Shingles pain often lingers long after rash goes
DEAR DR. DONOHUE: I have had shingles for five months now on the right side of my face. I am taking gabapentin for it. How long can I take this before becoming addicted to it? — M.H.
DEAR DR. DONOHUE: I came down with shingles on my right shoulder and right breast Dec. 15, 2008. I still suffer from it. The pain is abominable. My doctor has had me try all sorts of medicines, but all they did was give me side effects. Please help. — M.L.
ANSWER: Neither of you has shingles. You have postherpetic neuralgia, pain that lasts for more than three months after the shingles rash has disappeared. Shingles is the rash and pain caused by the chickenpox virus that lives in the body’s nerve cells from the time of infection until death. The virus, most often at older ages, leaves the nerve cells and travels down the nerve to the skin, where it causes an outbreak of small blisters on red patches. The rash goes away in at least four weeks. The pain of postherpetic neuralgia, however, can last for a year or more. The pain comes from the damage the nerve suffered when the virus traveled down it to reach the skin.
Many treatments exist for postherpetic neuralgia, but none works for all. One is the lidocaine skin patch. Lidocaine is related to the numbing agent Novocain. Capsaicin cream, gel or lotion is applied to the involved skin, and it can quiet the pain. It might burn at first but that sensation goes away. It takes a few weeks for this medicine to take hold. Antidepressant medicine, used for pain relief, is especially helpful at night, because it brings on sleep. Elavil is one example. Seizure control medicines also work. Your gabapentin (Neurontin) and Lyrica are two such medicines. I know you both have tried some of these. Have you tried combinations of them? The double punch can be effective.
When pain lingers as long as yours has, it’s time to see a pain specialist. Your family doctor can refer you to one. These doctors’ entire practice is devoted to pain relief, including postherpetic neuralgia pain.
M.H., gabapentin is not addicting.
The booklet on shingles explains this common affliction in detail. To obtain a copy, write: 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 very worried grandma. How safe is Gatorade for children 5 and 7 years old? When my grandson got the flu, I took him to the doctor. He asked what I was giving him for liquids, and I answered Gatorade. That is the only thing my daughter will allow these children to drink. The doctor said no to Gatorade. He said it has too much sodium for little children. When I told my daughter, she snapped and said she was told differently. For three years that’s all they drink. Is this truly OK? — H.C.
ANSWER: Gatorade is safe for children after they have been weaned, but I have never heard of anyone using it as the sole liquid for young children. It was designed to replace the sodium, potassium, chloride and sugar lost by people exercising hard and sweating profusely. The manufacturer states it is not a substitute for milk — and I am adding “or for water.” Its sodium content is higher than that found in the usual sodium-replacement fluids used for childhood diarrhea, but it’s not so high as to pose a health risk. Your daughter ought to abandon this practice. It sounds crazy to me.
DEAR DR. DONOHUE: M.S. wondered “if colonoscopies should be done if a person had no symptoms.” Absolutely! My doctor had me get a colonoscopy, and I didn’t see the point. He talked me into it. Thank God he did. I had stage 1 colon cancer. I have been cancer-free now for 11 years. — B.P.
ANSWER: Thanks for your input. Everyone is encouraged to have a colonoscopy at age 50. Colon cancer is a silent cancer in its early stages, when it’s curable. Only a scope exam can find it then.
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.