Help please with shingles

If you have a new rash, ie new vesicle-blisters, that means you have recurrent Herpes Zoster-Shingles and need a new course of Antivirals. You need to be on either

Famciclovir 500mg 3x daily for at least 10 days 1st choice.

Or

Valcyclovir 1000 mg 3x daily for at least 10 days.

Do not accept Acyclovir as the Antiviral as there is some resistance to this Antiviral to the varicella virus.

You must return to the Physician today to be placed on the Antiviral.

Do you have any autoimmune disorders such as Systemic Lupus Erythematosis-SLE, RA, Psoriasis, ITP, Sjogrens; IBD,

OR Are you on Corticosteroids or DMARDS, or have Cancer?

Usually, people do not have recurrent Herpes Zoster-Shingles, at least this quickly, unless there is an underlying reason.

I am going to to send another post with more complete information on Herpes Zoster-Shingles to you. My heart goes out to you, as I know exactly how you feel.

Best regards,

Merry Juliana

Dear Kathy,

Hear is a complete information sheet I prepared for individuals with Acute Herpes Zoster-Shingles and also Recurrent Herpes Zoster-Shingles.

I am a Nurse Practitioner in the States.

HERPES ZOSTER-SHINGLES

I am so sorry you are going through this right now. I understand the agonizing, lancinating pain, sleepless nights, and suffering. I have had Herpes Zoster-Shingles in my right ear every three to five weeks for the past twenty-one years and twice in my right eye. It has now spread to my entire right scalp with every episode.

This is a summary of the stages, signs and symptoms of Herpes Zoster-Shingles, and medical management of the disease.

During the Pre-eruptive Phase, you may have some of the following symptoms:

Duration 1-10 Days, but the rash occasionally takes much longer to appear

Headache

Photophobia

Generalized Aches and Pains

Fever, Chills, and Sweating

Enlarged Lymph Nodes near the pain and rash

Fatigue and Exhaustion

Pain usually preceding the rash

Itching

Description of pain: deep burning or aching pain, or electric shock–like pains. Lancinating pain

Acute Eruptive Phase

Rash of grouped vesicle-blisters in a dermatomal pattern.

Occurs in waves or crops over a period of 5-7 days.

Vesicle-blisters look dissimilar and are of different sizes.

The rash is on a red base.

The pain may continue to increase into the second and third week.

The clear vesicle-blisters cloud over, look like pustules, scab over, and turn black. This process may take between 2-4 weeks. Once every vesicle-blister has scabbed over, you are no longer infectious!

You are considered infectious (contagious) if your rash is open to the air, ie not covered, to anyone who has not had chickenpox. This includes all pregnant women! Remember, not all women know they are pregnant!

Chronic Phase (Post Herpetic Neuralgia PHN)

30 days after onset of rash. Definition varies

Duration may last months or years after initial episode of Herpes Zoster-Shingles.

The resolution of the scars can take up to a year to heal.

Management and Medications

ANTIVIRALS: THE CORNERSTONE OF TREATMENT

Famciclovir 500 mg 3x daily 7-10 days, sometimes 14 days.

Smallest Tablet

Convenient dosing

Least Resistance

Valcyclovir 1000 mg 3x daily 7-10 days

Large Tablets difficult to swallow for some

Based on Acyclovir

Acyclovir 800 mg 5x daily 7-10 days

Inconvenient Dose Schedule

Growing Resistance to Varicella Virus

Acyclovir is the antiviral most often prescribed in the UK

What dosage of the medication are you on? Sometimes, the Physician places the patient on a lower dose, but needs to increase it to help with the pain-itching.

Sometimes, you need to be placed on a cocktail of medications, as they will work synergistically to help you. These are all by prescription. I have grouped them according to class. A clinician would start with one from the Anticonvulsant class, taper the dosage up, then one from the Antidepressant Class, etc. This list is by no means complete.

ANALGESICS

NSAIDS

Ibuprofen

Naprosyn

Acetominophen

OPIOIDS

Oxycodone

Hydrocodone

Codeine

CBD

ANTI-CONVULSANTS

Gabapentin-Neurontin

Pregabalin-Lyrica

ANTI-DEPRESSANTS

SNRIs

Cymbalta

Effexor-Venlafaxine

Heterocyclics

Nortriptyline

Amitriptyline

2. I would find 100% cotton knit clothing. Make sure there are no seams to irritate your skin. The cotton knit is the most breathable, least irritating cloth to most individuals.

3. Use Lidocaine Cream or Spray OTC topically to help with the pain- itching, eg, Solarcaine with Aloe or Bactine. Many on this forum feel either Lidocaine or Benzocaine help with the pain-itching. The cream might soothe the inflamed nerve endings better and last longer on the skin. You can only use Lidocaine 12 hours on and 12 hours off, as the usefulness will extinguish itself.

4. Use ice or cool compresses. Do not take hot showers, as it will only increase the pain-itching

5. You need to rest and sleep. You cannot power through this disease. Do not go back to work! This virus is way stronger than you are, and you will only get more pain, the more exertion you do.

