SHINGLES: recovering from this painful condition

The community quarantine measures implemented during the 2020 pandemic limited within the boundaries and safety of our own homes, limiting our movement and access to external non-essential activities and movements. Coupled with the added mental stress or anxiety, these could have taken toll on our health our immune system. During that same period, there is a rise in need of health care workers, and thought of heeding the call and applied for a role in a government setup. Understanding the urgency, I volunteered to market the employment opportunity to my network and was able to refer a handful of applicants. Weeks after, they got deployed, and I got no update on my application. I was engrossed in this application since this could gradually remind me of the setup and basic procedures in the clinical practice. With the deployments going on and with nothing happening on my application after such promises, I succumb to what I can say, depression. I lost appetite, locked in my room, and almost slept the entire days coming, rarely initiating communication with anyone, just me and myself attached to my smartphone. By the way, I am a graduate and licensed nurse, however, a corporate slave for more than a decade.

Few days past, I felt toothache on my upper left molars and premolars. Then, a macule, red and flat skin lesion, appeared above my lip, followed by three more macules on my nose and cheeks the next day.  I thought initially, it was just another round of acne happening. I did not think of connecting the toothache and those lesions happening at the same time. I felt lazy and tired at the same time. Little that I know, I was already past the prodromal period of Shingles, or Herpes Zoster – a painful sequel of Chicken Pox, or Varicella zoster.

What is happening?

When you survived an active case of Chicken Pox before, you are also prone to develop Shingles after, should your immune system happen to weaken for certain reasons. The Chickenpox virus is not totally eradicated by your body after you fully recovered, but the virus lays dormant on your nerves. Once the reactivation occurs, the characteristic blister-like rash, called vesicles would appear along the path of the nerve affected. Vesicles are fluid-filled lesions on your skin.

A Course of Shingles diagram-multilang

Progression of shingles. A cluster of small bumps (1) turns into blisters (2) that resemble chickenpox lesions. The blisters fill with pus, break open (3), crust over (4), and finally disappear. This process takes four to five weeks. A painful condition called post-herpetic neuralgia can sometimes occur. This condition is thought to be caused by damage to the nerves (5), and can last from weeks to years after the rash disappears. (Source: Wikipedia)

a) skin surface
b) nerve fiber
c) awakened virus
d) dormant virus

What have I experienced?

Since there is a nerve affectation, expect pain on the same pathway. I felt continuous pricking and electrocuting like pain on the left side of my face. The vesicular rash spread more and reaching my eyes. There is a patch also on my left cheekbone area that is numb. The nerves innervating my upper left premolars and molars are affected hence, the continuous numbing pain on those teeth. It was hard to chew food at that time since I feel that my gums and teeth are separated by a thick sheath of tissue, however, there is no obvious inflammation.

shingles experience (2)
Details of the signs and symptoms of Shingles I had

As the disease process progressed, the vesicles spread already reached to my left eye. I have developed blisters already on both my upper and lower eyelids.  The eye got visibly red and my vision was cloudy. The agony of Shingles is real, and I struggled a lot.

What are the typical Signs and Symptoms of Shingles?

  • Fever
  • Chills
  • Headache
  • Fluid Filled rash in linear manner appearing only either left or right side of the body (unilateral)
  • Stabbing or shooting pain
  • Tingling sensation under your skin

What are the risk factors?

  • Old age
  • experienced a lot of stress at any age
  • Have cancer, HIV or other conditions that weakens the immune system
  • Have undergone radiation therapy, chemotherapy or have taken long term steroid therapy (Why? Because steroids reduce the activity of the immune system)

What was my pharmaceutical treatment?

