Shingles. Not the roof kind.

August 12, 2015 7:22 AM

A close relative has a bad case of shingles. Not a mild case like the ones described in previous asks. Despite taking antiviral drugs immediately after diagnosis, 8 weeks later relative is still in daily excruciating pain. The rash is no longer blistery, but the skin is still pink and tender and not ready for lidocaine patches. Is there any hope?

The shingles are on relative's rib cage, wrapping from sternum to spine on one side. Relative is a retired physician (age mid-60s) and has known, in their time, a lot of physicans and/or their spouses who abused prescription painkillers. This makes relative understandably reluctant to go there. Relative did take a short course of prescription painkillers about 2 days into the initial pain. Right now relative is mostly existing with ice and ibuprofen, and is not sleeping much. (Relative has never slept well, but this has put a dent in even that.)

We are now at the point where we have to start thinking about long-term pain management strategies. It doesn't look like this is going to go away. Obviously relative needs to discuss this with their own doctor. However, please tell me about your experiences with bad shingles that left nerve damage, management strategies that worked for you or didn't, what to expect for the long haul. Relative and Other Relative are feeling pretty demoralized. Do you have some encouragement to offer? Will it ever get better?

posted by telepanda to Health & Fitness (10 answers total)

Relative should see neurology or pain management. Strategies include medications for neuropathic pain like tricyclic antidepressants, topical capsacin, pain modulators like gabapentin.

Edit: I would imagine relative probably knows all of this already or has asked a colleague and learned the same. I would bet that said relative just needs to be encouraged to go to the doctor. Physicians are by far the worst patients, and we often view it as weakness or failure if we need medical care ourselves.
posted by gramcracker at 7:32 AM on August 12, 2015 [4 favorites]

I have a suppressed immune system and got a brutal case of shingles. I, too, thought that it was never going to get better and began to think of it as never having the possibility of going into remission around the two month mark, as well. After about month five, the pain began to subside, though. I had raised, painful red areas for about six months. Around month seven, I still had tingling and some burning, but it was tolerable. I think that the hardest thing for me was the bone crushing exhaustion. It did end, though -- just not on my time table. Their body is healing, albeit slowly, and likely imperceptibly at first.

Sleep tends to run a big part of the show in terms of healing, so maybe non habit forming sleep aids might be a boon to your friend.

How did I cope? I just kept trucking as much as possible and rested when it wasn't. I had a fear of losing the ability to function, so I pushed myself to keep going. I'm not sure whether that was wise, but I did come out the other end. This too shall pass, but no one can say when.
posted by batbat at 7:40 AM on August 12, 2015 [1 favorite]

Depending on where he lives, he might consider medical marijuana, which unlike many prescription painkillers won't cause physical addiction.
posted by showbiz_liz at 7:54 AM on August 12, 2015 [4 favorites]

My father's excruciating shingles lasted for about six months. I'm sorry to say it's possible your relative has a ways to go. It will eventually subside, but in the meantime there is just survival. My dad had it on his back, and he was a very reluctant patient so I think it was a while before he was diagnosed. It was so long ago I don't think they had the antivirals to treat it, so basically he suffered. I don't remember if they gave him pain meds and if so, what. Sorry!

This Times health guide on shingles looks pretty informative. I hope your relative feels better soon!
posted by clone boulevard at 8:30 AM on August 12, 2015

A friend of mine took turmeric in pill form and a nasty case just magically went away!! It was amazing....I am pretty anti-woo but I saw this first hand. Have friend check with Dr first of course before trying anything off the beaten path but it might not hurt...
posted by pearlybob at 8:33 AM on August 12, 2015

My partner is five months into a dose of shingles. She took antivirals early and was in excruciating pain in spite of it. Narcotics did not touch the pain and nor did ibuprofen and her neurologist told her not to bother with them. The only thing that worked (and still works: hello post-herpetic neuralgia) is gabapentin for the pain and Amitriptyline for the itching. Capsaicin just got where it shouldn't and caused more problems. Ice helped a bit but not enough. The turmeric pills she takes for MS had no magical effects. Deepest sympathies to your relative.
posted by firstdrop at 8:54 AM on August 12, 2015 [2 favorites]

My mother had shingles pain for almost a year, but once it was over, the pain was just totally gone. There was no nerve damage, no long-term effect.

She was always highly resistant to taking pain meds (like, she'd take half a baby aspirin for a crushing headache), but ended up on fentanyl patches. They gave her sanity and got her through it.

Pain meds treat pain, and untreated pain interferes with recovery. Your relative should take the pain meds and just be aware of the possible abuse. It's highly unlikely that he'll go that route, quite honestly. Most people who take pain meds for serious pain do not; it's only the exceptions that catch and hold our attention.
posted by Capri at 10:05 AM on August 12, 2015 [1 favorite]

It's a virus. There are alternative med groups that know how to effectively kill viral infections without drugs. It usually involves high dose supplementation of specific vitamins or other nutrients. I used to hang here a lot. The archives are searchable. So you do not need to join to try to find out what people there do for shingles.

My son had warts for like three years that would not go away. I took him in doctor and they froze them off and burned with acid etc, all to no avail. At some point, a doctor gave me a list of known effective home remedies that included, among other things, protocols using topical or oral vitamin A or vitamin E. It helped but didn't fix the problem. Then he was diagnosed with CF and this was the aha! moment letting me know I needed to use a higher dose and/or longer course. So I combined both the vitamin A and vitamin E protocol, adjusted the dose upwards and did both topical and oral treatments. Six weeks later, he was wart-free for the first time in years. Warts are also caused by a virus.

So there are mainstream physicians who know that some viral infections can be treated with high dose vitamin protocols. That gets dismissed as woo, but he should be able to find mainstream medical literature that corroborates the vitamin protocol as a valid treatment modality for some viral infections, such as warts.

I have tried turmeric. It didn't do anything impressive for me. It works for some people because it is an anti-inflammatory. Inflammation and infection tend to go hand in hand. Infection can cause inflammation and inflammation can make you more vulnerable to infection. There is research that basically links biofilms (which cause drug resistance) to inflammatory processes. So the general take away is that reducing inflammation may help. Some modalities for that include certain specific pain killers like ibuprofen (advil, not tylenol), modifying the diet, or other drugs that work as anti-inflammatories or any of a number of "woo" things like turmeric but not limited to turmeric.
posted by Michele in California at 10:16 AM on August 12, 2015

What firstdrop says. Also, putting lidocaine patches on the skin around the unaffected area helped Lady Fez when she experienced a similar bout with shingles nine months ago. She still experiences post-herpetic neuralgia and mostly soldiers through it but will go back to lidocaine patches when it gets unbearable. Friggin' shingles can be a total horrorshow. Sorry to hear about your close relative's encounter.
posted by Fezboy! at 12:49 PM on August 12, 2015

I had a relatively mild case and caught it early, and it was still excruciating. Medical marijuana was a godsend, with much milder side effects than gabapentin.
posted by judith at 1:02 PM on August 12, 2015 [1 favorite]