Hepatit partner

Big comprehensive post: What to expect/ questions to ask at first RE visit

2016.09.15 01:52 Meg449 Big comprehensive post: What to expect/ questions to ask at first RE visit

OK team, this is a big comprehensive list of what to expect/ questions to ask at your first RE visit.
What's missing? Does anything need to be edited?
https://docs.google.com/document/d/1LQ0LR2HB8rwHqsk420fW9YLJoNqQN3n0XSnQK-9_ISU/edit?usp=sharing
When to see an RE
How to schedule an appointment & some insurance information
  1. What does the plan cover for infertility diagnosis?
  2. What does the plan cover for infertility treatment?
  3. Does the plan cove offer discounts for medication?
  4. Is pre-approval required?
  5. Are certain treatments required (example: a certain number of IUIs) before moving onto other treatments?
  6. Does the plan require a waiting period of trying before they will cover infertility treatments?
What you can expect at the appointment
Common tests/ procedures during initial RE appointment for a female partner. (Note: some of these may have been done at an OB/GYN or primary care doctor prior to your RE appointment. If possible, it can be helpful to have these tests done at OB/GYN or primary care doctor prior to RE appointment so results can be discussed)
Additional possible tests during initial RE appointment for female partner
If you are in a female/ female relationship, the non-carrying lesbian partner may need blood work done at your RE appointment to be checked for infectious diseases
Common tests/ procedures during initial RE appointment for male partner
Additional tests for male partner depending on results of SA (Ask to be referred to a reproductive urologist)
Question checklist
Medical
About the clinic
Financial
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2013.05.28 03:58 KayGay Oral Guide for Gay Bros: Eliminate Halitosis & Minimize STI Risks of Fellatio and Anilingus (or, a guide to better breath and safer blow jobs and rimming)

TL;DR: I tried to organize everything so you can just read whatever interests you and skip the rest.

Intro

NOTE: This is not a guide on how to perform oral sex! I've been hooking up recently for the first time and I've been running into two oral issues. 1) Lots of guys have bad breath and it's a major turn-off, and 2) we tend to not use condoms with oral sex because part of the fun are the tastes and smells, but you are not immune to Sexually Transmitted Infections with oral sex. I've researched these two issues and thought I'd share my findings. Some of this is common sense, but some of it is not.
Disclaimer: I am not a doctor nor am I a sexual/public health expert. There may be mistakes here. If you catch any obvious ones, let me know and I'll update it. Do your own research, talk to a professional, and be as safe as possible.

Eliminate Halitosis

  1. Brush your teeth at least twice a day.
  2. Floss once a day. I know it's a pain in the ass, but it's important for getting rid of bad breath.
  3. Scrape your tongue once a day. Tongues are the biggest culprit for bad breath, and it's amazing how many people don't scrape their tongue. This is what I use, but there are plenty of other decent scrapers out there. Most modern toothbrushes tend to have rudimentary tongue scrapers on the back of them as well. Note: Brushing your tongue is not as effective as scraping.
  4. See a dentist regularly. They recommend every 6 months.
  5. (Optional) Chew gum. Chewing gum helps break down shit stuck in your teeth in addition to giving you fresher breath

Oral STI Prevention

  1. Ask your partner(s) about his STI and testing history AND sexual behaviors.
  2. Look for obvious signs of infections (e.g., sores, warts, pus). Of course, not all infections are visibly obvious.
  3. Get tested every few months. If you don't have the money, there are clinics that will do it for free.
  4. DON'T brush your teeth or floss 30 minutes before or after oral sex. These actions will create small abrasions in your gum that will make it easier for you to get infected.
  5. Spit or swallow, but don't let it wallow. I'm talking about cum here. The best thing to do is to not let him cum in your mouth. The second best thing to do is to spit it out if you let it in your mouth. Your stomach acids will kill MOST things if you swallow, but you're still ingesting it. The absolutely worst thing you can do is just leave the cum in your mouth, though! This gives it more time for it to be absorbed through your membranes.
  6. Don't perform oral sex if you have any cuts, burns, or sores in your mouth
  7. Wash your anus if you're expecting to be rimmed.
  8. Enemas can also help clear out any fecal matter, reducing the risk of certain infections.
  9. Vaccines for Hepatits A and B are readily available for everyone and there are two vaccines for HPV that are approved for those that 26 and younger. Cervarix protects against two strains of HPV that may cause cancer, and Gardasil protects against those same 2 strains and an additional 2 that may cause warts.

