A sad tale from the clap clinic

[NonnyMouse]

I am writing this as a type of public health warning -  if you are vaguely interested but can't be bothered to read the words, just drop down to the bullet points and the paragraph that follows. I am also posting under a pseudonym since I do not want to be labelled as the bloke to whom this happened. If you recognise the style of my writing (or my ISP address, moderators!), I would be grateful if you would not post your thoughts on line - just tell me to my face or pm me!!

 

Earlier this year, I spent some time happily mongering amid the fleshpots of Pattaya. Just before I left, I had an HIV / syphilis / gonorrhoea / chlamydia  test which came back negative.

 

After about a week of being at home, I started to get an irritation at the end of my penis. I thought nothing of it except possibly a mild urinary infection, best treated by drinking more. A week later, a small, almond shaped lesion about 3 mm in length appeared on my foreskin (being from neither a Semitic nor North American background, I am still the proud possessor of this flap of skin). Buggar, thought I, and trotted off to my local clap clinic. (A diversion - the running of this has been taken over by Richard Branson's empire - am I the only person to find the name  "Virgin Sexual Health Clinic" slightly bizarre?). The usual chat - how many sexual partners in the last year? - follow Jimslim's advice taking the actual number and dividing by 10 - off with my kit, an examination followed by a blood test. Results in two weeks. No problem.

 

Two weeks go by and the lesion has changed from an almond shape into looking like a volcano with a big, red, raised larva field around it about a centimetre in diameter and standing proud by a couple of mms. Not painful, but definitely exuding something. I ring for the results and am told that all they are all negative. I was gobsmacked and when I asked about my sore penis with its lesion, the nurse said that I should go to my doctor because it definitely wasn't an STI.

 

So I did and my doctor took more samples (for herpes - aparently very difficult to detect) and told me that if these came back negative, then she would refer me to the urology department at my local hospital because it might be penile cancer..... to be continued

[bumblebee]

Curiously awaiting your next installment NonnyM.  While the implication is that this tale is about to get worse, fingers crossed I am wrong.

[NonnyMouse]

And the tests came back negative.

 

By now, I was in a bit of a state (googling penile cancer was not helpful with its statistic of it being rare, some 500 cases per year in the UK, reconstructive surgery would help its appearance if they had to cut the cancer out- nothing about whether this would impact my ability to perform although I guess this would depend on how much they had to chop away).

 

God bless the NHS - mention cancer in a referral letter and the whole machine goes into overdrive. Within two weeks, I was seen by the top urology surgeon's assistant who did not like what he saw so he went to fetch the great panjandrum himself who came, accompanied by the sound of trumpets and seraphims singing in the corridor. They stood around me behaving like workmen gazing into a hole where something unexpected and expensive has happened, sucking in their cheeks and looking serious. Eventually, the Great Man spoke " I don't like this; we will book you in for a circumcision.  When that is done and we have performed a biopsy on the foreskin, then we will take it from there".

 

He then explained that it could be cancerous, precancerous or something else. He went on to say that it could be a viral infection (HPV - the family of viruses which cause varookas, warts and such like) which had turned cancerous. I understand that you can get HPV from oral sex (as does Michael Douglas or so he says), so it made a sort of sense. They wanted to operate quite quickly but I told them that I needed some time to get my head around all of this and we agreed a date five weeks later. Anyway, I went off to get the pre-surgery check which you have to have before having any scheduled general anaesthetic and whilst there, having an ECG, I noticed a slight rash on my chest.

 

Back home, the internet searching reached a frenzy. I am now a world expert on adult male circumcision (not much fun but not dangerous), viral transmission (in theory, everything might transmit viruses, but that's life - or death) and penile cancer (you don't want to know). And then I stopped and thought through the timeline and my symptoms and the fact that they were identical to the symptoms of syphilis; it was at this point, I contacted the clap clinic and demanded another test for syphilis.

[NonnyMouse]

I went for my test, explaining that I was not desperately happy about having surgery (it surprised me just how emotionally I am attached to my foreskin); the nurse looked at my lesion, called in an experienced colleague and they both looked at my now very rubbery volcano like lesion and again behaved like it was something they had never seen before. Which was all quite worrying.

 

Another two weeks go by (and by now I have got used to the idea of a circumcision, although what the biopsy would reveal woke up in a muck sweat at 4 in the morning - a good night's sleep is a long time in the past). The rash on my chest - not itchy - has spread and I look like someone who has a severe flea problem, literally hundreds of small, bright red spots. And I am tired, lost my appetite and my joints ache.  I then get a text message - come back to the clap clinic as soon as possible. There, they sit me down and tell me that I have syphilis. FFS!

