everything that we should to prevent transmission to partners, but I don't agree that that is necessarily true.  That is something that is a decision to be made between the two of you.  If you do wish to do everything you can to prevent transmission, you should go on daily antiviral therapy and you could use condoms with intercourse.  Antiviral therapy reduces transmission by about 50% and condoms by about 30%.  There are no topical treatments that I could recommend to treat herpes, but you could use a spray treatment for sunburn to help relieve the discomfort of an outbreak.  

I would not worry at all about transmission to your children.

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

I think this is actually the best result that you guys could have had in the long run.  No, you can have sex whenever you wish with no concern about re-exposure or triggering outbreaks in each other.    I think in the long run, you may not need suppression.  However, since you've been diagnosed and so has he, I think you will both recognize more outbreaks over time.  So good to play it by ear.  There is no medical reason for suppression at this point, unless you are planning a pregnancy, in which case suppression would be appropriate at the end of pregnancy.  
Glad you got this sorted out, there really is no need to change anything about your lives at this point.  Just carry on!
Terri

[shockedandscared]

Just returned from our appointment with my OB/GYN. Husband's test was positive for HSV 2. He is fortunate that he has never had any symptoms or outbreaks. We don't know who transmitted to whom (and it doesn't matter to us). I was torn on if I wanted him to have it or not (meaning I would never wish this on him, but if he didn't have it - it was going to perhaps change our sex life going forward).

Now that we know he does, my doctor thinks we really shouldn't change anything (sexual or otherwise) since we know this has been a part of our lives for the past 11 years (which was a huge relief to me).

Doctor recommended doing daily suppressive dose for 6 months and monitor how many (if any at all) outbreaks occur. After 6 months we may go to "as needed" or continue with daily depending upon the outcome.

One thing I forgot to ask my doctor is, even though my husband has never had any outbreaks, if he tests positive (IgG) for HSV 2, can re-exposure to the virus or a lesion cause him TO have an outbreak? (I am assuming no - that once you have it, you have it outbreaks or not, but I don't just want to assume that.)

Once again, thank you for your concern, advice and continued responses.

[Terri Warren, RN, Adult Nurse Practitioner]

I'm glad you think so.  Do let me know how this turns out.

Terri

[shockedandscared]

Husband's blood test is being done today. We will find out the results on Friday when we have a consult with my OB/GYN.

I will let you know the results & his recommendations.

Thank you so very much for all of your continued responses. I have absolutely gotten my $20 worth!!

[shockedandscared]

I have been trying to come up with the average number for the outbreaks since I found out. Strangely, they seem to be more frequent now than 11 years ago (everything I have read says they should get better over time).

At first, they did not happen that often, maybe 2-3 per 12 months. Now I would say 6-7. Based upon what you said above, my bikini waxes could be contributing to this number. This out break has been different in the level of the pain (worse) and for the 1st time in those 11 years, I now have 2 sores (not sure it matters but I thought I would mention it). I have no doubt that a bikini wax contributed in some way to this outbreak. The left side of my labia has been sore since the wax and then 4 days or so later, I developed a sore. The area has been sensitive since the wax roughly 3 weeks ago. Oddly enough, all lesions have always been on the left side of my labia (never anywhere else and until this time, only 1 sore).

For some reason, I think my doctor wants to wait for my husband to be tested before we decide to go to the daily dose vs. as needed. Sounds like you think the daily dose might be the way to go? I am a migraine sufferer and after reading the drug info, Valtrex used daily had headches as one side effect in 36% of the patients (16% for as needed use). I am open to do whatever I need to to make me feel better and minimize exposure to my husband (if he doesn't have it already).

I assume the sunburn spray you mentioned as an option would be okay to spray in that region of the body?

Thank you again for your continued responses.

[shockedandscared]

Also meant to ask - if there are no topical treatments to assist in numbing the discomfort of an outbreak, how are people with sores functioning in their daily lives?

I know that daily suppressive doses would help reduce the number of outbreaks, but based upon some of the photos I have now seen with multiple lesions, I am shocked that they can wear underwear and clothes comfortably; sit, stand or walk without extreme discomfort. My outbreaks (now that I know what they really are) have fortunately been only 1 sore at a time, but they are painful, especially in panties (men could wear boxers).

I assume since you mentioned the sunburn treatment spray, it will be okay to spray it in the genital area? I am taking Valtrex 2 x per day for 5 days for this now that we have confirmed what it is, but, 3 pills into it, I am still very sensitive in that area. I am currently covering the sore with a band aid.

My dr. said we will reassess "as needed" dosage vs. daily supressive dosage once we know my husband's test results.

[shockedandscared]

Yes, the test 11 years ago, I now know, was a culture. Now that I have been researching, I will never know if the 1st time I noticed a place was due to the compression garment 3 days after lipo or really the 1st outbreak. It could be total coincidence - but I do know that was the first issue of any kind in my vaginal area.

I do have another question (ran out of room on the 1st post) - I have been getting bikini waxes for almost 9 years roughly every 4-6 weeks. I don't think I have ever had a wax when I had a sore (too painful) but based on the viral shedding I have read about - can I continue to get bikini waxes? The person performing the waxes wears latex gloves, but do I risk spreading anything to other genital areas being waxed (i.e. labia vs. area atop my pelvic bone)?

Thank you for your prompt response. Before I posted, I read alot of your discussion threads. Most people on this forum are very scared and panicked and you have a very calming nature in your answers and responses.