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Suggest Treatment For Recurrent Bouts Of Shingles
Posted on
Tue, 30 Dec 2014
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Tue, 30 Dec 2014
Answered on
Tue, 27 Jan 2015
Last reviewed on
Question : Hello again Dr. Saghafi,
I have written you several inquiries re: recurrent bouts of shingles. I haven't written since October because I have had further complications and cannot get a good understanding of what is happening or good results w/ current physicians. You seem to be the only person who has a broader understanding of shingles being far more than just a rash of painful blisters. My hope is you can help me to continue to make any sense of this highly uncomfortable at times painful & ever present condition. Here are the highlights since October.
Last we spoke I had what I considered another bout of shingles w/ severe pain in L thoracic spine & suddenly I could expand my ribcage & breathe in again. After 2 months of not being able to which led to my belief of Phrenic nerve involvement. Then a dry, hacking unproductive cough occurred for about 2 weeks. I then had 2- day, intense horrific headache in back of my head & neck on L side w/ nausea but no vomiting. Then when the headache subsided I had what felt like my sinuses blew up/exploded with a feeling like something was lodged in my L throat about the area behind my adenoids. My local Dr. Said sinusitis/allergies & prescribed amoxcycillin. I was not having any nasal discharge but was having a constant flow of Mucousy fluid down back of my throat but nothing would cough up or blow out. Went to ENT who did sinus X-rays & CT which came back clear & normal, no sinusitis. I continue to have this muscousy flow down throat, headache in back of head & neck with what feels like fluid on my brain and my hair hurts. There seems to be some relief when I lean back w/ pressure on back of my head like when in recliner and/ or sitting in car w/ head on head rest. The other very uncomfortable symptom is that I have been severely constipated since all of this began back in July.
I am still experiencing all of those symptoms with another, less severe, outbreak of blisters in pubic region just days ago. No one I have seen for this believes all these symptoms are related, or shingles, and I am highly frustrated and very uncomfortable,still. Not to mention the huge expense on tests that seem to be normal. Please hope you can continue to enlighten me. Is it possible that this is still all shingle related? Is there a definitive antibody test to show shingles? Could this be viral encephalomenigitis? Please help! MRI results attached in the additional info. Thanks in advance. You knowledge has been helpful thus far.
I have written you several inquiries re: recurrent bouts of shingles. I haven't written since October because I have had further complications and cannot get a good understanding of what is happening or good results w/ current physicians. You seem to be the only person who has a broader understanding of shingles being far more than just a rash of painful blisters. My hope is you can help me to continue to make any sense of this highly uncomfortable at times painful & ever present condition. Here are the highlights since October.
Last we spoke I had what I considered another bout of shingles w/ severe pain in L thoracic spine & suddenly I could expand my ribcage & breathe in again. After 2 months of not being able to which led to my belief of Phrenic nerve involvement. Then a dry, hacking unproductive cough occurred for about 2 weeks. I then had 2- day, intense horrific headache in back of my head & neck on L side w/ nausea but no vomiting. Then when the headache subsided I had what felt like my sinuses blew up/exploded with a feeling like something was lodged in my L throat about the area behind my adenoids. My local Dr. Said sinusitis/allergies & prescribed amoxcycillin. I was not having any nasal discharge but was having a constant flow of Mucousy fluid down back of my throat but nothing would cough up or blow out. Went to ENT who did sinus X-rays & CT which came back clear & normal, no sinusitis. I continue to have this muscousy flow down throat, headache in back of head & neck with what feels like fluid on my brain and my hair hurts. There seems to be some relief when I lean back w/ pressure on back of my head like when in recliner and/ or sitting in car w/ head on head rest. The other very uncomfortable symptom is that I have been severely constipated since all of this began back in July.
I am still experiencing all of those symptoms with another, less severe, outbreak of blisters in pubic region just days ago. No one I have seen for this believes all these symptoms are related, or shingles, and I am highly frustrated and very uncomfortable,still. Not to mention the huge expense on tests that seem to be normal. Please hope you can continue to enlighten me. Is it possible that this is still all shingle related? Is there a definitive antibody test to show shingles? Could this be viral encephalomenigitis? Please help! MRI results attached in the additional info. Thanks in advance. You knowledge has been helpful thus far.
Brief Answer:
Sorry for the problems you continue to have
Detailed Answer:
Good afternoon and thank you so much in thinking of writing back to me with your questions here on Healthcaremagic.com. I very honored to serve you once again....I went back and reread out other correspondence just to refresh my memory and now I recall that we were talking about this shingles virus and diaphragmatic involvement.
I've now read through the other issues that you've been dealing with and I'm sorry that you've not been able to find the really right road to recovery but I will offer what I can from a neurologist's perspective.
The headache I will say is described as a migraine type of headache. The symptoms of mucous discharge and so forth are not uncommonly seen and are COMMONLY mistaken for sinus congestion. You should know that actual sinusitic triggered headache which is truly from a SINUSITIS is believed to occur in only about 0.5% of all headaches. In other words, true SINUS HEADACHES are one of the LEAST COMMON forms of headaches or migraines yet they are one of the most frequently diagnosed when people complain of congestion and facial or head pain.
Why?
