DEAR DR. DONOHUE: I am an 86-year-old woman. I have had shingles twice in my life. My family physician thinks I should get the shingles vaccine. I went to a health clinic to get the injection. I was told by the RN on duty that her instructions were not to give the shot to anyone who had previously had the shingles. How would you advise me? Should I have the vaccine? I don’t want the shingles again – ever. – V.J.

ANSWER: Shingles questions are among the most-asked ones I receive. Shingles comes from the chickenpox virus, which stays with people for life. It lives in nerve cells. Even if people say they have never been infected with chickenpox, more than 90 percent of adults have. The childhood infection could have been so mild that it wasn’t recognized as chickenpox.

Later in life, the virus leaves its nerve-cell home, travels down the nerve to the skin, where it gives rise to the typical shingles rash – small blisters on red patches of skin – and the typical pain of shingles. The pain that arises when the rash is present is bad, but the pain that stays after the rash is gone is worse. That’s called postherpetic neuralgia, and it comes from damage to the nerve that the virus caused as it traveled down the nerve to the skin. Lyrica is the newest medicine for postherpetic neuralgia.

Because of postherpetic neuralgia, the shingles vaccine was developed. It cuts down the chances of developing shingles and postherpetic neuralgia by 66 percent. If it doesn’t provide complete protection, it makes a shingles encounter less fierce. The Advisory Committee on Immunization Practices, a board of vaccine experts, advises older people to get the vaccine even if they have had shingles. However, a second case of shingles is rare. (V.J. is an exception to the rule.) A third case is very, very rare.

It’s up to you, V.J. If you want the vaccine, you are entitled to get it. First check on its cost and if your insurance will cover it.

The shingles story is told in the booklet on that subject. Readers can obtain a copy by writing: Dr. Donohue – No. 1201, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am writing you because my girlfriend suffers tremendously with a type of urinary-tract infection that does not respond to any type of medication. This has been going on since she was 19, and she is now 22. She has been on many different medicines for infections, but none has worked. She has tried cranberry juice. She no longer takes medicine, because it seems to increase her symptoms. This condition has taken its toll on both of us – mentally, emotionally, physically and sexually. Any suggestions would be greatly appreciated. – J.C.

ANSWER: Have your girlfriend make an appointment with a gynecologist or urologist familiar with interstitial (IN-tur-STISH-ul) cystitis (sis-TIGHT-us). It has symptoms similar to a bladder infection – frequent, painful urination and pelvic pain – but it’s not an infection. It doesn’t respond to antibiotics. Antibiotics can worsen symptoms. It’s often mistaken for an infection and often treated as an infection for years and years.

Elmiron – not an antibiotic – is one treatment for this condition.

DEAR DR. DONOHUE: I am on a diet in which the food portions for each meal are small. We are instructed to drink eight glasses of water a day. My question is: When is a good time to drink the water?

I understand that liquid drunk with a meal interferes with digestive juices.

The meals are small, with snacks about two hours after a meal. So every two to two and a half hours, I am eating and digesting food. When can I get this water in? I also heard that ice water is good to drink because it sparks your metabolism. Is this so? -P.F.

ANSWER: You can drink the water anytime you want. Water or other liquids do not interfere with digestion.

Cold water doesn’t spark metabolism, nor does it burn calories because the body has to warm it. You can drink it anytime you want – before, after or during a meal or snack.

DEAR DR. DONOHUE: I am a retired, 78-year-old male. I walk between one and two hours a day. My weight averages 155 to 165 pounds. When I was in the military, I weighed 150 pounds and was 5 feet 8 inches tall. Now my height is 5 feet, 3¾ inches. My son, a radiologist, and his wife, a family-practice doctor, are concerned by my loss of height. They tell me to ask my doctor for a bone density test. He refuses, saying women at my age need one, but not men. What is your take? – I.K.

ANSWER: I side with your son and daughter-in-law. Everyone loses some height with age due to compression of back discs and backbones. A height loss of 4¼ inches, however, is out of the ballpark.

Men do get osteoporosis, and you do need a bone density test. I don’t know why your doctor is being so hard-nosed about this.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com