Showing posts with label healthcare. Show all posts
Showing posts with label healthcare. Show all posts

Thursday, July 7, 2011

Japan and My Tonsils: Under the Knifu

Read part 1, 2, and 3 here.

Part 4

Welcome to the exciting climax of my Japanese tonsillitis adventure. I had tried everything but the one thing that I knew would work, cutting those suckers out. At the hospital the doctor agreed and scheduled my surgery in two weeks time.

After my meeting with the doctor was finished he told me to go with the nurse who would explain what I should and shouldn't do prior to surgery. The first thing she told me was "don't get sick." Very good advice, I thought. After that she told me the week prior to surgery I couldn't drink any alcohol, caffeine, or take any medicine or vitamin supplements. She also told me not to eat any garlic. Garlic? I think that was more for the surgeon's benefit than mine.

The nurse sent me upstairs to get all my pre-op tests taken care of. First was the urine test. I was handed a cup and was a bit dismayed to see that I didn't get my own private room to take care of it. There was just a normal bathroom with nothing but two urinals at which two guys were taking care of their cups. I waited until they left. I guess I'm shy. Next they took some blood. The nurse noted that my hands were sweating and asked me if I was scared. I told her that my hands always sweat when I'm incredibly manly. Also it was 100 degrees in there and I was dressed for the wintry weather outside. After that I had to get my chest X-rayed to make sure I had the correct number of organs. Next was the final step: the heart and lung test. For the heart test I had to lie on a table and the nurse put sensors on my ankles and wrists. I was a little embarrassed about the ankles since it was a cold day, which means I was wearing two pairs of socks. Don't judge me! We don't have fancy heaters in Japanese classrooms like your bourgeoisie country. My heart appeared to be working. Next was the lung test. I had to exhale into a tube while a computer measured my breathing. The nurse said I had to exhale in a very specific way. I had always thought I was pretty good at breathing since I practice literally always, but she kept saying I was doing it wrong. In the end I don't know if I ever did it to her liking but she stamped the sheet and let me go anyway.

The next two weeks passed by quickly. One week before surgery I had a "last night I can drink beer for a month" dinner at my favorite okonomiyaki restaurant. I had a big mug of the dark draft. It was delicious. I think I shed a tear.

The day before my surgery I was admitted into the hospital. I had a meeting with the surgeon and the anesthesiologist. My Japanese tutor, Mr. Ohta, and his wife were kind enough to come with me for this. My plan was to do this all myself relying only on my own Japanese ability, but then I realized I don't even understand everything English-speaking doctors say and it'd be safer to have a native speaker there with me so I don’t misunderstand something and end up with a kidney gone.

The anesthesiologist explained what would happen when I woke up. First they would ask me to open my eyes to make sure I'm conscious, then they would ask me to raise my hand and give the OK sign to make sure I can move, then they would look at me to make sure I'm not making an expression of excruciating pain. If everything looks good, only then will they take the breathing tube out of my throat.

I was shown to my hospital room. I was hoping for a private room, of course, though I knew that would be unlikely. The room was big, and held eight people who were all separated by curtains. It was actually not awful. Everyone had their own tiny fridge, a little safe for their wallet or watch, a desk, a closet, a TV, and of course the standard inclinable hospital bed.

That night I had my first Japanese hospital meal. It was spaghetti with meat sauce and it wasn’t bad. It was better than my own cooking at least.

I woke up early the next day, shaved, and brushed my teeth. I knew it would be the last time I would for awhile. I put on my hospital gown. A nurse came in and gave me a pill to help me "relax". I don't know what it was but I was suddenly drunk. I definitely didn't worry about the surgery any more though. It was more like "Woo! Surgery!"

"Woo! Toga!"

They wheeled me into the surgery room, which was huge and futuristic. The anesthesiologist hooked me up to the IV and began to reiterate the steps that would occur after surgery. I started to feel myself begin to pass out while he was talking and realized he was already giving me the anesthesia through the IV. I wasn't expecting that and wished he had let me know before. But whatever. Blackness.

I woke up and could have swore I'd been dreaming but I couldn't remember what. They made me open my eyes and give the OK sign. After that they took the breathing tube out of my throat. I was still out of it so I hadn't even noticed it was in there. I couldn't talk but for some reason I felt I had to thank them right then. So I gestured to a nurse and wrote "ありがとう" (thank you) with my finger. I don't know if she understood.

