Shingles

Hello, yes, it is totally normal. Flu like symptoms, lots of pain, very tired with no energy, etc., all very, though sadly, normal. I am sorry you are going through this. It could last for months.

Hi Zipper,

i felt like I had flu but without temperature, just really aching and painful. Ive had it twice now, the second time not as bad as first regarding aches and pain, but more shingle blister rash. Hope you are better soon.

Hi Zipper!

I am sorry you have Herpes Zoster-Shingles. Yes, it feels exactly like the flu without the respiratory symptoms. I hope you were given antivirals by your clinician. Also, the pain at the rash site usually increases the second week.

Most physicians are not tuned in to the excruciating pain and are reluctant to prescribe opioids to patients. You didn't state the location of the Shingles, but if it is on your face, it is usually even more painful. It is important to get the pain under control early. Otherwise, the risk of developing Post Herpetic Neurolgia PHN increases if the pain is not under control the first month.

It is imperative that you rest and sleep. You will feel a lot of exhaustion and fatigue and maybe depression. This is the world of Herpes Zoster-Shingles. Obey your body's desire to rest. You cannot power through this disease.

I am going to post to you my handout on Herpes Zoster-Shingles to help you. Please feel free to ask me any questions.

Best Regards.

Stay Safe and Sheltered

Merry Juliana

Hi Zipper!

I am so sorry that you are suffering from this disease. Unfortunately, there is a lot of misinformation among health professionals. Many health care professionals are abysmally ignorant regarding the diagnosis, the signs and symptoms of the disease, and the treatment and management of the disease. They are loathe to prescribe opioids for the acute pain.

My first episode of Shingles felt like I was giving birth via my ear canal while being tased!

I have had Herpes Zoster-Shingles in my right ear, mouth, and throat every three weeks for the past 24 years. For the past 2 years it has also spread to my entire right scalp. I have had it twice in my right eye. The third ENT finally diagnosed it correctly.

Because I suffered so much with the disease, I am extremely active on this forum. My goals are to educate, support, and advise the people. I have learned so much from many wonderful individuals on this forum. I am a retired Nurse Practitioner in the States.

There are three stages to Herpes Zoster-Shingles.

THE FIRST STAGE-ACUTE STAGE PREERUPTION

PAIN, often burning or lancinating

Itching

Patchy redness

Swelling, in the dermatomal area of involvement

Swollen Lymph Nodes, either at this stage or subsequently

Constitutional Symptoms

Headache

Photophobia

Aches and Pains

Mild Fever

Chills

Fatigue

Exhaustion

THE SECOND STAGE-ERUPTION

Grouped herpetiform vesicles-blisters developing on the red base (the classic finding)

The vesicles come in crops or waves over a period of

usually 5 days

Skin findings that typically appear unilaterally, stopping abruptly at the midline

Vesicular involution: Vesicles initially are clear but eventually cloud, rupture, crust, and involute (shrink)

After vesicular involution, slow resolution of the remaining

red plaques, typically without visible sequelae

Scarring can occur if the skin has been compromised by

excoriation, secondary infection, or other complications

Almost all adults experience pain, typically severe

A few experience severe pain without a vesicular eruption (Zoster Sine Herpete)

Symptoms tend to resolve over 10-15 days,

but can last much longer

Complete healing of lesions may require up to a month

THE THIRD STAGE PHN

POST HERPETIC NEURALGIA

Persistent or recurring pain lasting 30 or more days

after the acute infection or after all lesions have crusted (9-45% of all cases)

Pain usually is confined to the area of original

dermatomal involvement

The pain can be severe and incapacitating

Pain can persist for weeks, months, or years

Slow resolution of pain is especially common in the

elderly

PHN is observed more frequently after cases ofHerpes Zoster-Shingles Ophthalmicus (HZO)

Herpes Zoster-Shingles Oticus

(Ramsay Hunt Syndrome)

and in instances of upper-body dermatomal involvement

TREATMENT & MANAGEMENT

Antivirals

The cornerstone of treatment

Should be started within three days of onset of

symptoms or rash

Famcyclovir 500 mg 3x daily 7-10 days

Most efficacious

Newest Antiviral

Valacyclovir 1000mg 3x daily 7-10 days

Less efficacious than Famcyclovir

Large pill

Based on Acyclovir

Acyclovir 500mg 5x daily 7-10 days

Most resistance to this Antiviral

Oldest Drug

Cheapest drug- Used in the UK

Difficult schedule of 5x daily

USE THE FOLLOWING: one of each class together

Anticonvulsants

Gabapentin-Neurontin

Dosages must be tapered up and down

Effective as adjunct in acute stage and PHN

Pregabalin-Lyrica

Dosages must be tapered up and down

Effective as adjunct in acute stage and PHN

Weight Gainer

Affects moods

Difficult to wean off due to withdrawal symptoms.