6. Most Importantly, get the Shingrex Immunization. It is a two phase vaccine, two months apart. It is given intramuscularly. It is highly efficacious in stopping Post Herpetic Neuralgia PHN and recurrent episodes of Herpes Zoster-Shingles.

Shingrex is available in the US at the pharmacy and covered by insurance if you are over 50 years of age. If you are younger than 50, and have had a documented case of shingles, it is still covered.

If you are in the UK/Canada/Australia/NZ, I know it has been distributed there, but the national health insurance may not cover it until age 70, which is ridiculous. It is expensive, but I would have paid thousands not to have recurrent shingles.

RECURRENT HERPES ZOSTER-SHINGLES

I empathize with you regarding the agonizing pain, fatigue, exhaustion.

Also, not all your friends and family understand the excruciating Neurogenic pain and flu-like symptoms that accompany Herpes Zoster-Shingles.

Here is what I recommend to reduce the frequency and severity of pain of episodes.

1. Get the Shingrex Immunization. It is a two stage vaccination two months apart. It is an intramuscular injection. It is highly efficacious in stopping recurrent Herpes Zoster-Shingles.

It is available in the US at the pharmacy and covered by insurance. If you are younger than 50, and you have had shingles, it is still covered. You might need a note/ prescription from your Physician.

If you are in the UK/Canada/Australia/NZ, I know it has been distributed there, but the national health insurance may not cover it until age 70, which is ridiculous. It is expensive, but I would have paid thousands not to have recurrent shingles.

2. Google High Arginine Low Lysine Diet and Herpes. The amino acid Lysine helps prevent Herpes Zoster-Shingles, and Arginine triggers Shingles. Chocolate, Nuts, and Legumes are all high in Arginine.

3. Avoid the sun, UV radiation, as it triggers Shingles, big-time!

4. Try taking either Valcyclovir or Famciclovir as a maintenance dose daily. It does help some people. Do not take Acyclovir, as the Herpes Zoster-Shingles virus has developed resistance to this Antiviral. It is the oldest, and does not work, especially on people with recurrent Herpes Zoster-Shingles.

5. Remove stressful ie toxic people from your life! Easier said than done, I know, but...if you have "so called friends" that are just using you, get rid of them. Family members who are entitled? Learn to say "No!"

6. Is your job poison? Change it!

You need to examine your life, delegate what you can, and rid yourself of the stress when you can.

Stress is your enemy!

7. Do you have any medical conditions predisposing you to Shingles?

Autoimmune Diseases: Systemic Lupus Erythematosis-SLE, Psoriasis, ITP, Rheumatoid Arthritis, Gout

IBD, Crohns, Ulcerative Colitis

Chronic Kidney Disease, Diabetes Mellitus

Cancer, Blood Dyscrasias, Leukemia, Lymphoma

Medications: Corticosteroids or DMARDS

Prior Trauma or Surgery near or at the shingles site

Older Age

Make certain you are in control of your health and get top-notch Physicians you can trust!

I feel for you so much, as I know how painful and how lonely it is to suffer with no end in sight.

Please let me know if this helps you.

I am a Nurse Practitioner in the States.

Best Wishes

Merry Juliana

POST HERPETIC NEURALGIA PHN

Sorry you are still dealing with the aftermath of Herpes Zoster-Shingles. As you still are having pain-itching, you have Post Herpetic Neuralgia PHN.

1. What dosage of the medication are you on? Sometimes, the Physician places on patient on a lower dose, but needs to increase it to help with the pain-itching.

Sometimes, you need to be placed on a cocktail of medications as they will work synergistically to help you. These are all by prescription. I have grouped them according to class. A clinician would start with one from the Anticonvulsant class, taper the dosage up, then one from the Antidepressant Class, etc. This list is by no means complete.

Anti-convulsants

Gabapentin-Neurontin

Pregabalin-Lyrica

Anti-depressants

SNRIs

Cymbalta

Effexor-Venlafaxine

Heterocyclics

Nortriptyline

Amitriptyline

2. I would find 100% cotton knit clothing. Make sure there are no seams to irritate your skin. The cotton knit is the most breathable, least irritating cloth to most individuals.

3. Use Lidocaine Cream or Spray OTC topically to help with the pain- itching, eg, Solarcaine with Aloe. Many on this forum feel either Lidocaine or Benzocaine help with the pain-itching. The cream might soothe the inflamed nerve endings better and last longer. You can only use Lidocaine 12 hours on and 12 hours off, as the usefulness will extinguish itself.

4. At home, use ice or cool compresses. Do not take hot showers, as it will only increase the pain-itching

5. Most Importantly, get the Shingrex Immunization as the vaccine has been helping decrease the pain and itching of Post Herpetic Neuralgia PHN.

It is a two phase vaccination two months apart. It is an intramuscular injection. It is highly efficacious in stopping recurrent Herpes Zoster-Shingles.

It is available in the US at the pharmacy and covered by insurance. If you are younger than 50, and you have had shingles, it is still covered. You might need a note/ prescription from your Physician.

If you are in the UK/Canada/Australia/NZ, I know it has been distributed there, but the national health insurance may not cover it until age 70, which is ridiculous. It is expensive, but I would have paid thousands

Best Wishes

Merry Juliana