Posted By: Mike Stackpole Shingles? - 10-18-2007 12:53 PM
Long time no post, or need to, until now. I had my blood work yesterday, and everything looks
Posted By: Cookey Re: Shingles? - 10-18-2007 04:50 PM
Hi mike,i really cant answer your questions but i can give you an idea of how you would be feeling and what you would be seeing if it was shingles.
Shingles or "Herpes Zoster"by nature develops along the path of a nerve,the most usual ones being the trigeminal nerve,the sciatic nerve,and the nerve around the abdomen.It appears as a blister like sore and then develop into a red and very painful rash that follows the path of the involved nerve and ultimately forms a scabby top

The trigeminal nerve branches in three directions from the junction of your ear and the hinge of your jaw.The commonest symptoms of shingles are severe burning pain and itching.you will also find you have a flu like illness.

I cant say i have ever been aware of anything like the swellings you mentioned,but i am pretty sure you would be feeling quite unwell if it was shingles.

Any way not long to wait for your appointment so good luck.

liz
Posted By: emmylou1951 Re: Shingles? - 10-18-2007 08:25 PM
Mike: Give us an update as soon as you know something for sure...Several members of my immediate family have had 'shingles', hope you don't have it, and hope there is nothing new to worry about. Keeping you in our thoughts!

Lois & Buzz in NC
Posted By: Dr. Mike Re: Shingles? - 10-18-2007 09:17 PM
Mike,
Shingles (Herpes zoster) are caused by a virus that sits dormant in a nerve root and out of the blue when conditions a right expresses itself. The following website has some good info on shingles; http://en.wikipedia.org/wiki/Herpes_zoster
It can be a painful condition, but is self limiting and will resolve on its own without treatment. Usually medication and especially pain medication is needed to make the condition more tolerable.

Cheers,

Mike
Posted By: Brian Hill Re: Shingles? - 10-18-2007 09:43 PM
I agree with doc Mike, that these like other forms of herpes come and go on an unpredictable schedule, sometimes aligned with immune system depression.

Dr. Mike just a note to consider: I seldom refer anyone to Wikipedia for the simple reason that many parts of it are rife with misinformation. I rewrote the entire oral cancer section twice in the last year. The problem is that ANYONE can edit any page with whatever they want. Ideally in a perfect world, knowledgeable people put up accurate information to help others. Please go to the page you have recommended and type in that the condition will turn your brain into Gouda cheese. What you will find is that it will remain that way, with your bad information, for many days, weeks, and in at least one case I watched for over a month. Some person finallhy comes alng and makes the correction. Not all are free of the desire to screw with others, hence the world of malicious hackers (this is not really hacking in this case, anyone by using the edit button can add to any page in Wikipedia). When possible please use a source that can be assured of being accurate and that is routinely updated. Many hospital sites like Mayo, or MD Anderson or government sites offer good information, though too often in the world of oral cancer I find these behind the time in updates. But at least none of these suggest that your brain might turn to a form of cheese.
Posted By: Gary Re: Shingles? - 10-19-2007 07:45 AM
I've had shingle 3 times in 3 entirely different locations (aka dermatomes) and it hurt like hell (all pre-cancer too). The trick is to look for the subtle signs of it's occurence (typically like a virus coming on - lethargy, slightly elevated temperature, itchiness. etc.) and get on Acyclovir (Zovirax - or other anti-viral drugs) immediately. If it's fully engaged before you start Tx than it can take weeks and someones months to heal. It can also cause blindness. The first time I had it I went through 100 Vicodin ES in 10 days and it still hurt like hell. I understand that there may be a vaccine available for it now. Anyone who had chickenpox as a child is at risk. When it is active and has pustules, you are contageous and can actually spread chickenpox. The meds are basically the same as treating Herpes Simplex.

One thing that typifies it is phantom or psuedo pain along the nerve bundles emanating from the spinal cord. The actual eruption can be on your chest and the corresponding area on your back will hurt as bad but no eruption. Even breathing cool air on it can hurt like hell. It's an insidious little b*tch. You can even have an eruption inside your mouth.

None of the doctors I have talked too ever suggested letting it resolve on its own.

Surprisingly I never had problems with it during Tx or since (but I have a bottle of Zovirax at the ready). I also have HCV and the ct didn't impact that either - life is full of surprises...

Here's a fairly decent link about it: http://www.aftershingles.com/shingles.html
Posted By: Mike Stackpole Re: Shingles? - 10-19-2007 10:19 AM
And the winner is
Posted By: wilckdds Re: Shingles? - 10-19-2007 07:22 PM
Hi Mike,

Sorry to hear that you have shingles and I do understand your relief in finding out what it is.

The vaccine that has been out for about one year is made by Merck and it is called Zostavax. There are some critical criteria for getting the vaccine and as far as I remember they are:

1. you must be at least 60 years of age
2. you have to have had a case of chicken pox already
3. you cannot have had shingles
4. you cannot be immuno-compromised

According to my sources, there are some doctors giving the vaccine "off label" to some people that are under 60. For now 60 has been set as the minimum age because everyone in the original study was 60 or over. I believe the other three requirements leave no room for interpretation.

I am planning to get the vaccine since I meet all the criteria, but am waiting until my youngest grandchild gets his chickenpox vaccination next month. This is a live virus.

I have done a great deal of research on this vaccine as one of my partners in my practice has had neuropathy for about 2 years from his bout with shingles. He has multiple myeloma and has been on chemo for 5 years and is always immuno-compromised.

I am not telling you this to frighten you, but I think that everyone should know that the pain does not always go away quickly, although it is rare to last as long as his has.

If anyone meets the criteria, it is a great idea to get vaccinated.

Good luck.

Jerry
Posted By: Dr. Mike Re: Shingles? - 10-19-2007 07:31 PM
Brian,
I was unaware of the hackability of that site. I did however, read all the information before I posted it and it was at the time of my reading very accurate. I will, as per your advice, stick to better sources from now on. I do subscribe to Medline so I'll pull info from there.
Thanks,

Mike
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