Swelling with shingles

Thanks Merry 

I’m just resting at the moment and taking paracetamol. I have other conditions which mean I can’t take NSAIDs  or Codine based drugs. I on tv anti virals until next Weds so hoping it won’t get much worse .

Ruth

Hi Merry 

I’m a week into shingles and after the anti virals no new rashes or spots but after getting up and about more pain in thigh groin and now my hip up to my waist. Thigh is swollen too and hard to sit down . Should I ask for more anti virals? It’s getting me down now. Can’t take pain killers as they just make me sleep and can’t take strong ones anyway due to other medical conditions . 

Grateful for any advice 

Ruth

Hi Ruth,

I’m 35 and going through my first bout with Shingles and found this thread by googling everything I’m going through. Your experience mirrors mine to the T! I started to feel swelling in groin muscle area and started to feel swelling. I’m active so I thought I might have had a grade 1 groin sprain but after blisters showed on the same side but on my back toward my waste I went to urgent care. As soon as the doctor saw it he said it was shingles. I’ve been on valtrax since Monday and the blisters have not spread and are scabbed over.  However the swelling has spread from my groin area all the way to my hip and is painful and red. I’m a bit alarmed but started to take Motrin to help with inflammation. Any words of wisdom from experience would be greatly appreciated.

Keian

Hi Keian,

I am so sorry you are going through this right now. I understand the agonizing, lancinating pain, sleepless nights, and suffering.

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-two 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, but not always

Itching

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. You will need a prescription from your Physician.

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.

Best Wishes,

Merry Juliana

Thank you for such a detailed response.  I’m currently on 500 MG of Valtrex 3 times a day for 7 days. Currently on day 3. Also 800 MG of Ibuprofen as needed. The ibuprofen has helped with the swelling of the lymph nodes. 

Hi Keian,

The dose is 1000 mg 3x daily for Valcyclovir or Valtrex. You need to call the doctor and tell him to prescribe the full dose.

I hope you feel better soon.

Best Wishes

Merry Juliana

I goofed! I’m taking 2 500 mg bills 3x a day. 😬

Great...I was worried. .

Merry Juliana

Just to say that after a month with literally zero sleep... I discovered the best treatment was 4 ibuprofens, 2 taken 3 hours before bed and 2 half an hour before bed which dulled the pain and made me sleepy and then add the most important thing - a cold damp tea towel! Not only cools the area but insulates against rubbing clothes and sheets, which are a real nightmare!

Try not to stress, when it ends it ends really quickly, although you might get little flare ups for a few days after.

Mike,

Excellent, I am glad that works for you! I found the ice/cool compresses wonderful. Unfortunately, I have anaphylaxis to NSAIDS, so I cannot use Motrin, but for others without kidney problems, that is an excellent idea.

Best regards,

Merry Juliana

Thanks Gayleen

I’m hoping to get the shingles vaccine when this is all done with,Here they usually  only give it for over 70s but I’ll try. It’s a really debilitating condition isn’t it? I’ve just been sleeping for 2 days not got any energy to get up and about and the rash is so sore today 

Here they recommend the vaccine for 50+ but you can get the vaccine at any age if you have reoccurring. I have the reoccurring and I am going through another breakout as we speak. The doctor gave me a prescription for 6 refills as to keep taking the anti viral, so I can get the vacinne next year. You have to be free of an out break for one year to get the vaccine. Hope you find some relief. Gayleen