Antidepressants

Dosages must be tapered up and down

Effective as adjunct in acute stage and PHN

Can be difficult to wean off due to withdrawal symptoms.

Duloxetine-Cymbalta SNRI

Venlafaxine-Effexor SNRI

Amitriptyline-Elavil Tricyclic

ANALGESICS

OPIOIDS

Oxycodone

Codeine

Hydrocodone

IF YOUR PAIN IS NOT WELL CONTROLLED WITHIN THE FIRST TWO WEEKS, GET IT UNDER CONTROL BY DEMANDING OPIOIDS.

***The pain often increases markedly the second week of the disease.

HERPES ZOSTER SHINGLES IS ONE OF THE MOST PAINFUL AFFLICTIONS OF MANKIND SECOND TO CANCER AS IT INVOLVES NERVE PAIN.

IT IS THE PHYSICIAN'S DUTY TO HELP THE PATIENT IN PAIN. OPIOIDS STILL ARE THE BEST OPTION FOR ACUTE PAIN.

Gabapentin-Neurontin or Pregabalin-Lyrica can help decrease the neurogenic pain when used in conjunction with Opioids

Topicals

Lidocaine/Benzocaine

Found in Bactine, Solarcaine, Oragel, Salonpas

Auroguard for Ramsay Hunt Syndrome etc

Numbs the skin's nerve endings

Corticosteroid Sprays Creams OTC

Decreases inflammation, soothes topical swelling,

pain

Cool Compresses/ICE.

(DO NOT USE HEAT-CAUSES MORE PAIN AND INFLAMMATION)

100% COTTON CLOTHING soft & allows the skin to breathe!!!!!

SLEEP AND REST

You will experience fatigue and exhaustion and want to sleep. Obey your body. You cannot power through this. Take off from work. If you don't, it will only get worse.

CONTAGIOUS

Remember: your exposed rash is contagious to all individuals who have not as yet had chickenpox.

This list includes all pregnant women and their unborn fetuses. Many women do not know in the early stages if they are pregnant.

If someone has been fully vaccinated, they are protected. The unborn child is never protected.

Cover your rash with clothing or a dressing.

You are no longer infectious when every last vesicle-blister has scabbed over/ dried up.

PREVENTION of SHINGLES

Get the Shingrix Vaccine, a two part injection, taken 2-6 months apart.

The efficacy is 93%

1. It is available in the US at age 50 with insurance
2. If you have had Shingles, and are in the US, Shingrix is covered by your insurance. Have your physician write a note stating you have had Shingles.
3. In the UK, it is not available until age 70.

   ADDENDUM the Shingrex vaccine has helped decrease the intensity of pain of my episodes, but not decrease the frequency of episodes.

High Lysine Low Arginine Diet

Google High Lysine Low Arginine Diet and Herpes.

The amino acid Lysine helps decrease Herpes and Arginine triggers Herpes Zoster-Shingles.

If you binge on chocolate or nuts, and find yourself getting a horrible prolonged shingles episode after,

it is due to the high amino acid content of Arginine in chocolate and nuts.

You can take Lysine supplements, but there can always be issues with drug interactions, adverse reactions, and harm to the heart, liver, and kidneys.

It is my hope that this letter has helped you in understanding your disease and how to care for yourself.

Best Wishes,

Merry Juliana

some of the symptoms can become quite debilitating . some have a arsenal of meds antivirals to lidocaine and can be quite complicated and or if any even can help.

Also helps to obtain the new vaccine for shingles Shingex. it will help prevent nerve damage, recurrence and the severity of future breakouts.

i have had shinglest for 10 years and the vaccines have helped keep my shingles in check.