Day 65 - Stress

"Stress is the way that you feel when pressure is placed on you. A little bit of pressure can be productive, give you motivation, and help you to perform better at something. However, too much pressure or prolonged pressure can lead to stress, which is unhealthy for the mind and body.

When faced with a situation that makes you stressed, your body releases chemicals, including cortisol, adrenaline and noradrenaline. These invoke the 'fight or flight' feelings that help us to deal with the situation.

The fight or flight response was first noted by one of the early pioneers in stress research, Walter Cannon. In 1932 he established that when an organism experiences a shock or perceives a threat, it quickly releases hormones that help it to survive.

If the chemicals that are released during stressful situations accumulate from not being used, their effects are felt by the body. A build-up of adrenaline and noradrenaline increases blood pressure, heart rate, and the amount that you sweat. Cortisol prevents your immune system from functioning properly, as well as releasing fat and sugar into your blood stream.

Excess stress can manifest itself in a variety of emotional, behavioral, and even physical symptoms, and the symptoms of stress vary enormously among different individuals. Common somatic (physical) symptoms often reported by those experiencing excess stress include sleep disturbances, muscle tension, headache, gastrointestinal disturbances, and fatigue."*

*http://www.nhs.uk/Conditions/Stress/Pages/Introduction.aspx
http://www.stress.org.uk/What-is-stress.aspx
http://www.medicinenet.com/stress/page3.htm#symptoms

A number of people have asked me if my headache could be related to stress.

The human body is so complex that each and every one of us reacts to external circumstances in different ways. Maybe it is stress related.

Admittedly, we’re working very long hours here in Banjul: most days more than 14.

I have therefore decided to have body and head massages on a regular basis to try and relax a bit.

Luckily I am in living in The Gambia, where I can easily afford a masseuse.

I asked her to spend some time working on my temples - I told her to place a lot of pressure, especially on the right hand side, as this slightly alleviates the pain.

The intensity of the headache magnifies as soon as I lie down. Consequently, as much as I try and relax during a massage, I now become more tense and weary.

Day 58 - Wisdom Teeth

"Adults can have up to 32 teeth. The third molar teeth (commonly referred to as wisdom teeth) are the last to come through, right at the back. They usually appear between the ages of 17 and 25, although sometimes they appear many years later.

Nowadays people often have jaws that are too small for all 32 teeth – 28 is often the most we have room for. So if all the other teeth are present and healthy there may not be enough space for the wisdom teeth to come through properly.

Wisdom teeth can contribute to headaches. If a wisdom tooth is impacted or somewhat erupted, swelling can occur and gum tissues may be infected. The swollen gums and teeth can leave an individual with a badly aligned bite, which may then cause pain in the jaw area.

Inflammation and additional pain in the jaw joints and muscles leaves a person with what is called a wisdom tooth headache. If left untreated, pus may form and further inflame jaw muscles."*

*http://www.dentalhealth.org.uk/faqs/leafletdetail.php?LeafletID=43
http://www.headacheexpert.co.uk/DentalConnection.html

The drops for my low blood pressure that the Senegalese doctor prescribed have not alleviated my strong headache. I have been taking them religiously but have not seen any sign of improvement.

I was recently put in touch with a family friend who has suffered from similar headaches to mine - similar in the sense that no one knew what was wrong with him until he eventually found out what was causing the pain: his wisdom teeth.

I have therefore decided to have my teeth checked. The only problem is that I am currently in Banjul and there are hardly any dental clinics. I have asked around and have been told about one which is known to be fairly good.

As our car came to a halt off the dusty road, a hand painted wobbly wooden sign vaguely indicated that the Swedent Clinic was a few metres ahead.

The rundown building, with rolls of paint peeling off the walls, was open and I was greeted - to my great surprise - by two Swedish female dentists.

They explained they were living in the country for a few months training locals in dentistry.

I happily sat on the dusty reclining chair. I wondered how many people had (if any) sat on the chair before me.

I was surprised to hear the clinic had xray facilities.

