My poor Mum....shes 87 and has been in constant pain from a bout of shingles NINE years ago

Hi Trudi

So sorry to hear about your mum, that must be so difficult for her and indeed for you to watch her suffer! Post herpetic neuralgia is extremely distressing condition.

Get her GP to refer her to pain clinic for the management of her symptoms.

While awaiting referral, GP can prescribe lidocaine patches which can be cut to a small size to fit on the left side of her forehead, to be used 12 hrs on and 12hrs off. Some GPs not keen to prescribe to apply on face but pain consultants advocate that.

Possibly patch during her wake hours and at night, may be something to help her sleep like, Tramadol.

If there is no contraindication, Lyrica (pregabalin) will help in some, although you need to discuss the side effects with her doctor with respect to her other medical history.

Possibly Amitriptyline too added to above.

When u see pain consultant discuss Capsaicin patch. If agreed, it has to be applied after application of local anaesthetic gel and goggles to avoid contact with eyes. It can hurt otherwise, as it's made from chilli peppers. But it's known to control pain for weeks or months in those in whom it works. This is used more commonly in the US.

Final course would be possibly surgical like the ablation of the trigeminal nerve ganglia (this is the affected nerve if on the face). Again, pain consultant can discuss this.

Side effects are there with all medications and interventions, it's a balance between benefits and risks and at her age, I guess the prime importance must be to give her relief from pain

All the best.

xxx

Hi Trudi

So sorry to hear about your mum, that must be so difficult for her and indeed for you to watch her suffer! Post herpetic neuralgia is extremely distressing condition.

Get her GP to refer her to pain clinic for the management of her symptoms.

While awaiting referral, GP can prescribe lidocaine patches which can be cut to a small size to fit on the left side of her forehead, to be used 12 hrs on and 12hrs off. Some GPs not keen to prescribe to apply on face but pain consultants advocate that.

Possibly patch during her wake hours and at night, may be something to help her sleep like, Tramadol.

If there is no contraindication, Lyrica (pregabalin) will help in some, although you need to discuss the side effects with her doctor with respect to her other medical history.

Possibly Amitriptyline too added to above.

When u see pain consultant discuss Capsaicin patch. If agreed, it has to be applied after application of local anaesthetic gel and goggles to avoid contact with eyes. It can hurt otherwise, as it's made from chilli peppers. But it's known to control pain for weeks or months in those in whom it works. This is used more commonly in the US.

Final course would be possibly surgical like the ablation of the trigeminal nerve ganglia (this is the affected nerve if on the face). Again, pain consultant can discuss this.

Side effects are there with all medications and interventions, it's a balance between benefits and risks and at her age, I guess the prime importance must be to give her relief from pain

All the best.

xxx

Dear Trudi,

Your poor mum has Post Herpetic Neuralgia PHN. I have had

recurrent Herpes Zoster Shingles every three to five WEEKS in my Right Ear for the past twenty-one

YEARS and twice in my Right eye. She had Ramsey Hunt Syndrome if she had

a facial droop during her shingles episode. I have Ramsey Hunt Syndrome.

I am 65 years old. Unfortunately, I do not know your mum's medical history,

but here is how the PHN can be treated if your Mum does not have severe

contraindications

ie. Cardiac, Liver, Kidney Diseases. This should be done by an excellent

Neurologist,

FIRST, she can be placed on an anticonvulsant type of medication

Gabapentin-Neurontin

Pregabalin-Lyrica

These drugs are titrated up to maximize effect.

SECOND, the neurologist can try an antidepressant.

The ones used for shingles are Cymbalta and Venlafaxine.

There are older ones, as well.

THIRD, the neurologist could try Auroguard or Auralgon,

ear drops that contain Benzocaine to soothe the nerves topically.

I personally use Topiramate, an anticonvulsant, Venlafaxine-antidepressant, Auroguard topically,

and Oxycodone when I have an acute episode.

In any case, try to find a neurologist interested in pain control for shIngles.

There are also nerve blocks, which might be difficult to achieve for your mum.

I hope I have been of some help. I am a Nurse Practitioner in the States.

Best Wishes to your mum and you.

Please let me know how you make out.

Merry Juliana