Women and Shingles

I found out last week that my mother who suffers from Parkinson’s has Shingles.  From what I have seen of Shingles it looks very painful.  I wanted to find out more about it so I decided to surf the Internet and get as much information as I could.

What is Shingles?

Shingles, also known as herpes zoster or just zoster, occurs when a virus in nerve cells becomes active again later in life and causes a skin rash.

The virus that causes shingles, the varicella-zoster virus, is the same virus that causes chickenpox. It is a member of the herpes virus family. Once you have had chickenpox, varicella-zoster virus remains in your body’s nerve tissues and never really goes away. It is inactive, but it can be reactivated later in life. This causes shingles.

Doctors aren’t sure how or why the varicella-zoster virus reactivates, but they believe your immune system’s response to the virus weakens over the years after childhood chickenpox. When the virus reactivates, it travels through nerves, often causing a burning or tingling sensation in the affected areas. Two or three days later, when the virus reaches the skin, blisters appear grouped along the affected nerve. The skin may be very sensitive, and you may feel a lot of pain.

If you have had chickenpox, you are at risk of developing shingles. However, the virus doesn’t reactivate in everyone who has had chickenpox. Shingles most often appears in people older than 50 and in people with weakened immune systems. If you are having treatment for cancer, for example, you are more likely to get shingles. People with HIV commonly get shingles, which is often one of the first signs that the immune system is in trouble.  Your chances of getting shingles increase as you get older, although the disease can occur at any age. When shingles appears in children, which is uncommon, it usually is very mild. Up to 20% of people in the United States develop the disease at some point (Women’s Health).

None of my sisters nor I ever have Chicken Pox as a child but later when we as adults, my sister and I got it from our mother.  I still have the marks.  I am hoping that I am one of the people in whom the virus does not reactivate.

 

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Recently I have seen a commercial where a person has Shingles and it looks painful.  The rash on one side of  the man’s body looked red and very painful.  When I browsed the Internet, I saw pictures that made me cringe.  How those people must have suffered.  I think of my mother and I hope and pray that she isn’t in much pain.

What are the symptoms?

Pain

Symptoms of shingles are similar in men and women. The first and most common symptom of shingles is usually pain. This pain typically occurs before any rash is present and is sometimes called the warning stage of shingles. Women often describe a tingling, burning pain or an area of intense sensitivity on their skin. This often happens in a small area that is on one side of the body only. The pain may be mild or intense enough to require treatment with painkillers. The pain may last for a few days, may come and go or may be constant. It may continue once the rash and blisters form and usually lessens when the rash disappears.

Rash and Blisters

Another symptom of shingles is a rash that turns into fluid-filled blisters. This usually appears a few days or a week after skin pain starts. The blisters form a crusty scab in about 7 to 10 days and typically clear up in 2 to 4 weeks. The difference between the rash of chickenpox and that of shingles is that shingles usually appears on one side of the body only. Shingles commonly appears in a belt-like band around the midsection, corresponding to skin along the path of one nerve. Sometimes the rash appears on one side of the face and follows the major facial nerve, or it can involve more than just a single area of skin. Some cases of shingles have only a few or even no blisters. A shingle diagnosis can be missed in this case. Shingles without any rash or blisters is called zoster sine herpete.

Other Symptoms

Once the rash appears, women sometimes report flu-like symptoms, such as headache, upset stomach, fever and chills. About half of the people who have rash along the facial nerve experience eye complications. These complications are generally seen as inflammation of different parts of the eye and may involve a mucus or pus-like discharge and sensitivity to light. Eye problems from shingles are very serious and should be evaluated by a doctor immediately. Some women experience a condition called postherpetic neuralgia. This condition is pain that continues even after the shingles rash is gone. The pain has been described as a constant burning that hurts to the touch or pressure from clothing. It usually resolves on its own, but resolution can take 6 months to a year or even longer (Live Strong).

