And We’re Done

Posted: May 1, 2014 in Weekly update

Sorry for the late blog update. Things have been busy, but I’ll recap briefly:

Last Monday the 21st I took my final dose of antibiotics, and it’s all been uphill since. My urine color is no longer orange and my stomach issues have completely disappeared. When I sleep at night, I can even hear my liver telling me “thank you” through the layer of skin under my rib cage. It’s a faint sound, somewhat drowned out by the ticking of my titanium aortic valve, but I’m pretty sure that’s what my body’s second largest organ is saying to me.

Nurse Yohara came for one last confirmation. She even let me keep the pill box she lent me back in December. Now I have somewhere to store my warfarin medication. Now I just need somewhere to keep the pill box, as the kitchen table was meant to be a temporary holding cell. I also went to my cardiologist for a blood test. My INR was way too low but it should rise in inverse proportion to the amount of antibiotics remaining in my system. I’ll go back in two week for another blood test as well as my yearly echo to check on my heart function. I was supposed to have one back in October until this TB sidelined me.

Anyway, to finish off my final post, I’d like to offer a few words of advice to anyone who may become afflicted with TB in the future:

1) Don’t panic. TB is a lot like having the common cold. The only difference is that it’s a lingering cold that won’t go away on its own. As long as you take your meds as prescribed you’ll be back on your feet in due time. Six months of your life really is just a second tick on the big wristwatch of life.

2) Welcome support. Some people think that having TB is like having the cooties. Don’t be afraid to tell people you have the disease, as it will help change the negative stereotypes and misconceptions. Ask your family, friend, and loved ones for support, as a strong mental condition is the key to beating the disease. Well, antibiotics are the real key, but staying positive and mentally fit will help you heal faster.

3) Learn and share. As soon as you test positive for the disease, gather as much information as you can. Japan has an incredible support network and the first thing they do when you’re hospitalized is make you attend a slideshow presentation about the disease. They also give you a pamphlet covering a lot of frequently asked questions. I even received a copy translated into English. The more you learn about the disease, the stronger you will become, and you can start asking smarter questions to your doctor regarding treatment and complications.

4) Stay positive. This goes for anything in life of course, but it is especially true for TB patients. Being put away in quarantine is a bit like having the rug removed beneath your feet, and it’s easy to become depressed. Turn this challenge into an opportunity. Start a new project that you’ve always wanted to do but never had the time for. Read a book; or twenty. Write. Observe. Ponder. Think of the happiest times of your life and make an internal promise to yourself to return to those things after recovering. Every morning I stared helplessly at a beautiful chain of mountains vanishing off into the distance. I longed to explore those hills, taking in the aroma of fresh pine and cedar with a carpet of fallen foliage under my boots. I made it a goal to climb Mt. Kongo, the most prominent peak visible from my hospital bed. In February, barely six weeks after being released from the hospital, I stood on the summit of the wind swept slopes and looked down on the hospital where I was lock up all of the autumn.

5) Control your antibiotics. Don’t let the medicine become a crutch. It’s all to easy to make excuses because of the medication that you have to take. Sure, alcohol and cigarettes are off limits, but getting exercise and enjoying life certainly is not. Be vigilant about eating yogurt every single day as a way of helping to offset some of the side effects. Since being released, I’ve been hiking once a week, nonstop, for the last 4 months despite taking antibiotics every morning. Trick your mind into thinking that they are nothing more than vitamins and you’ll soon realize that the medicine really isn’t that big of a deal.

Thanks for following me on my long road to recovery over the last half a year. I hope that you’ve all learned a little about the peaks and valleys of tuberculosis along the way.

On top of the mountain of life

On top of the mountain of life

Week 25 (April 20)

Posted: April 20, 2014 in Weekly update
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The final week of medication was very smooth, as Kanako and I literally counted down the days each morning after my daily dosage. I’ve slid into the work rhythm as well, so the days are flying by and I’m finally on the last 100 meters of my 6-month round-trip journey through TB hell and back.

Nothing much to report this week except for the fact that I’ve only got one more day of medication and perhaps the trickiest obstacle ahead. Though I will have finished my treatment, it will take some time for my body to readjust and completely rid itself of the meds. Normally it wouldn’t be much of a big deal, but since I’m taking anti-coagulants I’ve got to keep my INR monitored and revert back to my pre-TB dosage. Fortunately I’ve got a check-up with the cardiologist this coming Friday, so I will know more about how my liver and INR are handling the transition.

