Sunday, 10 November 2019

Out and About

I have been out and about a lot in the past week. Fully recovered now and friends in town. This is the lovely Antonia, who I first met in 2007 when I was fresh off the boat and living in a little roundhouse in Kisimenti. She turned up at the gate with another VSO volunteer, Karen, both working with the Deaf community. I was a newly-arrived sign language interpreter here to support the development of Rwanda's first dictionary of Rwandan Sign Language. The VSO community is strong and many of us have stayed in touch all these years later. 

Antonia sometimes pops back to Rwanda to catch up with friends and visit ongoing projects. It was a real pleasure to see her again, it's been many years. Plenty to talk about over lunch at Kiseki. 

Kiseki Green Tea Ice Cream
Had a lovely evening at Harris's lodgings, which is also an Indian restaurant with a pool. It was dark, so no decent photos, but I hope to go back for a swim if it ever stops raining. We chowed down on malai kofta whilst watching El Camino, the Netflix follow-up film to Breaking Bad.

Also had a lovely lunch at Kigali Heights with the Kigali Entrepreneurs Forum, which is an informal business network. We meet at a different restaurant each month to chat and share business information. 

In between all that, I went for a tour of a local health centre that's opening in January. I'm waiting to start a contract with two survivors organisations, and this is one of their projects. It's really impressive and I got to look inside an ambulance. 

There's some interesting things about ambulances. To keep down noise pollution, they're only allowed to use their sirens at blocked junctions. Someone said they can be fined otherwise. This is maybe an okay strategy in cities, as none of the houses here have double glazing or any form of soundproofing, but it's tricky out on the country roads where they come tearing past in an emergency, but you don't hear them coming, so you only know if you happen to glance in your mirror. Sometimes feels like they're trying to drum up business.

A friend asked me why you'd need a siren on an ambulance, and I explained how in the UK, when people hear a siren, they know an emergency vehicle is coming, so all the cars pull over and stop to let it pass. It makes the response time much faster and avoids accidents.

Someone said, 'But it's the same with the president's cavalcade. It doesn't use sirens either.'

But the president's cavalcade, when it passes through town, radios ahead to the police who stop all the traffic. They don't need a siren to warn someone they're coming because there's nothing in the road to hit.

It's an interesting balance between wanting to keep noise pollution to a minimum and wanting to keep people alive - both patients waiting for emergency help and those who might accidentally get in the way of a speeding emergency vehicle. 

There was also the issue of equipping the ambulances, which is very expensive. Currently, the three ambulances above are sharing one defibrillator because they cost around FRW 3 million each (around £2,500/$3,300). And that's just one piece of equipment you need for an ambulance.

It was very interesting to learn about the challenges faced by emergency services, and to look around the health centre. It's going to be an interesting few months and I'm looking forward to visiting projects in the field again, which is something I haven't done in a few years. 

Had another nice night out with Harris, checked out a restaurant we hadn't been to before - Billy's Bistro at Century Park. They do a Fancy Friday and it's very fancy and very yummy. Shiny menus. For under 10,000 you get a starter, a main and dessert. We were even treated to an extra dessert - chocolate mousse and cheesecake. Great atmosphere, view of the convention centre, friendly staff and live music. Thoroughly enjoyable.

Excuse the excessive pictures of table tops, but they've decorated them to look like old shipping containers and I thought it looked really cute.

Then, last night, we headed over to see Andy and the gang at White Club, the new name for former Pacha Club/Metallica/Rosty VIP in Kimironko (places round here change their names a lot). Viva Beats is a tradition for us. I'd say they're the best live band in Kigali. Seriously talented group and a real music hall atmosphere. They don't start until late on a Saturday, but the place is always jumping by the end - so many people dancing to an infusion of rock, modern pop, Congolese and East African influences.

They live to spread happiness - it's always an endorphin rush. We stumbled home in the early hours. Three straight days of drinking and enjoyment. Having an exquisitely lazy Sunday today, doing nothing of any importance. Might tidy up a bit later, might not. Time for another cuppa tea. 

