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.

Day 29 - The Eyes & Ophthalmology

"In an average life, the eyes will see 24 million different images. They can focus quickly between distances of 10cm and infinity. We can see in bright sunlight and almost complete darkness and judge speed within 5-10% accuracy.

More of our brain is taken up with eyesight than any other bit of our body.

All this from a couple of balls only 2.5 cm in diameter.

Interesting facts:

- Brown is the most common eye colour, blue the rarest (only 8% of the world's population has blue eyes).

- Eyebrows protect our eyes from sweat running off our forehead. Over pluck at your peril.

- We blink about twelve times per minute. This keeps our eyes clean.

Ophthalmology is the branch of medicine which deals with the diseases and surgery of the visual pathways, including the eye, brain, and areas surrounding the eye, such as the lacrimal system and eyelids."*

*http://www.bbc.co.uk/switch/surgery/advice/body_mind/everyone/eyesight/
http://en.wikipedia.org/wiki/Ophthalmology

I am in Madrid and will be leaving for West Africa shortly. I got the results from the CT scan :

“Conclusion: no sinonasal cause for the patient's persistent right frontal headache is identified.”

A colleague of mine asked me if I have had my eyes checked. I haven’t. I headed to the Instituto Oftalmológico de Madrid, reputedly one of the best in Europe.

I was told I needed an appointment and was sent to A&E at a hospital nearby.

Having waited for two hours, I was eventually seen by an ophtalmologist. She told me there was nothing to worry about and could not see my eyes being related to my headache.

She told me to see a neurologist. I thought I might as well give it a go as I won’t be in Europe for much longer.

The neurologist said it is a migraine. I explained I was already prescribed migraine tablets and they did not help at all. Painkillers do not alleviate the symptoms, I explained to him.

He nonetheless prescribed some medication and sent me home telling me there is nothing to worry about.

He also advised seeing the same doctor as opposed to continuously changing person and also location (so far, I have seen people in the UK, France and Spain) - not a helpful comment given that my job constantly involves travelling and that so far all the doctors I have seen have been utterly clueless anyway.

Day 25 - CT Scan

"A CT (computerised tomography) scanner is a special kind of X-ray machine. Instead of sending out a single X-ray through your body as with ordinary X-rays, several beams are sent simultaneously from different angles.


The technique of CT scanning was developed by the British inventor Sir Godfrey Hounsfield, who was awarded the Nobel Prize for his work.

CT scans are far more detailed than ordinary X-rays. The information from the two-dimensional computer images can be reconstructed to produce three-dimensional images by some modern CT scanners.

Far more X-rays are involved in a CT scan than in ordinary X-rays, so doctors do not recommend CT scans without a good medical reason. Some patients may experience side effects due to allergic reactions to the liquid dye injected into the veins."*

*http://www.netdoctor.co.uk/health_advice/examinations/ctgeneral.htm

My company called me yesterday just after my appointment with the ENT doctor, and told me I am now going being posted to The Gambia in West Africa and not to Taiwan anymore. I immediately called the doctor and asked to be put forward for a CT scan.

I was reluctant to do a scan as I know they emit a lot of radiation - the ENT doctor recommended that, due to the negative health implications associated with CT scans, the maximum number of CT scans to carry out in one’s lifetime is five.

Today I went to a private hospital to get the CT scan done.

Obviously I expected to pay a large sum (I do not have private medical insurance) but what I was confronted with nearly gave me a heart attack (on top of the headache).

I was strapped to the machine and part slid into the tunnel - I could still move my legs about as only my head was tightly strapped.

The scan only lasted fifteen minutes or so, and I was relieved when it was over. Now all I need are the results which I am told will only take a day or two to get to me.

Day 24 - Otolaryngologist

"Otolaryngology is the branch of medicine that specializes in the diagnosis and treatment of ear, nose, throat, and head and neck disorders.

The full name of the specialty is otolaryngology-head and neck surgery. Practitioners are called otolaryngologists-head and neck surgeons, or sometimes otorhinolaryngologists (ORL). A commonly used term for this specialty is ENT (ear, nose and throat).

The term comes from the Greek ωτολαρυγγολογία (oto = genitive for ear, laryngo = genitive for larynx/throat, logy = study), and it literally means the study of ear and neck."*

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

I saw a private ear, nose and throat doctor today on Harley Street as I want to completely rule out the possibility of having sinusitis. Needless to say it cost a fortune.

