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Two and a half years ago I contracted shingles, one week after requesting the vaccine which was not readily available then.
I would like to alert caregivers of the importance of getting the vaccine for the loved one in their care.
Shingles can be a very painful condition and the pain can last for, weeks months or years. Everyone who has had chickenpox is at risk because the virus remains in the body and can later, especially in the elderly, appear as shingles. More than one attack is possible.
Contact the patient s PCP and ask for advice, because some people should not receive it, for example those with weakened immune systems or taking steroids such as prednisone or infected with the AIDs virus or are allergic to any component of the vaccine such as gelatin or neomycin.
The injection itself is a simple prick in the arm, no worse than any other injections and side effects are mild if at all. Even if you have already had shingles you should still get the vaccine, it can recur.
The downside is the cost, as it is far from free. Personally I paid a co-pay of $80 as I have a Medicare PCP plan and it is treated as a prescription drug and falls into the top tier of payments. Medicare also treats it as a drug and unless you pay for part D it will not be covered. Out of pocket it can cost several 100$s.
As far as treatment is concerned there is very little help. Gabapentin an anti seizure drug may help but it makes one very sleepy especially if taken on an empty stomach. Some of the tricyclic anti depressants can be prescribed but I have no experience with those.
Antiviral medication was prescribed within a few hours of the rash appearing so mine never did blister
I did and still do take the gabapentin and in the acute stage, when the pain was worse getting up to a 6-8 on the pain scale I put ice on it which helped a bit and later a heating pad. I think I tried every over the counter anesthetic cream or spray on the market. One of the sprays worked quite well because the propellant was cold when applied. On thing that is recommended is Capsazin cream and I would not wish that on my worst enemy. It burned and itched so badly I could not get to the bathroom fast enough to wash it off. Maybe it works for some people but I would only try a tiny area to see how you react. OTC pain medications may work and tylenol did help me a little. Sometimes even narcotics are prescribed when the pain is severe.The acute stage was accompanied by mild flu like symptoms and extreme lethargy. Clothes touching the area were very irritating and wearing a bra was almost impossible. A light cotton garment was the most comfortable so I spent a lot of time in a night gown and left the bra off at home.
I did get the vaccine when it became widely available but even so had a small relapse a few weeks ago when a tiny nerve off the main branch affected on my back became sore and a line of red spots appeared. Again a quick visit to the Dr got me more anti virals and it disappeared in a few days
At this time I have a dull ache in my side most of the time which is tolerable but heavy activity like gardening does make it worse.
As I said in the beginning caregivers should explore the need for their loved ones and themselves (I know many of you are also seniors as I am) if they have had chicken pox.
Shingles is not contagious person to person but can infect another who has not had chicken ,with that disease when the spots are open, so it is important to prevent contact with babies and pregnant women and young children and those who have not been vaccinated. It can be a very serious even life threatening in an adult.
Be very careful with caregivers you hire who have come from poor countries. The agency they work for should have checked their health records but they often work independently and get jobs by word of mouth. they can be well trained in their home country but it is not easy to get that training recognized in the US so they work as aides. This is even the case with nurses from other developed countries.
In closing I would again urge caregivers to ask their loved ones Dr for advice. Shingles adds to the distress of the terminally ill and I imagine makes the demented patient more difficult to manage

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I had a mild case of shingles in my 30's. Nothing made it better! But it was gone in a week. I know that in the elderly, it can kill a person, from enduring the pain over a LONG time period. Get the shot!
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