Saturday, June 22, 2013

The song is ended but the malady lingers on

Snowbrush out in Oregon has asked for an update on my shingles. Okay. Not all of them are on the roof of my house.

That was a feeble attempt at a little joke.

If memory serves, I first noticed the shingle marks on my body on February 24th or 25th. The very next day I went to our family doctor, who confirmed that, yup, sure enough, I had shingles. He gave me a prescription for ten days worth of Valtrex (valcyclovir) along with instructions to return in ten days. Ten days later, after the V-drugs had supposedly done their stuff (although I didn’t look any different or feel any different), the doctor switched me to gabapentin (the generic equivalent of neurontin) to deal with the ongoing pain caused by shingles.

He prescribed 300 milligrams a day of gabapentin -- one 100-mg pill in the morning, one in the afternoon, and one at bedtime. After two weeks, when it wasn’t helping the pain all that much, the doctor increased the dosage to 400 milligrams a day -- one pill in the morning, one in the afternoon, and two at bedtime. He mentioned that the pills came as large as 900 milligrams and that some people took as much as 3,600 milligrams a day. I said that I didn’t want to take any more than I needed to alleviate the pain.

March came and went. April came and went. May came and went.

The only thing that didn’t go away was the pain of shingles.

Our primary care physician has been in Marietta for over twenty years, but about ten years ago we moved 25 miles away to Cherokee County. Recently, we decided to get a doctor closer to home to save money and time; we made the change in mid-May. The marks from the shingles have now begun to fade, but there is scarring and the pain has remained.

My new doctor has come up with a new diagnosis: postherpetic neuralgia (PHN).

As far as I can tell, the only difference between shingles and postherpetic neuralgia is the color of the marks left by the eruptions on your body. Mine are now pink instead of red. The pain has lessened somewhat, but it has not gone away. I still have to sleep on my right side because it is still too uncomfortable to sleep on my left side or on my back.

Three guesses what the doctor prescribed for the pain of postherpetic neuralgia and the first two guesses don’t count.

Gabapentin, that’s what. Only the dosage is different and the pills are larger.

Now I’m taking 600 milligrams a day -- a 300-milligram pill in the morning and a 300-milligram pill at night, and there are five (count ’em, FIVE) refills on the prescription.

This is what is known, I suppose, as progress.

Thank you for asking.

10 comments:

richies said...

Hope you a feeling better soon. I had a friend who had shingles and he said it was the most miserable he had ever been.

An Arkies Musings

Snowbrush said...

Here's hoping you will feel better as the months pass.

I'm supposed to take 300 mgs of Neurontin three times a day, but could get as much as I wanted, if I wanted. The thing is that I don't take it as prescribed because it's my last line of defense against pain (better than narcotics, marijuana, and sleeping pills), and it seems to work best if I take it only when I anticipate a bad night, at which time I might take a whole day's worth (900 mgs) at once. I can't tell if I'm awake or asleep after I've had that much Neurontin. It's a trip when taken that way. I'm honest with the doctor about how I take it, and he gives me heck, and I go on doing it because it's good to know that when nothing else will help, it will.

Thank you for letting us know how you're doing. You had said at one point that you didn't want to do like so many and whine about your ailments. Well, why not? I certainly do, and while it's not all I write about, my life is built around managing pain. All day, everyday, it's at or near the top of my thoughts because I'm forever having to either take something for it or alter what I'm doing in order to keep my pain level from going through the roof, so it would seem odd to never mention it.

Yorkshire Pudding said...

Sorry the problem has continued but how brave of you to simply carry on. Fingers crossed by the end of this year these horrid shingles or whatever they are will just be a nasty memory.

rhymeswithplague said...

Thank you, guys, for commenting.

Snowbrush, so if I'm taking only 2/3 as much Gabapentin as you, does that mean I'm only 2/3 as decadent as you? (just kidding)

Yorkshire Pudding, please cross your fingers and toes and any other appendages you can. All good wishes are appreciated.

richies, your friend was absolutely right. It's much worse that kidney stones, at least the ones I had.

Hilltophomesteader said...

Pain is something I understand. Whining is something that other people frown upon, however there is a line between whining and 'informing', so we invented a method by which you can get totally away with whining once a week: Please pay attention. My daughter got tired of people asking, "How are you?" when nothing ever changes and she's always in pain. SO, we invented 'Whining Tuesdays'. You may not get away with whining, except on Tuesdays you may whine as much as you wish. On all other days, when asked "How are you?" You may honestly reply, "Can't complain."
(My family & I all suffer from Lyme Disease. It is painful and continual, though some of us suffer less than some of the rest of us....Some of us continue on regardless.....)
I'm so sorry Mr. RWP that you're suffering! It's no fun to suffer. I'll keep you in my prayers!

rhymeswithplague said...

Hilltopetc., I love it! What a great idea! And you don't even have to lie and say, "Fine."

"Can't complain" is just about perfect.

Helsie said...

What an awful time you've had. My mother has had a bout this year but after an initial week of being very unwell she came good thanks to getting the drugs on time to minimise the attack. She still feels the nerve ends tingling though but no pain thankfully.
Years ago my grandmother was not so lucky and suffered for a long while like you. It's a horrible illness. Hope you begin to feel better soon. I think it is amazing that you have not told us sooner. You are allowed to complain when you've suffered so long!

rhymeswithplague said...

Helsie, good to hear from you all the way from Brisbane, Australia. At one point when I was experiencing fiery pain, I said, "If hell is anything like this, I sure don't want to go there." I'm somewhat better, but the shingles and their aftermath are no fun. No fun at all.

Snowbrush said...

" if I'm taking only 2/3 as much Gabapentin as you, does that mean I'm only 2/3 as decadent as you?"

Ah, but you forget my other drugs and the demonically-inspired music I listen to. If you're in so much pain, why not increase your dose? It's not a drug that people tend to have trouble with as far as side-effects, and you already know that you're far from the allowable amount. Also, it's not addictive, and it doesn't cost a lot. Take more--why not? The doctor will probably be happy to give you all you want within reason, and hopefully you can go off it in another few months.

rhymeswithplague said...

Snowbrush, you're right, I forgot all about all that other stuff. So I must be no more than 1/3 as decadent as you.

I think my pain is slowly lessening, so I don't want to be taking MORE Gabapentin when I hope to be taking LESS Gabapentin before too long.