Shingles

[sengsational]

My doc was on the ball; I have an annual physical, where we go over vaccinations and preventive stuff, and as soon as the guidance changed to allow 50 and older to get the shingles shot, I got it. That was about 5 years ago.

As to eye proximity, my aunt got it in her scalp, forehead, and eye. This was back in April. There was a problem with pressure build-up and talk of needing a laser. But after a month of various drops and pills, she didn't need that. She's a trooper when it comes to pain (she's got more stainless joints than the 6 million dollar man), but this one was a tough one, apparently. So a month ago she reported that the virus was attacking her cornea and got Zirgan (ganciclovir) and Valacyclovir. Apparently been on steroid drops 4x a day since onset. Not a pretty picture, but she's probably got 20 years on you. Still can see/read fine, just a little blurry.

 

[ivinsfan]

I figure in 9 or 10 years guidelines on boosters will be much clearer. That's the only way I will know whether one is warranted.

True, I got mine right at 60 but I saw earlier in this thread there is a vaccine in the pipeline with 100% effectiveness if that's around when I turn 70, I'm going to spring for it,except for the cost, I don't see a downside.

 

[audreyh1]

True, I got mine right at 60 but I saw earlier in this thread there is a vaccine in the pipeline with 100% effectiveness if that's around when I turn 70, I'm going to spring for it,except for the cost, I don't see a downside.

Right - by the time I turn 65, I should be able to get good advice from my doctor about what are my best options. That's 9 years away.

And who knows - Medicare may cover even boosters by then?

 

[misshathaway]

I had it in 2012. It has not recurred. I wish the same for you.

 

[Golden sunsets]

So I posted earlier on this string that I had shingles(the scalp and forehead version dangerously close to the cornea) about 3 years ago and I also posted that my PCP subsequently recommended that I not get the shingles vaccine as having shingles itself was the best innoculation against a future shingles outbreak. What I did not also post was that I also had shingles(on my torso ) back in the mid '80's. The reason that I did not have the shingles shot when it became available was my PCP recommended against it as I had shingles in the 80's and therefore did not need a shot. In fact that conversation occured in 1/13. I had my second case in 2/13. So........ Long story short, I will have the shingles shot despite my PCP's rec. thanks to the OP for starting this string. I love my PCP but he appears to be behind the 8 ball on this issue.


Sent from my iPhone using Early Retirement Forum

 

[audreyh1]

Interesting.

I had never read anything that indicted getting shingles protected you from future outbreaks or lessened them, even though the vaccine would seem to work the same way.

 

[euro]

I get it. But everyone I know who has had it, would pay multiples of that price to have avoided it, or even just to have had a milder case.

-ERD50

+1, speaking from my own experience

 

[Nemo2]

Interesting.

I had never read anything that indicted getting shingles protected you from future outbreaks or lessened them, even though the vaccine would seem to work the same way.

I don't know, (I have absolutely zero background in this), but I'd presume that the body would/will generate antibodies (or somesuch) to combat the initial attack, and that the 'formula' for said 'antibodies' would remain in the system to be activated when necessary?

 

[euro]

I don't know, (I have absolutely zero background in this), but I'd presume that the body would/will generate antibodies (or somesuch) to combat the initial attack, and that the 'formula' for said 'antibodies' would remain in the system to be activated when necessary?

That's right but in the case of VZV, the resulting protection is less than perfect for a good portion of the population. In those cases, the vaccination has additional benefits.

 

[Meadbh]

I don't know, (I have absolutely zero background in this), but I'd presume that the body would/will generate antibodies (or somesuch) to combat the initial attack, and that the 'formula' for said 'antibodies' would remain in the system to be activated when necessary?

The thing is, first, you get chickenpox. It's the same virus (varicella zoster, or VSV). In some people, the chickenpox virus takes up residence in nerve cells near the spinal cord, and then goes dormant. Meanwhile, your immune system gets busy making antibodies to VSV, which, for the most part, protect you against another outbreak of chickenpox. However, they do not eliminate the dormant virus hiding in your spinal nerve roots. Many years later, when your defenses are down for whatever reason, the dormant VSV wake up and start to party in your nerve cells. Result: shooting pain in the distribution of that nerve, which is very typical for shingles. The map of the nerve distribution is called a dermatome. The distribution of the shingles rash is almost always confined to one dermatome, although it is occasionally bilateral.

https://en.m.wikipedia.org/wiki/Dermatome_(anatomy)

My point is that shingles does not represent a new infection with VSV. It's a reactivation of an old infection. Your antibodies can't prevent the infection because the viruses were already there.

 

[Nemo2]

My point is that shingles does not represent a new infection with HSV. It's a reactivation of an old infection. Your antibodies can't prevent the infection because the viruses were already there.

It's my intention to get the vaccine, even if it only provides minimal extra protection, I don't want to experience this again.....if I can help it.

 

[Texas Proud]

Interesting.

I had never read anything that indicted getting shingles protected you from future outbreaks or lessened them, even though the vaccine would seem to work the same way.