This week I submitted the doctor’s note to one of my universities that had requested it. Since I had to fork over 2000 yen (around 20 dollars) of my own money for the form, I thought of a novel way of submitting the documentation but being able to keep the original in case someone requests it in the future. With the help of technology, I simply scanned in the document, saved it as a .pdf file, and e-mailed it to my boss, who said it was sufficient. Man, now why didn’t I think of that back in January when I got the original doctor’s note? It would have saved a lot of hassle and a bit of money too. Lesson learned.

The weekend brought more favorable weather, which meant another hike with my friends Paul and Mayumi. As you may recall, Paul was the first person I had done a hike with after being discharged, so it was only fitting that my last hike during my treatment be under the same companionship. We headed to the border of Shiga and Fukui Prefectures, not far from where Tomomi and I ventured last weekend. Despite the calendar declaring that we were well into spring, mother nature decided to bring winter back for an unexpected encore, and we were grossly underprepared in our light jackets and t-shirts. We kept pretty much on the move, ducking into the forest once we could take the arctic gusts no longer. The lungs held up just fine and while the nose did run, my allergies weren’t nearly as bad as just a few weeks prior.

Since my medication is coming to an end, so will the regular blog posts. I will do one more update next week, followed by posts at the 6 month and 1 year anniversaries. Thanks for sticking along through two seasons of medical trials and tribulations. I’ll try to make my final post a good one.

 

Trying to keep my mind off the frigid temperatures

Trying to keep my mind off the frigid temperatures

Week 24 (April 13)

Posted: April 13, 2014 in Weekly update
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24 weeks of nonstop meds and the end is finally in sight. Only a little over a week before I can finally stop eating yogurt. Don’t get me wrong, I do like the stuff, but it gets old after 4 months of eating it every day. And now to recap the week:

The semester officially started, which meant it was an incredibly busy week. My body will slowly adjust to the new workout, but until it does, I expect to be hitting the hay at obscenely early times over the next few weeks. I did run into a few old students from last semester who were happy to see me and relieved that I am doing much better. I also got to meet one of the teachers who replaced me. He was a nice guy and seemed to handle my classes well after my sudden departure.

On Friday I headed back to Dr. Tamura for my final checkup. The blood test results were good except for the low INR again. I’m going to bump up the dosage slightly for about a week before reverting back to my regular pre-antibiotic dosage. I had another chest Xray as well. He said that it looked much better but to my eyes the ‘before’ and ‘after’ looked exactly the same! I’ve heard that TB will scar the lung tissue so I guess I’ll have cloudy X-rays from here on out. The next step in my treatment is an X-ray 6 months after treatment is stopped. That has been scheduled for October. If I have a relapse then they should be able to pick it up in the images and with blood tests. There’s only a 1% chance of that happening, but if it’s going to happen, it usually does within a year – hence the need for a follow-up X-ray in October and next April. After a year the likelihood diminishes greatly. Not sure what I can do to avoid a relapse of the disease other than to try to stay away from unwanted germs.

Speaking of germs, my body has finally kicked the nasty cold that took over my respiratory system. Though I do still cough a bit, it is much better than before. The only downside is that I gave my cough to Kanako and now she sounds really bad. Hopefully we’ll be back to normal by the start of summer.

Nurse Yohara came back to check on my medication and to make sure I had enough to last the remainder of my treatment cycle. She will only visit one more time after my treatment is complete. It was nice having that support from Osaka city but I look forward to not having to frantically clean the apartment once a week!

The weekend brought more fair weather, so I headed on another hike with my friend Tomomi. We rented a car and drove to northern Kyoto Prefecture for a walk in a virgin hardwood forest. There was still a bit of snow remaining, and fortunately the pollen counts were low. It was so great to finally be able to breathe in some fresh air with my actual nose instead of behind the fabric of a surgical mask.

This coming week is my final full week of medication. The home stretch to my long road to recovery.

Walking in the forest

Walking in the forest

 

 

Week 23 (April 7)

Posted: April 7, 2014 in Weekly update

The cold I developed at the end of last week blew up into a nasty affair. Although the nose has settled down a bit, the chest cough is still pretty bad, prompting more than one person to ask if my TB hadn’t come back for a second round.

