Surgery in Okinawa...or One Night in Kaiho

Sorry folks...no pictures this time...just a delightful story. I guess I should have been using my thinking cap and taking pictures along the way of my doctors clinics nurses hospitals and of course my arm.  Hindsight is 20/20 and sometimes 50/50, LOL. Let me say a couple of things about being in a Japanese Hospital.  I noticed a few things that were very different from American hospitals.  Let me just say that I showed up at 11:00 for a noon operation.  The first thing was probably the fact that the Kaiho Hospital was clean but not American-style sterile.  Many of the staff wore masks, which is not uncommon in Japan but they did not seem overly concerned about making sure everything was mopped up cleaned up sterilized and bleached. There were no hand sanitizer dispensers every 6 feet with warning signs about MRSA and hand washing techniques, and a slow painful gruesome death that awaits anybody who ignores the warnings.  The nurse who drew my blood wiped my arm with an alcohol swab then felt for a vein with her bare fingers, and drew the blood.  When I was admitted the paperwork was just: name, address, phone number, emergency contact…5 minutes max, including translation.  I got to my room a few minutes later and was met by a team of nurses all giggling, twittering, and bowing.  They quickly and efficiently got me into a hospital gown, orthopedic stockings, started an IV, took vital signs and practiced speaking English while I practiced speaking Japanese. When it was time to go to the OR I walked downstairs with my IV pole accompanied by a nurse and my surgeon to a big curtain draped across the hallway.  After changing out of my street shoes and into operating room slippers, I walked behind the curtain to see my Dr. sitting at a computer.  Behind him was a large open room with an operating table, towels and blankets, a large tray with instruments and a couple of people milling about in OR scrubs and masks.  Once again everything looked very clean, neat and orderly, but not necessarily sterile in the way a Navy Corpsman is trained to see it.  I was not in a position to be demanding an American style sterile field or to be questioning my surgeon just before going under the knife.  Plus it occurs to me that maybe the Japanese have a better grip on things than we do in some cases.  I just hoped that this was one of those cases.  I lay on the table draped for surgery with this surgeon telling me not to worry and everything would be fine, when in walks the anesthesiologist who pulls his mask down, and says “Konnichiwa, Garry san”.  So I’m laying there thinking "dude put a mask on", when Dr. Shiroma says, “now you’ll feel a pinch as I start the nerve block.” After that everything seemed pretty routine, I fell asleep, and woke up afterwards feeling like I just had a nice nap.  They rolled me back into my room on my bed about 3:00 and shortly after getting situated, my two colleagues Christina and Samantha arrived.  They told me that my Dr. had explained the surgery, the outcome and the prognosis to them in detail without the benefit of release of information and with no regard for HIPAA.  They laughed and said they could’ve gotten any information they wanted.  I replied maybe the Japanese do not look for a reason to sue somebody and do not see any personal benefit to be gained by knowing somebody else’s personal health information.  Christina and Samantha brought me a big soft pillow and some flowers, because someone had told them a pillow would be nice because all I had was a small stone…well actually 2 tiny buckwheat pillows.  I got through the night OK however the Japanese appear to have a much higher pain threshold than I have since my pain medication was a mild analgesic/anti inflammatory agent which I asked for at 6:30 PM when the first pangs of discomfort began.  I dozed off about 730 or eight but then woke up again at 10 as the pain began to throb even though my arm was elevated and strapped to a pole.  They told me that I could not get a shotto (injection) but that I could get a soppo, which I learned meant suppository pain reliever.  I really didn’t much care how they gave it to me at that point.  So it went all night every 3 hours alternating a shotto and a soppo.  Surprisingly I actually slept OK that night but in the morning my Dr. called to check on me.  He asked if I needed anything and I said, “stronger pain meds.” After breakfast and spilling some of my soup on my chest, my cadre of nurses came in giggling, twittering and bowing to remove my IV, help me change clothes, and get to the bathroom.  Apparently they forgot that I had a nerve block the day before so when the nurse released my arm from the pole, it just fell.  I guess I forgot too because I just watched my fist punch me in the face.  Apparently drinking water is BYOB, hence the confusing look on the faces of the nurses whenever I would ask them in my most polite Japanese for some water. They brought me a cup and filled it with tap water looking at me as if they were wondering, “what the heck is he going to do with that?” After a while I just decided I would get my own cups of water, as long as I could keep from hitting myself in the face.  So about noon I had lunch and then began the process of discharging, moving around the room by myself with my arm supported by my other arm and waiting for Christina to pick me up and take me to my doctor’s office.  They loaded me up with antibiotics, analgesics and antipyretics and a two weeks’ supply of Tramacet for pain collected my credit card payment and sent me on my way.  Overall I have to say the experience was…if not delightful, at least made pleasant for a guy 8000 miles from home