“Empathy. The capacity to understand or feel what another person is experiencing from within the other being’s frame of reference, i.e., the capacity to place oneself in another’s position.”
– Wikipedia
In my 25 years as a healthcare professional, I’ve encountered many older adult patients, clients, friends and family who have been diagnosed with shingles. I’m well aware of the basics (you can read more about them here, if you like), but it wasn’t until I, myself, was diagnosed with this virus that I developed a true appreciation for the impact it can have.
It began when I noticed a suspicious rash on my lower abdomen that wrapped around my body, all the way to my lower back. I called my physician right away and scheduled a “same day” sick patient appointment (something I hope your primary care practice offers to its patients as well).
She acted promptly to prescribe treatment with prescription antiviral drugs that can speed healing and reduce the risk of complications. I also saw an Infectious Disease Specialist who prescribed a medication called gabapentin (Neurontin). Despite my reluctance to take this for fear it would make me sleepy – a feeling I don’t like or have time for – I took a very small dose at night because she convinced me it could reduce the risk of post-herpetic neuralgia. Six weeks into this experience, I’m wondering if I should have followed her recommendation that I take a higher dose for a longer period of time. (I never said I was the most compliant patient!!!)
My first emotion was fear
My first emotion upon being diagnosed was tremendous fear. I thought of two clients, both of whom had developed such severe cases of shingles that they required hospitalization and aggressive pain management for months and years. For one, she was never fully pain free again. She’d describe “pings of electricity” in her body, coming and going unexpectedly, that would just stop her in her tracks.
I’d seen it all before, but until now, it was secondhand. Realizing what lay in front of me, I had great concerns about the coming weeks.
What causes shingles? How do we prevent and manage it?
The reason for developing shingles is unclear, but it may be due to lowered immunity to infections as we grow older. Those older than 50 are at risk (I hope you’re surprised to learn that this includes me!), and some experts estimate that half the people 80 and older will develop shingles at some point.
Shingles is caused by the Varicella Zoster virus, the same one that causes chickenpox. The varicella vaccine (Varivax) has become a routine childhood immunization to prevent chickenpox – it is also recommended for adults who’ve never had chickenpox. Though the vaccine doesn’t guarantee you won’t get chickenpox or shingles, it can reduce both your chances of complications and the severity of the disease.
A second vaccine is the “shingles vaccine,” Zostavax. This also doesn’t guarantee you won’t get shingles, however it will likely reduce the course and severity of the disease and reduce your risk of post-herpetic neuralgia. (I found myself wishing I’d had this!)
Zostavax is recommended for adults age 60 and older, whether they’ve already had shingles or not. Most insurance companies use the initial recommendation of “over the age of 60” as to when they will pay for it, so getting it earlier can result in an out-of-pocket expense of between $200.00 and $250.00.
Living with the pain
During the first week, just moving from one position to another and trying to shower and dress caused a lot of pain. I was more fatigued than usual and my patience would wear thin as the day progressed – something my husband was incredibly patient with in the evenings.
By the second week, I was experiencing tremendous stiffness, as a result of limiting my mobility. My physician reassured me that I wasn’t going to harm myself by resuming my normal functional activities (although she did encourage me to get more rest than I usually do.)
So, I resumed life. I took mild over the counter medications to manage the discomfort, practiced my meditation techniques more frequently, and moved on with my work and personal life. I focused on all the good aspects as I did not want to miss a thing, and tried to use the power of distraction to the best of my ability. For me, that worked well – but I consider myself “young and resilient.” For the older people in my life, I developed a much greater appreciation for how resumption of normalcy can take much longer. Having tremendous patience when interacting with such individuals is necessary.
Reflections/Lessons learned
Recommendations for management of shingles include trying to reduce the amount of stress in your life. Oh no, was my mom right again?
My loving mother watches my lifestyle, something that is full of work and fun. But more recently, it’s been complicated by selling our home; moving to a temporary apartment and office because our new home wasn’t ready; travel, including multiple speaking engagements; my husband’s upcoming retirement; and Open Enrollment season for both Medicare and employer-sponsored insurance plans.
And so she asked, “Are you taking good care of yourself?” Maybe I wasn’t. In the past, I’d probably develop a respiratory infection or a GI bug to slow me down. This time, maybe it was shingles.
Conclusion
Everyone’s reaction to life’s challenges is different and as a healthcare professional, I must have empathy for another’s experience. I encourage you to follow my mother’s advice and pay attention to whether you are taking adequate care of yourself, getting enough sleep, eating healthy foods, exercising and maybe practicing mindfulness.
Hopefully, I’ll do a better job of this for myself in the future. I certainly encourage you to do the same!