June 29, 2014

Shingles, and not the roofing kind

So, I get a shingles diagnosis to add/confirm to the feeling of getting old. Even though I guessed right on my diagnosis, I really didn't know much about it (other than it side-lined David Letterman a few years back). The quick stuff I read before heading to the doctor was not encouraging. I will dig more into it, but here is what I know so far.

Shingles is caused by the virus that gave you chickenpox as a kid. In some people, it reactivates later in life, causing shingles. From WebMD,
"Early symptoms of shingles include headache, sensitivity to light, and flu-like symptoms without a fever. You may then feel itching, tingling, or pain where a band, strip, or small area of rash may appear several days or weeks later. A rash can appear anywhere on the body but will be on only one side of the body, the left or right. The rash will first form blisters, then scab over, and finally clear up over a few weeks. This band of pain and rash is the clearest sign of shingles." 
After reading that, I went down my own list of symptoms. I definitely had the pain, red rashes and it was only affecting my right side. After clicking on a few pictures of sample rashes (I will spare you), it seemed like I was a candidate, even though the rashes more typically shows up on your torso first. Off to the doctor.

After looking me over, and asking a few questions, he confirmed that it was shingles. I don't have a regular doctor, so I wasn't sure how this guy would react to a patient coming in with his own diagnosis. I am sure with the ease of access to information, they get flooded with amateur doctors pretending to know what they are doing after ten minutes on the Internet. Unprompted, he said he appreciated how involved people are in this area in managing and researching their health. We chatted for a bit and he filled me in on what to expect.

Shingles is a viral disease. Once your bout of chickenpox runs its course, the virus remains latent in your nerve cell bodies. Years or decades later, the virus can break out of the nerve cell bodies and travel down the nerve to cause a viral infection in the skin area served by those nerves. The infection can spread within nerve cell clusters, but seems to stay to one side of the body (beyond my understanding of anatomy to know why).

The skin infection becomes painful, I assume because the infection is in the nerve. The rash eventually blisters, and this is when it could be contagious if someone were to come in contact a broken blister. From what the doctor said, though, the chickenpox virus is all around us already, so there is no need to really quarantine yourself.

He confirmed those phrases that no one wants to see connected with what they have - "we're not sure what causes it (the outbreak after dormancy)" and "there is no cure". The regimen is about trying to minimize and shorten the symptoms. I am on an anti-viral medication as well as a corticosteroid for the next week or two. The doctor said that the addition of steroids is somewhat controversial (in that the benefits are not clearly proven), but he said that on a risk/reward basis, the steroids could reduce the incidence of scarring and other long-term effects. He also said if I get snippy with someone, I can blame it on him/the steroids. I am thinking about having cards printed up.

The pain and rash typically subside within three to five weeks (your results may vary). The concern, beyond some possible scarring, is a condition called, Postherpetic neuralgia, a condition of chronic pain following a shingles outbreak. This apparently happens in one out of every five people, though more frequently in those over 60. Per Wikipedia, it affects closer to ten percent of those under 60. Postherpetic neuralgia is the damage to the nerves in the skin where the rashes appeared, causing them to send abnormal signals to the brain. "These signals may convey excruciating pain, and may persist or recur for months, years, or for life." Here's hoping I am not one of the 10%.

So, now you know as much as I do. It definitely hurts, with a lower-grade ache punctuated with some stabbing pain, and a burning sensation at the rash points. I am hoping that the anti-virals and steroids cut the time it takes for shingles to run its course, and really hoping there are not significant lingering effects. For now, since one of the hot points is in the palm of my right hand, I will work on improving those ambidextrous skills.

Cresting the rise

I have been feeling broken down lately. I have plantar fasciitis pain that has kept me from running for two months. I am currently wearing a boot to bed to try to keep the tendon stretched out. My right wrist started hurting the other day, so I had my carpel tunnel brace on as well. Pieces of me encased in hard plastic to keep me from hurting myself while I am sleeping. Danger, fragile!

On the last couple of bike rides, I have felt like I just don't have it anymore. I was climbing the last hill on the Seven Hills of Kirkland ride last month, which was actually the ninth hill because we opted for the longer route. I was really struggling. It is a difficult ride, but one I tackled well last year. As I tried to will myself up the hill, I wondered if my peak days were behind me. Was I now "over the hill" physically now that I can't climb this one. There was another tough ride a couple weeks later that felt harder than it should have been.

Intellectually, I know the day is coming where the times on the stopwatch will only increase. There will be no further personal best times, and the challenge of events will become something else. I do want to be that 75 year-old guy that is still out there running, and showing up at 5ks for the enjoyment of it all, race times be damned. Emotionally, though, I am not quite ready to give up. I still want to feel like I am on the up-slope of that metaphorical hill, even if I am climbing it more slowly.

Everyone has their own definition of when they are "old". Maybe it is a number, maybe it is an activity you no longer can do, or it could be the number of pills or splints it takes to keep you moving. My semi-joking line is that when I no longer sleep in a tent with just a Thermarest between me and the ground, then I will feel old.

