How long does shingles last?

My first question when I discovered I had shingles was "how long will this last?". Unfortunately, there doesn't seem to be any good answer. For mild outbreaks that are treated promptly, shingles may resolve in as little as two weeks. For more severe outbreaks or those not treated in time, shingles may persist for several weeks, and the pain may not subside for weeks, months, years, or forever.

When shingles pain persists beyond 4 months, it is classified as postherpetic neuralgia (PHN), aka "forever pain".  At week 5 of my shingles outbreak, my pain is still active and I live in fear of PHN. On the plus side, however, I've felt improvement in the last two nights, with last night being markedly better than the night before.

Hopefully I will have an even better night tonight than I did last night, and just progressively keep getting better and better.

That would be so awesome.

--

Medical marijuana for shingles

I read somewhere that the shingles virus interferes with the nerve's morphine receptors and hence morphine (and derivative drugs) aren't very effective pain relief. I can attest to having been given several doses of morphine at my first ER visit for (later to find out) shingles and the relief was both incomplete and very very short-lived.

Conversely, I read somewhere else that cannabis receptors are left intact in the nerve and, following that theory, pot smoking should relieve the neuralgia (nerve pain) brought on by shingles. After further reading, it turns out there are different varieties of medicinal marijuana (who knew?!) and getting the right relief means getting the right variety.

In the case of shingles or postherpetic neuralgia, the applicable strain appears to be cannabis indica. This strain is apparently sometimes referred to as night-time weed because it allegedly has a more relaxing, sedative effect - a body buzz instead of a high, if you will.

Cannabis indica also reportedly helps relax bladder muscles and stimulate the bowels, side effects that may be helpful in the treatment of neurogenic bladder or neurogenic bowel complications of the shingles virus.

Self help for shingles virus

I've read lots of self help tips for managing shingles pain and hastening the recovery from the shingles virus. Following is a list I compiled of potential shingles treatments:
  • Tagament (Cimetidine) 200mg 3x per day and 400mg at bedtime
  • Lysine supplements
  • Suppressing arginine consumption
  • Ice packs alternated with warm baths / moist (not dry) heat
  • Bee pollen (4 teaspoons once a day)
  • Apple cider vinegar dabbed on rash several times per day
  • Cayenne pepper cream on rash
  • Cod liver oil (immune system booster)
  • Vitamin C (immune system booster)
  • Manuka honey (some put it on rash, some ingest it; has antiviral/antibacterial properties)
  • Olive leaf extract (must be prepared to drink a lot of water if trying this)
  • Lidoderm / Lidocaine patches (can use up to 3 simultaneously, must not place over rash)
I've been trying all of the above. At week 4, I don't seem to be any better. Still waking up in the wee hours of the morning in a great deal of pain. On the plus side, I recently had a 48 hour break from pain which is by far the longest I've gone yet. However, it didn't last and when the pain did come back, it was as bad (if not worse) than before.

In fact, sadly, when the pain came back none of the shingles pain remedies I had successfully used before did any good. This included ice packs, soaking in a warm bath, and applying multiple Lidoderm patches.

I know I'm not very encouraging and I'm really sorry about that. I wish the news was better. I know there are a lot of folks out there also suffering who would like to find out that something - anything - works. I plan to continue all of the above methods, while also looking for something more effective.

I'll keep you posted.

Shingles pain worse at night

It's an extra twist of cruelty - where sleep might help a shingles victim recover better, the pain from shingles is much worse at night. I think the resulting loss of sleep exacerbates things, making it even harder to recover due to lack of sleep and the associated stress that causes.

Because hot baths reduce my shingles pain, many nights I've resorted to sleeping in the bathtub. It's a dangerous move and I realize that, but I'm so desperate for sleep that I chance it. When the water starts cooling, the pain comes back and it wakes me up. Sometimes I'm so exhausted, I just let out some of the water and refill with hot so I can grab another extra bit of sleep.

I think I need to find an adult swim collar to be on the safe side.

If my work schedule permits, I'll even go to bed as early as 7:00 at night - just to get in 4 or so hours of decent sleep before the pain wakes me up. Then I'll try to catch another hour in a hot bath. By 2 or 3 a.m. I'll put on a Lidoderm (Lidocaine patch).

