DEAR DR. ROACH: I am 66 and have multiple sclerosis. Should I get the shingles vaccine? On the one hand, I know it is recommended for everyone. However, I do have a compromised immune system, and it could be risky to inject a virus. Neither my family doctor nor my neurologist has an opinion — they say it is a toss-up. — D.E.P.
ANSWER: There are two issues here: Could the shingles vaccine, which is a live virus, cause shingles? And secondly, can it cause your multiple sclerosis to flare? Both of these are somewhat controversial.
The first question is less so. There is recent evidence that between the MS (or other autoimmune diseases) and its treatment, the immune system is still good enough to prevent any viral disease. The second question is more problematic, with MS experts divided in their opinions. Normally I would ask you to seek your doctors’ opinions, but since they haven’t been much help, I will just say that the risk of causing a flare of MS is theoretical and small, but the downside of shingles is so great that I would, in general, recommend the vaccine to someone in your position.
People on high-dose steroids or other medications that suppress the immune system should not get the vaccine. Neither should people with leukemia, lymphoma or advanced HIV.
Shingles questions are among the most frequently asked. The booklet on the shingles virus answers many of them. Readers can obtain a copy by writing: Dr. Roach — No. 1201, Box 536475, Orlando, FL 32853- 6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. ROACH: What is the difference between a CT scan and an MRI? — B.
ANSWER: A CT (computerized tomography) scan uses X-rays to create an image that looks like a slice through the body, head or a limb. The quality of the picture is excellent, but it has much more radiation than a regular X-ray. An MRI uses powerful magnetic waves to create an image that also looks like a slice. It uses no radiation. CT scans are cheaper and faster, in general. One isn’t necessarily “better” than the other. MRI tends to be better for looking at soft tissues, like the brain, and CT usually is better for looking at bones. Your doctor, or the consulting radiologist, can tell you which is more likely to be better in your individual situation.
©2014 North America Synd.