Consumptive Diaries 5: *&$#ing Bureaucracy

Will this nightmare of red tape EVER end?
Thought it was over once i got tested, but no, i breathed i sigh of relief WAY too early.

I thought the test would be the end of it, but it isn't really. The tests only checked whether i have ACTIVE TB. They don't check whether i have latent TB or not.
And all that the Nakahara-ku health official said was "Take care if you catch a cold and come back and get tested again in two years" or something along those lines.
So, i could have it. And if i get pneumonia/bronchitis or any other heavy illness, i have the potential of developing TB.
Fair enough, it is only a 30% chance that i have TB in the first place; and of that 30% only 5-10% get active TB, but still....if you were me, wouldn't you like to know?

It seems that the Japanese health care system doesn't really care about preventative measures.
Anything preventative, usually isn't covered by health insurance (e.g. smear test).
As long as i don't infect anyone else, it's OK. But my future health? No, not our responsibility.

And that's not the only crap i have been dealing with.
I mentioned before about the standard process with TB patients:

1. Doctor refers patient to hospital
2. Hospital contacts local public health of patient
3. Public Health official visits patient
4. Public Health official notifies anyone who needs testing

The whole process should take 7-10 days.
The German has been in the prison/hospital for 10 days today.
The health official will visit tomorrow (day 11).

Also, the health official spoke to me today. BEFORE speaking to K. And she has already spoken to people at K's company AND the clinic that referred him to hospital. Is that right? I mean, is it really OK to talk to EVERYONE else before speaking to the patient?
I'm not sure whether it's
A) 'you're sick therefore you lose all your rights/privacy' problem
or
B) 'Oh, shit, we have a foreigner, let's panic and forget the proper protocol' problem

But whichever it is, it is just wrong that everything has taken so long. And very tiring.

And just so you know what it's like, here's the German's home for the next 2 months. His bedroom, living room & dining room. At least he has a window. And that's the view. No wonder it's driving him crazy.

Consumptive Diaries Part 4: The Test

Wrote this while i was at the hospital this morning:

09:00

Arrive at the hospital. Explain I want a TB test.

The receptionist looks at me strangely;

"A what?"

"A TB Test"

"Oh...."

I pull out my official letter from the public health office.

"Oh! A TB TEST! OK, please fill out this form"

(Don't you just love the power of a bureaucratic piece of paper?)

09:10

Sent up to internal medicine. I'm prepared for a long wait.

Ever noticed how there are noclocks in hospitals? It's like time doesn't exist here. A kind of time vacuum. Kind of reminds of that scene in Beetlejuice...the part where he gets his head shrunk.

09:30

I need to pee, but I don't want to miss my turn. What to do?

09:32

Just got called to go down to x-ray. Good thing I didn't go pee.

09:36

Have had my chest x-ray. That was quick! Now back up to internal medicine again...

09:51

Because of the lack of privacy, I can hear EVERYTHING the woman in with the doctor is saying. And by god is she telling him everything. Haven't heard the doctor say anything. 10 minute monologue on every bowel movement, illness, ache, pain, worry, meal or whatever for the last 50 years (or so it seems).

09:55

OOOh...the doctor's trying to shut her up...NO. Unsuccessful...she's off again...sounds like one of those universal old ladies whose highlight of the week is the doctor visit. Please be quiet...

10:00

Spent 5 minutes with the doctor. Said my lungs areきれい (clean? Beautiful?) Also said I don't need to worry. But I will have a phlegm test too. Apparently it's the rule/law...

10:15

Am out of the hospital! Have a little bottle for me to cough into & take back to the hospital. Have you ever tried to cough up crap when you have a cough? Or any crap? Guess I'll have to smoke a pack of Marlboro reds tonight...

But the results so far are good. But I will wait for the phlegm test before I completely celebrate. Only thing is that it takes 4-6 weeks because that's how long it takes to cultivate TB bacteria...ew...

SEE! I told you I wasn't toxic!!!

Consumptive Diaries Part 3: Buggering Bureaucracy

Anyone who has lived in Japan for more than 5 minutes, knows about the joys of red tape here. On the whole, life here is pretty normal, but once you start interfering with the cogs of bureaucracy, things get really REALLY frustrating.
For those of you who don't know (probably most of you), there is a TB Control Law in Japan. So, not only are we dealing with K's hospitalisation and my potential infection, I'm also dealing with the wheels of bureaucracy.
I was quite content to let these wheels turn at their own pace & get tested when I was told, but due to peer pressure at work (I will not go into it here, but it's really adding to my stress & feeling of leper-ness), and I have to push the bureaucratic cogs.

First of all, let me explain the standard process:

1. Patient with active TB (The German) is admitted to hospital
2. Hospital notifies K's local public health centre (in this case, Naka-ku, Yokohama)
3. A representative from the public health centre goes to visit K and interviews him about his close contacts
4. Health centre dude (or dudette) will contact potential sick people directly (if in the same ward) or the local public health centre of the potential bio-hazard (if in a different ward)
5. Potential bio-hazards will be interviewed and if necessary be given a free pass to go to hospital to get tested.
6. Potential bio-hazard goes to hospital & gets tested
7. Gets results and is either very happy or embarks on a 6-month odyssey of tee-totalism, hospital visits and ostracism.