After a shitting awful month, things are slowly returning to normal. Health is immaculate, still haven't found Gizmo yet but not giving up hope, and my relationship has been salvaged. Was a bit rocky for a moment, but thanks to a three-hour time difference between here and Shillong, we were both awake at stupid o'clock in the morning one night. He texted and we started talking. We're crazy about each other, and I guess that sort of crazy can absorb a few mistakes. I just can't wait for him to get back - another two weeks. Long-term readers will know it's been over a decade since I tried an actual relationship, and that didn't go so well. It takes a while to adjust to having someone else in your life, being vulnerable, insecure, trusting each other and getting to know one another. Not to mention the difference in our living arrangements and lifestyles (his pristine house and full-time staff, my rather untidy, self-catered bachelorette pad with cats). Yes, we've been friends a long time, but drinking buddies. There's still a lot to learn.

But I'm looking forward to it. I'm very much in love and excited for the future.

I'll leave off with a lovely picture Harris took of the bonfire at Jo's place the other day.

Tuesday, 5 November 2019

What Does Malaria Feel Like?

Last night was a major step in my journey to full recovery. I went out on the lash with my very good friend, Harris. We emptied a bar of beer at Kigali Heights whilst putting the world to rights. I was a bit hesitant as the last time I drank beer, I woke up having a nervous breakdown - which turned out to be malaria round two. But this morning I woke up feeling really good and very happy. 

I just wanted to make one last post about malaria, because someone asked me about it the other day. I posted before on how to cope when you get sick with it, but there are symptoms of malaria that surprised me and I thought worth sharing.

The lady who contacted me had been living in Rwanda for a while and was really worried about contracting malaria. She thought she might have had it but wasn't sure and asked me what it felt like. She said that the answers I gave were useful because they hadn't come up on the websites she'd been looking at.

Having had malaria three times now, I feel like I'm starting to understand it better, but please remember I'm only talking about p. falciparum, which is treated with coartem. I can't vouch for any other form of malaria. Here's the main take away from all that fun and games:

Malaria is Different Every Time

The first time, I vomited once at the onset, extremely violently. The second time, I vomited every twelve hours like clockwork. The final time, I didn't vomit once. A friend who got it said she had a splitting headache for a few days. I didn't really get headaches. 

Essentially, when you look up the symptoms of malaria, you're likely to get a personalised pick 'n' mix, but not all of them. Just because you've had it once, doesn't mean it'll feel exactly the same next time.


Malaria Doesn't Always Present with Fever

This is the one that threw me the final time. Fever is the big thing that everyone thinks about when they consider malaria. It's what doctors check for when you first get to the clinic. The first time I had malaria, I had fever. The second time it went as high as 39.7. The final time - my temperature was normal or slightly low almost the entire time. It once went to 37.7 and once to 38.1, but it passed very quickly. Mostly it was around 36.3-5. I'm not sure whether this is more common in recurring malaria (when it never fully went away the first time) than in new infections, but it's worth knowing. 

There is Usually a Cycle

Although fever was rare the final time, there was a cycle that repeated and tends to be a hallmark of the infection:

  • Severe aches (all across shoulders, chest and sometimes neck)
  • Extreme chills (remember the teeth-chattering gif?)
  • Fever (if it's going to come) 
  • Period of normality (hours or days)
  • Repeat

I would get extremely emotional between the aches and the onset of the chills. Realised I've started to have a panic reaction to chills as they were so violent the second time around. There's not much you can do about it but cry.

Malaria Doesn't Always Show Up in Tests

Strangely, my friend Emmy told me this when I had malaria at the start of October. He said to me, "You should get a second round of coartem because sometimes the first one doesn't work and it doesn't always show up in tests if you've already taken medication."

This is something that is apparently well-known among many Rwandans who have had malaria. I had never heard this before, and decided to stick with my one box of coartem. Coartem contains artemether, which takes quite a toll on your stomach, so it's not advisable to take more of it than you absolutely need, not without additional medication to help protect your stomach.

However, in this case, Emmy's words turned out to be rather prophetic. The first round of coartem didn't fully kill off the malaria, but it did reduce it sufficiently that it took four weeks to show up in tests again. That was an extremely difficult time for me, knowing I was sick but not knowing what the problem was because the blood tests were clear. 

