[MissMontana (OP)]

My mum has shingles at the moment and is in a lot of pain.  She has been prescribed pain killers but it there anything else that she can take or apply to the rash to make it more comfortable for her?

I know that it is linked to the chicken pox virus but I don't really know much more about it.

[neilep]

Your poor mum.....TG, I had a quick look on the net and there seems to be quite a lot of advice out there....here's some tips I just copied and pasted from the NHS website:

Keep the rash area uncovered as much as possible.
 
 Try not to scratch the rash. Use calamine lotion to ease the itchiness.
 Pain which follows the disappearance of the rash can be reduced by cooling the area with a bag of ice.


'Men are the same as women...just inside out !'

[neilep]

...and here's the link TG.....hope yor mum feels better soon.   http://www.nhsdirect.nhs.uk/SelfHelp/conditions/shingles/shingles.asp

'Men are the same as women...just inside out !'

[MayoFlyFarmer]

I'm not very familiar with shingles at all, other than that its a very painful rash (which you've already covered) so I'm not sure if this is applicable at all or not, but I'll throw it out there anywho.  I have a very accute allergy to poision ivy, and a few years ago a kind nurse recomended something that most people I've talked to have never heard of before to make the rash go away.  It is called Domboro Solution (I think I spelled that right).  Basically it was a powder that came in packets over the counter at the drugstore.  You mixed it with water, soaked a cloth in the solution, and layed the cloth over the rash for a few hours at a time.  
Now like I said I'm not to up on my shingles info, and I'm not even sure how this solution works, so I'd definately look into it before I recomended it for your mom (mum, excuse me....geeze I wis I was from another country so i didn't talk like a stupid american....not canada though....I already talk like I'm from there...eh)  
At the very most if anyone else has poison ivy issues, they can refer to this.

Cut me some slack I'm new around here!

[Donnah]

MissMontana, your mum could try taking L-Lysine (DO NOT take for longer than 6 months at a time), a good B complex and vitamin C.  Also important are calcium, magnesium, garlic and vitamins A, C, and E.  She could make tea with fresh ginger slices every day to purify the blood and act as a cumulative painkiller.

[MissMontana (OP)]

Thanks all, really appreciated.

Is L-Lysine the stuff body builders take to bulk up?  Is it good if you're run down?  I'll make sure that she has lots of vitamins and minerals and I'll get her to try the ginger.  I'm not sure that we can get Domeboro (Googled it for spelling ) here but we have got some calamine lotion.  Hopefully she'll be feeling better soon.

[bezoar]

There is an antiviral medicine, I've forgotten the name of it, similar to Zovirax, but you take it in pretty large quantities as soon as possible in the illness, and it helps to avoid post herpetic neurlagia.  Unfortunately, some people are left with a neuralgia (nerve pain sensation) after the shingles that lasts them the rest of their life.  Get her on it ASAP.

[Donnah]

Yup, bodybuilders use the stuff too.  Lysine cannot be manufactured in the body, so it must be ingested (soy, yeast, fish, red meat, potatoes, milk, cheese, eggs & lima beans).  Tough to get 500 mg twice daily just by eating though.  It's absorbed better if taken with B and C.  My sources say that it is good to take after surgery.  I've taken it when I was run down and it helped me to feel better.

[chris]

Shingles, or zoster, is caused by a reactivation of latent chicken pox virus (varicella zoster - VZV).

Chicken pox is a member of the alpha herpes virus family, a class of herpes viruses that set up a lifelong latent infection in nerve cells. The virus periodically undergoes reactivation which can progress to shingles if the patient becomes low or immunosuppressed for any reason (being elderly is a good enough reason).

Whilst chicken pox affects the whole body (because in it's initial stages the virus spreads via the bloodstream) shingles, in contrast, only affects one patch of skin which is supplied by nerves from one particular region of the spinal cord.

The lesions are intensely painful and, as Bezoar has mentioned, can lead to chronic pain (post herpetic neuralgia) within the affected part of the body. I have seen patients for whom this was still a problem over a year after the shingles outbreak.

There is a class of effective anti-viral agents which have been shown to reduce the severity of the shingles outbreak and to reduce the risk of developing subsequent pain, but only if they are given rapidly. This class of drugs includes Aciclovir and (its valine-substituted derivative) Valaciclovir (the benefit of which being that you don't have to take it so frequently).

Once you have the pain syndrome there are a few drugs that have been tried with modest success and these include low dose amitryptiline (in high doses this works as an anti-depressant but in low doses is very good for neuropathic pain), and another agent called gabapentin (which is also used to treat epilepsy). Capsaicin (the substance that makes chillis burn) is also sometimes used because it can switch off the pain fibres thought to be responsible for causing the inappropriate pain.