Somewhat counter-intuitively, drinking hot coffee also helps me. Perhaps it's because I personally find sipping hot coffee to be relaxing. Or maybe the coffee stimulates the nerves similar to the way that Ritalin overstimulates and helps folks with ADD focus better. The over stimulation theory has some legs - I've read of some shingles sufferers deliberately causing more pain to the affected area because they claim it helps. I've not wanted to put that to the test, so coffee is it for me.

I should point out that I'm a long-time coffee drinker and caffeine doesn't seem to affect me. I can drink a pot of coffee and fall asleep directly after. If you're sensitive to caffeine, I imagine it could make the shingles pain even worse. I think it probably works for me just because I actually find coffee relaxing, not stimulating.

I've also been trying to minimize stress as much as possible, trying to stick with lighthearted or funny movies, listening to classical music, meditating, and doing gentle stretching exercises often. Combined it all helps but I'm getting sick and tired of spending 24/7 either in pain or working to prevent the onset of pain.

I hate shingles.

Shingles jokes

Knock Knock
Who's there?
Shingles.
Shingles who?
Shingles who gonna pwn you.

Why did the shingles virus cross the road?
To laugh at the 100 car pileup of inflamed nerve endings it caused.

What did the shingles suffering husband say to his lovely pain-free bride?
Fuck you.

What do you get when you cross the shingles virus with morphine?
Two seconds of pain relief followed by hours of unrelenting agony.

The shingles virus walks into a bar. Everyone leaves.

--

tl;dr: Shingles is no laughing matter.

If shingles was a computer virus

If shingles was a computer virus, it would be a rootkit-enabled malware that launched a man-in-the-middle attack against your central nervous system. The shingles virus hides in the nerve ganglia of its choice, exploiting any vulnerability it can to replicate through accessible nerve paths. After successful replication, the virus launches an additional attack against the epidermis.

In addition to causing hardware damage via nerve inflammation, the shingles virus also intercepts and manipulates nerve signals. Typically, the virus manipulates the nerve endings in the skin, tricking the brain into believing the skin is under attack by an army of tiny unseen enemies equipped with razor sharp tiny burning swords. As a result of the dual assault resulting from real nerve inflammation and spoofed epidermal pain, the victim system is typically rendered defenseless.

The shingles virus also includes the ability to steal sleep, cause loss of appetite, and force the victim system into endless pacing. In addition, the shingles virus includes a ransomware component, causing the victim to engage in mental bargaining in hopes of achieving a pain-free break. As with most ransomware, victims who do engage in this bargaining will find their efforts to be fruitless.

The shingles virus is dropped by the chicken pox virus, therefore any system previously infected with chicken pox is at heightened risk of a shingles infection, regardless of age or health.  Visible signs of a shingles virus infection often includes a rash on one side of the body (often delayed). Depending on the operating system, this rash may be small or large. Other symptoms include burning pain concentrated in one area on one side of the system, followed by a feeling of a vice-like grip throughout the affected zone.

While antivirus signatures are effective at detecting the shingles virus, they are not capable of cleaning a shingles infected system. However, if antivirus is employed within 72 hours of onset, it may reduce both the severity and longevity of the attack.

tl;dr: Shingles sucks.

Lidoderm (Lidocaine Patch 5%) for shingles pain

Shingles hurts. So much focus gets put on the skin rash but for most folks, the skin rash is pretty secondary to the whole thing. It's the nerve that is being inflamed by the shingles virus that is screaming painful. Any nerve can be affected and from there the pain radiates along three circuits, or so the doctors have said. In my case, the virus attached itself to my sciatic nerve. A lot of folks get it in their optic nerve, which personally I think would be way worse. And that's saying a LOT, because shingles in the sciatic nerve is very very painful.

In a previous post, I wrote about alternating ice packs and warm baths to help cope with the pain of shingles. While that method does help, it requires significant time investment. I went searching for more immediate relief. Before I get to that, let me just say that when I first started my desperate quest for a diagnosis, I was given several doses of morphine by the first doctor. Morphine took the edge off the pain very very briefly (hence the several doses). Effectively, it was useless against shingles pain.

That doctor also gave me a prescription for 5mg of percoset which proved to be equally ineffective. Another doctor upped the dose to 7.5mg of percoset. That worked better, but I would only be pain free for 3 hours of a 6 hour dose - but loopy throughout. The small amount of pain relief coupled with the loopiness made me shelve percoset. Besides which, percoset is an addictive narcotic and not something I wanted to rely upon to begin with.

