Thursday, February 27, 2014

Shingles...and not on the roof

G-d dammit. I need another health hurdle like a hole in the head, but here we are. I've had an outbreak of shingles.
Shingles is a painful skin rash. It is caused by the varicella zoster virus. Shingles usually appears in a band, a strip, or a small area on one side of the face or body. It is also called herpes zoster.
Shingles is most common in older adults and people who have weak immune systems because of stress, injury, certain medicines, or other reasons. Most people who get shingles will get better and will not get it again.
Um. Wrong. I had an outbreak back in the 80s along a nerve near my eye, which is a pretty dangerous area to get it. I was in a lot of pain for a  few weeks, with the weeping sores, burning, aw damn. I was under a lot of job stress at the time and that triggered the shingles. I was a lot healthier then, so I tolerated it better and recovered pretty well.
Shingles occurs when the virus that causes chickenpox starts up again in your body. After you get better from chickenpox, the virus "sleeps" (is dormant) in your nerve roots. In some people, it stays dormant forever. In others, the virus "wakes up" when disease, stress, or aging weakens the immune system. Some medicines may trigger the virus to wake up and cause a shingles rash. It is not clear why this happens. But after the virus becomes active again, it can only cause shingles, not chickenpox. 
You can't catch shingles from someone else who has shingles. But there is a small chance that a person with a shingles rash can spread the virus to another person who hasn't had chickenpox and who hasn't gotten the chickenpox vaccine.Shingles symptoms happen in stages. At first you may have a headache or be sensitive to light. You may also feel like you have the flu but not have a fever. 
Later, you may feel itching, tingling, or pain in a certain area. That's where a band, strip, or small area of rash may occur a few days later. The rash turns into clusters of blisters. The blisters fill with fluid and then crust over. It takes 2 to 4 weeks for the blisters to heal, and they may leave scars.
Yeah, all of that. Where did it occur this time?


It only occurs on one side at a time along the nerve. Think about where you really don't want sores like this and that's where mine are. Where the sun doesn't shine on my left side. TMI. The last few days have been pretty horrible, much worse than the last go-round.

I know why this happened. I am already immuno-suppressed because of the biologic meds I'm on for rheumatoid arthritis; when you pile on the insane pressure I'm currently under in my job, when I started feeling the sores erupt, I wasn't surprised by the diagnosis from the doctor today. The pain was familiar, the white hot burning, the stabbing pain. And sitting, standing, lying down are all painful.

There's not much you can do about this, btw, aside from treating the symptoms, keeping the outbreak clean and dry (secondary infection for me is a big risk) and wait for the progression to blisters and scabbing. The doc put me on Valacyclovir, an anti-viral horse-sized pill, 3x a day for 7 days. The worst-case scenario is infection, of course.. Then there's the neuropathic-like pain (postherpetic neuralgia).
"[A]bout one in five patients develop a painful condition called postherpetic neuralgia, which is often difficult to manage. In some patients, herpes zoster can reactivate presenting as zoster sine herpete: pain radiating along the path of a single spinal nerve (a dermatomal distribution), but without an accompanying rash. This condition may involve complications that affect several levels of the nervous system and cause many cranial neuropathies, polyneuritis, myelitis, or aseptic meningitis."

Anyway. What can I do except live through this sh*t shoveled onto my path. Sitting hurts like hell, so I'm popping additional Aleve. At least I am in good company -- Keith Olbermann has been felled and is off-air dealing with shingles.

I hear you, Keith. But I've had this for about 5 days now and I haven't missed work - no, I dragged my (literally) sorry ass all week except to go to the doc today - isn't it nice to be in IT? I'm off tomorrow afternoon to re-up my biologics just in time to be sick for the weekend as usual.

There is a shingles vaccine, but I'm not eligible to take it because I'm on biologic meds. Not that it would matter much. Even the vaccine is no guarantee you'll never have shingles activate.

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