Shingles on right arm 68 year old female, need any suggestions from knowledgeable people.
Posted , 8 users are following.
Shingles is covering at least half of arm from forefinger to high on shoulder. Slight pain for 2 days before rash started 5 days ago (couple pink spots) and has continued to expand to present along with pain. Shingles was diagnosed 4 days ago and anti-viral was prescribed, but pills were so big (1gm) they couldn’t be swallowed and now way pass 72hrs recommend time frame for start. Pain is extreme to point arm and hand cannot be used at all. Vicodin doesn’t relieve pain only allows 2-3 hours of sleep (which does help some). A melanoma was removed from forearm with 4 lymph nodes removed in arm pit 7 years ago.
All ready understand Shingles process but have questions that can’t seem to get answers about.
1) How long does the rash normally keep spreading?
2) At what point does the most severe pain slack off?
3) Any recommendations for pain relief?
4) Does anybody know if complications could happen because of lymph nodes removed?
2 likes, 73 replies
Merry19451 don53138
Posted
Dear Pat and Don,
I just reread all your notes, Don. I must ask, Don, if it isn't too impertinent, what is or was your profession? You are excellent at recording details of Pat's progress? Also, where do you live? You are such a devoted couple.
The lymphedema is caused by the removal of the lymph nodes, causing any obstruction of flow of the lymph material. Any infective process, such as the severe Herpes Zoster-Shingles in Pat's arm certainly magnifies the problem.
I would suggest that you ask your physician for a referral for Occupational or Physical Therapy for Compression Therapy, Massage Therapy, and Exercises. These modalities can be extremely beneficial in reducing and managing the lymphedema. The therapist should have the resources to help Pat and you, Don. Obviously, you both know that with the edema or swelling comes increase pain. I certainly would stay on the Gabapentin at this stage.
As you already know, Pat's melanoma predisposed her to Shingles in the same area.
As an amusing side note, as you may or may not know, I have had Herpes Zoster-Shingles in my right ear every 3 -5 weeks for the past 21 years. Until I read Pat's story, it suddenly dawned on me, I had a serious right sided head injury two years before I developed Herpes Zoster-Shingles. Talk about hitting me over the head again. LOL
I hope my suggestion helps you.
My best wishes for a continued recovery, Pat. I know how tedious it seems.
Fondly, Merry Juliana
don53138 Merry19451
Posted
I’m a retired mechanical/electrical troubleshooter-repairman from an industrial setting. Maybe that’s why I focus on details as they were always useful to me when troubleshooting. We live near Williamsburg Virginia.
Her PCP did mention therapy for lymphedema after shingles had cleared up. But at this point she can’t stand for anything to touch hand, upper arm or shoulder. She did have compression therapy awhile after the melanoma and lymph node removal, but she only had little pain at operation sight then. She even remembers the self massage exercises for the lymuphedema, but can’t do them yet. We’re not sure shingles process is complete yet, as she still has some skin peeling from thumb and spots up arm where rash was is still slightly visible.
Certainly sounds like your and her shingles are in previous trauma areas. As I have said before I sympathize with you on the re-occurring shingles!
Your suggestions are always appreciated, not only for time you contribute but for the knowledge and accuracy we have come to recognize.
Thank You and best of wises to you also.
Pat and Don
Merry19451 don53138
Posted
I had pictured a mechanical engineer type of fellow, but one with a huge heart.
Obviously, as you know, the therapy has to wait until the pain is diminished.
Best Wishes
Merry Juliana
HighPriest don53138
Posted
Coming from someone me who had singles and never seen it again after I've use, lysine amino acid supplements 500mg tablets 2 times a day, will help get the virus out of you, stop other outbreaks and relieve pain. also a good hint is to change up your diet as well to lean turkey, fish, chicken, veggies, and stop anything processed for a month to help the healing go as it needs too
don53138
Posted
Was wondering if there is any chance shingles or PHN could have inflamed Bursa in shoulder? We just today found a position in a recliner that can allow her to properly elevate arm longer than short periods without severe shoulder joint pain. We also started routine ice pack treatment of shoulder (Bursa area) with hope of helping if bursitis related. Note: she cannot tolerate NSAIDs to help with inflammation.
