I am a 29-year-old second-grade teacher who was diagnosed with chickenpox two weeks ago. I am no longer contagious and have scabs all over. The problem is I am experiencing pain on my left side from my neck down to my hip. My left arm becomes numb and I have tingling sensations, and I have chest pain on my left side. I am also having trouble sleeping. My doctor told me that this is normal for an adult who has chickenpox. She told me to take Tylenol for the pain and said I should be better in a week. Is the doctor right? Is there something more I can do to relieve the pain?

Linda

I cannot tell you for sure whether your doctor is correct because I have not seen you myself, but I can give you some general answers regarding chickenpox. Chickenpox, also called varicella, occurs when people are first infected by the varicella zoster virus. As you know, the infection causes vesicles (small blisters) to break out all over the body. Later in life, the same virus can reactivate, causing a disorder called shingles. Shingles also causes vesicles, but they are confined to one area of the body, though occasionally they spread. Another difference between chickenpox and shingles is that in chickenpox, the vesicles itch but are not very painful. In shingles, the blisters are very painful but not that itchy. Shingles can be a severe disorder with pain that lasts long after the vesicles have scabbed over. Such pain is unusual in chickenpox.

Since you describe a lot of pain, I wonder if you had shingles, rather than chickenpox. Also, weakness on one side of the body is unusual in chickenpox, though in rare cases the disease has some neurologic complications. An important clue to your diagnosis is whether you've had chickenpox in the past. If so, then your illness is almost certainly not chickenpox, because a second new infection would be very unusual. On the other hand, you must have had a chickenpox infection in the past to develop shingles now.

To control your pain, we need to pinpoint the cause. Pain due to chickenpox usually is short-lived and easily managed. Tylenol (acetaminophen) is certainly a good first choice. Unfortunately, if your pain is due to shingles, it can be hard to treat. Some people respond to acetaminophen or ibuprofen; others do better with a different class of medicines. I have had some success with an antidepressant called Elavil (amitriptyline).

I suggest you first see how you do with the over-the-counter medications. Try taking an anti-inflammatory drug such as ibuprofen as directed around the clock, rather than just when you have severe pain. Of course, be sure not to exceed the maximum recommended dosage. If this does not help in a week or so, go back to your doctor and ask about other remedies such as Elavil. If he or she cannot help, then perhaps you should see a neurologist. If you do have shingles, this can be a tough problem. Fortunately, only rare patients have symptoms that last more than three months.

Finally, your sleep problems are not unusual. They can occur after many different types of illnesses. Insomnia can be relatively simple to manage in the short term with over-the-counter sleep medications. If the problem persists, you should definitely contact your doctor, because nonprescription sleep aids should not be used for long periods.