I tested my "old" theory again this weekend. A few of us went on a "test" hike before our return to Delta Lake in August. A couple of us wanted to test out our new packs, and we all wanted to check our fitness  level before scrambling off the maintained trail. We hiked to Copper Lake, no small undertaking in itself, but ended up getting rained out and coming back early. It turned out to be a good thing.

My right arm had been bugging me for a couple of days. It felt like a nerve pinch starting in my shoulder, maybe from planks I had been doing during June. Thursday and Friday, I started noticing red blotches on my arm and hand. They were more painful than itchy, and I jumped online to check on the symptoms. There was a recent measles outbreak in Washington (thanks anti-vaxers), as well as an increase in Lyme disease from tick bites (though I hadn't made it to the woods yet). Nothing quite lined up, so I headed to the hills Friday morning.

Sunday morning, the pain and blotches were joined by some numbness in one finger, and swelling in another. Another possibility dawned on me, and after some more WebMD surfing, it was off to Urgent Care. My Internet research turned out to be right, unfortunately (I hate it when I'm right). I have shingles.

More on what that means in the next post, but just the diagnosis of "shingles" has me feeling pretty old. I am not giving up on on that hill just yet, but it does feel like I am starting to crest the rise.

June 15, 2014

Father's Day

There are many reasons Father's Day seems to play second fiddle to Mother's Day. First, the stereotype that moms are much more involved with the children holds true in my made up figure of 89.3% of American families. Moms do more, so they deserve more of our thanks. Another is that (again stereotypically) guys are not as easy with expressing or receiving gratitude and emotion. Just doing my job folks, no need to make a big deal out of it, and save the money, it doesn't grow on trees you know.

I have mentioned several times here and elsewhere how fortunate I am in my family, and I was reminded about it over breakfast this morning. I still haven't stocked the fridge after house/dog sitting for three weeks, so I went out to the local breakfast joint. I sat at the counter as I always do. Many families were out to celebrate over pancakes and bacon, but at my end of the counter, it was mostly single guys. 

The guy to my left was a bit younger than me. He appeared to be a regular, and was also named Sean. Many knew his name, so I kept looking up whenever he was greeted. To my right was a man not quite my Dad's age, but definitely a generation up. Where Sean was pleasant and engaging, the older man was brusque and gloomy. He swatted away normal conversation like circling flies, and talked over the waitress as if she were an impediment. 

When the waitress brought Sean his bill, she asked him if he was doing anything with his dad later in the day. Sean sort of chuckled a "no" and went on to explain that he hadn't spoken to his dad in years. He thought for a moment, and said the last time he called his dad was 1999, and the conversation did not encourage another call. I felt bad for Sean, and wondered if the clipped speech of the man to my right was avoiding the mention of Father's Day for a similar reason. 

So much of who I am is tied up in my parents. No need to discuss nature vs. nurture, as they were the major players in both. As is often the case, as I get older it is easier to see myself in my folks, or really them in me. Traits, mannerisms, ways of thought and speech. It is a common trope to freak out when you end up becoming like your parents, but I do not have those kinds of fears. 

I see in him my critical thinking, not satisfied with the trite answer. He gave me my love of books, though it did take a while to sink in. I see in him my belief in the system, as flawed as it may be at times. That it is not this separate entity, but an amalgamation of all of us, and that it fails principally when we don't take part. 

I think my love of the outdoors can be traced back to Dad as well. We went camping before I can remember, and on hikes when I was old enough to climb up a hillside (though probably not without a little whining). I have this flicker of a memory of him trying to cook Huevos Rancheros over a tiny pack stove, though I can't swear whether it was real or of the freeze-dried variety. He won't lay claim to any of the "crazy" running or biking I do, but I think the seeds of just getting outside were planted early. 

And my desire to write came from Dad. I can't exactly trace this one, but I know it is there. I didn't grow up reading anything he wrote (that didn't come until blogging took hold), but somehow I knew he wrote, and that it was important. He may be why I wrote journals in my twenties, and blogged in my forties. The desire to write a book someday may have started with him, and I was glad to have him as one of my first readers. 

There have been other influences that tweaked the path I have taken, and who I have become. Some may have been improvements, while other pieces probably aren't as good as the original version. I don't know what it is like to be a parent, and I can't swear to how it all gets passed down, but I feel pretty proud to be a blend of both Mom and Dad.

I was trying to take some notes on my phone at a stop light, and used the voice recognition to do the typing. When I said "Father's Day", the choices I was given were "Mothers Day", Mother's Day" and "Mother's Day in the UK." We are all a bit better at thanking mom, and apparently the database needs a bit of updating. Maybe Father's Day is more important in that respect. A spot on the calendar to say what we don't always say, and maybe things that dads would normally shrug off so as not to get all deep and fuzzy. 

So, we'll keep it simple. Happy Father's Day Dad. You are one of a kind, and I am glad you are mine.