My search for more viable pain relief led me to ask my doctor if I'd be a candidate for the Lidoderm patch. She thought I would so she kindly wrote a prescription. So far, I'm pretty impressed. The pain for me runs back to front so I cut the patch in two and put half over the pain point in the back and the other half in the front.

You cannot put the lidocaine patch on the rash itself! This is very important! I was extremely fortunate that my rash was tiny to begin with and in an area that was off to the side of the worst pain points so I was able to sandwich the patch in just fine.

Relief from the patch comes in about 20 minutes. It's the same level of relief (aka pretty darn good) that would ordinarily take me 4 hours of alternating cold and heat to the area. Coupled with my Tagament trial, I'm feeling hopefully optimistic. I'll keep you posted.

Tagamet (Cimetidine) and shingles

Desperate times call for desperate measures. After three weeks of battling shingles' pain, I could totally relate to that old saying. Over the course, the pain has led me to buy lots of books, Google lots of sites, and ask anyone I knew that had ever had shingles lots of questions. One thing that bubbled to the top in all of this was Tagament, the stuff you take for heartburn and acid indigestion.

Apparently, the active ingredient in Tagament (200mg of Cimetidine) may help reduce the longevity and severity of shingles. In fact, possibly as much as antiviral meds do and possibly with fewer side effects. So why is Tagament (aka Cimetidine) not being touted as a shingles treatment?

It turns out that the drug is no longer protected by patent, which in layman's terms means there is no money in it for the drug companies and hence no incentive to do the clinical research. But there have been some limited trials, one of which (the kickoff of it all, if you will) was a fluke.

A woman had been prescribed Tagament for heartburn just days prior to coming down with shingles. Her recovery from shingles was so swift, the doctors decided to do further studies - all of which seemed to indicate that shingles could be shortened / lessened via Tagament treatment. The dose they used was 200mg three times a day with a 4th does of 400mg (2 tablets) taken at bedtime.

Enter human guinea pig - I purchased Tagament and am giving it a go. Bear in mind that at already 3 weeks into shingles with no other treatment, I don't expect any miracles. But if I can get even a little relief, it will be welcome.

Yesterday was the first day I took Tagament and only got 2 doses in before my bedtime double dose. In other words, too soon to tell. I will say this, however. Tagament made me sleepy which isn't ideal but doesn't totally suck either. I was falling out and had to have a nap after my second dose. I set the timer on my phone to wake me up in an hour - and I reset that timer into a two hour nap.

On the one hand, I was supposed to be working and two hours down was a lot more than I could afford to miss. On the upside, it was a great sleep that I sorely needed. When I took the double dose at bedtime, I fell asleep much faster than I have since contracting shingles (within minutes, really) and I slept a solid four and a half hours before the pain woke me back up.

Four and a half hours may not seem like much, but it's about double what I have been getting. Combined with the two hour nap I got earlier in the day, I was pretty happy.

Is it the Tagament kicking in already? Who knows. It could just be a placebo effect or it could be just the act of it helping me finally at least get some amount of sleep. Either way, I'm happy and plan to continue the Tagament treatment. I'll post back in a few days and let you know how it goes.

My (too long) quest for a shingles diagnosis

To treat shingles, you must get on antiviral meds within 72 hours of its onset. Unfortunately, my experience revealed that 4 out of 5 doctors have no clue as to what the symptoms of shingles are. TL;DR - it took me ten days and multiple doctors to finally get what should have been a simple diagnosis of shingles.

Quick background: the pain started suddenly, as if someone had stuck a hot poker through my sciatic nerve. My entire lower right hip was in agony. Apparently, though, location of pain isn't that important to most doctors. Although, at least in the case of shingles, it really really should be.

The first doctor I consulted ordered an ultrasound and CT scan but found nothing conclusive besides some stones in my gall bladder. Which for reference, is located way north of where the pain was. Though I told the doctor those stones had been there for a few years and I was certain were not the cause of the pain (not to mention not even near the site of the pain), he recommended me for follow-up with a surgeon specializing in gall bladder surgery. Strike one.

Strike two was the first doctor's partner, who called me three times the next day to insist I come in on an emergency basis for gall bladder surgery. To get him off my back, I agreed to see the surgeon first thing the next morning, fully intending to ask that surgeon to re-examine me first.