So, even if your tests are clear, keep pressing the doctors if you know you're really not well, especially if you've already taken a round of coartem recently. The longer it goes untreated, the lower your immune system gets and the more susceptible you are to secondary infections (I had both a UTI and tonsillitis to add to my joy).  

It seems that tests are most likely to show positive if you get tested when you have fever. That's when it's hatching into your bloodstream, so there should be a higher count of the parasite. Of course, that's problematic if it's not presenting with fever.

There are Some Other Wacky Symptoms

Some symptoms that occurred every time for me, but which don't often show up on lists include:

Mad Appetite: One of the dead giveaways for me is a yo-yo hunger response. I'll be fine one moment, then absolutely starving hungry. Yet one bite of food will have me feeling full again, or I'll feel extremely hungry but not feel like eating anything. It's one extreme to the other fairly quickly. I don't know if other people have experienced this, though.

Unbalanced: I'm a bit accident-prone anyway, but I notice that even before the full symptoms come on, my sense of balance goes a bit squiffy. The first time I had malaria, I stepped off a platform and my legs gave way. The second time, I walked into a door frame I thought I had judged just fine. You go to do something and realise you're not quite calibrated.

Emotional: The last time I had it, when I had it but didn't know I had it, I became super emotional. I was sobbing all the time. It brought on a massive mood disorder. That's something to watch out for, especially a few weeks after a first round of coartem. Depression can be a sign that something isn't right physically.

How it Should Feel

The first time I took coartem, and this last time, I felt worlds better the moment the last dose was taken. It's a three-day course. Six doses of four tablets, taken morning and night (though our local pharmacist has just started offering a one-tablet ride, instead of four). You should start to feel much better very quickly, especially if you're taking decent painkillers with it. 

Within a day of finishing my last dose, I was back to my bubbly self. A week later, my energy is almost completely normal. I get tired a bit quicker, but that's because I haven't done much moving whilst sick. My emotions have also levelled out. I no longer burst into tears and I feel like I recognise myself again. I'm laughing a lot with friends and I'm fully functional at work. I still have a few aches and twinges, but given how much my body's been through in the past month, that seems acceptable. 

That was not the case when the coartem didn't work. I said to my friend, "This isn't how it felt the first time round." I was tired all the time. At first I was irritable, then I was openly sobbing when it started to hit. Then the aches returned - the shoulders and the chest when I breathed in. My normal energy level just didn't return. 

So, if you've taken coartem once and you're not feeling normal within a week, it's worth keeping an eye out for returning symptoms. 

It is best to get a medical diagnosis before taking a second round of coartem, because malaria shares a lot of symptoms with other things, such as typhoid and general infections, but if you start to feel like you're cycling, you're having aches, extreme mood shifts or fatigue, and you just don't feel yourself - keep pestering your doctor. Switch clinic if you need to. Just because it's not showing up doesn't always mean it's not there.

Final Note

And just a last note for women: not that you're going to feel much like shagging when you're sick, but coartem interferes with the contraceptive pill, so that's worth knowing.

Sunday, 3 November 2019

Holloa boys, holloa boys!

Picture of Health

And I'm back!

Finished my last dose of coartem on Wednesday 30th October, exactly one month after starting the first round. This was me the next day, out at Khazana with Harris. I felt a million dollars. Still do. Made me realise that the first round really hadn't worked. In 2015, when I had malaria the first time, I felt this good after taking coartem, but back in October, I was still really tired and under the weather after the first round.

Fingers crossed, that's an end to it. I took my last dose of antibiotics this morning. I'll give it a couple of weeks, then head to the clinic to check everything has cleared up and no symptoms return, but I'm feeling hopeful. My appetite has definitely returned, and I've been really enjoying food.

Spoilt rotten with a huge selection of chocolate, whiskey and pesto from Harris. They're still charging £7 a pot of pesto in the shops, so I'm super grateful. Been off alcohol since Gisenyi, so almost three weeks, but had a small G&T last night at the bonfire. All meds finished this morning, so I can slowly work back up to it. Looking forward to going out and having some fun.

