Shingles

My poor Ma in Minnesota is having an outbreak.  She is miserable.  Today, graduated from Tylenol to Percocet.  Has the elder in your life had to weather this?  Do you have tips? 

Has she had the shot from her doc???? There's only a short window in which it's effective, so quick action is needed. 

Which part of her body is affected?

When I had it I some years ago, my dermatologist put me on Valtrex and slowly but surely I recovered. Joanne, are you referring to the shingles vaccine? I got the shingles vaccine recently on the advice of my primary doctor because you can get it again. I don't think a patient gets the vaccine while they are in outbreak mode. breal, I am sorry your mom is suffering. Has she seen a doctor?

There's something they give you within the first 48 hours or so which helps to shorten the attack and mitigate the pain. It's like the vax. Because my sister wasn't diagnosed properly she suffered for over 3 months, 2 years ago.

It's quite important for older people to have it because they can get pneumonia and other problems as well with this virus and its effects. 

didn't da George write a blog on his attack a couple of years ago? And maybe Library Lady?

You don't get vaccinated during an outbreak, but starting the anti-viral as early as possible with an outbreak can reduce symptoms/duration.  

Anti-seizure medications are often used instead of or in addition to standard pain meds because they specifically help with nerve pain.  My sister just had shingles and got a lot of relief when they switched her to anti-seizure medication.  If this doesn't work, some people get relief from an old-time anti-depressant (amitryptilline/Elavil).

Valtrex if administered right away helps shorten the duration, but that is in pill form and is an antiviral, I believe. The vaccine won't help if you already have an outbreak. My mother's doctor several years ago said that since she was already having an outbreak (very mild, thank god) she would not recommend the vaccine later either, because the fact that she had the outbreak would lessen the severity of future events. Does that sound right, MJH? Or am I remembering it wrong?

I get cold sores, and anecdotally it makes sense to me, because I know my first outbreak was awful, but the severity has lessened significantly over time with successive outbreaks.

Peggy I was told the opposite. That we need to get vaccine to make sure the future outbreak is not severe. I was very lucky to have caught mine relatively early....not too bad in my case. But hearing about other cases, I did not want to risk getting it again.

Huh. Interesting. So then I have no idea what the doctor was telling us. It was awhile ago, and my brain was reeling from the shock of realizing how bad Mom's dementia had become so quickly, so I guess I remembered it all wrong.

Thank you all.  The onset was a week ago.  Started on her back, has now migrated to her front torso.  Too late for the shot, I think.  She has seen a doctor.  Cold packs are helping, but this is not fun.  Will pass along the suggestion about anti-seizure meds. 

I was on (and am still on) anti-seizure meds when I got shingles about 10 years ago and my pain was extremely mild.  I thought it was a rash.  So maybe there's something to that.

has she seen her doctor? That is probably the best place to start.

That stinks - I'm sorry. My mother had it badly and unfortunately had it in her eye as well. She has some permanent damage.

so who is and when are you supposed to get the vaccine?

conandrob240 said:

so who is and when are you supposed to get the vaccine?

Vaccine is recommended for people age 60 and above. 

Vaccine is approved for people aged 50 and up.

Generally speaking, then, insurance will not cover the cost unless you are 60, but you can get it earlier if you're willing to eat the cost (I don't know the cost).

I think the general worry about giving it earlier is that the immunity won't last long enough to cover your lifetime, and they don't know if/when to give a booster.

Okay. Not in the cards for me yet but I will ask my parents if they've gotten the vaccine, thanks!

I understand that it is now recommended beginning at age 50 (although some insurance companies do not pay until 60.)  I have read that some studies indicate that it works better if you have it in your 50s. I decided to go ahead and get it, with the understanding that insurance might not cover the ~$200 cost. But I never got a bill and it has been over a year, so I guess it was covered.  (Oxford Freedom/United Healthcare)  

sac said:

I understand that it is now recommended beginning at age 50 (although some insurance companies do not pay until 60.)  

Officially, it's approved for 50 and above, but recommended for 60 and above 

I'm also personally in favor of getting the vaccine sooner rather than later, but YMMV.

Ill look into this in a few years for myself for sure.  Is it a one-time vaccine?

conandrob240 said:

Ill look into this in a few years for myself for sure.  Is it a one-time vaccine?

Yes.

I know someone who got shingles in her mid/late 30's.  She tried to get the vaccine after that but her doctor said she couldn't get it until she was 50.  She got shingles again when she was 40.  I understand that the vaccine is only approved for people age 50 and over, but aren't docs allowed to use judgement and give something off label? I've lost touch with her, so I don't know if she ever got it again after turning 40, or is she was ever finally able to get the vaccine.

FWIW I got shingles in my eye in my 20s, and it was horrible because back then treatment treatment meant not talking about it (it was still something shameful that nasty old men contracted), I required daily cortisone injections in my eye, and I nearly violin in that eye. Plus it was the height of summer, and coping with heat and light was almost unbearable. 

