Week One: Stroke And Heart Attack Risk
While the risk of a post-shingles stroke is highest amongst those whose shingles outbreak impacted their eyes, overall, people with shingles have a 2.4-fold increased risk of stroke and 1.7-fold increased chance of heart attack during the first week after getting diagnosed, found a report featured in the journal PLOS Medicine. While ones risk gradually lessened after that, it takes about 27 weeks to completely roll the risk back to baseline. Its thought that shingles-induced inflammation may lead to blood clots that could then, in turn, cause a stroke or heart attack. Adding to the risk: A spike in blood pressure due to pain and stress associated with shingles.
What Causes Polymyalgia Rheumatica
The cause of polymyalgia rheumatica is unknown, but a combination of genetic and environmental factors is thought to be responsible.
Polymyalgia rheumatica is relatively common in the UK. It’s estimated that one in every 1,200 people develop the condition every year.
Polymyalgia rheumatica is age-related. Most people who are diagnosed with the condition are over 70. It’s extremely rare in people younger than 50. It’s also more common in women than men.
Does It Run In Families
You cant pass reactive arthritis on to your children. However, they can inherit the HLA-B27 gene, which could slightly increase their chance of getting the condition. This doesnt mean that by having this gene theyll definitely get reactive arthritis. However, the condition tends to be more common in people with HLA-B27.
Around 1 in every 10 people in the UK carry this gene.
The first signs of reactive arthritis are often:
- painful and swollen joints, usually in the ankles or knees
- sausage-like swelling of fingers or toes
- puffy, sore, red eyes, often with a mucus discharge known as conjunctivitis
- extreme, unexplained tiredness, known as fatigue
You may notice that your knees, ankles or toes suddenly become swollen, stiff and painful to move. Or the swelling may appear gradually over a few days.
Reactive arthritis can also affect other joints, such as your fingers, wrists, elbows and the joints at the base of your spine, known as the sacroiliac joints . It can also cause inflammation in the tendons around your joints, such as the Achilles tendon which runs down the back of your ankle.
You may find your whole finger or toe swells up if both the tendons and joints become affected at the same time. This is often called sausage digit or dactylitis .
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Rebooting The Nervous System
Its like restarting a computer, Dr. Rosenquist says. When its running slowly or acting weird, you restart it. We are trying to turn that nerve off. When it comes back on, hopefully, it will send an appropriate transmission as opposed to a pain transmission.
Treatmentoptions for PHN patients include:
Patientswith refractory PHN rarely need opioid pain medication. However,you should be evaluated by a physician. We cant make a blanket statement abouttreatment. It is individualized, she says.
How Long Does Postherpetic Neuralgia Last
Postherpetic neuralgia can last for weeks, months, or in some people, years after the shingles rash goes away. In most people, shingles pain goes away in one to three months. However, in one in five people, pain lasts more than one year.
The pain from PHN can be so severe in some people that it disrupts their life. Researchers dont know why some people have severe or long-lasting pain and others do not.
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Shingles Linked To Stroke Heart Attack
Not only do shingles flare-ups hurt, research says they can increase your short-term risk of heart attack and stroke following the virus outbreak.
Shingles was found to raise the risk of stroke by 35% and the risk of heart attack by nearly 60%, according to a study of more than half a million people. The risk of stroke was highest in those under age 40.
Its been known for a while now that zoster causes stroke, said Dr. Gwen Wigand-Bolling, an internist at . The inflammation it creates causes heart attack and stroke, and shingles causes increased blood clotting in the arteries, she added.
The risks of both stroke and heart attack were highest in the first year after the onset of shingles and decreases with time, researchers said.
Week Four: Healing Scabs
Most people with shingles do not develop a blister-related infection. Instead, scabs appear once the blisters dry up and crust over. That typically occurs seven to 10 days post-blistery outbreak, according to the Centers for Disease Control and Prevention. Its important to remember that until scabs appear, your blisters contain the virus, which can cause others to catch the chickenpox. Its also important to continue to wash the area with a fragrance-free cleanser daily until the rash, blisters and scabs are completely clear. Within a month, your skins appearance will most likely return to normal, though some people are left with darker or lighter spots where the shingles rash occurred.
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How Long Can Postherpetic Neuralgia Phn Last
Whats truly frightening about PHN is that it can last as little as a few weeks but as much as years.
So 4 to 6 weeks of painful, exhausting shingles isnt necessarily the end of the story. In fact, for too many people its the start of something truly horrific.
PHN can last months or years. Out of every 100 people who get shingles, two of them will suffer PHN for 5 years.
Having seen my brother nearly crushed by it over 8 months I understand why people who suffer its unrelenting pain for years often end up with serious mental health challenges.
Each time you have shingles you run a real risk of PHN straight afterward. Which is one of the strongest reasons I can think of to absolutely not want the illness a second time?
Symptoms Of Polymyalgia Rheumatica
The most common symptom of polymyalgia rheumatica is pain and stiffness in the shoulder muscles, which develops quickly over a few days or weeks.