I would have thought so myself.... most of the illnesses like those you get once and done... your body now has the anti-bodies to fight it off....


But, I guess that is wrong thinking... so I will have to get booster shots in the future...



Edit... well, Nemo beat me to this answer...

 

[6miths]

The thing is, first, you get chickenpox. It's the same virus (herpes zoster, or HSV). In some people, the chickenpox virus takes up residence in nerve cells near the spinal cord, and then goes dormant. Meanwhile, your immune system gets busy making antibodies to HSV, which, for the most part, protect you against another outbreak of chickenpox. However, they do not eliminate the dormant virus hiding in your spinal nerve roots. Many years later, when your defenses are down for whatever reason, the dormant HSV wake up and start to party in your nerve cells. Result: shooting pain in the distribution of that nerve, which is very typical for shingles. The map of the nerve distribution is called a dermatome. The distribution of the shingles rash is almost always confined to one dermatome, although it is occasionally bilateral.

https://en.m.wikipedia.org/wiki/Dermatome_(anatomy)

My point is that shingles does not represent a new infection with HSV. It's a reactivation of an old infection. Your antibodies can't prevent the infection because the viruses were already there.

Actually chicken pox and shingles are caused by varicella zoster virus (VZV) which is a virus that is in same family as HSV-1 and HSV-2, the viruses that cause herpes. Occasionally VZV is referred to as human herpes virus 3 (HHV-3). As Meadbh describes, they all behave in a similar way in that they take up residence in sensory nerve cells and lie dormant. They can then re-emerge in some as herpetic lesions which are blisters that are preceded by burning, pain, itching or tingling sensation. Shingles can also be followed by pain or burning sensation in the nerve distribution for a period after the outbreak is over. Outbreaks (recurrences) of both herpes and shingles are often occur following stressors or in otherwise immunosuppressed individuals. Epstein-Barr virus (EBV) which causes infectious mononucleosis is also in the herpes virus family.

While it is true that an outbreak of shingles would boost antibody levels, the fact that the person actually had the outbreak would indicate that they are likely more susceptible to a future recurrence than someone who has never had shingles. DW and I got the vaccine a few years ago at 52 and 57. If I were to have had shingles, I definitely would get the vaccine afterwards and would likely also get a booster every 10 years or so.

 

[Meadbh]

Actually chicken pox and shingles are caused by varicella zoster virus (VZV) which is a virus that is in same family as HSV-1 and HSV-2, the viruses that cause herpes. Occasionally VZV is referred to as human herpes virus 3 (HHV-3).

Oops, I goofed! Apologies for my error in nomenclature and thanks for correcting me. I have edited my post accordingly.

 

[Nemo2]

DW had her shot today, Dr.'s office said I should wait a couple months; (also that current vaccine has an estimated effectiveness of ~ 10 years).

 

[golftrek]

I had shingles in my early 50s, had not had the vaccine. Had a terrible rash around half of my waist. Terrible pain I THOUGHT I WAS GOING TO DIE!!! Had pain for 2 years, could not drive for months, ran a temperature for months, sick on my stomach, etc, etc. COULD NOT PLAY GOLF FOR TWO YEARS!!!

If you have not had the vaccine, PLEASE GET THE VACCINE!!! I am serious.

I got the vaccine as soon as I was allowed. I still got the shingles again a couple of years ago (in a different place). But it was nearly as bad this time.

I think there is a genetic component to shingles, everyone in my family has had it.

Shingles is a seriously bad disease.

Jo Ann

 

[audreyh1]

I had shingles in my early 50s, had not had the vaccine. Had a terrible rash around half of my waist. Terrible pain I THOUGHT I WAS GOING TO DIE!!! Had pain for 2 years, could not drive for months, ran a temperature for months, sick on my stomach, etc, etc. COULD NOT PLAY GOLF FOR TWO YEARS!!!

If you have not had the vaccine, PLEASE GET THE VACCINE!!! I am serious.

I got the vaccine as soon as I was allowed. I still got the shingles again a couple of years ago (in a different place). But it was nearly as bad this time.

I think there is a genetic component to shingles, everyone in my family has had it.

Shingles is a seriously bad disease.

Jo Ann

Was it as bad? Or not nearly as bad?

 

[Nemo2]

. COULD NOT PLAY GOLF FOR TWO YEARS!!!

So, it wasn't all bad then?

Kidding....sounds like an awful experience.

 

[golftrek]

Was it as bad? Or not nearly as bad?

Sorry I meant that after the vaccine, the second time I had shingles was not as bad as the first time. In my case, the shingles vaccine did help.

And I really missed not being able to play golf for 2 years because of the shingles pain, it broke my heart. Even today, 10 years later I still have some pain.

Jo Ann

 

[ownyourfuture]

I also had shingles this year. While it was very painful at times, thankfully I got through it fine. But I also got to experience firsthand, what I believe to be part of the national healthcare problem.
In my case, I believe that problem was over prescribing. The treatment I received was fine, & I definitely respect all those that supplied it, but I believe cases like mine are indeed, part of the escalating health care costs in America.