I happen to know Dr. Jun Gutierrez, a medical practitioner in Concepcion, Tarlac, during the period of hiring of health care workers. Since the Enhance Community Quarantine is in place, there is no way I would have a face to face check up to my doctor. I message Dr. Gutierrez, and he responded accordingly. I describe what I felt and sent him actual photos of my face. He confirmed that it is Shingles. Dr. Gutierrez sent me a digital prescription of antiviral cream and gave clear orders. He also reminded me of taking care of my immune system.

shingles left eye
Affected Left Eye (White residue because of Zovirax cream)

 

Having the rashes affecting the eyes could cause possibly permanent damage. Since I am already experiencing cloudy vision and painful eyes, I messaged Chua Eye Center, a well-known ophthalmology specialty clinic in Angeles City. I was able to reach Dra. Joy Chua, whom I previously invited as a Resource Speaker before tackling Health Awareness for HR Professionals, and she instructed me to send a photograph of my left eye. Afterward, Dra. Joy sent me a prescription of antiviral eye gel and oral medications.

shingles treatment
Combination of oral, eye gel and topical antiviral treatment for 7 days

I rushed to the nearest pharmacy and purchased all the required medication and started the medications soon I reached home.

In less than two days after starting those treatments, my condition gradually improved. The rash did not spread out and the remaining ones started to dry and scab. My eyes appeared less red and the cloudy vision diminished.

After more than two weeks since the appearance of the first rash, all of the vesicles have scabbed and dried. I felt significantly better; however, the patch of the numbed area on my left cheek and upper left premolars remained until the posting of this article. I researched for it, and it is a common complication of having shingles on the face. There is a momentary sensation of shooting or electrocuting pain or I would describe as tiny legs crawling on the affected nerves, and it happens from time to time, at different intervals. The pain is also somehow bearable now. There is also an occasional twitching of my left my cheek muscles.

What other home remedies I did?

I maintained the proper hydration throughout my convalescent stage. Additionally, I have taken beneficial teas like turmeric and chamomile. Due to the constant pain, I took Diphenhydramine, an over the counter anti-allergy drug that causes drowsiness, to have quality nighttime sleep. You should ask your doctor if you need this. I made sure that I was having quality meals and taken supplements too. I veered away from stressful thoughts and watched drama series online to keep myself occupied. Since it is difficult to wash my face during the active stage of the condition, I daily run a cotton bud soaked in 70% alcohol carefully around the lesions before I sleep.

It is helpful also to keep your nails short and clean to avoid accidental infecting the fluid-filled rashes.

Is Shingles contagious?

Yes, it is contagious to someone who never had an active Chickenpox disease before. It also spread through droplet infection, same with Covid19, and I wore a face mask even if I stayed home. I remained isolated most of the time, and also go out for meals and bathroom breaks. It is also best to avoid going near pregnant women, and patients you know have weakened immune systems.

Is there a vaccine for Shingles?

Yes, but it is recommended for older age population who are to risk to have the condition.

Did I have any scars? 

Yes, I have four pitted scars on my face that are currently hyperpigmented or darker in shade. Hopefully, the pigmentation would go away soon.

Does Shingles have a complication?

Yes, commonly it is called postherpetic neuralgia (neuralgia means nerve pain)., which I have as of writing. Other complications are eye or vision problems and inflammation of the brain or other nerve systems.

It is important that we have to watch our health, especially that we are currently in a pandemic state. Health is really our wealth. The cost of treatment today multiplies since of the fear of the Covid19. 

My Appreciation to these Doctors

 

I am thankful to Dr. Gutierrez and Dra. Joy for providing the urgent medical support I need during this personal crisis.

Dr. Jun operates GutierrezMD Skincare Solutions. For appointments, you can contact Dr. Jun through his official Facebook accounts: Jun Gutierrez MD or Doc Jun Gutierrez. He is also a resident of the Philippine Academy of Aesthetic and Age Management Medicine Inc.

Dra. Joy Chua is part of the group of eye doctor specialists of Chua Eye Center located in Balibago, Angeles City. She is a wellness advocate and runs yoga classes. You can contact Chua Eye Center at +63 917 525 1476 for inquiries and appointments. For yoga classes,  check the official Facebook page of The Yoga Playroom studio.

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