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Shingles and the shingles vaccine



DEAR DR. DONOHUE: I am an 86-year-old woman. I have had shingles twice in my life. My family physician thinks I should get the shingles vaccine. I went to a health clinic to get the injection. I was told by the RN on duty that her instructions were not to give the shot to anyone who had previously had the shingles. How would you advise me? Should I have the vaccine? I don’t want the shingles again – ever. – V.J.

ANSWER: Shingles questions are among the most-asked questions I receive. Shingles comes from the chickenpox virus, which stays with people for life. It lives in nerve cells. Even if people say they have never been infected with chickenpox, more than 90 percent of adults have. The childhood infection could have been so mild that it wasn’t recognized as chickenpox.

Later in life, the virus leaves its nerve-cell home, travels down the nerve to the skin, where it gives rise to the typical shingles rash – small blisters on red patches of skin – and the typical pain of shingles. The pain that arises when the rash is present is bad, but the pain that stays after the rash is gone is worse. That’s called postherpetic neuralgia, and it comes from damage to the nerve that the virus caused as it traveled down the nerve to the skin. Lyrica is the newest medicine for postherpetic neuralgia.

Because of postherpetic neuralgia, the shingles vaccine was developed. It cuts down the chances of developing shingles and postherpetic neuralgia by 66 percent. If it doesn’t provide complete protection, it makes a shingles encounter less fierce. The Advisory Committee on Immunization Practices, a board of vaccine experts, advises older people to get the vaccine even if they have had shingles. However, a second case of shingles is rare. (V.J. is an exception to the rule.) A third case is very, very rare.

It’s up to you, V.J. If you want the vaccine, you are entitled to get it. First check on its cost and if your insurance will cover it.

The shingles story is told in the booklet on that subject. Readers can obtain a copy by writing: Dr. Donohue – No. 1201W, Box 536475, Orlando, FL32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am a person between 65 and 80. I’ve noticed that my fingernails have taken on a condition that I’ve never heard talked about. From the cuticle to the tip of each nail, there are raised surface ridges. The nails no longer have a smooth surface. I am puzzled as to what could have caused this to happen. What did? – M.G.

ANSWER: I don’t know the cause, and I don’t know anyone who does. I do know that those ridges are very common and very normal. They most often appear at older ages, like gray hair. They’re not a result of vitamin deficiency or an infection, nor are they a sign of anything dire.

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, FL32853- 6475.

©2008 North America Synd.

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