Steps 1~5 are supposed to take 7 to 10 days. However, due to the aforementioned peer pressure, I started trying on the 4^th day. Great idea.

First of all, I called my local health centre (Nakahara-ku, Kawasaki) to see if I could get tested. The lady there was quite nice; and this is what she told me:

· There is free testing every Thursday (EXCEPT next Thursday!)

· I can only have free testing if I'm judged a potential bio-hazard

· To be judged a potential bio-hazard, Nakahara-ku needs to hear from Naka-ku.

But this lady was helpful enough to call Naka-ku to find out what was going on. So far no-one from Naka-ku has visited the German, nor has he been notified that someone will visit him.

Anyway, turns out that Naka-ku HAVE been notified. So, the Nakahara-ku lady said she could do the screening process with me over the phone. Basically, this consisted of a few questions about whether I have any symptoms and how close consumptive boy and me are. And she said I am not a risk. I ALREADY KNOW THIS. I AM NOT A DANGER. I AM NOT A BIO-HAZARD. But, I explained about the whole peer-pressure thing and how people around me are stressing out. And she said she would put the cogs of bureaucracy in motion and send me my free test pass. She also found a hospital near my station that does TB testing & told me to call to make an appointment.

Thank you, Nakahara-lady. You were calm & nice & accepted my foreignness without freaking out.

But nasty hospital bitch. I HATE YOU.

And why? So, I called the damn hospital to make an appointment.

Here's a rough translation of what happened:

Me: I'd like to have a TB test please

Hospital Bitch: Why?

Me: My boyfriend's been admitted to hospital with TB

HB: So, why don't you get tested at the hospital where he is?

Me: Because it's far away – in Shinjuku-ku

HB: So, why don't you get tested there?

Me: Because I live in Nakahara-ku, and your hospital is the nearest for me

HB: Did you call any other hospitals?

Me: No. This was the only number I have.

HB: Why?

Me: Why what?

HB: Why don't you have any other numbers?

Me: Because this is the only number that the Health Centre gave me

HB: Why did they give you this number?

Me: Because you're nearest to my home.

HB: Hmmm. Do you have a letter from the Health Centre?

Me: Not yet, but they are sending me one.

HB: Well, when it arrives come to here with it & make an appointment

Me: I can't make an appointment now?

HB: No. you need to bring the letter.

Me: So, when I get the letter I come to the hospital?

HB: Yes. Goodbye.

F.U.C.K.I.N.G H.E.L.L.

And just for the record: I AM NOT A BIO-HAZARD

Consumptive Diaries Part 2 - Phlegm Tests

The German had his first phlegm test results last night. (Officially called something like sputum test - which sounds just as dirty...)
For the TB test, phlegm is rated on a scale of 0-10; with 0 being non-infectious & 10 being toxic.
K's score was 10.
Typical German; if they do anything, they do it properly. No cutting corners, no half measures.
A full TEN. Now, if this were the Eurovision song contest or and ice skating competition or even bowling, 10 would be a good thing.
But not with this test. The doctor explained that it'll take a minimum of 2 months, possibly 3 in hospital.

So, the hopefulness of yesterday has kind of evaporated - for both of us.

Know i shouldn't moan because K's the one dealing with these, but this is MY blog, so excuse me while i have a quick rant...
I'm only on day 3 of my new schedule, but i am already tired. I'm leaving home at 8am and getting home at 9pm. And the thought of doing this for 3 months fills me with terror. Can i cope? Will i be able to function as a normal human being?
Also, I'm tired of people taking a step back from me when they hear what's wrong with K.
I'm also tired of explaining that, no, i am NOT infectious.
Yes, i may have TB and, if so, will have to be on antibiotics for 6 months, which also scares the crap out of me.
But right now, i have no symptoms and am therefore non-infectious. OK?

So, please don't ask me anymore.
I'm tired, emotional, miss the boy terribly (we can't even kiss), and beginning to feel like a leper.
I'm trying to be strong, but I'm finding it hard. I'm also trying not to wallow & trying to remain positive, but it's really difficult when you know you have possibly 3 more months of this hell.

But to counteract all the above negativity, i will try and end on a more positive note:

• Friends - thank you for all your lovely messages & words of support. I will be taking you up on offers of drinks & hugs (especially the hugs)
  
• The German WILL recover. It's going to be a long slog, but it's not as if he's dying or has something untreatable.
• I called the German Embassy this morning and they are going to give me a selection of magazines & stuff for K. The lady there was very nice & helpful. And spoke perfect English...
• K says the nurses & doctors are being really nice to him & some of the other patients have befriended him & are trying to teach him shogi.

Consumptive Diaries: Part One - The Admission

Some of you already know, some of you don't, but this week's BIG news is that the German has been admitted to hospital with confirmed tuberculosis. And, boy, what an exciting roller coaster the last 24 hours have been.

The German was officially diagnosed last Friday, but for some reason couldn't be admitted until yesterday. Despite the fact that TB is highly contagious, he was allowed to roam Tokyo for the weekend. (This was the first of many bizarre moments....)