Though absolutely and completely off the cigarettes now. I did enjoy smoking, but it's been a month of torture health-wise and I have no desire to start again. Thankfully, any nicotine withdrawal I suffered was totally eclipsed by the crappiness of malaria. Might as well just keep going.

Artistic Shot Taken by Sameer
Also taking precautions not to reinfect myself. Realised my house is swarming with mosquitoes since the wet season started. Females can apparently live indoors for up to a month! If one bit me when I had malaria and is still flying around the house, then bites me again... I have no idea about the logistics of this, but I'm taking no chances. I have bought a ton of spray and plug-in electric cocks. A veritable fortress of cock.

I went to a wonderful bonfire party last night, and the hostess, my friend Jo, came running up to spray me down with DEET the moment it started to get dark. 

It really was a lovely party, about sixty adults and children gathered around a bonfire for a night of thorough Britishness.

    Remember, remember the Fifth of November,
    The Gunpowder Treason and Plot,
    I know of no reason
    Why the Gunpowder Treason
    Should ever be forgot.
    Guy Fawkes, Guy Fawkes, t'was his intent
    To blow up the King and Parli'ment.
    Three-score barrels of powder below
    To prove old England's overthrow;
    By God's providence he was catch'd
    With a dark lantern and burning match.
    Holloa boys, holloa boys, let the bells ring.
    Holloa boys, holloa boys, God save the King!
    And what should we do with him? Burn him! 
It was a really wonderful night, full of sticky toffee pudding, mulled wine, baked potatoes and cheer. Though you do have to wonder about a nation whose main autumn festival involves gathering a group of children together to throw an effigy of a man onto a fire. My special appreciation goes out to the kid who yelled, 'Look, his arm's fallen off!' and another who wandered off to find more marshmallows. Nothing says quintessentially British quite like setting fire to stuff and screaming for a public execution...

When I got home, something about the size of my fist plopped past me on the drive. I was just quick enough to grab my camera and found a huge, fat toad. I've heard them many times, but never seen one.

Also saw this amazing caterpillar the other day, but sadly I think the cats found it before I did.


Entertainingly, when I woke up the other day, my cats had created a little toad hole of their own on the front porch. I was quite impressed by this. Looks comfy.

In not-so entertaining news, as I've been fairly house-bound for a while, I decided to use my time constructively and put my accounts in order. Like most people, I put all my receipts in a bag and then panic a couple of days before the deadline and try to stick them  into some kind of order. So, being sick has been stressful, but it's removed the stress of the financial year. Everything is neatly filed and up to date. Silver lining, I suppose.

Tuesday, 29 October 2019

Fuck Off Falciparum

Just an update on the health situation.

Felt a bit better for a couple of days, so dragged myself along to Kigali Black Food Festival. It's an international festival celebrating food that is coloured black, so basically the antithesis of unicorn food. Very little this unusual happens in Kigali, so I really wanted to go have a look.

It wasn't easy to find. They held it at Serena, which is a huge hotel in town, but nobody thought to put up a sign and none of the staff at reception seemed to have any idea there was an event going on. Just a load of lost people wandering around the car park looking for food. I was about to go home when I heard music and followed it to the very far side of the car park where there was a giant marquee. Even when I approached and asked the guy on the door, 'Is this the food festival?' He shrugged and told me to go to reception... Serena has a little way to go on event management.

I took a risk and went inside. It was the food festival. Instantly bumped into five people I know - which is the way of things in Kigali. Managed to get a picture in the live feed. 

L-R: Anysie, Leah and me.

Turned out to be more of a craft fair than a black food fair. There were some black samosas and someone had coloured the hot dog buns with beetroot, but mostly it was clothes, jewelry and cosmetics. Nice enough for a look round, though. I bought jollof rice and some exquisite peanut brittle from a Ghanaian lady who has lived here for the past couple of years.

Jollof Rice

Also bought some West African black soap. Both the soap and the jollof rice are things I was introduced to in Sierra Leone in 2008. Things you don't commonly see in Rwanda. Bought a few other things including an evil eye charm to hang over the door and a hot dog. Appetite was starting to return.