 

Shingles and pregnancy

Pregnant women can get shingles, but it is rare. While chickenpox can pose a very serious risk to a fetus, there is almost no risk to the fetus if the mother gets shingles. The symptoms of shingles are the same in pregnant and non-pregnant women. Any area of skin that has pain, tingling, itching or burning — even without a rash or blister — should be brought to the attention of a doctor, as this could be the early stages of shingles (Live Strong).  Thankfully, I got chickenpox years before I got pregnant.

 

Does Shingles affect women differently from men? According to Centers for Disease Control and Prevention (CDC):

  • Most, but not all, studies found that more women than men develop herpes zoster [1,2]; the reason for a possible difference between women and men is not known.
  • Some studies conducted in the United States and elsewhere found that herpes zoster is less common in blacks (by at least 50%) than in whites.[3]

 

How is Shingles Treated?

Self-care

If you develop the shingles rash, there are a number of things you can do to help relieve your symptoms, such as:

  • keeping the rash as clean and dry as possible – this will reduce the risk of the rash becoming infected with bacteria
  • wearing loose-fitting clothing – this may help you feel more comfortable
  • not using topical (rub-on) antibiotics or adhesive dressings such as plasters – this can slow down the healing process
  • using a non-adherent dressing (a dressing that will not stick to the rash) if you need to cover the blisters – this avoids passing the virus to anyone else

Calamine lotion has a soothing, cooling effect on the skin and can be used to relieve the itching.

If you have any weeping blisters, you can use a cool compress (a cloth or a flannel cooled with tap water) several times a day to help soothe the skin and keep blisters clean.

It’s important to only use the compress for around 20 minutes at a time and stop using them once the blisters stop oozing. Don’t share any cloths, towels or flannels if you have the shingles rash.

Antiviral medication

As well as painkilling medication, some people with shingles may also be prescribed a course of antiviral tablets lasting 7 to 10 days. Commonly prescribed antiviral medicines include aciclovir, valaciclovir and famciclovir.

These medications cannot kill the shingles virus, but can help stop it multiplying. This may:

Antiviral medicines are most effective when taken within 72 hours of your rash appearing, although they may be started up to a week after your rash appears if you are at risk of severe shingles or developing complications.

Side effects of antiviral medication are very uncommon, but can include:

 

Can Shingles Be Prevented?

Currently, there is no way to predict an outbreak of shingles.  Researchers have shown that giving older people a stronger form of the chicken pox vaccine used for children can boost the type of immunity believed necessary to hold the virus in check. Zostavax, a shingles vaccine developed by Merck, has been approved by the FDA. An initial study in people with HIV showed that Zostavax was safe and effective (The Body).

 

Is Shingles Contagious?

Shingles is not contagious (able to spread) in the sense that people who are exposed to a patient with shingles will not “catch shingles.” Anyone who has already had chickenpox or has received the chickenpox vaccine, and is otherwise healthy, should be protected and at no risk when around a patient with shingles. However, people who have never had chickenpox and have not received the chickenpox vaccine are susceptible to infection by a patient with shingles. These susceptible people, if exposed to the shingles virus, will not develop shingles, but they could develop chicken pox. However, people who have never had chickenpox and have not received the chickenpox vaccine are susceptible to infection by a patient with shingles. These susceptible people, if exposed to the shingles virus, will not develop shingles, but they could develop chicken pox. Such susceptible individuals include babies, young children, and unvaccinated individuals, so people with shingles are actually contagious for VZV infections in the form of chickenpox. Consequently, these individuals may get shingles at a later time in life, as can anyone who has had chickenpox. Covering the rash that occurs with shingles with a dressing or clothing helps decrease the risk of spreading the infection to others. Pregnant women are not unusually susceptible to shingles but if shingles develops near the end of pregnancy, the fetus may be harmed (eMedicineHealth).

 

Vaccines for Shingles

The shingles vaccine (Zostavax) is recommended for adults age 60 and older, whether they’ve already had shingles or not. Although the vaccine is approved for people age 50 and older, the Centers for Disease Control and Prevention isn’t recommending it until you reach age 60.

