Shingles

Rod

I shared your pain although, thankfully, my meeting with shingles was only on my back.

It is very tiring and people don't appreciate the discomfort that you are in.

I was given tablets by my doctor, I cannot remember the name but remember thinking they were very similar in composition to the Zovirax cream that is available over the counter for common coldsores.

No doubt, one of the more medically trained will be along soon.

Good luck.

In April and May 1994, I had a very serious attack of it.

It sharted as a severe pain and eventual paralysis in the two smallest finders of my left hand. I put it down to some form of trapped nerve, which a GP [not my regular one] agreed with, and said it would pass, but I was weary, and making mistakes as well.

A week later I was much worse, and my real GP took one look at me and told me to take my shirt off.

He was very decisive, and was also furious that the other doctor had missed it. He then gave me two weeks sick note and a prescription for four different medicines. I tentively asked which were completely necessary. He excused me getting the painkillers. I was off work for four weeks in the end [during the 50th anniversay of the D-Day Landings, which I watched on TV, but was really too poorly to appreciate much else], and three weeks after returning to work went to Norway for a fortnight, during which time I made a full recovery.

Apart from Kidney Stones (in 1985) and my hip infection in the late seventies I was never so poorly. It can be very nasty. I believe it can under some circumstances be a killer, if it is not correctly treated...

Fredrik

Stress related. Chill out. Drink red wine

It was stress related then, and that is why it went so bad. It was a week in before it was diagnosed, and truth to tell, that week was even more stressful because I made one or two mistakes which cost me a lot of work to redo as well. I think the GP understood this which is why he layed me off for so long...

Fredrik

You can get tablets for Shingles (Acyclovir or preferably Valaciclovir ). You have to start them within 72 hours of the rash/blisters starting or they are of no use. They will shorten the length of the rash/pain and cut down the risk of post rash pain (post herpetic neuralgia).

Get better soon. I had chickenpox at 26yrs and was off work for a month.

Keith

Get well soon, Rod.
Play some relaxing music and feel better!
Take your doc's advice.
I took Acyclovir some 20 years ago for an extended case of mono. Docs thought it was Epstein-Barr. The Acyclovir helped me feel better for a while.
Moving cities and changing jobs turned out to be the "cure" -- maybe too much stress!
David

Of all times, I developed Shingles about a couple of weeks before my wedding(!!!). In hindsight it was probably the stress of arranging the wedding and general anticipation/nerves that brought it on.

I was relatively fortunate in that it developed on one side of my torso, but sleep was very difficult. Felt like waves of a big sword-like object stabbing me in the side.

My advice is to keep taking the pills (I was on about 4 types of pills), the instructions will say that some of them have to be taken a couple of weeks after symptoms have gone, to prevent nerve damage.

Also it is advised to try and keep your distance from vulnerable people who have not had chicken pox (including kids and elderly). People can catch chicken pox from you, but can't catch Shingles from you.

All the best for you,

Andrew

Hurts like hell doesn't it? I was lucky and only had it on my torso - I blame the stress of getting royally dumped by my then girlfriend and having to be polite about it at work with her everyday thereafter.

Glad to hear there are now some medications, 20 years ago I was told there was nothing could help and that it would pass of its own accord

Bad memories - you have my sympathies.

Regards

Ian

Actually the effect of new anti-virals is fairly marginal. What is more effective is a range of treatments that may help post-shingles pain if it persists. You should consult your doc about this if it becomes a problem.

With regard to 'infectiousness' the story is a little complex. Shingles is a 're-activation' of previous chickenpox infection in a specific region. The blisters contain chickenpox virus and you could theoretically give chickenpox to a previously uninfected individual by direct contact with your affected skin. You cannot pass it on by being around people and coughing around them (unlike passing on chickenpox). You cannot pass shingles on (ie trigger shingles in another person), and contact with chickenpox does not trigger shingles in others.

Got that?

Bruce!

Some information here here and here

Thanks all

Sounds like (so far) I have been reasonably lucky, then.

The doc did prescribe me 800mg Aciclovir tablets, five a day. Coincidentally (or perhaps not) this is also the substance that is in cold-sore creams (Zovirax anyway). I didn't start the pills within 72 hours of the first blister, but perhaps I had used the cream, I can't remember. The blisters are still appearing and seem to be slightly reduced, although maybe I am imagining that. Somone also recommended vitamin B Complex, so I got some of that.