Hope your mother feels better soon.

Chris

"I never forget a face, but in your case I'll make an exception"
 - Groucho Marx

[MissMontana (OP)]

Thanks Chris, her GP has given her a topical preparation, I think that it was aciclovir, it's a liquid that is applied with a brush every 6 hours which seems to have taken the redness out of the rash, but it still looks so sore, like big patches of cold sores on her side and back.  

From what you said does that mean that she could get it again in the future?  

I'm also a bit confused.  The link that Neil posted said that you are unlikely to get shingles if you have never had chicken pox but when I went to give blood yesterday, I said that mum had shingles they asked if I had ever had chicken pox which I said I had and so they said it was ok for me to donate (given that I didn't have any symptoms and felt well).

[chris]

You cannot get shingles if you have never had chicken pox.

There are 2 phases to VZV (Varicella / chicken Pox) infection. The acute phase (when you catch it for the first time) is what we call chicken pox. The virus is acquired via the respiratory route from an infectious individual. It initially replicates in the lungs and from there travels in the blood to every tissue in the body. This manifests in the skin as localised viral replication to form a blister or vesicle. (So each vesicle arises from a chicken pox virus or cluster of viruses successfuly infecting a skin cell). These blisters are highly infectious. They are crammed with virus which can be spread to other people.

In the course of infecting cells in the skin the virus also comes into contact with nerve endings supplying that patch of infected skin. The virus enters the nerve cells where it enters a quiescent (dormant) state from which it can reactivate later in life. This is an ingenious way in which herpes viruses (like chicken pox, and herpes simplex virus which causes cold sores and genital herpes) evade the immune system - by hiding inside our own cells where they cannot be seen.

In the meantime, your body mounts an immune response to the infection including producing neutralising antibodies and T cells. These prevent you from ever getting chicken pox again.

But what about the latent (dormant) virus ? Scientists think that periodically throughout life some of the latent virus, just in one part of the nervous system that is harbouring it, reactivates itself and comes back out of the nerve cell where the immune system can see it. If you have sufficient immunity at the time the virus will immediately be inactivated, with the added bonus is that this extra bit of exposure helps to keep your immune system trained up in how to deal with chicken pox.

But as you get older, or if you are immunosuppressed for any other reason (e.g. HIV, drugs, alcohol, other chronic illnesses) your immune system becomes less good at responding sufficiently quickly, and with sufficient force, to stop the virus. This leads to a shingles outbreak. But it is confined just to the region of the body surface, called a dermatome, which is supplied by the group of nerves in which the reactivation has taken place. This is why the shingles rash appears in a 'band' on one side of the body. We think that the rash remains confined to one dermatome because the immune system kicks in to stop it before it has the chance to spread anywhere else on the body. People with poor immunity can develop a more widespread rash and become seriously unwell.

Shingles is highly infectious. The vesicles are laden with virus which can readily be transmitted to a susceptible individual, hence the reason the blood bank staff were concerned. If you had not had chicken pox in the past you could well have been incubating it meaning that there would be infectious viral particles in your blood. This would clearly pose a threat to any recipient of your blood if they had not had chicken pox themselves, or were susceptible to infection. The fact that you have had chicken pox tells the blood bank staff that your blood contains neutralising antibodies and therefore you are not an infection risk. Hence they were happy to proceed. If you had been at all uncertain about whether you had had chicken pox or not in the past they would have refused your donation.

To answer your final question about future episodes of shingles the answer is yes, you can get shingles multiple times, whenever your immunity drops too low. So having it once is no guarantee that you won't succumb again.

That said, a recent study showed that Tai Chi can help to prevent shingles by boosting the levels of a substance called "zoster virus specific immunity factor" - here's the link :

http://www.thenakedscientists.com/html/shows/2003.11.09.htm

Chris

"I never forget a face, but in your case I'll make an exception"
 - Groucho Marx

[tweener]

Very good post Chris, thanks!

----
John - The Eternal Pessimist.

[MissMontana (OP)]

Thanks Chris, it's much clearer now

[beckyboo2]

I Just wanted to throw this out there. Shingles are caused by a virus that is part of herpes family of viruses. I don't know all the technicalities about it but I do know that most doctors seam to prescribe drugs that work on herpes to patients with shingles.

So vygone has worked amazingly well on my cold sores which is herpes symplex virus 1 and on their website I have read that it works on shingles as well. They say that it even stops the pain immediately.

Anyway, I'm sure that you have figured something out by now but good luck:)




Mod edit - advertising link removed

[SteveFish]

There is now a vaccine available to prevent shingles. It is recommended for older individuals who have had chicken pox, but it is expensive. I am going to get it.