 

The doctor then said that the spots were a secondary symptom and that all my symptoms were archetypal syphilis; when I asked why the first test had failed to pick up the infection and why she had not recognised my chancre (pronounced shanka as in Ravi Shanka), she said that she thought it might be syphilis but was not sure - when the test came back negative, she assumed it was something else. As for nobody else - two consultants, one doctor and two clap clinic nurses - picking it up from what they could see, she said that once the tests come back negative, nobody thinks that the test results might be a false negative, but proceed to consider what else could be wrong with you. In addition, and this amazes me, syphilis is so rare nowadays that many doctors have never seen it. In her clinic - it serves a large university town and the surrounding areas - they had seen 6 cases in the last two years. In fact, so rare was it, did I mind if she brought in other doctors and nurses to see what primary (the chancre) and secondary (spots) symptoms look like? I didn't mind, so I sat there with my willy flapping around in breeze with a procession of medical people coming in, prodding me and going "ooh" and "ah". Then they took photographs of the offending member. (I had to sign a release form agreeing that they could publish pictures of my willy. So that's my 15 minutes of fame sorted).

 

Relieved but not much mollified, I went to have my injection of penicillin. Fuck me! It's an old formulation (because apparently there are so few cases it is not worth the pharmaceutical companies investing in the trials necessary to get a newer formulation through the authorities) and it coagulates quickly. So they push it into you very fast (two injections, one in each buttock) and it hurts like hell. And then they do not let you go home for 30 minutes in case you collapse and finally, in between 2 and 12 hours, you get a reaction to the dead bacteria (the Jarisch- Herxheimer reaction if you want to read more) which left me feeling as if I had a really bad case of flu. It can hospitalise you in extreme cases.

 

One week later, the circumcision operation is cancelled, my spots have gone, the lesion is healing, I am bemused by my experience and (the real reason for writing this) feel that it is worth sharing my experience with others (mainly UK although I suspect that the lessons I have learnt may be applicable worldwide):

1. The test for syphilis is not 100% accurate - it can give false negatives (unlike the quick HIV test which can give false positives)
2. Once you have a negative test result, accept that the medical profession will take that at face value and not recognise what is in front of their face, even when it indicates a false negative. This is not helped by the fact that many of them have not seen the symptoms of syphilis before.
3. If you then start down the route of "what else could it be" and the medical profession decide that it is something serious, go back for another test before agreeing to something that might be both unnecessary and painful or disfiguring.

Above all, do not think that if you have symptoms and then get a negative test, that's it. Even though I don't care what people think when it comes to my health, I realise that some people believe that going to the clap clinic to be slightly shameful and, once they have a negative report, would prefer to believe something else is wrong with them than to consider going back. Had I not gone back, I would be having surgery to remove the lesion. Luckily, it was on my foreskin. Had I not got a foreskin or the lesion had appeared somewhere else on my penis, they would be trying to hack out lumps of my penis. Not an appealing thought.

 

My advice to anyone in the same position as me is to go back for another test regardless of how you feel about going to the clap clinic. A little bit of embarrassment (if you feel that) is a lot better than unnecessary surgery.

 

I do not think that this is the fault of the NHS (in case somebody takes the opportunity to have a go at social medicine). One issue was that before the initial test and again when I saw my own doctor and the consultants, I washed extremely well so there was probably little exudate to pick up in the swabs. The last tests I had, I deliberately did not shower for 6 hours before hand just so there was something for the swabs to pick up. Why the first blood test came back negative is one of those curious things given that I was exhibiting symptoms of the primary stage of syphilis.

 

Some other points: the spots are apparently extremely contagious, so if your regular partner touches them (as in, puts her hand on them), she should get herself checked out. I had to go back home and say to my other half "Good news, I don't have cancer, bad news is that you have to get yourself checked for syphilis even though we have not had sex since god was a boy..." The rest of the UK may be having a heat wave but trust me, it's decidedly chilly around here.

 

The Health Advisor (the nurse who gives you mother like talks about condoms and such like) was insistent that I contacted all my sexual partners over the last year to tell them that I have had syphilis. Maybe she would have not wasted her time had I given the full number rather than dividing by 10!

[pacman]

Thank you for your thorough description of this most unsettling experience. I never knew tests for Syphilis could throw up a false negative. Given how contagious the damn thing is, I have no doubt there will be some among us who will need to know this.

 

Going by the warning given to you, one must assume that every partner in LOS you had after you contracted Syphilis now has it. And by extension, every partner they have had since now has it too. And every partner they have, etc, etc, etc....

 

Are we looking at an epidemic? 

