Stressed to Shingles

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The Itch

It started small; a spattering of circular bumps on my right breast. I assumed they were mosquito bites—it was summer in Yellowknife, a time when mosquitos infest the city. Bites were unavoidable, the bugs always managing to get you in the most uncomfortable places—in your middle back right where you can’t reach, or on your underwear line so that scratching in public is taboo. When I noticed the cluster of bumps on a Thursday evening, I thought nothing of it. Sure, they were itchy, but they were bug bites. Of course they were itchy.

For the next few days I continued to scratch at the bumps, until Sunday, when I got out of the shower and checked them out in the mirror. The five or six little bumps had multiplied, and there were now about 15, travelling in a line that started beside my right nipple and extended towards my armpit.

The next day I went to the drop-in clinic. The rash had spread from my armpit to my back. Is it leprosy? What should I put in my will? Who gets my DVD collection? Sitting in the waiting room, I noticed a tall, blond, young male doctor walk into an office. Please, please don’t let me have him as my doctor.  

I followed a nurse into the first office on the left. She gestured for me to sit down and assured me that my doctor would be with me in a moment. She did not specify the gender, or level of attractiveness, of this doctor. Please, please don’t give me the hot doctor. 

I was relieved to find that my doctor was not only a she, but looked about 40, and had out-of-control curls and a generous smile. After a thorough inspection of my chest and back she said she thought it was shingles but wanted a second opinion because I was so young.

She returned moments later with the blond doctor. I had never been fond of my A-cup chest, but now that one of my boobs was engulfed in red, blistery clumps? “It doesn’t always look like this,” I mumbled, and lifted my shirt up to my neck. He appraised the situation for all of 10 seconds before saying, “Yep. That is definitely shingles.”

I dropped my shirt, he left the room, and I had my diagnosis.

The Prognosis

Shingles, or “herpes zoster,” is a viral infection that causes a blistering rash. It is caused by the Varicella zoster virus—the same infection that causes chickenpox, but is usually found in people over the age of 60. Only someone who has experienced chickenpox in the past can develop shingles.

I had chickenpox when I was three. There’s a picture of my older brother and me, in our underwear, grinning and covered in the pox. What I didn’t know, though, is that after a chickenpox infection, the virus retreats to the roots of the body’s nervous system and hibernates there. Most of the time, the immune system keeps the virus under control inside the nerve cells. But, under certain circumstances, usually associated with illness, trauma, or stress, the virus can reactivate, escape the nerve cells, and travel along the nerve path to the skin. The infection follows a sensory nerve, which means shingles will occur only on one half of the body.

Interesting, I guess. But for me, the classic manifestation of the shingles made it impossible to find a way to sit comfortably, due to the way the blisters formed a line from my right breast to the middle of my back, and that put my stomach, side, and back off limits for comfortable sitting. If you looked at the left side of my body, I looked completely normal. Like Harvey Dent from Batman, I definitely had a better side.

If shingles was supposed to happen to people in their 50s, why did I get it? During my appointment, the doctor asked if I was stressed. I admitted to several sleepless nights. In two weeks I would be moving back to Victoria for my final year of university, and the hard work ahead was consuming my thoughts. It’s your last year, don’t screw it up, was on repeat in my head, and it was getting to me. She nodded, explaining that stress and exhaustion can weaken the immune system and increase the chance of contracting shingles. This got me wondering, does the stress of university increase a person’s chance of getting shingles?

A clinical trial in the 1999 publication Neuropsychobiology investigated how the stress of academic exams impacts the immune system of university students. In the study, 38 students gave regular blood samples throughout the course of the school term. Researchers then compared the relative number of white blood cells (cells that defend the body against infection) from the regular school week to the number present during exam period. What they discovered was that as the students became increasingly stressed leading up to exams, the white blood cell count dropped, resulting in a weakened immune system.

 

Although the diagnosis of shingles was a bummer, I was confident that the doctor would prescribe me some magical ointment and I’d be on my way. Unfortunately, though, I had seen the doctor too late.

If shingles is diagnosed within the first 72 hours, an antiviral medication can be prescribed to reduce the severity of the illness and improve the healing response to the blisters. There are three dominant antiviral medications: Zovirax, Famvir and Valtrex. These medications prevent the virus from spreading beyond its host cell, which stops the virus from penetrating other cells and infecting more skin. Since I first noticed the bumps on Thursday, and it was already Monday afternoon, I wasn’t diagnosed soon enough for the medication to be effective.

I left the doctor’s office dejected, heading home instead of back to work. I was contagious to anyone who hadn’t had chickenpox and had been instructed to stay away from babies and pregnant women. I trudged up the stairs to the house and put a sign on the door reading, “Welcome to the Shingles Shack: Where Dreams go to Die.”