Any advice is appreciated….. Don
hope4cure don53138
Posted
Merry19451 don53138
Posted
Hi Don or Pat,
Has Pat had shoulder pain before the shingles? Does she have an orthopedic surgeon she can see? I would schedule a visit with an orthopedic surgeon as soon as possible. Shoulder pain usually doesn't improve on its own, and is difficult to figure out. It certainly is painful. Hope for a cure is correct in the need for an imaging study.
Sometimes fluid can be drained from an inflamed bursa or corticosteroids can be injected into an inflamed joint with excellent relief. I had a shoulder injection done twice with Excellent relief.
Best Wishes
Merry Juliana
don53138 Merry19451
Posted
Pat did not have any shoulder problems before shingles and nothing to cause a problem during. It just seems to have manifested itself during the shingle/phn process. She doesn’t have an orthopedic surgeon, but that could be arranged. I had a routine doctors appointment today which is Pats doctor also, she indicated they could request imaging (X-ray and up to MRI if needed) and there was a doctor with their practice that can do the corticosteroid injection such as you suggest.
Thanks to hope4cure and you for great suggestions. If we don’t see improvement shortly we will certainly head in the direction both of you have suggested.
Thank you, Pat and Don
jamie86426 Merry19451
Posted
Merry,
You are amazing. I learned a lot just reading your comments.
I have rheumatoid arthritis, and it's never a dull moment. I started having pain under the arm and in the shouler. Then it started traveling down the arm. My pinky and ring finger started getting numb. Knowing I have herniated discs in the neck, I thought it was a pinched nerve, so I made an appointment to see the ortho. In the meantime I wound up with 3 pink welts that looked more like hives. I started a new med, so I thought it could be an allergic reaction. I saw primary care. They thought it was an allergic reaction as well. Then it just started to erupt all over the arm. It went across my upper back. Saw rheumy and my DO and they thought it appeared viral, but didn't fit the shingle typical pattern. My hand swelled up to the point it's hard to close. They found a dermatologist to get me in right away. He did 3 biopsies, which I'm still waiting for results. Couldn't say for sure what it is, but says he believes it's disseminating shingles. Even though it's way past 72 hours, I'm taking valacyclovir. I had to ask for gabapentin today, because the nerve pain is preventing me from sleeping. I'm still getting chickenpox looking spots on thighs. Nothing ever really broke open or "scabbed' which is strange. Just have very dark spots now.
I was never itchy. The bummer is I finally was able to walk after 2 years of tendonitis in the feet. Last year the posterior tibial tendon ruptured from the ra. They transferred a tendon and sliced the heel bone and moved it over. Took a year to recover. Then BAM....shingles! Fun.
I can't wait for the non-live virus vaccine, in hopes others with compromised immune systems, don't have to go through this.
You seem to be a great help and lots of support for people. I have to say thank you for that!
Merry19451 jamie86426
Posted
Jamie,
I am so sorry you are going through this. I am concerned if it is disseminated that you should be admitted to the hospital on IV Antivirals. Your judgement can be really poor when you are so sick.
I know my clinical judgement regarding myself has been poor when I am very ill.
Is Gabapentin helping the pain? I know RA and herniated discs, plus shingles can all be excruciating, but sometimes you need a cocktail of analgesics. You have probably read my suggestions regarding analgesics and pain control. If you are in agony, you can be admitted to the hospital for pain, BTW. If you are on biologics, I don't doubt the disseminated Herpes Zoster-Shingles. Well, I don't doubt it anyway, with your RA.
Physicians tend to disbelieve my recurrent Herpes Zoster-Shingles every three weeks and marginalized my identical twin's SLE, RA, & Sjogrens, until the blood work came out positive.
Please let me know how I can help you.
Best Wishes
Merry Juliana
jamie86426 Merry19451
Posted
Thank you so much, Merry!
I really appreciate your feedback.
