Shingles
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Shingles key facts
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Shingles (herpes zoster), is a viral infection caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox. After a person has had chickenpox, the virus can remain dormant in the body for many years. However, the virus can become reactivated later in life, leading to shingles. Here, we will take a closer look at the causes, symptoms, treatment, and prevention of shingles.
Understanding shingles
Shingles is caused by the reactivation of the Varicella-Zoster virus in the body. It mainly affects adults over the age of 50, but children can also be affected. The virus can remain inactive in the body in nerve tissues near the spinal cord and brain after a person has had chickenpox, but certain factors such as stress, or a weakened immune system can trigger the virus to reactivate, causing shingles. The exact reason for reactivation is not known, but it is more common in older adults and those with a weakened immune system.
Risk factors for shingles
Shingles is more common in adults over the age of 50. Individuals with weakened immune systems, such as those with HIV or AIDS are also at a higher risk of developing shingles. Those who have not been vaccinated against chickenpox and have never had chickenpox are also more likely to develop shingles.
Symptoms of shingles
Symptoms of shingles include:
- Shooting pain, burning, tingling
- Itching in a specific area of the skin
- Painful rash on one side of your body or face
- Fluid-filled blisters that eventually scab over and heal within a few weeks
- Flu-like symptoms such as fever, headache, and an upset stomach
Some individuals may experience symptoms without developing a skin rash.
Complications of shingles
Common complications include:
- Postherpetic neuralgia (PHN), which causes severe pain in the area where the shingles rash occurred
- Eye problems and vision loss
- Hearing or balance issues
- Bacterial skin infections
- Neurological complications such as encephalitis (if the virus spreads to the brain or spinal cord)
Diagnosing shingles
Diagnosis is typically made by a physical examination and medical history review. In some cases of shingles a small sample of fluid from the blisters may be tested to confirm the Varicella-Zoster virus is present, to help differentiate shingles from any other skin conditions.
Treatment options for shingles
Shingles is not curable, but treatments are available to alleviate the symptoms and promote faster healing aswell as the prevention of complications.
- Antiviral medications include aciclovir, famciclovir, and valaciclovir, to help reduce the duration and severity of the infection
- Painkillers, such as ibuprofen may be used to manage nerve pain and help reduce any discomfort
- Topical creams, lotions, cool compresses, and oatmeal baths may also provide relief from itching and discomfort
- Keeping the rash clean and dry to prevent bacterial infections
Prevention: Vaccination
Two vaccines are available:
- Shingrix: This is the preferred vaccine and is recommended for individuals aged 50 and older. The CDC (Centers for Disease Control and Prevention) recommends to administer Shingrix as two doses. Shingrix is more than 90% effective at preventing postherpetic neuralgia and shingles
- Zostavax is recommended for adults aged 60 and older
Who should get vaccinated
Immunization is recommended for:
- Individuals aged 50 and older, whether they have had shingles in the past or not
- Those who have previously received the Zostavax vaccine
The vaccine is generally safe, but pregnant women or breastfeeding women, those with severe allergies to vaccines, or those with active shingles, should speak to their healthcare provider before getting vaccinated. If the chickenpox vaccine is given before a child gets chickenpox, the risk of shingles can be reduced.
Side effects and risks of the shingles vaccine
Serious side effects from the shingles vaccine are extremely rare. However, potential allergic reactions include:
- Swelling of the face or throat
- Difficulty breathing
- Hives
- Fast heartbeat
Seek immediate medical attention if you have any of these symptoms after receiving the vaccine.
Zostavax is a live vaccine and may not be suitable for patients with weak immune systems or certain medical conditions. Speak to your healthcare provider about your medical history before receiving the vaccine.
Additional measures for prevention
To reduce the risk of shingles:
- Maintain a healthy lifestyle
- Manage stress
- Practice good hygiene, such as regular handwashing
- Avoid close contact with individuals who have active chickenpox or shingles
Frequently Asked Questions about shingles
Can you get chickenpox more than once?
Yes, but very rarely. People who have had chickenpox will be immune for the rest of their lives, however, the virus remains dormant in nerve tissue and may be reactivated later in life, due to certain risk factors.
What does the shingles rash look like?
Shingles look like a stripe of blisters, wrapped around one side of the body, either on the right or left side of your torso.
How can you prevent the spread of shingles?
A person with shingles may pass the virus to anyone who is not immune through direct contact with open sores of the shingles rash. Cover the rash if you have shingles, do not touch or scratch it, and wash your hands regularly to prevent its spread.
What is the best treatment for shingles?
Early treatment with antiviral medications is recommended. Pain relief medication such as paracetamol, wet compresses, calamine lotion, and warm oatmeal baths are also recommended.
What is the main cause of shingles?
Shingles are caused by the Varicella-Zoster virus, the same virus that causes chickenpox.
Is shingles caused by stress?
Shingles are not caused by stress, but your risk of developing shingles is increased by stress. The virus may become reactivated if you are severely stressed.
Do shingles go away?
