Successful treatment of the varicella virus in hospice patients

Successful treatment of the varicella virus in hospice patients

Published in NAHA Journal 14.3 Issue 2005 Successful treatment of the varicella virus in hospice patients, using essential oils of Ravensara aromatica, Citrus bergamia and Melaleuca viridiflora var. quinquenervia. by Noel Gilligan Abstract This case study describes the successful outcomes of using a synergy of three botanical oils in the topical treatment of six hospice patients suffering from shingles outbreaks. The synergy was provided in a 5% dilution with distilled water in a spritzer bottle. After 48 hours, all patients reported a reduction in pain and inflammation, and in one case the actual disappearance of symptoms. The Bieri scale was used to measure outcomes, and results indicated dramatic and significant improvement over pre-treatment symptom scores. Introduction to hospice Hospice care provides comfort and symptom management to persons facing a life-threatening illness. Because the goal of hospice is comfort rather than cure, many hospices today are looking to utilize a broad spectrum of services to enhance quality of life for our patients. Aromatherapy is one such service provided by the Complementary and Alternative Medical (CAM) team at Horizon Hospice and Palliative Care, a diverse urban home-based hospice and palliative care service, located in Chicago, Illinois. Over the past two years we have seen some remarkable aromatherapy results with patients presenting with shingles. While shingles itself is, of course, not a terminal condition, the stress of living with a terminal diagnosis can often trigger outbreaks of shingles in hospice patients. Patient stressors and shingles. Shingles is caused by the varicella zoster virus. This is the same virus that causes chickenpox and herpes zoster. The virus can stay dormant in the dorsal root ganglion for years after an episode of chickenpox. When the body’s immunological protection becomes weakened through radiation therapy and immunosuppressive drugs, the virus can be reactivated. Other stressors that can cause reactivation of the dormant virus include hearing bad news, hospitalizations, family reactions, and the loss of controls that healthy persons often take for granted. Shingles is therefore a rather frequent and always unfortunate occurrence in hospice patients. Shingles is a painful condition, and can take 2-3 weeks and sometimes much longer to clear. Symptoms include extensive inflammation of the skin, blisters and pustules that appear in a band-like fashion on the chest or torso, and sometimes on the face. Shingles causes scarring that is very similar in appearance to severe acne. Conventional shingles treatments include an oral tablet called Famvir (generic samciclovir) and an ointment whose active ingredient is capsaicin, made from peppers. Both of these treatments have some success. After doing some research on essential oils and shingles, I decided to create a synergy of three oils, and provide patients with a spritzer bottle, consisting of 95% distilled water, with 5% of the essential oil synergy in a vegetable solubilizer. The patients would be asked to use the spray frequently as a body mist, at least three times per day on the area of the shingles rash. The three oils I chose were Ravensara aromatica (Ravensara), Citrus bergamia (Bergamot) and Melaleuca viridiflora var. quinquenervia (Niaouli) Ravensara aromatica is a tree with a reddish-grey bark, indigenous to the Indian Ocean islands of Madagascar, Reunion and Mauritius. The essential oil is steam distilled from the leaves and twigs. The oil is safe and non-toxic and gentle to use on the skin. It has a “medicinal” and disinfecting odor. According to Battaglia, its emotional profile is uplifting. Both Davis and Schnaubelt have published clinical studies on the antiviral properties of Ravensara, while Lunny recommends it for the treatment of herpes zoster. Melaleuca viridiflora var.quinquenervia –Niaouli--is both anti-viral and anti-bacterial. Like Ravensara its major compound is 1,8-cineole. This oil has had documented results with acne. Since the scars and pustules raised on the skin by the varicella virus resemble severe acne, and since Niaouli has well documented skin-healing properties, I decided to add this oil to the synergy. Citrus bergamia is cold expressed from the fruit of the Bergamot tree. It is high in furanocoumarins, including bergaptene, which make