The nature of shingles


Shingles information from the FDA:.

People who have had chickenpox (varicella zoster) in their youth can develop shingles (herpes zoster) in later years. During an acute attack of the chickenpox virus, most of the viral organisms are destroyed, but some travel up nerve fibers along the spine, and lodge in nerve cells where they may lie dormant for years. A decrease in the body’s resistance can cause the virus to reawaken decades later. It then travels back down the nerve fibers to the skin’s surface.

Symptoms include fever, chills, headache, upset stomach, and a rash of small fluid-filled blisters on reddened skin. The pain can be intense and is often described as “unrelenting.” The rare and most dangerous form infects the eyes, nose, and face.

Occasionally, the rash will appear as a single spot or cluster of spots on the tip of the nose, called Hutchinson’s sign. This means that the ophthalmic nerve is probably involved and the eye may become affected, possibly causing temporary or permanent blindness.

Most people are surprised by how ill they feel with shingles. This seems out of proportion with the extent of the skin involved. Depression is often a feature of shingles, as in many other viruses. You may need up to three weeks off work.

Many experience a complication called post-herpetic neuralgia (PHN). This term refers to pain that is present in the affected area for months, or even years, afterward. PHN is difficult to treat. Described by sufferers as agonizing, excruciating, and burning, the pain can result in an inability to perform daily tasks of living, and lead to loss of independence and, ultimately, depression and isolation.

I’ve had all these symptoms except PHN, and have seen three doctors this week, the last an ophthalmologist who verified that I have Hutchinson's sign, and said that the eye infection will appear in about a week if at all.

I only had one day when I was too sick to do anything. That was Monday when I spent four hours in a crowded clinic for a follow-up to Sunday’s eye exam (a follow-up that I now know was unnecessary since it’s too early for an eye infection). I went to bed when I got home but hurt too much to sleep (I didn’t want to take pain pills) and kept thinking about all the things I needed to do. I got out of bed three times to work on one project or another but was too weak and muddled to get organized.

Today, I awakened feeling pretty good and set out to run several hours of errands, but came home after thirty minutes so weak that I was afraid to drive. During those thirty minutes, I went to three businesses and must have seemed like an idiot to the proprietors since that was how I was treated. At the tire company, I couldn’t make the exasperated man understand where the tire was supposed to be mounted (he said I kept contradicting myself). At the bank, I asked to use a phone and was told to use line three. I kept hitting numeral three instead of line three (much to the annoyance of the woman on line one), and someone had to come do it for me. Now, what kind of people have to be shown how to use a phone? Multiple choice: retarded people? people with dementia? shingles’ sufferers?

I know that such limitations will pass, yet I also know that they are a harbinger of what awaits me as I grow older.