So, yesterday we ventured up to the impressively named 'International Medical Center of Japan'.
Apparently, there are designated hospitals around Japan for TB treatment & this is one of the best, but i have to say that i really wasn't impressed yesterday morning.
Depressing pink walls, shared rooms, confinement/isolation, limited language resources...
I thought that was bad enough, then the doctor came in and told K that he would have to stay for 2 months. MINIMUM.

TWO WHOLE F-ING MONTHS??????

That freaked us both out. Anyway, i hung out with K for the first few hours to get him settled in his cell and then i hurried back to the office to surf the internet for more information about TB.

So, as you always wanted, here are some random facts on tuberculosis:

• As of 2006, approximately 30,000 people have TB in Japan, with around 3,000 people dying yearly (WHO statistics)
• Britain's figures, with a population about half of Japan, are about 10,000 & 1,000 respectively.
• Approximately one third of the world's population has TB (Scary fact!)
• However, tuberculosis is only infectious when it is active (ie reaches the lungs)
• And only 5~10% of people with tuberculosis become sick or infectious.
• Symptoms of active TB are coughing for more than 2 weeks; phlegm; fatigue & chest pain

Are you positively enlightened now? The good thing is that it looks like i probably haven't been infected - or at least i'm not infectious, but i will (hopefully) be getting checked next week sometime (once the local health centre gets in touch with me)

Went back to the prison hospital after work, and felt a lot better about the place.
Why? Well, the doctor waited to explain all the medication and stuff until i got there. He'd written everything down in English for the German and then painstakingly explained everything is simple English. Basically, K will be on medication for 6 months, minimum. However, he only has to be in hospital while his TB is active/infectious. The average stay is 2 months. So in a worst case, it could be longer. But in a more positive light, it could be less.
K just has to pass 3 consecutive phlegm tests over a two week period, and he can come home.

So, i am keeping my fingers crossed that K's phlegm quickly runs clean....

As for me, the hospital will get in touch with the local health centre, who will in turn get in touch with me. And then they will talk things through with me & get me tested. Apparently this will all happen in the next 7 to 10 days.

And just for your enjoyment, some other randomly bizarre moments from yesterday:

• The German being given a lecture about how bad smoking is and how he really shouldn't smoke. Just struck me as bizarre & weird timing...here he is being admitted for TB and they give him the smoking lecture. Wouldn't it be more apporpriate when he left?
• The nurse pointing out the Manga/book corner and not connecting the facts that a) K doesn't speak Japanese and b) the manga/books were all in japanese
• K getting his height checked & the little nurse being unable to read the scale because it was too high. Had to get the Dr to read it...
• Being on the 13th floor(the consumption floor). Luckily we're not very superstitious
  
• Getting into the lift, asking for the 13th floor and everyone taking a step back from me
• Random other TB patient doing his exercises, which involved him doing laps of the ward with two 2-litre water bottles. Kind of reminded of polar bears pacing their cages at the zoo
  

Will keep you posted on how things progress....I'm sure you're all eager for more fascinating TB facts.

*Recipe For Stress*

Ingredients
7 days of bad sleep
5 early mornings
1 sick German
1 tuberculosis diagnosis
1 order to return to Germany by August

Seasoning
A splash of rain
A sprinkle of allergies
A dash of cold symptoms

Method
1. Mix all ingredients in large bowl
2. Coat large saucepan with a thick layer of city stress
3. Pour ingredients into saucepan, mix thoroughly & cook on high heat until boiling
4. Serve on large plates with side dish of work frustration
5. Add seasoning to taste

Note: Best served with cold beer (in very large quantities)

::A to Z of Golden Week::

All night mayhem a few times too many
Beer and lots of it!
Connect 4 - Germany are current European champions
De-stressing and how i didn't realise exactly how much i needed it
Escape from the concrete jungle
First holiday with the German
Gig - The German's first one on Japan with his band (see L)
Hangovers (see B)
Izu - love that place!
Just being able to to relax and not have to worry about anything (see D & W)
Keni & Kathie at Paradise cafe; always so welcoming
Let's Go Amazing - the German plays bass
Michael & Shingo's new house in Kurihama; lots of light & greenery - lovely
No Worries! (The German's favourite new phrase)
Odoriko Go; the nice train that whisked us away from Kawasaki & directly to Shimoda
Poppies in Kurihama Flower Park - one million of them, apparently.
Quality Seafood - went to a great fish restaurant in shimoda called Ryoma
Rain in Izu (see C)
Sunshine in Izu (much better than R)
Trees and green space and no tall buildings (see E)
Urlaub (thanks to the German for this one....)
Very random encounter with Maxx & Dex's teacher at a house party in Harajuku
Work - none of it for 10 whole days
Xtreme lack of 7-11s in Shimoda (which if you are a Citibank user is quite troubling...)
Young french boy running around the beach in nothing but sunglasses and a yellow sun hat
Zzzzzz - sleeping for 12 hours, which i haven't done for ages

(Thanks to the German for helping me with some of the difficult letters....)

::Golden Week Images::