Dr. W. Dyson serves as a physician at the University of Victoria Health Clinic. Dyson said that stress can play a major role in contracting shingles. He explained that despite the common perception that shingles only affects the elderly, he has students come in every week presenting the condition.

According to the Encyclopedia of Women’s Health, in 2004 only five per cent of people under the age of 65 years old have a history of shingles. If that is true, and the University of Victoria has students in that demographic manifesting symptoms every week, it appears that post-secondary schooling may be a fast-track to infection.

When asked how to avoid stress-related shingles, Dr. Dyson answered, “The first thing you can do is not have had chickenpox, [but] it’s difficult to undo what’s happened in the past. Being a student, there’s a lot of stress you can’t avoid. School is structured to cause stress, it seems.”

For university students, the exam period signifies a one- or two-week ordeal in which courses are wrapping up, and all that stands in the way of freedom is a series of exams that evaluate students’ understanding of an exhausting breadth of course material. As if that isn’t stressful enough, we now have to stress about stress making us sick for our exams.

The Quarantine

After arriving home from the doctor that Monday, I decided having shingles wouldn’t be that bad. With my parents at work, I set up shop on the couch with an ice pack propped against my chest to ease the stinging and watched three romantic comedies, one after another. After sufficient exposure to teen romance, I went to bed mildly annoyed with the shingles diagnosis, but figuring things could be a lot worse.

And then they were.

The next morning I awoke to a crushing headache, feeling as if I spent the past eight hours wearing a helmet three sizes too small. I lifted my shirt to discover that the blisters were now flaming red and filled with pus.

I didn’t dare attempt to put on a bra, instead settling for a baggy promotional t-shirt from TD Bank. I spent the day popping Advil, taking baths sprinkled with Epsom salts, and applying calamine lotion to my rash-ridden skin. Periodically, I would phone Mom at work, usually catching her during a meeting, to cry about the unfairness of the situation. “This is supposed to happen to old people. If anyone should have this it should be you, not me!” I whined.

After two sleepless nights, I hit my low point. It was 4 a.m., and I lay naked and sobbing in a partially filled bathtub. I had already taken four baths that day, and the hot water tank was empty. Mom stood outside the tub with another pot of boiling water. I curled my knees into my chest, and she poured the water slowly into the tub with oven-mitt covered hands.

“Are they hurting really bad?” She gestured to the enflamed blisters.

“What the hell do you think? Of course they are! I haven’t slept all night because all they bloody do is hurt and itch and burn and I can’t take it anymore!”

Then I felt bad. It was 4 a.m., and she could have been sleeping, but instead, she was in here with me, wearing her nightie and oven mitts, listening to me complain like I had been for days.

The Aftermath

One week after my diagnosis, I boarded a plane to return for my final year at UVic. I had been warned that as long as the sores were blistering I was still contagious, and I was well aware that beneath my four layers of tank tops, the rash was still festering. I avoided eye contact with the airport security officer, worrying she could sense my unease, nervous that the scanner would cut through the fabric and identify the raw infection beneath.

Nearly three weeks after the first bumps appeared on my chest, the last of the sores crusted over, which was timely because classes were starting the next day. I was no longer contagious, and I was relatively pain free. I could even wear a bra again (which was less of a win than I expected; I had been enjoying the freedom of the baggy t-shirt). My life was mostly back to normal, except for the faded scattering of dots across my breast and back. 

To avoid shingles, an effective preventive measure is to receive the varicella (chickenpox) vaccine during childhood. The vaccine helps prevent chickenpox in those who have not had it, but can also prevent shingles. A person over the age of 13 who did not receive the chickenpox vaccine as a child can receive two doses of the vaccine Varivax, which is available at most university health services across the country.

I could attest to the stress associated with university. With exams, assignments, and presentations all on the go, it was hard to keep it all in check, and now I had an added worry: what if I got shingles again?

When I asked Dr. Dyson about this, he assured me that because I recently suffered from shingles, my immune system was now activated, so I shouldn’t expect a recurrence anytime soon. That being said, he suggested that if students notice a rash on their skin and experience unexplained itching, they should visit their campus health clinic as soon as possible.

Dr. Dyson said that when young people develop shingles, it is a message from their bodies—a sign that we need to slow down and take care of ourselves. “I think we should learn to live with less stress. So I think [shingles] is a good signal that you could do better [in terms of stress reduction], if you put your mind to it.”

As for me, it has been nearly two months since I noticed the first bumps on my chest, and I still have faint scarring along the entirety of the infected area. I have grown accustomed to the “ring of fire” style bumps that curve around my right breast, and I try to ignore the patchy pattern that skirts halfway across my back.

Now, when I look in the mirror, I can see my stress written on my skin. The faint scars offer me a reminder that while school is a major part of my life, staying healthy is more important.

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