They wheeled me back to my room. I passed Mr. Ohta and his wife on the way but they weren't actually allowed to visit me then. I slept for two or three more hours. The nurse came and told me that if I needed to use the bathroom within the next two hours a nurse would have to go with me. Seeing as how I hadn't eaten or drank anything in the past 16 hours it wasn't an issue.

The first day and night were by far the worst. To coat the wounds my body deciding making gallons of saliva was the best way to go. I felt like I was drowning all day. I couldn't sleep for more than an hour or two because I'd have to wake up to spit. Also, I could constantly taste blood which they assured me was normal, as long as I wasn't bleeding profusely. But they said that I shouldn't swallow because the blood could make me throw up. Throwing up right after throat surgery sounded like the worst thing ever. Fortunately I was nausea-free. Also pain-free due to my constant companion, the IV.

The next day I was already much better. The saliva factory that was my mouth had calmed down. At 7AM my surgeon and a nurse came in. The nurse took my temperature and gave me a new IV. The surgeon looked in my mouth and declared that everything looked normal. I asked him (by way of a portable dry-erase board I brought) about when I could eat. He said lunchtime. I was looking forward to it.

That lunch was the first of many identical lunches. The only food they had for people like me was called kayu, which is just watery rice. Do you remember that scene in The Matrix when they're eating in the real world? Their food is described as both runny eggs and a big bowl of snot. I bet dollars to donuts that they were eating kayu. I ate juicy rice for three meals a day for seven days. Never had my taste buds been so underused. By the end I was surprised they hadn't atrophied and died. One time they gave me some kind of fruit paste for dessert. It was like a mini Christmas. That mashed up fruit was the best thing I had ever eaten. It was strange; my biggest craving the whole time I was in the hospital was bread. Just some bread. I would have killed for a piece of toast.

I guess I should have mentioned that Japanese hospitals work a bit different than the ones in America. Not only is the health care socialized but it's also much, much cheaper. This plus them being extremely cautious about their patients lead them to not kicking me out the next day like I would have been in America. I had seven days to kill. I passed my time in my little curtained room studying Japanese, reading manga, and playing my DS. My friends and my girlfriend were nice enough to visit me a couple times, and I appreciated the company. But also, to be honest, I didn't mind my alone time. I'm usually so busy with work it was nice to just have a whole week to myself where my only obligation was to rest and get better.

I was by far the youngest person in my room. I made friends with a guy named Mr. Fukayama who had been in and out of the hospital for a year fighting off lung cancer. He had the bed next to the window, which was prime real estate. We would sit and talk about random things. It was all harmless conversation until one time he inevitably started talking about the war. He didn’t fight in it since he was ten at the time, but he sure had a lot of opinions about it. He wasn’t very sympathetic to my gaijin ears and talked too fast for me to catch everything. Old people love to bring up the war, especially if you happen to be an American. Of course I was negative 40 years old when the bomb was dropped so my end of the conversation was mostly looking solemn. Despite the war conversation he claimed to love Americans. He had traveled all around America as well as many other countries. He just kept saying how great everybody was. “Spanish? I love the Spanish!” “French? I love the French!” “Russians? I f***ing hate Russians.” Yeah, he wasn’t a fan of the Ruskies.

You'd think being in a room with seven other people would have been loud and annoying. But everyone kept their voices down. Well, except for one guy. He had sleep apnea and snored louder than I have ever heard a person snore. He slept constantly all day long: a never-ending snorefest. Fortunately at night the nurses would come and wheel him out of the room. I wondered where they took him and imagined a soundproof room covered in that black foam they have in recording studios, or somewhere underground.

