02 January 2007

Shingles

Well, I had great plans for my ten days off -- work on the apartment, organize the office, deep-clean the kitchen, read, and study Haskell!

So much for best-laid plans. Just before Christmas I came down with a shingles infection, which started in my right eye.

Shingles is a reactivation of the herpes zoster or "varicella" virus, the same virus that causes chicken pox. I did a near all-nighter the Monday a week before Christmas, which might not have been too bad, but then the following night we had a sick baby and I was also unable to sleep. That was apparently enough stress to cause the virus to reactivate.

Shingles is painful. I have become intimately familiar with two new types of pain, which I call the blowtorch and the nightstick. The blowtorch is a feeling like my skin is being burned by an open flame and is bubbling. That is the sensation of the blisters forming, although it comes at other random times too. The nightstick is deep pain along the nerves of my face, where they feel like I've been beaten. That produces a tremendous amount of muscle tension in my jaw, and around the base of my skull as well, where large areas are still hyper-sensitive to touch.

Valtrex (an anti-retroviral drug) also has nasty side effects. I got waves of fever and chills, often back-to-back. It also caused nausea, diziness, and strange visions. I'm off the Valtrex now, so thankfully those side effects have gone away.

For most of my ten days off work I was fairly incapacitated: unable to see, unable to read, lying in bed with fever or chills and with strange pains, covered with blisters and scabs. When I got out of bed, I was dizzy, stumbling around the house looking like a crazed sunburned pirate with an eye-patch on.

Anyway, I am now back at work. The scabs are gone, although my face is still visibly splotchy. My right eye is still swollen and there is still some pain. I am still using an antibiotic gel in my eye, which means my right eye is still hazy, so I am not driving yet. I see my regular doctor today and the ophthalmologist again tomorrow. I think the likely outcome is that my vision will not be significantly damaged. It seems like the pain will persist at reduced level for at least a while longer.

Dear reader, I sincerely hope you had a better holiday than mine. And if not, God bless you!

4 comments:

The Alternate Moebyus said...

Paul,

Hope you get well soon.

Paul R. Potts said...

Thanks! It is still uncomfortable to work at the computer for long stretches, but it does seem to be gradually improving.

Titine said...

Hi Paul, I hope you get well soon! My mom just contracted the same virus and in the face area. I suppose its affecting the facial nerv. Im really worried. She says today (for the first time she cant hear well - her ears feel blocked). As for her eyes this morning for the first time I see a blister on the corner of her eye. I told her to talk to her family dr about an eye patch. (oh she was in the emergency so taken meds - morphene, analg├ęsique, anti-viral). Can you describe the evolution of your symptoms. What did you eat during this time- she cant seem to get everything in without throwing up. I thought it was the morphene but like u mentionned it might be the anti-viral. Is there anything i can do to ease her pain? Or anything i can recommend? Would seeing an optimologist right now be a good idea before the eye gets infected???

Paul R. Potts said...

Titine, I never had any symptoms involving my hearing. That concerns me a bit. "Herpes zoster opthalmicus" is when the virus infects one of the three branches of the trigeminal nerve, usually on one side. There is a variation which can affect the ear, "Herpes zoster oticus." I would normally only expect to see the zoster infection in one side of the face in one of these nerve branches at a time:

http://en.wikipedia.org/wiki/Image:Gray784.png

If she has more than one branch of the nerve involved, that sounds like it will be more difficult and more complicated than my infection was.

I never had trouble eating. It is possible her stomach is sensitive to the anti-viral medication.

I would recommend getting her eye evaluated very soon. An optometrist could do an initial evaluation but if there is evidence of infection she should probably see an opthalmologist (an MD who specializes in eyes). Once the infection is underway, I don't think there is much that a doctor can do to prevent it from happening; he is just looking for symptoms of damage, trying to minimize the damage and prevent any secondary infection caused by rough scabs or blisters on the eyelid. The eyepatch was helpful for me because that eye was very senstitive to light and it felt best to keep it closed. I couldn't use it much anyway since I was putting an antibacterial gel in to keep it moist and free of secondary infection.

As for the hearing, I am not sure what to suggest -- talk to a doctor about that!

My symptoms started out as burning, itching, tingling in the forehead and eye area, and the first visible symptoms were that my eyelid became red and swollen. It took a couple of days before there was visible redness on my forehead. It was when I started to see swelling in my forehead that I had a good guess what the problem was, and the doctor confirmed my guess. This whole area including part of my scalp then started to form blisters. I have some pictures -- I look like I was scalded with boiling water, but only in that narrow zone around the eye, forehead, and scalp.

The pain was quite intense and it took quite some time before it went away. I eventually got acupuncture which helped a great deal to relieve some of the lingering nerve pain.

A year later my eye is normal, with no damage to my vision. There is still some vestige of nerve damage. When I touch my forehead in that area, it feels a bit funny, like it is slightly numb. If you look closely you can also see that the skin has a little mottling. If I tire my eyes, I feel some of the burning that I first felt when the infection came about, which reminds me to get off the computer and go home!

This illness is quite debilitating. Tell your mother she has my best wishes. I was able to recover completely but it took quite some time. Apparently it is becoming more common, even in younger people. I suspect this may be due to widespread use of chicken pox vaccines in children, which prevent older adults from being exposed to the virus periodically in their daily life. This exposure acts like a booster to the immune system. Without it, the body is prone to having the infection erupt from inside the nerves.

Good luck!