Oral STI Risks

Knowing what you are at risk for is part of the solution!
  1. HIV/AIDS
    • Oral Risk: Minimal transmission risk. Risk of HIV transmission through fellatio or anilingus is low, but still possible if there are cuts or sores in the mouth/anus/penis.
    • Symptoms: None to a lot. HIV may lead to AIDS without treatment.
    • Treatment: HIV is generally incurable, but those that are positive are able to live full lives with modern anti-viral drugs. The problem is that these can cost a lot of money.
  2. Herpes Simplex Virus (HSV-1 and HSV-2)
    • Oral Risk: High transmission risk.
    • Symptoms: Watery lesions in the skin around your mouth, anus, or genitals that come and go.
    • Treatment: HSV-1 and -2 are incurable. They can be treated with antiviral drugs which reduce the outbreaks and lower chance of transmission.
  3. Gonorrhea (aka, the Clap)
    • Oral Risk: High transmission risk. Gonorrhea can spread from mouth to anus, mouth to penis, penis to mouth, and anus to mouth.
    • Symptoms: Painful urination and penile discharge are classic signs of gonorrhea for a guy, but you can also get it in your throat and anus. Oral gonorrhea can present itself with a sore throat and rectal gonorrhea can involve anal itching, blood or mucous in stool, and soreness. Both oral and rectal gonorrhea can be asymptomatic, however.
    • Treatment: Gonorrhea is a bacterial infection that can be treated with antibiotics, but the bacteria is mutating rapidly to become resistant to current medical treatment.
  4. Syphilis
    • Oral Risk: High transmission risk.
    • Symptoms: Primary stage: An open sore on the initially infected area (lip, tongue, anus, penis, etc). Secondary stage: Rashes, swollen glands, headaches, and fever. Latent stage: No symptoms. Late stage: Organ damage, blindness, paralysis, and/or mental illness. Damage can result in death.
    • Treatment: It's a bacterial infection, so antibiotics will get rid of syphilis.
  5. Chlamydia
    • Oral Risk: Penis-to-throat and throat-to-penis transmission is possible
    • Symptoms: Usually no symptoms in the throat, but can cause a sore throat. If left untreated, chlamydia can cause eye problems.
    • Treatment: Chlamydia is also a bacterial infection and can be treated with antibiotics.
  6. Hepatitis A, B, & C (HAV, HBV, & HCV) (Hepatitis is simply the inflammation of the liver. It can be caused by a number of things, but I'm focusing on the viral infections here)
    • Oral Risk:
      • HAV: High risk for the person performing anilingus on a person that is infected.
      • HBV: Low transmission risk because blood transfer is necessary
      • HCV: Very low sexual transmission risk, also because blood transfer is necessary
    • Symptoms: Jaundice, fatigue, loss of appetite, and nausea. Sometimes there are no symptoms (especially with HCV).
    • Treatment:
      • HAV: Your body usually fights it off within a couple of months with no lasting harm. There's also a vaccine.
      • HBV: Your body will fight it off, but it's a little tougher to do so than HAV. Vaccines are usually given in middle/jr. high in the U.S.
      • HCV: May be incurable, but sometimes your body fights it off over time and antiviral medicines help out tremendously. There is not a vaccine for HCV.
  7. Human Papillomavirus (HPV)
    • Oral Risk: High transmission risk. HPV is spread through skin-to-skin contact.
    • Symptoms: There are many strains of HPV. Some cause warts, some may cause cancer, most of the time nothing happens. Throat, penile, and anal cancers are possible from certain strains of HPV, but are unlikely. This is the scariest part for me, albeit rare, is that you can get warts in your throat!
    • Treatment: Your immune system usually gets rid of the virus after a while. Warts can be removed with acids or freezing at home or with the help of a doctor. There's also a vaccine called Gardisil that prevents infection of 4 strains of HPV. Two of which cause 70% of cervical cancers (which can also cause cancers in men), and two of which cause 90% of warts. I'm looking into getting this vaccine as soon as possible.
  8. Parasites
    • Oral Risk: High risk for the person performing anilingus.
    • Symptoms: Symptoms may include diarrhea, fever, and stomach pain, but can vary depending on the parasite. For example, Pinworms will mainly cause anal itching.
    • Treatment: Varies based on parasite.
  9. Other Bacteria (E. coli, salmonella, shigella, etc.)
    • Oral Risk: High risk for the person performing anilingus AND high risk of UTI for a guy who receives fellatio after person performing it performed anilingus (i.e., don't rim then suck).
    • Symptoms: Symptoms may include diarrhea, fever, and stomach pain, but depend on the infection.
    • Treatment: Typically antibiotics, but many varieties of bacteria are growing resistant to antibiotics.

Conclusion

Unprotected oral sex is much less risky than unprotected anal sex, but sex is never risk-free. Knowing what the risks are and how to minimize transmission is important to you and your partner's health. Also, bad breath is a turn-off, so do something about it!

Some Additions by godot613

  1. In general STDs often coexist. You should ask to get screened for ALL of them.
  2. STDs are reportable by law.
  3. Syphilitic chancres are painless and often present on the penis as demarcated regions that do not have pus or pain but with small bubos (swollen lymph nodes). Syphilis and HIV together are a disaster. Syphilitic lesions increase the likelihood of the spread of HIV. HIV predisposes to neurosyphilis.
  4. Chancroid (H. ducreyi) is painful, prurulent (has pus), with a jagged margin with large bubos.
  5. Herpes (HSV2) is painful, oozes pus, has an ulcerating margin, but does not have a bubo. It is highly associated with relapse. Multiple vesicles ulcerate because of friction from underwear. Initial infection presents with systemic symptoms with enlarge regional lymph nodes. Subsequent bouts gradually become less severe. Shedding of the virus is possible even if no lesions are present.
  6. Chlamydia causes LGV that is painless, with a huge bubo, presenting with thickening of the skin but no penile ulcer.
  7. Men who have sex with men are more at risk of contracting painless STDs (e.g. syphilis) because the lesions can hide in your ass.
  8. N. gonorrhoeae sucks because it a discharge with a lot of pus, usually. Can be asymptomatic. Can cause proctitis or pharyngitis. Your strep throat may not be strep throat. It could be gonorrhea! The pharynx of men who have sex with men were colonized in 5% of cases in a 2006 study (SR Morris, Clin Infect Dis 43:1284, 2006).

Edits

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