DEAR DR. DONOHUE: I am a 59-year-old female who had a severe case of chickenpox as a child. It has been recommended that I get a shingles vaccination after my 60th birthday.

However, my husband never had chickenpox, and I have a 1-month-old granddaughter. Are my husband and granddaughter at risk for becoming infected when I get the vaccine? — J.Z.

ANSWER: The shingles vaccine Zostavax contains live but weakened virus. Transmission of the vaccine virus from someone who just received it is theoretically possible, but actually is a rare event. Your husband’s chances of catching the vaccine virus are close to zero.

Although your husband says he never had chickenpox, 99 percent of adults bear evidence in their blood that they did have childhood chickenpox. Many of these people have no recollection of being sick. That might be because the infection was so mild that they never knew they were infected. Furthermore, all adults, whether they remember they had chickenpox or not, are urged to have the vaccine after their 60th birthday. Your husband can get the shot along with you.

As far as your 1-month-old grandchild goes, her chance of catching the virus from a recently immunized person is small. However, you can eliminate the risk completely by waiting to have your immunization until your granddaughter gets her chickenpox immunization at 12 months; you don’t have to be immunized on the day you turn 60. Or you can be immunized before your granddaughter gets her chickenpox vaccine, and then wait to hold her and care for her for two or three weeks after you have the shot.

Shingles is the bane of older people. The booklet on this illness describes it in detail and how it is treated. 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 in my 80s, in reasonably good health and planning a vacation to an altitude of over 9,000 feet. Is there something I can do to prepare, or is there a medication I can take? — A.S.

ANSWER: You can become accustomed to a high elevation by not ascending to a height greater than 8,000 feet on day one. Sleep at that lower level for one night. This is the same air pressure as the pressure in an airplane. If you tolerate air travel, you’ll tolerate this height fine.

On day two of your trip, you can reach the 9,000-foot level, but don’t be overly active on that day. Keep yourself hydrated. It helps you acclimatize.

Medicines can be of help. Viagra (sildenafil) and Cialis (tadalafil) assist you in coping with high elevations. You might recognize these two medicines as ones used for erectile dysfunction. How they were discovered to assist people in coping with high altitudes, I don’t know. Diamox, a water pill, also can ease acclimatization.

DEAR DR. DONOHUE: I am an elderly woman. I came down with rheumatoid arthritis 10 years ago. In the past two years, I got several nodules on both arms. What causes them? They have gotten larger. I would appreciate some information on them. They don’t hurt, but they look awful.

My hands are crippled, so my handwriting is not so good. — D.B.

ANSWER: About 25 percent of people with rheumatoid arthritis develop nodules — small, nonpainful bumps under the skin. Most spring up at points of pressure, like the elbows and the forearms. They also pop up on the Achilles tendon at the heel and on the lower back.

They’re composed of dead cells, and have an outer core of collagen fibers, similar to scar tissue.

Painful nodules or extremely large ones can be injected with a cortisone medicine. Surgical removal also is possible. Don’t have them removed until you check to see if your insurance or Medicare covers the cost.

Your handwriting is infinitely better and more legible than mine.

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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