Wednesday, September 3, 2014

My Japanese Hospital Experience

Thank you to everyone who has emailed me or commented on this blog about my medical challenges. I really appreciate your concerns.

Between my UK trip and the surgery, I have tons I could blog about.  I haven’t downloaded my trip photos yet, so today I’ll write about my experience at the hospital.  Going in (and still) I am much more afraid of the hospital than the surgery itself.  Luckily, I didn’t have to stay as long as they told me I would.

So anyway, we went to the hospital on Thursday morning, first to talk with the doctor and the anesthesiologist (with the help of the hospital translator), then to check in. The day before I received an email from the doctor saying they decided the cancer was more advanced than they originally thought, so I required a more invasive surgery than they told me about before.  They wanted to take all the abdominal lymph nodes instead of just a sampling.  Opening me up more to find the lymph nodes would require more time in the hospital to heal.  I had lots of questions about what would happen when and wanted to make sure the staff would use gloves with me (it isn’t as automatic here as in the US). I'm not germaphobic, but I do want to avoid them when I can, especially when I'm in the hospital.   I had the doctor tell me exactly what needed to happen in order for me to be discharged.  I made a check off chart, so I wouldn’t have to stay any longer than necessary.  As much as I hated being there, I have to say, Dr. Teramoto and her staff took excellent care of me.  They did everything I asked to avoid germs, even if they didn’t think it was necessary. The gynecology ward has one single room and the doctor reserved it for me.  I am really glad she did, even though initially I thought I would forgo the extra expense.  The room was bigger than a hotel room and less expensive.  (I’ll write about medical costs in Japan another day).

After last minute tests and measuring, they left me alone for the evening. Ted stayed in the hospital room with me (on a tiny cot) the night before and the night after surgery. The cost of the cot was 440 yen a night. I didn’t sleep at all the night before.

One thing that keeps the costs down is that they ask patients to bring most everything to the hospital – towels, washcloths, cups and straws, eating utensils, etc.  You are required to rent hospital pajamas (70 yen a day) for the day of surgery and the day after, but can wear your own things after that.  Everyone I saw, except me, wore hospital pajamas the whole time. The surgery day pajamas was a long thin robe that folded over and double tied in front. After taking a shower, I had to wear that and slippers to walk down to the surgery floor on Friday, but they were taken away as soon as I got to the surgery room. Right away they gave me oxygen and started putting tubes in both hands. Soon after that they used another gas in the breathing apparatus and I was out.  (They wanted to give me a spinal block in addition to the general anesthesia, but I refused. Pain relief was the only advantage and there were many disadvantages, so I saw no point in it.)  The next thing I kind of remember was them putting the robe back on me. I kept my eyes closed, but Ted was waiting for me when they transferred me by conveyer belt from the surgery room to the bed from my room that was waiting on the other end of the conveyer belt in the entry of the surgical area. The surgery took less than three hours. I was surprised to be able to see the incision.  All the layers are stitched up with dissolving thread.  The stitched incision area is covered with a white kind of spongy lattice work that is all (including my belly button) covered with a huge piece of clear stretchy tape.  I don't know what happens to it all, but nothing has to be changed or messed with and I can see it all through the clear tape.

I don’t know what all was in the IVs (maybe fluids, antibiotics, pain killers, other things?), but I had a lot of tubes going in and wasn’t allowed anything to eat or drink. I was to lay still on my back at first, but later they wanted me to roll to my side to prevent pressure on my back.  I wasn’t in much pain, probably due to the painkiller in the IV, but it did hurt to try to turn. I had a push button pain thing that I used the first day for turning, but didn’t need after that. The nurses checked me every two hours through the next morning.  I made up a chart so Ted could write it all down for me to see later. One of the “Get Out” items was no fever and my temperature was a little high the first day.  The nurses brought me ice pillows to help bring it down.

Early the next morning they took blood and I was allowed to start sipping water. (A good blood test and keeping water down were other things on the “Get Out” list.) At 9 am, I was allowed to sit up, then stand, then walk a short distance, with the help of the nurse. After that I went to x-ray in a wheel chair. (An abdominal x-ray with no blockages was another thing on the “Get Out” list.) A good x-ray was required to start eating soft foods, which was another “Get Out” list item. The food wasn’t so good, but I understand why they had to give me soft bland foods. The nurses were always asking about gas and it was a long time before I could say yes. This wasn’t an item on the list, so I wasn’t so concerned about it.   I walked up and down the hall every hour, starting with only one lap and doing more as I felt stronger. As soon as I could, I was out of the hospital pajamas and into my own “real” day clothes, wearing my own pajamas only at night. Walking up and down the hall in thin pajamas without a bra wasn’t so appealing for me. The nurse wanted to give me a "bed bath", but I was walking around and could do my own "sink bath" without any help.

Another item on the list was no bleeding, which got checked right away.  Ability to control pain with medications was another easy thing to meet because I had very little pain, especially after the first day. The IV started leaking under the skin, so they removed it earlier than they planned.  The doctor said my vein was tired.  I was glad to have it all removed so I didn’t have to pull the tower on wheels and tubes along with me everywhere. After the IV was out, they brought me envelopes of medicine to take.  Ted wrote what each thing was for and how often to take it on the envelopes.  I was surprised they didn’t dole out the medicine instead of giving it all to me at once, but that’s what they did. I’ll write about the medicine another day.

That brings us to Monday morning. I was more than ready to go home and packed up all of my stuff, but this was only the third day after surgery so all of the nurses thought it was too soon.  There was also still one thing on the list – no drainage at incision site. I had two drainage tubes coming out of my abdomen and one was draining a ton of fluid out.  The container was 400 ml and had to be emptied several times a day. I was feeling very well, walking, eating – the only thing was the drain pipe.  The doctor decided to take out the tube, stitch the holes closed and let the fluid be absorbed.  At this point the doctor wanted to add bowel movement to the list, but I said too late – ashita (tomorrow).  I was discharged Monday afternoon and have been resting at home ever since.

I feel really good, but I’m going to take it easy to make sure I continue to improve.  I have an appointment to see the doctor next week and find out what the pathology report says.  Keep your fingers crossed that surgery is all I need to get over this!


Wendy said...

I am so glad that everything went well...I will continue to lift you up in prayer, believing that surgery will be all that you need....prayers and wishes of speedy recovery and healing sent your way...

Lisa J. said...

I'm crossing my fingers for you Pamela.

Lorri said...

Thinking good thoughts for you.

Queeniepatch said...

How nice it must be for you to be home again. Take it easy and recover well!

Sheryl said...

Oh gosh Pamela, what an ordeal to go through when you are in a different country from your own and there is a small language barrier. I´m so pleased that all went along as planned and you had a very short hospital stay. Must take it easy now. Get well wishes going your way.