Black Soap

Only stayed about an hour, got home pretty exhausted but extremely happy I'd been on an outing and brought home some yummy food. Ate, watched Bojack Horseman, went to bed early.

Next day, still feeling fairly okay. Pottered about, washed some clothes. Started writing a contract bid. Got to the last paragraph - aches. Real bad aches. Swiftly followed by tears and shivers. I lay on the couch in a complete state and knew, one-hundred percent, this wasn't in my head. But lay there a long time because I was worried that if I went to the clinic and all the tests came back negative again, I wouldn't be able to take it. Thought it might just be better to lie there and let it pass without the discomfort of moving too much. 

Then the shivers started to sooth as my temperature bumped up and I thought, time to make a decision.

Talked myself through everything, out loud: get bag, wallet in bag?, get clothes, wrap up warm, get keys, take phone...

Left with three layers on and still felt like the Arctic all the way to the clinic. Had to go via an ATM machine and could hardly get the card in the slot I was shaking so hard. I love the Polyclinique du Plateau, but I wish so much that they'd get a card machine. They still do everything by cash and that's tough when you're sick and need emergency treatment.

Anyway, turned up sobbing as usual, was ushered into a side room, then a private bed. Again, the doctor was great. This time didn't ask a single question about my mental health, just took blood samples and got the nurse to jab me in the bum with a soothing dose of diclofenac. When I was able, I headed to the bathroom for another urine test. Then I closed my eyes and tried to sleep for a while until the results came back.

When the doctor walked into the room, I was really bracing myself. 

"Everything negative?" I asked.

"No," he replied. "You have malaria."

I burst into sobs all over again, but this time it was utter relief. 

I was fairly certain it was that quite early on, but when the tests kept coming back negative, I believed them. Now we had a name for what was happening and a course of action. I couldn't stop thanking him. 

They gave me an injection of something to help protect my stomach, because coartem is really harsh on the tummy, plus the antibiotics hadn't cleared up the UTI so I needed a seven-day dose of a different brand, and to top it off, I'd also developed tonsillitis. My immune system was wiped by the malaria.


Still, I must have been the happiest person on the planet to get it. Or at least to know I had it. The not knowing was hideous. I felt like I was starring in my own personal remake of Gaslight. Starting to question my sanity, wondering if it was all in my head. At least now I can cry like a child, safe in the knowledge I'm not losing my mind. 

I finish my last dose of coartem tomorrow morning. Due to it being very late when I got home from the clinic, and that you're suppose to take the second dose eight hours after the first, then every twelve hours after that, I unfortunately have to wake at 6 a.m. to take my morning dose with milk. I usually find it tough to get back to sleep after that, so I'm pretty tired right now, and sleeping a lot in the afternoons, but the aches have almost gone and the waterworks are under control. Fingers crossed, this is an end to it. 

It's now a case of building my strength back up and trying to repair some of the torture I put my body through with all the artemether, antibiotics and painkillers. It's been rough. Starting out with two large tubs of the most incredible locally-made natural Greek yoghurt from Casakeza. Delightful to eat and full of good bacteria.

In a bit of really lovely news, I took delivery of some beautiful art the other day. I did a favour for a friend and stored some of her stuff for a couple of years whilst she was away. In return, she asked her artist friend Rukundo to help transform the bass strings of my old Lirika piano into a giant treble clef. It was really emotional taking the strings off the piano. We took it apart to see if we could replicate it through the Kigali Keys project, and I knew I didn't want to throw them away. I had the idea of a treble clef, but nothing prepared me for what Rukundo came up with. It's incredible. A real statement piece that looks fabulous on my wall. Emmy came to drop it off, and it's as tall as he is!

Fingers crossed that by the next time I post, I'll be well on my way to recovery. Already doing much better, and I've been overwhelmed by the love and support of my friends. So many kind messages and hugs. Really got me through.

I will leave you with a scene from Rwanda's wet season. We've been having lots and lots of rain.

