Posey Diagnosed With Shingles, Giants Need Caution

A few hours before first pitch in the San Francisco Giants game against the Colorado Rockies on Wednesday evening, news broke that Giants catcher Buster Posey was pulled from the lineup. The problem? Posey’s come down with shingles.

Shingles is caused by the same virus (varicella-roster) that causes chicken pox in children. The virus remains in the body’s nerves in a dormant state until activated years later. According to the National Institutes of Health, those adults most likely to develop shingles are over the age of 60, had chicken pox before the age of one, or have an immune system weakened by medication or disease. Stress, and stress-related fatigue, can also trigger a shingles outbreak.

Posey turned 25 in March. Giants beat writer Andrew Baggarly reported that Posey remembers having chicken pox when he was five or six years old. That suggests that medications, stress or weakened immune system were the likely triggering factors for Posey’s case of shingles.

Initial symptoms include fatigue and flu-like aches and pains. A few days later, pain and tingling begin, followed by a rash of blisters. Typically, the rash appears near the spine (where the virus lays dormant over the years), the chest, the stomach, or around the face and eyes. A shingles rash around the eyes can be very dangerous and lead to serious vision problems. Unlike chicken pox, the rash caused by shingles is more painful than itchy.

According to Baggarly, Posey first started feeling “run down” toward the end of spring training. The blistery rash appeared late on Sunday, at the end of the Giants game against the Arizona Diamondbacks. Posey’s rash is under his left arm and around his left shoulder and back. He does not have a rash on his face.

Posey was scheduled to be off on Monday, and the Giants were idle on Tuesday. Doctors started Posey on anti-viral medication and advised him that the condition “generally clears in four to five days, but can take as long as three weeks.”  The National Institutes of Health’s website states that the condition usually clears in “two to three weeks.”

About one of every five patients with shingles develops postherptic neuralgia (PHN), although the incidence is as high as fifty percent in patients over 60 years. Patients with PHN suffer from deep and unbearable pain that can significantly curtail their physical activities. PHN can last anywhere from 30 days to several years.

After Posey was pulled from the Giants lineup, but before first pitch in Wednesday night’s game, manager Bruce Bochy said that Posey was available to pinch hit and “will play” in Thursday’s game. Bochy’s comments struck me as a bluff, trying to leave the Rockies unsure as to whether Posey truly was unavailable. After all, Posey is just starting his comeback from the horrific left leg he suffered last season after a vicious home plate collision. The Giants had planned on giving Posey extra days off this season, to keep his leg strong and his body fresh. And yet, in a game that was already out of hand, with the Rockies leading 16-8 in the eighth inning, Bochy sent Posey up to pinch hit. Mercifully, he flied out to right field and returned to the dugout.

There is a lot we don’t know about Posey’s case of shingles: how severe the rash is, how severe the pain is, how fatigued he feels, etc. Nevertheless, given his season-ending leg injury last year, and the fact that this season is just a week old, the Giants would be wise to take a cautious approach. Nevertheless, Posey is in the starting lineup for Thursday’s game against the Rockies.

In 2009, relief pitcher LaTroy Hawkins, then with the Houston Astros, was diagnosed with shingles and developed tremendous back pain. He pitched with the pain for several weeks, with bad results. Eventually, the Astros put him on the disabled list. He returned to game action after fifteen days.

No doubt the Giants are anxious to keep Posey in the lineup as much as possible. San Francisco’s offense took a big hit last year when Posey went down in late May. In the first three games of the season, Posey had four hits in fourteen plate appearances, including one home run. More importantly, though, the Giants started the season with only one back-up catcher, twenty-two year old Hector Sanchez. The Giants optioned Eli Whiteside to Triple-A and traded Chris Stewart to the New York Yankees. Whiteside was Posey’s main backup in 2010. He and Stewart split catching duties after Posey was injured last season.

Sanchez jumped from Single-A to Triple-A in 2011, mostly due to his hitting, and looked over-matched behind the plate during his September call-up. His catching skills have improved but he has a lot to learn, particularly when it comes to working with the Giants’ starters. Other than Barry Zito, the rotation has performed uncharacteristically poorly so far this season, putting even more pressure on Sanchez should he have to carry a bigger load.

