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.

So here's the doctor's diagnosis:

• Hyponatremia

• Shingles with Ramsay Hunt Syndrome

Hyponatremia or low blood sodium

This is a condition wherein you don't have enough sodium in your blood. We need some sodium in our bloodstream to control how much water is in and around the cells in our body

Symptoms

Hyponatremia signs and symptoms may include:

• Muscle weakness, spasms or cramps

• Nausea and vomiting

• Headache

• Confusion

• Loss of energy, drowsiness and fatigue

• Restlessness and irritability

So Mum lately don't have much power in her. She gets tired easily just by standing for few minutes. And at night she had cramps and her head is always light.

Shingles

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.

How long Shingle Lasts

The doctor says it can take up to 4 weeks for the rash to heal and the skin can still be painful for weeks even after the rash has gone but eventually gets better in time.

Is Shingle Contagious?

The doctor said it's NOT contagious. You cannot pass your shingles to others but those who have not had chickenpox before could catch chickenpox from you.

When people get chickenpox, that virus remains in our body. Then it can be reactivated later and cause shingles especially if their immune system is low.

Ramsay Hunt Syndrome

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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.

How long Ramsay Hunt Syndrome Last

You will get better completely within a few weeks if there's not much damage to your nerve. And you may not fully recover if the damage is more severe.

That is why it's very important to see the doctor immediately if you have the symptoms and get treatment within 3 days for your chance of recovery is better.

Source:

https://www.mayoclinic.org/diseases-conditions/ramsay-hunt-syndrome/symptoms-causes/syc-20351783

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.

Remember

If you know someone experiencing the symptoms, let them see the doctor immediately. The early treatment you get, the chance of recovery is better and to avoid further complications.

Thank you for reading!