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Saturday, 1 March 2014

Shingles Is Like The Invisible Man

I was standing in the reception area of my office one Wednesday just heading out to go to see the doctor for a scheduled injection. Suddenly there was a very odd feeling just below my waistline on one side. It was like a vibration, or a sort of buzzing feeling.  I mentioned it to the doctor but he brushed it off as trivial and it had stopped by the time I got there. That symptom is called a prodrome.


Invisible Man

A week later there was severe pain in my back. I went out and got an ObusForme for my office chair thinking it was a back problem, but that and heat did not seem to help so I went to a walk-in clinic for help. After an examination the doctor gave me a prescription for muscle relaxants. They did nothing and I was beginning to doubt the evidence of my own body when the pain moved to the front on the same side.

I went on working though the pain was sometimes in the back, sometimes in the front but always intense. Since my regular doctor was still on vacation I went to emergency. The pain was the worst I'd ever had.  All the doctor there did was give me a prescription for painkillers which I tried once. When that didn't help I got rid of the pills since they also produced nausea.

So after three doctor visits and three weeks of pain I still had no idea what  was wrong with me.

On the weekend our errands included a trip to the local drugstore to pick up a prescription. I started talking to the pharmacist and asking her for ideas to control the pain problems I was having. She asked "Do you have a rash anywhere?" I said yes, I had a very little rash under my belt buckle but assumed it was an irritation. So she said it was likely shingles and I should hurry to the doctor first thing Monday morning. The reason for the rush is that once the rash comes out you need to start anti-viral treatment within 72 hours for the drug to work.

I managed to get an appointment and was given a prescription for Famvir. Unfortunately that made me feel worse than shingles did so I went back to the doctor and she gave me a prescription for Valtrex, another anti-viral which worked well. After a few days I started to feel better.

Shingles is a herpes virus (herpes zoster) and these same drugs are used to treat or prevent other strains of herpes. If you ever had chicken pox there is a chance that you might get shingles, particularly if you are taking immune-suppressing drugs.

Shingles affects defined areas of the body called dermatomes. You can see them in this poster that has been on my doctor's cupboard door for years. She got it from one of the manufacturers of shingles treatments.



If I were not taking immune suppressant drugs currently I would ask for the shingles vaccine. Unfortunately it is a live vaccine and my rheumatologist strongly advises me not to have it.

My advice if you had chicken pox and your immune system is not suppressed would be to ask your doctor about a shingles vaccination.

http://www.ncbi.nlm.nih.gov/pubmed/23932722

Risk of herpes/herpes zoster during anti-tumor necrosis factor therapy in patients with rheumatoid arthritis. Systematic review and meta-analysis.


Comparison of national clinical practice guidelines and recommendations on vaccination of adult patients with autoimmune rheumatic diseases.

2 comments:

  1. Wow, Annette, I'm so sorry you have yet another thing to bear. Thank you for always being proactive and sharing what works, and information that helps someone who's new to the illness. I hope never to experience it myself, but it's some comfort to know I can go to someone who knows. I hope your pain stays down and that you take care. Hugs, Jane.

    P.S. The notify me box isn't working for me. Can you test it at your end to see if you get the same problem?

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  2. Thanks Jane, I'll try to re-install that notify button.

    Luckily this post is about shingles in the past, not a current episode. It really troubled me that I could not figure out what I had, and instead almost doubted my own pain. When your symptoms seem inconsistent and the doctor looks at you with disbelief you are really stuck. It also doesn't help that when you have nerve pain from shingles, or from sciatica there does not seem to be any good treatment for nerve pain.
    With shingles toughing it out is not a great idea because the pain can cause of pain that remains after the shingles is gone. That's called PHN (post herpetic neuralgia).

    Anyway, iI wanted people to know that a new pain with no apparent cause could sometimes be shingles. Forgot to say it runs along the nerve pathways from the area of the back where it originates

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