Tag Archives: Herpes

Straight, No Chaser: Living With An Incurable Sexually Transmitted Infection

May 9, 2016Genital/Urinary, Infectious Disease, Obstetrics and GynecologyAIDS, Anal sex, Behind the Curtain, Female condom, Herpes, HIV, Hiv And Aids, HIV/AIDS, HPV, Safe sex, Sexual intercourse, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

You’ve requested it, and it’s only fair. We’ve spent a lot of time discussing sexually transmitted diseases and infections (STDs, STIs). It’s reasonable to discuss living with an STD. The first point to appreciate is most STDs can be treated; that’s been discussed at length in several previous posts. Next you should understand that those that can’t be treated don’t represent a death sentence. STDs are simply diseases. To be clear you will need to make adjustments to you life, and this Straight, No Chaser will discuss those.
Even if you were irresponsible in acquiring an STD, you must be learn to be responsible in managing it once it’s known that you have an incurable STD such as HPV or HIV/AIDS. Refer back to the Straight, No Chaser Comprehensive Safe Sex Guide for details.

There are important differences between managing different diseases. Putting HIV/AIDS aside momentarily, consider the following general considerations regarding herpes or HPV.

You can live a mostly normal life with these conditions. Unless you’re in the midst of a herpes outbreak or are showing the warts of HPV, you will appear normal. Every other positive attribute you possess will still be intact. Use that positivity to help you through.
It’s only fair and reasonable to have a conversation with existing and/or new sexual partners about your condition. You and your partner should meet with your physician to discuss risks and possibilities. You will want this information to make informed decisions about what you choose to do moving forward.
If you are showing symptoms or in the midst of an outbreak, you should avoid any sexual activity.
Unless you’re in the midst of an outbreak, you can have sex. Remember that these STDs can be transmitted even in the absence of symptoms, so please protect yourself and your partner.

A really reasonable way to think about having sex with an incurable STD is to think about kissing someone with a cold or the flu. You could still do it, but you’re likely to be at risk. When the symptoms aren’t there, your partner could still be a carrier of the disease and could still give you the disease. Your better course of action is to wait until all symptoms are gone and then still be careful.

You have to simultaneously appreciate that your life will be approximately normal, even as you’ve had a significant change. Even as you get about living the rest of your life, you should be aware of risks that can cause an outbreak.

Of course intercourse is a very risky activity. Couples who have been exposed to one STD are likely to have been exposed to multiple. You don’t want to “ping-pong” diseases between you and your partner. Follow the recommended guidelines for having and avoiding sex based on your symptoms.
Surgery, trauma or any cause of a reduced immune system can produce an outbreak. If you’re diabetic, on steroids, have lupus or other conditions that affect the immune system, have a conversation with your physician.

At some point, you’ll get over the guilt and shame associated with having an untreatable STD and start focusing on the rest of your life. Be sure to live that life so it’s not causing more damage along the way; out of sight can’t be out of mind with an incurable STD. Be especially mindful of your risks of giving your partner your disease, both from specific acts of intercourse and from other sexual activities besides intercourse. Remember, these diseases all affect more than sex; managing these diseases is managing your health.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: What To Do You If You Suspect a Sexually Transmitted Disease (STD)

May 7, 2016Genital/Urinary, Infectious Disease, Obstetrics and Gynecology, Health Prevention844-SMA-TALK, Behind the Curtain, chlamydia, Gonorrhea, Herpes, HPV, PID, STD, Sterling Medical Advice, SterlingMedicalAdvice.com, STI, Straight No Chaser, SyphilisJeffrey Sterling, MD

It’s been a long and productive sex week here at Straight, No Chaser. We’ve run the gamut of common sexually transmitted infections (STIs) and other genital conditions, and links to many are included within this post. However, many of you have rightfully asked a simple question: “What happens if and when I contract a STI?” This and the next post will look at three scenarios around contracting, managing and living with a STIs.

What you should do immediately if you suspect you or your partner has a sexually transmitted infection

You first job is to stop the denial. STIs don’t go away on their own. Well, actually herpes does, but it’s more accurate to say it goes into hiding, waiting to return another day. At the first suggestion of any abnormality (e.g. vaginal/penile discharge, the presence of bumps, a rash, warts or ulcers, itching or burning when you urinate, or abnormal smells, etc.), get evaluated. This clearly is an example of it’s better to have it (an evaluation) and not need it than to need it and not have it. STIs cause consequences, including PID (pelvic inflammatory disease), birth defects and any increased incidence of cancer. HPV even causes cancer, and without vaccination, virtually 100% of the sexually active population will obtain it at some point in life.

