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Hi Blog. Continuing the August semi-vacation where I am commenting less and letting Debito.org Readers take the helm, here’s some good news for a change, where Cabby writes about a good experience he had in Japanese hospital in Okayama, Central Japan. With all the stories Debito.org has covered about how COVID has affected NJ Residents adversely, this story comes a welcome respite. Debito Arudou, Ph.D.
Ten Days in May: A Memorable Japan Hospital Experience during the COVID-19 Crisis
By Cabby, Exclusive to Debito.org, May 17, 2020
As if submerged in a deep dark viscous pool and slowing ascending to the surface, I awoke in the Intensive Care Unit of a hospital with doctor and two nurses in attendance. My vision was unfocused and mind disoriented. I saw I was enclosed in some type of clear vinyl box with what seemed like a wooden frame.
The first external sound was that of a doctor asking if it was all right. My first mumbled utterance, “Where am I?” was answered with Okayama University Hospital I.C.U. The next words from the doctor were, “Is it okay for us to remove the ventilator? We need it for another patient.”
My confused reply . . . “What ventilator? What time is it? The doctor informed me it was Saturday afternoon and that I had been unconscious for about 26 hours. He asked once more about the ventilator. I now assume there was a matter of urgency to the request but at the time I was still quite groggy and did not even understand why I was on a ventilator. I answered, “if you think it is OK. You’re the doctor.” It was removed and in it’s place a large clear plastic oxygen mask was positioned over my nose and mouth.
As I began to regain a semblance of mental clarity I could see that I was in a large room with many patients. At the foot of the bed was a large blue and gray high-tech machine of some sort and a nurse sitting behind it. She was focused on a laptop computer resting on the surface of a tray in front of the mass of the machine.
Before long the doctor returned and informed me that they were going to move me to a different part of I.C.U. to lessen the threat of COVID-19 infection. He also told me that I had been tested upon admittance and the results were negative. This was not my primary concern at the time. The very professional staff proceeded to wheel my bed along with the blue and gray machine down a short hallway to a somewhat more secluded section of the ward.
I was placed into what to me resembled the most sanitary stable stall I’d ever seen. It was enclosed on three sides from floor to ceiling with the entire section at the foot of the bed open. For the next 24 hours, as with the previous, I remained flat on my back with a nurse in attendance the entire time as she monitored the reading on the machine and checked the laptop. I mainly slept the first evening and slowly became aware that both wrists were secured to the side rails of the bed, forcing me to remain almost completely immobile. I could see a line running into my left wrist. I later found it ran directly to an artery. There was a surgical tube through a hole in my right side over my ribcage. I was unaware of its existence until Sunday morning when a very competent doctor with a bushy black beard removed it and used stitches to close the open hole. He then removed the large oxygen mask, replacing it with a smaller one. Later that day it too was replaced by a small light nasal cannula.
During my stay in the ‘stall’ my only complaint was that my back hurt. I repeated this numerous times in English and Japanese. I knew it was because I couldn’t move from this fixed position and that nothing was broken, but the attentive and caring nurse had someone from radiology come up with a portable X-ray machine to X-ray my back. I’d never seen anything like it before. Naturally the results were negative. This was just one indication of the high degree of professionalism and concern exhibited by all staff I came in contact with during my ten-day stay at the hospital.
At the time I was unaware that there was a tube through my left nostril that went to my stomach for forced feeding. Honesty, I’m not certain when it was removed and only became aware of it when I misunderstood a nurse later in the week and thought they wanted to put a tube down my throat to my stomach. “I’m sorry but I get panic attacks and I couldn’t take having a tube go down my throat”, I said excitedly. Yukari, my nurse, smiled and calmly said, “Don’t worry. There was a tube in your nose that went to your stomach. It was already removed.” It was actually a humorous exchange. I was happy to have been completely unaware of the nasogastric incubation having taken place.
