Broken Heart Syndrome

You can die of a broken heart — it’s scientific fact — and my heart has been breaking since that very first day we met. I can feel it now, aching deep behind my rib cage the way it does every time we’re together, beating a desperate rhythm: Love me. Love me. Love me.
Abby McDonald, Getting Over Garrett Delaney

I recently learned about broken heart syndrome when Dr. Marla Shapiro was talking about it on TV. She mentioned that it was first described in 1990 in Japan as Takotsubo Cardiomyopathy.  Takotsubo is a Japanese term for an octopus trap because of the ballooning shape of the heart during an attack. What is broken heart syndrome?  It is a temporary heart condition caused by an extremely stressful event.  It is a recently recognized heart problem and it can strike you even if you are healthy.

People with broken heart syndrome think that they are having a heart attack when they have a sudden chest pain.  In broken heart syndrome, there is a temporary disruption of the heart’s normal pumping function while the rest of the heart functions normally or with more forceful contractions.

There may be shortness of breath, irregular heartbeats (Arrhythmias) or cardiogenic shock can occur. Cardiogenic shock occurs when a suddenly weakened heart can’t pump enough blood to meet the body’s needs.  This can be fatal it it is not treated right away.  In fact, Cardiogenic shock is the most common cause of death among people who die from heart attacks.  Any time you experience chest pain, you should call 911 and get emergency medical care.  All chest pain should be checked by a doctor.

Women are more likely than men to have broken heart syndrome.  It can be brought on by the death of a loved one, divorce, a break-up, physical separation, betrayal or romantic rejection, a frightening medical diagnosis, domestic abuse, natural disasters, job loss, asthma attack, car accident or major surgery.  It can even occur after a good shock such as winning the lottery.  It is more commonly seen among post-menopausal women. Research is ongoing to find out what causes this disorder and how to diagnose and treat it.

As mentioned before the most common symptoms of broken heart syndrome are chest pain, shortness of breath and very rapid or irregular heartbeat.  WebMD mentions two other symptoms, arm pain and sweating.  It is usually treatable.  Most people who experience it have a full recovery within weeks and and the risk of it happening again is low although in some rare cases it can be fatal.  The only way you can be certain if you have broken heart syndrome is for you to have some tests.  These tests used include the following:

  • Medical history and physical exam
  • Electrocardiogram
  • Chest x-ray
  • Echocardiogram
  • Blood tests
  • Coronary angiogram

If you have any questions about Broken Heart syndrome, please visit Seconds Count and download their PDF file.

A broken heart is a real condition.   In 2010 the Wall Street Journal wrote an article of a 63 year old woman named Dorothy Lee who lost her husband on night when they were driving home from a Bible Study group.  He had suffered from a heart attack. At the hospital after she learned of his death, Dorothy began to experience sudden sharp pains in her chest, felt faint and went unconscious.

An X-ray angiogram revealed that she hadn’t suffered a heart attack.  There was no blood clot and her coronary arteries were completely clear. Dorothy had suffered from broken heart syndrome.  It was triggered by the sudden loss of her husband of 40 years.  She was literally heartbroken.  Thankfully, she was at the hospital when she had her symptoms and she didn’t die although the episode severely weakened her heart.  She required a special balloon pump to support her left ventricle during the first couple of days in the hospital.  Five days later she was discharged.

Despite being cautioned by doctors, she attended her husband’s funeral. She was able work through her grief positively and spiritually.   To date she has had no effects of the heart episode.

It is extremely important that if you or someone else experience any chest pain that you don’t ignore it or feel embarrassed to call for help.  At the first sign of symptoms, get help. This can save your life or someone else’s life and limit the damage to the heart.

A broken heart is not just something out of a romance novel.  It is a reality.

 

 

broken heart syndrome

 

Sources:  American Heart Association; Mayo Clinic; National Heart, Lung and Blood Institute; Wikipedia; Women Heart; WebMD; Uptodate

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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.

 

shingles-s16-photo-of-woman-receiving-vaccine

 

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