Did you even know that was a possibility? Admittedly, neither did I, until I suffered from zoster sine herpete (ZSH) just two weeks ago - and thought I was dying. The first few days, I felt sore whether I was moving or resting. My body just ached. I can remember the very first sensation honestly, down the right side of my neck and right shoulder just moments after I resigned from a fairly toxic position. I hadn't made the connection though. I wondered if I had slept wrong, if I might be having gallbladder issues, or maybe strained it somehow. I am not as young as I use to be after all.
As the days passed though, the pain moved down my back and ribs, even down into my hips. I wondered about pelvic inflammatory disease, it was that significant, but nothing in my abdomen was sore. It was clear inflammation though because it hurt to be still and even more, it hurt to move, more so in a jerking motion.
My brain hurt. My eyeballs hurt. I questioned meningitis, but ruled that out when touching my chin to my chest didn't increase my discomfort. Either way, without a fever and due to the apparent widespread #inflammation, I knew it had to be viral and should last ten days to two weeks.
Unfortunately at the onset of this torture, I had flown down to Florida see my bestie and she immediately recognized it as #shingles - she's smart that way, also a nurse-midwife. I had no blisters though, but as she pointed out, my pain followed dermatomes - brain, eyes, down my spine and radiating from my spine sideways - ribs, kidneys and hips. There was no pain in my chest or abdomen. I felt as if I had been badly sunburnt, just under my skin, down my back. In fact, I even lifted my shirt to check to see if my skin did look burnt, but in spite of seeing no evidence of trauma to my skin, the pain was significant just below the surface. I was assuring my will was in place as my bestie was giving me Valtrex.
Shingles is a painful rash caused by varicella-zoster virus - the same one that causes #chickenpox. If you've had chickenpox previously, the virus continues to hang out in the body, laying dormant, until some level of stress impacts your immune system, whether an illness or a toxic job. Generally shingles presents with blisters in a band or belt-like pattern following dermatomes on the skin. Herpes can also cause cold sores or genital lesions, but when zoster sine herpete presents, the internal organs become inflamed. Pneumonia can result, hepatitis if it spreads to the liver, encephalitis when it impacts the membranes of the brain, transverse myelitis in the spinal cord, and problems can even happen in various blood vessels when herpes becomes active internally. These conditions are all very serious and can be life-threatening. Hospitalization can be necessary.
Until my friend diagnosed me, I was simply awaiting the resolution of some odd virus - which may or may not kill me - but once I recognized her brilliance and ultimately, my suffering resulting from a herpes virus, I gained a bit more confidence that I might survive. Quite literally though, I slept the entire week away on her couch. Day ten came and went and I was still in significant pain so into the literature I dug and learned that this virus can last two to four weeks! I also learned that following internal shingles, which is exceedingly rare, postherpetic neuralgia results in about ten percent of people - long-term nerve pain. As a functional medicine clinician, chronic pain is something I see regularly; the idea of suffering as these clients do on a daily basis was quite an overwhelming potential reality. Imagine suffering significant pain simply from the lightest touch or even change in temperature. Antidepressants can actually be helpful in managing this pain at a dose much lower than if one was actually wanting to treat depression. Capsaicin is another substance, made from chili peppers, that can help to treat pain (Zostrix).
Other more rare presentations are shingles in the ear, Ramsey Hunt syndrome, which can lead to hearing or balance problems, dizziness, earache, and paralysis of the face or shingles of the eyes, causing permanent scarring of the corney, glaucoma, or vision problems.
Pain medications are certainly appropriate in these circumstances, and anti-viral medication. Shingles without blisters are not contagious, but with blisters, they can be. Sleep. When awake, take an easy walk. Read. Distract yourself. Listen to music. Talk to your bestie. About twenty percent of those over 40 will suffer shingles at some point in their life, as 99 percent of us did have chickenpox as a child.