Last Thursday I took Phoebe to the pediatrician with what I thought was a nasty case of poison ivy. Traditionally, we spend Memorial Day weekend down the shore with my family. I felt confident that the good doctor would hook me up with some ointment and antihistamines and I would leave the rest up to what my grandmother calls “the healing powers of salt water.”
Little did I know that I was about to get sucked into a week-long circular conversation that felt like a medical version of Abbot and Costello’s “Who’s On First?”
It all began with…..
Conversation #1: The Diagnosis- Jessie and Dr. #1
Doctor: “Has she had the chicken pox?”
Jessie: “No. She had the first vaccination. My husband had shingles recently, though.”
“I think this is shingles.”
“What? How? But my husband wept like a schoolgirl was in a lot of pain.” (as we watch a naked Phoebe gallop around the room making pony noises).
“I don’t know. I just know this is shingles. It’s following a singular nerve path.”
“So she caught it from my husband?”
“Well, you can’t catch shingles from shingles.”
“Huh? You can’t get shingles from shingles? Then how do you get shingles?”
“From a dormant virus that stores itself in the spine.”
“Oh…ok…well, we were supposed to go down the shore this weekend with my family…but you are saying that won’t be a problem? It’s not contagious, right? Since you can’t get shingles from shingles?”
“Well, it is contagious if someone who has not had the chicken pox comes in direct physical contact with the actual blisters of the person with shingles.”
“So then that person would get shingles?”
“No, they would get the chicken pox.”
“Oh. Ok, well my 93 year old grandmother is going to be down the shore, but I don’t need to worry about her, right?”
“93? Oh no, I wouldn’t risk that.”
“But she’s had chicken pox. So she can’t catch chicken pox from shingles because she’s already had them. And she can’t get shingles from shingles. Right?”
“I just wouldn’t take that chance.”
“What chance?”
“Of getting shingles.”
“But…..(sigh)…ok. Thanks.”
Go home. Explain to Phil that I feel like I may have been brainwashed or hypnotized by the pediatrician, as I feel dumber for having talked to him. Phil takes matters into his own hands and calls the 24 hour nurse hotline.
Conversation #2: Phil Calls the Nurse
Nurse – “I am glad to help where I can Mr. Braun, it is certainly unusual for a 2 yr-old to get shingles.”
Phil – “My first question is how did she get this – I had shingles, did she get it from me?”
“Well you can’t get shingles from shingles. In fact, she would have needed to have had chicken pox to get shingles. Perhaps she had undiagnosed chicken pox.”
“Could she have gotten chicken pox from the vaccine?”
“Let’s see. She was vaccinated in Sept 2010 so that is not likely.”
“But if the chicken pox went undiagnosed then how would the date be…(sigh). Ok.”
“When did you have shingles, Mr. Braun?”
“Right before Easter.”
“Well that is outside the 21 day incubation period for the shingles virus.”
“Wait, I thought you can’t get shingles from shingles.”
“Unless she had chicken pox. You know what the best source for info is on this… CDC.gov.”
(Both pull up website) Nurse: “Ok here: Shingles cannot be passed from one person to another.”
Phil – “Then do we need to keep her away from other people, or no?”
“Oh, yes, you do not want anyone to touch the shingles for concern of transmission.”
“Even people who are already been vaccinated or have had the chicken pox.”
“I can see you are having a hard time wrapping your head around this Mr. Braun.”
Sigh.
Conversation #3: The Second Opinion- Jessie and Dr. #2
“Hi, we were in yesterday and the doctor said that Phoebe had shingles, but I guess I am still having trouble really understanding how that is possible. My husband had shingles 8 weeks ago so I thought she got it from him, but the nurse said the incubation period is only 21 days. Which really shouldn’t matter anyway, because you can’t get shingles from shingles…right?”
“I would agree that she has shingles.”
“Ok, but how did she get it?”
“Well, you can only get shingles if you have had the chicken pox. So she must have had a mild case of the chicken pox and you just didn’t know it.”
“How do we know this isn’t the chicken pox?”
“Because chicken pox typically begins on the trunk and then spreads out. It doesn’t stay in one concentrated area. Although if you get the chicken pox after the vaccine, the vaccine changes how the virus presents itself, so all bets are off.”
“She’s had the vaccine. So if all bets are off, couldn’t this be chicken pox?”
“No, it’s shingles.”
Sigh.
“So will Phoebe still get the second chicken pox vaccine when she is 4?”
“Well, she may be immune at this point. Unless of course she gets it again. So yeah, probably.”
“(sigh). Ok…well, we planned to go away this weekend but the doctor yesterday said we shouldn’t expose Phoebe to my 93 year old grandmother, even though my grandmother has had the chicken pox….which means she couldn’t catch the chicken pox from Phoebe’s shingles. So if you are sure that this is shingles…and you can’t get shingles from shingles….”
“93? Oh no, I wouldn’t do that. I mean, why take the chance?”
So, if you ever get shingles, here is all the information you will ever not need:
Shingles (Herpes Zoster): a painful blistering rash due to the varicella-zoster virus, the same virus that causes chicken pox. Most cases of shingles occur in people age 6o and over, patients with cancer or AIDS, people on immunosuppressive drugs, and healthy 2 year old girls. People who get shingles are then immune to the virus. Except for the people who get it like 5 or 6 more times.
Causes: After a person has the chicken pox, the virus remains dormant in certain nerves of the body. That virus can reactivate years later as shingles. But your dormant virus can’t be activated by someone else’s now active virus, unless you rub up against his/her open wounds on the 3rd Sunday of the month during a harvest moon when Saturn is in the 5th house. Then you could get it. Maybe.
Prevention: Chicken pox must be prevented in order to prevent shingles. Unless you never get chicken pox and then hang out with someone with shingles, in which case you will get chicken pox, and then maybe a few years down the road, get shingles. Randomly. Not from the original schmuck who gave you the chicken pox from his/her shingles. The chicken pox vaccine greatly reduces the risk of developing shingles, except in the cases when it actually causes it.