My heart goes out to you and your family.
I'm actually a twin - not identical. I often wonder how much being a premie has impacted my immune system.
I'm still waiting for the biopsies. The rash is clearing up, but the pain isn't easing up yet. I only had 2 gabapentin so far.
This stuff, on top of dealing with the ra, wears me out. :\
The dermatologist did mention if it looked like things weren't getting better, I would need an IV.
I wish you all the best, and am very grateful for your help!
Big hug to you
Jamie
jamie86426 Merry19451
Posted
Geeze! Just saw blood tests I had before I started the valacyclovir. The creatinine is 1.26 and gfr is 48. I know the antiviral is bad on kidneys. I started a medrol pack when I thought it was a pinched nerve. I wonder if that messed with kidney values. I'm concerned with taking this antiviral, especially since I started way after the 72 hours. I reached out to all my docs. Need to stay on top of everything!
Merry19451 jamie86426
Posted
A Medrol pack or short term seven day dose of Valcyclovir should not cause irreparable harm to your kidneys. I would not do maintenance therapy with Valcyclovir, however.
People taking daily NSAIDS do more harm to their kidney function, cause peptic ulcer disease and hypertension. You are right to be concerned regarding your kidney function and should be seeing a nephrologist, ASAP. I am in Stage 3 Kidney Disease.
Merry Juliana
jamie86426 Merry19451
Posted
Sorry to hear that Merry.
My DO and rheumy watch my liver and kidney values all the time. They are all over the place depending on the medications.
Geeze, this nerve pain is terrible. It seems to be worse at night. Gabapentin isn't helping yet. Norco doesn't do anything either. I get the biopsies stitches out tomorrow, so I'm going to see what the dermatologist can give me to help. Still didn't get the biopsy results.
I hope you feel better. I can't imagine going through this as often as you do. I really appreciate your help. I'm sure others do as well.
Have a wonderful day!
Jamie
Merry19451 jamie86426
Posted
Jamie,
Norco isn't worth taking. Try Oxycodone 10mg every 4 hours.
Also, Lidocaine Cream topically.
Merry Juliana
jamie86426 Merry19451
Posted
Thank you once again!
I just saw dermatologist and asked for something for pain. Since my DO gave me the gabapentin he wants them to manage it (?? geeze).
I know the gabapentin takes a while to get in the system. I'm going in if it ease up soon. Sad thing is I'm used to pain.
I hope you are feeling well!
I really appreciate your feedback.
Merry19451 jamie86426
Posted
Jamie,
I'm sorry. It sounds as if the dermatologist doesn't wish to be bothered. Most physicians these days don't even care if their patients are in pain.
Being used to the pain doesn't mean you function well with the pain, however.
I know agonizing pain (and itching) very well, unfortunately.
Best Wishes
Merry Juliana
Merry19451
Posted
I have some choice words for your dermatologist, BTW.
Merry Juliana
don53138 jamie86426
Posted
"I know the gabapentin takes a while to get in the system. I'm going in if it ease up soon. Sad thing is I'm used to pain."
Jamie, sorry about what you’re going through. My wife (subject of this thread) took 1800mg daily of gabapentin for over a month, with no pain relief at all. She is still suffering with pain (now in 7th month) from PHN of arm/hand diagnosed by neurologist she’s been seeing for couple of months now.
She only started getting some relief when he prescribed oxycodone-acetaminophen 10-325mg ever 6 hrs as needed. Exactly as Merry suggested to you and very early is this thread for my wife. We’ve found her to be right on target from the beginning.
jamie86426 don53138
Posted
It broke my heart reading what your wife is going through. Merry truly is a blessing. I learned a lot in these threads. I also have it my right hand and arm. It's horrible.
I'm going to make an appointment with my DO. The system is screwed up when people that need help with pain can't get it because of government bs and people that abuse the meds. I deal with ra pain everyday, but the nerve pain is a lot different. I don't want to wind up with permanent damage.
I wish your wife all the best. She's very lucky to have you. We are lucky to have Merry.
