Hello Dr. Karon-Flores:
I was wondering if you've encountered patients in your practise before who had this occur? As you would know, the S3 dermatone innervates the back of buttocks and extends down and around into the vulvar/labia/vaginal area and in my case seems to be in rectal area too (so I wonder if s4, or s5 is affected also? ....although the rash is not in that dermatone) I'm 35 weeks pg, am on day 6 of treatment with valacyclovir to try to clear this up prior to birth (it was started within 48 hours of rash onset). It's really painful (hurts to pee, sit, poo and I can't imagine having sex) and I'm nervous about the potential for post herpetic neuralgia (PHN). I am going to see an anaesthesiologist in a pain clinic in a few days (as apparently there is some clinical studies that show nerve blocks initiated early greatly reduce the risk of PHN).
Have you encountered patients with shingles in this dermatone before? If so, how long did it take for the pain to subside? Did any go on to develop PHN? The literature is unfortunately, so scant when it comes to sacral dermatone shingles and pregnancy. I'm so worried that with the trauma/swelling from childbirth that my outcome might not be so great...
Also, are there any naturopathic treatments for shingles that have been validated by studies, that reduce the serverity and reduce chance of PHN? Obviously you cannot give specific advice here; however any links to information/research would be greatly appreciated! I am following a good diet, trying to get adequate rest, taking prenatals, floradix, cal-mag-D so I'm not sure what else I can do. (Our only naturopathic physician here is away on holidays for at least the next couple of weeks, and always has a wait list, so it's no use trying to contact her).