Because, unfortunately migraine headaches tend to activate the same nerve pathways that are tied to activation of sinus and nasal gland functions resulting in mucus production, sinus drainage, feelings of congestion of the nasal passage and so forth without there really being any of infectious or true congestion to begin with. The real clue to your "sinus" headache being a migraine headache is the symptom that your hair hurts with the severe pressure/pain of headache in the back of the head. The hair hurting symptom is actually referred to as ALLODYNIA and is really only present in migraine headaches when the condition exists on the head. It never occurs during a bout of sinusitis. Of course, the fact there was never any nasal drainage and of course the sinus films were negative is more proof still that sinus headache was the incorrect diagnosis....so 1 round of unnecessary antibiotics.
For the outbreak of blisters in the pubic region did you have someone examine those to verify that they are in fact, herpetic? I wouldn't be at all surprised if they were. It is unusual for something like shingles to break out in that region but actually, there's nothing set in stone that says they can't. Have you ever had genital type of Herpes Infection? In other words, Herpes Type 2?
Doubt this is any form of encephalomeningitis since you lack the typical changes in mental status, fevers, and other symptoms/signs of general malaise which would be quite severe if it were a meningitis.
I am not finding any uploaded MRI information with this message. My concerns are that you get the headaches PROPERLY dealt with and diagnosed....can you schedule to see a HEADACHE SPECIALIST by chance? Turns out I'm one....but we're slightly removed physically to make an invitation to you to come out to my office very feasible! HAHA!
Also, you need to possibly get on the Valtrex or Acyclovir again for those blisters IF THEY ARE INDEED HERPETIC and represent another outbreak. If you'd like to upload an image of them as well to take a look at I'll take a look at them as well. Don't scratch or break those and you should also avoid sexual contact until they clear and you're on proper suppressant therapy for at least 4-6 weeks.
If this information has been helpful and I've answered your questions would you do me the favor of some written feedback and a STAR RATING of the answer as you so generously did on the other questions?
And if you have no further questions or comments to place CLOSING THE QUERY and alerting the network to process, archive, and credit this question appropriately for future reference would be greatly appreciated.
In the future I'm happy to answer questions personally and you would allow me this privilege by going to the following website and writing your questions:
bit.ly/drdariushsaghafi
This query required 60 minutes of physician specific review, research, and final draft documentation for envoy.
Sorry for the problems you continue to have
Detailed Answer:
Good afternoon and thank you so much in thinking of writing back to me with your questions here on Healthcaremagic.com. I very honored to serve you once again....I went back and reread out other correspondence just to refresh my memory and now I recall that we were talking about this shingles virus and diaphragmatic involvement.
I've now read through the other issues that you've been dealing with and I'm sorry that you've not been able to find the really right road to recovery but I will offer what I can from a neurologist's perspective.
The headache I will say is described as a migraine type of headache. The symptoms of mucous discharge and so forth are not uncommonly seen and are COMMONLY mistaken for sinus congestion. You should know that actual sinusitic triggered headache which is truly from a SINUSITIS is believed to occur in only about 0.5% of all headaches. In other words, true SINUS HEADACHES are one of the LEAST COMMON forms of headaches or migraines yet they are one of the most frequently diagnosed when people complain of congestion and facial or head pain.
Why?
Because, unfortunately migraine headaches tend to activate the same nerve pathways that are tied to activation of sinus and nasal gland functions resulting in mucus production, sinus drainage, feelings of congestion of the nasal passage and so forth without there really being any of infectious or true congestion to begin with. The real clue to your "sinus" headache being a migraine headache is the symptom that your hair hurts with the severe pressure/pain of headache in the back of the head. The hair hurting symptom is actually referred to as ALLODYNIA and is really only present in migraine headaches when the condition exists on the head. It never occurs during a bout of sinusitis. Of course, the fact there was never any nasal drainage and of course the sinus films were negative is more proof still that sinus headache was the incorrect diagnosis....so 1 round of unnecessary antibiotics.
For the outbreak of blisters in the pubic region did you have someone examine those to verify that they are in fact, herpetic? I wouldn't be at all surprised if they were. It is unusual for something like shingles to break out in that region but actually, there's nothing set in stone that says they can't. Have you ever had genital type of Herpes Infection? In other words, Herpes Type 2?
Doubt this is any form of encephalomeningitis since you lack the typical changes in mental status, fevers, and other symptoms/signs of general malaise which would be quite severe if it were a meningitis.
I am not finding any uploaded MRI information with this message. My concerns are that you get the headaches PROPERLY dealt with and diagnosed....can you schedule to see a HEADACHE SPECIALIST by chance? Turns out I'm one....but we're slightly removed physically to make an invitation to you to come out to my office very feasible! HAHA!
Also, you need to possibly get on the Valtrex or Acyclovir again for those blisters IF THEY ARE INDEED HERPETIC and represent another outbreak. If you'd like to upload an image of them as well to take a look at I'll take a look at them as well. Don't scratch or break those and you should also avoid sexual contact until they clear and you're on proper suppressant therapy for at least 4-6 weeks.
If this information has been helpful and I've answered your questions would you do me the favor of some written feedback and a STAR RATING of the answer as you so generously did on the other questions?
And if you have no further questions or comments to place CLOSING THE QUERY and alerting the network to process, archive, and credit this question appropriately for future reference would be greatly appreciated.
In the future I'm happy to answer questions personally and you would allow me this privilege by going to the following website and writing your questions:
bit.ly/drdariushsaghafi
This query required 60 minutes of physician specific review, research, and final draft documentation for envoy.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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