You must get all your sexual partners evaluated and treated. Ping pong is not just a sport. You getting treated without all of your partners doing so as well is pointless. Even your asymptomatic partners can be carriers of the disease. Sorry folks, but guys are much more likely not to have symptoms even if infected. Don’t let that fact change the reality of who needs to be told and treated (or who could have caused the infection). Not telling your female partners about STIs can have devastating consequences.

You should make a commitment to wearing condoms. Either get over the subjective difference in how sexual intercourse feels with and without condoms, or get more creative to adjust for the difference. The issues are common things happen commonly, and the best predictor of future behavior is past behavior. If you have had a STI, you’re more likely to have others in the future. It’s more likely to be in your social network, and you may be the one who is a carrier (of herpes, for example). Given that STIs “hang out” together like a gang (meaning the same individuals infected with one STI are the ones most likely to have others), you want to avoid contract some of the incurable STIs, such as herpes, HIV or HPV.

What we will do if you suspect you have a STI

When you come to your physician’s office or the emergency room with the possibility that a STI exists, or you know you’ve been exposed to one, you will be treated. This is not a situation in which we wait to treat some of the more common conditions, such as gonorrhea or chlamydia. Because of the community, dealing with STIs is more of a “treat now, ask questions later” situation. Besides, many individuals are carriers without the presences of symptoms (particularly those with herpes). I must restate: this is neither the time to be bashful or in denial. If it’s syphilis that’s in question, say so. If you have sufficient symptoms, your medical team will figure it out, but it’s better for you if you already know what the likely culprit is.
You should not be offended by the questions you will be asked. Physicians are in the treatment business, not the judging business. Expect to have frank conversations about your sexual habits and preferences, with and without your partner(s) present.

If a definitive diagnosis is made for certain conditions (e.g. gonorrhea, chlamydia, syphilis or PID), you will be treated prior to leaving the emergency room unless you have allergies preventing the use of certain medicines. There are two particular considerations for you after you’ve been treated for a curable STI in an office or ER setting, both regarding your resuming sexual activity. First, if cultures were drawn, you should wait to begin sex until after these results have returned. The cultures will clarify exactly which diseases you have and which antibiotics work against them. Normally this would have been an issue, but antibiotic-resistant gonorrhea is a real thing. Additionally, you should wait to begin sex until all of your current partners have also been treated and cleared. You can and will become reinfected from all STIs on more than one occasion.

The final post in this series discusses managing the presence of an incurable sexually transmitted infection.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Doctor/Patient Sexually Transmitted Disease (STD) Talk

April 26, 2016General Health and Wellness844-SMA-TALK, Bacterial vaginosis, Behind the Curtain, Chlamydia infection, Gonorrhea, Herpes, HIV/AIDS, HPV, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, SyphilisJeffrey Sterling, MD

As an emergency physician, my first consideration is to eliminate life threats. Along the way, I cure disease and provide a ton of information. With all of these efforts, I provide a heavy dose of tough love and straight talk meant to empower (and hopefully never belittle). This is heavy on my mind because this week we’ll be discussing sex – not the pleasant aspects, but those instances when something has gone wrong as a result of sex.

I’ve been on the receiving end of hundreds (more likely thousands) of couples coming in, usually one dragging the other by the ear, attempting to determine if “something’s going on”, and yes, more than a few relationships have left the emergency room dissolved after such conversations. I would like to have the beginning of such a conversation with you much in the way that I might have with one of these couples. This is a very appropriate prelude to a conversation about sexuality transmitted infections (aka STIs aka STDs).
Patient: I have a foul smell coming from my vagina. I know he’s doing something!
Doctor: Can you tell me what it smells like? Is there any vaginal discharge, rash or other lesions that you’re seeing?
Male partner (who would have been better off saying nothing): It smells like fish!
Patient (after shooting eye lasers at her partner): I am not having sex with anyone but him, so I know he did something!
Male partner: Doc, I’m not doing anything. She’s the only one I’m with, and I don’t have any symptoms.
Doctor: So each of you only has each other as a partner?
Couple: <nods yes>
Doctor: Would you bet your lives on it?
Couple: <Stunned silence>
Doctor: Well that’s exactly what you’re doing every time you’re having unprotected sex. Now about that discharge…
This upcoming week we are going to address several of most common and/or most important STIs out there for you to know about.

