What can I take

QTHREE years ago I had a nasty attack of shingles which was not diagnosed for five weeks.

I now have end-of-nerve damage which makes my skin in that area so sore. When I shower in the morning I could scream with pain when the water hits my skin.

I am already taking gabapentin, aciclovir, atorvastatin and paracetamol.

Could you please offer me some advice? Are there any creams that would help?

ASHINGLES is caused by a reactivation of the chicken pox virus, which travels down one of the nerves from the spinal cord to the skin, where it causes the characteristic blisters.

It also causes inflammation of the nerve, leading to severe pain which may continue after the skin has healed, known as post-herpetic neuralgia.

Standard painkillers such as paracetamol often don’t help much and treatments that alter the pain message as it travels down the nerve are usually much more effective, though they do have to be taken regularly every day for at least a couple of weeks to reach full effect.

The dose usually also has to be gradually increased. Gabapentin is one of these drugs and it usually helps to take the edge off the pain but it would be worth checking if you are on the maximum dose. If you are, then it may be worth trying another medicine such as carbamazepine or amitriptyline. Applying capsaicin cream to the affected area can help and if this isn’t effective, then using a plaster containing the local anaesthetic lidocaine is another option.

Both of these are available on prescription from your GP.

MY grandparents are in their 70s and they both have a problem with excess saliva. What causes this and can it be cured?

AON average, a healthy person produces around a litre of saliva each day. Production is stimulated by chewing food, peaks when eating and is at its lowest during sleep.

Too much saliva can be due to excess saliva production or an inability to swallow effectively to clear saliva from the mouth.

Increased production can be due to gum disease, false teeth, particularly if they fit badly, and acid reflux from the stomach.

Difficulty swallowing can be associated with neurological conditions, including Parkinson’s disease, and may occur after someone has had a stroke. Apart from feeling uncomfortable, excess saliva can lead to drooling from the corners of the mouth, which can be embarrassing and can make the surrounding skin sore and prone to infection.

I suggest you ask your grandparents when they last saw their dentist and especially if they have false teeth, check whether they fit properly and also that their gums are healthy.

If the dentist rules out a problem with their teeth, then they should see their GP.

MY daughter recently returned from holiday with symptoms of dengue fever. I was amazed when she was given antibiotics by her GP without a blood test being carried out.

The next day she was taken by ambulance to A&E and diagnosed with dengue fever and a chest infection. I think she was badly let down but what is your opinion?

ADENGUE fever is caused by a virus that is spread by mosquitoes. It does not occur in the UK and only in people who have been bitten by an infected