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	November 2004 47th Year No.11 Internet Edition Page 4 Click below for Page 1 Page 2 Page 3 Page 5 Home

In Memoriam

Darius Charlemagne (1927-2004)

On Friday, 15 October 2004, Darius Charlemagne died at his home in La Clery after a long illness.
To his wife Daphne and their five children Delia, Deighton, Dennison, Desmond and Dalkeith, we extend our deepest sympathies. In 2002, Darius and Daphne celebrated their 50th. wedding anniversary.

Darius was born in Soufriere and received his early education at the local primary school and upon graduation taught for two years at the same school. He then moved to the local Post Office as a Postman. Darius then joined the Civil Service as a Clerk of the Courts in Soufriere. From Clerk of Courts, he moved to be sub. Collector in Dennery/Micoud, Anse-La-Raye and Gros Islet. During this time he pursued studies in England and in Trinidad and Tobago. On his return, he was attached to the Ministry of Finance as disbursement officer in the Treasury Department and then he was moved to the post of training officer as well as being a Government negotiator in labour relations.

Promotions continued. He was appointed Postmaster General, then Permanent Secretary in the Ministry of Communications and Works, followed by his appointment as Manager of the Sea Port Authority. Finally he was employed by the Government of Tortola for a period of two years where he piloted the establishment of the B. V. I. Port Authority.

But Darius found the time to devote to various activities both to the Church in La Clery and to various associations and activities. He was involved in his parish as a council member and kept the Presbytery office functioning in the absence of the Parish Priest. He served on the Board of the Marian Home for the Elderly and at the time of his death was Chairman of the Board. He also served on the Board of the St. Lucia Diabetic and Hypertension Association and was the current treasurer. Darius also was a Justice of the Peace (JP). He was awarded the MBE in 1992 and the Les Piton (gold) medal in 1999.

This record depicts a loving father, a man of integrity and honesty, a man who loved his church and country and a dedicated man on behalf of the poor.

May he rest in Peace.

Saint of the Month
Solemnity of All Saints
November 1st
Some Saints of The Eucharist

by Sr. Theresa Corbie, S.J.C.

Pope John Paul II has proclaimed the year October 2004 – September 2005 year of the Eucharist, calling on the faithful to have a deeper devotion to Jesus present in the Blessed Sacrament He began his Encyclical Letter “Ecclesia de Eucharistia” which he presented to the Church at St. Peter’s in Rome on 17lh April. Holy Thursday. 2003. by stating:

"The Church draws her life from the Eucharist. This truth does nto simply express a daily experience of faith, but recapitulates the heart of the mystery of the Church. In a variety of ways she joyfully experiences the constant fulfillment of the promise: “Lo I am with you always to the close of the age (Matt. 28:20) but in the Holy Eucharist through the changing of bread and wine into the body and blood of the Lord, she rejoices in this presence with unique intensity.”

It seems fitting, therefore. that on the Solemnity of All Saints in this Eucharistic Year, some saints notable for their devotion to Jesus in the Eucharist. should be presented to you.

St. Frances Xavier Cabrini: feast day November 13, was born in Lombardy, Italy jn 1850, one of 13 children. In time she became the foundress of the Missionary Sisters of the Sacred Heart. It is related of her that on a feast of the Sacred Heart she remained in adoration twelve continuous hours, absorbed and as it were so magnetized to Our Lord in the Eucharist, that when a Sister asked her if she had liked the arrangement of flowers and draping adorning the altar, she answered : I did not notice them. I only saw one flower, Jesus and no other.”

St. Alphonsus de Liguori, feast day August 1, expressed his heartfelt appreciation of the Blessed Sacrament in this way: “Our most loving Redeemer. on the last night of His life,, knowing that the much- longed-for time had arrived on which He should die for the love of man, had not the heart to leave us alone in this valley of tears; but in order that He might not be separated from us ~even by death. He would leave us His whole self as food in the Sacrament of the Altar; giving us to understand by this that having given us this gift of infinite worth, He could give us nothing further to prove to us His love.”

St. Peter Alcantara, feast day October 19. in one of his meditations wrote: .”No longer is able to express the greatness of the love which Jesus bears to every soul. Hence that His absence might not be an occasion or forgetting Him, He left to His spouse, the Churchbefore His departure from this world, this most holy Sacrament in which He Himself remained, wishing that between them there should he no other pledge than Himself to keep alive the remembrance of Him,”

St. Mary Magdalen de Fazzi. feast day. May 25, expressed her faith and love for the Sacrament by praying: “0 Lord. You are as truly present under the sacramental species as You are in heaven at the right hand of the Father. Because I have and possess this great wonder, I do not long for, want, or desire any other.

Sr. Bernard of Clairvaux, August 20, calls the Sacrament of the Altar, “The Love of Loves.”