“Your teeth are in excellent condition, and you haven’t even had any fillings” I was told. The dentist told me she couldn’t see any wisdom teeth but I begged her to do an xray just to make sure.

She did some xrays with an obsolete machine which nonetheless processed the results immediately: “You will never have wisdom teeth. Thirty percent of people never get them, and you’re one of them.”

Great, I thought to myself - at least I won’t have to go through all the pain of removing wisdom teeth.

But now another possible cause of the headache has been ruled out. The dentist nonetheless advised carrying out some small exercises by stretching and moving my jaw, should my headache be related to problems with my mandible.

I am however - once again - back at square one, with no concrete results.

Day 50 - Low Blood Pressure

"Blood pressure is the force exerted by circulating blood on the walls of blood vessels, and constitutes one of the principal vital signs of life, which also include heart beat, rate of breathing, and temperature. Blood pressure is generated by the heart pumping blood into the arteries and is regulated by the response by the arteries to the flow of blood.

Low blood pressure (hypotension) is pressure so low it causes symptoms or signs due to the low flow of blood through the arteries and veins. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidney, the organs do not function normally and may be permanently damaged.

For example, if insufficient blood flows to the brain, brain cells do not receive enough oxygen and nutrients, and a person can feel lightheaded, dizzy, or even faint."*

*http://www.medicinenet.com/low_blood_pressure/index.htm

The doctor measured my blood pressure yesterday during the physical examination and said it was abnormally low. He did not take any measures as he said he would check it again today when picking up my test results.

This morning I was told all blood tests are normal and there is no sign of any parasites or tropical diseases.

The doctor measured my blood pressure again - it was still very low. Given the normal blood results, he is utterly convinced my headache is due to my low blood pressure.

I myself feel that my headache is caused by something elementary that is being overlooked.

I am therefore highly enthusiastic about this new diagnosis and firmly believe the doctor may well be right.

Furthermore, the fact that the pain intensifies when lying down leads me to think that my headache may well be related to low blood pressure, as the blood circulates differently when standing or lying.

The doctor has prescribed some drops to take for three weeks on a daily basis; this, he says, should raise my blood pressure thereby putting an end to my headache.

I have now promised myself that whosoever may solve my headache will receive a bunch of flowers, a box of chocolates and a card explaining how grateful I am for having finally resolved my mysterious headache.

Day 49 - Tropical Diseases

"Tropical diseases are diseases that are prevalent in or unique to tropical and subtropical regions. Insects such as mosquitoes and flies are by far the most common disease carrier or "vector".

These insects may carry a parasite, bacterium or virus that is infectious to humans and animals. Most often disease is transmitted by an insect "bite", which causes transmission of the infectious agent through subcutaneous blood exchange.

The so-called "exotic" diseases in the tropics have long been noted both by travelers, explorers, etc., as well as by physicians. One obvious reason is that the hot climate present during all the year and the larger volume of rains directly affect the formation of breeding grounds. It is possible also that higher temperatures may favor the replication of pathogenic agents both inside and outside biological organisms.

Socio-economic factors may be also in operation, since most of the poorest nations of the world are in the tropics."*

*http://en.wikipedia.org/wiki/Tropical_disease

Needless to say I did not take the medication the Spanish doctor prescribed. Migraine tablets did not improve my symptoms over Christmas, and they certainly weren't going to do so now.

I am now in West Africa. On Friday, my colleague and I drove from Banjul, the capital of The Gambia, to Dakar, Senegal, to seek medical advice.

Health care in The Gambia is very limited so a trip to Dakar for some more blood tests was the only viable option.

The Clinique de la Madeleine, a privately funded French hospital, is a modern, soulless building located in the centre of Dakar.

I was seen immediately.

It has been nearly two months now and I am keen to try everything possible to rid my body of this tempestuous headache.

Maybe I caught a bug in Nigeria, and it may well be that a parasite is causing my infamous headache.

I told the doctor that I wanted to ‘do every possible test available on the face of the earth, in particular all tests to detect any possible tropical diseases’.

I need to return to the hospital on Monday morning to get my results.