In the same wing of the hospital but in a different hallway were women and small children. There was one shower room to share with everyone. Because of this, for only two days a week us men had a four-hour window to take a shower. I was forbidden to use the shower after my surgery in case of... something. I was finally granted permission on day five of post-op. This was by far the longest I've ever gone without taking a shower. Entering the shower room I was not surprised to find it was a Japanese communal shower and bath similar to a sentou, a Japanese bathhouse. My high school didn't have communal showers, I've never been in the army, and so far I've kept out of prison so I never had the pleasure of having to shower with a bunch of naked guys. The idea never interested me, which is why I've never gone to an onsen, a Japanese hot spring, which some people find blasphemous. "You live in Japan and have never been to an onsen? They're TO DIE FOR!" That may be so, and you might think I'm shy, but I'm not. And maybe I will go someday, but I wouldn't want to go alone and hang out with a bunch of naked strangers. But also I can't imagine going up to my friends and saying, "hey bros, let's get naked and take a bath together because that is a normal thing that people actually do." I had one experience in a Japanese sentou while staying at a ryokan, a tradition Japanese inn. It was just me and a Texan named Woody who kept talking to me while I did my best to ignore the fact that I was talking to a naked Texan named Woody. Anyway, at the hospital, I was so happy to finally get a shower that I actually enjoyed making small talk with the extremely old naked guy at the shower next to me. It totally didn’t feel weird. Which was weird.

At one point during my stay I had just been given a new IV and was sitting on my bed. Suddenly everything seemed to sway and I felt a little nauseous. I thought the IV was making me sick but then I noticed the IV line was swaying as well. “Just a small quake,” I thought. That turned out to be the Great East Japan Earthquake, one of the five worst quakes ever recorded. It was over 450 miles away.

I have nothing but good things to say about my stay in that Japanese hospital. All the staff were extremely polite, friendly, and helpful. My surgeon was great and I recovered much quicker than the Internet would have led me to believe. I was never in any real pain and every day I felt drastically better than the one before. That being said, there was one issue I had which is more of a Japanese thing than a specific problem with the hospital. Payment. No matter where you go in Japan, money is the most inconvenient thing. It seems like they haven't completely figured out how it should work. For example places that accept credit cards are rare, banks close hours before you get off of work, and even ATMs close because for some reason even machines need a break. Also your own bank's ATM charges you a fee for using it after the bank is closed, as if you have a choice. These are minor quirks compared to the problem I ran into at the hospital. The rules are as follows: A, you aren't allowed to bring large amounts of money for fear of theft. B, there is no ATM on site. C, they don't take credit cards. D, you must pay when you leave. Meaning you're expected to pay the equivalent of thousands of dollars in cash with money you’re not allowed to have and which can only be gotten from a place you’re not allowed to go until you pay the thousands of dollars in cash. In the end Mr. Ohta was nice enough to pay up front then drive me to an ATM so I could immediately pay him back. But that's not a payment system. That's the complete lack of a system. And this happens with every patient?

But besides that, my experience with a Japanese hospital was nothing but good. At first I was worried about getting my tonsils out in Japan instead of America, but in the end it couldn't have gone better.

To sum up this four-blog-entry-long tale: from the time I first got sick I had felt a healthy dose of frustration, disappointment, and fear in dealing with Japanese doctors and health care. But in the end it all worked out. I feel so positive about the whole experience now that I forget that there was a time when I was cursing Japan and it's health care system. Now I can't help but praise it. To any foreigners living in Japan who are in need of surgery: you may be considering paying the extra money to fly to your home country and getting it done there. No need! Believe it or not their techniques and medicine are just as good as back home, and in some cases much better judging from the horror stories my friends have told me about getting their tonsils out in America. It's been three months since the surgery (I'm pretty bad at getting these blog entries out in a reasonable time, aren't I?). It's the longest I've been without strep throat in years and I think I can knock on wood and say that part of my life is over. Now I can go do karaoke without fear of getting sick the next day.

I also want to add a message to all those adults out there with tonsillitis because their parents didn't love them enough to get their tonsils out as a kid (just kidding Mom!): just get the dang surgery. And hey, might as well do it in Japan, right?

Good night, and good luck.

Wednesday, April 27, 2011

Bye Bye Bacteria!?

I've been tending to agree more and more over time with the AJATT (All Japanese All The Time) philosophy, which basically says that total immersion is the best way to learn a language. Failing that, get as much exposure as possible, and make sure you have fun. If studying becomes a drudgery, you lose motivation and everything can go to hell.

Lately I've been feeling a bit lazy and have lost some ground on the JLPT textbooks and Anki usage. However, I have been playing a lot more (Japanese) video games, and I continue to try and do some reading in Japanese. That brings me to the topic of today's post. 