There was a need for more bed space in the I.C.U. on Sunday, and the attending doctor who removed the tubing returned with what seemed like a ream of documents for me to sign. I couldn’t focus well, and the bed could only be raised slightly, so I am certain all of my signings are illegible. I made a feeble attempt at humor with the doctor. Instead of the word “signature”, the English version of the forms had “autograph”. I told him before I gave an autograph it would cost ¥500 per autograph but I would provide my signature for free. Being competent in English as well as medicine, he smiled.
I then asked him, “What happened to me on Friday afternoon?” He said, “You had a light case of pneumonia.” I said, “a light case?” To which he responded, “Along with a collapsed right lung.” Now that one got my attention. Although I didn’t feel it, my condition must have been improving because he informed me that I’d be leaving I.C.U. in a few hours and explained the current room situation and costs. Due to the crowded conditions in the respiratory ward, my first choice, whether it be a private or four-person room, might not be available. I opted for a private room, at least, for a few days and was fortunate to get it and remain there for the rest of my stay.
The next part of our conversation was mildly confrontational since I was informed that I would probably have to move to a different hospital due to the need for beds. This hospital is one of the four in the prefecture designated to treat COVID-19 patients. I was adamant about not wanting to move, knowing that I would receive the best available treatment right where I was, since I was already an outpatient there for my COPD condition. The doctor told me not to get too stressed over it as any other hospital would have to approve my transfer, even though I tested negative for COVID-19. Many hospitals in the area were refusing patients due to the epidemic.
At about 2:00 in the afternoon I was moved to a private room in the respiratory ward. I could never have anticipated the reception I received when my bed was wheeled past the nurse’s station. I actually had a nurse assigned to me for both day and night shifts. However, this does not mean that she remained in the room. Of course I was aided by many different nurses every day. It being Golden Week (a week of national holidays), the conscientious nurses were working with a full ward of patients and a skeleton crew. Somehow they managed to remain cheerful and attentive at all times. Their constant positive demeanor amazed me.
Afraid of being moved to another hospital, I did something I am not accustomed to doing. I told the nurse assigned to me that I did not want to move to another facility and then began name-dropping. I told her that I have been teaching nurses in this hospital for the past three years. I quickly learned she was aware of this and had wanted to take my class last year but it was full. The next time I saw the doctors I did the same thing and let them know that fifth year students at the Dental Hospital all use a textbook that I wrote and edited with university dentists.
Every day as my condition improved there were small changes. After two days of nothing but soft foods three times a day, I was able to change to a regular diet. It was a pleasant surprise that the most meals tasted good. I devoured every morsel served to me as I wanted to regain my strength and return home as soon as possible. My only complaint was that there wasn’t enough food, but I understood why. As is currently the case in most hospitals across Japan due to COVID-19, no visitors were allowed, so receiving food from outside was not an option. The ban on visitors placed an extra psychological strain on patients. It also caused additional work for the nurses. Since I arrived by ambulance I had none of the many things needed for a prolonged stay in a Japanese hospital. When I arrived in the ward I was able to get my phone and wallet that my good friend, Tony, brought to the hospital. I felt bad about having to impose on the nurses who needed to go to the first floor convenience store to buy me a comb, toothbrush, toothpaste, chopsticks, etc. at a time when they were so busy and short staffed. The shops were only open a few hours a day during Golden Week. Another good friend, Paul, went to my apartment to gather some clothes and a few other needed items and was able to bring them to the nurse’s station for me. I now had my Kindle to read from, which made passing the time much easier.
When the nurses came to check my condition, administer medications through IVs and injections through a hole in my neck that had three different lines, they were always cheerful and we had fun in mixing Japanese and English. They would often bring a tablet that they could speak Japanese into and English text would appear on the screen. As one might expect with translation software, it wasn’t very accurate. At times the errors were truly funny and when I’d explain what the translation meant we’d all crack up laughing. 0ne said, “After you stop breathing, how do you feel?” At one point a nurse was trying to find a medical expression in English and I began to laugh. She didn’t understand and I asked if I could see the laminated sheets of paper she was holding. I flipped through them to the correct page and explained they were the pages of bilingual expressions used in my lessons. We both enjoyed that one. I noticed that there were corresponding pages in Chinese, too.
