Shingles on right arm 68 year old female, need any suggestions from knowledgeable people.

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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

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  • Posted

    Quick 12 week update. Pats PCP did begin imaging study yesterday with X-rays of shoulder and hand (as suggested by hope4cure and Merry), also blood test to rule out clot as possibility for swelling. All of which showed no problems, they also started her on and antibiotic to rule out any bacterial infection. Follow up appointment this coming week to decide on next process going forward. Both NP and doctor involved felt sure that present hand/shoulder problem were not associated with PHN and approved slow taper down of Gabapentin but did prescribe more pain control as needed to get through this process. We’ll see how it goes and if any connection is found to be related to original shingles phase or PHN going forward I’ll return with an updated.

    Don

  • Posted

    Hi Don and Pat!

    Is Pat's shoulder feeling more arthritic than burning, ie like Shingles pain? That would actually be a good thing, as it would be easier to treat. The thumb swelling and pain certainly has me concerned. Is the thumb very red, swollen, and throbbing?

    It is amazing how much a tiny bit of appendage on the body can cause so much pain, isn't it? I often thought of that regarding my right ear...as I would writhe silently in pain. At least they are taking Pat's complaints seriously.

    My best wishes to you and Pat as we approach spring.

    Merry Juliana

    • Posted

      Hi Merry,

      Sorry for late reply but been tired up all day. Pat’s shoulder pain is more like what (we would think) arthritic pain might be like. A constant lower level pain deep in shoulder (Glenoid cavity) area extending up towards (Acrormin), which increases with usage and sometimes has sharp shooting pain thru that area with certain movements which at times can even be felt in back (Acromial angle) or (Scapular spine) area. I had to look up all those medical terms for description. She does have minimal burning pain, ie like Shingles/PHN pain on outer area of upper arm but it is tolerable where the shoulder pain is not.

      All fingers are swollen but thumb is worst. We would not consider the thumb as “very” red even though there is a couple spots that slightly redder than rest. It does not throb, but feels tight and painful, more so when touched. She cannot curl any of her fingers, only wiggle them. She can barely make her thumb and forefinger touch can’t even hold small piece of paper between them. The swollen skin of fingers/hand have a shinny appearance and strangely enough the fingers slightly stick together like if you had pancake syrup on them even thought clean.

      Doctor did feel for swollen lymph nodes in arm pit area, but didn’t find any.

      Thanks for your continuing concern and support.

      Pat and Don

    • Posted

      More info, Merry

      Follow-up appoint PCP confirmed no bacterial infection, no sign of bursitis, arthritis, bone spurs found in shoulder or visual sign of fluid there or hand (IIRC). They believe it to be rare “Complex regional pain syndrome” short wikipedia description “a disorder of a portion of the body, usually the arms or legs, which manifests as pain, swelling, limited range of motion, and changes to the skin and bones”. They recommended physical therapy which sounds like it will also include compression therapy as you suggested earlier.

      Pat and I are not sure but she is willing to try the therapy. What puzzles her is when she lowers (lower arm) so that hand is level or lower than elbow, hand turns red or blue tone until it is raised again above elbow.

      Don

    • Posted

      Don,

      My suggestion is that she consult with a sophisticated pain center and have more tests done. She should be seen by a team of neurologist, physiatrist-physical rehabilitation), specialist, and pain specialist. They can perform nerve conduction studies and electromyography, blood studies to see what is really going on. Complex Regional Dystrophy Syndrome is a diagnosis of EXCLUSION. Perhaps that is the only diagnosis, but it's really complicated with Pat. The Herpes Zoster-Shingles and lymph node excision certainly precipitated this, and at least for her arm and any where the pain and or rash initially was, Post Herpetic Neuralgia can be agonizing.

      She can be placed on a better cocktail of medications for the pain. I am not saying she doesn't need therapy for the arm, BTW. I feel she needs a thorough work up, however. I would do this if this were me, BTW.

      (I have had to be my own advocate to get help for severe spondylolisthesis grade IV and slipped discs. I needed surgery in my neck and my lumber spine and was walking with a walker before anyone would operate on me. The surgeries were both successful, BTW.)

      I shall be thinking of you both.

      Fondly,

      Merry Juliana

  • Posted

    I'm 68 contracted shingles on inside of right arm very painful in blister stage. I was on amtrak and the only thing I had was alcohol spray as soon as I sprayed it-on the blisters the pain totally went away. The alcohol dried up the blisters. I only had medicare and it doesn't cover the shingles vaccines( 2 doses). I'm an RN I researched foods to-eat during shingles and foods to avoid which helped alot. ie: some foods to eat, honey encapsulates the herpes zoster so it keeps it from replicating, pears, l-lysine, red skinned apples, raw spinach, asparagus, sweet potatoes,

    some foods to avoid: pasta, certain carbs like white potatoes, rice, white bread, caffeine, and foods with arginine in them. Drink lots of water get plenty of sleep youcan take baths I would rub baking like a paste and leave it on. I covered mine with bandaids after spraying blisters with alcohol and clothing I didn't want to take a chance of breathing in the virus from the blisters even though I believe the alcohol killed them as it also helped them to scab over( dry up) quickly. . This is an awful painful virus and can cause complications afterwards. I recommend anyone getting the vaccine when possible.

    even if you've had the shingles still get the vaccine.

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