One of Khatzumoto's (of AJATT) recent tweets:

Yes! I'm going to approach that a little differently. Say you want to read some news (or just read something) in Japanese, and say your vocabulary and/or grammar are limited. Sitting down with your dictionary and a long article may really help you improve. If you have the time and motivation. But if not, is it better to just do something else? Maybe, but I'd say it's worth skimming. Look up key words and anything else that may strike your fancy, but otherwise just try to get the main idea of what's going on.

I took just that approach with a Yahoo Japan article about fluorine in toothpaste. I recommend aiming for something like this, which isn't too long, is written for a general audience (meaning no extremely technical terminology), and is relatively interesting (as this was for me since I like reading about health). 

I would also suggest that for these speed readings you use either the Firefox add-on Rikaichan, or for Chrome its brother extension, Rikaikun. They're useful for getting the readings and meanings of words on the quick, but just be careful not to get too used to them as crutches.

This piece took me all of 5 minutes and I walked away with two or three new vocabulary words:

フッ素 (フっそ) = fluorine
塗る (ぬる) = to coat
弾く (はじく) = to repel

For those of you who are interested in reading or skimming it for yourself, go on. I'll just wait here for you.


Ok, good - now that they're gone, let me summarize the article for the rest of you.

The article is about protecting yourself from cavities with simple fluorine care. It starts off by noting that the amount of fluorine found in commercial products and those in hospitals and dentists' offices are different. How, you wonder? That's what the article is aiming to explain.

First off, it seems that some people think using fluorine on your teeth coats them and protects against things like water and dirt or germs (like waxing a car). Actually, it doesn't have so much to do with protecting the surface of your teeth as it does with aiding the enamel in three ways.

1. It strengthens the enamel.

2. It promotes recalcification (repair; restoration of mineral, calcium in this case).

3. It slows down the bacteria that cause cavities.

Bye for now, bacteria!

Finally, what is the difference between commercially-sold toothpaste and the hospital-caliber stuff? The former is limited by law to 1000 ppm (.1%), whereas the doctors' toothpaste packs 9000 ppm (.9%). So if you're worried about getting cavities, you should see your dentist every 6 months for a cleaning with the good stuff.

There you have it.

By the way, I searched several oral care companies' websites but failed to find any fluoride content information. According to Wikipedia, however (the next best thing to solid research), most toothpastes (I presume in the West) contain about 1450 ppm. I guess that may be why we hear about Japanese toothpastes not being as effective - because they have a comparatively lower flouride content.

Wednesday, April 20, 2011

Japan and My Tonsils: Celebrity Doctors and The Looming Surgery

Read part 1 and 2 here.

Part 3

A brief recap: After coming to Japan almost 3 years ago I somehow caught a nasty bug that would often leave my throat in pain and me having to waste my precious sick days on actually being sick. It finally got to the point where I decided I needed to get my tonsils out at the tender age of 25. Per the suggestion of a friend I decided to see a "celebrity doctor" who I was hoping could also be my surgeon.

Besides all the advice I had taken from Dr. Phil which would always backfire hilariously, I've had very little experience with celebrity doctors in my life. I found the doctors in Japan that were simply at the normal level of popularity weren't cutting it so I needed to take it up a notch. The ear, nose, and throat doctor I decided to see, who I will call Dr. Ninki, had been featured on a couple of news programs for being super-great. Or something. I don't know. In the morning I called his office to make an appointment for the evening. I was told by the perky receptionist that because of Dr. Ninki's enormous popularity they could not accept reservations for any time after four in the afternoon. Apparently that's the designated free-for-all time. I decided to just go with the hope that I wouldn't be stuck in the waiting room indefinitely.

The place was easy to find. It was in a shopping center near the train station to which I had arrived. After entering the building, I was a bit disheartened to see that the waiting room was completely filled to capacity. There were forty people seated on an extremely long couch that ran along every wall as well as a circular couch in the center. I talked to the receptionist, gave her my info, and was told to be seated and the doctor would see me momentarily. Momentarily, eh? We'll see.

I noticed that when the nurse would come out to call a patient's name, she would always call five people at a time. This seemed strange since I knew Dr. Ninki was just one, albeit famous, guy. After a relatively brisk 30 minutes my name was called with four other patients. We were taken back to another waiting area consisting of one small couch. We were told that as our names were called we should slide down the couch so the next patients could sit down.

