Help please with shingles

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I have had shingles on One side of mt tummy & under breast for about 4 weeks. Had anti viral meds for 5 days. Radh is very angry at times & seems no better. This morning I have rash spreading & looks like new blisters. Am I infectious again ? A bit confused about it . Any help much appreciated. Kathy 2250 

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  • Posted

    Kathy,

    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

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  • Posted

    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

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    • Posted

      Dear Merry19451,

      I cant thank you enough for all the information that you sent. Its so helpful, honestly amazing. 

      I have had graves disease in the past & had 3 lacular strokes & now ? In AF. They have just recently inserted a loop recorder. 

      I was to go abroad to visit  a family member who is to start radiotherapy in two weeks time but have decided for his benifit its best I dont visit. 

      I will definitely visit my GP on monday . So can I just clarify Merry you think possible this is a new outbreak ? As I say I had shingles 3-4 weeks ago & thats still very angry & red. 

      Thank you again for taking the tome to post so much appreciated. 

      Kind Regards 

      Kathy 2250 x

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    • Posted

      Kathy,

      This is definitely a new outbreak. If you have had lacunar strokes from Afib, I hope you are now on a blood thinner and are evaluated by a hematologist regularly. I have had two ischemic strokes can from Afib and am now on Eliquis.

      I would not visit anyone having radiation right now to protect both of you. You need to rest and sleep. As the rash is covered by clothing, you are not considered contagious, but I would be extremely careful around anyone with cancer receiving radiation.

      You also need to care for yourself, as you just had another episode, and any exertion or activity is more stress.

      One point I don't stress enough is you cannot power through this disease. The more you do, the worse it gets!

      I know from personal experience and from so many others, we all say the same thing! You need to take it easy!

      Get the Antivirals Today!

      Best Wishes

      Merry Juliana

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    • Posted

      Hi Merry 19451,

      Thanks so much for all your help. Yes am sure your spot on with all you say.

      I have been trying just to carry on to be honest.

      I have now retired from work  following my strokes. & ( I was a nursing sister in a hospice) 

      I will definitely visit my GP on monday as no surgery over the weekend. 

      I hope you are keeping well.

      Kind Regards 

      Kathy x

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    • Posted

      Dear Kathy,

      I had to retire after my second stroke, as well, although I didn't wish to. I did receive Alteplase, but am unsteady on my feet, especially when I have Herpes Zoster-Shingles.

      I worked with many patients in the hospital and home care who could have used hospice. I was honored to care for my two parents with my twin in their final months.

      Can you not go to A&E to get the Antiviral sooner, perhaps Sunday? The sooner the better!

      Best Wishes

      Merry Juliana

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    • Posted

      Hi Merry,

      Will try & go tomorrow, just feeling so fatigued at the moment & you can be in A & E 5-6 hrs ! They are just so busy.

      Yes I loved my job as well no hardship to go to work. I felt very privileged to care for our patients & families. I had been nursing since I was a cadet at 16 .  A few years ago !!! 

      I have done well after my strokes , it’s been 2 years now & starting to feel much better. 

      Hopefully we will both keep well.

      Will let you know tomorrow how I get on.

      Kind Regards

      Kathy x

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    • Posted

      Hi Merry,

      Went to out of hrs yesterday afternoon. Seems I now have an infection on top of my shingles! Got medication so hopefully will inprove now.

      Thanks for your advice, so glad I went to out of hrs now.( its just you hate taking an emergency appointment)

      Take care

      Kind Regards

      Kathy

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    • Posted

      Kathy,

      You never know until you examine it. A secondary bacterial infection is the most common complication after a viral infection. I am so glad you went.

      Best Regards,

      Merry Juliana

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