麻豆传媒

FOR a few months last year, I broke the habit of a lifetime and started keeping a diary. I hadn鈥檛 taken a sudden interest in recording my innermost thoughts, I was conducting a scientific-experiment-cum-book-project. I called it my 鈥淢ustn鈥檛 Grumble鈥� diary; every evening, I noted down all of my minor health woes from that day.

Keeping a record confirmed what I had suspected 鈥� that I鈥檓 constantly slightly ill. Highlights included a cold, a twitchy eyelid that drove me nuts for three days and a terrifying loss of taste and smell. There was also the tedious matter of my chronically sore shoulder and athlete鈥檚 foot. All in all, I battled dozens of minor ailments.

I hesitate to extrapolate my findings to claim that everyone is a bit ill all the time, but I have yet to come across somebody who isn鈥檛. Think about it: when was the last time you enjoyed a day when there was absolutely nothing wrong with you?

And yet there is no formal scientific definition of a minor ailment, and medical understanding of such conditions is often surprisingly rudimentary. This should be a big issue, because about three-quarters of family doctor appointments in the UK are for conditions that rarely require medical intervention, such as back pain, dermatitis, indigestion, coughs and sprains. In the US, about 25 million people a year visit their doctor with common colds.

Even so, the coronavirus pandemic has dragged us back into a world where someone with a sniffle or high temperature can be gravely ill or even dead in a week. It is time for a major re-evaluation of minor ailments.

Obviously, there are occasions when we are properly ill 鈥� forced to retreat to our beds or make a doctor鈥檚 appointment. I鈥檓 not talking about that level of illness. I鈥檓 referring to the mild, irritating ailments and aches and pains that niggle us on a daily basis: headaches, coughs and sneezes, backache, cuts and bruises, zits, hay fever, heartburn, nosebleeds, constipation, insect bites and the rest. There is a lot that can go slightly wrong. All told, my research into the subject covers more than 100 minor ailments.

The vast majority of our illnesses are trivial, but even though they generally clear up by themselves, they collectively add up to a great deal of human misery. Occasionally, they can even cause serious complications. For some people 鈥� for example, those who are immunocompromised 鈥� everyday ailments can progress to something worse. Some can be early symptoms of a serious disease.

I would never discourage anyone from going to the doctor, but if we were collectively a bit better at distinguishing genuine minor ailments from the more worrying ones, we would save ourselves a great deal of wasted resources and unnecessary grin-and-bear-it suffering.

Tasteless sandwiches

Most of my woes turned out to be utterly insignificant. But in November 2020, I had a proper scare. I made a sandwich for my lunch and it tasted of鈥� nothing.

I went to the kitchen and opened the fridge. Cheese tasted like chalk; juice was watery. Chilli sauce packed some heat, but had no discernible flavour. I pulled out a beer, but it was only lunchtime, so I sniffed the cat鈥檚 bowl instead. For once, it failed to make me gag.

Uh-oh. My son had caught covid-19 in his second week at university and the first thing he noticed was a dulled sense of taste followed by a total loss of smell. Around that time, anosmia was starting to be recognised as a common early symptom. (He made a full recovery, but is significantly younger and slimmer than me.)

I will admit that I was scared. Thoughts of hospital, intensive care and even death intruded on my fevered mind. And even if I pulled through what I had by now convinced myself was an unquestionable case of covid-19, there was long covid to worry about.

Many respiratory diseases dull taste and smell due to a build-up of snot, but covid-19鈥檚 assault on the senses is more insidious. The virus sometimes invades the body via cells in the lining of the nose, leading to inflammation, which causes sensory neurons to malfunction.

I hotfooted it to the nearest walk-in centre and did a test. Sixty anxious (and largely flavourless) hours later, my phone pinged: negative. I was mightily relieved. My taste buds got the memo straight away and roared back to life. It seems probable that my loss of taste was just a common cold.

Man flu

I felt a bit foolish about my covid-19 wobble. I am not given to hypochondria and don鈥檛 easily crumble in the face of illness.

However, in this day and age, and at my age (51), being slightly worried and vigilant is actually rational and healthy. Not only is catching problems early better than letting them linger, I am also a man, and for us vigilance is doubly important.

The idea of 鈥渕an flu鈥� isn鈥檛 entirely without scientific merit. Women generally have stronger immune systems than men by virtue of having two mighty X chromosomes. Men, however, only have one X and one Y, which is smaller and has fewer genes (yes, men are genetic degenerates).