Have a good night!
don53138 jamie86426
Posted
Were you able to see DO and get some help with pain relief? You’re right on target about government bs and abuse by some of meds, a point Merry has made in other ways in the past.
Thanks for well wishes for my wife. We wish you the best also, both with this and your arthritis.
Don
Merry19451 don53138
Posted
I was thinking about you and your wife as I was going through another bout of Herpes Zoster-Shingles. My wonderful husband and son were caring for me, not much to do, but cooking and cleaning, LOL, but you know what I mean! I thought of how you cared for your wife through it all, and researched options.
How is she doing, currently?
Are you and Pat going to get Shingrex?
I will, once it becomes available in Delaware..
All my best to the both of you!
Merry Juliana
Merry19451 jamie86426
Posted
I am playing catch-up. I have had two shingles episodes, pretty much back to back. How are you doing, now? I know the RA pain and dysfunction never completely resolves...my mother had it, and my identical twin has it along with SLE.
I hope the worst of Shingles is over for you. Please let me know if there is anything I can do.
Best regards.
Merry Juliana
don53138 Merry19451
Posted
Sorry to hear you’ve been having repeated back to back episodes, that is more than I can even imagine! But glad to hear you have support with husband and son.
Pat has made a little progress in last month. Slight pain reduction requiring only one Percocet near bedtime. She has ~20% of arm usage but no finger usage yet, but encouraged that some progress is happening be it extremely slow.
We do plan to get Shingrex but not sure how far Pat has to improve with the PHN issue. We would also like to see more improvement of right arm before getting shot in left arm, incase it causes problems there, making her armless so to speak.
Don
jamie86426 Merry19451
Posted
Hi Merry,
Geeze I'm so sorry you are going through this so often. I can't imagine how you feel. Once is bad enough. I wish there was a way I could help you! I'm glad you have a wonderful family helping. Going through this alone is rough.
I'm hanging in there. The nerve pain is horrible at night. I wind up itching more as well. We increased the gabapentin , but I'm not sure that's helping. I might switch to Lyrica to see if that's better. It's weird that the area where the rash started keeps fading and then gets red/pink again. Not sure if that's normal. I'm about 5 weeks into this.
We had some terrible heat and humidity in the Chicago area. That doesn't help.
I'm finding that a low dose of xanax ( 0.25-0.5mg) seems to help me cope a little better.
It's a shame that one has to beg for the pain relief needed to deal with chronic pain. I hope you have a team of understanding doctors to get you through.
I really appreciate your help and support, especially when you are not feeling well!
I finally have a disability hearing scheduled. I haven't been able to work for 3 years. That system is broken as well because of abuse. I'm praying it goes through. I live alone and I really need them to do the right thing. I paid into it for 40 years!
You take care. I wish you relief!
Thanks again for all the people you are helping!
Jamie
jamie86426 don53138
Posted
Hi Don,
I increased the gabapentin and took the norco or tramadol when I needed. The nerve pain still gets bad at night along with the itching. I'm going to make an appointment with a pain management doc. I need help with neck, back, and the ra. Maybe there other things that will help along with the meds. It's sad to have to say pain is a part of my life, and something I learned to deal with.
I hope your wife is over this terrible virus!
I keep telling people to get the vaccine!
Thank you for your thoughtful words.
I wish you the best as well.
Jamie
Merry19451 jamie86426
Posted
Please let me know about the disability hearing. As you are older, your chances are higher. I did get disability after my second stroke, but I was almost Social Security age, anyway.
Best Wishes
Merry Juliana
jamie86426 Merry19451
Posted
Hi Merry,
I was just wondering how you are doing.
Luckily my nerve pain calmed down and I'm starting to taper off the gabapentin.
I have my meeting with the lawyer this week, prior to my hearing. I'm praying they do the right thing by me! This is really stressful.
I hope you are feeling better!
Big hug to you
Jamie
jamie86426
Posted
I really hope your wife is doing much better! She had a really rough time with this.
I keep telling people to get the vaccine if they can!