I started feeling bad the last week in April. By Monday, May 2nd, I knew what I had. BTW: I'm in my mid-50s
I called my doctor & set up an appointment for Wednesday, May 4. The doctor confirmed what I had, gave me a prescription for 21 pills, (a one-week supply) of Valacyclovir & set up an appointment for one week later Wednesday, May 11.

By the time of my 2nd appointment on May 11th, I was already feeling 100% better, but he went ahead & renewed the prescription.
Not a 1 week supply of 21 pills, not a 2 week supply of 42, not a 3 week supply of 63, & not a 4 week supple of 84, he prescribed another 90 pills.

Price: $989.89

I had another follow-up appointment on Wednesday, May 18th. Everything was fine, except he wanted an eye specialist to examine my right eye two days later, on Friday May 20th.

After a quick look at my eye on Friday, the first thing the specialist said, was “stop taking the pills immediately”
I was prescribed a total of 111 pills at a cost $11 per pill, or $1,221.00
I used 51 of the pills, & threw away 60, $660.00 worth.

I'm guessing that maybe the pills prescribed, work faster for some, & slower for others ?
In my case they worked faster, & I believe that the doctor should have continued with one week prescriptions instead of prescribing another 90.

I do not like questioning the medical industry, or any doctors nurses etc. working in that field.
But I stand by my conclusion.

Would love to hear your opinion

 

[razztazz]

Why did the eye doc want you to stop taking the pills?

 

[6miths]

Why did the original doctor want you to take more pills?

 

[Ronnieboy]

I also had shingles this year. While it was very painful at times, thankfully I got through it fine. But I also got to experience firsthand, what I believe to be part of the national healthcare problem.
In my case, I believe that problem was over prescribing. The treatment I received was fine, & I definitely respect all those that supplied it, but I believe cases like mine are indeed, part of the escalating health care costs in America.

I started feeling bad the last week in April. By Monday, May 2nd, I knew what I had. BTW: I'm in my mid-50s
I called my doctor & set up an appointment for Wednesday, May 4. The doctor confirmed what I had, gave me a prescription for 21 pills, (a one-week supply) of Valacyclovir & set up an appointment for one week later Wednesday, May 11.

By the time of my 2nd appointment on May 11th, I was already feeling 100% better, but he went ahead & renewed the prescription.
Not a 1 week supply of 21 pills, not a 2 week supply of 42, not a 3 week supply of 63, & not a 4 week supple of 84, he prescribed another 90 pills.

Price: $989.89

I had another follow-up appointment on Wednesday, May 18th. Everything was fine, except he wanted an eye specialist to examine my right eye two days later, on Friday May 20th.

After a quick look at my eye on Friday, the first thing the specialist said, was “stop taking the pills immediately”
I was prescribed a total of 111 pills at a cost $11 per pill, or $1,221.00
I used 51 of the pills, & threw away 60, $660.00 worth.

I'm guessing that maybe the pills prescribed, work faster for some, & slower for others ?
In my case they worked faster, & I believe that the doctor should have continued with one week prescriptions instead of prescribing another 90.

I do not like questioning the medical industry, or any doctors nurses etc. working in that field.
But I stand by my conclusion.

Would love to hear your opinion

There are definite problems with the health care industry, high costs of prescription drugs are just the tip of the iceberg.

Two comments, 1) Always shop around for prescription prices. Just call two or three pharmacies in the area to get the price of the rx, you would be surprised at the price differences. You didn't mention if you got the 1gm or 500mg tablets of Valacyclovir but 90 of the 1gm at Costco is $104, cash price. https://www.costco.com/pharmacy/dru...gName=Valacyclovir&drugSearch=alphaDrugSearch

Walgreens, CVS, and Rite Aid are about the most expensive places you can purchase your medications. Don't think that just because you have a $10 copay, it doesn't matter if 'I go to the more convenient Walgreen's drive thru', your insurance is getting over charged too. Granted it is not the $989 but it is probably in the $150-$200 range and if they pay more then your premiums go up at next open enrollment.

2) You don't have to get the full amount that the presciber wrote for, if you feel that you are on the mend you could get a weeks worth till you saw the eye doc and then not gotten the rest or picked up the rest if s/he said to keep taking them. Granted it will have probably cost a few bucks more buying 30 once and 60 the second time if you were to continue, but much less that if you didn't pick up the remaining because the doc said to stop.

 

[kramer]

You can also take generic Aciclovir instead of Valacyclovir. You just have to take it more often (like 5x daily instead of 3x) because your body doesn't absorb it as well (otherwise same thing as Valacyclovir as Valacyclovir turns into Aciclovir after absorbtion). Here in the Philippines where I live, Aciclovir is a cheap over the counter medicine, so I was able to buy it and use it within the hour of my shingles self-diagnosis at 11 PM one evening after a quick trip to the drugstore.

 

[Nemo2]

Here in the Philippines where I live, Aciclovir is a cheap over the counter medicine.

Not that I'm about to go there, but out of curiosity how well regulated are medications in the Philippines, are there fakes/knockoffs that you have to watch out for?