Friday, February 27, 2009

Sigh, I feel like Typhoid Mary . . .

By Lonnie Cruse

Shingles on a roof can be a problem when high winds hit, ripping them off and dropping them on your lawn, several feet below where they really belong. IF you're lucky, your insurance will replace them. If not, likely you will soon be up on the roof all by yourself, hammer in hand, precariously balanced and praying not to slide off and join the rest of the shingles, far below.

Shingles on the human body, the viral kind, can be a far worse disaster. IF you are a senior citizen, you really need to research this problem, on the Internet and among your friends. Here's what I found out. An elderly relative of my hubby suffered from a bout of shingles all the way down one leg and had severe pain for over a year. Wearing street clothes was extremely difficult for her, so she spent a lot of time in a loose robe. Another relative was on a trip with friends, several hundred miles from home. On reaching their destination, he had to be taken to the nearest ER, with severe pain on his upper back. His annual golf trip, long anticipated, wasn't much fun. The diagnoses, shingles. That was a year ago this February. When I asked him last week how long the problem lasted, he said he still had it, a year later! Not the rash/blisters, mind you, they faded in about thirty days or so, but the area is still tender and painful to the touch.

A search of the Internet will most likely scare you like it did me. Along with the severe pain (shingles attacks your nerve endings) sufferers can be blinded if the facial area is afflicted, and if pneumonia results, the sufferer can die. Not something I wanted to have happen, particularly since I had a huge case of chicken pox when I was five, and those of us who had chicken pox are more at risk for shingles than those who didn't. Urrrrr.

On my first visit to my new family doctor, I noticed several signs spread around the office urging patients to consider the shingles vaccine. I asked for more info, and here's what I learned. The vaccine is expensive, usually around $200 per dose. And it's a bit delicate to store. It MUST be kept frozen until just minutes before the injection. Most, if not all, doctors are reluctant to order and/or store the vaccine. Instead, they fax the order to local pharmacies who then order it. It takes two to three months for the orders to be filled because there are so very many of us seniors learning about it and rushing to sign up.

Many of the pharmacies will also give patients the shot right there in the store because transporting it to the doctor's office can be tricky as well. Let the vaccine thaw for more than thirty minutes and you've just blown two hundred samolians. And by the way, this $200 buys you about a half inch worth of vaccine when it's placed in the syringe. Whew. Is it worth it? You be the judge. I'm not a fan of severe pain, and seeing/hearing how shingles affected others was enough to convince me.

So where does Thypoid Mary come in? In case you're too young to know who Typhoid Mary was, (or don't remember all the details, as I didn't until I did an Internet search) she was the first person in the United States to be identified as a healthy carrier of typhoid fever. In the early 1900's Mary, (I'm not using her last name) a young cook, immigrated to America and came into contact with dozens of unsuspecting people as she took jobs in various homes. In EVERY place she worked nearly everyone in the family became seriously ill and some died. Typhoid fever is contracted after the victim consumes food or liquid handled/prepared by a carrier of the disease.

Since Mary was certain she'd never had typhoid fever, she continued to deny she was the cause, even though the disease spread throughout every single family she worked for. Researchers believe her mother had it during her pregnancy and that caused Mary to become a carrier. Thus the term Typhoid Mary came to mean anyone who infects others without suffering the results themselves. Mary's complete refusal to admit she might be the problem, and her continuing to work as a cook and causing severe suffering (and in some cases death) in those around her resulted in her being forcibly quarantined twice in her life. She eventually died in quarantine at the age of sixty-nine. (After her release the FIRST time, she continued to work as a cook, even though she promised not to as a condition of her release. And, yes, those people got sick as well.) At least two men have also been identified during that era as carriers who had not knowingly had the disease.

When I first researched the shingles vaccine, I learned that the vaccine is "live" and therefore I would need to avoid contact with infants and young children who had not yet had chicken pox or been vaccinated for same. Okay, I could do that. We didn't have any small children in our family, and I could easily avoid the infants I routinely come into contact with at church or in public. Couldn't I? Hmmm.

My family doctor ordered the vaccine to be shipped to our local pharmacy in Metropolis, and to my relief, there was someone on hand to give me the vaccine when I arrived to pick it up. No dashing across the Ohio River to Paducah (and risk getting stuck on the bridge IF there was a problem) in order for the doctor's office to administer it. All was well. That shot was probably the LEAST painful I've ever been given, since the giver uses the fatty section of the arm between shoulder and elbow (sigh, she had no difficulty locating MINE.) Yeah, I'm talking about the chicken wing that swings under the arm, below where my muscles used to live. Sigh. But I digress. And I've had no reaction to speak of from the shot. Not even a rash. Back to Typhoid Mary.

