SHINGLES or herpes zoster is rapidly becoming the 21st century plague for us baby boomers. Health Canada statistics suggest one in three seniors will experience this unpleasant and painful disease sometime after age 55. Other younger groups including cancer patients and anyone else with compromised immune systems such as diabetics and HIV victims are also likely victims. The source is the varicella or chicken pox virus you experienced preadolescent consisting of generalized body blistering over an approximate two week span followed by a healing phase of drying and scaling of the lesions. What was not known or understood at the time is the virus doesn’t die, it enters a dormant phase hiding along a section of nerve roots somewhere in the body then reactivating many years later for unspecified reasons including ageing, poor nutrition, onset of diabetes, stress and many other immune deficiencies.
There are two phases to this disease, a PRODROME warning phase consisting of non-specific flu-like symptoms, fever, headache, nausea and a variable pain component over part of the body variously described as tingling, numbness, burning, itching, or even shooting electric shock quality pain. The pain may be intense and dependent on where on the body it occurs, can mime kidney stone, aneurysm or even heart attack. Many a competent emergency room physician has done some serious head scratching over the diagnosis in this phase. Some two to seven days later the diagnosis becomes obvious with the appearance of an intensely painful blistering ONE SIDED rash with the patient very often describing the skin as intensely sensitive to even light touch. The active phase lasts three to four weeks with eventual drying and crusting of the blisters. The unlucky majority of patients continue the pain component called post herpetic neuralgia for months, even years. It’s an uncomfortable process but not life threatening although there are serious consequences if the lesions occur around the eye or the groin interfering with urine outflow.
Us baby boomers should be the last generation to experience chicken pox because of the new vaccines given to children in following generations although there is a growing ill-informed counter culture not signing for the vaccine for their children. I need to emphasize chicken pox is NOT a skin disease, it is a systemic virus with potential for serious compromise of major organs including brain inflammation.
There is treatment available for shingles with the operant word being PREVENTION. There is a vaccine available for seniors. It costs in the range of $225 and is not currently covered by public health plans although it should be. Intelligent government (is that an oxymoron?) would recognize the scope of its own predictions and address the cost effectiveness of such a move. For those at risk and not immunized, the key to effective management is EARLY RECOGNITION. The clue is the distinctive distribution of the pain over a one sided part of the body without apparent cause. The DIAGNOSIS should be made the day the blisters appear. See your physician immediately and start an antiviral as well as appropriate analgesic that day. Both are covered in senior drug plans. The sooner the antiviral is started the quicker the response and the greater the likelihood of suppressing the painful after phase The best available medication for pain is probably GAPAPENTIN excellent for nerve source pain and relatively inexpensive and doesn’t have the addictive properties of opiates.
Oh, the blistered chest in the picture? That’s me when the doctor doesn’t take his own advice!