DEAR DR ROACH: I’m 60 years outdated now. I by no means had rooster pox as a toddler however was examined as an grownup, and I do have the antibodies. I’ve been on a typical dose of acyclovir for 15 years after I had a extreme neurological response to a possible however unconfirmed herpes simplex an infection.
My physician mentioned there’s proof that upkeep acyclovir seems to forestall shingles from creating. I imagine she additionally mentioned that I must cease taking acyclovir across the time of the vaccine, and it is a very scary thought, given the severity of my response 15 years in the past. (I nonetheless have important neuropathy with lesions on my spinal wire.)
So, we determined in opposition to giving me the shingles vaccine. Do you agree with this strategy? How sturdy is the proof that upkeep acyclovir prevents shingles outbreaks? — A.G.
ANSWER: I discovered a handful of research that confirmed a profit to the prevention of shingles; nonetheless, the dose was a lot larger than what would usually be used for herpes simplex — 800 mg each six hours. The dose generally used for stopping herpes simplex (generally 400 mg twice day by day or 200 mg 5 occasions day by day) isn’t more likely to be excessive sufficient to forestall the zoster virus, which is considerably extra proof against acyclovir and associated medicine.
When it comes as to whether acyclovir must be stopped, I assume your physician was pondering of the outdated shingles vaccine, Zostavax. It was a stay vaccine, and acyclovir did should be stopped earlier than receiving the vaccination. This shouldn’t be the case with the brand new recombinant vaccine, Shingrix, which I strongly suggest for you.
Another reader requested whether or not the Shingrix vaccine would make genital outbreaks extra doubtless. I discovered one examine that confirmed some safety from genital herpes outbreaks following a vaccination for zoster, however most research confirmed neither profit nor hurt. There is not any purpose to suspect that there can be hurt, so I like to recommend that folks with genital herpes get vaccinated for shingles simply the identical approach as the overall inhabitants.
DEAR DR. ROACH: I had whooping cough as a toddler, regardless of being vaccinated. I appear to have a very deep cough each time I get the flu. As an aged grownup, I now have an issue of coughing, a lot in order that at occasions, I’ve hassle catching my breath. If I handed out, would my common respiration return? It’s regarding if this could occur whereas I’m alone or driving. — L.W.L.
ANSWER: Some folks have a strong cough reflex with nothing significantly incorrect with them, however frequent coughing can point out a lung downside. A extreme lung an infection, particularly at an early age, can lead to a point of lung damage, so it might be worthwhile getting your lungs evaluated. Both X-rays or CT scans and lung testing by respiration exams (pulmonary perform testing) present worthwhile data.
In the uncommon case that folks move out from coughing, the mind has mechanisms to restart regular respiration. However, it’s nonetheless not a good suggestion to move out whereas driving!
Dr. Roach regrets that he’s unable to reply particular person letters, however will incorporate them within the column each time potential. Readers might electronic mail inquiries to ToYourGoodHealth@med.cornell.edu or ship mail to 628 Virginia Dr., Orlando, FL 32803.
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