Friday, 25 October 2019

Crash and Burn

This is Sam's friend who visits every day to smack her head against the window. That's a pretty fit analogy for the past week, which has been one of the toughest in a very long time. Currently having an awful time of it. This is going to be a long, therapeutic unload.

And it's worse, because it started in such a lovely place. Ice-cream-and-apple-pie-on-the-beach lovely.

Did some editing by the water's edge whilst Sam was at work. Admired the wildlife.

Hadadas, so named because they make an insanely loud hadada hadada call.
Technically an ibis.

(panoramic, click to enlarge)

So, things on the plantation were going well. Until they weren't.

Had such a lovely night out a week last Tuesday at Serena. Really nice meal, snuggley and happy.

Woke up the next day to a phone call from the vet, saying they'd lost Gizmo. Literally, not euphemistically. The vet arrived in the morning to find his cage open. The door to an adjoining bathroom was also open, and the mosquito netting around the window was torn. So, looks like he made an escape. I'd dropped him off there before going to Gisenyi because he had an infected wound on his leg that just wasn't clearing. He was fighting me when I tried to tend to it, so I thought I'd leave him with the professionals whilst I was away for a few days and pick him up on the way back.

Not to be.

If you live in Rwanda, please take a photo of this picture and WhatsApp to anyone you know in the Niboye area of Kicukiro. Extra points for reaching local security guards.

Well, fuck, I thought. What a couple of weeks:

  1. Malaria
  2. Car crash
  3. Lost my cat

Not great, but I was feeling pragmatic about it. Couldn't get mad at the vet because she's a friend and was also distraught about it. Nothing like this has ever happened there before. Trust Gizmo to be the first.

Over breakfast, I started a discussion about when I should head back to Kigali. Sam was leaving for India for a month and I thought he might need a couple of days undistracted to pack. Agreed the next day would be okay.

And that's when the trouble started. I began to have big, dark thoughts. This world of sadness descended and continued to build. By the time he came back for lunch, I was sobbing uncontrollably. Absolute mess and incapable of saying why.

And yes, I know, malaria, car crash, cat - I know. But this was out of the ball park, and the thoughts I was having were all about fears for the future and personal insecurities. Wasn't having flashbacks to the crash or thinking about my cat. It was a full-on depressive meltdown.

Think Sam was a little bit stunned by this, and headed back to work with the suggestion of watching a movie later.

At which point, I did something monumentally silly.

I packed my bags, walked out of the gate and hailed the next bus back to Kigali.

When I feel extremely sick or extremely drunk, I have a homing instinct that would put most pigeons to shame. I just get up and walk out of places. I have to be on the move. Sitting on a bus is one of the most cathartic things when you're emotionally fucked, because you're surrounded by people but no one asks you to explain anything. You can just sit there and watch the world go past.

By the time I reached Kigali, it was dark and I didn't feel any better, but I needed to be in my own bed, in my own house, alone. Still, I really should have told him I was going and not put my phone on aeroplane mode. That was undeniably shitty, but I was in no state to cope.

Except for one brief trip to the vet on a futile search for Gizmo, I spent the next four days in bed sobbing my heart out and aching like a fucker. By the time I realised it wasn't going to stop, it was the weekend, and the International Clinic isn't open on weekends, so I had to wait until Monday. I didn't feel too certain about going to my local doctor in such an emotional state, because I wasn't sure how they would view a tearful mzungu. Traditionally, you're not supposed to cry, and I've felt bad in the past undergoing burn treatment when I've cried loud enough for people to hear. A lot has changed over the past few years, but I thought perhaps I'd fair better at the Belgian Embassy. It's the go-to for many expats.

So, round one. International Clinic, Monday morning.

I turned up hardly able to string a sentence together, I was crying so much.

The doctor checked my blood pressure, heart rate and glands, and took some blood samples for overnight analysis. I did say, 'I'm not sure if I need a head doctor or a body doctor,' and when she learned I had a history of mental health in my youth, she told me to go straight to counselling.

I went home, e-mailed my friend (who runs the counselling centre) and enquired, but decided to hold off for the blood tests.

