Time out for a public service announcement: on shingles
Those who know me well know that, although I have no special interest in medicine and never, never wanted to be a doctor, I have a strange quirk of mind that means I happen to remember medical facts and histories without even trying.
As a result, my friends often call me when they have mysterious ailments their doctors have failed to diagnose and/or treat. For some reason I seem to have a gift for making the proper call, something like the TV character “House” (although I try to do it far less grumpily).
Yesterday a friend described over the phone a painful rash that had been diagnosed as a spider bite, and I immediately thought, “No. Shingles.”
Why did I think it was shingles? Well, I’ve had a lot of friends with shingles, and some have been misdiagnosed. I’ve had it myself, and because of the research I’ve done I was able to stroll into the emergency room in the wee hours of the morning and declare that I had shingles and wanted the antiviral medication that, if given early enough, can help prevent one its terrible possible complication: post-herpetic neuralgia.
That’s why I’m writing this. If you have a painful rash that is on one side of the body in the distribution of a nerve dermatome (see chart below), take yourself to a doctor ASAP and say the word “shingles.” Tell them neo-neocon sent you.
Oh, and by the way, I was correct about my friend. Shingles it was.
[NOTE: The face can also be involved, even though the above chart doesn’t indicate that. The rash doesn’t have to be in the entire nerve-root distribution, just part of it. But it never involves both the left and the right side of the body at once, although it often involves front and back.
If you want to Google “shingles” under “images,” you’ll get a better appreciation for what I’m talking about. But don’t say I didn’t warn you; the pictures are pretty repulsive.]
Seek treatment. If not attended to, shingles can progress into a full blown case of aluminum siding. Sorry, bad joke, but I couldn’t resist.
While I take as little medication as possible, I was exceedingly grateful for the medication available for my case of shingles. The irritation from shingles without intervening medication can put one’s life at a standstill.
Years later, I still have some numbness in my eyelids and around my face, but it is something I can live with.
I was impressed that the MD who treated me was open enough to not hide his going to some sort of manual/textbook which he used to help diagnose me. No one should expect an MD to have all knowledge needed for the job inside his brain.
Information-seeking to help solve problems is fine. After all, engineers and scientists consult books and journals in the process of their work. Why should MDs be any different?
About four years ago I had some blistered sores on one side of my torso. They seemed to come from nowhere and hurt a lot. I assumed that they were insect bites and would go away soon. They didn’t go away and the pain got even worse. Sleeping was almost impossible. Working was almost impossible too. After a couple weeks I gave in and went the my clinic urgent care.
I described my symptoms and the doctor asked to see the sores. He immediately said “Shingles.” I’d heard of Shingles but didn’t know anything about it. The doctor prescribed seven days worth of gigantic pills and said come back a week after I finished taking all the pills as prescribed if the symptoms didn’t start to improve.
About ten days after starting the pills, things began to improve. It took a while but things did slowly get better. It took another month before I returned to normal. I read up on Shingles and found that my case was relatively mild one and things could have been much worse. I was very lucky.
My sores were in almost a straight line on the right side of my torso along the T6 line on your diagram. As Neo says, early treatment is the best thing you can do.
I had shingles in the early ’90s when I was around 29, although I believe it’s seen more commonly in older people. Cases tend to be worse in older people, from what I remember reading.
I didn’t know what I had at first either. Mine was on the front of my right thigh (in the area on the diagram equivalent to L3 or L4) and was a splotchy reddish rash, not a solid band of purple like some of the Google results show. Some friends tried to tell me it was poison ivy but, although it bore some resemblance to poison ivy, it didn’t itch at all, and I’d never had a case of poison ivy that didn’t itch like crazy. I was working temp jobs so I wasn’t in the mood to rush off to the doctor, but when it started to spread I knew I had to. He told me pretty quickly it was shingles (which I had heard of but didn’t know anything about at the time) and presribed me those big old pills. Four a day for ten days, IIRC. Mine healed up pretty uneventfully after that, with the only thing to show for it being a few small, faint permanent scars on my leg from some of the lesions. I didn’t get any of the longterm complications some people get of ongoing pain, although the short-term pain was certainly there.
The good news is, from what I recall reading and from what the doctor said, that the chances are it will never bother me again. It’s like the original chicken pox – you get it once and then it goes away forever. In that sense, getting it young when complications are much less likely was a blessing.
Good for you Neocon. You possibly saved your friend untold agony. By publishing this information you may help many others.
My wife had shingles on her face in the late 80s. Two Doctors correctly diagnosed the problem, but took no action. She suffered horribly. Her eye was affected, and still cause her problems; she cannot tolerate glare and has thus not been safe to drive at night for the past 20 years. For all of these years she has suffered neuralgia and has actually scratched small bald spots on her head. Although medication gives her some relief, she has suffered off and on for many years. Clearly, shingles can be devestating.
Now, I had shingles diagnosed twice. The first time in the early 80s and again in the early 90s. The first time the Doctor took no action, but it cleared up on its own within a couple of days; the second the Doctor immediately started me on anti-viral medications and I had relief within a couple of days. I may or not have had shingles the first time since I have never heard of it running its course in such a short time; but the Dr was firm in his diagnosis. A different Dr diagnosed the second episode and the symptoms were identical–painful rash in exactly the same area on my neck. I mention this to high light that it is wrong to believe that you are susceptible to shingles only once.
I don’t know if the knowledge about early treatment with the anti-viral medicines was available when my wife had the shingles, or whether the two women who treated her were simply not conversant. In any case the result was disasterous.
At the first indication of a painful rash, and it is a unique pain, it is essential to get to a Doctor for examination. If shingles are diagnosed insist on treatment with anti-viral drugs. It is also a good idea for each person to discuss the new shingles vaccine with their Doctor.
Oldflyer: I think the antiviral meds may not have been available back then.
I do hear it’s possible to have shingles more than once, but highly unusual.
Sorry to hear your wife has had such a rough time with it.
I had shingles (ironically while I was taking a class in Virology) in the trigeminal nerve. The textbook had a gruesome picture of some poor guy suffering from a much worse case than mine. This nerve runs from your eye up the side of the head and across the top of your head to the rear on one side (there is one such nerve on each side of the head). Your diagram does not show it. Apparently about 30 percent of shingles cases appear in this nerve. Why that should be so is not known. In my case there was a rash but no real pain, but my right eye was swollen shut for a week or so.
there is a vaccine for shingles
http://www.webmd.com/skin-problems-and-treatments/shingles/news/20061025/shingles-vaccine-to-be-routine-at-60
I thought it was a spider bite, then a bone bruise, then poison oak, then I went to the doc and he set me straight. That was not a fun month and a half. Contrary to what I’m reading here, I understand shingles will return. My wife knows a woman who’s had it five times and is only in her fifties. I fully expect to get it again some day, but at least I will react more swiftly.
This is what the Mayo Clinic site says:
“Most people develop shingles only once, but recurrences in other areas are possible.”
That’s mostly good news, I guess, for those of us who have had it once. Mine was 15 years ago.
I had shingles 5 years ago across the front and back of the left side of my body. I thought I was too young for shingles, that it must be something else. I got the the anitvirals after the rash started spreading and it was clear that it was only on one side. I still have scars underneath my skin that look like busted veins and they still hurt after 5 years.
I gather the young lady at the pharmacists must have thought I needed the drugs for something else because she tried to tease me about them.
I count myself lucky, one of my former co-workers got it in his eye. He can’t work, or do much of anything any more.