Shingles and work
Posted , 22 users are following.
I was diagnosed with Shingles Tue. but actually had the rash at least on Fri. (how the ER AND Urgent Care didn't realize it was Shingles I don't know!) and I am on the anti-viral, gabapantin 2700mg and ibprofin 800mg.
I teach 5th graders and I have now missed a full week of school, I am in A LOT of pain, and taking 2-3 hour naps still. I really want to go back on Tuesday, but wanted to get people's opinions...I mean I guess I can be in pain at school just as well as at home, yes? I just don't know what to do about work...Please give me your opinions...Thank you!
4 likes, 67 replies
kkf44 rlyndecker
Posted
Take L-LYSINE 1000mg & B-12 1000mcg cheap at Walmart 2 aday to start.
Stoped the burning in my side Shingles 2 years ago.
Lillyta kkf44
Posted
Goodwater_Betty rlyndecker
Posted
I guess it depends on whether or not you can tolerate the pain and teach at the same time. I could not have done it for a while, especially when I wasn't getting much sleep at night.
babs99203 rlyndecker
Posted
Rlyn, I am truly sorry you've joined our "club", but glad you found us, I'll be the first to welcome you but there are plenty of others who will give you more good information. Briefly, I had a similar story started back in October, got it in my back and chest, was on Gab (eventually 2400 mg/ prescription NSAID, Tylenol and Lidocaine 4% pain cream--Aspercreme is better than store brands). However I am not doing much better, but did develop PHN which is essentially damage to the nerves which causes pain for months or years. Luckily mine is less severe than other's.
First, where are your shingles? Did you get anti-viralsl such as Valtrex? I assume not. Next, read as much as you can here--it is one of the be sources for accurate info I have found. I worked as a medical secretary for over 30 years, so I'm NOT an expert but it helped me sort thru the info I've read online. Last, there is a lot of inaccurate info about shingles--the pain is MUCH worse than people realize and doctors usually are inept at treating it and understanding it. Work with your own doctor and with a good pharmacist. Lastly PUT YOURSELF FIRST! Your recover depends on that.
Here are some key points--2700 mg (assuming 900 mg/3X day) is quite high to start out on, I hope it took at least a few days to get to that leve, but I doubt if it did. Usually they titrate to that level over 2-3 weeks to allow you to adjust to the meds. It too me over a month and I was at less than that.That's why you're so exhausted. Gab can lessen the pain, but it may take days, it's not like Tyelenol. Read about the side effects, confusion and fatigue are the most commono.Next, the most important thing to do is REST! Seriously, this is a disease of your nerves, the more you do, the more you irritate/fire off those nerves, the more pain you'll have and the longer the recovery.
Next, I'm sorry to say this, but the best thing is to stop working--you're not congtagious, but it's likely the pain and symptoms of the shingles (possible nausea, headache, fever, mood swings and/or depression) will get worse. This IS a virus in addition to something irritating your nerves, so you are sick. The Gab and the virus will make your life miserable. Some people "power through" it, but it doesn't help you, in fact, as I said, it can cause it to last much longer. Plus at that level of Gab, you've already realized it's hard to function. The Gab can also cause severe emotional distress. If you've ever had problems with depression, that sucker may come home to roost for a bit, sorry. I took "powered through" the first week until family and friends finally said, STOP!
Your own circumstances vary, but hubby and I are semi-retired so he was able to take over cooking, cleaning etc. My shingles is in my back and chest and my doctor said, "if it hurts, don't do it". The less pain I could cause, the better it was for me. But I had NO idea how almost everything you do, leaning, bending, turning, lifting ANYTHING increased the pain. I eventually figured out ways to get around that. Even now, I'm back to about 80%, but I won't lift a gallon of milk (8 pounds there), and am careful doing wash or bending.
I hope this isn't too discouraging, believe me, we've all been there, but we're here to support you and give suggestions. I don't know what I would have done if I hadn't found this group at 2:00 am when I was sobbing with pain. AND it's OK to let it all out here. It's scary stuff, a huge life change (at least for a few weeks). We know that others don't understand that we're not being melodramatic, it's just our new reality. Babs
Take Care.
cathryn93621 babs99203
Posted
I just found this group and am so glad. I’ll been a year, so don’t know if anyone is on here...
I am a 65 yr old elem art/music teacher and have just missed the first 5 days of school. The severe pain wakes me up at night, even after taking 600mg of Gabapentin. I think I even have it in my esophagus! Some level and side as the rash...
