DEAR DR. DONOHUE: I read your remarks on shingles. You did your readers a disservice by not mentioning the benefits of the shingles vaccine. I got the shots. A year later I contracted shingles, but it was very mild. – R.H.

ANSWER:
R.H., L.P., L.I. and many more regretted that I had not mentioned the shingles vaccine, so I will.

Every year 1 million Americans come down with shingles, and most of these people are in their senior years. Shingles (also called herpes zoster) is the work of the chickenpox virus, which lives on forever in nerve cells after infection with that virus. It lives there in hibernation. In later life, it wakens, travels down the nerve to the skin and produces the shingles rash.

For some, shingles is a most unpleasant interlude lasting around two weeks. For others, however, shingles pain lingers long after its rash clears, and the pain can be agonizing. This is not shingles. It is postherpetic neuralgia, the result of nerve damage done by the virus on its journey to the skin. For a very few, shingles affects the eye and can bring on blindness in that eye.

In May of 2006, the shingles vaccine Zostavax became available for people 60 years old and older. In a lifetime, one in three people will be a victim of shingles. The vaccine cuts in half the number of those who break out with shingles and reduces the severity of an outbreak in most of the rest. It also prevents the dreaded postherpetic neuralgia.

Everyone 60 and older should get the vaccine. Before doing so, inquire about the cost and if it is covered by insurance.

The shingles booklet delves into this topic in greater detail, but it doesn’t mention the vaccine. It was published before there was a vaccine. 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 have always wondered if shingles is catchy. A neighbor, in the early stages of shingles, decided to attend Easter dinner with her son and his family, which includes three children under 12. Within a week, all three came down with chickenpox. I have my answer. – R.S.

ANSWER:
Shingles isn’t catchy. However, there is live chickenpox virus in the rash when it is still in the blister stage. Those who never have had chickenpox can catch chickenpox from it. Since the chickenpox vaccine has had such widespread use, this applies mostly to young, unimmunized infants.

DEAR DR. DONOHUE: I want to get the shingles vaccine. I am 84. I can’t remember if I ever had chickenpox. Is there any danger of getting the shot if you didn’t have chickenpox? – L.L.

ANSWER:
Even if you didn’t have chickenpox, you can safely get the shingles vaccine. A person who never had chickenpox doesn’t need the vaccine. However, 99 percent of older people in the United States have evidence in their blood of having had chickenpox, even though they have no recollection of having had it. You can assume you’ve had it.

DEAR DR. DONOHUE: I had the shingles last November, and the pain lasted four months. My family got the shot after seeing what I went through. I am 82. I read that it is unusual to get the shingles twice, but it happened to me. – R.B.

ANSWER:
Some studies indicate that only 4 percent of those who have had shingles get a second attack. If this is true, it might not be so urgent for people who have had shingles to get the vaccine. Other studies indicate that recurrences are more frequent, so many experts recommend that even those who have had the shingles do get the vaccine.

DEAR DR. DONOHUE: A lot has been said in the past year about the need for girls and young women to receive the vaccine to protect them from the human papillomavirus, which is passed through sexual encounters. Why isn’t it equally important for boys to get the vaccine to prevent them from spreading the virus to females? How do males get it in the first place? – E.G.

ANSWER:
Some strains of the human papillomavirus cause cervical cancer. Boys don’t get cervical cancer. The vaccine, therefore, was tested only in females. Its effectiveness for males isn’t known. Studies are under way to determine if the vaccine works in them too.

You want to know who was the first to get a papillomavirus infection, a male or a female? This virus has been a nuisance for humans for a long, long time. How it arose and whether it first appeared in males or females are questions that will never be answered.

DEAR DR. DONOHUE: In January of this year, I was told I had sugar diabetes. I don’t know what type I have. My sugar numbers have been 104 to 110 when I test it. What type do I have, and what should diabetes numbers be? – A.G.

ANSWER:
Doctors make a diagnosis of diabetes when the plasma glucose (blood sugar) after an eight-hour overnight fast is 126 mg/dL (6.99 mmol/L) or higher on two separate occasions. Numbers between 100 and 125 (5.5 and 6.93) indicate “prediabetes” – not diabetes, but on the road to it unless some steps are taken to prevent it by losing weight, exercising and watching what you eat.

If you have been given a diagnosis of diabetes, you have type 2 diabetes, the kind that used to be called adult-onset diabetes. It usually can be controlled with diet and oral diabetes medicines. Sometimes, however, type 2 diabetics are required to use insulin for sugar control.

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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