Q: I am 69, and my sister is 71. We don't remember ever having chickenpox. I have asked two doctors if you can get shingles if you never had chickenpox. I got two different answers. The same thing happened with two pharmacists. Please break the tie. We're trying to decide if we should take the shot or not.
A: If you really never had chickenpox as children, you can't get shingles as adults. The virus that causes chickenpox (Varicella zoster) lingers in the body and can crop up later in life as painful blisters called shingles.
Although it's rare, adults can catch chickenpox, either from an infected child or directly from skin contact with someone who has shingles blisters.
Even for people who are susceptible to shingles, the vaccine (Zostavax) is not foolproof. Studies show that it reduces the risk by about 55 percent (Journal of the American Medical Association, Jan. 12, 2011).
A reader points out what this means in practical terms: "Getting the shot does not guarantee that you will not get shingles. I had shingles years ago and got the shot when it first came out. I had shingles again two years ago."
Q: I want to sound an alarm about Gelnique in elderly patients. My 86-year-old father applied this gel for bladder control.
After three weeks of daily use, he started acting odd. A month in, he had symptoms of dementia. The insert that came with the drug never mentioned this as a side effect.
I made him quit taking it because he developed a rash. Not only did the rash go away, but so did most of the cognitive symptoms. Hopefully he will get back to where he was once the drug is out of his system.
I don't want others to lose their minds needlessly. Thank goodness I did not chalk this reaction up to his age, as his physician did.
A: Your father was fortunate that you were so vigilant. Drugs for overactive bladder such as oxybutynin (Ditropan, Gelnique, Oxytrol) can affect memory and cognition, especially in older people (Current Urology Reports, October 2011). Whether the drug is taken orally or as a patch or gel, it gets into the circulation and can affect the brain.
Many other medications also may interfere with optimal brain function in the elderly (Der Internist, October 2012). They include anti-anxiety drugs such as alprazolam (Xanax) or lorazepam (Ativan), certain antibiotics (e.g., ciprofloxacin), some antidepressants (amitriptyline, doxepin) and narcotic pain relievers (oxycodone).
We are sending you our Guide to Drugs and Older People for more detailed information about many other medications that should not be taken by seniors. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (65 cents), self-addressed envelope to: Graedons' People's Pharmacy, No. O-85, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.
Q: I take a multivitamin after breakfast. I notice that my urine turns bright yellow for several hours afterward. What causes this change in color, and is it dangerous?
A: Riboflavin (vitamin B-2) can color urine an almost fluorescent yellow. It is not dangerous.
Q: Are there any natural approaches for the pain of neuropathy?
A: There are two possibilities. One is alpha lipoic acid. A meta-analysis of 15 randomized controlled trials demonstrated that it is safe and probably effective for treating diabetic nerve pain (European Journal of Endocrinology, October 2012). The other possibility is benfotiamine, a synthetic derivative of vitamin B-1 (Pharmacological Research, June 2010).
One reader shared this experience: "Benfotiamine has absolutely stopped the sharp electrical pains in my feet. It also has considerably relieved the tenderness and pain on the skin of my feet. Nothing else helped me.
"I started with 300 milligrams a day — 150 milligrams in the morning and 150 milligrams in the evening. I have reduced that now to 75 milligrams a.m. and 150 milligrams p.m."