That night, I had a fever of 38.1, and extreme shivers and aches. Didn't get to sleep until 4 a.m., with the aid of paracetamol. I'd had aches before - like flu - but until then I was still managing a full eight hours' sleep. But I'd always wake in the morning and within two minutes be soul-tired and crying again.

The next morning, I texted the doctor to tell her about the fever and shivers, but she said the blood tests all came back clear and to give it a few days and go talk to somebody.

Wasn't certain about that. Absolutely I was depressed, but that felt like a symptom, not a cause. I know the mind can affect the body, but vice versa, and I really wanted to rule out everything else before parting with 30k to sit on a couch. Decided to drag myself to my local clinic. Which, turns out, is where I should have gone in the first place. I like it there, they know me, it's always very efficient, and the doctor was amazing.

The first clinic hadn't told me what they were testing for, and just told me 'everything came back clear.' This doctor (who I also sobbed at for the first few minutes), decided to run every test they had. From pregnancy and STDs through to blood sugar and malaria.

He also asked a lot of questions about my day-to-day life, stress levels and even my dreams - which was a new one. Pretty clued in to mental health. Quite impressed by that. But no, I don't have nightmares or anxiety dreams, I sleep well most nights, I seriously miss my cat but my friend Emmy took me driving around for an hour handing out flyers to local bars, and I wasn't crying then. I cry when I wake up in the morning and when I ache. And I ache a lot. And it comes on so suddenly, and goes on for so long. I've lived overseas a while now, had my ups and downs, but this isn't normal.

Went back in the afternoon for the results.

Again, the doctor was great. Sat down and went through all the results with me, explaining everything. Not pregnant, no STDs (always nice to know), no malaria, but I had an infection and a fasting blood sugar level of 125, which is apparently one point off diabetic.

We went over and over whether I had eaten anything that morning, and I hadn't.

I texted to ask the International Clinic what my blood sugar had been the day before, because I also hadn't eaten then, but they hadn't taken a blood sugar test so no previous data to go on. They also hadn't taken a urine test - which is how they caught the infection.

Must admit, felt a little annoyed at that point. When you've had a history of mental health problems, however long ago, it can be extremely stressful to have that brought up as the go-to issue. Like you have to prove your sanity before you're taken seriously about physical pain, in ways people who walk in without that history probably don't have to do. I can understand why, from the doctor's perspective - vital statistics seemed normal, blood tests seemed normal, patient bawling her eyes out. Case closed.

But, realistically, you can't talk away an infection or hyperglycemia, no matter how good the therapist.

Fully willing to admit that the meltdown was an accumulation of everything: malaria, crash, cat, fella leaving for a month, but not willing to admit that's the conclusive reason for the physical pain I'm in. No doubt massively added to the stress, and stress crying is a thing for me, but not at all convinced this is all in my head.

The second doctor was pretty alarmed by the sugar results, and drew me a helpful chart showing how I should be eating. 

So incredibly sweet, and if I was eating, I'd have given it a go. Easier to achieve in Rwanda with melange, which is basically a buffet containing all of these ingredients, so you could happily load your plate like that.

He gave me antibiotics for the infection and some kick-ass painkillers and told me to come back for another blood test the next day.

Oh, my gods, what amazing painkillers. I swear, within twenty minutes of dropping them, I was giggling like a lunatic. Just to have that break from the aches. And my lovely friend Maia called to talk for forty minutes whilst walking home down Oxford Street. I was in tears all over again because she was so supportive. I owe my sanity to my friends: Harris, Solvejg, Dara and Jo. They all have infinite patience and kindness. Maia was the first to get me properly laughing again. No judgement, listened to everything that had happened, even the bits I wasn't proud of, believed me when I said it was physical, and just made it all seem a lot smaller.

Back to the clinic the next day...

Human Pin Cushion

Aiming for a sugar level below 100, got 104. Score. First day I wasn't weeping, so felt like the painkillers and antibiotics were kicking in. Continuing with that course at the moment. Still occasions when my back and chest are killing me, but emotions are a little more stable. Apparently infections and inflammation can trigger mood disorders. Just feeling believed and listened to made a huge difference. Feels like I'm taking some affirmative action.

