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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Severe Thigh Pain Despite Taking Valacyclovir For Shingles?

My mom was hospitalized with Shingles on July 5th. She was given Valsiclozar (?) and later some pain meds from her doctor. Her left thigh is in terrible pain from the nerve endings. I have lidocaine patches for her BUT I think the nerve pain is too severe. She saw her doctor just yesterday but I think she made need something stronger than the patches. She was, but stopped taking Gabapentin and Tramadol. It was making her loopy. Can you suggest anything please?
Wed, 17 Aug 2016
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General & Family Physician,  's  Response
Shingles is characterized by a painful skin rash with blisters involving a localized area. It is caused by varicella zoster virus. Chickenpox is due to an initial infection with VZV. Once chickenpox has resolved, the virus may remain inactive in nerve cells. Shingles occurs when viral antibody titer and cellular immunity decline to levels that allow viral reactivation. Predisposing factors are old age, immune-compromised patients such as HIV infection, patients on chronic steroid and chemotherapy. Shingles resolves within 3–5 weeks, but secondary bacterial infection and chronic pain due to post – herpetic neuralgia may occur. High potency live attenuated VZV vaccine (Zostavax)is available and it reduce the risk of getting shingles in individuals 50 years of age and older. Vaccination reduces the frequency of post – herpetic neuralgia. Duration of recovery from post – herpetic neuralgia is uncertain and variable.
Advice
1.     If your’s mother age is more than 50 years she can take Zostavax vaccine under medical supervision
2.     Amitryptyline 25 mg at bed time
3.     Do not take mental stress as it aggravates shingles
Thanks
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What Causes Severe Thigh Pain Despite Taking Valacyclovir For Shingles?

Shingles is characterized by a painful skin rash with blisters involving a localized area. It is caused by varicella zoster virus. Chickenpox is due to an initial infection with VZV. Once chickenpox has resolved, the virus may remain inactive in nerve cells. Shingles occurs when viral antibody titer and cellular immunity decline to levels that allow viral reactivation. Predisposing factors are old age, immune-compromised patients such as HIV infection, patients on chronic steroid and chemotherapy. Shingles resolves within 3–5 weeks, but secondary bacterial infection and chronic pain due to post – herpetic neuralgia may occur. High potency live attenuated VZV vaccine (Zostavax)is available and it reduce the risk of getting shingles in individuals 50 years of age and older. Vaccination reduces the frequency of post – herpetic neuralgia. Duration of recovery from post – herpetic neuralgia is uncertain and variable. Advice 1. If your’s mother age is more than 50 years she can take Zostavax vaccine under medical supervision 2. Amitryptyline 25 mg at bed time 3. Do not take mental stress as it aggravates shingles Thanks