Shingles: Painful ailment targets over-60 group
"Once I started the antiviral meds,
the blisters went away in a week."
- Tom Lunney aption
Something was very wrong. Tom Lunney was awakened in the middle of the night by the worst pain he had ever experienced or imagined, shooting through his lower abdomen. If he could just drift back to sleep, he told himself, the searing pain would resolve itself and he would awaken to the blessing of morning.
There was no going back to sleep, however. By 5 a.m., Lunney was in such pain that he told his wife Cynthia he needed to go to the Emergency department at Community Hospital of the Monterey Peninsula.
"As I was putting on my clothes," says Lunney, "Cynthia noticed the rash wrapping around my body. Once the hospital folks looked at it, this collection of blisters following the nerve line, they thought it was shingles. My mother had gotten shingles a year or two before, but she was 88 years old. I was 60. It never crossed my mind that I would get it. Not at my age."
Shingles, also known as herpes zoster, is a painful nerve infection that spreads over one side of the body in line with the nerve path. It usually occurs after age 60, showing up in a strip across the torso; but it can also occur on other areas, including the head, face, and lower abdomen, or down the leg. There are an estimated 1 million cases annually in the United States, affecting 2 in every 10 people in their lifetime.
Herpes zoster is not caused by the same virus that causes genital herpes, a sexually transmitted disease, or cold sores.
"Shingles is a reactivation of the chicken pox virus that lies dormant in our nervous system from childhood," says Dr. Gary Grant, chair of the Internal Medicine Division at Community Hospital. "Some people never had chicken pox but were exposed to it, which means they, too, could get shingles."
Antiviral drugs are used to treat shingles, and since 2006 a vaccine has been available to reduce the risk of outbreak for those over 60 years of age. Researchers found that the vaccine, Zostavax®, reduced the occurrence of shingles by about 50 percent for those over 60. Those who did develop shingles even after being vaccinated reported slightly less pain than sufferers who did not receive the vaccine.
The vaccine is expensive, however -— usually between $250 and $290 -— and most insurance carriers do not cover it.
The vaccine hasn’t been tested on people who have already had
shingles, and Grant doesn’t recommend it for them.
"I usually don’t recommend it because the risk is so low that you’ll get shingles again," he says. "Once you’ve had it, perhaps the immune system gets stronger against it."
Shingles usually shows up without warning. A painful tingling and burning sensation begins and lasts for a number of days. Typically, this is followed by an eruption of red bumps on one side of the body that turn into blisters. Most often, it develops after a period of stress.
"I don’t know why it came on," says Lunney. "I was in a happy mood; my wife and I had just come back from a wonderful trip across the world, and I still had another month of summer to enjoy before I went back to teaching. We did have some terrible flights, though, and we spent a lot of time in airports. Sometimes travel is more stressful than we realize."
Nothing, says Lunney, was as stressful as the shingles itself. Although shingles usually runs its course over a few weeks, the pain and tingling have been known to linger months or even years.
"Once I started the antiviral meds," says Lunney, "the blisters went away in a week. But the internal searing, burning nerve pain lasted for more than six months. They called it postherpetic neuralgia, this lasting nerve-ending pain. They put me on Lyrica®, a medication typically used for diabetics experiencing nerve-ending pain in their feet. It was good for me as well; I took it for another four months.
"Most people endure the pain and the blisters, and then the shingles goes away. I wasn’t so lucky. A result of the lingering pain in my side was that it made me walk funny, which caused a bulging disk in my back from overcompensating. And this screwed up my knee.
"Luckily, Dr. Grant says it’s unlikely I’ll ever get shingles again. I even asked him about getting the shot, just to be sure; but he said I don’t need it. I say for anybody else, find out when and where you can get it. I definitely think it would be worth it."
The shingles vaccine has very ridgid storage and handling requirements, so not all healthcare providers keep it on hand. Check with your doctor or pharmacy for availability. The Visiting Nurse Association offers the vaccine by appointment and may be contacted at (831) 372-6668.