Having An Operation In Japan
It was a Thursday afternoon, and I was playing basketball with a girls' junior high school team at the school I taught in in Shizuoka prefecture. We had just started practice and were doing some basic drills.
Suddenly, I felt and heard a basketball hit me in the back of my left leg. When I turned around to see who hit me with a basketball, everything stopped. Two girls were standing there just looking at me.
I couldn't even see a basketball anywhere. There was nothing but a searing pain shooting up the back of my leg.
My foot would not lift up off of the floor when I tried to walk. Total panic grabbed me. I began to sweat. I knew what had happened, but couldn't believe it.
It was my Achilles tendon.
People who ruptured their Achilles were out-of-shape and older, so I thought. They were the people who did nothing physical and then decided to join the company volleyball team for the city competition, or something along that line. I, on the other hand, rode my bicycle to work every day, ran three or four times a week, and played basketball a couple times a week with my students. I was in great shape and used my Achilles on a regular basis. I was no "weekend warrior."
The right doctor
At the time of my injury, I was lucky to have been at school and to have a teacher help me locate and get to the orthopedic surgeon. In Japan, you must know exactly what type of doctor you need to see for whatever your problem happens to be. There is no general medicine or "family doctor" type system.
Usually, no appointment is necessary to see a doctor, but you must wait for a while in a full waiting room. When I got in to see the doctor, he took x-rays (Japanese doctors love to take x-rays) and told me that I did, in fact, rupture my Achilles. It wasn't completely ruptured. A strand was hanging on. I needed to have surgery if I expected to continue playing sports in the future.
In Japan, doctors and hospitals only provide certain services on certain days. And this doctor performed surgery only on Wednesdays, but I needed to have the surgery done as soon as possible. So, as is usual in such cases, the doctor referred me to another doctor who does surgery on Mondays, and called the hospital to make a reservation for the room, staff, materials, etc.
This reminded me of a friend who broke his arm in Japan and was told he had to return to the Emergency Room the following Thursday because the doctor who sets arms wasn't there that day. They set broken bones only on Thursdays!
As it turned out, I did not feel good about the second doctor. The teacher who accompanied me didn't like him either. And when I found out the first doctor had now called and said that actually he wanted to perform my surgery, I counted three votes against the second doctor. I planned to have surgery on Wednesday. But then I learned of another doctor who operated on my world-class martial artist friend.
He happens to be a sports doctor and does work for the local Shimizu S-Pulse soccer team. When I first met Dr. Fukuoka at the Shizuoka Rheumatism Orthopedic Rehabilitation Hospital, I liked him right away. He had a lot of confidence and showed me on his computer what surgery he was intending to perform.
No incision would be necessary. The doctor would simply put six holes in the skin around my Achilles tendon through which he would put the instruments to sew my tendon back together. This was Monday, and he could perform the surgery the next morning. He was in a rush to get it done because my body had already begun its own repairs.
How happy and relieved I was to see that Dr. Fukuoka was a modern doctor using today's technology. Initially, after researching surgeries online, and talking to the first two doctors, I had pretty much dismissed the chance of getting a more up-to-date surgery. In fact, I had watched a video of the traditional incision surgery on the internet, so I knew exactly what was going to happen.
The right technology
So, when Dr. Fukuoka talked about rehabilitation with a walking brace, I was even more impressed. After all, my friend's experience of having surgery in Japan to remove a life-threatening cancer has her taking medicine every day for the rest of her life. When she returned to Canada after her surgery, doctors there told her the procedure they used in Japan was ten years out of date in the West, where there is now a much better procedure to cure the cancer she had that doesn't require on-going medication.
However, this doctor of mine was talking about all of the most advanced medical treatments I had read about on the internet. There was nothing outdated about him or his methods. The only question was about the insurance covering the walking brace.
I was lucky to be working for the Shizuoka Municipal Board of Bducation. Not only did I have the National Employee's Insurance, I had a supplementary policy as well. All three of my doctor consultations, the surgery, hospital stay, follow-up doctor visits, and physical therapy were covered. That means the Employee's Insurance paid 70% of everything. The supplemental insurance paid 80% of my 30% share, including the walking brace.
I did have to pay the 30% up front and then get reimbursed, but that is great insurance coverage no matter how you look at it. If you are working legally in Japan, you are eligible for insurance benefits. The payments come right out of your paychecks, so it is effortless.
