DEAR DR. ROACH: I have a friend who lives in Paraguay and had been diagnosed with chikungunya. It has been extremely painful for her for several years. Her doctor prescribed 90 mg of etoricoxib daily and a shot of duodecadron once a month.

I’ve never heard of chikungunya, and the medical care she is getting seems sketchy. I wish there was a solution for her immense pain. Do you have any knowledge of this virus and/or the medication for it? Are you aware of any new or trial drugs that might be worth trying? — J.

ANSWER: Chikungunya may not sound like a real medical condition, but it is a viral disease that was first found in West Africa. It has since spread to the Caribbean and the Americas with transmission occurring in the Dominican Republic, Puerto Rico, Hawaii, and a few cases in Florida.

It is spread mainly by mosquito. The word “chikungunya” is from an African language and roughly translates to “stooped walk” due to the joint pain caused by the disease. In addition to joint pain, people with chikungunya usually have a fever and often a skin rash. Headache and even meningitis may occur. However, joint pain is the most common long-term complication.

While most people will clear their joint symptoms within about six months, symptoms can go on for years in some people. Your friend is receiving a COX-2 inhibitor (etoricoxib), which has the potential for heart damage, so it is not approved in the United States.

She is also on a chronic steroid, dexamethasone, which is used in North America but may not be the best long-term treatment as it has numerous long-term side effects. In North America, people with chronic joint pain from chikungunya would be treated similarly to those with rheumatoid arthritis. This often includes methotrexate or another disease-modifying antirheumatic drug. I urge your friend to see a rheumatologist.

DEAR DR. ROACH: I frequently read in your column letters from people who have to get up during the night to urinate. My husband had this problem and got up hourly. We assumed it was as a prostate issue. After prostate surgery, he had a catheter for a few days, and we found that he was producing almost two liters of urine during the night. The urologist immediately ordered a sleep study to determine if sleep apnea was present.

He tested positive, was started on a CPAP machine, and only needed to get up once on the very first night. It changed his life. — D.S.

ANSWER: I thank D.S. for writing. Obstructive sleep apnea is a well-known cause for urinating at night, but we often forget to think about it. A really useful tool for sleep apnea, the STOP-Bang questionnaire, doesn’t include excessive urinating at night, but your letter is a good reminder to consider this diagnosis in people who are at risk for sleep apnea.

The risk factors in the STOP-Bang questionnaire are Snoring; Tired enough to fall asleep easily during the day; Observed stopped breathing or gasping for breath during the night; high blood Pressure; a Body mass index over 35; an Age older than 50; a Neck size larger than 16 inches (40 cenitmeters); and the Gender of male.

A person who answers positively to three or more of these risk factors should at least prompt a consideration of whether sleep apnea is likely enough to test the person for it.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2025 North America Syndicate Inc. All Rights Reserved