Chlamydia

Gonorrhea

Syphilis

Herpes

Not talking about them, not protecting yourself from them, and not testing yourself for them is truly believing that ignorance is bliss. In this case, what you don’t know can kill you. No matter what you think about how ‘good’ it is, it’s not worth risking your life over. Also, as an additional conversation, I’ll discuss Bacterial Vaginosis.
If you’re sexually active, you really should follow this series. There’s going to be a lot covered. Might I suggest you cover it as well?
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Shingles – Return of the Chickenpox

July 17, 2015Skin/Dermatology844-SMA-TALK, Behind the Curtain, Blisters, Chickenpox, health, herd immunity, Herpes, Herpes zoster, Immunocompromised, Rash, Shingles vaccine, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Varicella vaccine, Varicella zoster virus, Vesicles, ZostavaxJeffrey Sterling, MD

I wonder if any of you haven’t had chickenpox. That’s a question that never would have been asked a few decades ago. Chickenpox is caused by the Varicella Zoster virus, which is one of the Herpes viruses (No not that one; we’ll discuss that next week.). Repeat infections or reactivation of the virus that went dormant inside of you causes shingles. When I was younger, no one ever got shingles because no one got chickenpox twice. Chickenpox was something you got as a child, and when you contracted it, everyone in the neighborhood would bring the kids by so everyone could get it and be done with it. The first case of shingles I actually remember seeing was during residency in a HIV+ patient who actually died from it (Herpes Zoster pneumonia; I was told it happened to the elderly or patients with lowered immunity).

Then an odd thing happened. A chickenpox vaccine came out. Chickenpox started being seen in older individuals, because all the kids were immunized, and the loss of the ‘herd immunity’ phenomenon allowed some individuals to sneak by without getting chickenpox as a child, only to develop it at an older age. Then shingles started being seen more often.

The shingles rash is classically a group of lesions stretched around a single dermatome (an area of skin corresponding to the distribution a specific nerve root), usually in the abdomen or back, but seen with some frequency on the face and involving the nose and around the eyes. Infection begins with general nonspecific symptoms like headache, light sensitivity, pain, itching and burning in the area a few days before the rash appears. The pain should be emphasized, as it can last for a year after the rash (which typically lasts for 2-4 weeks). Amazingly 30 out of 100 Americans will now develop this illness at some point in their lives.

Anyone who has had chickenpox may get shingles. However, you can now get a shingles vaccine, which serves two purposes: it may prevent shingles, but if it doesn’t it can make the episode less painful. If you’re 50, you can get vaccinated, and it can cut the risk of contracting shingles in half. Please discuss this with your physician. If you’re eligible, you’ll thank me; if you don’t get vaccinated and contract shingles, you’ll wish you had.

Quick Tips:

If you have never had chickenpox and have never gotten the chickenpox vaccine, avoid contact with people who have shingles or chickenpox. Fluid from blisters in both conditions is contagious and can cause chickenpox in these groups.
If you have shingles, avoid close contact with people until after the rash blisters heal.
Certain people are at heightened risk from chickenpox and shingles, including anyone pregnant, elderly, ill or with a diminished immune system.

I welcome your questions, comments or stories. For the sports fans out there, this pictorial trivia question shouldn’t be hard to answer. Who’s this famous manager pictured here with shingles?

In the meantime, if you’d like to read Behind the Curtain ahead of its national launch, we are now shipping orders made exclusively on www.jeffreysterlingbooks.com!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd. Preorder your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com.

Straight, No Chaser: Living With An Incurable Sexually Transmitted Infection

December 9, 2014Genital/Urinary, Infectious Disease, Obstetrics and GynecologyAIDS, Anal sex, Female condom, Herpes, HIV, Hiv And Aids, HIV/AIDS, HPV, Safe sex, Sexual intercourse, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, WordPressJeffrey Sterling, MD

You’ve requested it, and it’s only fair. We’ve spent a lot of time discussing sexually transmitted diseases and infections (STDs, STIs). It’s reasonable to discuss living with an STD. The first point to appreciate is most STDs can be treated; that’s been discussed at length in several previous posts. Next you should understand that those that can’t be treated don’t represent a death sentence. STDs are simply diseases. To be clear you will need to make adjustments to you life, and this Straight, No Chaser will discuss those.
Even if you were irresponsible in acquiring an STD, you must be learn to be responsible in managing it once it’s known that you have an incurable STD such as herpes, HPV or HIV/AIDS. Refer back to the Straight, No Chaser Comprehensive Safe Sex Guide for details.

