It Hurts When I Click Here
BY Frank Spinelli, M D
March 16 2010 2:40 PM ET
In an age when dating and shopping are a mere mouse click away, it would seem plausible that diagnosing and treating oneself via the Internet could be just as easy. But with the advent of easily accessible medical information online comes a new wave of cyber-hypochondriacs carrying with them a database of bad diagnoses. For every ailment, down to the common cold, a set of symptoms improperly interpreted through a cursory online search can lead to “the big C,” cancer -- and a sore throat doesn’t usually mean cancer. It’s enough to make Hippocrates choke on his oath. Many doctors cringe when we hear the words “I looked it up on the Internet and it said…” as few patients are trained to interpret symptoms. While it is in your best interests to be proactive and learn as much as possible about your own health, cyber-hypochondriacs often go beyond self-diagnosis and actually treat themselves by purchasing prescription drugs online, without a doctor’s supervision. This could have dangerous repercussions. Medications bought online are not always regulated by the Food and Drug Administration and as a result could have varying chemical components. A study by the Dutch National Institute for Public Health and the Environment found counterfeit Viagra and Cialis available for purchase online containing impurities including the stimulant amphetamine. These pills are not necessarily the same ones your doctor would prescribe. So continue to use the Internet for your own education, but leave the diagnosis, prescribing, and treatment to your doctor.
HIV and the Law
Recent criminal cases in Georgia, Colorado, and Texas highlight the variations in state laws concerning nondisclosure of HIV-positive status to one’s sexual partners. Pennsylvania’s statute is particularly severe -- calling for the same punishment as second-degree murder -- though an HIV-positive Texas man was recently sentenced to an astonishing 35 years for spitting in the face of a police officer, even though there is no evidence to support HIV transmission through saliva. Activists are concerned that harsh laws will lead to further HIV stigmatization. Disclosure is a sensitive subject for many, but I advise my HIV-positive patients that it is their responsibility to inform partners. Of course, everyone should be accountable for himself or herself and insist on practicing safe sex.
Plumbing the Depths
Typically, urinary tract infections occur more frequently in women than in men. But in my own practice I have found that gay men are especially prone to UTI, particularly if they engage in unprotected sex. (I advise that nonmonogamous partners always have protected sex.) The cause of UTIs in gay men is Escherichia coli, a bacterium commonly found in human feces. Symptoms of UTIs can include pain during urination, fever, and lower pelvic pain. (If you note discharge from your penis, it’s more likely you have an STD, and you should be tested accordingly.) To avoid getting an infection in the genitourinary tract, I strongly advise you to urinate after insertive sex. The act of urinating literally cleans out the pipes and is the best way to rid your body of debris and potential pathogens.
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