Being admitted to a hospital in Japan requires a lot of paperwork to be filled out, an insurance card, a guarantor, and answers to a lot of personal questions. Also, you want to pack your bag with any comfort items, snacks, games, etc.
This hospital was private, so maybe it is different in public hospitals, but I had to pay to use the phone and TV with a pay card purchased in the hallway outside my room. All of the meals were Japanese style which didn't bother me, but if you would rather not eat fish and miso soup for breakfast, take something with you.
I had a private room because the other bed was empty, but all that separated my room from the next was a wooden wardrobe and a window shade pulled down to the top of the wardrobe. I'm not sure of the definition of "private" in Japan. It may be along the same lines as "marathon" and "veranda" - other English words which can have very different meanings in Japan.
There was a woman in the next room who continually checked the time throughout the night on a speaking clock. "It's now 23:13." "It's now 00:20." "It's now 1:07." And so it went all night. When morning arrived, the same quality timepiece rang out in song with happy bird chirping noises to let me know it was time to prepare for my surgery.
The first step was a Japanese version of a sponge bath. They gave me two towels. The blue towel, I was instructed, was for wiping the face and body. The yellow towel was meant for wiping my private bits. I convinced myself that all of the yellow towels were new, had never been used by anyone else, and are thrown away promptly after use. If this is not true, don't tell me.
Next came the needles. The drip in the back of my hand took two goes, but then worked quite well as my body seemed to drink the liquid in quite fast. They even had time to put another bag on before my surgery. As time drew nearer, a trolley was brought in, and I was given a terribly painful injection to "relax" me. My arm hurt for a week from that injection.
After the trolley ride to the operating room, I was met by a nurse comedy duo asking me all sorts of easy questions like my name, where I'm from, and which leg was to be operated on. Do you recall the man in Florida whose doctor accidentally removed the wrong leg? This is when the comedy ended for me, and I started to feel nervous.
I was hooked up to equipment monitoring my heart rate, given an epidural, and a catheter was put in place - all before the doctor arrived. There was no turning back now. Everything in the room was white including the scrubs the nurses and anesthesiologist wore.
When the doctor came into the operating room looking like a Japanese butcher all in white - what with his calf-high rain boots, we all listened to my heart rate increase. How bloody would this be? There wasn't supposed to be an incision. Where are the green scrubs? It looked as if I was about to be filleted. I was completely numb from the waist down and couldn't possibly run away.
Although I was awake for the procedure, I couldn't see anything other than my chest x-ray hanging up in front of me. I couldn't feel a thing. The surgery took all of ten minutes. That's it! I hadn't been allowed to eat or drink anything for 12 hours, had to stay overnight in the hospital, and go through two hours of preparations that morning - for just 10 minutes of surgery!
Once back in my room, I was feeling confident again, but extremely thirsty. I wasn't allowed to drink anything again for another six hours. The epidural wore off gradually starting at my waist. I gained feeling down through my legs and feet until I was in extreme pain. And although this meant I would no longer need the catheter, I wasn't in a very good mood.
The nurses had to cut the cast on my leg open. They brought in a saw and demonstrated how it would not, could not, cut into me, then got to work on the cast. I don't think I've ever been so sweaty. This pain surpassed the initial rupture pain 100%, I felt. I was starting to regret the surgery. Come morning, I felt much better, though, and knew I'd made the right decision.
I didn't see the doctor again until Thursday afternoon. He explained to me that the pain was as bad as it was because it had been four days since the surgery. My body had made repairs leaving my muscle high in my leg, so when he pulled it back into place, he tore up the natural repairs. I'm not sure if it is just me or not, but when things are explained to me and I can understand what is happening, whatever it is doesn't seem so bad.
Dr. Fukuoka released me from the hospital, and I got to leave Friday morning. The other two doctors I consulted said I would be in the hospital after surgery for at least a week. From what I understand, people stay in the hospital much longer in Japan than patients in the States. Women who give birth in a hospital stay for a week. A co-worker of mine stayed for almost a month because he had a viral infection in his face. I don't know if long hospital stays are good or bad, but in my opinion, hospitals are like prisons. The object is to get out. Especially if you have to pay to use the phone!
My overall surgery and hospital experience was a good one. I got the best surgery available with an excellent doctor, and the most advanced rehabilitation. Good medical care, as in any other industrialized country, is available in Japan. You may have to do some searching, but with the Japanese insurance system, searching for and getting more than one doctor's opinion is no problem. I wish I could find the same insurance scheme in the States.
Medical information in Japan
Here are some websites that give more details about Japanese health care and insurance.