Let me describe the sight I beheld:

The room was huge and very busy. Thirty patients were spread throughout while seven or so nurses darted around checking on them. To my right was a row of strange machines. Patients were seated in front of them, intently breathing into hoses. Through a doorway I could see another room with people lying down with IVs in their arms. Scattered throughout the main room were more people seated with IVs. Directly in front of me was a display that had screencaps of all the television news programs Dr. Ninki had appeared on. In the center of the room were two patients seated on reclining chairs. Between them was a table neatly covered with ten copies of every type of shiny metal ear, nose, and throat checking instrument. Next to this table stood Dr. Ninki checking one patient then the other while dictating notes to the nurse that stood by his side.

After five minutes my name was called and I sat on one of the reclining chairs in the center of the room. The doctor came up to me and looked pleased to have a foreigner to speak to. He started off in English asking me what was wrong. He was very charismatic. I explained how often I got strep throat and that the antibiotics I was taking weren't working very well. He nodded and looked at my throat with various instruments. Then he suddenly stuck a tiny camera in my mouth. He took a picture which appeared on a fancy TV screen next to my head. He pointed and explained that these were tonsils and that they were swollen. I knew this already but still couldn't help but be impressed. He said he'd give me an injection of antibiotics and that I should go with the nurse. The whole encounter with Dr. Ninki took under two minutes. I didn't have time to ask about surgery but I thought I'd see him again for the injection which I nervously imagined would go right in my throat.

The nurse led me to the breathing machines. The first one was for the nose and had a hose with two small nozzles on the end. The second one was for the throat and went in the mouth. They emitted some kind of mist. At first I thought I was supposed to inhale the mist but that just made me cough embarrassingly. The nurse told me to stop breathing it in. I wasn't entirely sure how to breathe with a tube in my mouth without breathing from the tube in my mouth but I did my best. I had a feeling that these machines were just to stall for time.

After that the nurse took me to the room which had IVs hanging from the ceiling connected to the arms of people lying down on beds. It reminded me of the scene in Inception at the opium den-esque cellar. I was given a bed and the nurse stabbed my arm with the IV. Me, still expecting an injection, asked what was in this liquid that was now flowing into my arm. "Antibiotics," she said. Oh, so this is what he meant by injection. I was glad the image I had of getting a needle to the throat was wrong.

Finishing the IV, I was ushered to the front desk where I paid and received my little baggy of antibiotic tablets. I was happy to see they were an exceptionally strong dosage. Though, I was sorry that I never got another chance to talk to the doctor about surgery.

On the train ride home I realized my throat was already feeling better. When I arrived at my apartment I looked in the mirror and my throat looked noticeably improved. It was then I realized that in those two minutes I talked with Dr. Ninki, he listened better than any doctor I'd had in Japan. He really does deserve the moniker of "famous doctor".

Despite my somewhat bizarre but successful experience with Dr. Ninki, I still knew that I should get my tonsils out. I called some hospitals and found a local one that did tonsillectomies. After getting a referral from a different hospital (a convoluted process) I was able to talk with a surgeon. He looked in my throat and agreed I should have them out ASAP. The surgery was scheduled in two weeks time.

And thus ends this edition of Japan and My Tonsils. Be sure to check back for the final chapter "Under the Knifu"!

Tuesday, March 1, 2011

Japan and My Tonsils: The Healthcare Strikes Back

Read Part 1 here.

Part 2

When last we saw our hero, me, I had just recovered from my first bout of Japanese strep throat. I had taken the four days worth of antibiotics, which seemed to do the trick. I felt better, my fever was gone, and my throat was pain free. I was a little concerned however, since my tonsils seemed to be a little swollen. I decided not to worry too much and went on with my life.

After another couple months I got sick again, went to a different doctor who became my primary care physician, and got more medicine. Again, only four days of antibiotics. Then two months later I got sick again. Another four days of the same antibiotics. Three months later, sick again. Four days of antibiotics. I would have been concerned except my doctor seemed incredibly unconcerned. I would go see him, he'd ask what's wrong, and I'd say the same thing as always. He would laugh, "Haha! Again? OK, here's your four days of antibiotics." This went on for years. I kept saying I should have my tonsils out but the doctor said it wasn't necessary. In hindsight, I should have gotten a second opinion. Maybe I could have convinced someone else to give me stronger medicine for more than four days and finally had this strep knocked out for good. I still wasn't confident enough in my Japanese, though, to go to a non-English speaking doctor. And when it comes to English speaking doctors in Japan, the pickings are slim.