Jamie
Merry19451 jamie86426
Posted
Best of Luck to you with your hearing! Please let me know how it goes! I am still on the waiting list for the Shingrex immunization at the pharmacy.
I keep getting Herpes Zoster-Shingles every 3-4 weeks, as usual... but continue to enjoy life.
Best Wishes
Merry Juliana
jamie86426 Merry19451
Posted
Hi Merry,
I really hope you are feeling better.
I had my hearing yesterday and they are finally doing right by me. I will be accepted, but it's not official until I get the letter. It's been a long 3 years.
I wound up in the er a few weeks ago for my back. They gave me norco 10, 60mg of prednisone, valium, toridal shot and it didn't help. They then gave me a morphine shot and it did nothing. I must be opioid insensitive. I don't get it.
Best of luck to you. I can't imagine what you go through with the reoccurring shungles. It's crazy.
Jamie
Merry19451 jamie86426
Posted
Jamie,
I am relieved for you, as I know the struggle of living with disabilities. I hope they give you a fair amount of salary to live on.
Unfortunately, the Herpes Zoster-Shingles has escalated and intensified. When I have it in my right ear every three weeks, I have difficulty swallowing and the usual excruciating pain...I am used to that along with the constitutional symptoms of fatigue, aches and pains, fever, sweating and chills. It has spread to my entire right scalp, including the neurogenic pain, neck stiffness, increase headache...
I had been unable to find a pharmacy who the Shingrex vaccination, but my Hematologist tracked one down. I received the first injection almost a week ago! Hooray for clinicians who are excellent and still care!
Please keep me posted!
I hope you are not in Florence's path!
We are on the fringe, hopefully, in Delaware....I wisely do not live on the shore, but winds and rain can always do damage inland.
It is always wonderful to hear from you! My husband, son, antique 22 year old cat, and I otherwise are doing well!
Again,
Fondly,
Merry Juliana
jamie86426 Merry19451
Posted
Hi Merry,
I wish they could find a way to stop the shingles for you! I can't imagine what that must be like. Once is enough!
You need some relief! I rheumy appt today and talked about the vaccine.
Geeze, I thought once I was approved the stress would go down. Trying to figure what supplemental insurance plan I need is crazy.
I'm in the suburb of Chicago, so I'm safe. I hope you don't get too much rain. I have friends close to where Florence is going to hit. If it stalls, flooding could be pretty bad.
I lover your comment antique cat.
My sassy brat is getting up there. They bring me a lot of comfort!
Take care and I hope they can figure this out for you. Thanks again for all of your help!
Merry19451 jamie86426
Posted
Jamie,
I remain ever optimistic that the Shingrex vaccination will either decrease the frequency and intensity or even cease the shingles entirely. My hematologist just viewed my cbc with fresh eyes (he sees me for atrial fibrillation) and realized my white cells are chronically misbehaving, just like me....( lymphocytes and neutrophils)
There are always many people who are far worse than I am, so I am perpetually grateful for what I have.
Thank you for your kind words and support.
Unfortunately, I think our neighbors to the South will be hard hit with Florence. I feel for these individuals, as I have weathered too many hurricanes and nor'easters.
Best Wishes
Merry Juliana
jamie86426 Merry19451
Posted
Hi Merry!
I'm just wondering how you are doing and hope the shingrix vaccine helped. I had my first dose. Luckily no real side effects other than my arm hurting for several days.
The disability finally went through, which is a big relief.
I hope you and your loved ones have a wonderful Thanksgiving!
Jamie
Merry19451 jamie86426
Posted
Hi Jamie,
The initial dose of Shingrex decreased the frequency and intensity of episodes markedly.I am barely sick with Shingles, but get the burning rash on my scalp, insomnia, headache, earache, but am not bedridden Hooray! I am due for the second injection now, but the pharmacy who has it is a 1-1/2 hours drive.
Thanksgiving shall be quiet this year... Fortunately, no horrible health problems are leaping up in our family, as in years past....as one friend has repeatedly told me, it sucks to be you.... LOL.
Best Wishes
Merry Juliana