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382842
Wed, 10/07/2015 - 13:19
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The Debilitating Effects Of Shingles

By Erda Khursyiah Basir KUALA LUMPUR, Oct 7 (Bernama) -- Sheela Paul was expecting her second child when she suffered a rather painful episode of shingles about 20 years ago. When she first felt a sharp pain and some itchiness on her left hip near her waist, Sheela, who was 28 then, had no idea what it was all about but it worried her as she was already six months into her pregnancy. She immediately visited her gynaecologist, who diagnosed it as shingles. She was prescribed a topical cream which she was told to apply on the rash that had erupted on her left hip. Due to her condition, alleviating the excruciating pain she felt with a strong painkiller was out of the question. "I suffered for a week... I had never suffered so much pain and discomfort in my life. It was too painful for me to sleep on my back, so I sat on an armchair the whole night... I dozed off whenever the pain subsided only to wake up when it returned. "Luckily, my unborn baby was not affected in any way and I eventually gave birth to a healthy girl," recalled the 48-year-old teacher from Shah Alam (in Malaysian state of Selangor), who hoped that she had seen the last of the disease that had caused her much distress. Shingles, also known as herpes zoster, is a viral disease caused by the varicella-zoster (VZ) virus, which also causes chickenpox. The chickenpox virus is known to remain in one's nervous system for years before flaring up again as shingles. So, in other words, if one has had chickenpox, he or she is at risk of being struck down with an unpleasant episode of shingles. Early symptoms of shingles include itching as well as a tingling and burning sensation, which is almost always confined to one side of the body or face. This is followed by a rash with fluid-filled blisters. SHINGLES CAN LEAD TO COMPLICATIONS Sheela is fortunate that she is none the worse for her experience. Other shingles sufferers may not be so lucky, according to senior consultant physician and head of Hospital Sungai Buloh's Infectious Disease Unit Dr Christopher K.C. Lee. Apart from being "an extremely painful and debilitating" disease, it could also lead to various complications, he warned. For some people, he explained, the pain would lessen as the rash healed but for others, shingles could cause long-term nerve pain, called post-herpetic neuralgia (PHN), which could last for months or even years, in some cases. "PHN is the most common complication of shingles and is defined as pain persisting for longer than 90 days after the onset of rash," he told Bernama on the sidelines of a forum on 'Coping With the Burden of Shingles', held here recently. The forum was organised by healthcare and pharmaceuticals company MSD Malaysia, a subsidiary of Merck & Co of the United States. Dr Lee said a person's risk of developing PHN after a shingles episode increased with age, adding that about 95 per cent of adults over the age of 50 were at risk of contracting shingles - and possibly PHN - because they may have had been infected with the chickenpox virus earlier in their life. "Approximately 50 per cent of people who reach age 85 would have had shingles at some point in their life," he added. According to the United States Centre for Disease Control and Prevention, one in three people will develop shingles in their lifetime. PHN MAY LEAD TO DEPRESSION Malaysian Association for the Study of Pain President Dr Mary Cardosa, who also spoke at the forum, said PHN was one of the "most painful chronic conditions" that could drastically affect a patient's quality of life. She said studies of pain severity have shown that the long-term pain of PHN exceeded pain scores for childbirth, musculoskeletal pain, osteoarthritis and chronic cancer pain. PHN sufferers may even find the touch of soft clothing or a light breeze against their skin excruciatingly painful. "Shingles patients suffering from PHN are likely to experience decline in physical and social functioning, as well as an increase in emotional distress. "In fact, the overall impact of shingles and PHN on quality of life is comparable to other health conditions such as congestive heart failure, diabetes and depression. "It's important that shingles pain be managed well, otherwise psychological stress from PHN can trigger varying degrees of depression," she warned. Dr Lee, meanwhile, pointed out to other complications that could occur as a result of shingles, including scarring, pneumonia, visual impairment, hearing loss, skin infection and muscle weakness. Outbreaks that start on the face or eyes could cause vision or hearing problems. "An average 10 to 25 per cent of people with shingles suffer from shingles opthalmicus (shingles in the eye). Some 50 to 72 per cent of patients with shingles in the eye will suffer from chronic recurring ocular (eye) disease and visual loss," he said. TREATMENT FOR SHINGLES AND PHN As shingles is not a life-threatening disease, Malaysia does not keep specific data on Malaysians suffering from shingles or its complications. Dr Lee said although it was not a fatal disease, efforts should be stepped up to educate Malaysians on shingles and its painful "side-effects", and the precautions they could take to prevent it. "It may not kill but the long-term consequences of untreated shingles can severely impact a patient physically, psychologically and socially, which will affect their quality of life. "It will also impose a major financial burden on the affected individuals, their families and society as a whole. We are seeing a significant increase in the number of people with long-term health conditions and it's something to worry about since hospitalisation and medical costs will continue to escalate over the next few years," he added. As there is no known cure for shingles yet, patients are advised to seek medical advice at the earliest sign of the disease. Anti-viral medicines can be administered within 72 hours of onset of shingles to help lessen the severity of pain and duration of the disease. Alternatively, people who have had chickenpox previously can opt for the shingles vaccination as it can help reduce the risk of reactivation of the VZ virus which, in turn, reduces their risk of developing shingles. As for those suffering from PHN, there are also medications available for nerve pain called anti-neuropathic agents, said Mary. "Normal painkillers may not work (for patients with PHN) because they (painkillers) don't address the underline problem, as well as what is going on in their nerves," she said, adding that besides giving patients the appropriate medications, they should also be taught relaxation techniques and exercises that could help them to manage the pain. -- BERNAMA

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