Two months ago, over the winter break, I went back to America to visit my family. Two days into the trip I got strep again, as usual. Fortunately I was expecting this and already looked into how my insurance worked to make sure I'd be covered. I was excited. An American doctor with American drugs. The strength of American drugs was probably best summed up by Jerry Seinfeld who said, "Figure out what will kill me and then back it off a little bit." I got ten days of meds at two grams a day. That's almost seven times more powerful than the Japanese meds for over twice as long. Each pill was almost the size of a Werther's Original. It was some powerful stuff. I felt better after two days but of course took the pills to completion. I hoped this would be the end of it.

A month later, back in Japan, I got sick again.

I went back to my normal doctor for the last time. I brought the empty bottle of the giant America pills as proof and explained that if these didn't work, then obviously weak pills for four days wouldn't either. I asked him again about surgery or his opinion on taking literally any other option instead of the same pills for four days. He said he still didn't think I needed surgery. It was just because of this dry Japanese air that I was getting sick. He said he'd try something new though. He handed me my prescription, reminded me to gargle, and sent me on my way. It wasn't until I picked up my meds that I realized it was a prescription for the same pills as before, for five days.

I took the pills but after four days I saw little improvement. It's a bit scary when antibiotics stop working. I realized I needed a change. I needed stronger drugs, or surgery, or something. I didn't really know what to do. I decided to leave that to the professionals. I noticed there was an ear, nose, and throat doctor near my house. My Japanese had improved by this point and I felt confident that I could make myself understood. I went and at first I thought he was great. He looked at my throat with a bunch of different shiny metal sticks and depressors and magnifying thingies. He even wore that classic doctor's reflective circle on his forehead. He seemed confident until I told him that I was already on antibiotics. He asked to see them and I showed him. "But these are for five days! These aren't working?" No, I told him, they weren't. I showed him the American med container and pointed out how much stronger they were. I asked if maybe he could just prescribe me more meds to take with these antibiotics. He sat there with his head down looking at his notes, taping his pen, and muttering "geez, what to do..." Eventually he made a decision, wrote me a script for more meds, and I left.

I was happy. That doctor had seemed to take this seriously. He hadn't laughed and brushed it off like I was used to. I looked at the prescription and was pleased to not recognize it, meaning it was something new. I had hope. I took the prescription to the pharmicist to have it filled. She asked if I had any questions. I asked her if I could take ibuprofin with this medication since I found ibuprofin was always good for pain and fever. She said, "well... this is ibuprofin... so no." Wait, what? I asked her to clarify; these aren't antibiotics? "Nope! Ibuprofin! Here you go! Odaijini!"

Ibuprofin?! A pain killer?! I don't need a pain killer! I need a strep killer! I was frustrated. I went to two different doctors and neither of them seemed to be taking this seriously. Then I started thinking, well maybe it's not serious. Maybe everything I've heard from others and the entire internet is wrong and strep isn't actually dangerous. Maybe I could just let my body fight it off on it's own.

No. I want my tonsils out. I'm sick of them and I want them out, I finally decided. I will deal with these amatures no more! It was time to find a surgeon.

In America, as far as I know, all ear, nose, and throat doctors are also surgeons. They're all qualified to remove tonsils. I wasn't sure of the situation in Japan but I decided I needed to find a good one. If he didn't do surgery then maybe he could recommend a hospital that does. I put my request on Facebook to see if my Japan based friends new of any good doctors. I got a reply from Paul's (this site's owner's) girlfriend, Yoshie. She had taken it upon herself to do research and it appeared there was a famous doctor that was only about 40 minutes away. A famous doctor? Sounds great! I went immediately.

What followed was the most bizarre experience I've ever had at a doctor's office. It cannot be put into words. Except it will be.

Stay tuned for the next chapter, Japan and my Tonsils: Celebrity Doctors and The Looming Surgery!

Tuesday, February 15, 2011

Japan and My Tonsils: An Epic Tale of Love, Tribulations, and Redemption(?)