The Giants have a tough call to make. Posey says he’s well enough to play and is likely eager to get back to game action after missing two-thirds of last season. Hector Sanchez wasn’t expected to catch multiple games per week. Eli Whiteside is only a phone call away, but the Giants would have to either put Posey on the disabled list or send another player to Triple-A to make room for Whiteside.

Shingles can be tricky, and if not properly treated, could lead to a longer and more painful recovery period. The prudent thing might be to give Posey a few more days rest and then re-evaluate the situation. As the Giants learned last season, they can’t afford to lose Posey for a significant period of time.



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Wendy writes about sports and the business of sports. She's been published most recently by Vice Sports, Deadspin and NewYorker.com. You can find her work at wendythurm.pressfolios.com and follow her on Twitter @hangingsliders.


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fergie348
Guest
fergie348
4 years 5 months ago

So far (sss), the offense hasn’t been the issue. We need to shore up the pitching and the defense. I imagine catching (with the gear and all the squatting) probably won’t be comfortable for Posey for awhile. I’d bet first is easier for him to play.

My guess? Based on how it’s going I’d imagine Whiteside comes up to catch Lincecum, Bum and Vogey and Sanchez catches Cain and Zito for the next couple of weeks. The odd man out? Probably Belt, who’s been benched anyway. Sadly..

Kyle H
Member
Kyle H
4 years 5 months ago

Im willing to bet the fact the offense has been decent and the pitching hasn’t is definitely a sss problem. The Giants haven’t changed since last year by all that much.

Sean
Guest
Sean
4 years 5 months ago

Is this WebMD? Awesome analysis!

Derek
Guest
Derek
4 years 5 months ago

Great piece and obviously well researched. Some additional information about PHN.

From UpToDate: “the probability of developing PHN increases with advanced age. Most studies agree that PHN is rare in children. In adults younger than 60 years of age with herpes zoster, the risk of PHN is estimated to be less than 2 percent” (UpToDate sited this information from: “Prevalence of postherpetic neuralgia after a first episode of herpes zoster: prospective study with long term follow up. Helgason S, Petursson G, Gudmundsson S, Sigurdsson JA).

From my readings, assuming the Giants started Posey on either acyclovir or valacylovir they are following protocol to prevent PHN.

I am not going to pretend to know everything about Herpes Zoster or PHN, but from what I have learned and read, I am not worried.

DrBGiantsfan
Guest
4 years 5 months ago

Agreed. PHN is certainly a possibility,but it sounds like he is getting appropriate treatment and given his age, PHN is much less likely than in older adults or the total average incidence.

I do not believe playing increases his risk so that is entirely dependent on how he feels.

DrBGiantsfan
Guest
4 years 5 months ago

While H-Z is more common in patients with weakened immune systems due to age or disease, it also occurs in young healthy people for no apparent reason.

gryfyn1
Member
gryfyn1
4 years 5 months ago

And this is the First Plague Leveled by God, untill Bruce Bochy sees fit to free Brandon Belt

chuckb
Member
chuckb
4 years 5 months ago

Giants’ fans need to start throwing frogs onto the outfield grass in between innings in order to speed this process up.

kick me in the GO NATS
Guest
kick me in the GO NATS
4 years 5 months ago

I’ll believe you if the next home run hits the mud of a parted bay!

Jack
Guest
Jack
4 years 5 months ago

While Barry Zito did not perform poorly, doing such would not be uncharacteristic.

chuckb
Member
chuckb
4 years 5 months ago

From what I understand, shingles is extremely painful. As my mother-in-law lay dying of lung cancer, she developed shingles in what amounted to a miserable final couple of weeks. Granted, she was over 60 but this apparently isn’t at all like the annoying, itchy chicken pox most of us had as kids. It can’t be easy for Posey to don the tools of ignorance and squat behind the plate 150 times, much less hit and slide and do all the other normal baseball maneuvers.

