Saturday, May 27, 2006

CT Scan Japan

Thursday afternoon I retrieved Cornucopia's pink class cap from the daycare center, because she needed it for a daycare trip to a park, all the mothers and children together, which took place on Friday 26 May 2006.

The same day, I went alone to the Meijin Hospital for a CT scan of the brain. By way of follow-up for the lymphoma for which I was treated last year in Japan, Dr Gunma, my hematologist, arranged blood tests, a CT scan of the brain, an MRI scan, a consultation with a specialist at the hospital's eye department, and, to be done later this year but as yet unscheduled, a CT scan of the full body.

For some mysterious reason I was under orders to fast until the CT scan, though it was a scan of the brain, not involving the gut. On four previous occasions I underwent CT scans and never fasted for any of them.

When I got to the hospital I had no idea where to go, so presented my paperwork at the nearest staffed desk, and a nurse kindly took me all the way up to the next floor, where I ended up at a desk marked in both English and Japanese as an X-ray facility.

The CT scan, which was straightforward, was at 1000, and my appointment with Dr Gunma was at 1130, so I decided to buy a snack.

I was sure there would be a shop in the hospital, since one part of Japan usually replicates another, and there is always a shop, including all kinds of things to buy.

So I asked my way to the shop and found it, only to be disappointed because there was nothing in the shop but paper: books, magazines, notebooks, nappies and the like.

Later, just as I was leaving the hospital, getting lost while trying to exit the place at about 1 pm, I came upon ANOTHER shop, just round the corner near the first one, complete with the expected range of snacks, and, additionally, entire meals already cooked, ready to eat and there to buy.

However, having failed to find the food-supplying shop, I went instead to the restaurant, and bought the "morning set", which cost 580 yen.

There was an A set which was a Western meal and a B set which was a Japanese-style meal. The B set looked more substantial so I went for that.

The meal consisted of a small tub of natto (fermented soy beans) which I rejected, a bowl of miso soup, a bowl of rice, a packet of dried seaweed wafers to go with the rice, a small helping of pickles and a piece of fish. Also a glass of water.

I have now seen the inside of five different hospitals, the one where Cornucopia was born, the one where I was seen for fruitless investigations during 2004, two hospitals that I visited while scouting around for a new hospital to which I might switch, and Meijin Hospital.

All these hospitals are pretty much identical. If one has a credit-card-size plastic ID card for patients, they all do. If one has a restuarant, ditto.

The only realy surprise at Maijin Hospital was that it had (a) a flower shop and (b) a barber's.

Before I got to see the doctor, I was asked to show my card showing that I was a member of the Japanese national health scheme. This is not a particularly good scheme but it has its good points. First, you are entitled to join as of right, so your medical history is of no account. Second, you get a 70/30 split in the costs, with the state paying 70%. Third, it is related to income.

My income in the last financial year was zero so, consequently, the fraction of my income that I had to pay added up to zero.

When I was asked for my national health insurance card, I presented my wife's, which has two additional names entered on it, duly certified by the appropriate authorities, one being my caughter Cornucopia and the other being me.

I then kept my appointment with Dr Gunma, which was a little late.

He told me that the blood tests which I underwent last month were just fine.

By the time I kept the appointment, Dr Gunma had already looked at the CT scan, and told me that he could see no problems.

I was scheduled to have an MRI of the brain in July, but Dr Gunma got on the phone and phoned around, and ended up arranging an appointment at a different hospital at 2 pm on Tuesday 30 May.

He warned the hospital that my Japanese was "heta" (ie lousy) and asked if they were prepared to deal with me. They said they were.

Dr Gunma was very anxious about whether we were communicating, and went over the instructions three times, then the nurse went over them again, though they were pretty straightforward, and I followed the Japanese well enough.

I go to Mizonoguchi station, go to the hospital (map provided), hand in a letter of introduction (provided by Dr Gunma), go have the
MRI at 2 pm, wait for one hour until the film is ready, uplift the film, then, when I return to Dr Gunma's hospital, bring with me the MRI film and deliver it to the eye department at 0900 on Tuesday 6 June at 0900.

Once I was done with the doctor, the nurse gave me some paperwork, then I went to the cashier to pay.

At all the other Japanese hospitals I have seen, they take your paperwork then give you a number. You sit until your number scrolls across an LCD screen which tells you which counter to go to. At Meijin Hospital, however, they called people by name, first surname, then surname followed by personal name.

My all-up cost for the consultation with the doctor and for the CT scan of the brain came to a total of 9770 yen, which, at the present rate of exchange, 110 yen to the dollar, is about US $99.

Regarding the up-coming consultation scheduled at the hospital's eye department, Dr Gunma told me he will have the eye specialist have a look at the MRI and try to see if he can find a curable cause for the deterioration of my eyes, but Dr Gunma indicated that in all probability it's a "shoganai" situation, "shoganai" meaning "that's tough".

I've done a little research on the Internet and got 11,700 hits for demyelination in association with "radiation induced". Obviously I'm not the first person to whom this happened.

To save you a trip to the dictionary, which I've already made, demyelination is defined as "A degenerative process that erodes away the myelin sheath that normally protects nerve fibers."

Back at Auckland Hospital, Dr Jerusalem told me that my eye damage was probably caused by demylination, and that it would not be progressive. He was wrong on the "not progressive" front but, clearly, he had heard about demylination.

The more I think about my radiation oncologists the unhappier I am with them. I specifically asked about the possibility of radiation damage to the eyes.

The only thing I was told on this subject was to expect the development of cataracts in two to three years.

The most charitable way in which I can characterize this answer is to say it was inadequate.

The bottom line seems to be that radiation therapy trashes your eyes. Not always but definitely sometimes.

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