Shingles without the rash

Thank you

Dear elizbrig,

I am so sorry for your pain and suffering.

The medical term for shingles without the rash is Zoster Sine Herpete. You hurt just as much as those of us with rashes.

If your eyes are affected by the Herpes Zoster-Shingles, you should see an ophthalmologist, immediately.

I hope you were started on an antiviral as soon as you were diagnosed. I also am hoping the physician gave you strong analgesics.

It sounds as if the area of your pain is quite extensive.

The fatigue that accompanies the Zoster can be overwhelming. Most physicians are unaware of the other symptoms that occur with Zoster-Shingles that simply drain you. The pain obviously is the worst, but the exhaustion, fatigue, (headache, fever, chills and sweating are pre-pain phase) resembles the flu. The fatigue and exhaustion can last for months...

I have had Herpes Zoster-Shingles in my right ear every three to five weeks for the past twenty years. I am a Nurse Practitioner in the States.

Please let me know if I can help you.

Best regards

Merry Juliana

Good morning sorry you are experiencing so much pain I was diagnosed about a month ago and I experienced the itching and the burning with no rash however the pain was mild the doctors gave me Valtrex which is a antiviral medication in Tramadol for the pain itching and burning lasted for about 2 weeks shingles can be very uncomfortable hope you feel better soon, peaying for some relief in your healing. They says shingles can come from stress

Just replied to Danielle999 also.  My husband has exact symptoms as you and the pain is aweful.  No blisters other than 2 bumps but internal pain left breast area and left scapula area next to thoracic spine is aweful especially when trying to sleep and seems to subside when moving but laying down he just can't get comfortable.  Its been about 10 day and not much relief.  Any suggestions other that back to the ER?

Thank you

I am sorry to reply to this thread but I couldn't figure out how to send Merry a message on my own. Merry I wanted to ask you about a blood test for shingles. I had heard in the past that there was no test to be done via blood or otherwise unless they scraped puss from the shingles wound, providing you had that type of outbreak, which I don't, but anyway that was what I was told by many dos in the past. I have finally been diagnosed by a neurologist. Dr Virdia in Flemington. I had pics saved on my phone of a outbreak on my leg that doesn't usually surface. Based on all my testing and all my dr visits he finally diagnosed me. Having said that, I am seeing a new GP and she isn't familiar with shingles at all. I needed her to keep my anti virals going as well as my blood pressure medication since my outbreaks were raising my stress level which raised my blood pressure. Anyway the GP had me do more blood workup and she tested for varicella zoster IgG and varicella zoster Ab, IgM. Do you know anything about these tests? Both tests came back over the result limits and both said flag however she said both tests showed that I did not have shingles. The most frustrating thing is when Dr's don't believe me since they can't see the pain I am in. I feel like I have finally been diagnosed but not one but two drs who do believe me and now this dr says my test was negative and wants to test me again when I have my next outbreak to see if my results change. I am curious to know your thoughts. I also wanted to know in your profession, do you treat and diagnose this type of virus? What type of medicine do you practice?

Hi D...

First, I am a Nurse Practitioner in the States with over forty years of experience. I went to Columbia University in NYC and the University of California, San Diego. I have a graduate degree. More importantly, I read medical journals every night to keep up to date.

The direct fluorescent immunobody staining test is less accurate than the PCR Polymerase Chain Reaction Test - most accurate. Both involve scraping of the viral particles in the vesicle-blisters that have newly formed on the skin. The Varicella IgG and IgM blood tests are least accurate. They are testing your titers of the chronic and acute stage of the Varicella virus. Timing is everything in this test, as it has to be done when you are acutely ill with Herpes Zoster-Shingles, but wait until the titers to rise. If you are on corticosteroids, for example, you may come back negative, as it is suppressing your body's natural ability to fight the Varicella virus. My question to you is, were you diagnosed with chickenpox at one time? Have you had the vesicle-blisters typical of the shingles rash, with the excruciating, lancinating pain following one or two dermatomes? Was it preceded by some of these symptoms including headache, fever, chills, sweating, aches, and pain,malaise and fatigue?

The thing is, I listen to the individual, believe the person regarding the pain and accompanying symptoms, and treat the person.

Often times with recurrent Herpes Zoster-Shingles, depending on the frequency, if it is often, it pays to be on Neurontin, which is titrated up. This helps with the chronic neuropathic pain. Once the pain has become chronic,the body does not know how to shut off the pain signals. The Neurontin helps suppress these signals.

Also, if you are in significant pain, some people also respond to the addition of SNRIs, like Cymbalta or Venlafaxine.

These drugs are for people in significant and chronic pain. As with any medication, there can be significant side effects.

BTW, I am on a drug similar to Neurontin called Topamax, that also helps with my chronic Migraines. It has totally suppressed them. Topamax has helped attenuate the severe neuropathic pain I have with the recurrent Herpes Zoster-Shingles every three to five weeks in my right ear. I am also on Venlafaxine. I am certain that I would have Post Herpetic Neuralgia PHN if not for these two drugs.

