Expat Life · Japan

One Week in a Japanese Hospital

I spent the first week of August this year staying at the hospital in Japan. Yeah, not cool.

The story all started several weeks beforehand. Around the second week of July, I truly started to notice that I was not feeling my normal self. The weather had just begun to get disgustingly hot (every day was at least 30 Celsius, or 86 Fahrenheit, with humidity of 70% or higher on most days) and I, being a Pacific Northwesterner and not accustomed to these kinds of temperatures, chocked it up to my lack of heat tolerance and just did my best to keep myself cool and hydrated.

A week later, I started displaying signs of some sort of cold. I was coughing, had a stuffy nose, a headache, and just felt generally blegh. Later on that same week, I woke up and found that my eyes were extremely puffy. I told myself and my boss that if there wasn’t a change by Monday, I’d go to the doctor and get things checked out.

Monday came, and I tried all my resources short of calling a cab to get to the doctor. All of Akira’s family members were at work, and my coworkers had other meetings to attend. I was not feeling up to walking to whichever doctor was closest before work (and good thing I didn’t try—I had to lie down after the ten minute walk to my workplace later that day!) and all the places I could’ve gone after work were closed, so I didn’t end up going to the doctor at all.

Tuesday came, and there was a special event at work. I arrived in the morning apparently looking as bad as I felt, as the event’s nurse took my temperature and asked me about my symptoms. I was given cold medicine and pain killers, and I made it through the first half of the day okay. After a bit of exertion, though, I went downhill quickly, to the point that the nurse forbade me from participating in the special event any longer that day or the next day. I spent the rest of the day, night, and following morning stretched out on a futon, covered in ice packs to help bring down my fever, which was above 38 Celsius (100.4 Fahrenheit).

On Wednesday, once the event was over, one of my coworkers drove me to a hospital, where I was seen by a doctor who asked me about my symptoms, listened to my breathing, prescribed me some antibiotics, and sent me on my way. I spent the rest of the week lying in bed, taking my medicine and waiting to feel better. On Friday, my boss took me to the eye doctor because my eyes were still puffy, and I found out that I had pinkeye (for the second time—got it in April, too) and was prescribed some eye drops to fix that.

Akira’s mom took me grocery shopping on Sunday, and when I mentioned that I didn’t feel any better, even though I was almost done with my antibiotics, she offered to take me to the hospital again before work on Monday.

So Monday morning came, and off to the hospital we went. A receptionist helped me fill out a form with my symptoms, I explained them in more detail to the nurse who came out to take my temperature and blood pressure, and then was told that I’d have a blood test and a flu test before seeing the doctor. For those who have never had a flu test, they stick a giant q-tip up your nose practically to your brain. Fortunately the nurse was quick about it, but my eyes still watered and it hurt for quite a while afterward.

I had a different doctor than I’d had the previous Wednesday. She spoke a bit of English, which was an unexpected courtesy and a little bit of a comfort for me. She, too, listened to my breathing, looked in my throat and felt the lymph nodes around my neck (which I’d found had swollen to an alarming size), and had me lie down so she could press on my abdomen.

By the way, exam rooms are set up quite differently from how they are in the U.S. When it’s your turn, you draw a curtain aside and go into what’s more like a cubicle with the back part open. The doctor is already sitting there, in front of a computer, and you place your bags in a basket set aside for luggage before taking the stool in front of the doctor. Because the back part of the “room” is open, nurses and other doctors walk back and forth during your interview and examination, and many of them stop to watch while the doctor is examining you. I’m told this is a sort of double-checking system. The onlooking doctors and nurses will speak up should they notice anything the main doctor misses.

Anyway, back to the story: Then she showed me the results of my tests.

No flu, but extremely high white blood cell counts (ten thousand above normal) and extremely high liver readings. (Mine were about two hundred above the normal range.) The doctor was certain that I had a viral infection, but wasn’t sure if the liver dysfunction was caused by the infection or by something else. So she ordered more tests.