Fortunately, that surgeon did prove to be wiser than the previous two doctors. He re-examined me and said while he didn't know what was wrong, the pain almost certainly was not being caused by my gall bladder. I will never be able to thank that surgeon enough. Had I had that surgery, not only would it have been unnecessary but the stress on my body would have been even worse and there's no telling what impact that would have had on my (then still undiagnosed) shingles. The surgeon was strike three, but I don't blame him. After all, he's a surgeon. It would be like expecting a great chef to also know how to fish. (Him, the surgeon, being the great chef, of course).

After the surgeon, I visited another doctor who unfortunately was no better than the first two (surgeon excluded). She tried to convince me that scar tissue had pulled my gall bladder down so it was seated closer to my hip. Even though the CT scan showed all my organs in their proper place? Even though the surgeon had already struck down the gall bladder theory? Really? Wow.

After telling her (I thought nicely) that I really wasn't willing to consider her 'gall bladder has moved' hypothesis, she then prescribed muscle relaxants and a laxative - which is doctor-speak for "you contradicted me so therefore you're a hypochondriac who needs to take a chill pill and a poop".  And frankly, I think she's a quack. But whatever. Strike four.

Finally, the 5th doctor I visited (fifth!) nailed it. Even before I finished describing the pain, he immediately diagnosed shingles. Yes, I now adore that doctor. Yes, I think he's a very good doctor and very smart. But do I think he's a genius or that it takes a genius to diagnose shingles? No. He was, perhaps not so simply, just a very good doctor who cares enough about his patients to actually hear and weigh what they are saying. And he knows his shingles, thank goodness.

So what went wrong with all the others? I think back to that first visit at the first doctor, when I was still well within the 72 hour treatment period. Now that I've had a chance to learn all about shingles, (much of it from firsthand experience!) I realize there were so many clear shingles indicators it boggles the mind as to how any of them missed it.

First, the pain itself was so very typical of shingles pain. In addition, I'd complained about decreased urination, which (I've since learned) is another hallmark of shingles if the sciatic nerve is involved (which mine was). They even cath'd me before the ultrasound and the nurse kept commenting on the volume of urine that resulted (a lot!) and how unusual that was. A common side-effect of contracting shingles in the sciatic nerve is its effect on the bladder muscles, aka the bladder fails to contract so therefore you do not know you need to pee. I didn't know this at the time, of course, but shouldn't they have known?

Neither morphine nor percoset would alleviate the pain, at least not for very long. I've since learned that both morphine and percoset aren't very effective at abating the pain from shingles and their ineffectiveness is itself a valuable clue for shingles diagnosis.

Two of the earlier doctors I consulted did at least ask if I had a rash. But I did not. In hindsight, perhaps they thought that was a valid check for shingles. But I've learned - just from reading Google searches - that shingles quite often presents without a rash. After all, shingles is an acute inflammation of a nerve ganglia, not a skin condition. Rash optional. Maybe what's needed is for more doctors to read Google searches?

In any event, doctor #5, the only one that nailed it, knew right away - just based on the pain symptoms - that it was shingles. He only asked about a rash after he'd made the diagnosis. By that point I actually did have a teeny tiny row of dots - hardly something I would have called a rash and it was very late into the progression (a full 10 days after the onset of the pain).

So what have I learned from all this?
  1. An awful lot of doctors have no idea what shingles really is. They're looking for skin eruptions when they should be listening to pain descriptions.
  2. If you're not careful, a missed diagnosis of shingles can lead to unnecessary surgery with all its accompanying risks.
  3. You only have 72 hours to get treatment. Be persistent. If there's even the slightest suspicion of shingles, insist that the doctor do a simple blood test so you can start the appropriate treatment immediately if necessary.
  4. If I ever do really need to have my gall bladder removed, I will go right back to that surgeon who was kind enough to re-examine me beforehand and nixed the procedure.
  5. A good primary care physician is a gold mine. If there's any good that came out of this, it will be finding doctor #5.
I wrote this blog in the hopes that it might help someone else avoid what I went through. For anyone out there suffering from acute or chronic pain of any cause, you have my deepest heartfelt sympathy. May you find a cure.

The tell-tale signs of shingles

Shingles is not a skin ailment, regardless of what some websites may claim. Shingles is an acute inflammation of a nerve ganglia (see "What is shingles" for the real truth about shingles).