Wobatus
Guest
Wobatus
4 years 5 months ago

I had it in my 20s and didn’t really even notice it. I told other people who’d had it and they were shocked. For most it’s quite painful I’m told. I was dating a nurse and she noticed the tell-tale rash across my back. I’d had chicken pox so I had it checked out and sure enough, it was shingles. Went away pretty quickly.

bstar
Guest
bstar
4 years 5 months ago

Chuck, it suckkkkkkkks. When my rash first appeared around my ribcage, I honestly thought it was an alien that had popped out of my stomach. It basically felt like I had 20 needles sticking out of my body. It was painful to wear a shirt. 20 years later, I still have post-shingles pain: If I twist and reach behind me to get something, I’ll have that recurring “alien” sensation for a few seconds. Fortunately, there’s good medication for it. How much pain Posey depends on his particular case; the pain can be mild to excruciating at times, just depends.

Wobatus
Guest
Wobatus
4 years 5 months ago

Yeah, see, that’s what everyone tells me. I had no pain at all. I just had a mild case of what I thought was backne (and no, I wasn’t taking PEDs), but it was along a nerve line on my back. I guess I was lucky.

kick me in the GO NATS
Guest
kick me in the GO NATS
4 years 5 months ago

Absolutely horrible! I had it about 8 years ago all over my left chest.

Cheech
Guest
Cheech
4 years 5 months ago

hysteria.

sprot
Guest
sprot
4 years 5 months ago
Rob
Guest
Rob
4 years 5 months ago

That was longer and didn’t mention baseball. I’ll stick to FanGraphs for all my medical news.

kick me in the GO NATS
Guest
kick me in the GO NATS
4 years 5 months ago

LOL. at least all that counts

Bo Knows
Guest
Bo Knows
4 years 5 months ago

Shingles is no joke it can really sap your energy, my Mother had it a few years ago (weakened immune system) Posey is a new dad so that kind of stress mixed with playing pro-ball probably got him.

Rufus T. Firefly
Member
Rufus T. Firefly
4 years 5 months ago

Rub some dirt on it and get back out there, Buster!

wily mo
Member
4 years 5 months ago

now scott cousins has given buster posey shingles. hath this man no honor

sawages
Member
sawages
4 years 5 months ago

I’m a healthy 32 and had shingles a few months ago. No other illness, low stress. Stress may be a trigger, but not always. Hurts like cray for a while, itches like crazy after that. could still function as a teacher, don’t now about catching. I wouldn’t be surprised if he sat out through the weekend. If he got on antibiotics early, that would help. Very contagious to anyone who has not had chicken pox or the vaccine. Interesting to see if any other players get it.

Derek
Guest
Derek
4 years 5 months ago

Anyone who has ever had chicken pox has the potential to get shingles All herpes viruses have the ability lie dormant. Once you get chicken pox, the virus responsible, herpes zoster, lies dormant in your spinal cord. When it resurfaces, it follows a particular dermatome, hence the distinct pattern. Shingles is not contagious in the sense that I can pass shingles to someone else who has had chicken pox. However, during a shingles flare, the patient is capable of spreading the herpes zoster virus to people who have NOT had chicken pox before. If his kids have not received the varicella vaccine, it would be advised because they are the people Posey could infect, not his teammates (assuming they have all had chicken pox before/received the vaccine)

Derek
Guest
Derek
4 years 5 months ago

Totally misread your post where you said “very contagious to those who have not had chicken pox”. My apologies.

Wobatus
Guest
Wobatus
4 years 5 months ago

When I had it I’d been sharing a beach house with some young couples, and 2 of the women were expecting. They freaked out and called their doctors. Yes it’s contagious, they were told, but mostly through direct contact. One doctor said just dont lick his back (where i had the rash). Being in the same room wouldn’t be an issue. But sure, buster should probably sleep in the guest room a but.

theDAWG
Guest
theDAWG
4 years 5 months ago

Valley fever, trampolines, shingles, saying you love Fidel Castro…

Being a baseball player is wicked dangerous, eh?