The doctor said everything looked normal and wrote a letter for a doctor in Taiwan - which is where I am due to be posted for a few months - should my headache persist.

He advised I do a CT scan should my plans change and should I be sent to Africa again. In the meantime, he has prescribed a nasal spray to use for two to three weeks.

Day 17 - Acupuncture

"Acupuncture is a form of traditional Chinese medicine which involves the insertion of very fine needles at key points (known as acupuncture points) into the body.

Acupuncture is based on the Chinese belief that the human body is controlled by a life force known as Qi (pronounced 'chee'). Qi flows through the body in channels, known as meridians. When your Qi is disturbed or unbalanced it can make you unwell. Acupuncture aims to restore the balance of Qi, and helps it to run smoothly through your body.

Acupuncture is primarily used to ease symptoms of pain and discomfort. Studies suggest that there are a number of conditions which acupuncture can help to treat, including post-operative pain, migraines and nausea."*

*http://www.nhs.uk/conditions/Acupuncture/Pages/Introduction.aspx

The Chinese clinic where I had my foot massage also offered acupuncture.

I told the doctor about my one month headache. I was asked to remove my shirt and lay down on the bed.

I felt heat all over my back and needles penetrated my skin. It didn’t hurt.

The doctor murmured some things under her breath, in Chinese.

In broken English she told me to stay still, and that she would return shortly.

She eventually returned and took the needles out.

I feel more relaxed although the headache is still the same. I know things like this take time to come into effect so all I can do now is wait.

Day 17 - Foot Reflexology

"Reflexology is the physical act of applying pressure to the feet and hand with specific thumb, finger and hand techniques. it is based on a system of zones and reflex areas that reflect an image of the body on the feet and hands with a premise that such work effects a physical change to the body.

Archeological evidence Egypt (2330 BCE), China (2704 BCE) and Japan (690 CE) points to ancient reflexology medical systems. In the West the concept of reflexology began to emerge in the 19th century, based on research into the nervous system and reflex.

Pressure sensors in the feet and hands are a part of the body's reflexive response that makes possible the "fight or flight" reaction to danger. Feet ready to flee and hands ready to fight communicate with the body's internal organs to make possible wither eventuality. The sudden adrenal surge that enables a person to lift a car is an example of this reaction. Reflexology taps into this reflex network, providing an exercise of pressure sensors and thus the internal organs to which they are inextricably tied."*

*http://www.reflexology-research.com/whatis.htm

When travelling in China a few years ago, I treated myself to a foot massage nearly every day.

Although certain pressure points feel very tender or even sore, foot massage’s health benefits have long been known. Post massage, I myself feel a lot more relaxed, and at the same time also more energetic.

I decided to have foot reflexology today.

The usual reflexology points made me jump and cry out in pain: spleen, liver and kidney.

The pressure point that corresponds to the head (the big toe) did not hurt at all.

This leads me to think that the pain is related to my internal organs such as the gut, liver or kidney, as opposed to being caused by something in the head itself, such as an inflamed blood vessel.

Day 17 - Chinese Herbal Medicine

"Chinese Herbal Medicine (CHM) therapy involves the use of natural plants, minerals and even some small amount of animals, each having its own specific characteristics and particular medical use to treat diseases. These rectify the over-activity or under-activity of yin and yang, and help restore the body to its normal physiological functions.

Like other Chinese Medicine disciplines, Chinese herbal medicine is based on the principle that good health springs from maintaining a harmonious balance of energy, yin and yang, both inside and outside of the body. If this balance is lost, either within ourselves or in our environment, disease may develop.

Treatment with Chinese herbs involves the use of several hundred commonly used ingredients, including roots, stems, flowers, leaves and barks as well as other non-plant materials. Pre-prepared combinations of herbs in the form of pills, powder capsules and creams (for external use) are also used.

Combinations of these herbs, often using formulae designed and used for over 2000 years, are matched to the individual's needs, based on the pattern of symptoms presented to the practitioner."*

*http://www.atcm.co.uk/medicine.htm#acupuncture
http://1stclasshealth.com/gpage1.html

The Chinese doctor did not speak English; a colleague of hers, a Chinese lady, translated for us.

During my consultation, the doctor looked at my tongue and took my pulse at both wrists.

She suggested there were problems with my liver and kidney and advised taking a number of supplements and herbs to help detoxify, thereby alleviating the pain and eventually ridding my body of my miserable headache.

I have to take the supplements daily for the next six weeks.