Remember when?

  • Tue Jun 17th, 2008 8:00pm
  • Life

Remember when we were little kids and the neighbor’s kids had chickenpox? If we hadn’t had them yet, our mothers would take us to the pox infested household, where we’d share cups and play with our sick friends. This was all done in the interest of good health, much akin to electric shock therapy. The moms would hope the exposure would cause us to get chickenpox while we were still little and hopefully not have to miss much school.

As I recall, it was VERY important not to miss school. It turns out that no matter how well-intentioned our mothers were, this may not have been the best plan of action. Approximately 90 percent of American adults have had chickenpox and every one of us is at risk for developing shingles. Lucky us.

We have learned that while we recovered from that childhood illness, the little buggers that cause chickenpox, herpes zoster, may not leave us. If your own immune system doesn’t fully destroy the virus after the initial infection, the virus furtively hides along the nerve tracks and opportunistically waits for the next chance to strike. And herpes zoster can be very, very patient – sometimes waiting decades until they again become active. Approximately half of the nearly 1 million cases of shingles in the US each year will occur in people age 60 and over. If we live to age 85, half of us will develop shingles. The older we are when we get shingles, the longer the outbreak may last.

Shingles are more apt to appear when disease, age, or stress weakens the immune system. Symptoms often occur in stages. Initially you may have a headache, feel sensitive to light or even feel flu-like. For others the first indication is a tingling, itching or painful area on the skin. Subsequently a rash can appear, turning into clusters of fluid-filled blisters. The rash or blisters will typically follow along a nerve path. Because nerves run along one side of your body, the rash or blister pattern typically is only on one side, left or right. When the blisters rupture they can shed live virus. Until the blisters scab over, avoid contact with people that have weakened immune systems (e.g. receiving cancer chemotherapy), newborns, pregnant women, or anyone who hasn’t had chickenpox.

Shingles can be very painful, leading to a debilitating nerve pain that remains long after the blisters have healed. I have witnessed this pain persist for years in some patients. Other complications may include: scarring, hearing or vision loss (if those areas are involved), bacterial skin infections, or muscle weakness. This is not an illness for wimps.

Early treatment can help shorten a shingles infection and minimize the chance of complications. The sooner you seek treatment, the better off you will be. I can’t stress this enough – I mean “soon” by Marge’s definition, as within 72 hours of onset, not to be confused with “Lopez soon” – which is about eight weeks. Oral anti-viral medication can shorten the duration and lessen the severity of the outbreak if begun quickly (see “soon”). Tylenol®, ibuprofen or prescription pain medication may help with the pain. Topical steroid creams may help with itching and topical prescription lidocaine patches may lessen pain. Other topical treatments to help with the pain and itching include taking a cool bath with colloidal oatmeal and the Mayo clinic suggests applying cool, wet compresses to the blisters. They recommend using 1 oz of vinegar in 32 oz of water.

There are preventative treatment options that should be considered. If you have never had chickenpox – think about being vaccinated against chickenpox. And if you have had chickenpox and are over age 60, there is a shingles vaccine. Studies indicate this vaccine will decrease the chances you will have a shingles outbreak by 50 percent. Additionally, for those that do have an outbreak, the severity of that outbreak will probably be about 50 percent less. These vaccines require a prescription, so it might be worth discussing at your next doctor visit. Do it soon!

Pharmacists Marge and Rick McCoy own and operate Lopez Island Pharmacy. Between the two of them, they have over 60 years of pharmacy experience.