I'll just have to ride it out I guess. At least no anti-biotics therefore no ban on alcohol (although to be honest I don't much feel like drinking*). I'm very pleased about the turn in the weather - somehow bright sunshine was very unpleasant for it, so it's an ill-wind etc.

Cheers

Rod

*this is the definition of me being ill...

o

Rod, yes it is extremly painfull isn't it, I do feel for you. Its the way the disease operates, attacking nerve endings etc. Headaches were so bad I was convinced it was a brain tumor. Very strong prescription pain killers were required. My particular version was stress related (apparently it was to be that or some form of breakdown so my doc said)
My cold sore developed round my left eye, attatced itself to the rear of the eyeball & left me needing glasses due to the scar it left. It was a close call to being hospitalised for that one for a while. Took forever to get over it. Do as they say :- rest, lots of it & NO GOING BACK TO WORK EARLY!

quote:

Originally posted by Keith Tish:
You can get tablets for Shingles (Acyclovir or preferably Valaciclovir ). You have to start them within 72 hours of the rash/blisters starting or they are of no use. They will shorten the length of the rash/pain and cut down the risk of post rash pain (post herpetic neuralgia). was off work for a month.

Keith

I was prescribed these antiviral drugs last year and they were effective. Early diagnosis is essential as if you leave too long, they are less effective. Mine was on my face too just in front of my ear. Week off work was nice I suppose but i didn't actually feel too bad or ill so I felt rather guilty.

quote:

Originally posted by Bruce Woodhouse:
Actually the effect of new anti-virals is fairly marginal. What is more effective is a range of treatments that may help post-shingles pain if it persists. You should consult your doc about this if it becomes a problem.

Oral acyclovir therapy accelerates pain resolution in patients with herpes zoster: a meta-analysis of placebo-controlled trials.
Wood MJ; Kay R; Dworkin RH; Soong SJ; Whitley RJ. Clin Infect Dis 1996 Feb;22(2):341-7.

Meta-analysis of four double-blind, randomized, placebo-controlled trials of oral acyclovir (800 mg five times daily) for the treatment of herpes zoster was conducted to provide definitive assessments of the effect of acyclovir on the resolution of zoster-associated pain. The studies involved a total of 691 patients, and the analysis was performed on an intent-to-treat basis. A range of milestones of pain cessation were evaluated by means of Cox regression models with adjustment for relevant prognostic factors. The proportion of patients with postherpetic neuralgia at 3 and 6 months was also determined. Advancing age and more severe pain at presentation were associated with more prolonged pain. Acyclovir was clearly shown to accelerate pain resolution by all of the measures employed. Benefit was especially evident in patients 50 years of age or older. Fewer acyclovir recipients had postherpetic neuralgia at 3 or 6 months. Overall, the reductions of pain duration and prevalence were approximately twofold.

In the second meta-analysis that included one additional trial, treatment with ACV significantly reduced the incidence of PHN at six months by 46 percent.

The effect of treating herpes zoster with oral acyclovir in preventing postherpetic neuralgia. A meta-analysis. Jackson JL; Gibbons R; Meyer G; Inouye L. Arch Intern Med 1997 Apr 28;157(8):909-12.

BACKGROUND: Herpes zoster is a common affliction in older patients, with up to 15% experiencing some residual pain in the distribution of the rash several months after healing. Despite numerous randomized clinical trials, the effect of treating herpes zoster with oral acyclovir in preventing postherpetic neuralgia remains uncertain because of conflicting results. METHODS: Meta-analysis of published randomized clinical trials on the use of acyclovir to prevent postherpetic neuralgia using the fixed-effects model of Peto. RESULTS: Thirty clinical trials of treatment with oral acyclovir in immunocompetent adults were identified. After excluding studies with duplicate data, suboptimal and topical dosing, non-placebo-controlled or nonrandomized designs, and those using intravenous acyclovir, 5 trials were found to be homogeneous and were combined for analysis. From these trials, the summary odds ratio for the incidence of "any pain" in the distribution of rash at 6 months in adults treated with acyclovir was 0.54 (95% confidence interval, 0.36-0.81). CONCLUSION: Treatment of herpes zoster with 800 mg/d of oral acyclovir within 72 hours of rash onset may reduce the incidence of residual pain at 6 months by 46% in immunocompetent adults.

