Brief Answer:
yes, it can cause diaphragmatic paralysis.

Detailed Answer:
Good evening. My name is Dr. Dariush Saghafi and I'm a neurologist from the XXXXXXX Ohio region of the world. Greetings to you wherever you are.

I'm sorry that you've had 2 bouts of shingles. OUCH! I hope you have been placed on a good stiff dose of SUPPRESSIVE therapy of the varicella (Herpes Type) virus and remain on that regimen for a good period of time in order to minimize your risk for repeat bouts.

Varicella zoster virus is a known (but relatively rare) cause to diaphragm weakness and even paralysis by reason of transmission through the Phrenic nerve which comes down for the Cervical spinal nerve roots (C3-C5). However, since zoster tends to only affect one side of the body at a time then, only one of the HEMI-diaphragms will be affected. Even if paralyzed most people will not notice much difference clinically in their ability to breathe or get a good breath of air. That is an example of how much redundancy is in the human systems and how well designed our organ systems are which have 2 sides that function such as the diaphragm.

The virus will eventually recede from the phrenic nerve and its contact or connection with the diaphragm. However, unfortunately, the virus will recede only back to the nerve roots from whence they came and at some point in the future may be released again. There is nothing we have yet that can get into the areas where the virus "hides out" in order to destroy it.

Here is a good informational like which actually talks a little about herpes zoster affecting the diaphragm muscle:

http://www.healthhype.com/paralysis-of-the-diaphragm-breathing-muscle-problem.html

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Also, if you have no further questions or comments to place could you also do me the favor of CLOSING THE QUERY which will alert the network to process, archive, and credit this question appropriately for future reference.

In the future I'm happy to answer questions personally and you would allow me this privilege by going to the following website and writing your questions:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474

This query required 35 minutes of physician specific review, research, and final draft documentation for envoy.

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Brief Answer:
Yes-I believe you should be on SUPPRESSIVE therapy

Detailed Answer:
With 2 outbreaks in such a short period of time I believe the chance of a 3rd outbreak is highly likely and may even be imminent. I definitely would treat any patient with that type of scenario with at least 4 if not 8-10 weeks of suppressive therapy (meaning Valtrex at what are known as suppressive doses). For clarification, you should probably consult with an Infectious Disease specialist but in terms of what I know?....I believe this is the time to try and stop the recrudescence and spread of this problem.

Please do me the favor Ms. Wellnesspartner and provide some written feedback and a STAR RATING if my information has been of help. Also, if you'd close the query then, this will signal to the network that we are now ready to process, archive, and credit these questions appropriately to their respective individuals.

Cheers!

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Brief Answer:
Both excellent questions

Detailed Answer:
Thanks for writing questions and asking these very good questions indeed.

1. There is NO cure for the zoster virus which as you know is a herpes family virus that infects the nerve roots (dorsal root sensory ganglia) and is virtually ubiquitous and present in everyone on the planet who has suffered from chickenpox....and that includes me...and I suppose you! HA!

What happens is the virus gets INSIDE the nerve root itself and that's where it hides out FOREVER. It is part of the cellular machinery so to speak....your nerve roots are fine, not irritated, not inflamed....they don't even realize the virus is present...that's why viruses are such powerful critters....they HIJACK nerves and cause therefore, cause havoc when they COME OUT TO PLAY so to speak...and that's what an outbreak is all about. The manifestation of that viral explosion are the skin lesions that you see and FEEL. But--- by the time the patient sees or feels anything going on in terms of the herpetic breakout followed by all the postherpetic neuralgia that follows.....the VIRAL PARTICLES are back inside where they came from in the sensory ganglion, protected from any medicine attack etc.

Valtrex therefore, given acutely (at the time of the attack) is virtually worthless as an ATTACK drug because it really doesn't do much KILLING AT ALL....it doesn't even do much mopping up because whatever few viral particles remain to irritate the nerves...are all INSIDE THE NERVE FIBERS....do you see how that works? The medicine is not at all designed to SEARCH AND DESTROY viral particles are being masked and protected by the body's own tissues and cells. The medication only works for anything that might be "hanging around" or hasn't yet found a host to live in...and that's almost impossible. Viral particles which enter a person's body..almost immediately are transported to where they plan on setting up shop....


2. THAT'S WHERE PREVENTION COMES IN.....that's what PROPHYLAXIS and SUPPRESSION are all about. Provide a PHARMACOLOGICAL ENVIRONMENT which makes it more difficult for viral particles to either come out to play or even want to come out to play and causes symptoms. Remember, so long as they are not triggered to stimulate the nerves....you don't have an outbreak. They just sit inside the cells and putz around without much care about anything else. They are quite dormant and happy to be so....but under certain conditions (such as stress, or changes in metabolic environment such as when a person gets ill or sick, or becomes imbalanced metabolically or chemically) the virus is activated. Sooooooo,
with the suppressive therapy in place....or perhaps with the vaccine being given....the viral exacerbations just never happen or if they do....the intensity of exacerbation is so mild that most patients probably don't even know they've had one.


As far as the vaccine for shingles is concerned. I think that for someone like yourself it is a reasonable thing to try since you've already had 2 outbreaks and in my opinion, without being on long term suppression therapy I believe the odds of you having another repeated outbreak is high. Therefore, the vaccine may be able to avert this undesirable event from happening again.

If this information has been helpful to you could you do me the grand favor of rating with BOTH a STAR grade as well as a little written feedback. As well, could you CLOSE THE QUERY which will help the system process, archive, and credit me for the conversation we've had.

Of course, in the future I would love to hear from you or personally take care of your other questions on an ongoing basis. Please contact me through:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68474

This query required 57 minutes of physician specific time to review, research, and format for final draft envoy.

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