The rash covered my left breast, and even though the rash is fading, my breast, along with the rest of the left side, is very, very sore!
When should I return to work???
Merry19451 rlyndecker
Posted
I am sorry for your suffering with this disease.
Did you receive Antivirals? I certainly hope so. Where is the rash?...
My suggestion is that you stay at home and rest and sleep. What the physicians neglect to inform you is that you need to rest rather than power through this. If you go to work, the pain will intensify, the exhaustion will overwhelm you, and the episode will last longer. If you return to work, the risk of Post Herpetic Neuralgia increases.
I am a Nurse Practitioner in the US and have had Herpes Zoster-Shingles every three to five weeks in my right ear for the past twenty years and twice in my right eye.
Please let me know how I can help you
Best wishes
Merry Juliana
cathryn93621 Merry19451
Posted
I’m SO glad to find all you. I am a 65 year old teacher of elementary art and music. I have just missed the first 5 days of school due to shingles, and still have severe pain waking me up at night, even after 600mg of Gabapentin. I have completed 7 days of acyclovir. I also have pain on the left side of esophagus... hurts with hot or cold. Shingles internally? I wonder if I should try going back to school... or when? I don’t know how to judge. Help!
Merry19451 cathryn93621
Posted
I am so sorry you are going through this right now. I understand the agonizing, lancinating pain, sleepless nights, and suffering.
Where exactly is the rash and pain?
Gabapentin 600 mg total for 24 hours is a low dosage. Are you on any other analgesics for the pain?
I get Shingles in my throat, ear, and scalp, and have difficulty swallowing. In fact, I often choke on my food, liquids, and saliva during each episode...
I am also fatigued and have zero energy.
If you have more vacation or sick time, please take it. This disease is a scourge, and any physical exertion will only cause additional spasms of pain and prolong the healing process.
I am a Nurse Practitioner in the States. 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.
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
Description of pain: deep burning or aching pain, or electric shock–like pains.
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!
I will continue this post in a few minutes!
Merry Juliana
cathryn93621 Merry19451
Posted
I’m glad you are there!
My rash is on the left side at breast level. In fact, my breast is so, so sore. The pain has moved from all in the back, now also to the front and side, including upper left arm, inside . My back pain has improved a bit. Can I have it on my esophagus? Very sensitive to hot and cold liquids in that same place on the left... internally.
I started having the pain and rash 2 weeks ago, started on acyclovir after 4 days. I had gone to the chiropractor twice for pain thinking I had a rib out!
The rash didn’t blister except in two areas. The pain is the main thing. I was on hydrocodone for several days, which didn’t help. Now I am alternating Tylenol and ibuprofen every 3 hours, which helps more than anything else with pain.
I don’t know what to tell my principle about returning to work.
I appreciate your advice!
Merry19451 cathryn93621
Posted
If you are having sensitivity to hot and cold fluids when you drink, I am certain the virus has affected the sensation when you swallow. The cranial and spinal nerves aid with swallowing. It sounds as if you have several dermatomes affected on the one side. I would ask for one week off, then tell the principal it could be another 1 -2 more weeks after that. It is difficult to state how long it takes to recover, but the older one is, the longer it takes. You cannot power through this. Usually, people feel exhausted. You need to obey your body and sleep.
Merry Juliana
cathryn93621 Merry19451
Posted
Merry19451 cathryn93621
Posted
Here is a complete summary of Acute Shingles, Diagnosis, Treatment, and Management I try to send to the individuals on this forum....
I might suggest if you are truly only on Gabapentin 600 mg daily, that you ask your Physician to taper up, as it does help with the Neurogenic pain.
Please keep me posted.
Best Wishes
Merry Juliana
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
Description of pain: deep burning or aching pain, or electric shock–like pains.
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.
Merry19451 cathryn93621
Posted
Merry Juliana
cathryn93621 Merry19451
Posted
(Of course, if I’m not medicated, I’m walking around the house in the middle of the night crying from the pain, waiting for the next dose to kick in.)
Merry19451 cathryn93621
Posted
Of course, that is how we were brought up and how they make us feel.... however...your first responsibility is to yourself and to get better. No one really cares at work if you are suffering. (Except your dearest and closest friends)
I found out the hard way we are all dispensable)
I had Herpes Zoster-Shingles as a single mother and worked through it, and paid for it by getting recurrent Herpes Zoster-Shingles every 3-5 weeks for the past 21 years.You owe it to yourself to care for yourself. We in the service professions do too little of that. We are underpaid and overworked and overstressed.
Best Wishes
Merry Juliana