Confused about symptoms - Herpes or not?

[nurseinprogress]

Hi Dr. I am pretty confused about some symptoms that I am having. I'll lay out the timeline and see what your thoughts are. I've searched the web high and low and can't seem to find anyone having these particular signs/symptoms of what I have convinced myself is most probably herpes.

December 14, 15, 16: Had unprotected sex with a new partner. Asked if he had any STD's and to his knowledge he did/does not.

December 19/20 ish: I noticed soreness at the vaginal opening with slight itching and bad odor (I have chronic BV so I wasn't really surprised by that part). I looked pretty closely and couldn't really see anything except for redness and slight swelling at the vaginal opening. I'm starting to not feel well in general. I had flu like symptoms (massive headache, low grade fever). I will admit my first thought was herpes, for whatever reason. I've pretty much convinced myself at this point that this is what it is.

December 21st: Sought medical treatment with Dr (She was a OBGYN nurse for 20 years before obtaining her PA) with concerns of herpes, who dx me with yeast infection and BV, she looked over the sore pretty well and advised that it looked like a tear that had become irritated. She did not think that it was herpes and advised that there were no blisters that she could see. She prescribed meds for both and took a swab of the tear/sore and advised we would test for herpes, etc and results would be back in apprx 1 week. On a side note, I was running a low grade fever (99) at the time, which is not normal for me. I could also tell that my body seemed to be trying to fight off something as I didn't feel good in general.

December 22nd: I noticed 2 bumps had appeared on the right upper side of my vaginal lip. They did not hurt at that time. They just appeared.

December 23rd/24th25th: Now the bumps hurt and have become larger. They are still under the skin, no blisters that I can positively identify and they catch on my panties, which causes some pain. I could still sit and move around pretty well, it was just uncomfortable. And scary.

December 26th: Now the bumps are itchy! Terribly, terribly itchy! But it hurts to rub on them or mess with them too much so I just leave them alone. They are still just the 2 bumps, both under the skin.

December 27th: The bumps under the skin are still hanging out. They still itch, although not as bad and neither bump has blistered or oozed or burst. I called this morning and made an appt to see the Dr again tomorrow morning to go over these new symptoms and to retrieve results from last weeks swab. Also, the sore at the opening has not healed yet but it not cause any issues urinating and aside from being slightly sore, I have not had any kind of real pain.

So that's the timeline. I don't know what this is. I have read that some people just have a bump or 2 with an outbreak and that's it. From the time a bump appears, what is the normal waiting period before they blister? Should it have blistered by now if they were herpes? I know that everyone is different but it's killing me, not knowing. I've pretty much decided that it's herpes and now just want to deal with it because whatever this is, is awful! I've noticed a slight tingling sensation as well but I'm not sure if that's my brain putting it there since I've been reading about the tingling sensations or if that's really what I'm feeling.

Does this sound like anything you've dealt with before?

Thank you so much! I have read your responses and you are so encouraging and supportive. After seeing this new PA, I've pretty much decided I want to go into women's health. I'm in nursing school and intend to carry on into the PA program once I have my bachelors. Thank you again and I look forward to your thoughts.

[nurseinprogress]

I put some Zovirax cream on the area that was itching and wha-la! Relief!

It's not an itching coming from the vaginal entrance. The itching was coming from the area where the lesions were on the right outer lip of the vagina.

Thanks again Grace.

[gracefromHHP]

itching is common but if it's really intense, time to be seen again and get checked for yeast and bacterial infections vaginally too.

[nurseinprogress]

I am going to call tomorrow about the cultures. I'm sure the results are in, I just need to get the confirmation.

I have yet another question (sigh). Once an outbreak starts to heal can there be some pretty intense itching going on? I'm itching quite a bit off and on and the area is still tender while wearing jeans. I notice that I'm having to shift around a little bit to get comfortable.

Or could this be a sign of a back to back outbreak kind of thing (terror!!)

Thanks Grace.

[gracefromHHP]

the first ob can be a doozy and it isn't too unusual for the skin to hurt even when obvious lesions are almost healed. your ob is still running its course even though you have had 10 days of valtrex.  when there are no obvious lesions, consider yourself healed.

did your lesion cultures come back yet?

[nurseinprogress]

Ok, I think I have just one more question and I might be able to stop driving you crazy - And before I ask, thank you SO much for all your answers. I can't tell you how much respect I have for you guys to take on all these questions.

Also, thank you for letting me know I'm not a walking biohazard because at the moment, I kind of feel like I am. I'm ready to stop being such a paranoid freak.

Ok, last question (I hope) - Once an outbreak is in healing mode, can it hurt for awhile afterwards? Today will be the 10th day of the Valtrex 1 gram and I will start the maintenance part of it tomorrow but I'm still slightly uncomfortable where the ulcers were/are. How do I know when I am completely healed? When the pain is all gone?

Thanks again Grace, for everything. I really appreciate you and the time you take to help us with our sometimes legitimate, sometimes not, concerns.

[gracefromHHP]

yes you are being paranoid. no need for any extra cleaning either - just wash your hands after using the toilet or touching yourself intimately like you already do. really, you are not a walking biohazard!!!

[nurseinprogress]

Oh yes, I've read the handbook and everything else I can access on the internet, including blogs, forums, health sites, etc. I've been power researching for the last 3 weeks.

Can I spread this to my lips even though I have been washing my hands like an insane OCD person? I have a tender area on my upper lip that looks like it might be slightly swollen. I just noticed this in the last hour or so.

I think I might be in paranoid mode - I keep thinking it's everywhere.

