NEW HOPE FOR AN OLD DISEASE

by Mary-Ellen Siegel and Gray Williams

QUESTIONS & ANSWERS ABOUT SHINGLES

If I come down with shingles, what kinds of symptoms can I expect?
There are two main symptoms. One is a patchy rash of small bumps that turn into blisters. The other is burning or stabbing pain in the area of the rash. It may begin before the rash appears, and may persist after the rash has healed.

Is it true that shingles only turns up on certain parts of the body?
Shingles can occur just about anywhere on the body. But, it occurs most frequently on the trunk, especially near the waist (the name shingles comes from a word meaning "belt"). The second most common location is the face, especially the region of the forehead, eye, and nose.

How do I know if I have shingles?
About the only way you or your doctor can be sure you have shingles is to identify the rash when it appears. Symptoms that occur before that are often too vague or too easily mistaken for something else to make diagnosis certain. However, you might consult your doctor if you experience a couple of telltale signs of the disease, other than rash. The main one is tingling, itching, or pain in a limited area on one side of your body or face. The pain also tends to be distinctive: sharp, stabbing or burning, and relieved somewhat by rest. And, of course, if you see any signs of rash, you should get in touch with your doctor immediately.

How long can I expect the shingles rash to last?
The rash usually lasts about a week to ten days from the time it first appears to the time that most of its scabs are crusted over. Complete healing may take a week or two longer.

Will the pain go away when the rash disappears?
Episodes of pain are likely to occur for another couple of weeks after the skin is healed. The normal duration of shingles is up to five weeks. If the pain persists or come back after that, it is described as post-herpetic neuralgia.

What are my chances of recovering completely from shingles?
Most people do recover completely, without any complications. Those seriously affected may suffer persistent pain‹what¹s called post-herpetic neuralgia. Other possible complications are less common.

My wife had a terrible case of shingles last year. Is it at all likely that she'll get it again?
It is uncommon for anyone to have shingles more than once. The overall risk is about one in twenty, but most of those are people with extremely weak immune systems, as the result of other disease, medical treatment , or advanced old age.

When my husband had shingles, I discouraged my eighty-nine-year-old mother from visiting us, for fear she might catch it. Was I wrong to be concerned?
When you have shingles, you can't give shingles to anyone else. You can give chickenpox to someone who hasn't already had it, but the chances are that your mother has already had chickenpox.

What drugs can I take to relieve the pain of shingles?
There are essentially four types of painkillers used to make shingles pain more tolerable:

• Aspirin, ibuprofen, and other non-steroidal anti-inflammatory drugs (NSAIDs for short).
• Acetominophen, of which the best known form is Tylenol.
• Narcotics, also known as opioids.
• Corticosteroids, sometimes called simply steroids.

When my aunt had shingles, her doctor suggested that she crush some aspirin tablets into powder, mix it with rubbing alcohol, and dab it on the rash. It really seemed to help. Is this a common remedy?
Nobody has made a commercial formulation of crushed aspirin and evaporating fluid, but a number of clinical experiments have found that it relieves shingles pain at least temporarily as the fluid dries.

When my neighbor had shingles, she started doing some exercises to reduce psychological stress. What has shingles got to do with stress?
Pain of many kinds can be triggered or intensified by psychological stress. Conversely, the reduction of stress can actually relieve the perception of pain. Stress-reducing techniques can powerfully reinforce the effects of drugs and other medical agents in relieving shingles pain.

When the pain of shingles on my chest kept me from sleeping, my doctor recommended wrapping the area with an elastic sports bandage. It really did help--but how did it work?
What your doctor recommended was a simple application of a natural process of pain relief called counterirritation. The mildly irritating sensations produced by the pressure of the elastic bandage are transmitted to the central nervous system, where they trigger reactions that diminish the perception of pain. Another form of counterirritation that sometimes helps ;with shingles is a liniment such as oil of wintergreen, which initially makes the skin tingle.

From Living With Shingles, by Mary-Ellen Siegel and Gray Williams. Copyright ©1998 by Mary-Ellen Siegel and Gray Williams, Jr. Excerpted by arrangement with M. Evans and Company, Inc. $19.95. Available in local bookstores, or by calling 800-462-6420, or click here.