Part 1

I hate my tonsils. I hate them and I want them out. Years I've spent alternating between agony and fear. Agony as they swell to the size of
golf balls in my throat, raising my temperature, and preventing me from eating delicious foods since starving always seems the better option to the pain of swallowing. The fear would set in as soon as I felt better. As soon as they shrunk to a size that could pass for normal I'd worry about the next time. Possibly the cruelest part was that one of my greatest joys, a night out with friends singing karaoke and drinking beer, seemed to be the magical combination that would nearly always lead to my personal tonsil apocalypse.

Why don't I just get them out? The issue is complicated by my current location. In America I'd simply go to an ear, nose, and throat doctor, pay $5000, and my tonsils would be gone as soon as the check cleared. But I'm not in America anymore. I'm in Japan. The medical system here works a bit differently. But I'm not going to tell you about it. I'm going to show you. I will take you on my
adventure from my very first week in Japan until today.

July 2008

It was a long flight. I left from Los Angeles International Airport and arrived in
Haneda after 11 hours of flight time. It was also a late night as my new friends and I celebrated our first night in Tokyo, Japan. Long flights, new germs, lack of sleep, and alcohol: the perfect recipe for getting sick. My comrades and I spent four days in close quarters as we attended lectures on how to adapt to our new lives as English teachers in Japan. This time for me was one of wide-eyed discovery. To the new, unwelcome residents of my tonsils however, it was the incubation period.

The morning of the fourth day we set off on the
Shinkansen to Osaka. I noticed I had a bit of a scratchiness in my throat and voiced my concern to my new friend, Brian. "It's just allergies!" Oh the young fool I was believed him. We enjoyed the 3 hour trip, making new friends and drinking green tea.

We finally arrived in Osaka and switched to buses to continue our journey to
Hyogo Prefecture where we would meet our representatives from each of our respective schools. I was starting to feel a bit cold despite the hot, humid, Japanese summer. I felt a pang of worry as I realized I was indeed becoming sick. "No matter," thought I, being the burly, young man I was, "Immune system! I leave this to you! I have other matters to attend to." My immune system was too busy to respond. My mind moved on to other things as we arrived at the meeting hall. There I met my school's representative who was to be my English speaking go-between. He would help me in all matters in which I may need help while adapting to Japanese life. I said goodbye to my new friends, swearing to contact each other once we acquired mobile phones and the Internet, and continued traveling to the high school in which I would be an English instructor.

The ride was pleasant with interesting conversation. I was happy to learn I would be teaching with this person. My new friend.

Arrived at school. Something wrong. I was hot now. Couldn't think... straightly. Tired. Meeting principal. Hello! Bow. I
konnichiwa... hajime... yoroshiku... Bow? Ah tea, yes tea is good. It reminds me of... other hot drinks I've drunk. Yes, let's see the school. It looks nice... where are your beds? I would like to try out... pillows. Tired...

After a couple hours it was finally time to see my apartment. My go-between and the office clerk took me. The bed looked wonderful and I yearned to simply jump inside. But first I had to be shown all the other wonderful details of my new apartment. Push this button for hot water, push this button for hot air, push this button for flushing the toilet, buttons, buttons, buttons. Switches for lights, switches for power, switches, switches, switches. Plugs and outlets and appliances and machines. Cracks and holes and dents and dings. How much time had passed? I wasn't sure. Now it's time for the tour of the city. "NO! BED! Bed would then be too far for sleeping in!" the voice of my immune system yelled in my head.
Ol' immuney finally spoke, and he was right. I was sad to admit defeat after trying so hard to make a good first impression as a young, go-getting teacher, but I was finished. I told them I felt sick and just needed to sleep. My predecessor was still around the city and he could give me the tour later. They exchanged looks (concern? disappointment?) and wished me well.

The next day I decided I was sick. Seriously sick. My throat hurt. It was a test of will to swallow. My tonsils were not looking good. They obviously were taking one for the team. I knew what was wrong now though. I had seen this before in childhood. Strep. I was sure of it. I got it fairly often as a kid but hadn't had it in years. I had just arrived in Japan but I thought it was already time to meet my first Japanese doctor.