There are important differences between managing different diseases. Putting HIV/AIDS aside momentarily, consider the following general considerations regarding herpes or HPV.

You can live a mostly normal life with these conditions. Unless you’re in the midst of a herpes outbreak or are showing the warts of HPV, you will appear normal. Every other positive attribute you possess will still be intact. Use that positivity to help you through.
It’s only fair and reasonable to have a conversation with existing and/or new sexual partners about your condition. You and your partner should meet with your physician to discuss risks and possibilities. You will want this information to make informed decisions about what you choose to do moving forward.
If you are showing symptoms or in the midst of an outbreak, you should avoid any sexual activity.
Unless you’re in the midst of an outbreak, you can have sex. Remember that these STDs can be transmitted even in the absence of symptoms, so please protect yourself and your partner.

Of course intercourse is a very risky activity. Couples who have been exposed to one STD are likely to have been exposed to multiple. You don’t want to “ping-pong” diseases between you and your partner. Follow the recommended guidelines for having and avoiding sex based on your symptoms.
Surgery, trauma or any cause of a reduced immune system can produce an outbreak. If you’re diabetic, on steroids, have lupus or other conditions that affect the immune system, have a conversation with your physician.

At some point, you’ll get over the guilt and shame associated with having an untreatable STD and start focusing on the rest of your life. Be sure to live that life so it’s not causing more damage along the way; out of sight can’t be out of mind with an incurable STD. Be especially mindful of your risks of giving your partner your disease, both from specific acts of intercourse and from other sexual activities besides intercourse. Remember, these diseases all affect more than sex; managing these diseases is managing your health.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: The Doctor/Patient Sexually Transmitted Disease (STD) Talk

November 8, 2014General Health and Wellness844-SMA-TALK, Bacterial vaginosis, Chlamydia infection, Gonorrhea, Herpes, HIV/AIDS, HPV, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, SyphilisJeffrey Sterling, MD

Chlamydia

Gonorrhea

Syphilis

Herpes

Not talking about them, not protecting yourself from them, and not testing yourself for them is truly believing that ignorance is bliss. In this case, what you don’t know can kill you. No matter what you think about how ‘good’ it is, it’s not worth risking your life over. Also, as an additional conversation, I’ll discuss Bacterial Vaginosis.
While you’re waiting for the next post, go back and reread another of the most common sexually transmitted diseases: this post on ‘The Sexually Transmitted Cancer”. It definitely should be considered required reading for everyone who is sexually active or about to become active, and I would have addressed it first had I not already covered it. Might I suggest you cover it as well?
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com(SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Sexually Transmitted Disease Summary and The Week In Review, Sept. 29th, 2013

September 29, 2013Infectious Disease, The Week In ReviewAIDS, Bacterial vaginosis, Chlamydia infection, Conditions and Diseases, Disease, Gonorrhea, health, Herpes, HIV, Safe sex, Sexually transmitted disease, Straight No Chaser (composition), SyphilisJeffrey Sterling, MD

Based on your responses to the pictures posted this week, I should have renamed the blog, Scared Straight, No Chaser. The irony of it all is without exception, those pictures were very typical representations of the various sexually transmitted infections (STIs). Some of you didn’t like it, but I do appreciate that large numbers of you read it all. I hope you learned a lot and even more importantly were moved into (in)action. In case you missed anything:

On Sunday, we began the week with a look at bacterial vaginosis (BV), which may be associated with sex but is not an STI. It’s important for women to take an active effort to learn their bodies and the effects various activities have. Remember, BV is easily treated, but it’s always fair to take the opportunity to ensure that STIs aren’t also present.

On Monday, we reviewed the most common bacterial STI, chlamydia. Chlamydia is a really typical disease in that it’s contagious, easily transmitted and has substantial complications if not treated.

On Tuesday, we reviewed gonorrhea, which very often occurs in tandem with Chlamydia. Like chlamydia, it’s contagious, easily transmitted and has substantial complications if not treated. Think of gonorrhea when copious discharge is present, and don’t forget this includes the eyes, throat and joints.

On Wednesday, we reviewed the various stages of syphilis. This easily treatable yet very dangerous disease has the nasty habits of mimicking many other disease and spontaneously disappearing – which is not the same as it being cured. Instead, it progresses to more harmful stages if not identified and treated. Remember the association of syphilis with rashes involving the palms and soles.

On Thursday, we reviewed the treatment of syphilis. It is so important to understand how easily this is treated, so get checked. We also reviewed the story of the Tuskegee Experiment of Untreated Syphilis and how that (unethically) led to the knowledge we have about syphilis and the mandatory protections now in place for humans participating in medical experiments.