Shingles can happen to anyone, at any age or any level of health, who has ever in their life had chicken pox. Which means, everyone who has ever had chicken pox is at risk. You have no more than 72 hours to get on antiviral meds to curtail shingles. If you don't get on them within 72 hours you are out of luck and will have to let shingles run its course, in which case you will be at higher risk of long term complications (aka 'forever pain').

Incidents of shingles are on the increase, ironically thanks to the effectiveness of the chicken pox virus. Since we aren't getting re-exposed to chicken pox as adults, our immunity to it wanes and lays the groundwork for the dormant shingles virus inside us to take hold.

 Make sure you know what the real tell-tale signs of shingles are:
  1. A sudden onset of burning unexplained pain, confined to one specific area on only one side of the body. 
  2. The pain will quickly lead to a feeling that the area is in a vice grip; like it's cramping or being squeezed (if you've ever given natural birth, think labor pains in one specific area). 
  3. A day or so after the onset of pain, you may experience numbness over the entire affected area. The numbness does not alleviate the pain - instead it feels like there is a deep layer of pain covered by a more external area of numbness just under the skin.
  4. A rash may or may not appear and may be quite small if it does. Do not rely on the presence of a rash as your guide. If it's there, it just makes the diagnosis easier; the absence of a rash means nothing either way.
If you have the tell-tale signs of shingles described above, insist on a blood test to check for shingles and see if you're a candidate for treatment. Remember, you have only 72 hours to act.

Keep a shingles pain diary

Being in chronic pain is no picnic. Being proactive can help alleviate some of the stress that pain causes. When I was first told I had shingles, I knew nothing about the virus except that it came from chicken pox. I also had a lot of misconceptions about who got shingles, which you can read all about in my post "How it all began". This post is about one proactive step I took that has really helped me a lot: keeping a pain diary.

After finally getting a shingles diagnosis, I was able to approach the pain in an almost analytical, philosophical way. I wasn't sure I could beat it, but I at least thought I might be able to manage it better. I knew I needed to pay close attention. I also knew some days were just much worse than others. I decided to keep a pain diary to see if I could narrow down a cause, logging what I ate, drank, when I slept, used the bathroom, etc. While it might seem obsessive to some, keeping that pain diary ended up being a lifesaver. Or, at least, a pain saver.

Because of the pain diary, I quickly realized that certain foods were triggers. Most notably, red wine, which might seem a no-brainer. But some things that bubbled to the top weren't as obvious as perhaps alcohol (in any form) should have been. Oatmeal, as an example. I love oats. And they're so good for you! Yet every time I ate oats, hours later I would be besieged by heightened levels of pain.

It was because of the pain diary and realizing the oats = pain connection which led me to discover arginine and its impact on shingles. Turns out that whole grains (including oats) are high in arginine and any food high in arginine promotes the virus.

The pain diary also helped me realize that my most pronounced pain occurred after 11 p.m., usually between 2-4 a.m. in the morning. So I switched sleeping habits, going to bed at 6:30 p.m. to get enough hours of sleep in before the worst pain started. Being well rested has made an enormous difference.

In short, everything I learned about coping with the pain of shingles came about because I kept a pain diary. I also believe keeping a shingles pain diary helped me psychologically (which is important!) because it helped me feel some measure of control, thereby reducing my stress. Since stress naturally makes pain worse, anything that reduces stress is a good thing!


Coping with the pain of shingles

I'm a mom that went through natural childbirth. I know pain. The vice-grip that is shingles feels a lot like labor, just very concentrated in one particular area. In my case, my right hip. The doctors prescribed percoset but (a) percoset didn't do much to alleviate the pain, at least not for very long; (b) even if it had worked, I can't function at work on pain meds, and (c) percoset is addicting which scared me too much.