Nathaniel Dawson
Guest
Nathaniel Dawson
4 years 5 months ago

He’s going to be just fine. Whether or not he develops PHN.

It can be painful, yes (and unsightly if it occurs on a part of your body that’s visible to other people), but it’s the kind of pain that he’s not even going to be thinking about while he’s playing a Major League baseball game. At most, it’s just going to be an occasional distraction and irritation during down moments in a game. At night, while he’s trying to sleep or just relax in front of Sportscenter, yeah, it might be very bothersome, but it’s not something that’s going to keep him from being Buster Posey while he’s playing.

Oscar
Guest
Oscar
4 years 5 months ago

Everyone stop worrying … Nathaniel Dawson said it will be fine.

bstar
Guest
bstar
4 years 5 months ago

No, you’ve never had a bad case of shingles, obviously.

Nathaniel Dawson
Guest
Nathaniel Dawson
4 years 5 months ago

Well, yes I have, actually.

Nate
Guest
Nate
4 years 5 months ago

It is important to keep in mind that [i]all[/i] medical knowledge is some statistical average over a very large sample of people. Professional athletes comprise a fantastically tiny subsample that is not randomly chosen. In fact it is a sample that the primary factor is that their bodies work much much better than some random sample. In addition to this genetic difference, this sample keeps their body in a much healthier condition that the overall sample. Additionally, medical treatment is far more aggressive than most people receive, both in speed and power of treatment.

Michael
Guest
Michael
4 years 5 months ago

Nate, having superior hand-eye coordination & quick-twitch muscles (staples of professional athletes) does not in any way make athletes “healthier” than non-athletes. Overall health has far more to do with diet, lifestyle, immune system, etc. – athletes aren’t necessary superior in these areas.

RC
Guest
RC
4 years 5 months ago

No, they aren’t necessarily, but in the vast majority of cases, a professional athlete eats better, excercises more, and gets better care than your average american.

JKG
Guest
JKG
4 years 5 months ago

They were talking about playing Sandoval at catcher if necessary, weren’t they? Hoo-boy.

Bubba
Guest
Bubba
4 years 5 months ago

Last time the G-men had a 3rd Baseman catch (Pedro Feliz) there followed some comedy.

shthar
Guest
shthar
4 years 5 months ago

Poor bastard.

I’d rather have my leg broken.

maqman
Guest
maqman
4 years 5 months ago

I’ve broken a leg (twice) and had shingles, the leg hurts worse. (So did fracturing my skull and breaking my neck; broken fingers and ribs not so much.) Being an old guy I developed postherpetic neuralgia in the same area (right shoulder) months after the shingles healed. Trust me it is very painful and it doesn’t go away, in my case it just gets worse and at age 75 it will stay with me as long as I’m aboard the planet.

Herbalist
Guest
4 years 5 months ago

think the giants would be better off with Belt in the Minor Leagues if he is not going to play everyday in the big leagues.

I was one of many fans who experienced visceral pain during the 2011 season during every single one of Aubrey Huff’s 579 plate appearances; however, is not a post about why Belt should be in the lineup everyday.

It is abundantly clear that as long as Aubrey Huff is on the payroll, Brandon Belt will not get a chance to play and get significant at bats at the big league level.

Brandon Belt belongs in Fresno not because he struck out in 5 of his first 10 plate appearances (PA) but because Bochy and Sabean will not give him a chance to get 250 PA and demonstrate what he can do with big league pitching over a larger sample size.

read more by clicking on my name

Lex Logan
Guest
Lex Logan
4 years 5 months ago

“varicella-roster” should be “varicella-zoster”.

Timmy
Guest
Timmy
3 years 7 months ago

I know this is a dead and old thread, but the idiots on here that think that shingles is a walk in the park have no idea what some cases of shingles feels like. I have it on my scalp, face, mouth, inside my mouth and on my ear/eardrum on the left side. The pain is unbelievably excrutiating with strong pain medications barely putting a dent in it. I wouldn’t have thought this myself if I saw someone that had a shingles rash because it doesn’t ‘look’ like that much pain could possibly come from that. But live and learn.

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