5. Medical Tourism 1

5. Medical Tourism 1

30 November 2023

Migraines do not readily respond to one medication and, even when they do, this can randomly stop, which is why the search continues.

I first heard about occlusal splints from a nurse who had worked for a Professor of Oral Medicine at the Royal Victoria Hospital, Glasgow. He had cured her. ‘You must see him,’ she said. Her eyes shone and I understood why. Unfortunately, by this time he had moved to Belfast, which was not so convenient. But, when you live in the Highlands, medical tourism is often necessary.

Early in my condition’s career I had been advised that mercury fillings were guilty. I never had my fillings replaced; I couldn’t afford it. But I did fully embrace the occlusal splint as designed (not exclusively) by this professor, who was by then a consultant in Oral Medicine at Queen’s University Belfast with many learned papers to his name and a particular interest in migraine.

A cure was on the horizon. My pathological optimism kicked in.

So off we went to Belfast one May morning in 1998. We took the ferry from Campbeltown while it briefly existed. And we made a jaunt of it.

I liked Belfast immediately. It offered an organic café, a lovely bookshop and it was my size. I’m particular about the size of cities. I like to be able to walk about easily. Of course the sight of several policemen with guns pursuing someone and fully barricaded police stations did detract a little.

The professor’s treatment was for those who wake up with a pounding head. This, he said, was due either to clenching the jaw or grinding the teeth in sleep. Even on the phone he was sure he could cure me and, of all the healers I had consulted, he was the most credible.

On our first meeting, he exclaimed when he saw my clenching muscles that he had never seen stronger ones (‘outside of a bull terrier,’ I added, and he was not amused), and although it was certainly not a compliment, I did not weep or lay about him but took it as an excellent omen. ‘You will never be far from a migraine,’ and he was right. It was good to hear that; I had never heard it before and it was true.

He was certain the splint would do the job. There is simply no other way these muscles can develop. He showed me extra bone that had grown in my mouth and what he called mutilation marks in my inner cheek! He was not surprised to hear my migraines were becoming continuous. I was at war. And … I was losing. Two clenching hours was all it took. If I clenched for one hour at night and added a couple in the day I would produce enough neuropeptides in my saliva to trigger an attack, as this, he said—and not chocolate, cheese, wine or any of the famous triggers—was the problem.

‘Can I take Imigran?’ I asked lamely, and immediately—and with godlike confidence—he said: ‘You will not need it.’ And I suppose I believed him and disbelieved him at the same time. He added that his work on the effect neuropeptides have in the saliva was groundbreaking.

This first consultation was not long or involved. After much exclaiming about my circus-ready mouth, he took an impression and said the healing occlusal splint would be ready in a few days, so off we went to Donegal, or Ireland proper, as I call it.

The Sandhouse Hotel at Rossnowlagh, with views of Donegal Bay and the Atlantic sweeping away to Canada, was not the hotel of our dreams. Our large room was cold and full of pretend antique furniture I expect to see in a down-at-heel B&B, but it had three AA stars and four Irish stars. Worse, there was no complimentary tea and coffee and no TV. I told reception I had a medical condition and needed boiling water all hours of the day and night, and they explained that their guests wanted to get away from TVs. But not guests who don’t have TV at home. Hotels were where we watched it.

Dinner the first night was mediocre, with too many doilies and not enough heat and taste. Breakfast the next morning was long waits and much guest muttering. The staff were run off their feet bringing wrong food to wrong tables—ignoring others. I raided the nearby table for milk when our muesli came without it and started a rush from others claiming cups, milk and cutlery, but without acknowledging my leadership even with a grateful nod. There were lots of Americans, some making a fuss, some accepting. Didn’t they know we rely on them for the fuss? We noticed one man being served immediately so we assumed he was from the AA.

As tourists, albeit health tourists, we started in Donegal town tourist office, where I bought a guide book I will glance at casually and cards I will never send. We drove round the picturesque coast of Donegal Bay to Killybegs, which smelt badly of fish processing, and where H’s father had been as a young fisherman. We then greatly enjoyed a wander on some of the highest and most impressive cliffs in Europe at Slieve League.