One of the X chromosomes in a female cell is mostly inactivated. But for reasons unknown, a few genes remain active. Some of these are involved in the immune response, including a gene called TLR7, which makes a protein that detects viruses. Women, therefore, have a stronger antiviral immune response than men, which may explain why men are known to get sicker and die more often from some viral diseases, including influenza and covid-19.

Armed with this knowledge, I keep the wise words that Spike Milligan famously wanted engraved on his gravestone on the tip of my tongue: I told you I was ill.

Headaches

Another minor aliment that made a regular appearance in my diary is the headache. This is no surprise: , headaches are the most common complaint in medicine and count as 鈥渁n almost universal human experience鈥�.

However, as with many trivial conditions, scientific understanding of headaches is surprisingly rudimentary.

The International Headache Society鈥檚 , also known as tension-type headaches even though tension isn鈥檛 a recognised cause. This list doesn鈥檛 include migraines or a category called trigeminal autonomic cephalalgias, the best-known of which are cluster headaches; these aren鈥檛 minor illnesses.

The vast majority of headaches have no known cause. By the same token, the ICHD notes that many things that are widely believed to causes headaches don鈥檛, including tension, stress, dehydration, bad eyesight, high-pressure weather systems or 鈥渂rain freeze鈥�. Some unfortunate souls get , a debilitating condition that is mercifully rare, although more common in men.

Even though a headache can feel like it is your brain hurting, it isn鈥檛. Brains don鈥檛 have pain receptors and cannot hurt. Instead, it is pain receptors in the blood vessels, nerves and meningeal membrane surrounding the brain that are doing the complaining, or often the muscles of the face and neck.

Painkillers are pretty effective for common-or-garden headaches. And yet such headaches are still a major cause of sickies and lost productivity. , and nearly half said they were less productive when they had a headache. For the roughly 1 in 20 people with chronic headaches 鈥� which means getting one most days 鈥� the impacts are even higher.

鈥淲omen have a stronger antiviral immune response, which may be why men are more likely to get sicker鈥�

For those who fear the worst when they have frequent headaches, the good news is that even chronic headaches rarely turn out to be cancer. Brain tumours can cause pain, but only 1 per cent have headache as their only symptom. So rest assured that if your head hurts, yet you are otherwise OK, it almost certainly isn鈥檛 fatal.

Aches and pains

Alongside endless entries on my sore shoulder, my diary also recorded pain in my knees and ankles. My shoulder is now better, but my elbow has inexplicably decided to flare up in its place. I feel like I am falling apart at the seams.

Which is because I am. My aches and pains are all in my joints, those overworked and damage-prone parts of the body where bone meets bone. Joint pain is extremely common and has multiple causes, some of them horrible (in a word: gout). But most of the time, the problem is just wear and tear.

Back pain is another leading cause of misery and economic losses. About .

Often they are caused by a , commonly called a muscle knot, on the front of the torso, which is somehow transmitting pain signals to the back. This . . Yet doctors often don鈥檛 even consider them when investigating unexplained pain.

Myofascial trigger points are essentially mini muscle cramps caused when small patches of muscle tissue go into a chronic spasm, often due to overuse. They feel like hard or squelchy nodules just under the skin, which are painful to the touch but can often be broken up by fingertip massage. This has led to the belief that they are crystals of lactic acid. They aren鈥檛. Massage works by relaxing the cramped-up muscle fibres, which causes the knot 鈥� and its pain 鈥� to vanish. The relief can be considerable, though often far away from the knot itself. Ironically, if something is hurting, 鈥渨here does it hurt?鈥� is often the wrong question to ask.

Overall, my Mustn鈥檛 Grumble diary confirmed what I have long suspected: I am not a well man. I didn鈥檛 get properly ill, but not a single day went by without there being something small to sweat about.

But I didn鈥檛 grumble. I have come to believe that our minor ailments deserve our respect and even gratitude. Victorious Roman generals employed slaves to whisper 鈥淢emento mori鈥� (remember you will die) to them during their open-top chariot parades, to keep them from getting too big for their sandals. This is how I see minor ailments: a nagging reminder that we are mortal, but that it could be worse, and one day it will be.

In the meantime, chin up: we mustn鈥檛 grumble. After all, what doesn鈥檛 kill you only makes you stronger.

Graham Lawton is the author of Musn鈥檛 Grumble: The surprising science of everyday ailments and why we are always a bit ill. To buy a copy, go to