After the shot, Hubby and I went to have breakfast and while waiting for my pecan waffle to arrive, I read the mile long warning/instruction paper included with the vaccine. Along with infants and small children, I'm to avoid "close contact" with pregnant women. Okay, I can do that, even though the young woman who sits beside me at church every Sunday and Wednesday night is newly pregnant. I'll simply move to another pew. But for how long? After all, we have at least three pregnant ladies in our congregation, and three or four little ones who are at risk from me, and it's not a large building. The mile long warning paper doesn't specify. I search online, beginning with the company who made my vaccine. Nothing, except the same warnings. I call their 800 number. The person on the other end of the line says: "It depends on the individual." Okay, I pride myself on being an individual, so give me a ball park figure. How long to I avoid close contact? He can't say. Or won't. Urrr.

I call my doctor. Bless her heart, she takes time out of a very busy day and researches my question. But she can't get me an answer either. I call the pharmacy. They also have no clue. I look at the drug company's website again. (You'll notice I'm not mentioning names. I don't need grief from them. I've already shelled out $199 for the vaccine, and I don't have insurance to cover it. But it was worth it, more on that later.) Where was I?

I call a different number at the drug company. This person has no clue either. Sooo, how long do I sit in a different pew? (If you attend church regularly you likely know how very territorial we church goers are, and how we hate having to sit out of pocket.) And since I routinely hug and chit chat with the expectant moms in the bathroom between Bible study and worship, I now have to use the RARELY used potty waaaaay in the back of the building, by the class rooms. Urrr. I have given everyone I might be a danger to a head's up, that they should turn and run in the opposite direction, IF I happen to wander into their space accidentally. They agree (were they a wee bit too eager, or was that just my imagination?) I begin to feel like Typhoid Mary.

After further research, reading/wading through information on the Internet designed for doctors and other care givers about the vaccine, and actually understanding it, I decide thirty days should be long enough for me to be "safe," live vaccine or no. I might wait longer than that to return to "my pew" because I do NOT want to cause problems for the newly pregnant mom. I'm thanking my lucky stars that the vaccine arrived when it did, because she and her family lived with us for nigh onto two weeks after the ice storm that took out their power, so for all of that time we were indeed "in close contact" as the pamphlet-as-long-as-a-roll-of-toilet-paper cautioned against. Luckily they were able to move home just a couple of days before I received the vaccine and learned about the cautions. Did I mention I felt like Typhoid Mary?

I've been surprised to learn how many other seniors are not yet aware of the vaccine. Shingles is a serious threat to all of us over sixty, and sometimes to those who are younger. The side affects of the vaccine are generally mild, bit of a sore arm, etc, but well worth the protection. According to my research, the vaccine doesn't guarantee that everyone receiving it won't get shingles. But while those who do get shingles will have the rash and blisters, the pain will not be as severe. The vaccine helps protect against that. For me, it's well worth the cost, both in money and time. And I can survive a month or so of avoiding those at risk from me. What about you?


Janet Koch said...

Great post. I can see why you felt like Typhoid Mary. And what an effort for you to track down that seemingly basic information. Bizarre.

I ended up with shingles last fall. Thought they were spider bites at first so I didn't get to the doctor until long after the magic shot would have helped me. (I'd decided I had a staph infection and had already chosen the books I'd take to the hospital.)

Luckily it was a mild case of shingles, but the fatigue wore me down until after the holidays. And I still get that cat-scratching-burning pain around my ribs when I get tired. So boring.

Glad you got the vaccine, Lonnie. A month of being Typhoid Mary is much better than the chance of months of shingles!

Lonnie Cruse said...

Janet, did you know you can still take the vaccine IF you wait for three months after having shingles? Might be worth researching for you. Thanks for stopping by!

Sandra Parshall said...

I've known a couple of people who had shingles, but I had no idea it was a special problem for (cough) "older" people. If the vaccine is $200 per dose, I can understand why so few people get it. It's hard for a lot of people to pay basic medical bills these days.

judyalter said...

My experience with the vaccine was very different. My mother developed shingles along her jaw, lost teeth, and was in great pain. So all these years later I asked my doctor. He had it in his office, checked to see my insurance would pay (it would)and gave me the painless shot. No warnings about who I should avoid, including my 16-mos. grandson. I never looked back but am now thinking about the pneumonia vaccine. A whole different story, I suppose.

Anonymous said...

Holy crow, Lonnie. I know what you mean. My partner got shingles over her face and around/under her eyelid. Her doctor had dismissed her eye irritation as a sty and so she took the ferry from Vancouver Island over to the mainland for an agility meet. She could barely make it back. Imagine trying to drive a truck when you're swollen up like Quasimodo. She was in such nerve pain for weeks that she had to beg her doctor for something more than Tylenol 3. He scrawled her a script, tossed it at her, and stormed out of the room. Thanks for posting about this little known but very disabling ailment. And a very few people do get it a second time.

Lonnie Cruse said...

Thanks everyone for your comments. In case I didn't mention it, the shot was the least painful I've ever had. Yes, $200 is expensive, but from what I've heard about the pain, it was worth it. Ya'll take care!