How long will it be before I’m free from the pain of shingles?

I HAD shingles a few months ago and was given tablets. The blisters have gone but I still have pain across the side of my ribs where they were. Will it go away?

SOMETHING I noticed, during lockdown was a larger-thanusual number of my patients getting shingles.

It’s a nasty condition caused by the same virus as chickenpox, which lives, dormant, in our bodies after we first get it as youngsters.

It can, for a variety of reasons, become reactivated.

No one knows for sure why it happens but it’s thought it’s linked to a lowered immunity.

Stress, sun exposure, illnesses or medicines that suppress the immune system, and simply older age, are also thought to raise the risk.

The virus – varicella zoster – lives in the nerves and so the blisters usually appear along a line the nerve supplies.

Most commonly, they’ll wrap around one side of the body but they can appear anywhere.

We usually prescribe an antiviral tablet, aciclovir, which helps clear up the rash faster.

The pain with shingles is known as neuralgia and it’s quite debilitating: patients say it feels like burning, pin pricks or little electric shocks.

When this continues, even after the rash has gone, we call it post-herpetic neuralgia.

Most people will suffer for a few weeks but for some it may go on as long as a year and it is hard to say why it persists.

Normal over-the-counter painkillers do not really help.

For severe cases we prescribe medication that specifically targets nerve-related pain.

This includes amitriptyline, pregabalin and gabapentin, and they do not suit everyone due to side effects.

You can make yourself more comfortable by wearing loose, soft clothes over the ribs and keeping cool. Cold packs can be good for neuralgia and some use a non-irritant plastic wound dressing to cover the area, preventing contact or irritation.

There is also a prescription cream containing capsaicin, derived from a chemical found in chillis, that some people find effective for nerve pain.

I THINK I may be suffering from ‘long Covid’. I had it in March but I still can’t smell anything. Will I have to learn to live with this?

TYPICALLY, it takes people two or three weeks to recover fully from Covid-19. But it appears that for an unknown reason, some have protracted illness and this, although not yet an official diagnosis, is being called by some doctors and patients Long Covid, or Covid long tail.

From early data it looks as if this could affect as many as one in ten people who’ve had the virus, and we cannot say how long this may last.

Long Covid seems to be taking many different forms: for some it is an ongoing tiredness and fatigue, for others a specific symptom such as a loss of smell, chest pain, or breathlessness.

This is something we see with other viruses: we have long known about post-viral fatigue.

Infections, such as flu, can lead to a long-lasting loss of smell. A chronic loss of smell has a major impact on how we feel.

Not being able to enjoy or sense smell from food or pleasant things can be distressing but also a risk. Without smell you cannot detect smoke, a gas leak or whether food has gone off.

It is important you recognise this for your own safety.

There is a charity, Fifth Sense (fifthsense.org.uk), providing support to those with smell and taste disorders.

They may recommend ways to go about smell training, a kind of therapy where patients ‘rehabilitate’ the smelling nerves by sniffing pungent aromas such as eucalyptus.

NHS England this month are set to launch an online service for people suffering with Long Covid to get advice from nurses, physiotherapists and mental health teams, and fellow sufferers.

MY SON missed out on his first HPV jab in April. Will they be rescheduled, and is there any downside to the delay?

AS WELL as missing out on lessons, school closure resulted in children missing vaccinations, including HPV vaccines for boys and girls, in addition to the teenage boosters of tetanus and diphtheria, and the meningitis vaccination.

There is plenty of catching up to do: it is particularly relevant, as 2020 is the first year for boys to be included in the HPV vaccination programme, run by school nurses and local council immunisation teams, rather than GPs.

They’re planning a catch-up programme, starting later this year when schools reopen.

Children who have missed their first will receive one. But, normally, we give two jabs, a number of months apart – and children waiting for a second dose may not get that. One dose does offer good protection against HPV, and therefore the cancers they cause, at least in the short to medium term, until a second booster dose can be given when life returns to normal.

A delay of years between the two doses will not reduce how effective the vaccination is.

The delay of a few months or even a year for those waiting for their first dose means protection against HPV will start only once the vaccination has been given.

All children should receive a letter and a consent form via their school for the catch-up.