Monday, October 27, 2008

Shingles shot

Comment from a 65 year old nurse who came in today with a painful case of shingles on her abdomen:

I could kick myself for not getting the shingles shot.

This after spending 4 and 1/2 hours in the ER two days ago with the pain that preceded the outbreak. She got a CT scan, an ultrasound, many exams, and a raft of bloodwork looking for other causes for the pain.

While people are getting more and more familiar with the patchy, one-sided, blistered skin associated with an outbreak of shingles, many patients don't realize that severe pain is often the first sign of the disease and can predate the rash by several days.

For more information on shingles, see The shingles shot.


"his-self" said...

I tried to get my doc at KP to give me the shot as I've had shingles and relapse a couple of times. She said I was a good candidate but there was an extreme shortage of the vaccine. I'm on the list to get it next year.

janeywan said...

Certainly was the case for me. I never did break out with the rash. Pain last 4 or 5 days after the med's ran out. Sure glad we treated before the rash appeared.

femail doc said...

HS: Actually, this lady did not get the shot because there was none to be had where she went either, so all her kicking really was to no avail. We're all out at our office too.

JW: Interesting how short and mild your case was. The earlier the treatment, the better. Glad it worked so well for you!

Anonymous said...

We actually got some this week, after having had it backordered since July. The rep assures me that the log jam will break in January.

D.K. Raed said...

After having 3 shingles outbreaks this year (none before this year), I was told there is a vaccine but it's not for you --- yet! The doc said it's for those over 60 AND I should be shingles-free for 2-yrs prior or the vaccine itself could cause shingles. Also not for me if I'm allergic to neomycin (I am allergic to erythromycin, don't know about neomycin). For me, the first outbreak was by far the worst, but the last one, while not as blistery, was painful for 8 long weeks. Starting a course of Valtrex as soon as I felt that special pain for the last 2 outbreaks did short-stop the blisters, but not the painful rash/inflamed skin. I HOPE I'm now done with it. It was bad enough when the weather was nice & I could air out the area; can't imagine going through it when I'm all bundled up for winter.

ps, found your site through a friend who has listened patiently to my shingles complaints.

Katie said...

I'm glad to know I am not the only one with this mess! I am 30 and was treated 2 1/2 weeks ago with Famvair for 7 days 500mg/3 times a day along with a cream for the rash. The rash seemed to be drying out well and never really hurt only burned a bit. Well yesterday, I noticed it was begining to get rather sensitive again and after my shower I saw that it was back with a vengence. Now I think it is on fire! I guess either the antiviral wasn't strong enough or long enough, or I remain one of those 1% of special people. Do you think this could be is a new shingles outbreak or just a reemergance of the first? My dr was off today, so it will be Monday before I can baffle her mind again :) I will surely ask about the vacine, this stuff Sucks!
Thanks for providing a site where I can see I am not alone!

femail doc said...

DK: Good heavens, 3 outbreaks in one year. I've not heard of anyone having such a blizzard of shingles. I've given the shot to some less than 60--two problems with that strategy however: 1) Studies were conducted on 60 and over so no confirmed evidence that it works in younger though it should, and 2) Due to the lack of FDA official approval, insurance would doubtless be reluctant to pay for pricey shot in younger set.

And in your case, if 3 outbreaks of shingles didn't jack up your immunity to this virus, I wonder if the shot would have any useful effect.

Katie: Wow, not quite as unlucky as DK, but back with a vengeance? What a bother. Rashes of course always look awful after a hot shower as the heat dilates blood vessels and accentuates the red. Did you get a recurrence of blisters? I'd be interested to hear how this came out and what your doctor had to say.

Katie said...

Hello again,
I have a question please...I have now done 3 separate rounds of Famvir for 7 days (3 times a day). My dr has decided they were not shingles since they kept returning, although she agreed they were confined to a specific dermatome. Now I did tell her they did not ever completely go away, but they seemed to improve (both in appearance and the burning pain) after taking the anti-virals for a few days and then returned visciously 3 to 4 days after completing the round. She decided that did not sound like shingles, so she did a punch biopsy of the area. The biopsy showed only inflamation, so I have an appointment with a dermatologist on Friday. I am wondering could it still be shingles and they have just not been hit with a powerful enough dosage either length or strength to wipe them out totally? Also, since the virus lives in the nerves, would the biopsy sample have the virus in it, and is there a definate "test" for shingles. I am quite desperate at this point, as they are truly making me crazy. Thank you for your time and I appreciate your opinion on this.

femail doc said...

Hi Katie, I'm as confused as your doctor. I am unfamiliar with shingles lasting this long--even if you hadn't treated it at all. That said, I have no ideas about what it might be nor why it would seem to respond to Famvir. I also don't know what about a biopsy of shingles would make it distinctive. If this is shingles, I think your doctors need to consider whether you might have some sort of immune deficiency that renders you unable to beat this pesky virus back into the nerve ganglion where it belongs. Please let me know what you find out from the dermatologist.

ms&sm said...

I just started HRT. Early menopause. I am 45 and haven't had a period for 18 mos. (24 mo. if u don't count that one) I smoke. .05mg Vivelle-dot and medroxyprogesterone ( just started 3 days on and 3 days off of 1.25 mg a day) and low dose aspirin with a little red clover tea each day.

Day 7: I am breaking out with shingles. First time. I took Valtrex and the 3 hour old welts are going down. yea.

I love that my brain seems to be coming back. (VF big problem for a teacher)
..but maybe I am not thinking clearly when I think that I can stay ON the estrogen? Surely it is just a coincidence of stress. :)