Sunday, November 25, 2012

Hey all
Hope everyone had a nice holiday. Thanksgiving is my favorite holiday so I was really looking for to it. Unfortunately I had to work Friday so I couldn't go home home for the holiday but I had a nice little dinner with some of the other residents. Now I'm home and I'm on vacation for the week so I'm excited to take a little break from work. I'm going to be visiting a big metro and staying with one of my best friends from med school so it should be a good trip.

My STD symptoms are gone..I decided to just prescribe myself antibiotics rather than get seen again. I'm pretty certain I got some atypical urethritis and there wouldn't be any good test to get a diagnosis so I just went for the doxy. Yea I know, not the most kosher way to do things but doctors do make the worst patients. Anyway it was an interesting ordeal to say the least. I doubt it will do much to change my sexual practices. I still play safe for anal but I just could not bring myself to get blown with a condom on.

Phone guy is out of the picture. Yes I realize the whole thing was really fiction without any true commitment to meet for real. It was a powerful thing though. As much as it sucks it didn't work out for all the insane reasons you guys warned me about, it was nice. At least I have hope that I could find something like that again. It's funny there's that saying about plenty of fish and now with all our stupid phone apps and online sites you'd think it'd be even easier to find a good man but I almost think this over-connected world makes it even harder to really connect meaningfully.

In unrelated news I saw this story on naked yoga the other week and I found the idea intriguing. Yoga would definitely be a good way to meet some positive-minded men and the chance to do it naked, why not? I looked up both naked yoga and gay men's yoga in my city and alas neither is offered. But where I'm going on vacation will potentially have a class so I'm gonna try to get away on my own and try it. I'm a sexual deviant at baseline but aside from that I just find something very liberating about nudity. Trust me I don't have a Sean Cody model body but it's just nice to be naked. And to be able to participate in a group naked in a non-sexual way sounds very refreshing and like a great experience. So I'll let you guys know if I get to attend and if you're in a big metro check it out and see if anything like it is offered and try it out and report back!

Wednesday, November 7, 2012

i received my test results today. negative for gonorrhea and chlamydia (GC and CT). WTH??? i don't know what to make of these results. i thought for sure i'd have something. to make matters worse i'm still having a little bit of symptoms so i don't think i've been treated completely.

i'm not sure whether to believe the GC/CT tests. the urine sample i gave was a midstream sample when it's supposed to be a first-void sample. i was pretty sure the urine for GC/CT had to be first-void (meaning the urine when you first start peeing) versus midstream (taken when you've peed out a little) but i asked the nurse and she was like, "oh give a midstream sample!" so i did. i don't know how much that affects the test results but when you get results you don't believe you look for any little thing. i did a literature search on first void versus midstream and it shouldn't make that much of a difference but i'm still doubtful. yes being this anal about how a urine sample is collected is why i'm a doctor.

ideally i wish i could have just done a urethral swab and gram stain on myself and just made a definitive diagnosis. i was even thinking last week, how hard would it be to get into the hospital lab and set up my own slide without raising any eyebrows. but then i remembered i would have no idea how to set up a gram stain anymore so that option was out. nerd science talk out of the way, i'm not sure what to do next. my options:

1. be re-seen by a healthcare provider and do whatever they want, then quietly dictate what care i actually want. (by the way we hate patients who do this)
2. treat myself with a cocktail of antibiotics.
3. be seen by the public STD clinic.
4. ignore things for a few days then decide what to do.

4 is very tempting (well they all are), but realistically i'll probably do 3...and maybe still politely suggest they do all the things i want them to do if they don't suggest it themselves. i'm just hoping there's not something more serious or weird going on. i'm actually wondering whether i got the urethritis from rimming/oral interchange but as you might imagine it's hard to find good data on that.

on a side note, i wonder how my care would have been if i didn't mention that i was a doctor. i was seen by a PA and she picked up fast that i knew a little healthcare lingo and we both knew why i was there. after she said she'd run the urine tests that was the last i saw of her though and some nurse came in to give me my butt shot and my discharge papers. i was a little disturbed because 1, the nurse forgot to mention that i had a prescription for the pills i needed to take and 2, the prescription technically wasn't written correctly and i got no instruction otherwise.

the treatment for gonorrhea is ceftriaxone 250mg IM (intramuscular..aka the butt) and azithromycin 1000mg by mouth in one dose. the azithromycin is for added activity against gonorrhea (but is not sufficient treatment alone for gonorrhea) and also for presumed co-treatment of chlamydia. (since they frequently run together) anyway the script for the azithromycin was just written out as a standard z-pak, so if i was a regular person i would have gotten the pills and taken it the wrong way and still potentially be infected. that's just bad healthcare. i'm giving the PA that saw me the benefit of the doubt that she did things that way 'cuz she knew i would know what to do and otherwise would have explained things out to me if i was just some regular slut off the street, but who knows.

the point is, make sure you know what your doc is trying to do to you and always ask questions if you don't know what the hell is going on. yes we hate when patients ask questions but you guys deserve at least a few answers.

anyway i'll keep yall updated...hope this is all not TMI, but better to live vicariously through me than experience it yourself.

Monday, November 5, 2012

well two embarrassing things to talk about today but i'll be an open canvas and share with yall.