I had my first ever CT scan. (The machine spoke Japanese, of course, so the technician was kind enough to explain what the machine would say and what I should do beforehand.) I also had to go see the nose and throat doctor to have him get a better look at my throat, because the regular doctor had not been able to get a good look at it. The throat doc blew some air into my nostrils, which I assume was to numb them, then held up the camera to show me what he would do. I had just enough time to look at him with abject horror before the camera was headed down my nose and into my throat. It was an uncomfortable sensation, but fortunately it probably only lasted about fifteen seconds, just long enough for him to get a good look. The whole time he was saying, “I know it hurts. Just hang on a little longer. Hang on a little longer. Hang on. And we’re done, good job.” My throat, especially my tonsils, were extremely swollen, so much so that the doctor was surprised when I told him that I’d been able to eat, though I had no appetite. He mentioned that if the swelling didn’t go down, he may have to remove my tonsils. Ugh. (Apparently most Japanese kids get them removed after their first throat infection; where I’m from you don’t take those puppies out unless they’re causing more trouble than not.)

Then I was back to the other side of the hospital to get a chest x-ray and an EKG, since sometimes liver dysfunction can actually be a sign of a heart problem. Both of these tests I’d had before at different times in my life: an EKG as a child when the doctor thought I had a heart murmur (no, I was—and still am—terrified of doctors, so my heart was going crazy) and a chest x-ray earlier this year when I thought I might have pneumonia.

After all these tests, I waited some more, and the doctor came out to tell me that she was transferring me to a different doctor who specialized in internal organs. I waited some more, then went in to see him, and he informed me that I’d have to stay in the hospital for at least a week.

I did my best to hold it together, but I cried a little once I was out of the doctor’s sight, I have to admit. See, in America (for those reading from outside the good ol’ U.S. of A), you don’t stay at the hospital unless you absolutely need a physician’s or nurse’s care, practically unless you’re dying. In Japan, they’ll keep you in the hospital for much less than that. Basically, they hospitalize you so that you can’t go to work when you should be resting. But, of course, being American myself, the first thought that entered my mind was, “Oh my god am I dying?!”

A nurse came and explained the hospital stay process, handing me a manual and a bunch of paperwork that needed to be signed. Because the hospital charges extra for borrowing clothes and for the use of disposable utensils, I was allowed to go home and pack a bag before beginning my stay. Akira’s mom had offered to wash any clothes I used while in the hospital, so I packed accordingly. I made sure to download an audiobook (The Amazing Maurice and his Educated Rodents, if you’re curious) onto my phone, plus I brought my tablet and a comic written in Japanese (Yotsuba&) should I feel well enough to enjoy any of these.

Back at the hospital, I paid 50 thousand yen (approximately $500) that first day, which the hospital would hold until I was discharged. If I didn’t end up using the whole amount during my stay, they’d return the remainder. Obviously, I ended up paying more on top of this, but we’ll talk about that later on. I got my patient bracelet put on, and the nurse went about the business of attempting to start my IV. She tried twice, then got another nurse, who also tried twice and then grabbed yet another nurse, who tried once and then decided, with my permission, to place the IV in the crook of my elbow, where blood is usually drawn. That meant I’d have to hold my arm straight, but I figured that was a small price to pay to avoid being poked over and over into eternity.

hospital setup 3

After the first IV, which was a thirty minute antibiotic drip, they hooked up a four hour saline drip. After dinner, which I was barely able to eat, and a trip to the bathroom (lemme tell ya, not easy while holding one arm stick-straight and dragging the IV drip caddy thingy around) I began to regret that decision. My arm ached from holding it straight for so long, and I still had one more antibiotic drip to go afterwards.

They woke me when my final drip of the day ended, and I begged them to please take out the IV. Since I wouldn’t have another drip until morning, the nurse obliged, and I was able to bend my arm again and sleep somewhat.

When the morning nurse came, I told her about the trouble the other nurses had gone through the previous day, but unperturbed, she started an IV just above my watch on the first shot, hardly any pain from the poke, too. Of course, a few days later they had to move the IV, at which point we had to go through the whole trial again—two different nurses, four different pokes, but they finally got it in just above my elbow. They told me that my veins are narrow and roll away from the needle. Apparently I became infamous among the nurses for this reason.