By Monday I could brush my teeth in bed and stand up next to the bed for a short time. Tuesday I got up and into a wheelchair with an oxygen tank attached, and a nice young nurse took me to a room with a beauty salon type chair and shampooed my hair. I was beginning to feel human again. Later we went to the first floor radiology center for a chest X-ray. On Wednesday they removed both the catheter and oxygen line. A nurse bought a card that allowed me to use the room TV and ward washers and dryers, so I was able to wash clothes right on the ward. It felt so good to be untethered again. I met with doctors a few times on Thursday and Friday and they changed my tentative release date from the following Tuesday to Sunday.
Once free of all tubes and hoses I began to wander the ward trying to get some circulation through my legs and build up their strength. I met a few interesting old gentlemen during my laps around the ward. One was a retired merchant marine captain who had been around the world many times. Friday I had a brief explanation about the new daily medication I would be taking at home and continued my walking. It felt nice not to burden the nurses with taking away my food tray after meals or having them go to the vending machine for all the bottled water I consumed. I had the stitches removed from my side where the tube had been inserted, only to have them replaced on Saturday as the hole reopened slightly during the night.
Saturday morning, I met with the head of the respiratory rehabilitation therapy section, answered some profile questions and later in the afternoon a very nice young therapist, Sho, met with me about breathing exercises. He was excited to be able to communicate in English and we talked about music for a bit. I was very happy to learn that he and all the doctors felt the QiGong, Louhan Patting, stretching and Tai Chi I’d been doing every morning since October were all good for my lung conditioning and recommended I continue my daily routine.
Sunday morning was interminable as I awoke at 5:00 and was counting the minutes until my 10:00 release time. The last 30 minutes seemed like an eternity as I didn’t get to leave until 10:30. When I got to the nurse’s station, two friends whom I’ve known for more than thirty years were waiting for me. It took all the restraint I could muster not to run up to them and give them a giant hug. Instead we did a Corina shoe tap. Hardly sufficient. In addition to the fantastic care and encouragement I received from doctors and nurses, being able to use FaceTime to connect with my daughter and friends was invaluable in keeping my spirits up at a difficult time. The online support and well wishes from so many friends made through both my career as an educator and a lover of music were unbelievable.
I would be remiss in completing this saga without describing what had happened before waking up on a ventilator. On Friday afternoon, May 1, I was feeling great and about to take a shower and go for a 6km walk as I had the two previous afternoons. Suddenly I felt as if I were experiencing the onset of a panic attack. Since talking usually helps to relieve the anxiety and get back to normal, I phoned my best friend, Tony. After a few minutes the conversation ended. Almost immediately I hit the high anxiety level and called him back. During the conversation I became very frightened and asked him to please get a cab to my place. He knew where I lived but not the address. I texted that quickly and told him I’d leave the door open. That was my last memory until waking in the hospital the next afternoon. My friend found me slumped on the sofa, eyes open but glassy and breathing, but barely. After I couldn’t respond in a coherent manner to a few questions he called 119 and had an ambulance sent. Within five minutes the excellent three-member team from the Okayama Fire & Rescue Department arrived in what could be termed hazmat suits, and together with my friend carried me in a body sling down the building steps to the ambulance. At first the driver was unsure the university hospital would accept me as I was exhibiting COVID-19 symptoms, so we slowly made our way toward town and as soon as they received approval, the driver hit the siren and sped to the ER.
I owe so much to so many for saving my life and providing highly professional treatment and care. I am quite fortunate to be here to write this and to have so many friends who were there when I needed them most.
CABBY (2,618 words)
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