Thursday, January 30, 2014

Now, Shingles? Really?

One week ago I was diagnosed with Herpes Zoster, commonly known as Shingles.  According to Taber's Cyclopedic Medical Dictionary, h.zoster is, in part, "reactivation of varicella virus years after the initial infection with chickenpox...A painful vesicular eruption occurs along the course of the nerve (called a dermatome) and almost always is unilateral...the virus may cause meningitis or affect the optic nerve or hearing. The incubation period is from 7 to 21 days. The total duration of the disease from onset to complete recovery varies from 10 days to 5 weeks." Fan-frickin-tastic.
Oddly enough, even though I'm only 42 and Shingles most commonly afflicts those age 60 and older, this is not the first time I've had a Shingles outbreak. My first outbreak occurred when I was 19 years old. Apparently it never crossed the mind of my family practice doctor at the time that what I presented with could be Shingles, so he "cultured" one of the "vesicular eruptions", which, in English means he popped one of the blisters, rubbed a long Q-Tip on the fluid that oozed out (seriously, that's exactly what happened) and sent it to the lab for analysis. 48 hours later he called to tell me I had Shingles. That was approximately 46 hours after I was peeled from the ceiling of the exam room because the popping and oozing hurt so frickin' much. 
Although Taber's doesn't mention it, it's commonly thought that the likelihood of a Shingles outbreaks can occur when one is under stress and natural immunity is lowered. It is scientifically proven that people who are immunocompromised (undergoing chemotherapy or have HIV/AIDS) are more susceptible to Shingles. Since I don't fall into either of those two categories, I'm left with this outbreak being prompted by "stress" which both concerns and confuses me.
Those of you who follow my blog, have friended me on Facebook, or just talk with me from time-to-time know that the past four years have been less than smooth. Ok. I was laid-off from a job I didn't really like, started graduate school full-time, completed a year long unpaid internship, graduated, turned 40, went to my 20th high school reunion, got a job in my field, left that position after getting a job working with what I thought would be my "ideal population", realized that was not a good fit, then went back to the agency where I had previously worked but in a new position. I had surgery on the great toe of my right foot, several basal cell carcinomas removed, and a breast biopsy from an abnormal mammogram. I lost my Grandpa Krause, one of my great-aunts, a great-uncle and my dog Peanut to the natural process of death. I gained a daughter-in-law and a grandson. There were family issues, marital issues, vacations to Hawaii and Utah, family weekends in the Dells, a trip to Super Bowl XLV, and the addition of a wonderful, hyper little dog we named Apollo.  This is the "stuff" of life when "life happens."
During particularly stressful periods, in the back of my mind, I thought about a potential Shingles outbreak. Sometimes I wondered, if the stress I was under wasn't enough to trigger an outbreak, what kind of stress on God's green earth would be required for an outbreak? I didn't want to consider what my life would look like with that level of stress involved.
Then last Tuesday, 01-21-14, at the end of the day I felt an ache in my lower back. When I woke up on Wednesday, the area just to the left of my tailbone felt swollen and I couldn't lay on my back or sit with my back against the back of my office chair without feeling really uncomfortable. That night I stopped by my parents' house and my mom looked at it (with a magnifying glass, no less) and said I should see my doctor. Since I couldn't really see the area that hurt, I wasn't all that concerned, until the pain prevented me from sleeping most of Wednesday night. So on Thursday I saw my very competent doctor who took one look at it and said, "You've got Shingles." So there you have it.
My insurance won't pay for the Shingles vaccine because I don't meet the first qualification of being at least 60 years old. Granted, it's been 23 years between outbreaks, but if there is something that could lessen the intensity should I have another outbreak before I hit the magic age of 60, I would like to take advantage of it. Shingles at 42 is odd enough, but add into that the fact that I had them once before when I was 19, well that's just a medical anomaly in my view. I'm not going to get into the politics of insurance-driven health care decisions because I've been in that fight since I was 23 years old in one form or another and my goal here isn't to get all righteous about how, because of my history, my insurance should cover the cost of the vaccine. Interestingly enough, when I picked up the medications my doctor did prescribe to help with my symptoms, my pharmacist told me that the retail price for the vaccine is approximately $219. That's not really in my budget right now and I'm ok with that. In another 23 years I will meet the criteria of being at least 60 years old (I'll actually be 65) and then Medicare will pay for my vaccine! Medicare, provided that's still around.
You know me: I quite enjoy being the odd-duck, the anomaly, the somewhat-weird one who odd things happen to - provided it's not something that will get me into serious trouble of any kind. I have finished my 5-day course of steroids and have two days left of anti-viral medication which I will finish even though I'm feeling a bit better after spending last weekend trying to rest; it's uncomfortable and awkward when you can't lay on your back. Although I will admit, I do enjoy the look on the faces of co-workers when I tell them I have Shingles and they assume I'm contagious on the same level as someone spreading SARS.
I'm just hoping for another stress-free 23 years. And although I did choose the photo below, I look nothing like this! Trust me!