We visited Glencolmcille Folk Village, a shrine and splendid memorial to Fr James McDyer who established a self-reliant movement in the 1950s, bringing electricity, water and hope to a place of little hope. A place beaten down by a long heartless history.

Here my Catholic background and H’s Highland one melded nicely as I explained the stations of the cross, made from ancient stones, dotted about the village, and how following these universally gruesome images as a small child was probably responsible for much clenching. Indeed, may have started it.

The next morning, as neuropeptides appeared to be in triggering mode, I took paracetamol with a large dose of hope and we had a wonderful walk along the everlasting beach, the tide on its way out exposing hard sand. Donegal has many wonderful beaches. The cold wind didn’t help but the walk did. Cold wind about my head is often a trigger.

The pain stayed all day, but I managed a tour of the nearby Franciscan Friary called a Centre for Peace and Reconciliation, two things any relationship can do with. And also because every thread of my background stitched into the tapestry of our marriage is good. I live surrounded by his background and even then it is a mystery.

Much explaining was needed when H met a shrine to the three children of the Portuguese town of Fátima; in 1917, the Blessed Virgin Mary chose them to deliver a message of such horror that the Pope wept for weeks until runnels appeared down his cheeks (so introducing me to the word runnels).

This Fátima story had wrecked the peace of my childhood and definitely made clenching a cert. The Virgin Mary delivered three messages, from God I presume, but the third was so horrific that the Pope refused to tell anyone. All would be revealed in 1960, he promised. Meanwhile we must pray non-stop to prevent communist Russia, so recently our salvation, from taking over the world and wiping out Christianity. Even New Zealand would not be spared and they would force us to convert by threatening to pull out our fingernails and slice up our tongues.

And suddenly I became too ill to go on. Seeing lovely places while feeling hideously ill is the lot of clenchers.

So back to bed with Imigran to try and be well enough to travel to my splint fitting in Belfast.

The professor was much more relaxed and friendly. To my surprise I found myself in a line of occupied dental chairs. A conveyor belt of the afflicted.

He immediately started telling me about his 17 books that had never made him a penny and had I seen the TV programme about how Jeffrey Archer had entertained all the HarperCollins reps to push him into the bestseller lists. I twigged that he thought I was a medical journalist because he had asked if I were a housewife! Forcing me to say I was a writer. ‘Do you fancy a piece about all this for World Medicine?’ I may have said as I waved my arms at the conveyor belt. World Medicine was a doctors’ journal I had written for. 

The splint fitted my circus mouth and I was introduced to a German woman on my left and an Irish man on my right, both sufferers who were still able to go to work every day, which struck me as odd when they had migraine all the time. But they assured me that the professor and his splint had changed their lives.

It would not be overstating it to say I was almost sure that for the rest of my life I would wake painless and nowhere near a migraine. Of course, the Professor did say it could take a bit of time to work, which I chose not to hear, and despite his drug-free claims he also prescribed a daily dose of Prothiaden. Whether this was routine or whether he had been truly shocked by my ability to clench and knew an appliance would be up against it, I will never know. He called Prothiaden a muscle relaxant, but I soon discovered it was a tricyclic used to treat depression with anxiety and was famous for interacting with many other medications, including herbal. I was not overjoyed to be taking it but took it of course. I was also given a relaxation tape to do before bed—minus splint I assumed.

And the several-hundred-pound fee included a year’s treatment—weekly, monthly as needed—which would have been fine were we in Northern Ireland but useless to us in Lismore.

Wearing a splint to sleep is like having a large foot in your mouth you are very keen to eject. For this reason it has clips. I resembled a rugby player about to enter the scrum. Nevertheless I wore that splint day and night with no appreciative change in the number or severity of the attacks.

So before the first year was up I decided to invoke my year’s treatment promise and go back.

Photo by Karolina Grabowska: https://www.pexels.com/photo/a-dentist-at-work-6627423/

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