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Suggest treatment for pain after suffering from shingles

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Posted on Wed, 24 Sep 2014
Question: My Mother is 101. She had been pretty healhty. She was fairly well minded, continent and XXXXXXX She is suffering from congestive heart failure. She had a radical masectomy in 1968 of her right breast. She has had no reoccurence of breast or any other cancer. My question is here: She contracted Shingles in April of 2014. She did a round of antibiodics. She started with the nerve pain after shingles sometime in May. It has gotten worse.
The Doctor put her on Gabapentin, lorazapem, and trazadone. She still seemed to be suffering calling out it hurts it hurts. The medicine diasabled her. She could not stand or move or talk very much and when she was coherent she was saying she was still in pain from the shingles. The pain is at her masectomy site. My sisters said they did not want to see her like that so they took her off the pain medications. Is there anything else we can try? We have an acupuncturist coming in with herbal treatments and acupuncture. My sisters are giving her tylenol and cold compresses. Could this be something other than shingles pain? It has been going on for months. Is she too old to fight it?
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Answered by Dr. Prakash H Muddegowda (26 minutes later)
Brief Answer:
Local capsaicin or lidocaine patches can be tried.

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.

Looking at the medical history and query, my opinion is as follows:

1. If the pain is in the area, where the blister like lesions of shingles were seen, then it is definitely shingles. However, if you are not sure, it should be a burning type of pain.

2. Shingles leads to post-herpetic neuralgia, which is a very painful condition. She was on good medication, which could have given her comfort. However, they do have central nervous system side effects, thereby debilitating her.

3. Local Capsaicin application or similar patches can be used. Do watch out for burning of skin.

4. Another possible method, could be use of lidocaine patches (anaesthetic patches) over the area. You will require a prescription from your doctor for it. It is known to be helpful.

5. If acupuncture and herbal treatments are working, it is good. If not, you can try the above once. Importantly, try to make it as less painful as possible for her. It is about her comfort rather than the caregivers.

6. Narcotic medications like codeine can also be tried. You would need a prescription for it. Tylenol is very low grade analgesic and is not going to help much.

Avoid keeping her in pain for too long. She can still fight. Good family support and nutrition with mild to moderate exercises will improve her psychologically and physically. Treatment can help in reduction of pain. There is no complete cure for pain at her age.

Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Prakash H Muddegowda

Geriatrics Specialist

Practicing since :2004

Answered : 2138 Questions

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Suggest treatment for pain after suffering from shingles

Brief Answer: Local capsaicin or lidocaine patches can be tried. Detailed Answer: Hi, Thanks for asking. I am Dr. Prakash HM and I will be answering your query. Looking at the medical history and query, my opinion is as follows: 1. If the pain is in the area, where the blister like lesions of shingles were seen, then it is definitely shingles. However, if you are not sure, it should be a burning type of pain. 2. Shingles leads to post-herpetic neuralgia, which is a very painful condition. She was on good medication, which could have given her comfort. However, they do have central nervous system side effects, thereby debilitating her. 3. Local Capsaicin application or similar patches can be used. Do watch out for burning of skin. 4. Another possible method, could be use of lidocaine patches (anaesthetic patches) over the area. You will require a prescription from your doctor for it. It is known to be helpful. 5. If acupuncture and herbal treatments are working, it is good. If not, you can try the above once. Importantly, try to make it as less painful as possible for her. It is about her comfort rather than the caregivers. 6. Narcotic medications like codeine can also be tried. You would need a prescription for it. Tylenol is very low grade analgesic and is not going to help much. Avoid keeping her in pain for too long. She can still fight. Good family support and nutrition with mild to moderate exercises will improve her psychologically and physically. Treatment can help in reduction of pain. There is no complete cure for pain at her age. Hope it helps. Any further queries, happy to help again. Dr. Prakash HM