1. re: phone guy, he ended up calling me the day after i posted so i felt stupid for writing a post freaking out about it. he had dropped his phone in the toilet and had trouble getting back his data including my number. so i was relieved to know he wasn't dead or critically ill. i should have made it more clear but i did try to contact him in that week so i presumed something was up from his lack of a response. thanks for your comments though..i did like the one comment from an anonymous poster who said, "Welcome to gay dating, where people will be all about you one moment and completely over you the next."

anyway that was a relief to hear from him to know that he was not completely over me and had tossed me aside. we got back to our routine but then had a discussion about where this was going and if we were ever going to meet each other for real. a little bit difficult to rehash exactly how the conversation went, but basically he is still adamant about not wanting to get truly involved while i'm in residency. in fact, he doesn't even want to meet. he says he doesn't want to be a distraction to me while i finish but obviously i think there is a lot more behind that. i know it's difficult to convey to you readers, but we have a definite connection, and i think he is scared to meet me for real and fall in love and be stuck in this long-distance relationship. i know he's a hypersexual guy and that would be hard for him and all the baggage that comes with a long-distance thing. but as i tried to tell him (and some of you have pointed out), how can we know any of this is real without seeing what the chemistry is like in person? but he doesn't even want to give it a shot.

so that left us with what are we doing with each other now? why are we even bothering wasting our time talking if it really won't go anywhere for the foreseeable future? as you can imagine, now we are trying to emotionally separate ourselves. yes i've been setting myself up for this over the past few months. but i was happy to. this (sadly?) was the deepest relationship i've had and if anything at least i know the possibility of the intense emotional connection i want from a man is out there. i don't believe in soul mates but at least i know there is probably another man out there who is right for me. it may still end up being phone guy. i don't believe the story is closed with him, but for the time being it's being laid aside.

2. i very likely contracted an STD. i started having symptoms at the end of last week (painful urination, penile discharge..gross i know) and against every bone in my body i went and got seen at an urgent care over the weekend. i swear if the treatment for gonorrhea was a pill and not a shot in the butt (which i got, and FYI it hurt like a mother for a few hours) i would have just prescribed the damn medication to myself. but i went the more ethical route and got treated officially even though any monkey could diagnose an STD.  the official test results will come back in a few days so i'm at least interested to see what it is. i think it was probably a non-gonococcal urethritis as the discharge wasn't as copious and purulent as is typical for gonorrhea but who knows. and while my symptoms weren't that bad, in general, having discharge from your cock is a horrifying thing.

so comes the point of how i got it. i've actually been dating a guy for the past month and i had last seen him about two days before i started having symptoms. i've talked to him about it, and i have been the only guy he's been with, for several months actually. and i believe him. he told me he actually had had a little dysuria a few weeks ago after one of our dates, got tested, was negative, and didn't tell me about it 'cuz it was negative, which i also believe. that just leaves me wondering how exactly this cycle worked. i certainly believe i'm the more promiscuous one and if anything i gave something to him, which he gave back to me, although ironically i wasn't sleeping around while dating him so i guess my infection predates me ever going out with him.

this was all based off oral btw. if you have ever thought that oral is safer than straight up raw bareback anal sex, you are very wrong. both gonorrhea and chlaymdia can infect the throat, and they may not necessarily cause symptoms, so one can end up being colonized by these bugs and pass it on unknowingly. so every time you suck a dick or have someone take yours, you take that risk of getting an STD. but obviously no one likes getting sucked oral with a condom on -- i can think of maybe one situation in the past where a guy has wanted to use a condom for oral to be safe - it just doesn't happen in the gay (or straight even) culture.

so if you thought oral sex was safe, i hope i've enlightened you. if you already knew that there was risk, but did it anyways, at least let me be a cautionary tale that infections are out there. i obviously have been aware of the risk of STDs even with oral sex, but i have always chosen to ignore that risk, and here i am today. it is also important to note that resistance to gonorrhea is increasing, especially in the 'men who have sex with men' population, meaning it is very plausible down the line that we will not have an effective treatment for gonorrhea. very scary thought. i'm actually a little concerned because i'm going into almost 48 hours post-treatment and i'm still having some symptoms..oh geez i hope i didn't hit the jackpot and get the resistant bug.

will this experience change the way i practice sex in the future? i don't know. i sure like getting and giving oral without a condom. but i also don't like crazy disgusting discharge coming from my dick and shots in my ass.

i do know that i will be celibate for awhile as i think about this infection and about phone guy. kind of a sucky one-two punch this week.

interestingly this all happened when i've tried to be a good boy and date and take things in the right steps. i've hooked up with dozens of guys and done some very, very questionable things in the past, and escaped for the most part without any problems. i certainly have more than deserved something to happen to me, and i guess here it is. i will do the right thing and try to contact any sexual partners in the last 60 days to tell them to get checked and i will be getting checked again for syphilis and HIV in a few months. (i was recently checked but gotta check again after a diagnosis of an STD)

i guess my point of all this is, no one is immune to STDs, not even the doctors who treat them. i'm not thrilled to be sharing this news with the internet and if you want to judge me for having an STD that's fine with me. i think it's funny that society is like "ewww STD!" but is like "sex? great!" you can't really have it both ways. the risk is always there and i think it's important that we all get a reality check that infections happen. but you make your decisions and live with the consequences. just don't be surprised if it happens to you. be educated, be as safe as you can be, and be honest with your partner(s). and don't believe what anyone else tells you about being "clean"!