Learnings from Shingles

As I posted in my last blog, I had shingles. Shingles a.k.a. Herpes Zoster is a recurrence of chicken pox. Once a person is infected with chicken pox, the Varicella Zoster virus (the virus causing chicken pox) stays dormant deep within the nerves, and stays there sleeping. Once a person's immune system goes down, the virus wakes up and travels from the nerve to the surface of the skin, resulting in Shingles. Most of the time, this affects old people (>50 years old), or people who are immuno-compromised (like PLHIV and cancer patients). But, this can also affect healthy people (though not very common). Shingles is infectious to people who haven't had chicken pox before, and it will manifest in them as chicken pox, NOT as shingles.  

Unlike chicken pox, shingles usually doesn't spread throughout the entire body. It manifests in a certain pattern following the path of the nerve. It only manifests in one part of the body (either left or right). And it is more painful than itchy. The nerve pain may stay on even after shingles is healed, sometimes until 1 month, and in a some cases, even until 1 year. And worse, it looks ugly... really disgusting! So I'm not posting any real-life photo.  

But, herpes zoster is not the typical herpes or herpes simplex. This is a common misconception. Although they are from the same herpes virus family, they are two different things! Herpes simplex is caused by the virus called HSV, while shingles is caused by the virus called Varicella Zoster. Herpes simplex may be sexually-transmitted, while Herpes Zoster is never sexually-transmitted, but merely a recurrence of chicken pox. Both stay dormant after they are healed, but may recur once a person's immune system goes down. 

So, what have I learned from my shingles outbreak? A week or two before my shingles infection, I have been stressed out. Stressed at work. I have been working till late and been getting little sleep. At the same time, I over exerted myself. Even if I was stressed out, I played badminton, started working out at the gym again, and even swam some laps in the pool during that week. These definitely affected my immune system, thus resulting in shingles outbreak!

I might be feeling well and normal now. But I should never forget that I still have HIV in my body, and that my CD4 is still considered to be very low (at < 100 count, < 9%). I should be more careful now... and take extra precaution. I should know my limits as I don't want to compromise my health! Shingles can recur if my immune system goes down again. I don't want this to happen again. It's itchy, painful and yucky! 

On a good note, this virus gave me the much needed 2-week rest from work. Just sleep, eat, read, TV, and DVD. I hope this is enough to recover my immune system. 


P.S. An IDS also told me that Vitamin B complex helps protect PLHIV from shingles outbreak, as it keeps the nerves healthy. And that IDS also advised me that some Vit B+ brands out there don't have as much amount of Vitamin B. So, I better change my brand, and go for a higher dose, to help speed up also the post-pain (post herpetic neuralgia) this shingles is causing. This pain is already giving me some sleepless nights, and is also waking me up in the middle of the night. :( 

Good news, this IDS also told me that a vaccine for shingles will soon be available for PLHIV, most likely next year! Can't wait. I'm sure this vaccine is way cheaper than 1-2 weeks of intake of acyclovir or valacyclovir, and definitely worth than suffer the pain, discomfort and yuckiness of shingles. 

Hospital Again After 1 Year

Exactly 1 year after I was confined for meningitis, I'm back. Same hospital, same floor :( There were some improvements in the hospital though. Bigger room. My TV now is 32" LCD, a big improvement from the 14" CRT TV last year. Incidentally, like last year, I was watching again The Voice PH Blind Auditions in the hospital. This made me wanna sing: "Same bed but it feels just a little bit bigger now..." hehe.

After I consulted my IDS at SAGIP, my doctor wanted to admit me ASAP. Why? I've been taking Valacyclovir for 4 days already, yet she saw that there were still some new blisters coming out due to my shingles (herpes zoster). Since my CD4 is still below 100, she wanted to be sure, and didn't want the infection to spread to my internal organs (like brain, ears, eyes... yikes, that's scary). 

Okay, so I made the room reservation after my consultation with my IDS. Then, I went home to get my stuff, and went back to the hospital. On my way to the hospital, I was so sad and worried, that I wanted to cry; I remembered my hospital admission last year. Uncertain of what might come, yet looking forward to the day when I will be discharged. 

When I got to my room, it was the same Q&A from the resident doctor. What meds are you taking? Are you on ARV? When were you diagnosed? What were your OIs? Did you have sex with women/men? Are you heterosexual/homosexual? How many sexual partners did you have? When was your last sex? What types of sex did you do (in short, are you top/bottom, oral receiver/giver)? How did you get infected? Did you use drugs? Next time, I swear, I'll bring an FAQ sheet, so I don't have to answer them again and again... 

After the admission protocols, there goes my IV.

Then, the nurses came. One by one, they started to greet me. They were all very friendly. "Hi sir, I remember you! You were here last year, right?" Seems like they were happy to see my again (in a positive way). Also, all of them (even the nursing aide) said, you gained a lot of weight? Nicer built now! Good... I'm flattered! Perhaps, due to how serious my illness was last year, and how thin I was at that time (at 115 lbs), they were quite surprised to see me looking well and fit. It also seemed like they were surprised that I was only hospitalized again after 1 year (and perhaps to still see me alive), despite having an advanced AIDS illness last year. 

Anyway, those comments lifted my spirit. So happy to have recovered pretty well from that painful meningitis last year. And I'm also glad that this hospitalization, is a lot less serious than than. 

After 1 week, my shingles dried up with acyclovir antiviral IV. The bad news was, that acyclovir IV was so damn expensive! And Philhealth only covered 10% of my bill. 

Good thing that I recovered in 1 week as expected. My shingles started to dry up. It did not spread to my internal organs. After 1 week, I was discharged. Thanks to my doctors for managing me well, and making sure I don't get any complications. And thanks to the nurses who were very friendly when they saw me again, though I don't want to see you guys again (at least in the hospital). :)  Also, buti na lang I'm paying Philhealth as an Individually Paying member now, apart from the contribution of my employer. At least, I don't need to ask for an MDR and certificate of contribution from my employer. And for that, they will not know that I was admitted in a hospital again.  

Damn, I lost 3 lbs in the hospital. Well... this is my license to eat at Vikings next week. :)

#latepost