See what happens in another three days when the meds run out.

Also, my adorable friend, Harris, gets back in a few days. He's a doctor and knows me really well, so hopefully he can offer some advice if it hasn't cleared up.

Slightly worrying.
Both the antibiotics and the painkillers look pretty similar.


I left off there to go spend an hour looking for Gizmo. Couldn't find him. If it was any of the others, they would come running up to greet me, but Gizmo is such a shy little boy. If there's anyone in the compound, he hides and won't move until they've gone. Hopefully, that means he's still around the vet's somewhere, but I'm only guessing.

Got home. Ate. Aches kicked in like a fucking bastard (swearing helps reduce pain). Harris called when I was in the middle of a full-on sobbing session. Continued for about an hour after the call, accompanied by extreme shivers. I was already on the good painkillers, but they weren't working. Then temperature bumped up and I was warm again. Heat soothes the pain. I'd rather have a fever than chills any time.

Totally exhausted, going to bed.

It's just the continuous pain. If I knew it was flu or malaria and had some idea how long it might last, I think I'd cope better. Thought the antibiotics would have really killed it by now, but still a couple more days to go. Going to ride it out and then see where we're at once they're finished.

Harris will be here really soon and I'll be in good hands. At this point, I want to try everything to see if anything helps, so it's really good to have a medical professional on hand to say, "Uh, that's not a good idea." Pain can drive you crazy.


So, that's been the shit side of things. And it has been pretty shit.

Also not sure if I still have a relationship at the moment. Walking off like that was crappy, and he was hurt. We've exchanged a call and a couple of messages since, but who knows. A month is a long time. I'm just going to focus on feeling well right now. The rest can wait.

Despite all of this doom and gloom, there have been some really nice things happening, too.

Between test results, I managed to hall myself to lunch with someone I've wanted to meet for a really long time. She's a bit of a living legend in Kigali, having developed tourist maps for Kigali, Kampala and Nairobi. She also runs a social media community and website for Kigalians, which I've been helping to moderate for about a year now. 

Before her Facebook group there was one called Expats in Rwanda. A while back they decided to have a clear out of their membership to remove all Rwandans and only make it about expats, but in doing so, they removed a lot of African members who came from places like Uganda and Kenya, and were legitimately expats in Rwanda. Seemed extremely racist, so a lot of us - including me - left. She set up her group as an inclusive place for all  people living in Kigali, so I like it much more. It's now got over 8,600 members, which is a huge achievement.

She lived here for a really long time, but now she's based in Canada, so although we've exchanged the occasional e-mail, we'd never met.

Went to Kiseki, where I managed to eat everything on the right-hand side of the plate. Major step forward. Ironically, an all-you-can-eat buffet, and that was all I could eat.

Just talked for ages and shared stories. Was really nice. She's extremely talented and very driven.

Then, on one of my better days, held it together long enough to attend an interview with an organisation I'm really excited about. I'd been for an interview a couple of months back. It went really well, but then didn't hear anything, so thought maybe they didn't need me. Turns out the director just had something else to attend to. By the end of our second meeting, he made me an offer that was pretty amazing. Significantly more than I expected, and great working conditions. I'm not jumping around the room yet, because nothing is signed, but we're in the process of drawing up a contract. If it goes through, the extra income would be pretty life-changing for me.

Randomly, one of their associate partners also dropped me a line and I'm going to discuss a contract with them as well next week. 

As fate would have it, they're both working in trauma and mental health. Also got a strong emphasis on human rights, which appeals. 

So, that's really exciting and given me something to look forward to. Going to work hard on my health so that I'm able to take this on. If I can get these contracts signed by mid-November, that should also help smooth over my visa application as they're renowned organisations in the country.

Action plan for the next week:

1. Finish meds, take painkillers, return to doctor if they haven't worked.
2. Squeeze the life out of Harris when he arrives.
3. Go get me a couple of contracts and a healthy living.
4. Continue to look for Gizmo.

Right, back to bed.

Poster on Clinic Wall Warning About Ebola