Tuesday, June 5, 2012

Going to the Doctor in Kitami

Lazy or Incompetent? 

I am referring to doctors in Japan.  If you are a frequent reader of my blog (hi, Mom!), you have noticed that I’ve been quite busy recently.  Within two months I’ve had two international trips, and hosted my family as they were on an international vacation.  I’ve also attended a wedding and gone on a girl’s weekend trip to Lake Toya about six hours away from Kitami.  Right in the middle of this, I caught a nasty cold.

I thought I was recovering while my family was here, but even the week after my family left, I continued to have an irritating cough.  Normally I’d ask my dad to check it out, he’d sigh and check my throat just so I’d believe him when he’d tell me that it’s nothing and I’ll get better soon without medicine. 

However, living in Japan has made me a bit of a hypochondriac. After my horrid experience at the eye doctor’s (which I don’t think I blogged about because it was that awful), and another experience getting told that I was fat by a different doctor, I’ve been trying to avoid going to a clinic no matter what.  My hyper-vigilance has made me aware of every little thing that might be a sign of something bad to come and has increased the amount of time I spend worrying about my health.

I should say, this is not entirely out of paranoia.  Last year, a non-JET foreign English teacher got the MUMPS!  Yes, my kerosene heater isn’t the only old-fashioned thing about Japan.  Another JET out in eastern Hokkaido got a nasty bacterial infection from tonsillitis which resulted in a week-long hospital stay and a loss of about 15 pounds in two weeks.  A different JET started to get such chronic sinus infections that he needed surgery to breathe through his nose again.  These are just people that I know personally.   Rare instances?  Logically, maybe, but I sometimes feel like I’m not so sure…

So when I had a cough that wasn’t going away, even after my other cold symptoms had mostly stopped a week and a half before, I thought that I’d use one afternoon to go to the clinic just to check. I wanted to rule out anything contagious.

So here’s what happened:

I arrive at the recommended clinic around 2:00pm.  A nurse workes with me, entirely in Japanese, to fill out the new patient form.  She does it in a loud voice in middle of the waiting room.  I respond in a voice that only she can hear, while she does not take the hint and responds like I’m deaf. So much for privacy.

She asks me if I have a fever.  I respond that I don’t think so. She asks if I’m cold, I say that I’m not cold now because the room is hot (true).  These are not definitive answers, yet she never takes my temperature. I wait another twenty minutes before being taken out of the waiting room to a different sub-waiting room.

Suddenly I’m called to see the doctor, sat down in a dentist-like chair, surrounded by three nurses and the doctor.  The doctor pulls out my tongue for me and checks my throat.  Then he checks my ears.  Then he uses some tong thing and checks my nose.  Before I realize what’s happening, he sprays something up my nose! He literally does not ask me a single question.  He didn’t even say hello. Then he looks at the nurse and says that my nose and ears are fine, but my throat is --- (I missed the word, must’ve been “irritated”) and tells her to give me throat medicine.

Then I’m out. Less than 60 seconds. Truly. In less than a minute, he has seen all he needs to see, treated me like livestock, and felt confident enough to prescribe me medicine.  No one has taken my temperature.  No one has weighed me to take that into account for the medicine doses. No one explained anything.  The next patient is ushered in.

The nurse ushers me into another section of this large-ish exam room, slightly curtained off. Children from the sub-waiting room are peeking around the corner and staring.  I am sitting in front of a gas chamber thing. She says that I should breathe this gas for three minutes.  Typically, I trust doctors.  I’ll do research on my own but I expect experts in any profession to do their job competently.  I did not trust this doctor. I asked the nurse for an explanation about what this is, and she couldn’t even give me the name of the device.  Or at least she wouldn’t, even though I asked in Japanese for the name of this thing in Japanese.  I also declined this contraption because every single patient was told they should do this.  Is it really possible that we are all sick in the same way?
What is this??

So I decline the treatment, probably shocking the nurse. I take the prescription list and head over to the pharmacy.  I don’t wait long, maybe 15 minutes.  Then the pharmacist calls my name and we sit down to discuss the six prescriptions that the doctor prescribed for me in the less than 60-second examination!  Plus, there’s no way that the drug dosage could really be tailored to my body.  Five drugs were in pill form, and were intended to be taken three times a day.  One of them was supposed to be two pills at a time, three times a day, for a grand total of 18 pills a day for a week. The sixth prescription was a gargling medication.  With confidence, I can say that the Japanese seem to gargle much more than I’ve ever seen in my life.  It would be totally normal for me to gargle at work, at the sink in the staff room, while everyone else is correcting papers.  My apologies, I digress.

That poor pharmacist, I made him look up all six drug names in English, and the active ingredients. Here is what the doctor prescribed for me and the information I could find about the drug:

1. Meiact – can be used in the treatment of respiratory tract infections, community-acquired pneumonia, UTIs, cystitis, acute sinusitis, and surgical wound infections.
2. Mucodyne – can be used to treat cystic fibrosis, middle ear fluid build-up, chronic bronchitis, and COPD (chronic obstructive pulmonary disease)
3. Pronase/Empynase P 18000 – this was hard to find online.  It seems like it may be used primarily in Japan.  What I could find suggests that this is used to treat bronchitis, bronchial asthma, and pulmonary tuberculosis.
4. Astomin – difficult to find information on it online.  All I could find was that it is an antitussive, cough-suppressant medication.
5. Mucosta - anther medicine that was hard to find English information about.  What I could find says that it is an NSAID and used for gastro-ulcers and age-related hearing loss.
6. Azund – this is the gargling medication that apparently is used to treat throat inflammation, tonsillitis, stomatitis, acute gingivitis, and oral wounds.

As I’ve talked with friends about my experience, this sounds totally normal.  The doctors here treat patients like cattle, and the patients never ask questions.  Everyone is prescribed a cocktail of medications, even to treat things like a cold.  For example, going in to see a doctor for a cold (which my dad always said was completely unnecessary if you’re otherwise healthy) results in a prescription for your runny nose, another for your cough, another for a headache, etc. Rest and relaxation are not options when the whole point of visiting a doctor is to get better immediately so you can go back to slaving away at work.

In the end, I did end up doing the entire drug routine.  I didn’t find any research saying that this or that drug had been banned or is discouraged from being prescribed in other countries.  So for now, I’m a huge pill-popper, though hopefully temporarily.  Maybe if I take all this pills all week as prescribed, I can also cure my hypochondriac tendencies because this drug cocktail should catch almost anything I could possible think I might have.  What could possibly be left after this drug cocktail?   

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