How do I shake off my shingles?

I AM 74. About three months ago I had a bout of shingles. It left me with intense pain all over my skin. The doctor prescribed Pregabalin but it’s given me severe vertigo. Will anything else help?

SHINGLES is characterised by intense pain in one area, blistering skin and feeling generally unwell. It is caused by a virus – the same one that causes chickenpox – that has lain dormant in a nerve for a long time.

The virus reactivates when the immune system is compromised. It is concentrated in one nerve, so it causes pain to the specific area that the nerve controls. This pain, which is called neuralgia, can strike even before the telltale signs of shingles.

Some sufferers say it feels like constant burning or repeated electric shocks. A quarter of those over 60 who get shingles will, like you, experience something called post-herpetic neuralgia. This means the pain continues after the rash has cleared up, sometimes for up to a year.

It is thought to be related to nerve damage or inflammation caused by the shingles virus.

Standard painkillers such as paracetamol won’t help. Pregabalin is specifically designed to treat nerve pain but the noticeable side effects, such as headaches and dizziness, mean it’s not suitable for all. Instead, amitriptyline, duloxetine and gabapentin are effective options. But look beyond tablets too. Cold packs – not deep heat – may be useful, as is loose, cotton clothing. Protect the sore areas with a plastic wound dressing to prevent you touching it.

A chilli-based cream called Capsaicin can help to soothe irritation, as can Lidocaine (an anaesthetic) plasters.

Even though you’ve had shingles, it’s worth considering getting the vaccine to prevent further attacks. Talk to your GP about getting the jab on the NHS – it is available for some groups. CAN you help my son? He is 33 years old with severe depression – he’s lost his job, can’t get out of bed and talks about wanting to end it all. Our GP says that there’s currently a six-month wait for therapy. What else can be done?

THIS is a situation familiar to many NHS patients awaiting treatment for a mental health problem. It seems hopeless, given the lengthy delays facing many, but there are a few options.

Acting quickly is vital – suicide is the leading cause of death in men of this age.

Although some people with depression are able to wait six months for therapy, others who can’t work or even get out of bed should not be left waiting.

Many people in this position aren’t even able to get to the doctor’s surgery. In these cases, asking a GP for a home visit is perfectly appropriate.

If there is resistance to a home visit, try a telephone consultation instead.

A GP will do a risk assessment, deciding if the patient is likely to harm himself. They can also treat the symptoms with antidepressants, if it’s deemed appropriate.

The GP can also refer to NHS mental health crisis teams, which exist in every area and will come to your home.

They aim to prevent a hospital admission, and can offer medication and therapy within days.

Your local service will be listed on the NHS website, sometimes referred to as a ‘home treatment team’.

The Samaritans can also help talk through difficult feelings – call for free on 116 123.

If your son does not feel able to talk, he can write down his thoughts and email them to jo@samaritans.org.