it phototoxic, but it is possible to find versions of this oil that are furanocoumarin free (FCF). As all of the patients being treated were homebound, and would not be exposing the skin to the sun, phototoxicity was not a great concern. This oil has well-documented results with cold sores, which also are caused by the varicella virus. In addition, it has tension and anxiety relieving properties that can help the highly-stressed. All of these oils are rich in compounds such as ketones and ethers, proven in clinical studies to have anti-viral and analgesic effects. Before aromatherapy was offered, patients were completely assessed for allergies and other possible contraindications. Physician’s orders were documented in the care plan, and safety labels were added to the spritzer bottles. Our hospice keeps Material Safety Data Sheets on all of the products used in the aromatherapy program in order to comply with federal OSHA regulations. Many patients decline CAM services for a variety of reasons. Some have never heard of them, some trust what they have always known, and some are just leery of what they do not know. The six patients in this study were the only six presenting with shingles’ symptoms who accepted the offer of aromatherapy over an eight month period. Measuring Patient outcomes with the Bieri scale. After 48 hours of using the spritzer as a body mist at least three times a day (four patients used it at least six times per day), all six patients in our program reported the following: a significant reduction in shingles pain, a scabbing and healing of the shingles pustules, and either a disappearance (one case) or reduction (five cases) or a “drying up” (three cases) of the pustules. In hospice, we use the Bieri scale, a visual- numeric analog, to measure symptom management and treatment outcomes. Before using the aromatherapy spritzers all six patients rated their shingles pain at a 6 or higher on a scale of 1-10, with 1 being no pain at all, and 10 being the worst pain imaginable. After 48 hours of use, they rated their pain as a 3 or less. In addition to reduction in pain, there was a visible reduction in inflammation. Table of Patient Outcomes
	PATIENT Pain rating BEFORE aromatherapy treatment Using the Bieri scale Other treatments used (Specify) Pain rating after 48 hours Other outcomes 1 8/10 Increased pain medication Tylenol 3 2/10 Pustules dried 2 7/10 Famvir 3/10 Inflammation reduced 3 8/10 none 3/10 Pustules dried 4 6/10 none 1/10 Rash eliminated 5 8/10 Famvir 2/10 Inflammation reduced 6 6/10 none 2/10 Pustules dried
	Other factors affecting outcomes In addition to the aromatherapy spritzers one patient increased her analgesic medicine, and two others tried conventional treatments (Famvir) in addition to the aromatherapy. It is therefore not appropriate to conclude that the aromatherapy treatment alone was responsible for the reduction in pain in all six cases. However, I have never heard of a pain medication that actually dried up shingles pustules! In addition, one of the patients reported that he had suffered frequent outbreaks and that the aromatherapy remedy was “by far the most effective, and worked faster than any of the conventional treatments.” Conclusion The patients in this study all reacted positively to the aromatherapy spritzers. There were no negative outcomes. All of the patients who used these aromatherapy spritzers reported a rather more radical reduction in their shingles’ symptoms than they were used to experiencing when using more conventional medications without aromatherapy in previous outbreaks. Author bio Noel Gilligan received his aromatherapy training in Europe and the United States. He earned master’s degrees from Loyola University and Keller Graduate School in Chicago, IL, where he also runs an aromatherapy educational consulting business for health care organizations. He is a RA Registered Aromatherapist on the CAM team at Horizon Hospice and Palliative Care, and is a member of NAHA. Noel has spoken at national conferences on the subject of aromatherapy. E-mail: Noel@mystic-monk.com References: Battaglia, Salvatore: the Complete Guide to Aromatherapy, Second Edition (2002) Structure and Function of the Human Body Thibodeau/ Patton (Mosby 1999) Davis, Patricia, Aromatherapy, An A-Z Lawless, Julia: The Encyclopedia of Essential Oils Lunny, V. Essential Oil of Ravensara, Aromatic Thymes, winter 1998 Schnaubelt, Kurt: Advanced Aromatherapy: The Science of Essential Oil Therapy