The shingles vaccine is a live vaccine given as a single injection, usually in the upper arm. The most common side effects of the shingles vaccine are redness, pain, tenderness, swelling and itching at the injection site, and headaches.

Some people report a chickenpox-like rash after getting the shingles vaccine.

Although some people will develop shingles despite vaccination, the vaccine may reduce the severity and duration of it.

The shingles vaccine isn’t recommended if you:

  • Have ever had an allergic reaction to gelatin, the antibiotic neomycin or any other component of the shingles vaccine
  • Have a weakened immune system due to HIV/AIDS or another disease that affects the immune system
  • Are receiving immune system-suppressing drugs or treatments, such as steroids, adalimumab (Humira), infliximab (Remicade), etanercept (Enbrel), radiation or chemotherapy
  • Have cancer that affects the bone marrow or lymphatic system, such as leukemia or lymphoma
  • Are pregnant or trying to become pregnant

The cost of the shingles vaccine may not be covered by Medicare, Medicaid or insurance.  Check your plan (Mayo Clinic).  One of my co-workers got the vaccine this year and recommends that I get one too.

 

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Is there a Cure?

There is no cure for shingles, but treatment can help ease your symptoms until the condition improves. In many cases, shingles gets better within around two to four weeks.  However, it’s still important to see your GP as soon as possible if you recognize the symptoms of shingles, as early treatment may help reduce the severity of the condition and the risk of potential complications (NHS Choices).

 

Caring for Shingles

How to care for a Patient with Shingles

If you are helping to care for someone with shingles and particularly if they are elderly, then here are some ideas to make life more comfortable for them:

  • As soon as the rash appears and has been diagnosed as shingles, start treatment. If treatment can be commenced within two or three days of the outbreak, the shingles will be less severe and there is less chance of the patient going on to suffer from postherpetic neuralgia.
  • You cannot catch shingles by touching the sore skin or the bed or chair where the person has been lying or sitting so if wearing less clothing will make the patient more comfortable then encourage this. Some people with shingles are very sensitive to touch so try to touch only the side of the body that does not have the rash.
  • You can catch chicken pox from a person with shingles blisters so keep anyone who has never had chicken pox away from the patient.  (This particularly applies to pregnant women where there is a danger to the unborn fetus).
  • Relieve any discomfort with cool compresses unless your patient finds it makes the pain worse.
  • Look for ways to relieve the stress of the pain for your patient such as meditation or listening to soothing music.
  • Make sure your patient has a pain reliever if necessary and you may need a prescription for something to help insomnia if this is a problem. In some cases, the pain can be very severe and with such pain, it is hard to find a comfortable position whether sitting, lying down or walking around.  Your patient needs as much sleep as possible.
  • Constant pain can affect your patient’s appetite – try to encourage your patient to eat well (you may need to provide extra tasty treats).
  • Constant pain can also make your patient cross, sad or depressed – this will need extra patience and kindness on your part (Healing Natural Oils).

My mother is doing well.  She is on an anti-viral drug and not in any pain.  I was relieved to find out that her blisters are on her arm and not on her face.  She is frustrated because she is quarantined but the nursing home has to do what is best for all the residents.  I hope she gets better soon.  In the meantime, my family and I will do as she requested and stay away.

If you have a loved one who has Shingles, call them often.   Hearing from you may bring them some comfort.

 

Sources:  Live Strong; Women’s Health; Mayo Clinic; The Body; CDC; eMedicine Health; Healing Natural Oils

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Women And Infertility

I was watching General Hospital and one of the characters received the news that she could not have children.  Any child she carried would not be carried to full term.  She would lose the baby.  What heartbreaking news.  It hurts to see women who want to be mothers and who would be great mothers unable to have children while those who are unfit have children.  It doesn’t seem fair.  Lulu, the character wondered why this happened to her since there was no family history of infertility.  Before that she blamed herself for her condition because she had had an abortion when she was a teenager.