On Friday, we reviewed herpes. Many were shocked to learn these groups of small blisters (vesicles) can be found wherever an infection occurs, including the fingers, eyes and mouth. Think of herpes when you get a painful genital ulcer, and get checked ASAP.

On Saturday, we discussed the cauliflower ear, a too common, very preventable and apparently sought after (by certain athletes) condition seen in those with trauma to the ear. The trauma results in the accumulation of blood and clots, which damages and deforms the ear into its prototypical appearance. This leads to a life of pain and deformity.

Here are three final considerations on sexually transmitted infections.

1. They all tend to coexist. Your exposure to one places you at risk for acquiring others, including HIV/AIDS. What you don’t know can hurt you; in fact it can kill you.

2. Remember that until your partner is treated, you’re not treated.

3. Most of these diseases lead to conditions that physiologically make acquiring HIV/AIDS more likely. I didn’t discuss HIV/AIDS this week because it’s involved enough that it is its own topic with several different considerations. We’ll address these another time.

If you’re not prudent enough to practice safe sex, please be diligent enough to get tested and treated based on any suspicion. Even better – do both. The life you save will be your own.

Straight, No Chaser: Can You Get Chicken Pox Twice? Emergency Room Adventures: Introducing Shingles

August 8, 2013Medical Treatment, Health PreventionBlisters, Chickenpox, health, herd immunity, Herpes, Herpes zoster, Immunocompromised, Rash, Shingles vaccine, United States, Varicella vaccine, Varicella zoster virus, Vesicles, ZostavaxJeffrey Sterling, MD

It’s another interesting night in the ER. My nurses are hounding me because there’s a patient with a rash, and they don’t know what it is. They’re so good that they rarely get stumped, and they get excited when they are. The patient had a pretty impressive cluster of little blisters called vesicles (see the picture above) under one eye with significant reddening of the skin under the cluster. Unknown to them, their problem with this patient is she’s African-American. Many healthcare professionals have difficulty identifying common rashes in dark-skinned individuals.
I wonder if any of you haven’t had chickenpox. That’s a question that never would have been asked a few decades ago. Chickenpox is caused by the Varicella Zoster virus, which is one of the Herpes viruses (No not that one; we’ll discuss that next week.). Repeat infections or reactivation of the virus that went dormant inside of you causes shingles. When I was younger, no one ever got shingles because no one got chickenpox twice. Chickenpox was something you got as a child, and when you contracted it, everyone in the neighborhood would bring the kids by so everyone could get it and be done with it. The first case of shingles I actually remember seeing was during residency in a HIV+ patient who actually died from it (Herpes Zoster pneumonia; I was told it happened to the elderly or patients with lowered immunity).
Then an odd thing happened. A chickenpox vaccine came out. Chickenpox started being seen in older individuals, because all the kids were immunized, and the loss of the ‘herd immunity’ phenomenon allowed some individuals to sneak by without getting chickenpox as a child, only to develop it at an older age. Then shingles started being seen more often.
The shingles rash is classically a group of lesions stretched around a single dermatome (an area of skin corresponding to the distribution a specific nerve root), usually in the abdomen or back, but seen with some frequency on the face and involving the nose and around the eyes. Infection begins with general nonspecific symptoms like headache, light sensitivity, pain, itching and burning in the area a few days before the rash appears. The pain should be emphasized, as it can last for a year after the rash (which typically lasts for 2-4 weeks). Amazingly 30 out of 100 Americans will now develop this illness at some point in their lives.
Anyone who has had chickenpox may get shingles. However, you can now get a shingles vaccine, which serves two purposes: it may prevent shingles, but if it doesn’t it can make the episode less painful. If you’re 50, you can get vaccinated, and it can cut the risk of contracting shingles in half. Please discuss this with your physician. If you’re eligible, you’ll thank me; if you don’t get vaccinated and contract shingles, you’ll wish you had.
Quick Tips:

If you have never had chickenpox and have never gotten the chickenpox vaccine, avoid contact with people who have shingles or chickenpox. Fluid from blisters in both conditions is contagious and can cause chickenpox in these groups.
If you have shingles, avoid close contact with people until after the rash blisters heal.
Certain people are at heightened risk from chickenpox and shingles, including anyone pregnant, elderly, ill or with a diminished immune system.

I welcome your questions, comments or stories. For the sports fans out there, this pictorial trivia question shouldn’t be hard to answer? Who’s this famous manager pictured here with shingles?