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My mother-in-law who is 88 years old was complaining that her head down to her neck was painful. We also notice some rashes on one side of her face, ear and neck. It happened during the weekend and Bank Holiday Monday was approaching so we have to wait for Tuesday to phone the doctor. We told Mum that we're going to take her to the hospital so they can get it check. She wasn't able to sleep at night and she was pretty upset. She said maybe she will be okay tomorrow. She doesn't want to go to the hospital and keep saying "she's old, the hospital wouldn't want her there".
Tuesday. The Doctor phones back after we book for an appointment and gave Mum a prescription that didn't help her to at least deal with pain. It's not helpful if you're only talking to the doctor over the phone because some people don't know what to say and how to explain what they are going through. But still, because of covid around, you can't just see your doctor and even booking for appointment to talk to the GP is challenging. This Mum's case must be seen not heard.
The next day, she feels worst and started crying. She doesn't feel good at all, didn't sleep for 4 nights. We tried our best to persuade her to go to the hospital. She said no at first but say yes after.
It took 7 hours of waiting before Mum was able to see the doctor in the emergency department. The doctor was very good and very nice. Before she did anything she asks Mum questions:
regarding the pain like on a scale of 1-10 and 10 is the highest, how painful it is?
How long is this going on?
Did she have this before?
Some questions I have to meddle when I know Mum didn't say the correct answer as I know she forgets some things.
After asking her important questions, she checks Mums coordination skills first: her eyes, arms and legs. Then check her rashes from her head down to her back. She also checked the inside of her mouth and ears.
Then she said, "It looks like Shingles to me." So she wants to run a CT Scan to make sure that there's no rash on the inside of her ears as she wasn't able to have a good look at it as Mum said that it's painful whenever she put her device on her ears. For another hour we wait for her to get the scan. The doctor also said she has to discuss it with other specialists for her eyes and ears. Had the scan and while waiting for the result the doctor takes Mum inside to check her eyes further using the Snellen Chart.
The CT Scan came out fine, everything is good but the blood test shows that her sodium just like the last time that she was hospitalized drops again, which in medical terms is called Hyponatremia.
Shingle is an infection caused by the same virus that causes chickenpox and it's most common in older people, though everyone can get it. The first symptoms of shingles can be:
painful or tingling feeling in the area of skin, blotchy rash on 1 side of the body
sorehead or feeling generally unwell.
You must go to the doctor within 48 hours that the symptoms started because the doctor said they can give medicine within that time frame that can help speed up the recovery which cannot be given in Mum's case as it is more than 2 days.
Ramsay Hunt syndrome (RHS) is a peripheral facial nerve palsy accompanied by an erythematous vesicular rash on the ear or in the mouth. Ear abnormalities such as tinnitus or ringing in the ear and loss of hearing are also present.
This syndrome happens when shingles affect the nerves in the face close to either one of the ears. It is a condition caused by a virus called herpes zoster oticus. Chickenpox which is common in children is caused by a general varicella-zoster virus. The virus reactivates and causes shingles if you've had chickenpox in your life.
Both shingles and chickenpox are most recognizable by a rash that appears in the affected area of the body. Unlike chickenpox, a shingles rash near the facial nerves by your ears can cause other complications, including facial paralysis and ear pain. When this happens, it’s called Ramsay Hunt syndrome.
If you get a rash on your face and also start noticing symptoms such as facial muscle weakness, see your doctor as soon as you can. Early treatment can help make sure you don’t experience any complications from Ramsay Hunt syndrome.
Mum was admitted to the hospital. After 25 hours she was discharged and given prescriptions which she has to take for a week.
She was prescribed steroids, Aciclovir and Lansoprazole on top of her other medications. It's her 3rd day of treatment and she is still sore and generally unwell. If you're in the UK make sure that you get the Shingle Vaccine. Shingle vaccine is available for the '70s and over. It's just that Mum didn't know about it. For those in other countries and worried for your beloved elders do check your local health centre or ask your doctor regarding the vaccine for shingles to make sure they don't get through this horrible experience. It's really that painful and especially for old people.