Saints and Feast Days

1. THE SOLEMNITY OF ALL SAINTS
2. COMMEMORATION Of ALL SOULS
3. St. Martin de Porres,. Religious
4. St. Charles Borromeo. Bishop
5. St. Sylvia. Mother of St. Gregory the Great
6. AJl Saints of Ireland; St. Bertille. Religious
7. Sts. Carina (Cassina) and her Companions, Martyrs
8. St. Godfrey (Geoffrey), Bishop (Amiens
9. DEDICATION OF THE LATERAN BASILICA
10. St. Leo the Great, Pope and Doctor
11. St. Martin of Tours, Bishop: Baptismal Date of BL Anne Marie Javouhey, Virgin and Foundress of the Sisters of St. Joseph of Cluny
12. St. Josaphat, Bishop and Martyr
13. St. Frances Xavier Cabrini, Virgin
14. St. Sidonius, Abbot
15. St. Albert the Great. Bishop and Doctor
16. St. Margaret of Scotland: St. Gertrude. Virgin
17. St. Elizabeth of Hungary , Religious
18. DEDICATION OF THE CHURCHES OF STS. PETER and PAUL, Apsotles
St. Rose Philippine Duchesne. Virgin
19. St. Mechtildc (Mathilda)
20. St. Benhard. Bishop of Hildeshelm
21- CHRIST THE KING; PRESENTATION OF MARY
22. St. Cecilia. Virgin and Martyr
23. St. Columban. Abbot; St. Clement I, Pope and Martyr; B1. Miguel Agustin Pro, Priest and Martyr
24. St. Andrew Dung - Lac, Priest and Companions, Martyrs of Vietnam
25. St. Catherine Labourc, Virgin
26. St. John Bcrchmans, Religious
27. St. Maximus. Bishop
28. FIRST SUNDAY OF ADVENT; Sl. James of lhe March., Priest
29. St. Saturinius, Bishop and Martyr
30. ST. ANDREW, Apostle

Shingles: Causes, Complications and Treatment

by Winston C. V. Parris MD, FACPM, FACA, CMG

Shingles, medically known as Herpes Zoster, is an acute viral illness that usually affects persons who are very ill, elderly, subjected to significant emotional stress or who are immunocompromised. The immunocompromised patient is one in whom the immune response system is malfunctioning. This malfunction means that the body’s natural protection mechanisms against invading organisms do not function properly. In those circumstances normally harmless bacteria, viruses or fungi may become serious and occasionally fatal infections. Thus, it is important for one’s well being and survival, to have the immune response intact and working efficiently. Examples of immunocompromised patients include patients with some kinds of cancer, human immunodeficiency virus (HIV-AIDS) or patients taking chemotheraperatic agents for the treatment of cancer. There are also some chronic illnesses for example tuberculosis or some collagen vascular diseases (eg, systemic lupus erythematosus) that may produce a compromise of the immune response system. In all the above mentioned illnesses and others where immunosuppression occurs, shingles may develop.

It is important to point out that in different countries there may be different cultural causes for the development of shingles. This was well demonstrated in a study I performed showing that the major cause of shingles in Japan is related to emotional stress whereas the major causes of shingles in the United States is related to cancer, HIV-AIDS and old age.

Shingles is caused by a virus called the varicella virus. This virus is present in most infants and children and manifests itself as chicken pox. Chicken pox occurs in infants and children and is associated with a pock-like rash all over the body. This rash lasts about 10 to 14 days and is usually associated with fever and other constitutional symptoms. When the rash heals and disappears, the virus usually disappears but in most patients it may recede and hide in sections of the central nervous system especially the spinal cord, major spinal nerves and a part of the spinal cord called the dorsal root ganglia. Infrequently the virus can stay dormant in the brain. Several decades later, either as a result of old age, severe emotional stress, HIV-AIDS viral infection or development of an illness or cancer affecting the immune response, a reactivation of the virus occurs. At that time the reactivated varicella virus affects the spinal nerves and the surrounding tissues around and over the spinal nerves including the skin. This clinical syndrome is referred to as shingles or herpes zoster. The affected tissues produces a characteristic rash with vesicles (small water like pockets under the skin) and these vesicles may subsequently become secondarily infected.

The location of the rash and vesicles could occur anywhere in the body. A review of the literature shows that 50 – 60% of the rash usually occurs in the thoracic or chest and is commonly located around the nipple area. The head and neck may also be affected by the rash and vesicles and in some cases the rash may spread to the cornea of the eye producing corneal scarring and subsequently blindness. Other locations for development of the rash include the abdomen, limbs pelvis and buttocks. There are some studies that have shown a correlation between the dermatologic (skin) distribution of the rash and a particular tumour. For example, some studies show that some gynaecological tumours (cancers of the ovary, cervix and uterus) and genitourinary tumours (cancer of the prostate and bladder) showed a preference for the development of shingles in the low back, sacral and buttock areas, whereas breasts and lung cancers were associated with thoracic or chest involvement with shingles. The blood related tumors for example leukemia, lymphoma and multiple myeloma were associated with shindles of the head and neck areas.