Strep throat isn't a disease to be taken lightly. Caused by group A Streptococcus bacteria, strep throat usually starts with the swelling of the tonsils which soon become covered in white patches. Other common symptoms are pain/difficulty swallowing, nausea, high fever, and low energy. It differentiates from other throat infections by a lack of coughing and congestion. It is very common in children but rare in adults. It's seen as an annoyance nowadays. Start on a
regimen of antibiotics and you'll feel better almost immediately. It's easy to forget the days before Penicillin. This disease was the deadly and feared scarlet fever. If you've ever read the children's story The Velveteen Rabbit the very sick child had strep. Strep if left untreated can do serious damage to heart, kidneys, and other organs. Friends of my parents made the decision to let their daughter recover naturally from strep without antibiotics. Sadly, a month later, she passed away from a ruptured appendix. The link between the untreated strep and her appendix was theorized but not proven. Having recently heard this story I knew that I needed some good, strong medicine.

I went into work and talked to my go-between, "I need a doctor. And medicine." OK! Phone calls were made and he took me to a nearby English speaking doctor. It was his one day a week at that location so I was lucky. I explained my problem, told him I was allergic to Penicillin, and he prescribed me another antibiotic, a
cephalosporin. Four days worth. Four days? I thought the worldwide standard for antibiotics was seven to ten days? Isn't four days the point when you feel completely better and stupid people stop taking their medicine and end up creating unstoppable, drug-resistant super-bugs? Well, maybe this is some powerful stuff. I paid my 1000yen, about $10 then, for the drugs and office visit (thank you cheap, Japanese health care!).

I took the medicine and after four days felt great.

But it was not to last.

This tale is not over. It is merely beginning. This was simply the first act. The start of my three year tonsil hell. Stay tuned for the next edition, Japan and My Tonsils: The Healthcare Strikes Back!

Tuesday, September 14, 2010

Another thought on Japanese healthcare

...perhaps not the last of them.

By the way, here is an interesting article comparing our healthcare in the U.S. with that in Japan.

I actually talked about this with Joe a couple weeks ago, but weekend medical service in Japan is fairly limited. Joe recounted a story about his girlfriend's brother being really sick on a Sunday and the family going to the hospital and waiting for it to open.

This weekend I was in Saga and Yoshie wasn't feeling too hot. She said she'd go to the hospital the next day, and I suggested we go together that day. But no, it was a Sunday - the hospital was closed, she told me.

I understand that there are some emergency (ambulance) services and that facilities vary from place to place...but it just seems pretty shocking to me that there are hospitals that aren't open 24/7. If it's a matter of budget, how about cutting back an hour or so during the week? Sure, maybe a few less people with runny noses would be treated, but at least there would be some recourse for people who are sick or injured on Sundays...

Tuesday, September 7, 2010

More on Japanese Healthcare

The other day Joe and I were talking about the pro's and con's of American and Japanese healthcare. I think we came to the conclusion that it really varies from person to person depending on their individual experiences and level of coverage. For example, if I were currently in the States and uncovered (as I am), I probably wouldn't be too happy right now.

For my part, my experiences with Japanese healthcare haven't been bad. My chief complaints are that things often take time and running around (though I guess that's often the case in the States, as well) and that most doctors here are specialists. Back home since most doctors (GP's anyway) learn a smattering of everything, you can see your family doctor for most things, and if he can't handle it he will usually refer you. I readily acknowledge the fact that I'm no expert, of course - that's just my impression based upon my experiences and having a doctor in the family.

In my most recent case, this bump on the back of my neck got red and painful last week, so I called a dermatology clinic, but was told they were very sorry that I didn't have a referral. Thus I wound up going to my local 内科 (internal medicine) clinic. I had been there before, so I thought I knew what to expect. Last time the doctor had seen me for 2 minutes, not even looked at my problem because it was out of his realm, and promptly written me a referral and charged about 2000 yen for it. Well, at least it was speedy. This time I expected a referral, but instead he prescribed me some antibiotics and told me to come back in a few days if they didn't work. They didn't - I developed a fever on Sunday. Took off work and went back on Monday and procured a referral to a general surgeon.

The surgeon was a welcome surprise, an interesting character. He looks to be in his 60's, which probably means he's actually like 90. He got his medical degree in Milwaukee, so his English was more than passable. The office was kind of run down - looks like business is slow these days. Anyway, he wasted no time in telling me he needed to lance the sucker. Needled me with a local, then lit a cigarette and shot the shit for a few minutes. Both amusing and disconcerting to have him standing next to me smoking while waiting for my neck to go numb.

Well, I survived anyway. Have to go back every day for the next few days to have my bandage and gauze changed. If anything goes horribly awry, I'll be sure to report.