Karen never quite recovered after this last surgery. She wanted to go see family and we kept planning visits but she was very lethargic and when it came down to it she just never had the energy. To make matters worse, Wednesday evening - the 15th - she got what looked like a bad spider bite on her back. The next day there were a lot more, following from her back towards her stomach along her abdomen. The looked more like flea bites now, with the first one she had gotten still looking worse than the others. Some friends visited from out of town and when she showed them, one of them was quite certain they were bed bug bites.
We compared pictures of flea bites to bed bug bites and couldn't tell the difference. I had been urging her to see a doctor since the bites had popped up and they had become so insanely itchy over the weekend that she agreed to call first thing Monday morning. Dermatology at Mayo was able to see us the same day. The doctor took one look at the bumps which had just started to blister and declared them to be shingles. Apparently it's very common for them to appear on just one side of the body and go from back to front about abdomen level. This is because the virus affects only the skin that the affected nerve supplies. Since we had been comparing pictures, it's worth mentioning the images that come up in google image search aren't nearly as bad as the outbreak Karen had.
The doctor told us that they don't typically start worrying about shingles until people get into their 60s. She said shingles are often triggered by a surgery, low immune system, stress, or an upper respiratory infection. Karen had all of these. The surgery and it's results had been a source of stress, and she got an upper respiratory infection afterwards - we assume from the tube they had put down her throat scratching it. Oh, and she's had a low immune system since the chemo. The doctor warned us that even after you get shingles, there's roughly a 10% chance of getting it again, and suggested Karen get a shingles vaccine once she's recovered from everything.
The drugs they give you to deal with the itching and nerve pain were all drugs Karen was already on due to her neuropathy. Perhaps if this weren't the case we'd have been in sooner. We were given a prescription for an antiviral, famciclovir, but were told it really works best those first 24 to 48 hours, and may not help much now. Antivirals help reduce the severity and duration of outbreaks, but famciclovir is also used in cases where someone has a weakened immune system. This is to keep the virus from spreading to other locations - it's not uncommon for shingles to spread to other nerves nearby. All things considered, this is not a bad outcome.