Not really marginal Bruce. Do you have an email address I can email a review from UpToDate.

Keith

I didn't mean to start an argument...

I don't think I got to the tablets within 72 hours as I believed the first blister was a cold sore for several days and only went to the doc once it has multiplied (five days after it started - visually anyway). However I had been using cream containing aciclovir (zovirax). If taking these pills is to lessen the risk of prolonged pain in the future, that's alright with me. The doctor tells me they're frighteningly expensive

I'd like to know how long the rash (or indeed the whole thing) lasts for. Although I've never really regarded myself as vain, I feel terribly self-conscious. And of course, having not shaved (the mere thought...) I look like a tramp to boot.

Of all the options, I really didn't think I'd be watching the England v TT game alone, with the curtains drawn, whilst drinking cups of tea.

At least I can watch it. I don't think I am experiencing quite as much pain as others apparently have. It hurts, but it's not absolutely unbearable.

Thanks for the kind words, there is some comfort (bizarrely) in knowing others have suffered similarly.

Rod

Rod, it was six weeks before I was allowed to so much as lift a pen. A good friend was so ill he was off for 9 months.
Just rest lots!

quote:

Originally posted by rodwsmith:
I didn't mean to start an argument...

I wasn't trying to disrespect Bruce, please don't take it that way. Rereading my own post it was a little terse, sorry Bruce.

Keith

Keith-no worries.

I was being a little loose in my original post. The effect of antivirals in the acute phase is not especially impressive, I agree that more recent data (since the review I posted first) suggests a reduction in PHN at some intervals but it is still not that impressive actually. A recent UK summary is here. Intrestingly it does not seem to use the references you posted.

Perhaps I was trying to make the point that an anti-viral is not a magic treatment for the condition. Even if PHN is reduced the incidence in treated patients is still quite high.

Shall we leave it at that?

RS
Plenty of time to play with your HIFI - get well soon see you at work!!

quote:

Shall we leave it at that?

More than happy to

Keith

ps Have a look at UpToDate. I use it every day and find it an invaluable resource. Written in such a way as to be perfect for when you have a clinicalquestion and want a sensible answer. It is most certainly not a stuffy textbook/OTM/Harrisons type site.

quote:

ps Have a look at UpToDate

I know that resource but find it a bit 'transatlantic' for my tastes. I tend to use Prodigy most, occasionally GPnotebook but often use NELH to sift the databases. Clinical Evidence is good, not least because it tends to reveal how little is known about most things!

I sometimes feel that the 'summary' sites tend to simplification and the repetition of 'factoids'. DTB and Bandolier provide a fiercely independent antidote to that.

I guess you know all these but I'll post links if you want!

quote:

Originally posted by antony d:
RS
Plenty of time to play with your HIFI - get well soon see you at work!!

Hey fella

I didn't realise you were up and posting on here!
Cheers for the message. At risk of bringing work to the Naim forum, Emma from Avery's called me yesterday...

I have been listening to music, although loud is not very appealing (neither is staring at a screen for any length of time).

Cheers

Rod

PS Buy the new Snow Patrol Album (vinyl = easy). You'd like I think.

quote:

Originally posted by Bruce Woodhouse:

quote:

ps Have a look at UpToDate

I know that resource but find it a bit 'transatlantic' for my tastes. I tend to use Prodigy most, occasionally GPnotebook but often use NELH to sift the databases. Clinical Evidence is good, not least because it tends to reveal how little is known about most things!

I sometimes feel that the 'summary' sites tend to simplification and the repetition of 'factoids'. DTB and Bandolier provide a fiercely independent antidote to that.

I guess you know all these but I'll post links if you want!

I use EMIS which used to give access to "Prodigy", but now has only "Mentor". Mentor seems a bit clunky, perhaps I'll try some other sites. To be honest, I rarely look anything up. I tend to just guess most of the time.

quote:

I tend to just guess most of the time.

Surely not!


I use these mostly when working with GP Registrars (I'm a trainer).

I have to admit to being very happy in my niche in a hospital. I freely admit that I would be so far out of my depth in GP-land that just the thought of it truly scares me.

Uk trained but working in Sydney you can see the heavy US influence on practice here. Astonishly defensive medicine. Your patient asks for a test, you counsel against it, they still want it, they get it. Simple. Might explain why I find UTD a good resource here in Aus.

Enjoy the music.

Keith