‘Awful’ shingles on rise as boomers age

Dr. William Milam, left, and nurse practitioner Jennifer Prager discuss the symptoms of shingles, which they said roughly one third of their patients have suffered from at some point.


marian galbraith

Dr. William Milam, left, and nurse practitioner Jennifer Prager discuss the symptoms of shingles, which they said roughly one third of their patients have suffered from at some point.

With intense pain, long-lasting nerve damage, and frightening statistics, shingles appears to be on the rise, particularly as more baby-boomers pass the age of 60.

“I’ve suffered more from shingles in the last 11 months than I ever have from anything else in all my years combined,” said Milner Carden, an 83-year-old cancer patient who contracted shingles last fall.

“It started on the back of my neck, and I still have a lot of pain there, as well as around the side of my head.  It gets so bad, I can’t even sleep.

“I wouldn’t wish it on my worst enemy.”

Otherwise known as herpes zoster, one in every three Americans will develop shingles at some point in his or her life, according to the Centers for Disease Control (CDC), and anyone who has recovered from chickenpox is at risk.

Local physician William Milam, M.D., and nurse practitioner Jennifer Prager concur with the CDC’s statistics.

“Yes, I’d say about a third of our patients come in with shingles at some point,” Prager said. “If you’ve ever had chickenpox, the virus lies dormant in the nerve roots until some kind of stress or trauma brings it out.

“It starts as a painful rash with red vesicles on a red base, and it forms linear patterns on the skin along the nerve lines underneath.

“The rash goes away after about a month, but many people develop a complication afterwards called postherpetic neuralgia, or PHN, that can last up to a year.

“Fortunately, the symptoms can be reduced by drugs like Lyrica or Neurontin.”

PHN, she said, is basically a continuation of the same, sharp pain along the damaged nerve fibers where the rash formerly appeared.

Milam said most of his cases appear right around the spring and fall equinoxes, as opposed to the middle of summer or winter months.

“It’s brought out by stress, and we find that stress levels are increased around those times when the day lengths and light angles are changing rapidly and people are preparing for the holidays or the change of seasons,” he said.

Prager added that tax time in the spring as well as respiratory infections in the fall could be among the types of stressors on the body that can trigger an outbreak at those times of year.

“It’s a one-time vaccine, and it’s approved for anyone over 50,” Milam said, “but most insurance plans won’t cover it until you’re 60 or over.

“Medicare Part D definitely covers the cost of the vaccine for those over 60, and I strongly recommend it for almost everyone that age, with a few important exceptions.

“For example, if you’ve ever had a bad reaction to any vaccine, you shouldn’t do it, or if you’re immuno-compromised for one of several reasons.”

Milam then deferred to the “Shingles Overview” on the CDC website for exact details on who should not get the vaccine, such as those who have ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of shingles vaccine; a person who has a weakened immune system because of HIV/AIDS or another disease that affects the immune system, or is undergoing treatment with drugs that affect the immune system, such as steroids, cancer treatment such as radiation or chemotherapy, cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma; and women who are, or might be, pregnant.

Once any of these conditions or treatments have stopped, however, Milam said he still recommends the vaccine once these conditions are stabilized or when the cancer is in remission.

“You can’t take the vaccine while you’re in chemo,” he said, “but once the treatments have stopped and your condition has stabilized, it’s a good idea to check with your oncologist and find out when it’s safe to get the vaccine.

“I’d definitely recommend it for all diabetics, too, as long as they’re not immuno-compromised.

“We don’t give the vaccine here at the doctor’s office, but you get a prescription from your doctor, and then you get the vaccine at the pharmacies we contract with.”

Milam added that even those who have already contracted shingles should get the vaccine as soon as it is safe to do so, because the condition has been known to come back.

While the vaccine does not guarantee prevention of shingles altogether, it has been shown to reduce the severity of symptoms in those who do develop it.

According to the CDC website, clinical trials involving thousands of adults 60 years old or older, the vaccine known as Zostavax, was shown to reduce the risk of shingles by 51 percent, and the risk of post-herpetic neuralgia by 67 percent.

While the CDC has not identified any serious problems with the vaccine, some side effects include redness, soreness, swelling or itching at the shot site, and/or headache.

Research suggests that the shingles vaccine is effective for at least six years, but local physicians and pharmacies recommend it as a one-time vaccine that generally lasts for life.

While Milner Carden said he will never be able to get the vaccine because he may remain on chemotherapy for life, he said he hopes to carry his message to as many others as possible.

“I’d strongly recommend that anyone who’s ever had chicken pox should get the vaccine and do all you can to prevent shingles,” Carden said, “because once you get it, there’s really not much you can do about it, and it’s awful.”

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