I had shingles a few months ago and got pills. The blisters have disappeared, but I still have pain on the side of my ribs where they were. Will it go away?
One thing I noticed during the closure was that a larger number of my patients got shingles than usual.
It is an evil condition caused by the same virus as chickenpox that slumbers in our body after we first got it as a teenager.
It can be reactivated for various reasons.
Most people will suffer for a few weeks, but for some it can take up to a year and it is difficult to say why it stays that way, writes Dr. Ellie Cannon (file photo)
No one knows exactly why it happens, but it is believed to be related to decreased immunity.
It is also believed that stress, sun exposure, diseases or medications that suppress the immune system and simply age increase the risk.
The virus – Varicella Zoster – lives in the nerves and so the blisters usually appear along a line that the nerve supplies.
Most of the time they wrap around one side of the body, but can occur anywhere.
We usually prescribe an antiviral tablet, acyclovir, which helps get rid of the rash faster.
The pain with shingles is known as neuralgia and is quite debilitating: patients say it feels like a burning sensation, pinprick or small electric shock.
Stress, sun exposure, diseases or medications that suppress the immune system, and simply aging may also increase your risk of developing shingles (file photo)
If this continues after the rash, we call it postherpetic neuralgia.
Most people will suffer for a few weeks, but for some it may take up to a year and it is difficult to say why.
Normal over-the-counter pain relievers don't really help. In severe cases, we prescribe drugs that specifically target nerve-related pain.
This includes amitriptyline, pregabalin and gabapentin and they are not suitable for everyone due to side effects.
Relieve the economy … by opening public toilets!
Many companies are open, but keep their businesses firmly closed, writes Dr. Ellie Cannon
I would suggest one thing to boost the economy and get people back into stores: Open the toilets!
There is a significant shortage of public toilets in the UK – the councils have largely secretly privatized the amenities, as many of us are now dependent on stopping by on the toilet in Pret or at a local coffee shop.
But now many companies keep their loos tightly closed while they're open – I guess because it's just one area less that needs constant cleaning.
In the meantime, I know that some public parks keep their toilets closed and actively punish people who nibble in the bushes.
To be honest, a large number of people are prevented from leaving the house. It is terrible to be in a nutshell and is a special problem not only for those who have had bowel or bladder problems, but also for the elderly and families with young children.
You can make yourself more comfortable by wearing loose, soft clothes over your ribs and staying cool. Cold packs can be good for neuralgia, and some use a non-irritating plastic wound dressing to cover the area and prevent contact or irritation.
There is also a prescription cream that contains capsaicin and comes from a chemical found in chillies that some people find effective for nerve pain.
I think I may be suffering from "Long Covid". I had it in March, but I still can't smell anything. Do I have to learn to live with it?
It usually takes two or three weeks for people to fully recover from Covid-19. But it seems that for some unknown reason, some have a lengthy illness, and although not yet an official diagnosis, some doctors and patients call it Long Covid or Covid Long Tail.
Early data suggests that this could affect up to one in ten people who had the virus, and we cannot say how long this could take.
Long Covid appears to take many different forms: for some it is persistent fatigue and exhaustion, for others it is a specific symptom such as loss of smell, chest pain or shortness of breath.
We see this with other viruses: We have known about post-viral fatigue for a long time. Infections such as flu can lead to permanent odor loss. Chronic odor loss has a huge impact on how we feel.
Not being able to enjoy or feel the smell of food or pleasant things can be stressful, but it can also be a risk. Without smell, you cannot see smoke, gas leak, or food.
It is important that you recognize this for your own safety.
There is a charity, Fifth Sense (5thsense.org.uk), that supports people with smell and taste disorders.
They may recommend methods for olfactory training, a type of therapy in which patients “rehabilitate” the smelling nerves by sniffing pungent aromas like eucalyptus.
NHS England will launch an online service for people with Long Covid this month to receive advice from nurses, physiotherapists, mental health teams, and others affected.
My son missed his first HPV shock in April. Are they postponed and is the delay at a disadvantage?
The school closure not only missed classes but also resulted in children lacking vaccinations, including HPV vaccines for boys and girls, in addition to the youthful boosters for tetanus and diphtheria and meningitis vaccination.
There is a lot of catching up to do: this is especially important since 2020 is the first year that boys will be enrolled in the HPV vaccination program, which is carried out by school nurses and immunization teams from local authorities instead of family doctors.
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They are planning a catch-up program that will begin with the reopening of schools later this year.
Children who missed their first get one. But we usually give two kicks several months apart – and children who are waiting for a second dose may not get it.
One dose provides good protection against HPV and thus the cancer that it causes, at least in the short to medium term, until a second refresher dose can be given when life returns to normal.
Delaying years between the two doses does not reduce the effectiveness of the vaccination.
The delay of a few months or even a year for those who are waiting for their first dose means that protection against HPV does not start until after vaccination.
All children should receive a letter and consent form for the catch-up process from their school.
Not all skin cancers are urgent
Very urgent skin problems like a possible melanoma take precedence over less worrying lesions like basal cell carcinoma, which tend to grow very slowly (file photo)
I wrote two weeks ago about how useful photos and technologies are for remote skin problems – and that they allow us to identify and refer patients with suspected skin cancer for quick assessment.
These systems are fast, but are still reserved for very pressing skin problems like possible melanoma.
These problems take precedence over less worrying lesions such as basal cell carcinoma, which are classified as skin cancer, but grow very slowly and only affect the surface of the skin. It is still worthwhile to see a family doctor right away to have them examined and arrange a referral. At the moment, however, there may be waiting times.
I know it can be troubling, but these types of cancer are almost never life threatening, which should provide some reassurance.
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