In a study I performed and published in 1986, I reported that of the patients I saw in my Pain Clinic at Vanderbilt University between 1985 and 1986, 60% of the patients who presented with shingles and who never had any evidence of cancer before went on to develop a cancer within 12 months after presentation. The cancers that usually developed were cancers of the colon, Hodgkins disease and leukemia. This is not to say that if one develops shingles they will get a cancer, but the sound clinical practice should be that if one develops shingles, there should be routine tests performed annually to ensure that patient is not developing a form of cancer. Shingles have also been associated with patients who have had radiotherapy and chemotherapy as treatments for cancer. The clear inference is that these treatments suppress the immune response system and makes the affected patient susceptible to developing shingles.

The word pathogenesis means the causes and mechanisms for the development of a disease process or pathology. The pathogenesis of shingles is such that there is an acute inflammatory change taking place in the nerves affected and these changes lead to permanent damage, hemorrhage and necrosis of the affected nerves. As a consequence of this damage, a process known as axonal degeneration of the nerves takes place and this process produces a variety of changes in the function of the nerve and all these changes may result in varying degrees of pain severity. This, of course, is a gross oversimplification of the pathological process of shingles which is much more complicated than this description. The net effect of all those changes produces scarring of the skin, extreme skin sensitivity to the slightest touch, electric like stabbing sensations and occasionally intractable and intolerable pain.

The treatment of shingles consists of the following:
1). Use of an antiviral medication for about one week. My preference is to use the antiviral agent acyclovir 800 mg 5 times per day for 5 – 7 days.
2). Use of an antipruritic agent (calamine lotion) to soothe and dry the affected skin.
3). Prophylactic measures to prevent the development of post-herpetic neuralgia.

It is appropriate at this time to discuss Post-Herpetic Neuralgia which is the syndrome resulting from damaged and scarred skin where the acute shingles infection was located. In those patients after the herpetic lesion of shingles had dried up and healed, there is usually residual pain in the same areas although the skin has completely healed. This syndrome is called post-herpetic neuralgia and results from destructive damage to the affected nerves; those changes are referred to as “deafferentation and demyelination” changes of the nerves. Post herpetic neuralgia pain maybe very intense as a matter of fact, I will share with you a very early experience of mine in treating this condition. In 1979, when I was just beginning to develop the concept of pain management, I saw a 79 yr old gentleman who was the father of a country western star in Nashville, Tennessee. He presented with severe left sided facial and neck pain which was the result of shingles he had developed 3 years prior to my seeing him. His pain was very intense and he had consulted every prestigious institution in the U.S. without obtaining any significant pain relief. At that time, my experience level in treating shingles was very limited and while in the process of treating him, he did not obtain satisfactory relief. One Sunday morning, he put his shotgun to his mouth and blew his head away. This suicidal action is occasionally the consequence of unrelieved and progressive pain which is usually found after the development of shingles.

The treatment of post-herpetic neuralgia is usually very disappointing primarily because the patients are usually seen long after the development of shingles. The key to successful treatment is to employ prophylactic measures early in the course of the development of shingles. These measures include the use of sympathetic nerve blocks (stellate ganglion blocks, lumbar sympathetic blocks) and epidural steroid injections. Published reports indicate that if shingles is treated within the time of onset and three months, there is a 75% chance of successful outcome; treatment within three to six months produces a 50% chance of success outcome. Treatment after six months produces a 5-10% chance of successful outcome. The clear implication is that early treatment is vital for successful outcome.

Treatment strategies for Post-Herpetic Neuralgia are:
1). Sympathetic nerve blocks
2). Epidural steroid injections (especially for chest lesions)
3). Tricyclic antidepressant drugs
4). Anticonvulsant drugs are extremely effective (e.g. , neurontin, carbamazepine, topamax, etc.)
5). Topical capsaicin
6). Intravenous lidocaine infusion
7). Transcutaneous nerve stimulation (TENS)
8). Narcotic analgesics (not usually effective)
9). Intrathecal morphine pumps
10). Dorsal column stimulation techniques

Most of those treatments if applied late, lose their efficacy and the more aggressive measures for example morphine pumps, are reserved for those cases when all conservative measures have failed. The development of this kind of nerve-related (neuropathetic) pain may be very incapacitating and debilitating. In conclusion, it is appropriate to reflect on the words of the famous philosopher , John Dryden who wrote “For the all happiness mankind can gain, it is not in pleasure but in rest from Pain.”

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