Wednesday, September 21, 2011
Health Care and Shingles
According to WebMD, shingles (herpes zoster) is a viral infection of the nerve roots. It causes pain and often causes a rash on one side of the body, the left or right. The rash appears in a band, a strip, or a small area. Shingles is most common in older adults and people who have weak immune systems because of stress, injury, certain medicines, or other reasons. Most people who get shingles will get better and will not get it again.
The shingles virus is the same virus that causes chickenpox, according to the Mayo Clinic. After you've had chickenpox, the virus lies inactive in nerve tissue near your spinal cord and brain. Years later, the virus may reactivate as shingles. While it isn't a life-threatening condition, shingles can be very painful. Vaccines can help reduce the risk of shingles, while early treatment can help shorten a shingles infection and lessen the chance of complications.
You can't catch shingles from someone else who has shingles. But a person with a shingles rash can spread chickenpox to another person who hasn't had chickenpox and who hasn't gotten the chickenpox vaccine, according to WebMD. Shingles symptoms happen in stages. At first you may have a headache or be sensitive to light. You may also feel like you have the flu but not have a fever. Later, you may feel itching, tingling, or pain in a certain area. That’s where a band, strip, or small area of rash may occur a few days later. The rash turns into clusters of blisters. The blisters fill with fluid and then crust over. It takes 2 to 4 weeks for the blisters to heal, and they may leave scars. Some people only get a mild rash, and some do not get a rash at all. It’s possible that you could also feel dizzy or weak, or you could have long-term pain or a rash on your face, changes in your vision, changes in how well you can think, or a rash that spreads. If you have any of these problems from shingles, call your doctor right away.
According to the National Institutes of Health (NIH), the first symptom is usually one-sided pain, tingling, or burning. The pain and burning may be severe and is usually present before any rash appears. Additional symptoms may include:
•Difficulty moving some of the muscles in the face
•Drooping eyelid (ptosis)
•Loss of eye motion
•Swollen glands (lymph nodes)
You may also have pain, muscle weakness, and a rash involving different parts of your face if shingles affects a nerve in your face.
Factors that may increase your risk of developing shingles, according to the Mayo Clinic, include:
--Age. Shingles is most common in people older than 50. The risk increases with age. Some experts estimate that half the people who live to the age of 85 will experience shingles at some point in their lives.
--Diseases. Diseases that weaken your immune system, such as HIV/AIDS and cancer, can increase your risk of shingles.
--Cancer treatments. Undergoing radiation or chemotherapy can lower your resistance to diseases and may trigger shingles.
--Medications. Drugs designed to prevent rejection of transplanted organs can increase your risk of shingles — as can prolonged use of steroids, such as prednisone.
Your doctor may prescribe a medicine that fights the virus, called an antiviral. The drug helps reduce pain and complications and shorten the course of the disease, according to the NIH. Acyclovir, famciclovir, and valacyclovir may be used. The medications should be started within 24 hours of feeling pain or burning, and preferably before the blisters appear. The drugs are usually given in pill form, in doses many times greater than those recommended for herpes simplex or genital herpes. Some people may need to receive the medicine through a vein (by IV). Strong anti-inflammatory medicines called corticosteroids, such as prednisone, may be used to reduce swelling and the risk of continued pain. These drugs do not work in all patients.
Other medicines may include:
•Antihistamines to reduce itching (taken by mouth or applied to the skin)
•Zostrix, a cream containing capsaicin (an extract of pepper) that may reduce the risk of postherpetic neuralgia
Cool wet compresses can be used to reduce pain, according to the NIH. Soothing baths and lotions, such as colloidal oatmeal bath, starch baths, or calamine lotion, may help to relieve itching and discomfort. Resting in bed until the fever goes down is recommended. The skin should be kept clean, and contaminated items should not be reused. Nondisposable items should be washed in boiling water or otherwise disinfected before reuse. The person may need to be isolated while lesions are oozing to prevent infecting other people who have never had chickenpox -- especially pregnant women.
According to eMedicineHealth, Many cases of shingles go away by themselves, with or without treatment. The rash and pain should be gone in two to three weeks. However, shingles may last longer and be more likely to recur if the person is older, especially older than 50 years of age, or if they have a serious medical problem.
•Pain may last after the rash is gone. This is called postherpetic neuralgia (PHN). About 10%-15% of all shingles patients get PHN. The older the patient, the more likely they will develop PHN, and the pain that develops frequently is severe. PHN pain often lasts months and occasionally may go on for years.
•Other possible complications include a bacterial skin infection, spread of infection to internal organs of the body, or eye damage. Scarring is common.
•About 10%-25% of people with shingles develop eye involvement. This is termed herpes zoster ophthalmicus and may involve several eye structures. The disease can lead to blindness and should be considered a medical emergency. Ramsay Hunt syndrome is a variation of this infection that involves the facial nerves and results in facial paralysis, usually on one side of the face.
•Unfortunately, individuals can get shingles more than once. Although multiple shingles outbreaks are seen infrequently, they are significant because they usually occur in people with multiple medical problems or increasingly weakened immune responses. This complication of shingles often indicates that the person has increasing medical problems that need to be diagnosed or aggressively treated (or both).
•Pregnant females who get shingles are not at as high a risk for viral complications as those pregnant females who become infected with chickenpox. However, if shingles develops within a few weeks of the delivery date, the infant may be at risk for viral complications, and the affected woman should notify her OB-GYN doctor immediately. In addition, shingles at any time during pregnancy may require special treatments; the OB-GYN physician needs to be contacted to help arrange individualized treatment plans.
According to the Mayo Clinic, Two vaccines may help prevent shingles — the chickenpox (varicella) vaccine and the shingles (varicella-zoster) vaccine.
1.) Chickenpox vaccine: The varicella vaccine (Varivax) has become a routine childhood immunization to prevent chickenpox. The vaccine is also recommended for adults who've never had chickenpox. Though the vaccine doesn't guarantee you won't get chickenpox or shingles, it can reduce your chances of complications and reduce the severity of the disease.
2.) Shingles vaccine: The Food and Drug Administration has approved the use of the varicella-zoster vaccine (Zostavax) for adults age 50 and older. Like the chickenpox vaccine, the shingles vaccine doesn't guarantee you won't get shingles. But this vaccine will likely reduce the course and severity of the disease and reduce your risk of postherpetic neuralgia. The shingles vaccine is used only as a prevention strategy, however. It's not intended to treat people who currently have the disease. The vaccine contains live virus and should not be given to people who have weakened immune systems.
So, although shingles is not typically fatal, you should see a medical professional if you feel that you may be experiencing the symptoms. Left untreated, the disease could cause long term health issues in severe cases. Those who have contracted the disease should stay away from exposing others to it, and attempt to maintain a degree of personal comfort during the period of time they are going through treatment. Shingles usually are a short term medical issue, but taking care of the problem in a preventive manner is best rather than leaving it untreated.
Until next time.