Almost 12 months later, treatment changed completely when the first of the vaccines appeared. 

So: first thing to realise about treating the pain is that shingles virus follows the entires nerve pathway - the pain message can strike anywhere along that pathway.  It is critical to take any medication on time and before the pain message is full blown ("screaming") I.e. Don't be brave and try to tough it out. What you need to do is block the pain before it begins, not damp it down once it's started. 

For this reason OTC pain relief won't be strong enough, and might set you up for rebound pain. Hence the need for prescription meds. As mentioned above, you might get something that blocks the pain messages in your brain, or in your muscles or along your nerves, depending on how you're reacting at that stage of progression. 

Some people suggest that taking extra vit Bs for nerve strength with help: folic acid, etc. I can't remember if it's B1, 2, 6 and/or 12: check. You may want some extra magnesium and possibly zinc &A to bolster your immune system for this period. People in chronic pain support groups say it makes the acute times easier to bear and lessens the chance of lasting weakness afterwards. Lysine might help.

Have the spots appeared? Have they blistered? If they haven't yet appeared she's still contagious. If they haven't yet blistered, she'll need to be careful about covering them, because that's another level of pain...if they have blistered, the pus can spread the infection, but the blisters need to be uncovered if possible to heal. So clothes and bathing are challenges, and painful. (I used a lot of Friars Balsalm but there are better things now)

Don't use powder and try not to use creams on the spots. Even the ones to cool and soothe. It's not worth it. You land up with scars. Cold sore cream is not the same as shingle treatment even though they're both 'herpes'. 

Because it's over a week, sadly, your mum is probably in for at least a month of discomfort. This is a virus, and will have to run its course. Remember at base it's chicken pox gone wild. So treat psychologically for chicken pox As it heals, the nerves slowly stop being on high-alert: that means that as they slowly go back to normal, everything will be translated as pain. Heat, cold, rough, smooth, tickle, breeze, any sensation will be translated as pain - but slowly it will lessen. Most people go back to normal. Anything leftover might be treated with a muscle relaxant or an arthritis medication, or even an antidepressant, because of how they address inflammation and pain. 

Good luck! Hope she heals quickly!

You've probably done the basic searches  

https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000555.htm 

And

http://nihseniorhealth.gov/shingles/aboutshingles/01.html 

I got it in my mid 50s. My doctor does not recommend the vaccine until turning 60  I will be getting the vaccine when I turn 60 just cuz I want to avoid a second outbreak  

The vaccine is not 100% effective  

I had a college boyfriend that got it while we were in college. And I remember both of my fathers sisters getting it years ago- well before they were 60. All of them had horrible experiences especially the college boyfriend. I remember him getting it in his eye as well and missing a large part of his tennis season

The problem with getting it on your eye is that the nerve also affects your scalp, your cheek and your nose. So you can get the blisters anywhere along there including on the roof of your mouth - which means down your throat if they break and you swallow the pus; or down your respiratory passages if you blister inside your nose. I was lucky to only blister lightly on the skin of my nose but I'm still scarred there and on my eyeball, and eyebrow region.

My mother got it, but did not tell anyone.  Partly a result of a stubborn Midwestern German Catholic farmer trying to tough it out.  She was also afraid she burnt herself with her heating pad and would "get in trouble" with her doctor or someone and be told she couldn't live at home?  Anyway, by the time someone figured it out, it had gone one way too long.   She developed Post Herpetic Neuralgia and had pain on and off for the rest of her life.  She took gabapentin for it.  It caused memory problems and made her sleepy and a little out of it.  A friend who's mom died of Alzheimer's was really bothered by this and wanted us to get her off the gabapentin, but honestly watching mom sleep and having to repeat things to her repeatedly was a lot better than listening to her whimper in pain.  My mom NEVER complained.  Her motto in life was, "oh get on with it" so I know the nerve pain that shingles can cause some people must be absolutely tortuous.  

Anyway, hopefully that isn't the case here since she is getting treated, but if there is still pain after the rash is gone, don't discount it and insist the doctors help your mom find relief.  It may be that another medicine could have helped my mom without the side effects, but by this time she was so sick with other things that it hardly mattered.  

I got the vaccine at 51.  I've heard such horror stories I'm terrified of it.  Great use of FSA funds. I think it was $200.

I had shingles the summer of 2013. I had gotten the vaccine in 2010 at the advice of my doctor. Alledgedly getting shingles after the shot is supposed to be less severe. I can't imagine how! I was diagnosed on the 4th of July at a walk-in clinic. Had to wait until after the holiday to see my GP.

The rash and discomfort lasted about 3 weeks, but I still have residual nerve pain along the path of one of the nerves affected which may or may not go away.

Without the vax, I was in acute agony for 3 months. 

Daily injections in the eye for a month, drops for a week before that. And I couldn't leave a darkened room except for medical treatment. Recovery took another 3-6 months as we phased in different kinds of pain relief.

Yep, the vax makes a huge difference. 

And I was 24.