 

If the only treatment is Penicillin, then a few people are in trouble. Anyone prescribed Penicillin enough times develops an allergy to it. I remember being told by a doctor he didn't want to give it to me in case I needed it for something more serious. I can't remember what I was being treated for, it was a long time ago but there was a real fear of using it & leaving me vulnerable later to something that only Penicillin could treat.

[rxpharm]

NonnyMouse, you've done a great service sharing your experience here. Too many guys participating in p4p assume the great bugaboo of STDs is HIV - yet syphyllis, gonorrhea and chlamydia are also serious infections. In fact drug resistant gonorrhea is becoming more common - so the stark reality is that barebacking is extremely risky, not only for contracting HIV, but also everything else.

 

It's far better to cover up and use a condom. I'm glad your case turned out ok, and you didn't end up like Idi Amin or Robert Mugabe with untreated syphylllis spread to the central nervous system (brain and spinal column).

[Jimslim]

 I'm glad your case turned out ok, and you didn't end up like Idi Amin or Robert Mugage with untreated syphylllis 

 

Don't forget Al Capone 

 

Thanks for posting this NonnyMouse , I'm sure many of us have picked up a few unwanted souvenirs in our Thai travels but this was potentially serious .

[bumblebee]

Good to hear you got this sorted without drastic, unnecessary surgery NM.  Interesting that you mention the old style penicillin that they used. I remember once getting bitten by a dog in Patttaya, and just for safeties sake i got a course of anti rabies jabs straight afterwards. When i got home I mentioned this to my GP, and she said i was lucky I did it there in Thailand as there is not much of the formula available in my home country.  It makes sense, but we just tend to falsely think that the West has all the necessary medicines for all our problems.

[anothermouse]

glad to hear you are well, nonnymouse, but

given what i have recently learned from the somewhat similar experience of someone close to me, i find it curious that along the sad and agonizing road you were forced to walk, none of the brightest medical minds in the UK mentioned that -- not unlike a test for HIV -- the test for syphilis can often show a negative result within the first 3 months of infection -- *even* when the test subject already is showing what any experienced medical practitioner should recognize to be a ravi shankar of a clearly syphlitic nature.

of course, when i say 'experienced medical practitioner' i must unfortunately exclude everyone working at the clinic in Ermita (diagnosis: "abrasion. apply cream. do not worry."); as well as the doctor in charge of infectious diseases at the clinic in dumaguete (diagnosis: "chlamydia. i have seen this before.").

the doctor at Siliman University in Dumaguete could only shake his head at the earlier errant diagnoses, impart the information with which i began this post, write a prescription for penicillin and direct the patient to go downstairs and out the door to the right to the ER to get shots in the ass which -- as mr. nonnymouse correctly indicated --  provided a degree of discomfort that may never be forgotten.

by the time the pain in the ass subsided sufficiently to sit down, the infection had been killed and the lesion had begun to fade.

at least, that's what my friend told me happened.

btw, she also told me syphilis can be contracted by placing your cock in the mouth of an infected person whose sore you would not see unless you had them face toward a sufficient light source and bend back their lips to see their gums.  given the near-universal indulgence in bareback blow jobs by those on and off this forum, it's a damn good thing syphilis is so rare.

 

let's hope it stays that way. but meantime

 

be careful out there

[pentire]

An absolutely fascinating read and thank you to Nonny Mouse (whomever you are) for revealing this dreadful  experience  very eloquently with humour.

In early September I visited my usual (although sadly about to retire) Thai Doctor in Pattaya for the annual check up of all known sexually transmitted infections as well as a few other nasties, much easier to arrange for this type of thing in Thailand as opposed to back in the UK via the overworked NHS when arranging appointments and explaining in detail one’s sexual history, orientation and whether or not you partake in oral, anal, go with hookers etc etc.

Anyway, the Thai Doc was telling me that Syphilis and the similar looking yet frequently more painful bacterial infection Chancroid Ulcers are really on the march in Pattaya these last twelve months particularly among the gay community and especially ladyboy sex workers.......so that I was under no illusion about how vitaly important it is to “rubber up” he showed me some images on his iPad from farangs he has been treating.

Luckily at the moment, Syphilis offers absolutely no resistance to Benzylpenicillin so long as it’s administered in a high enough dosage depending upon the stage of infection.

No body needs telling to wear protection when shagging sex workers especially up the back passage however, very worryingly the Doc also mentioned Syphilis can be passed on by BBBJ’s and open mouthed kissing if there are primary stage Syphilitic ulcers in the other person’s mouth.

FFS.......

 

[EyeMahk]

Isn't Syphilis how Al Capone died?  Were there LBs back then?  

[TEXASMAC]

Yeah, J Edgar Hoover.