Husband has shingles on face and eye - need advice
Posted , 11 users are following.
My husband was misdiagnosied with a migraine for a week before he was finally admitted to the hospital for evaluation. They treated him for a migraine on the right side of his face UNTIL the rash appeared. Immediately changed treatment to shingles. Shingles affted the nerve on the right top of head down the tip of his nose (including eye). Started all the meds - acyclovir, sterioids, etc. He is home now recovering. Unfortunately the shingles afftected his right eye nerves (motion and lid, actual eye is ok). Doctors say it is self limiting and will resolve in time. Anyone else experience this? He is in so much pain. We started percocet around the clock wtih gabapentin. The two biggest complaints he has are severe night sweats (needs to change clothes 3 times per night) and sharp eye pain and sensations in the head. We are 3 weeks out from the initial start of the pain (2 weeks out post rash). Any advice? When will he get relief? How long does this last? How long for eye muscle to strengthen? So many questions.....
2 likes, 93 replies
Merry19451 lisa46244
Posted
My dear Lisa and husband,
I am so sorry for the pain and suffering of your husband. Fortunately, on this site, we know all too well the excruciating severe lancinating burning pain your husband is suffering from.
To begin with, this is what to expect with ophthalmolgic Herpes Zoster-Shingles.
It begins with symptoms of a severe lancinating burning headache, one sided, with fever, chills and fever, aches and pains, malaise, photophobia, and fatigue. This can last for up to two weeks before the rash appears. With Shingles affecting the eye or ear, one can also experience nausea and vomiting as inflammationation of the eye center in the brain stimulates the nausea center there, as well.
Once the rash appears, you are in the acute phase. It can take up to five days for the vesicles-blisters to appear in crops or waves. Then, it takes one month for these vesicles-blisters toform a black crust or scab over, and fall off. When all the vesicles-blisters have formed scabs, he is no longer contagious. After one month, the acute phase is considered over.
It is vital to achieve excellent pain control during this month as those who don't often are at higher risk to get the dreaded complication of Post Herpetic Neuralgia PHN. As he is on Percocet and gabapentin, plus I am certain ophthalmic drops, steroids and acyclovir, he is on the correct medications.
He has a viremia or the Herpes Zoster-Shingles virus circulating in his blood stream causing the symptoms similar to the flu.
I have had Herpes Zoster-Shingles in my right ear every 3-5 weeks for the past 20 years and In my right eye twice I understand the agony your husband is having.
I am a Nurse Practitioner in the States.
Please let me know how i can help you.
Now that he is on the correct medications, including acyclovir, the fever chills and sweating should diminish, slowly.
It is difficult to diagnose Herpes Zoster-Shingles until the rash appears. I am a migraneur, and when the first episode occurred, initially I thought it was a migraine. It took three ENTs before the otoneurologist finally diagnosed it. It was 3-4 weeks before the rash made it outside my eardrum. I am 64 years old currently.
Hopefully, it is the inflammation causing the weakness with the cranial nerves and it usually resolves.
Best regards.
Merry Juliana
lisa46244 Merry19451
Posted
My husband is complaining of lightning sharp pains that come and go and move around in his head. The doctor increased the gabapentin dose at night (300mg) and he also increased the percocet. I don't want him to become addicted to percocet but he really needs it. Hoping these meds find him some relief soon. Any other suggestions for pain? When will he turn the corner and begin feeling better??????
Merry19451 lisa46244
Posted
May I ask how old your husband is, when did the pain start, and when did the rash appear?
Also, what other medical diseases does he have? When was the acyclovir started?
Thanks.
Merry Juliana
lisa46244 Merry19451
Posted
He's 51 years old. Started acyclovir within 24 hours of rash. However, he had pre-rash symptoms/pain for about a week before the rash appeared. No other health issues.
Merry19451 lisa46244
Posted
Lisa,
The severe head and eye pain should slowly start dissipating over the next two weeks. I know that even a breeze in the room can trigger more pain. Your husband won't become addicted to narcotics when he is in this agonal pain. I also take oxycodone every three to five weeks for the 3-5 days when I need it. Then I stop as soon as the severe pain is gone. This painful episode of your husband's will stop, but the ophthalmolgic Herpes Zoster-Shingles is usually more complicated than Shingles elsewhere. The pain in the head is more severe and lasts longer. He seems to be on all the appropriate medications.
Best regards
Merry Juliana
jane97743 lisa46244
Posted
I had the same thing, in my head , forhead and eye, and now after 4 months I get such terrible itching in the area where the rash was, and it is worse in the eye area,it is called PHN, The pain went weeks ago but the itching remains . it comes and goes every day, and I still see the eye dr regularly, My vision is good, I am sorry for your husband's pain, i know it gets excruciating, I even cried at the surgery one day as i was in so much pain, and felt so awful and was getting depressed with it iall, but then after being given stronger painkillers and amytriptyline at night, I started to be pain free and finally sleep at night, Good luck, I hope he doesn't get the complications!
lisa46244 Merry19451
Posted
Pain meds are not giving much relief. Just curious, does medical marijuana help? We are willing to try anything.
Merry19451 lisa46244
Posted
Lisa,
If your state already allows medical marijuana, I would try it. I am dealing with a terrible episode presently and am glued to the bed. I certainly have my own standards of care issues that I deal with regarding legalization of marijuana. These include how much, drug testing, drug interactions, and impairment.
Merry Juliana
lisa46244 Merry19451
Posted
New questions...my husband is taking gabapentin 300mg 3 times a day along with percocet. Gabapentin doesn't seem to be doing much. Is that a high enough dose? I am going to see neurologist on Monday to discuss. Should we consider switching to Lyrica? Any experience. Also, my husband tried acupuncture and it gave him 24 hour relief. We are definitely going back.
