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CANADA'S
NATIONAL
NEWSPAPER
THE GLOBE AND MAIL
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Toronto,
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Tuesday,
February
•
4, 1997
Snow changing
National News
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The Globe and Mail. Tuesday. Februarv 4. 199
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Dr. Fred Hui uses cupping, a traditional
Oriental technique,
to draw more blood to the affected area. (EDWARD REGAN/The Globe and.Mail)
Dousing the fire of shingles
BY WALLACE IMMEN
Medical
Reporter
UE can laugh about it now,
-.--r~L.!l1C'!ltljs
Cy:r:jUlat. -_
~ .••••
son '>'as in so much pam
from shingles he felt he was continually on fire.
I uldn' I
1 uldn'
I
"CO,
t seep. co . ~eat
couldn t even wear a shirt, said
the !)4·year-oldfrom Port Perry,
On.t
As with thousands of other Ca.
nadians, shingles had left his
nerves so raw that any movement
caused excruciating pain. Until
now,treatments offeredonly short
reprieves from months or years of
pain.
But new experimental approaches are offering hope for
taming one of the most common
forms ofchronic pain.
"Once you've got shingles pain,
there is no great treatment for it.
At age ;5, a person with Shingles
is likely to have a so-rer-cent
chance of having pain for a year
or more," said Dr. Charles Lynde,
a specialist in dermatology at the
Toronto Hospital. Shingles is the
most common cause of chronic
nerve pain and at least 50,000new
cases are reported m Canada each
year
"~'e need something to help
these people," said Dr. Peter Watson (no relation to Cyril Watson),
assistant professor of medicine at
(he University of'ibronto, who is
beginning a clinical triaJ of a drug
that eases the pain in patients
who have sufferedfor months.
The drug, venlafaxine hydrochloride (sold in Canada as Ef·
fexor). is a newly approvedantide-
pressant that acts to increasethe
levels of natural pain-killersin the
nervous system, Dr. Watson said.
The most commonly used antidepressants, including Prozac, don't
have this effect.
Dr. Watsonis collaboratingwith
several U.S. researchers in the
clinical trial, which is just begin.
ning. In preliminary tests, some
shingles patients found their pain
subsided and they could quit the
drug, but some may have to take
the medication indefinitely. he
said.
,
•
...
New remedies ustnq drugs and traditional
-meihvds--offel'-lw[)€oy;
"If this works for shingles pain,
it could also be useful for other
persistent pain." In'eluding phantom limb pain and other kinds of
nerve
iuries, Dr. Watson believes.
Dr. Fred Hui, a Toronto practitioner, is taking another approach.
Dr. Hui, who has also trained in
traditional Chinese medicine, says
a combination of Western treatments with Oriental techniques
such as acupuncture and herbal
medicines to strengthen the body
can bring rapid relief.
Dr. Hui describes his approach
as like pushing a car that is stuck
in the snow. "One person can't
budge it, but several teaming up
can overcomethe problem."
None of the treatments used
alone cures the pain, but he reports that 60per cent of the 200patients he has treated for difficult,
severe shingles pain have had full
recovery. Another 20 per cent
have rated their pain greatly improved. Those who weren't cured
often dropped out of the treatment
before they could have felt an effect, he said.
"I was at wit's end when 1 saw
an item about Dr. Hui's treatment
in a seniors' paper; CyriI Watson
said. "I had gone to a number of
doctors and didn't get very good
results. The only thing some doc.
tors could suggest is take a pain
killer and go to bed."
1llJ'
can work and do things 1 was
doing before," Sister McKeIinsaid.
She has returned to looking after
chrem-ie-pafn--suffere'rs.---t-he-dil'ling....-l'OOln-Bf
-tac CathG>i·ic
order which helps women and
girls and supports foreign missions.
by no means does it help everybody."
D L d
ked
I' . I
Dr. Hui said his approach ber. yn e wor
on c imca
gins by using a German medical
trials of two new drugs that re- technique that injects a local anesduce the amount of nerve damage
h .
'J
b h
the virus causes if they are given t etic to ternporan y nurn . t re
within 72 hours of the beginning nerve. He explained that this 1S
of the infection.
like turmng off a computer to reBut Dr. Watson said that people boot 11.
who get the infection often don't
Oriental approaches to stimurealize how serious it is and delay late the body's defences are used
seeing a doctor until the damage next. Acupuncture needles are inis already done.
serted at points along the nerve
Shingles is caused by varicella and, at some acupuncture points,
zoster, the virus that causes Dr. Hui pricks the skin to draw
chicken pox, one of the most infec- some blood. "This sends a small
tious childhood diseases. A child's emergency signal that rallies the
immune system develops a de- body's repair crews to the spot."
fence, but some virus remains dor- he explained. Cupping, a techmant at the base of the nerves and nique that uses a flame to burn
can reemerge if the body's un- the oxygen out of a glass cup and
mune defences are low because of create a vacuum, is also used. The
age or illness.
suction on the skin draws more
No one is sure why, but shin- circulation to the area.
gles infections commonly occur eiBut success in the treatment dether on the forehead or on the mid pends on having a good repair
chest. Itchy, scaly blisters form crew, Dr. Hui said. Many of his pathat last a few weeks and then
heal, but the infection leaves tients. need something to pep up
nerve endings sensitive to the their ~mune syst:m,so he might
slightest pressure.
prescribe a. combination of. mexWhen Dr. Hui asks new patients pensive Chinese herbs ~d tablets
to rate their pain they typically to Improve the body s healing
say it is between eight to 10 on a processes.
. ..
10-pointscale.
The treatment must be individHis program generally contin- ualized to the body type and conues daily treatments for 10days or stitution and that will make his reuntil the patient reports that the sults difficult to prove in a largepain is gone. "I tell patients if it is scale double-blind study, Dr. Hui
He said a skin specialist pre- not gettingbetter in fivedaysthey said.
scribed pills and sunburn lotion,
which did not help.
After 11 treatments from Dr.
Hui, "I feel all right; you can pinch
it and it doesn't burt. I'm able to
sleep better and I can take a
shower without pain."
Dr. Lynde said that while Dr.
HUi's report of almost immediate
results sounds "pretty remarkable.
I would treat it with healthy skepticism." Dr. Lynde said that acupuncture is one of the treatments
that is used against shingles, "but
111:1i' t"
can can quit. But usually by the
"I've made 80per cent of people
third day the pump is primed; the feel much better," he noted. "If a
patient gets such improvement he drug company can make 40 per
won't let me quit the treatment."
cent of sufferers of a disease feel
Sister Bertha McKerin, one of better that's considered a great
Dr. Hui's patients, said her pain discovery."
was "close to 10" for two months
His fees for consultation and inbut it was gone after a week of the jections are covered by the Ontadoctor's treatments. The pain no Health Insurance Plan, almeant she could hardly walk and though the costs of the acupunccouldn't do her work with the ture, cupping and herbs and other
Catholic Sisters of the Good Shep- specific treatments must be paid
herd in North York.
by the patient. Acupuncture treat"I still have some soreness but I ments cost about $40a session.