Wednesday, October 15, 2008

Shingles -- A rare medical post but sadly personal

Feel free to bypass the information in Italics below if you find it a little boring or too much information and move on to the main. I did think of your sensibilities and not include any photos but be prepared if you click the links. Clicking on the schematic diagram to the left give a little more information about the progression of a course of shingles.

Shingles or Herpes Zoster Virus (HZV) is the same virus that causes chicken pox. In fact, in people who have had chickenpox, the virus is never fully cleared from the body; instead, it remains dormant in the nerve tissues. When physical or emotional stresses to the body weaken the immune system, the virus re-activates and spreads along the nerve fibers to the particular area of skin supplied by the involved nerve.

Anyone who has ever had chickenpox is at risk for the development of shingles, although it occurs most commonly in people over the age of 60. It has been estimated that up to 500,000 cases of shingles occur each year in the U.S.

Is it contagious? Only to those who have not had chicken pox and it will be manifested as chicken pox and not shingles for the first infection.

Shingles start as small blisters on a red base, with new blisters continuing to form for three to five days. The blisters follow the path of individual nerves that comes out of the spinal cord. The entire path of the nerve may be involved or there may be areas with blisters and areas without blisters. Generally, only one nerve level is involved.

As with the blisters of chickenpox, the blisters in shingles eventually burst and begin to crust over and heal. The entire outbreak can last for three to four weeks.

Drugs that fight viruses (antivirals), such as acyclovir (Zovirax), valacyclovir (Valtrex), or famciclovir (Famvir), can reduce the severity and duration of the rash if started early (within 72 hours of the appearance of the rash). The addition of steroid drugs may have limited benefit in some cases, but studies have not conclusively confirmed the benefit of steroids in combination with all antiviral drugs. In addition to antiviral medication, pain medications may be needed for symptom control.*

Yes, I have shingles. What a bummer. You know some years ago while I was still working one of my coworkers came down with chicken pox. The whole Pharmacy Department, around thirty people had a blood sample taken to obtain a titre for antibodies to chicken pox. If it showed none, then the plan was that you could not come to work until the incubation period for the disease had passed. My blood showed zero antibodies. I insisted that I had had chicken pox, you don't forget that let me tell you, and they permitted me to work.

So here is the conclusive proof my friends, I definitely had chicken pox as a child. The long dormant virus has made a reappearance in the form of shingles. At first I thought I had a case of hives when the rash appeared two days ago, although I am not usually allergic to anything. A friend suggested shingles which had not occurred to me but a little online research soon convinced me that was probably the cause and today my physician confirmed it.

A week long course of the oral antiviral valacyclovir along with a daily high dose of prednisone should hopefully ameliorate the severity of this disease, at least I'm hoping so. Too much knowledge is not always a good thing.

One of the complications of Shingles is Postherpetic Neuralgia, a painful condition affecting the nerves and skin which can last for months, even years. I am hoping to be one of the lucky ones who escapes it, as it affects under 20% of those who develop shingles.

Trust me, I know only too well there are many worse diseases that I could have and I am very grateful that I have enjoyed good health so far. Those of us who toiled in the Pharmacy Department in my hospital workplace were always happy to be down there rather than patients in the beds upstairs, with their diverse health problems. Mind you, that's not to say you won't hear muttering and complaining from this neck of the woods. It's only early days as yet.


* This information is taken from here. It is not exhaustive nor does it constitute medical advice. If you think you might have shingles consult your doctor immediately since treatment needs to be started within 72 hours after the appearance of the rash to have an effect. If you live in the USA you might ask your physician about the vaccine Zostavax which significantly reduces the incidence of shingles in adults over 60. Recently it has been approved for use in Canada and will be available sometime in 2009.

19 comments:

Crushed said...

Well, I hope you get better soon. Chicken Pox is bad enough.

Incidently, they say you can't get Chicken Pox twice, but my Mum did.

Moggs Tigerpaw said...

Yes, I wish you a speedy complete recovery with as little discomfort as possible.

Liz said...

Oh no, jmb! that's horrid. I hope you make a speedy recovery.

I had chicken pox twice: once as a child and once when my children had it. Horrid, horrid, horrid. Do get well soon!

Dragonstar said...

Oh, poor JMB! Aileni had it some years ago, and it was miserable for him. We were on the island at the time, without easy access to medical help, so I used aromatherapy - geranium oil is specific, and it soothed. By the time he got to the doctor it was already easing, and fortunately he avoided complications.
Get totally well very soon please.