Merry19451 lisa46244
Posted
The pain relief dosage of Neurontin- gabapentin can be titrated up to 1800 mg daily. So, he definitely could go higher before trying Lyrica.
Best regards
Merry Juliana
lisa46244 Merry19451
Posted
Hello Merry Juliana,
Well a lot has happened. My husband is severely depressed and was in terrible pain. It wasn't being managed well by his internist (300mg gabapentin 3 times/day plus percocet). Went to Neurologist and he is adding cimbalta and carbamazepine to the mix. He also gave him a nerve block. The nerve block seems to help a little. Last night he was extrememly itchy in his eye - unbearable. Any suggestions? I read that some people take zytec. What are your thoughts?
My husband still has eye palsy. Good news his vision is ok. Hoping the eye palsy is self limiting according to doc. He also has twitching in face and droppy lid. Again, hoping it resolves.
Would love you advice? You really have been so helpful to me any many others suffering from this AWFUL virus.
With love,
Lisa
lisa46244
Posted
Merry19451 lisa46244
Posted
The itchy eye started with the initiation of the new medication, correct? My educated assumption is that either Cymbalta or Carbamazine is the guilty party. Call the neurologist regarding this. It is better to stop the medication than to add new medications for side effects. If he has a tic or twitch in his eye, it can be due to the following reasons:
1.Withdrawal from narcotics. My own
opinion
is go down slowly, but he should not be
having pain! Physicians are being
regulated by legislatures who are
concerned re the Opioid overdoses in our
society, but are ignoring pain suffering.
2. Cymbalta is a very stimulating antidepressant that could cause the tic.
3. The severe itch can cause the itch.
I am going to look up these additional meds re the itch component and then write more to you. Please call the neurologist, however...
Best regards
Merry Juliana
Merry19451
Posted
Ooooooops!
Severe itch can cause the tic...
Tegretol Carbamazine >>Cymbalta both can cause severe, but rare skin condition, but it would manifest with blisters in the mucus membranes of mouth, on skin, etc. and that is a medical emergency. Both can dry out the mucus membranes, including the eye, but should not cause the severe itching.
I did not find anything re either drug causing itchy eye. I would use cold compress, ask. Ophthalmologist if he could write script Eye
Drops eg steroid eye drops (dexamethasone) during day, and ointment at night for the itching.
Herpes Zoster-Shingles of the eye also can cause severe itching, especially in the more chronic stage.
If your husband has glaucoma, you have to be much more careful re eye drops. With all medication, the interactions are numerous, and I am not knowledgeable re his other medications.
I hope this helps.
Best wishes
Keep me posted
Merry Juliana
lisa46244 Merry19451
Posted
Merry Juliana,
Wanted to check back in with you. We are at week 6 now. My husband's pain was a bit better today for the first time. We are weaning off of percocet. I am giving him 1/2 10mg pill, 2x/day for the next 3 days. Then dropping to 1/2 pill at night for 3 days, then stopping. Should I add Tylenol more frequently? The doctor didn't really explain how to wean off percocet and how to transition to Tylenol. Any advice would be greatly appreciate.
He's currently on gabapentin 300 mg, 3x/day, and Symbalta 60 mg/day. Seems to be helping. Also doing accupuncture with chinese herbs.
Fourth Cranial Eye palsy has not resolved yet (he sees double vision) but the actual eye is ok. Doctor thinks this will resolve in about 3 months. My husband is disappointed with this information because we are at week 6 and he wants this to end already. Anxiously waiting for some improvement.
What should we expect going forward? My husband has been home resting now for 6 weeks. He can't get himself to work. I walk with him 2x/day to get him moving. We live in FL so it is really hot here and that is not comfortable. How do you get the energy and courage to return to life again?
Thanks again for being here for all of us in this forum. You have been a tremendous help to us.
?Lisa
helen1932 Merry19451
Posted
Shingles are not contagious except to those who have NOT had measles, is that what you meant? You can't give it to someone who has had measles or I think the measles vaccine. I am still careful to let people I first meet know that, so if they haven't had them, I don't get near, although I think aft 6 weeks, its not a problem. I am afraid of getting the dreaded post shingle misery also, as I thought with a mild case like mine, it would be gone. I am no longer on the viral med, and have only had it the first week. Is it opportune, at this time, to start on it again?
Merry19451 helen1932
Posted
Hi Helen,
Shingles is contagious to those individuals who have not yet had chickenpox. It is the varicella virus. Your vesicle-blisters have to be completely scabbed over, which take up to a month after they appear. You would also be contagious to infants and children who have not as yet received the immunization against the Varicella virus as well as a pregnant woman's unborn baby. Immunocompromised individuals are especially susceptible acquiring it.
I am sorry you have this.
Best wishes
Merry Juliana
helen1932 Merry19451
Posted
Where was my head? I meant the "chicken pox" and I know better. I am also a retired nurse, so that was just a slip of the tongue. I never got the blisters. I knew all of the things on "shingles to certain people, etc., " but did not know that if a person who had never had chicken pox was exposed to shingles, they then got CHICKEN POX, not shingles. So I am suspecting that no one can actually catch the shingles, only get chicken pox from them. Still, its a miserable disease and I am lucky at 84 to have just what is called a "mild " case, if that can be called mild:-)
Merry19451 helen1932
Posted
Helen.....
When it happens to you, it is not mild....the virus can be found in someone's tears, as well...I figured you were just sick and mistyped,, and knew that shingles was due to chickenpox, but I just wanted to be sure you knew...
No matter what, it is a miserable disease.
Best regards
Merry Juliana