I worked out in the yard most of the day about a month ago. It was sunny and warm, but not too hot, and I enjoyed my time outdoors very much. The next day, I noticed a bit of irritation on the back of my neck on the right side, and when I looked in a mirror I could see an area of redness in that area. “Odd,” I thought to myself. “Why would I get a sunburn on one side of my neck only?”
The next day the sunburn feeling was a bit more intense, and when I rubbed the back of my neck, I noticed a little bumpiness in that area. I couldn’t see the back of my neck very well, even in the mirror, so I asked Carol to look at it. She confirmed that several little bumps were coming up there. “You must have been bitten by something when you were working outside,” she said.
We’re not bothered much by insects in San Antonio and I didn’t recall any insect bites, so I didn’t think that was the problem. That evening I rubbed my hand gently over the back of my neck as I was going to bed, and I could feel a couple more small blister-like bumps there. Suddenly, it all clicked together in my mind: I had shingles!
Indeed, over the course of the next three weeks I experienced a classic case of shingles. The little bumps went on up onto my scalp, and some became blisters like chicken-pox blisters. That area of skin and scalp was sensitive to touch, and I had a low-grade headache for a few days (very unusual for me). For a few days I experienced sharp, piercing pains in my right ear every five or ten minutes. They made me wince, but lasted less than fifteen seconds. I did not get any blisters in or around my ear, which was fortunate. Shingles of the auditory nerve can be devastating.
By the second week, I knew I was getting better, and by the end of the third week, most of the signs and symptoms were gone, though my neck still was sensitive to touch. I was fortunate, because shingles can often last for a month or longer, and post-herpetic pain can follow for many months or even years.
Why did I get shingles, how common is it, and what are its long-term consequences? I’ll explore these questions with you in the remainder of this newsletter.
I had chicken-pox when I was a small boy. The virus that causes chicken-pox is the same one that causes shingles. Anyone who has chicken-pox early in life is susceptible to getting shingles later in life. Before we had a chicken-pox vaccine, most people had chicken-pox as children. This means most older people are vulnerable to having shingles. One long-term study found that half of the population being studied suffered from shingles by age 85. In short, it is a common problem for people over the age of 60.
When a child gets over chicken-pox, the virus does not go away. Instead, it goes into hiding and remains dormant in a nerve ganglion near the brain or spinal cord as long as a person lives. For some mysterious reason, when a person is under unusual stress or their immune system is compromised, the virus erupts again, this time traveling along a nerve route. The virus causes skin inflammation, and blisters pop up at the nerve endings of the nerve affected. The involvement of the nerve endings is what makes it such a painful condition.
Shingles is always one-sided. It can erupt along any nerve track on either the right or the left side of the body, but never on both sides. It can appear anywhere from the scalp to the bottom of the foot, depending on what nerve the virus travels along. Thankfully, it rarely involves more than one nerve track. The inflammation and blisters may last for three to six weeks, but the damaged nerve endings may cause pain for years afterward in what is called the post-herpetic syndrome.
Treatment for shingles is aimed mainly at prevention. A vaccine called Zostavax is now available to help prevent or reduce the severity of shingles. Recommended for people at age 60, it cuts the risk of having shingles by about half, and reduces its severity in those who do come down with it. For those who develop shingles, medication that may shorten its course and lessen its severity is available by prescription. It works most effectively if given within a day or two of onset of symptoms.
Pain is often a major problem with shingles, and many patients require a lot of pain medication. Yet, pain medication only masks symptoms. It does nothing to improve underlying healing dynamics. Because of this, I resist taking pain medication as much as possible. Although I was tempted to take some Tylenol when I was suffering from headache and piercing pains in my right ear, I decided against doing so. Happily, the pains cleared up within a few days.
Recent research shows that eating abundant fruits and vegetables helps prevent shingles, and reduces its severity when it does occur. I was not aware of these findings until doing my research for this newsletter, but it may explain why my case of shingles was relatively mild. I’ve known for a long time that eating lots of fruit and vegetables is good for health, but this emphasizes how valuable they are for boosting the immune system.
In summary, shingles is a common problem after age 60, often being triggered by stress. Getting the vaccine at age 60 to minimize its risk is worthwhile. If you miss getting the vaccine, eating a healthy diet with abundant fruits and vegetable may be equally effective. Of course, eating a healthy diet with lots of fruits and vegetable is valuable for many other reasons also. Fruits and vegetables truly are dietary all-stars!
John Robbins
This is a good lead-in for the Food Revolution taking place under the leadership of John and Ocean Robbins. I will interview John Robbins on my radio show on Monday, June 18th, and Ocean Robbins on Monday, June 25th. Both interviews will be full of great information about healthy foods, healthy eating habits, healthy people, and a healthy planet. Please plan to tune in for a lively, enlightening program!
You can learn more about the interview with John Robbins and listen to it here.
Be Well!
Ed Dodge, MD, MPH