The muscles in the neck and hips are also often affected. Both sides of the body are usually affected.
The stiffness often feels worse first thing in the morning after you wake up and starts to improve after about 45 minutes as you become more active.
Some people with polymyalgia rheumatica have additional symptoms, including:
- a mild high temperature of 37-38C
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What Is Reactive Arthritis
Reactive arthritis causes you to have extremely painful, swollen joints and can make you feel very tired. It can affect your joints after youve had an infection somewhere else in your body, such as a tummy bug, diarrhoea , or a throat infection.
The most common joints to be affected are the knees and ankles.
Its sometimes called Reiter syndrome and can affect people of any age, including children.
Reactive arthritis is a type of inflammatory arthritis. Unlike other types of inflammatory arthritis, for many people reactive arthritis lasts a relatively short amount of time – usually around three months to a year.
However, some people find it lasts longer and can have random flare-ups years after they first get it.
The pain, swelling and extreme tiredness of reactive arthritis come after the initial infection. The infection itself may have been so mild you barely noticed it.
It is not yet known exactly why infections trigger reactive arthritis. One theory is that once your immune system has dealt with the infection, fragments of bacteria travel through your bloodstream and collect in the lining of your joints. Your immune system then reacts by causing joint inflammation.
Most people diagnosed with reactive arthritis find they have good days and bad days. It usually clears up within six months without leaving any lasting problems. However, a small number of people do go on to develop another type of arthritis that needs long-term treatment.
Seek Treatment Right Away
Many people have the mistaken impression that, like poison ivy, shingles is a nuisance rash that fades on its own. But in fact a shingles rash should alert people, especially in middle or old age, to seek immediate medical help, says Dr. Oaklander.
Rapid treatment with one of three antiviral drugs, acyclovir , valacyclovir , or famciclovir , can shorten a shingles attack and reduce the risk of serious damage, such as:
- Long-term pain. Pain that lingers in the area of a healed shingles rash is called postherpetic neuralgia. This often-disabling pain can last several months to a year.
- Prolonged itching. Many people are left with an itchy area from their shingles, which can be as disabling as chronic pain. It is most common on the head or neck.
- Damage to vision and hearing. Pain and rash near an eye can cause permanent eye damage and requires an urgent ophthalmological exam. When the nerve to the ear is affected, it can permanently damage hearing or balance.
- Strokes and heart attacks. A PLOS Medicinestudy that tracked about 67,000 people ages 65 and older who were newly diagnosed with shingles found that stroke risk more than doubled in the first week after the shingles diagnosis. The same study reported an increased risk for heart attacks in the three months after shingles, but the additional risk dissipated after six months.
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Who Is At Risk Of Getting Postherpetic Neuralgia
Factors that increase the risk of developing postherpetic neuralgia include:
- Older age: The chance of developing postherpetic neuralgia increases with age. If youre older and develop shingles, youre more likely to develop PHN and have longer lasting and more severe pain than a younger person with shingles. About 10 to 13% of people over age 50 who have had shingles will get PHN. People under age 40 rarely get PHN.
- Weakened immune system: Your immune system weakens as you get older, which allows the inactive varicella-zoster virus to become active again and cause shingles in some people. Medical conditions that can weaken your immune system include cancer, chronic infectious diseases , being an organ transplant recipient or taking medications that weaken your immune system .
- Severity of your shingles: If you have a severe rash, you have a greater chance of PHN.
- Painful, itchy or tingly feeling before shingles rash: If you had these symptoms in an area of skin a few days before your shingles rash broke out, you are at higher risk of PHN.
- Waiting to see your healthcare provider after shingles rash: If you wait longer than three days after your rash appeared missing the window to receive antiviral drugs you have an increased chance of PHN.
What Are The Symptoms Of Shingles In Adults
The first symptom of shingles is often oversensitivity or a painful burning sensation either on the face, chest, back, abdomen or pelvis, usually on one side of the body, explains Dr Wild. You might also have a high temperature, or feel unwell for a few days before a rash appears on your skin.
But this rash isn’t the same kind you’d get if you have sensitive skin, eczema, or suffer during allergies season. The rash usually starts as small, raised red spots before turning into small blisters full of cloudy fluid. “These blisters dry up after 5-7 days and form scabs that usually drop off within 2-3 weeks”, she says.
If you’re worried that you have shingles, you should also check for red blotches on your skin on one side of your body. “A rash on both the left and the right side is unlikely to be shingles,” Dr Wild explains. “Shingles can affect both sides of the body, but its very rare, usually only in those with a weakened immune system. Shingles blotches can become painful and will blister. Your skin around the infected area will remain painful or uncomfortable until the rash has completely disappeared.”
As with chicken pox, you should avoid scratching the rash as it can leave scars.
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What About Vaccines For Shingles
There are two vaccines available to help prevent shingles: Zostavax, a live vaccine, and the newer Shingrix, a nonliving vaccine that was approved by the FDA in 2017.
