Being Hospitalized in Japan

An ambulance waiting outside ready to take a patient to the emergency room

2020 was a rough year for all of us. The pandemic took us by surprise and uprooted our plans for the year, leaving us shellshocked. I had planned on a year of relative ease, with a lighter workload and stable housing situation. However, I did not anticipate that despite my best efforts, I would have a health scare.
Not coronavirus, though.
Appendicitis.

Uh-oh
In the first week of November, I was in a weakened state. I had been in and out of the clinic for the past month with gradually increasing abdominal pain, and doctors suspected that I had appendicitis. I wasn’t able to eat much of anything and standing for a prolonged period was difficult. Then, during my shift at the information center, the pain in my abdomen migrated over to my right side and I knew I needed to go to the hospital right away. When I got to Nadogaya Hospital, I was running a fever. I went through all the tests once again and the doctor showed me that the blockage in my appendix (盲腸) had increased dramatically in size and ultimately diagnosed me with appendicitis (虫垂炎). Then he gave me my treatment options: I could either go on another regiment of antibiotics and see if things improved or have my appendix removed entirely. Since I heard from the doctor that the recovery time and the prognosis were better for the surgery, I decided that would be the best option. They put me in hospital clothes, gave me an IV (点滴), and escorted me to my new temporary home.

A private hospital room in Japan with a leather armchair and a bed
*Not an actual photo of the room

My New Crib
Because of the pandemic, people could not visit me. Even my share house friends who brought my things had to hand them off to the front desk to keep the patients safe. I had the nurses to keep me company though and reached out to my friends and family through social media, discussed getting the High-Cost Medical Expense Benefit (高額療養費) with the national insurance agency, and filled out medical disclosure forms to pass the time until I could go in for surgery. I wasn’t allowed to eat until my surgery, but the IV had some calories in it and they occasionally let me drink hot tea. For the first time in my life, I began to feel hungry…for tea. Then, once the 24-hour countdown to surgery started, I was no longer allowed to consume anything.

A fully-equipped surgery room for laparoscopic appendectomy
*Not an actual photo of the room

Evicting the Freeloader
I went into the surgery room and the surgeons had me lie down on the stretcher. I remember hearing one surgeon utter a “Woah, she’s tall” and we all started laughing. They asked me if I was nervous and I told them “No, I’m excited to be able to eat tacos again” and the laughing got louder. Then, another surgeon told me he was going to start the anesthesia and everything slowly faded into black.

The first thing I remember is the feeling of the breathing tube coming out of my throat. I gagged and suddenly woke up to hear the surgeon tell me it was finished. Then, I felt the pain. I was still coming out of the anesthesia, so I was confused and scared. All I could say is “It hurts, it hurts” and I didn’t really open my eyes. I wasn’t aware of my surroundings yet and I just wanted the pain to stop. The doctors pushed my bed, but I didn’t know where I was going. They just did their best to calm me down and reassured me that the pain medicine would be coming soon. I went straight to sleep shortly afterward.

An American woman recovering from an appendectomy in Nadogaya Hospital in Kashiwa, Japan

Recovery
The next day when I woke up, I tried to sit up and found that my body wouldn’t let me. I lacked the strength to even pull myself up with my arms and there was a dull ache from my abdomen. I did the usual morning routine with an additional question: “Did you fart today?” (おならしましたか?) and sometimes pushed the call button when the pain meds wore off.

On the second day after my surgery, I got to eat my first real breakfast: okayu, some fruit, tsukemono, and tea! I ravenously devoured my meal, though I had to use the remote on my bed to move into a sitting position. After the morning routine, the nurse came in and I was freed from my adult diaper and the catheter that I had completely forgotten they put into me. Then they helped me to my feet and I shakily walked to the bathroom, holding onto the IV stand tightly. Satisfied in knowing that I wouldn’t develop thrombosis, they left me so I could take a nap.

Throughout my week-long stay in the hospital, my strength gradually returned to me. I was very excited when I was cleared to take my first post-surgery bath, especially because the laparoscopic surgery came with shoulder pain because of the remaining gases in my abdomen. Doctors don’t completely understand why this happens, but short-term shoulder pain is a common side effect. I began to venture out of my room and occasionally go to the lounge area to drink tea or work on presentations for school. For each of these trips, I gradually relied on my IV stand less and less until the IV was removed and I was walking on my own once again. Finally, once I stopped having fevers and it was clear that my digestive system was repairing itself, I was given the OK to return home. Since I had registered for the High-Cost Medical Expense Benefit, my medical expenses were capped off and I was able to pay for everything other than my clothing and towel rental fees upfront. Then, I stepped back out into the world and began my readjustment into normal life.

Meme photo of candles and an appendix with the words "In memory of Sydneys appendix" and the years 1990-2020

Lesson Learned
The most important thing I learned from this experience was the existence of the High-Cost Medical Expense Benefit. I would have never found out about this if it wasn’t for my boss and coworkers here at the information center. Since I have Japanese National Insurance, I’ll explain the process in my situation.

For people on National Insurance, the process is relatively straightforward but extremely difficult for even Japanese people to understand in detail. I thought that my difficulty in understanding was due to my own struggles with keigo, but it turns out that people use a lot of jargon when they describe insurance benefits. I would make sure you have a Japanese friend to help you through the process, which I barely got through myself. It is absolutely worth the struggle though because your costs will be capped based on your income upfront or, if you have already paid the full cost of hospitalization, you can get a lot of the money you paid reimbursed.

A copy of the Japanese National Health Insurance High Cost Medical Expense Benefit Certificate with a list of the different cost ceilings

The first thing you should do is contact the National Insurance Department of City Hall. You’ll need to tell them when you will be hospitalized, where you will be hospitalized, and when you will need to have surgery. The National Insurance Department will then send you a certificate stating that you have been approved for this benefit, which you should give to the front desk at the hospital at the beginning of your hospitalization. In an emergency situation, they will sometimes allow you to submit the certificate at the end of your stay or even send it to you during your hospitalization. I couldn’t exactly plan for the emergency with my appendix, so they made an exception in my case.

I feel incredibly lucky to be living in a country that is taking care of me so that I am able to take care of all of you as well, and I hope that my story will help you feel more confident if you need to have surgery in Japan.

 

 

Hey guys! I’m Sydney, your friendly neighborhood foreigner! I moved to Japan in 2014, but I came to Kashiwa in 2019. Despite my name, I’m American not Australian.

When I first arrived in Japan, I was so relieved to find articles written by other foreigners about how to make my way in my new country. Now that I’ve been here a while, I’d like to share what I’ve learned as well and pay it forward.

みんなで創る! 柏の情報ワンダーランド

Kamon かしわインフォメーションセンター

かしわインフォメーションセンターは柏駅前にあり、誰もが気軽に立ち寄れるまちの情報拠点、「柏のまちのコンシェルジュ」として、柏市内を中心に近隣市町から千葉県各地の地域・観光情報のご案内と情報提供をしています。

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