mrs d had two severe attacks of stabbing pain in her brain last night, so I’ve been reading up on PHN. Most of the descriptions of PHN seem to be of completely different symptoms, with only passing reference to occurrences of severe sharp pain. Treatment options seem also to be limited, with Zostavax and tricyclic anti-depressants appearing to be the most successful approaches. The first, as poikilotherm indicated recently, won’t even be back on the market until late next year. The other – I wonder how well it really works?

What I also discovered in my reading is that occasional bouts of extreme but transient tenderness of patches of skin that I have suffered for years do fit the descriptions of PHN symptoms. Weird, ‘cos I have never had chickenpox nor have I ever had shingles.

poiky, OCDC, any ideas on how to ease mrs d’s suffering? It’s bruddy scary to be woken by a loud scream in your ear in the middle of the night.

Farrk! Spelling error in thread title – how embarrassment! Should be, of course, Herpetic

Farrk! Spelling error in thread title – how embarrassment! Should be, of course, Herpetic

yes, post heretic would be more a burning sensation.

Boris said:

Farrk! Spelling error in thread title – how embarrassment! Should be, of course, Herpetic

yes, post heretic would be more a burning sensation.

It could be described as a burning pain, I guess.

Just goes to show how frazzled I am by this shingles malarkey.

>>yes, post heretic would be more a burning sensation.

Gold.

TCAs would be worth a try (good at causing sleep too), not everyone can tolerate them though, just ask OCDC….there are some other options but id go low dose TCA first. Away from home so don’t have any refs, but, there are other things like carbamazepine et al. I’ll have a look on Tue if ocdoc hasn’t turned up.

poikilotherm said:

TCAs would be worth a try (good at causing sleep too), not everyone can tolerate them though, just ask OCDC….there are some other options but id go low dose TCA first. Away from home so don’t have any refs, but, there are other things like carbamazepine et al. I’ll have a look on Tue if ocdoc hasn’t turned up.

Geoff, I have had stabbing pains in my scalp before now. Not sure if that is the same thing. Bloody uncomfortable. My understanding is that they were related to some sort of sinus issue.

morrie said:

poikilotherm said:

TCAs would be worth a try (good at causing sleep too), not everyone can tolerate them though, just ask OCDC….there are some other options but id go low dose TCA first. Away from home so don’t have any refs, but, there are other things like carbamazepine et al. I’ll have a look on Tue if ocdoc hasn’t turned up.

Geoff, I have had stabbing pains in my scalp before now. Not sure if that is the same thing. Bloody uncomfortable. My understanding is that they were related to some sort of sinus issue.

Sorry, I didn’t mean to put that last comment as a quote under poikilotherm’s post.

morrie, these pain episodes have definitely arrived with the shingles. We’ll have to wait to see if they carry on after the shingles has cleared before looking for treatment options.

Post Heretic…..I like this :D

poor Mrs Geoff :( I don’t like the sound of what she is experiencing

I’d go a TCA first-line. Some people notice improvement within days of starting – they’re not acute analgesics – but can take longer. However, the sleepiness can start with the first dose, and if one is sleeping better, pain during the day is less of a burden, IYKWIM.

A lot of consultants like gabapentin but it isn’t PBS for pain IIRC and can need multiple capsules tds, whereas TCAs are usually a single nocte tab that won’t knock one out during the day.

People metabolise them different, so if the SE are too bad with one (generally endep is first up) there are other options. If Mrs D gets drowsy from pan forte, then endep should be fine.

Thanks, OCDC. We’ll see if the episodes fade away or not over the next few weeks. She’s not really post herpetic yet.

If it’s disrupting sleep, it’s probably better to get onto it sooner rather than later, and once the pain settles she can wean off.

OK, if more episodes tonight & tomorrow night, it’s off to the GP on Tuesday.

Geoff D said:

mrs d had two severe attacks of stabbing pain in her brain last night, so I’ve been reading up on PHN. Most of the descriptions of PHN seem to be of completely different symptoms, with only passing reference to occurrences of severe sharp pain. Treatment options seem also to be limited, with Zostavax and tricyclic anti-depressants appearing to be the most successful approaches. The first, as poikilotherm indicated recently, won’t even be back on the market until late next year. The other – I wonder how well it really works?

What I also discovered in my reading is that occasional bouts of extreme but transient tenderness of patches of skin that I have suffered for years do fit the descriptions of PHN symptoms. Weird, ‘cos I have never had chickenpox nor have I ever had shingles.

poiky, OCDC, any ideas on how to ease mrs d’s suffering? It’s bruddy scary to be woken by a loud scream in your ear in the middle of the night.

you might be better off going down the hospital and seeing if you can get someone to prescibe something more powerful.

The pain is transient – gone in a couple of minutes. Rushing off to the hospital in the middle of the night is not in keeping with my plan of trying not to further stress the dear lady.