My suggestion to you is to switch your treating physician for Herpes Zoster-Shingles... I am glad they are ruling out other causes of the pain, just to be certain....but you need a physician who believes you.

Best wishes

Merry Juliana

Thanks so much for your reply. I knew you were a NP I was wondering if you treated patients with shingles. I currently see a NP in Hackettstown and would come visit you if you saw patients as I live less then 30 min from you. You are far more knowledgeable then anyone so far other then this last nuerologist I recently saw. Most pp don't know anything about reoccurring shingles however knowing you suffer from the same thing as the rest of us on this site makes you more compassionate as well as knowledgeable and that's where we all find comfort in you.

I hate to put too much of my info out there but yes I was diagnosed with chicken pox, not only once but twice. I was 21 the first time and 34 the second. Herpes twice after I was 21 and shingles started when I was 28. Chicken pox never surfaced. I was covered in spots but nothing I could pick. Shingles started with a red mark on my back that was extremely painful but never became anything more then a red mark under my skin. I have had about a dozen cases of shingles that had similar red marks until it came out on my right leg 4 years ago and never fully went away. I knew when I was getting sick because it itched and then the pain would start in my back. The last case started in Dr hand I still have it at least twice a month since. Sometimes I am in bed for up to a week because I can't walk and I am weak. The pain has traveled down my hip into my leg. Sometime inner thigh. Only the right side of my body. I have been desperate to find answers since December. It used to be a round of valtrex would get rid of it and I was fine in a day or two but never missed a day of work. Since December I have been in so much pain that I can't function. I was getting off a plane one day in December when this case started, not knowing what I had, I couldn't move. I got into charlotte airport and was fortunate to see a massage place literally as I got off the plane. My 10 yr old daughter had to wait by herself in this waiting area while I went back for a massage. I was scared to leave her but I had no choice. He told me my back was tight and he worked it out so I could walk. I was only there for 30 hours. Worst trip of my life. Couldn't wait to get home to take an anti inflammatory and a muscle relaxer. I was in bed for almost ten days. Clueless as to what I had. It took a few months of this before I put it all together and this is when my life changed due to shingles. I do not get a fever, chills or any other symptom you asked about. I now just can't move for 3 days twice a month which i think I finally have it under the best control possible since December due to the anti virals. After talking you a few months ago about this I had my dr change my prescription to famir instead of valtrex. This dr doesn't believe me and now since the blood test she just took, it's going to be harder for her to treat me with the famir willingly. I can send you pics that I took every month of my leg and how the rash comes out in me. I disclosed too much into to another person on this forum and told them about the stress level I am under which I contribute shingles to and I hope once my stress level changes, this virus won't be as debilitating.

I had a typo on "dr hand" which was autocorrected and was supposed to be December.

I have tried all those drugs and then some. What I am doing this time is taking nuerontin, cymbalta and famir on a regular basis. I have been doing this since my last outbreak which was the last week of august. I changed my diet and got serious about taking these pills three times a day. I am taking 1500 mg of famir which I think is a lot but I am trying to see if I can avoid getting this virus again twice a month. I did have a problem with the famir in the beginning of September since my GP wouldn't refill it for me so I had to go one day without an antiviral and then I had a refill on the valtrex so I took that instead until I saw the GP on 9/8 and convinced her to give me enough famir to try to see if this drug three times a day for 30 days would make a difference and she believed me enough to allow it. Today being the 23rd of the month I can honestly say I am showing improvement. I do have pain in my right this week but it's that time of the month and this has also created a lot of more pain only on my right side every 30 days. My cramps are so bad and it's strange that my cramps are now only on my right side.

I am not sure if you had read any part of my story in the past but I had emergency surgery in 2012 after I fell on to my dog to protect him from another dog who charged at us. I got taken to the hospital where I had internal bleeding and what they had first said was a ruptured appendix. Once I got in for surgery they said my appendix was fine and other then my abdomen being full of blood, they were baffled as to what was wrong with me and where the blood came from. I wasn't happy with them not knowing so I checked out of Hunterdon medical and checked into Morristown. They ran every test known to man and came up with a slew of issues but nothing pertaining to this fall, where the blood came from and the appendix which was fine. Ever since that unnecessary surgery, I have never been the same and it's all been on my right side.

I mentioned in a past post that my Obgyn diagnosed me two weeks ago for the first time, as they also diagnosed me many years ago with herpes. She told me that I have Post Herpetic Neuralgia PHN and gave me some ideas as to how she would treat me. She asked me to discuss it with the nuerologist the following day because that was my appointment that I waited so long for. I didn't tell him what she told me because I wanted to see what he would diagnose me with and he too told me I had PHN. I had told him before his diagnosis all the efforts I have made since December and I have truly done every test, every pill, every MRI, scan, blockage, trigger point, diet, drs, there is NOTHING I haven't tried. He wanted to look at my dozen or so scans but in the meantime he wanted me to take 1000 mg of vitamin C for 30 days to see if there was any difference. He increased the topical cream with stronger numbing ingredients and that's it. Nothing more can be done for me other then trying to reduce my stress level, getting more rest and trying to increase my immune system.