DEAR DR. DONOHUE: Will you kindly write about shingles? My story started last December with pain. Two days later, I saw the doctor again, and he told me I had shingles. It had spread to my back. Now the scabs are almost healed. Incidentally, the outbreak on my back was on both sides. – D.S.

ANSWER: Yearly in the United States, a million cases of shingles occur, and most patients are past their middle ages.

The chickenpox virus causes shingles. Once that virus infects people – usually during childhood – it stays with them for life inside nerve cells. When the immune system has a transient lapse in vigilance, the virus emerges from its nerve-cell home and travels down the nerve root to the skin, where it causes the typical shingles rash. The rash is just about always on one side. It comes in a band from the back and sweeps somewhat downward across the chest to the middle of the breastbone. It also can be on the face or the legs or arms. It’s a rash of tiny blisters on a red base. New crops of blisters continue to form for a few days. The blisters merge and form a sore that becomes a scab. The rash phase of the illness ends in about two or three weeks. Pain can be severe.

As bad as shingles is, the aftermath of shingles is worse. It’s pain that lingers long after the rash has gone. That is postherpetic neuralgia, and it comes from the damage done to the nerve when the virus traveled down the nerve to the skin.

For shingles, the antiviral drugs acyclovir, famciclovir or valacyclovir are sometimes prescribed. Pain medicine is essential. For postherpetic neuralgia, Lyrica or neurontin often can control pain. Amitriptyline is also used, as is the lidocaine skin patch.

The shingles booklet discusses this common illness in detail. Readers can order 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 a 58-year-old lady with osteoporosis. I will not take any drugs for it because I have chronic stomach upset. I am doing resistance exercises for 10 minutes, three days a week. I have lost 30 pounds. Will 10 minutes of resistance exercise three days a week be enough to tone up muscles and help bones? – L.

ANSWER: Resistance exercise is weightlifting. Ten minutes of resistance exercise is better than zero minutes, and three days a week is enough. If you could add another 10 minutes to your program, you’d obtain better results. Resistance exercise is the kind of exercise that’s useful for both bone and muscle building.

DEAR DR. DONOHUE: Please help me with a question. I am in my 70s. When we were children, my sister had chickenpox. It was assumed I would get it also. I played on the bed with her. But my parents said I had no symptoms and no rash, and assumed I wasn’t infected. Later, my three children had chickenpox, but I didn’t catch it from them. So it is not known if I had a very mild case.

I would like to have the shingles vaccine. Will it cause me to get chickenpox or shingles, since I’m not sure if I ever had chickenpox? – P.O.

ANSWER: Zostavax, the shingles vaccine, has two big selling points. It greatly lowers the chance of getting shingles, and it reduces even more the chance of coming down with postherpetic neuralgia if a person does get shingles.

Chickenpox is highly contagious. After the four intimate exposures you had to chickenpox, it is highly unlikely that virus didn’t infect you. More than 90 percent of adults in the U.S. and Canada have proof in their blood that they were exposed to chickenpox, even though a large number claims never to have had the illness.

Whether you had chickenpox or not, the vaccine will not cause you any harm. Of course, you don’t need it if you never had chickenpox. Please inquire about the cost of the vaccine. Some places charge an astronomical amount for it.

DEAR DR. DONOHUE: I have been on birth-control pills for more than 10 years. I worry that this might make me come down with ovarian cancer. Will it? My friend says it will. – J.J.

ANSWER: Your friend is wrong. The birth-control pill decreases the prospects of ovarian cancer, and the longer it is used, the less likely are you to develop it.

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

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