After not being able to eat my rice for either breakfast or lunch, I explained to a nurse that with my swollen throat, rice was just sticking in there and I couldn’t swallow it. So they kindly switched me to bread. Except they gave me too much bread, and after trying for three meals to finish it, I gave up and asked them to cut my portion in half. It was smooth sailing after that, food-wise.

hospital food 2

The meals themselves were always perfectly-balanced, with vegetables, fruit, protein, and grains. While the food definitely wasn’t restaurant-quality, I’d still say it was pretty darn good, especially when compared to the hospital food I’ve had in the U.S.

hospital food 1

I noticed a couple of things during my stay. First of all, from what I could tell, the nurses had twelve-hour shifts, but I never had the same nurse two days in a row. I’d have a day nurse and a night nurse, and then two totally different people the next day, and then two totally different people the day after that. I’m not sure if the other nurses just rotated among the other patients, or if they had a certain break period between those long shifts.

Another thing: Because of the language barrier, the nurses and doctors didn’t go into long, detailed explanations with me, though I heard them do so with other patients. For the most part, they just gave me a brief overview and then did whatever they were going to do. I was grateful for this, because one, I probably wouldn’t have understood their technical explanations anyway, and two, the longer the explanation, the more nervous I get, so that saved me a lot of anxiety.

I was fortunate enough to have one really awesome nurse who went above and beyond to take care of me. She wanted to make sure I understood what she was telling me, so when I had trouble with a certain word, she went and looked it up, then came back to tell me the translation. She also asked me questions about myself with no hesitation, chatted with me, checked up on me after my IV was finally placed successfully, and was just generally fantastic.

Hospital life was as regimented as you’d expect. Lights came on at 6am, breakfast was at 7:30, lunch at 11:30, dinner at 5:30, and lights out at 9. These times weren’t upheld perfectly. Sometimes the lights came on closer to 5:30am, or dinner would be fifteen minutes late, or something of that nature. Vitals checks happened four times a day, and after my first two days, IV hookups were three times a day. The doctor visited twice a day except on Sunday, when he had the day off and a nurse practitioner (or someone who seemed like a nurse practitioner) checked on me instead.

IV drip

What was nice was that after the first night, the nurses didn’t wake me up in the witching hour for any sorts of medicines, IV, or tests. When I stayed in the hospital post-surgery as a twelve-year-old, it seemed like every night somebody was waking me up to give me medicine or test something or other.

As for my actual accommodations, I was in a room with four beds, which were separated by curtains. Each bed area had a TV, a mini fridge, a narrow (about two hand-breadths) closet, and a little cupboard. There was also a nurse call button, of course, and a floor lamp that could also be turned on via a button. The bed was a plain, flat one with no tilting functions or any other fancy attributes, except railings. (I was informed that the main cause of injury inside the hospital was patients rolling off the beds by accident.) The pillow was a traditional Japanese-style pillow, filled with beans rather than feathers or stuffing. Honestly, I found the pillow quite uncomfortable—I like flat pillows, myself, and there was no flattening this one.

To make phone calls, I had to go out to the elevators so as not to disturb my roommates. I also had to use headphones when watching Netflix on my tablet or listening to my audiobook for the same reason. Most of my guests stayed for less than twenty minutes so as not to bother the other patients, and if I had longer staying guests, then we headed to the cafeteria to stay out of everyone’s hair.

Each day, I grew gradually better and better. The first two days, I didn’t come close to finishing my food, but after that, I was able to finish all of every meal. I was able to sit upright longer and longer, and trips to the bathroom down the hall no longer felt like an ordeal. My blood tests showed that my numbers were gradually going down, and I was gradually feeling better.

And then discharge day finally came. My blood test showed I had improved greatly (not back to normal, but getting there) and my visit to the throat doctor showed that my throat had gone back to normal. (Yay for no tonsillectomy!) I was told I could go home, and as Akira’s mom, my mom (She’d been planning to visit for a couple months, and I got unlucky enough to end up in the hospital for the first two days of her visit.) and I took my things to the elevators, several nurses and even my doctor came to see me off, telling me to take care of myself. I was handed a sheet telling me how to take care of myself at home and another sheet informing me of my follow-up doctor’s appointment, then I went downstairs to finish paying.

Guess what? All those tests I had on Monday, plus a week in the hospital, and it all amounted, total, to 70 thousand yen, or about $700. For all that. And all I have is Japan’s national insurance, which pays for 70% of any medical fees I incur. It’s the typical insurance plan most everyone in Japan has, and it only costs me 1800 yen a month, or about $18. Seriously. Back at home, the bills would have amounted to the price I paid for my car, and that’s with insurance. It may not have been what I was planning to spend my budget on this month, but all in all, I feel like I got out for pennies!

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