Stress, intense physical exertion, and the wear and tear on the body can further compromise the immune system, creating a perfect storm for shingles outbreaks…
After busier than usual cycling week a perfect summer day dictated more, so I decided to throw in a very casual century. The next morning I awoke to a slight itch on my forehead, a spider bite or maybe helmet rub? Forward, twenty four hours, I’m sitting in the exam room of the local dermatologist. The doctor opens the door and without passing through its frame (standing a full 6′ away) bellows out “shingles”. I retort with “No thanks, I just installed a 30yr roof”.
Leaving her office I feel like a public safety hazard with the plague. Scripts for the standard faire were issued – Valtrex (anti-viral) and Gabapentin (narcotic free “painkiller”), the latter I scoffed at and didn’t fill (dumb ass mistake, though guy syndrome). Confident in the “you caught it in the first 72 hours” so it’ll be “short lived” logic, I planned to miss only a day or two of life. Two weeks later unable to leave the house, now swallowing up Gabapentin (as prescribed of course), multiple trips to the optometrist and neurologist, I was barely able to see. Suddenly this was frightening — potential hearing and sight loss coupled with long term postherpetic neuralgia. As always is with one many Murphy’s Laws, in the previous month I had been preaching to others about getting the Shingles vaccine, go figure, I rarely follow good advice.
What I learned is that as athletes age, their bodies undergo numerous changes that can affect their overall health and performance. One such concern for aging athletes is the increased risk of shingles outbreaks. Shingles, also known as herpes zoster, is a viral infection caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. This condition is characterized by a painful rash and blisters that typically appear on one side of the body or face. For aging athletes, shingles can pose significant challenges, impacting their training, performance, and overall quality of life.
The risk of shingles increases with age due to the natural decline in immune function. This decline, known as immunosenescence, makes older individuals more susceptible to infections, including the reactivation of latent viruses like the varicella-zoster virus. Aging athletes, despite their generally better physical health compared to non-athletes, are not immune to this decline in immune function. Stress, intense physical exertion, and the wear and tear on the body can further compromise the immune system, creating a perfect storm for shingles outbreaks.
Shingles typically presents with initial symptoms such as tingling, itching, or pain in a specific area, followed by the appearance of a rash and blisters. These symptoms can be particularly debilitating for athletes, as the pain and discomfort can interfere with their ability to train and compete. The rash often follows a nerve path, causing severe pain that can last for weeks or even months, a condition known as postherpetic neuralgia (PHN). PHN can be especially challenging for athletes, as it can lead to prolonged periods of inactivity and recovery.
In aging athletes, the impact of shingles goes beyond physical discomfort. The psychological stress of dealing with a painful condition can also affect their mental health and motivation. The need to take time off from training to recover can lead to a loss of fitness, increased anxiety about performance, and a sense of frustration. Additionally, shingles outbreaks can disrupt training schedules and competitive seasons, potentially affecting an athlete’s career and goals.
Preventive measures are crucial for aging athletes to reduce the risk of shingles. The shingles vaccine, recommended for adults over 50, can significantly lower the chances of developing the condition and reduce the severity of symptoms if an outbreak occurs. Maintaining a healthy lifestyle, managing stress, and avoiding overtraining are also important strategies to support immune function and overall well-being.
A shingles outbreak poses a significant risk for aging athletes, impacting their physical performance, mental health, and training schedules. Awareness and preventive measures are essential to mitigate this risk, ensuring that athletes can continue to pursue their passions and maintain their health as they age.
An outbreak along any of the dermatomes is never good, but anytime the face/head is involved the risk of long term problems is increased. A full year later I still suffer from PHN (they say that the pain just never subsides for some patients) and the itching that seems to come and go throughout the day. Thankfully my vision and hearing were unaffected. But I do walk around all day wanting to “put my eye out”.
Neuropathic itch is a potent trigger of reflex and volitional scratching although this provides only fleeting relief. Rare patients whose lesion causes sensory loss as well as neuropathic itch can scratch deeply enough to cause painless self-injury. The most common location is on the face (trigeminal trophic syndrome). Treating neuropathic itch is difficult; antihistamines, corticosteroids, and most pain medications are largely ineffective.”Neuropathic itch is a potent trigger of reflex and volitional scratching although this provides only fleeting relief. Rare patients whose lesion causes sensory loss as well as neuropathic itch can scratch deeply enough to cause painless self-injury. The most common location is on the face (trigeminal trophic syndrome). Treating neuropathic itch is difficult; antihistamines, corticosteroids, and most pain medications are largely ineffective.”
Oaklander AL. Neuropathic itch. Semin Cutan Med Surg. 2011 Jun;30(2):87-92. doi: 10.1016/j.sder.2011.04.006. PMID: 21767768; PMCID: PMC3139924.
Oh, and if you want to audition as an extra in zombie flick, just take the Gabapentin, you’ll rule at the role of “the walking dead in pain”. Cause’ in my experience, that’s all that drug is good for — zombification.
So all you 50 plus year-olds, check out the “Beav” in the video below. Then the BIG QUESTION to Vax or not to Vax, with this one you have the freedom to choose — and hey, enjoy your ride.