Shingrix is now preferred over Zostavax. It is recommended for people age 50 and older, including those who have rheumatoid arthritis . Its given in two doses, with two to six months between doses.
According to the CDC, Shingrix may be used for adults who are taking low-dose immunosuppressive therapy, are anticipating immunosuppression, or have recovered from an immunocompromising illness.
Though Shingrix has been shown to be more effective at preventing shingles than Zostavax, some experts question whether its safe for people with inflammatory arthritis. The Shingrix vaccine was studied in HIV patients, cancer patients, and transplantation patients, who all did fine, Elizabeth Kirchner, MSN, CNP, from the Cleveland Clinic told MedPage Today.
But patients with immune-mediated inflammatory diseases such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and lupus were all excluded from those trials. The concern: kicking up the immune system in autoimmune patients who already have an overactive immune system, she told MedPage.
Getting the shingles vaccine does not guarantee you wont get the disease its only used as a prevention strategy. You should ask your doctor if Shingrix is safe for you.
Just When You Think Youre In The Clear
11 months later my brother had shingles again.
We looked at him as he told us the news and we were totally lost for words.
That didnt matter though. Because he had something to say to us. He told us this time its going to be different.
This time he was going to save himself from the misery of everything that had happened before.
First, that afternoon, he went to the doctor. My brother respected doctors knowledge even though it hadnt helped him last time.
But, second and this was where things would be different this time he was going to take matters into his own hands too.
His first experience of postherpetic neuralgia had been awful. Doctors had been unable to help and he just had to wait it out.
As the pain and exhaustion had worn him down hed looked for other ways of addressing the misery. And hed got hold of a shingles treatment program from a natural health practitioner called Julissa Clay.
The Shingles Solution has a very solid reputation and tens of thousands of delighted followers. Julissa Clay herself is a celebrated and highly respected natural health practitioner who specializes in resolving some of the worlds worst illnesses.
My brother isnt really into natural remedies. But hed been in that much pain he was willing to step outside the box in search of something to end the misery.
One problem: hed got hold of the program way too late. Hed had painful PHN for more than 7 months at that point.
My brother was disbelieving, relieved, grateful.
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What Increases The Risk Of Long
The risk of developing post-herpetic neuralgia increases with age. Four weeks after getting shingles,
- 27% of 55- to 59-year-olds and
- 73% of over 70-year-olds had nerve pain.
Women seem to be more likely to have longer-lasting nerve pain than men. Post-herpetic neuralgia is also more likely to develop if your eyes were affected by shingles.
Year Five: Chronic Or Recurrent Eye Disease
When shingles impacts the eyes its called herpes zoster ophthalmicus, or HZO. And according to a report in the journal Ophthalmology, 25% of patients experience chronic or recurrent eye disease within five years of HZO. Although most patients with HZO do not experience recurrence, it is important for patients to remain vigilant for recurrences due to potential for long-term damage to their eyes, says Dr. Shekhawat. Recurrent HZO can cause severe dry eye, corneal nerve damage and inflammation and scarring on the inside of the eye, which can damage vision and cause elevation of intraocular pressure leading to glaucoma, says Dr. Shekhawat.
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Is It Possible To Avoid Shingles
Most people get shingles only once, but it is possible to get it two or more times.
Anyone who has had chickenpox can get shingles later in life. There is a shingles vaccine that may help prevent shingles, or make it less painful. The vaccine is recommended for adults ages 60 and older, even if theyve previous had shingles.
For children and adults who never had chickenpox, there is a vaccine that can help avoid getting the virus that causes both chickenpox and shingles.
For anyone who has never had chickenpox and has not received the chickenpox vaccine, it is best to avoid contact with people who have shingles or chickenpox. Fluid from shingles blisters is contagious and can cause chickenpox, but not shingles.
No Mistakes This Time
And this time he didnt make the mistake he made last time. This time he maintained the changes. And 7 years later hes not had even a whisper of shingles.
In fact, he believes that the virus that causes it has died out completely.
Now all this is good and well. But it wouldnt be a reason for me to be writing to you today if that was the end of it.
Once again, it wasnt the end of it. But heres the twist in the tale.
6 months ago it was me who had shingles.
I went to bed fine, I woke up very much not fine.
But at least I knew what it was. And I knew what to do. My first call was to my doctor. My second was with my brother.
Brother, send me that program. Send it now.
He did. And I did exactly what the program told me. I followed the guide to the letter. I cut no corners, took no chances.
And I saw my shingles out in just 15 days. Which has to be some sort of world record.
But more than that and I thank my stars for this I never suffered postherpetic neuralgia .
The possible weeks, months, or years of intense nerve pain, sleepless nights, and very low moods were what I was most scared of.
Id seen my brother suffer it all. And Id read about other peoples experience of PHN and I wanted more than anything to avoid that. And I did avoid it. All of it.
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