As a result of my pain meds reluctance, I had to develop other pain management strategies. Following are a few things I've learned to help deal with the chronic pain caused by shingles. Depending on which part of your body shingles occurred, not all of these tips may be applicable.
  • Start with an ice pack on the affected area. (See below for how to make a great homemade slush pack). Be sure to put the ice pack in a pillow case or wrap once in a towel - do not apply directly to the skin. This is especially important for shingles sufferers who are also experiencing numbness in the area - you don't want to end up with frostbite on top of all the pain! The standard advice is to use an ice pack for only about 20 minutes. I think that advice comes from folks who have never had shingles. I generally leave my ice pack on for an hour or more. (Yes, that may sound extreme, but so is the pain of shingles). Just be sure to have some barrier (be it a towel, pillowcase, clothes, etc) between the ice pack and your exposed skin!
  • Follow up the ice pack application by soaking in a very warm bath with either epsom or sea salt added. If you're only soaking the affected body part and you're also experiencing numbness, be sure to check the temperature of the water with a non-affected body part so you don't inadvertently burn yourself! If you can't soak the affected body part, warm moist compresses may help. The moist part is important; I found dry heat (aka a heating pad) to actually cause more pain. You mileage may vary.
  • After you've soaked and dried off, gently pat down the entire affected area with apple cider vinegar. If shingles is in your eye area, you want to be very careful not to let the vinegar get in your eye or on your eyelid or directly under the eye. (And you have my deepest sympathies, seriously).
  • Whenever you are most pain-free, try to sleep. My worst pain tends to occur sometime after 11 p.m., usually between 2 and 4 a.m. I've given up a social life and have been getting to bed by 6:30 p.m. just to get enough hours of sleep in before the pain wakes me up. The more rested I am, the better I seem able to manage the pain effectively.
To make a very effective homemade icepack:
  1. In a large ziploc bag (the kind with a good seal) mix 1 cup of vodka (or rubbing alcohol) with 2 cups of water. 
  2. Squeeze out as much air as you can, seal the bag, and place inside a second ziploc bag. 
  3. Squeeze as much air out of that bag as well, then seal and freeze. 
The alcohol keeps the water from fully freezing, creating a slushy ice pack that will easily mold to whatever body part you need it on. Besides being so wonderfully pliant, the slush pack doesn't sweat as much as a bag of ice does - meaning that your bed, couch, whatever, won't get soaked. Plus, the slush pack stays much colder much longer than ice alone does (go figure!). 

Why did I get shingles?

I'm healthy, young enough, no indicators that would point to heightened risk. So why did I get the shingles virus? I have a theory.

L-arginine.
A couple of months prior to contracting shingles, I had switched from drinking cow's milk to drinking unsweetened almond milk instead. As I have since learned, nuts are a high source of L-arginine, an amino acid that, while great for muscle building, apparently promotes the growth of the shingles virus. The opposite or L-arginine (from a shingles standpoint), is L-lystine which helps inhibit the virus.

Turns out that almond milk is very high in L-arginine and has very little L-lystine. Google 'arginine and shingles' and you'll find lots of body builders who supplemented with arginine complaining about coming down with shingles.

I'm definitely not a body builder but I was drinking almond milk everyday in the two months leading up to shingles. I was also eating more shellfish than I had in the past which, as it turns out, is also high in L-arginine. Another contributor - I had been drinking coconut water a few times a week for several months. Guess what's also high in L-arginine? Yep, coconut water. :-(

Obviously, I can't say for certain that my inadvertent high intake of L-arginine led to my shingles outbreak. But the only lifestyle change I'd made in the 2 months prior was the switch to almond milk and eating lots of shellfish. Unbeknownst to me, by doing so I had inadvertently increased (by a LOT) the amount of L-arginine I was consuming.  My coconut water habit, though very moderate, wasn't helping. And by giving up dairy, which contains the protective L-lysine, I think my bid for that "healthier diet" inadvertently delivered the one-two punch the shingles virus needed to overtake my immune system.

Ironically, the cow's milk I had given up is high in L-lysine (as are all dairy products) which would have helped keep the shingles virus in check. I've since switched back to real dairy and, as much as I love it, will probably never drink almond's milk or coconut water again. In addition, I've started taking a supplement for L-lystine, just in case.

The shingles vaccine: hype or not?

We've all seen the Merck commercials pushing the shingles vaccine. There's a before and after aspect to my life now. Before I had shingles, I would do an inward eye-roll every time the shingles vaccine commercial came on. (Sorry, Merck!). After getting shingles, I wish they would change the ad to be even more urgent sounding than it is. In fact, after getting shingles, I honestly don't think Merck can overstate the risk, given the pain shingles causes and the possible life long (forever pain) complications it may present.

At the time of this writing, the vaccine is only approved for folks 50 or older. Just previous, you had to be 60 to get it. That age requirement aligned well with what I formerly thought about shingles - that it was an old person's disease or those with compromised immune systems. Boy was I wrong - and that wasn't the only misconception about shingles that I had.

I also thought shingles was pretty uncommon. And apparently it used to be. The problem was that I was relying on old information and had never bothered to update my knowledge about shingles. In fact, I'd never actually researched it at all.