Shingles do not go away. It remains dormant in your body after you have had chickenpox. Shingles symptoms do however normally improve within 2 to 4 weeks.
Conclusion
Shingles is a viral infection that can cause significant pain and discomfort. Vaccination is strongly recommended for people aged 50 and over, to reduce the risk of developing shingles and its complications. Staying informed, taking preventive measures and seeking early medical attention can reduce your risk of developing shingles and its associated complications.
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Service Guide
Everything you need to know about Getting Treated Privately
What does the Get Treated Privately service do?
The Get Treated Privately service is a private prescribing service which is designed for adults aged 18 years and over, who are experiencing health issues and who would like to receive a fast-track assessment and if applicable, a treatment plan from a qualified prescribing clinician. Treatments are dispensed and delivered to your home or workplace from our regulated online pharmacy.
Is this a safe service?
Yes. Our formulary of medications prescribed and conditions treated are controlled, governed, and continuously risk-assessed by our Medical Director, Dr. Aseel Hamoud. Unlike other prescribing services which operate using faceless questionnaires, our service is conducted through remote video consultations, also known as synchronous consultations. This builds patient safety and prescribing appropriateness into our service, ensuring our prescribing clinicians can be satisfied with who and what they are treating. There is no guarantee of supply of medications, and any prescriptions supplied are at the sole discretion of our clinician prescriber. There is no charge for the consultation.
What is a prescribing clinician and is it safe for me to use them on the NowPatient platform?
Our prescribing clinicians are board-certified pharmacists, nurses, or doctors who can also prescribe any medicine for any medical condition, subject to accepted accreditation and good clinical practice. They are all registered with their respective regulatory bodies. For example, a pharmacist independent prescriber is registered with the General Pharmaceutical Council (GPhC). Each prescribing clinician undergoes an extensive background check including a disclosure and barring service check (DBS). In addition, they undergo a rigorous license verification process. When you book an appointment with our prescribing clinicians you will see their full name, license number, and any specialized credentials they have.
Is the service available worldwide?
Yes, the Get Treated Privately service is available worldwide.
Do I need to pay for this service?
Yes. This is a private service. You do not need to pay for the consultation. You only pay for the cost of the medication you are prescribed.
How do I book a consultation?
Once you have logged into your account, you will need to navigate to the Get Treated Privately service card which is located as a service item on the dashboard.
Using the action button on the service card, you can select one of the following – ‘Search Treatments’ or ‘Search Conditions’.
Depending on the search type and the product/condition that you would like to get treated, you will be taken to a consultation booking screen. Follow the simple steps to complete your booking. During the booking confirmation, you will be able to select a date and time that is convenient for you, along with the preferred language and gender of the prescribing clinician you wish to choose. You will then see a list of all available expert clinicians who are trained to assess the medication or condition chosen. Once you have confirmed your booking, you will see a summary of the appointment including preliminary information about the consultation. At this point, you will also be able to add a reminder to your calendar. Always ensure your account health profile is up to date before any consultation. This ensures that our clinicians have the most up-to-date information about your current health status and anything that may influence their prescribing decisions. You will receive a push notification, SMS notification and email reminding you of your consultation, 30 minutes before the virtual consultation is due to start.
Depending on certain medications which require our clinicians to have your up-to-date blood pressure readings, you may be required to submit a virtual blood pressure check, using your smartphone or device. We will provide you with full instructions, when this is required.
What happens during the remote video consultation?
During the consultation, the clinician will ask you a series of questions that will allow the clinician to assess your condition and potential treatment options. At the end of the consultation, the clinician will decide if a treatment is a safe and suitable option for you. If it is, the clinician will discuss the various treatment options that may be available, so that you can jointly agree on the option that is most suited to you. Once you have jointly agreed on a treatment plan, the clinician will issue a prescription order which will be available in your Cart at the end of the consultation.
Also, with your consent, the clinician may wish to inform your doctor of the treatment that was prescribed. We recommend that you agree to this since your doctor is responsible for your overall care and they should have a record of this consultation and medication prescribed. In addition, our clinician may take the opportunity to advise you on your overall health including advice on healthy living or stop smoking.
What happens at the end of the consultation?
At the end of the consultation, you will receive a notification which will summarise the outcome. It will also advise you if any referrals were made to your doctor, along with any other advice that was given to you by the clinician.
If a referral letter was issued to your doctor, you will be able to view a copy of this in the ‘Documents’ section of the dashboard. If you were prescribed a treatment, it will now be available in your Cart.
When you go to your Cart, you will be able to select the treatment, checkout and make payment. Once the checkout is complete, your prescription order will be sent to our regulated online pharmacy for processing.
What if the prescriber does not prescribe what I want?
We operate a safe prescribing service. This means that our prescribing clinicians always exercise their clinical judgment when prescribing. Unfortunately, we do not operate a self select service where you can choose a medication and simply buy. If the clinician that sees you does not prescribe anything, then you will not be charged.
Will I get status updates for my order?
Yes. When your treatment is approved, and after you have checked out and paid for your order, we will keep you fully updated with the status of your order. Every time the status of your order changes, you will be notified immediately. These notifications will appear in the ‘Notification Feed’ section on the dashboard.