[gracefromHHP]

You won't see scabbing like you do on say a cut on your hand.  It refers to a stage of healing, not actual scabs.

have you read the herpes handbook yet?

[nurseinprogress]

So the bumps on my hands have pretty much resolved themselves. That was a strange occurrence so soon after my exposure to the herpes virus. They are still there, just smaller and appear to be slowly going away.

Is it common to have mild tenderness/soreness in the vaginal area as a whole during an outbreak? I am 7 days into the Valtrex and although I don't see any additional blisters and the ulcers that I had appear to be healing I am not seeing any 'scabbing over' and I am still red, slightly swollen and tender throughout the entire area.

I know everyone is different but I wondered if this is fairly normal.

Also, what is the typical length of an initial outbreak? My Valtrex scrip is only for 10 days and then I begin maintenance. Is this enough medication to control the outbreak?

Thanks Grace, for all your help. I can only imagine some of the stories that you hear and the questions that you are asked. I'm so glad there are health care professionals like yourself available to us commoners in the world.

[gracefromHHP]

whitlow is painful as soon as the bumps start to appear.  

zovirax ointment isn't really all that effective for genital herpes let alone whitlow. I wouldn't bother continuing to use it on your hands.  

[nurseinprogress]

Does it take a while for whitlow to become painful? I'm noticing numerous bumps popping up on on both hands now but they are not painful - yet. I'm still putting the Zovirax cream over all the bumps but how does it spread from one hand to the other? Also, how long does it take for the pain to start? A week, like the genital outbreak? I am on the Valtrex as well - does that not help with possible whitlow on hands?

I've been so careful about washing my hands constantly. I did read that if you touch a lesion you can spread it but even though I was putting the Zovirax cream on the genital lesion, I washed my hands immediately with soap and water.  

[gracefromHHP]

the vast majority of people don't realize they are infected with herpes until they are blood test or have a humdinger of a recurrence that makes them go and be seen and get properly diagnosed.

whitlow hurts like a s.o.b.  if these don't hurt, odds are they aren't whitlow.

[nurseinprogress]

Is it common to have an initial outbreak at any time or is it generally within the 2-20 days from exposure timeframe? I guess my question is could I have gotten this from someone else but just now had a major outbreak?

Also, it looks like I have a cluster of bumps on my right hand index finger knuckle. I have been reading about 'whitlow' and I have been putting the Zovirax cream on the bumps but this just keeps getting worse and worse. Is it possible to have an outbreak on your hand? I have been washing my hands like crazy since finding out. Is there anything else I need to be watching out for?

I can't even explain how I feel anymore...  

[gracefromHHP]

too bad they dropped the ball so much when you were seen :(  you can still be tested for bv when you have your period as well as treat for it.

herpes blood testing is accurate for the vast majority of people who get it done. keep in mind that people who have no reason to doubt their testing don't bother coming to online forums for help so the boards get unevenly skewed towards the false positive side.

[nurseinprogress]

I am still waiting for the original swab test to come back. As far as the ulcers go, she just did a visual diagnosis. Apparently it was pretty obvious. I have taken 3 doses of 1 gram Valtrex to date along with using the Zovirax cream and the difference has been miraculous, to say the least. The pain has diminished almost overnight.
She did not retest for the BV just yet since I am still on my period but I have metrogel to continue treatment for that if needed.
I will be planning to go back in apprx 3 months for bloodwork. I'm not sure how much good that will do since it appears that many people's bloodwork comes back with false negs and false pos.

[gracefromHHP]

did she do any actual testing or did she only do a visual diagnosis?

did they also retest you for bv?

[nurseinprogress]

Yes, you're right, as always. It was a stupid, stupid decision on my part. The worst decision of my life to date.

Went to the Dr today and it's confirmed herpes. It's not a massive outbreak but the 2 bumps are in the ulcer stage at this time. She prescribed Valtrex and an ointment to put on the ulcer and advised that since this is an initial outbreak there could be more to come this time around. I'll begin maintenance once I finish the initial 10 day treatment.

It's heartbreaking right now; although I know I'll be ok. What a stupid, ignorant decision I've made. And now I'll pay for it.

Thanks Grace.

[gracefromHHP]

going to be seen again is the best thing to do. since you had unprotected sex, you also have to properly cover your std testing bases too. you can get tested for chlamydia, gonorrhea and trich after 1 week post encounter. syphilis after 6 weeks. herpes, hiv and hepatitis after 3 months. if they see symptoms suggestive of herpes, they can do a lesion culture and typing now.

unfortunately bv makes you more vulnerable to std's. since you have ongoing bv issues, you should always be having protected sexual contact unless it's a long term monogamous partner whose std status you are sure of. it's also rather naive to believe a stranger when they tell you they don't have anything - most folks don't get regular std testing and those who do, only get tested for 3 std's at the most.  

stop back and let us know how your appointment went today :)

grace

[nurseinprogress]

I forgot to mention, I've had body aches as well, in my back, hips, some cramping (although I started my menses on Tuesday, so that could be playing a big part in that part of it) . When I started the metrogel that the Dr prescribed, I then had a RAGING yeast infection. I've never seen so much yeast come out - yuck. Also, a big reason why I originally went to the Dr (aside from thinking I had herpes) was that I had this strange watery discharge that would just run out of my if I was standing up. I have Never had that happen to me before and I have had chronic BV for the past 5 years or so. Also, the  2bumps that appeared on my vaginal lip appear shiny in appearance, even though they are still under the skin. And they are uncomfortable/painful but not what I thought a herpes outbreak would be like. I just wish I knew what was going on with my body :(