The reality is that shingles is on a major uptick. Ironically, the success of the chicken pox vaccine given to children has led to fewer adults getting a second exposure to the virus. That second exposure would cause a new immune response, bolstering our defense against shingles for years to come. No second exposure = no increased boost = higher than ever rates of shingles. Even among younger and otherwise perfectly healthy adults.

Why the age limit on the vaccine? I can only speculate, but from what I've read thus far, the initial demand for the vaccine outpaced the supply. Merck ended up opening a new facility to produce the vaccine and thus provide a steadier supply. That's when the age limit was lowered to 50. I'd love to see that age limit decreased further, making it available to anyone 35 or older.

Some sites pooh-pooh the vaccine, stating that it's only 51-80% effective (depending on which site you look at). Honestly, shingles is so bad that if there's something that can reduce the risk of getting it even by half, it is so worth the vaccine. If you're old enough to qualify, see your doctor and ask for the vaccine.


What is shingles?

In many people's minds - sadly, also including doctors - shingles is synonymous with a painful skin rash. In fact, nothing could be further from the truth. Oh sure, there might be a rash. And it might be painful. Or there might not be a rash. A rash is not the tell-tale symptom of shingles. The pain, however, is.

Shingles is an acute, extremely painful, inflammation of the nerve ganglion. Whichever cluster of nerves is impacted dictates where the pain will occur and also how severe it will be. According to the doctor who finally diagnosed me, the chicken pox virus hides in the nerve ganglion that was closest to the biggest outbreak of the chicken pox. Some folks have the virus hiding in their optic nerve. When that happens, it's called 'occular shingles' and can result in vision loss. Shingles is serious stuff.

In my case, shingles struck my sciatic nerve which - in addition to excruciating pain throughout my right hip - also resulted in some urinary and bowel disorders. Basically, my nervous system was shot in the entire area, which made it difficult to pee or poop. (Sorry if that offends anyone!).

Despite its name, shingles is not a plural. It's singular and is based on the Latin word 'cingulum' which essentially means a band or girdle. Anyone who's come down with shingles can probably attest to the fact that it feels like there's a vise-like grip on the affected area.

As mentioned, shingles is serious stuff. In worst case scenarios, it can affect the brain, liver, and lots of other internal and critical organs. Left untreated, victims are at high risk of what's known as postherpetic neuralgia, a fancy term for what I've come to call simply 'forever pain'.

To reduce the risks, you have to be treated with antiviral meds within 72 hours of onset of the pain (or rash, whichever comes first). That is a hard fast 72-hours so if you suspect shingles, don't delay. Get to your doctor immediately and ask to be tested.

And remember, shingles can strike at any age and anyone who has had chicken pox, regardless of how healthy or old they are, is at risk of shingles.

How my shingles (and this blog) began...

It started innocently enough. Drinks and dinner with a few friends & co-workers. Relaxing, engaging conversation. The night was still pretty young. The pain struck seemingly out of nowhere, as if someone had suddenly impaled my lower right hip with a red hot iron. It took 10 days, 5 doctors (including 2 trips to the ER!) before I finally got my diagnosis.

I had shingles.

Unfortunately, treatment for shingles is only effective if diagnosed within 72 hours, in which case they can prescribe some pretty harmless antivirals. Since I was 10 days out, there was nothing doctor #5 could do - although I was (and still am) extremely grateful just to have a diagnosis.

From my experience comes this blog, in the hopes that someone may be spared the agony I went through. Before getting started, here are a few key points everyone should know:
  1. Shingles does not always start with a rash; pain is quite often the only symptom. In my case, ironically, along with the burning pain in my hip was a sensation of numbness across the entire area. No rash appeared for almost 2 weeks and even then it was teeny tiny, only about a 2" area affected.
  2. Shingles can strike anyone, regardless of age or overall health. Google shingles and you'll find plenty of folks from 18 to 80 who have been its victims. If you have ever had chicken pox, you are at risk.
  3. A simple blood test can diagnose shingles. If you have unexplained severe pain on one side of your body - regardless of where - insist on a blood test for shingles. Remember, you only have 72 hours to act; otherwise you're stuck letting the disease runs its course. And without treatment, you're at high risk of forever pain.
If you already have shingles, you have my deepest sympathy. I hope the tips and tricks in this blog will help you find relief from the pain and start the road to recovery.