How will my order be delivered?
All orders are shipped in discreet and unmarked packaging. This means it is suitable for delivery wherever you require (home, work, or a neighbour).
For thermo-sensitive orders (e.g. Insulin or weight loss injections) we use cold chain-validated packaging. Your parcel will normally receive an estimated delivery window from the courier on the day of delivery.
For your protection and safety, your first order can only be delivered to the address that is registered with NowPatient. Future orders can be delivered to any other address, for example, your workplace.
Do you ship cold-chain or temperature sensitive products?
Yes. We use a specialist courier service for all thermo-sensitive deliveries. This is to ensure that cold chain integrity is always maintained and thus the product quality, safety and efficacy.
Learn more about how we handle the delivery of temperature sensitive products.
Where do you deliver?
We currently deliver to all postcodes/zipcodes worldwide. Some postcodes in rural areas may have a slightly longer delivery time.
When will my order arrive?
We aim to ship all orders placed Monday – Friday before 3pm on the same day. Orders placed outside these times will be shipped the next working day. All deliveries are shipped by Royal Mail, which delivers Monday through Saturday in the UK. For deliveries outside of the UK, please check with your national postal service for accurate delivery days.
Our delivery options have the following delivery times:
- UK – Royal Mail Tracked 24 & Signed for Delivery – Next day delivery
- Europe – Royal Mail Tracked – Typical delivery of 3-5 working days
- Worldwide – Royal Mail – Typical delivery of 5-7 working days. If a tracked option is available for your country via Royal Mail, this service will be applied.
What should I do if my order has not arrived?
Delivery is normally made promptly after your dispatch notification is received. You can check the tracking details of your order in the ‘Notification Feed’ section of the dashboard, at any point after dispatch.
Unfortunately, packages can sometimes get lost in the delivery system. If after 10 days you have not received your delivery, please contact us and we will do all we can to resolve the problem.
Can you prescribe GLP-1 weight loss injections?
Yes. However, with GLP-1 weight loss medications, the license requires that there are support resources put in place as part of the plan including coaching for a healthy lifestyle, exercise, and diet. Our clinicians will discuss this with you, if you are prescribed this type of treatment.
You can learn more on our Weight Loss Programs feature page.
What’s included with my order?
If you are ordering prescription medication, your order will contain your medication only.
If you are ordering weight loss injections, your order will contain:
- Your prescription of pre-filled weight loss injection pens
- Needles
- Sharps bin for safe disposal of needles (if ordered as part of the bundle)
Can I reorder my medication, if I have already been prescribed a course?
Yes. However, as a responsible prescribing service, we do not issue more than one monthly cycle of medication at a time. This means that, if you would like to reorder, you will need to rebook a consultation.
This is important, because it allows our clinicians to keep track on the progress of your treatment plan and ensure that the medication remains safe and effective for you.
What is the earliest I can reorder my medication or treatment?
14 days after you have received your first monthly supply, we will send you a notification to advise you that you are eligible to reorder your medication. To ensure that we are able to safely prescribe the next supply, you will need to rebook a consultation.
This ensures that our clinician can check in on your treatment plan and ensure it is working as intended and continues to be safe, suitable and appropriate for you.
How do I reorder my medication?
When you are eligible to reorder your next medication, we will send you a notification reminder. This notification reminder will request that you book a consultation with a NowPatient Clinician.
You should book a suitable time and date for the consultation.
At the end of the consultation, the clinician may advise you to either
- Stop the treatment
- Stay on the current dose
- Increase the dose
If our clinician deems it safe for you to continue taking the medication, the medication will be added to your cart, from where you can checkout.
Delivery will be made in line with our delivery timescales.
As a responsible prescribing service, we will always monitor your treatment plan to ensure that it remains safe, effective and suitable for you.
How do I reorder weight loss medication?
Our weight loss programs are built to closely monitor treatment progress and safety. Please refer to the Weight Loss Programs Service Guide that explains how you can reorder or step edit your dose.
About Telehealth
Everything you need to know about video consultations
Are remote video consultations right for me?
How do I know if the remote video consultation service is safe?
Do I need to verify my identity during the remote video consultation?
Can I have a chaperone (carer, friend, family member) join a remote video consultation?
How can I be sure that you are handling and protecting my data securely?
How is my data stored?
Are my consultations confidential?
Can I select which clinician I have my consultation with?
Will my doctor be informed of any consultations I have through the app?
Do remote video consultations save money for health systems?
Are remote video consultations safer than online questionnaires?
What quality of care can I expect to receive from a remote video consultation?
Why am I being asked to provide my Blood Pressure reading?
If I don’t have a Blood Pressure monitor, how can I provide my readings?
Is the remote blood pressure monitor safe and medically accurate?
How does the remote blood pressure monitor actually work?
When and how is my remote blood pressure reading taken?
What devices does the remote Blood Pressure monitor work on?
Why do my results keep failing when using the remote blood pressure monitor service?
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