Shingles

It started with my shoulder hurting as though I had strained it. I had been moving some boxes around and, at first, thought it was nothing more than that. Then, I started feeling poorly -- under-the-weather -- achy and tired like I was coming down with a virus. In the early morning on Saturday, I discovered I had a livid rash on my chest, like I had gotten into poison ivy. It was Daniel who pronounced the diagnosis: shingles.

Wikipedia has a great page about shingles. The virus that causes chicken pox is a retro-virus that stitches its DNA into nerve cells in the ganglia along the spinal cord. At some point, the virus gets turned back on and starts a new infection that travels along the axon of the nerve and infects the region enervated by the spinal nerve, producing the rash in a small zone-like belt on just one side of the body. The rash is quite painful:

The pain may be mild to extreme in the affected dermatome, with sensations that are often described as stinging, tingling, aching, numbing or throbbing, and can be interspersed with quick stabs of agonizing pain.

I got into see the doctor on Sunday and got prescriptions for acyclovir and tramadol. Acyclovir is a neat antiviral medication -- one of the first treatments developed in the study of HIV. Retroviruses use their own DNA polymerase to replicate and this gets taken up as a base to be incorporated into the viral DNA, but lacks the 3' end where the next base would attach and causes the DNA molecule under construction to be terminated. Tramadol is a synthetic analog of codeine that is particularly effective at blocking nerve pain.

Prior to seeing the doctor, I'd been taking ibuprofen for the pain, which was actually pretty effective. And, at first, the rash was not terribly painful. Over the next couple of days, however, the rain became much more painful and I was grateful for the tramadol. It's effect is interesting: when I move the skin with the rash, or it brushes against fabric, I can feel that it hurts but, instead of hurting, it feels more like when you hit your funnybone: an odd uncomfortable feeling, but not pain. When the tramadol starts to wear off, however, I'm under no illusion regarding what I'm feeling.

It appears that the antivirals are having a positive effect: the rash has become much less livid and, although I still have ups and down, I'm starting to feel like I'm getting through to the other side.