I have often wondered why are some women unable to have children or carry them to full term?  There was a time when I was afraid that I would not be able to have children.  In biblical times barren women were looked down upon by other women.  Sarah was despised by her servant Hagar because she was able to conceive while her mistress couldn’t (Genesis 16:4).  Hannah was tormented by Peninnah, her husband’s other wife and rival because the LORD had closed her womb.  She made Hannah’s life a living hell until God blessed Hannah with children.  Rachel rejoiced when she conceived her first child, saying, “God has taken away my reproach” (Genesis 30:23).

In developing countries women face ostracisim and see their infertility as a failing or a curse.  Newsweek ran a story in 2008 about women around the world who are coping with infertility.  One woman was uable to conceive for the first 13 years of her marriage.  She said that people would ask a woman her name—and then, “How many children do you have?” When the woman answered “none”, they don’t know what they can talk to you about.”

It must be so difficult for a woman to be surrounded by family members and friends who have children of their own or to see mothers where ever you go with their children and know that she would never have that experience.  It’s ironic. There are women who can have children but choose not to and there are women who would like to be mothers but are unable to have children.

What causes infertility in women?  Women’s Health Government has a fact sheet which answers these and other questions about infertility.

What is infertility?

Infertility means not being able to get pregnant after one year of trying (or six months if a woman is 35 or older). Women who can get pregnant but are unable to stay pregnant may also be infertile.

Pregnancy is the result of a process that has many steps. To get pregnant:

  • A woman’s body must release an egg from one of her ovaries (ovulation).
  • The egg must go through a fallopian tube toward the uterus (womb).
  • A man’s sperm must join with (fertilize) the egg along the way.
  • The fertilized egg must attach to the inside of the uterus (implantation).

Infertility can happen if there are problems with any of these steps.

Infertility among women is common.  According to  the Centers for Disease Control and Prevention (CDC) about 10 percent of women (6.1 million) in the United States ages 15-44 have difficulty getting pregnant or staying pregnant.

What causes infertility in women?

Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.

Ovulation problems are often caused by polycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman’s ovaries stop working normally before she is 40. POI is not the same as early menopause.

Less common causes of fertility problems in women include:

What increases a woman’s risk of infertility?

Many things can change a woman’s ability to have a baby. These include:

Check out the Women’s Health Government fact sheet to find out how age can affect a woman’s ability to have a child; how long a woman should try to get pregnant before consulting a doctor; how a doctor determines if a woman and her partner have fertility problems and treatments.  They also offer more information (links) on infertility that may help you or someone you know who may be having difficulty getting pregnant.

Glen Meade Center for Women’s Health outlines the ways in which women can be tested for infertility:

  • Blood tests to check hormone levels, including progesterone and follicle stimulating hormone (FSH)
  • Checking morning body temperature to determine if ovaries are releasing eggs
  • Hysterosalpingography (a radiologic assessment of the uterus and fallopian tubes)
  • Pelvic ultrasound
  • Laparoscopy (inspection of pelvic region)
  • Luteinizing hormone uterine test (ovulation prediction)
  • Thyroid function tests

There is hope for women experiencing infertility.  Glen Meade offers the following treatment options depending on the cause of the infertility:

  • Education and counseling
  • Fertility treatments, such as intrauterine insemination (IUI) and in vitro fertilization (IVF)
  • Medications that treat infections and clotting disorders
  • Medications that help women grow and release eggs from the ovaries

Notes to Women wants to reach out to women facing infertily by encouraging them to read articles from women who are coping with it such as this one.  We hope that the tips for living with infertility will be helpful to you and give you some comfort.

Sources:   http://womenshealth.gov/publications/our-publications/fact-sheet/infertility.cfmhttp://www.glenmeadehealth.com/ms_infertility.html; http://www.thedailybeast.com/newsweek/2008/09/14/what-it-means-to-be-a-woman.html