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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest treatment for limbs and facial numbness and shingles

Answered by
Dr.
Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4372 Questions

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Posted on Mon, 20 Apr 2015 in Brain and Spine
Question: I am going into 7 mo post OP ACDF C-3 through C-6, have "sryinx" C-6 through T-2, and Chiari 0, each week increasing extreme pain through below ACDF down through shoulders into T spine, by mid Nov 2014, from head to toes, but could draw a line through body and main PHN pain on left side, left side continued to weaken, paralysis issues beginning late Dec into XXXXXXX and now, involving all limbs and facial numbness, have been to ER more times than I can count, nothing they can do for me but keep paper trail so far,,, finally had rash on neck at one of the trips for paralysis on March 2nd last month, was told shingles,,, after much research,,,and finding out where my surgery was done, the floor below me is one of the top research centers in the world for shingles research, besides the added complications of the spinal SM sryinx adding a 10% chance to develop internal shingles from the spinal trauma of the surgery...so, the ER dr ordered a full weel of anti viral med Aclyvir, first time in 7 LONG months I get any kind of relief from the horrific pain, and I live with enough nerve pain from my other conditions! Ok, finish med, next morning feel half way normal for a CHANGE for a HALF day! Then an extremely bad stressful situation again brings on another shingles attack! Put back on a maintenance dose of 1 tab a day of the anti viral med, continue to have out breaks of the shingles while on it! The nerve pain is out of control until I take this med, so I try to time it to when the pain "spikes" more ER trips, more bad break outs fever begins, 97 to 104, get blood done, UA all of it, get referral to disease specialist will see on the 22nd of this month, put back on the antiviral full strength for 10 days as have more parathesis and now shingles in my mouth and gums and both sides of spine, legs all over pretty much, as one heals one breaks out....now,,,what do I do when this med runs out in 10 days???? it will be a 2 weeks wait to see the specialist, and this from what I can tell is systemic, yes I do know allot about the body, have had 7 long months to research, and yes am fully aware of the complications I could be dealing with, such as shingles dialated central canal, although rare, or Gullian Biarr or Ramseys hunt and more as it has gone for so long with no care, sorry for the typos, am in extreme pain now....my new NS is outraged over the lack of care the surgeon has not given me, and I have been begging for help, my PM Dr even tried to reach the surgeon as he suspected internal shingles as he has seen this before from spinal surgery...anyway,,,,I know like antibiotics it is unwise to continue them as they are not effective after a length of time, is it the same for anti virals??? And what organs should I be most concerned with other than heart and lungs, those are both good BTW and brain is good also! Got those checked out at least! But I do need a MS MRI, and a few other test am sure,,, I would have to go back to the ER for help as this is very complicated now, can't post why am sure you can respect just from what you have read and assume the worst scenario, thank you!
doctor
Answered by Dr. Prof. Kunal Saha 4 hours later
Brief Answer:
Shingles is a painful external infection caused due to herpes virus.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have carefully gone through the problesm. Shingles is a viral infection caused by a herpes virus. It is a very painful condition. Once infected, the virus remain in the region of same nerve supply, for the rest of life. It cannot be eliminated and shows flare ups when your immunity is weak. It is only in cases of extremely serious cases that complications like internal infection with herpes, for eg. herpes encephalitis occurs. It is possible that the conditions like dialated central canal and the related conditions are suspected to have occurred due to the same infection. The antivirals like acyclovir reduce the rate of viral replication and thereby limit the progression of the disease. But it is very hard for me to comment on the significance of continuing it on long term basis. I am sure that your doctor knows the situation better and has taken the decision after weighing the odds.

Like most medicines, the antivirals are metabolized and eminated by the liver. So, long term use may lead to liver problems which need to be monitored for.

Hope that helps.

If you found my answer helpful, please close the thread with a positive review and a 5 star rating.

Regards
Dr. Kunal Saha
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prof. Kunal Saha 3 hours later
should I ask to be kept on full strength antiviral until I see the specialist if liver function is good? If that is what I read your answer to be....I do not see a dr with ANY experience in this until the 22nd, not even my GP, nor do I care to for LEGAL reasons, it is complicated! I had to fight for my life now,,came close to really believing was not going to be sitting here typing this that is how bad off I was before the anti viral,,,,am one of those people with one of those rare diseases that looks fine outside no one can see, but the pain is so extreme, but lets add a little internal shingles into the picture! My uncle was one of the best NS in the state, there is a minimum of standard of care by any dr even on the smallest of levels, 1. when a PT comes to you complaining of post OP spinal pain after spinal surgery that has only increased to an extreme measure after 6 weeks, 2. the PT is to be admitted into the hospital given a nerve root block 3. all films ran 3. if no cause for the pain can be found to be from the mechanics structure of the films of the PT 4. INTERNAL SHINGLES should be ruled out FIRST this is printed in the spinal surgeons handbook, I know because my uncle had one found it in the garage after my DX at the ER! But if safe to be continued on the anti viral will go back to ER let them run the labs on blood and re order the antiviral until I see the specialist then, thank you, that did answer my question!!!
doctor
Answered by Dr. Prof. Kunal Saha 11 hours later
Brief Answer:
Please continue taking the antivirals as prescribed

Detailed Answer:
Thanks for writing back. Sorry for not being able to write back earlier.

You should take the antivirals as prescribed (read:full strength) for the prescribed duration. I do not think that you need to worry about liver function or to go to the ER for the tests. Most often these medicines are well tolerated and do not cause side effects. So, I guess that you can take your medicines and wait for your appointment.

Regards
Dr. Kunal Saha
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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