Devonshire Dumpling said...

I am so sorry to hear this as a few years ago I had shingles and the pain was unbearable. I also had to work (or face the sack) and how I crawled round for a few weeks was a miracle. Fortunately I had it on one side of my waist/buttocks but my late Mother and Grandmother had it on their faces and both lost an eye.

There are creams (don't work) there are pain killers (do work) I think its worse with the pain before the rash but unfortunately the pain lingers so make sure you have plenty of pain killers and if it is round your waist/torso then keep light clothing over it. Its getting cold weather so I suggest a light vest with a jumper or blouse on top - just something light over the rash/area.

I am so sorry and I do sympathise with you very much. Look after yourself. Its debilitating and tiring and oh so painful.

Sarabeth said...

I wish for your a short course of it and no pain.

rlbates said...

I feel your pain, JMB. I had what was a "mild" case, but painful enough almost 7 yrs ago now. Turn the temp down on your bath or shower water. If the skin isn't infected/broken, try using a balm or ointment like Aquaphor to heal "seal" the skin. I found that a shirt that fit against the skin was easier to wear than a loose one that kept brushing against the skin as my area was very sensative to breezes, touch, etc. Anyway, take care.

Carver said...

JMB I am so sorry to hear that you have shingles. I have several close family members who have had it (including ones in their 50s) and I've been told to ask my doctor about the vaccine. I haven't done it yet but this post was a reminder which I appreciate. I just hate so much that you are dealing with it as I know it can be so painful. Take good care of yourself, Carver

Ian Lidster said...

My deepest sympathies to you, dear friend. That's a bitch. I've known many people who have had shingles, and know it's not easy or pleasant. Be well soon.

Janice Thomson said...

Oh JMB how awful for you. I sincerely hope this goes away soon. My late Grandmother had shingles so I know what's involved. Do take care my good friend - will be thinking of you.

Vic Grace said...

My dad had that once and I know it can be very painful. I hope you get over it soon.

jams o donnell said...

I hope you have a speedy recovery jmb. I've had shingles myself. Not fun. Take care

CherryPie said...

Oh no! I hope you recover from that quickly, I now how badly people can suffer with it. Take care and look after yourself xx

I just hope I never get it! My bout of chicken pox was quite awful, it spread into my throat.

Dr.John said...

My wife Betty had shingles when she was pregnant with Patrick. It was horrible.

jmb said...

Hoping for the best Crushed, girding my loins.

Thanks Miss Moggs, me too.

Yes Liz and poor you. Thanks

Dragonstar, poor Aileni, glad he didn't get the dread PHN.

DD, that's awful and thanks for the handy hints, I'm glad for all every one.

Thanks Sarabeth.

Ramona, you are too young to have had this, although it seems to affect young ones too. Thanks for the advice.

Thanks Carver. I think they only recommend the vaccine for those over 60 but ask anyway.

Thanks Ian, I am hoping for the best.

Hi Janice, I hope you are OK. This thing seems to attack many who are rather vulnerable already due to aging. Thanks for the good wishes.

Thanks Vic Grace, hoping for the best case scenario.

Gosh Cherrypie, that's awful, hope you avoid the shingles.

Poor Betty, Dr John, that is rather young to have shingles. Obviously all went well in the end.

Thanks for visiting and commenting everyone and for your good wishes.

-eve- said...

You're right; the more you know, the more worried one becomes, sometimes - and yet, with everything there's risk, and statistics don't actually work at all; they're just something to quote :-) am pretty sure you'll be fine :-)get well soon! :-)

Corey~living and loving said...

oh no....I'll be hoping and praying you have a mild case.
Hugs.

soubriquet said...

My sympathies... I was there thirty years ago, and remembering still brings a grimace. The treatment then included some liquid in a bottle with a brush-cap. God knows what it was, but I can't remember, it was supposed to be painted over the affected area three times per day, and felt like liquid fire. After the second treatment (on the soles of my feet!) my wife, in tears, refused to do it any more. I didn't argue. I was probably thinking "Just shoot me now, please".

Gian said...

Shingles usually appears due to a weakened immune system, which could be the result of another disease or trauama. It spreads to a specific region of the body and infects the nerves, sending mixed signals to the brain and resulting in a rash of painful blisters.
It is extremely important to begin treating your condition as soon as possible with the best Shingles Natural Home Remedy. I believe in a natural approach to cure Shingles, as taking drugs or chemical lotions can be quite harmful for your body.