I was looking back at my notes on experiences during Susie’s initial and recurrent brain cancer diagnosis/ treatment. My thoughts centered around what we might be able to do in preparation for another recurrence/ progression. The most challenging experiences IMHO were surviving complications from low platelets (thrombocytopenia) and low white blood cells (neutropenia). I feel there is not much prep we can do to stop either condition, mostly just try to live a healthy lifestyle (eat a balanced diet and exercise regularly).
However, I do recall one complication that manifested when Susie’s immune system was severely compromised. This was when she was part of a Phase 2 Clinical Trial at MD Anderson Cancer Center. She experienced a terrible case of Shingles, which is the reactivation of the Chickenpox (Varicella Zoster) virus. Her outbreak was extremely painful and in multiple locations, lower legs, torso and back. Twenty years ago the chicken pox vaccine was not widely available, in fact the herpes zoster vaccine was licensed in May 2006. Even if it was, she was 35 at the time and chances of getting Shingles for a healthy adult are very unlikely.
Looking at the Centers for Disease Control and Prevention website, they have a section under Vaccines and Preventable Diseases for both Chickenpox and Shingles. The Shingles Vaccination page is very informative. It looks like there are two types of vaccines, Shingrix (recombinant zoster vaccine) and Zostavax (zoster vaccine live). According to the website, Shingrix stays above 85% effective for at least the first four years.
Fast forward to the 2010s, Susie obviously has had the varicella vaccine. Now the question to ask is when to get a booster.
PS – I found the 2 Docs Talk Podcast, Episode 118: Scratching the Surface of Varicella, available via Apple iTunes, very informative. Coincidentally the Varicella podcast immediately follows Episode 117: Glioblastoma Multiforme – What would Jimmy V do?