Even though I spent the week hacking, it was off to some of my schools for beginning-of-semester meetings. It was good to see some of my old co-workers again, who were still in a bit of shock after my sudden exit in the fall. Fortunately, the teachers at my school were tested for TB but no one showed any positive results. Not sure if any of my students caught it but I am sure I would have heard by now if they did. Next week the teaching starts for real so hopefully I can run into some of my old students and explain my sudden departure in more detail. I still don’t know if the staff told all of my students that I had TB. There have been stories in the past of school officials lying to students when it comes to a sudden teacher disappearance. You can usually find these things out when the students start asking you about your grandmother’s health. I’m prepared to play along with that story if need be.

The remainder of the week was pretty low key, as I rested a lot and ate a lot of soup to help me beat this infection. A week on I must say that my body has done a relatively good job of bouncing back, but I’d rather have another week off to fully recover before running full steam ahead into my classes. It’s a shame that the cold is not caused by bacteria, because I’ve got enough antibiotics flowing through my veins to ward off a tsunami of infectious diseases.

April means that the flowers have started blooming. On Saturday I fought the crowds to get a glimpse of some of the cherry blossoms in the ancient capital of Kyoto. My lungs held up all right despite the hacking, productive cough. The following day saw some flower action right here in Osaka. With temperatures hovering around freezing, Kanako and I took a brisk stroll along the deserted riverside through a tunnel of white flowers.

The end of my TB treatment is now in sight, as I can now count down the days instead of months before my medication comes to an end. Well, at least I hope that this cough is not a remission of the disease. I will know for sure when I go back to Dr. Tamura this week. I’ll ask for some powerful cold medicine while I’m there, as this over-the-counter stuff just doesn’t do the trick.

Cherry blossom tunnel in Osaka

Cherry blossom tunnel in Osaka

 

 

 

Week 22 (March 31)

Posted: March 31, 2014 in Weekly update

Ok, so I just spent the last half hour typing up a really detailed blog post for your enjoyment, but all my hard work ended up in vain, as the words were swallowed by a giant monster living somewhere in cyberspace. I hope my words were delicious.

On Monday I had my final day of teaching at the company class. We did a more relaxed lesson, as I turned the contents of the TOEIC test into a 2-team competition. It was a great way to wrap up the 28-day business English boot camp, and the students all said they enjoyed my class.

The following morning, I headed to Shikoku island for a day hike with my good friend Ted. Shikoku island is home to a 1200-km Buddhist route that loops around the entire island connecting 88 temples associated with the Shugendo sect of Buddism. After briefly visiting temple #1, we drove to the final temple and took a taxi down the valley so we could hike the last 8km of the route. Even though the pollen counts were high, it was an enjoyable walk in the countryside and a chance for Ted to do a little more research for a book he is writing about the pilgrimage. We finished off the long day with a soak in a local hot spring.

Mid-week brought another home visit from nurse Yohara. I asked her if patients ever accidentally skip doses and she said it was fairly common among elderly patients. I feel proud to admit that I haven’t forgotten to take my medicine even one time, but I sure I probably just jinxed myself by saying that. I’ve still got 3 weeks to have a mental lapse which could very well happen considering my schedule will change dramatically from the second week of April when the semester officially starts.

Since rain was forecast for Sunday, I seized a small fair-weather window and woke up at the crack of dawn for another hike on Saturday. I went to northern Kyoto Prefecture near the Sea of Japan where I thought the pollen counts would be lower. Unfortunately my nose rain like a neglected faucet and I even starting coughing a bit. I guess I was tempting fate by not giving myself enough time to recover from Tuesday’s hike. On Sunday morning I woke to find my usual clear mucus had turned yellow and that my chihuahua hack had developed into a full-blown cough of the Saint Bernard variety. I guess it was my body’s way of telling me to take a few days off and rest.

The last day of teaching with my company class

The last day of teaching with my company class

 

 

Week 21 (March 23)

Posted: March 23, 2014 in Weekly update

Well, I survived St. Patrick’s Day unscathed. Actually it’s not such a big holiday over here except with the Irish expats, and since I can’t drink alcohol anyway I avoided all of the madness and focused on keeping my histamine levels under control. The pollen has hit my immune system with a vengeance, so I keep that mask tightly secured every time I head outside. I’m not sure if the antibiotics acerbate the problem or not, but I’m not taking any chances.

Being kooked up inside all day is not good for the conscious, so fortunately my trips to the office to teach English help me forget about my runny nose if not momentarily. Actually, some of my students also suffer from seasonal allergies so in that case I don’t feel alone. It is estimated that 30% of Japan’s population is afflicted with some form of cedar fever. Most years I evacuate to cedar-free areas in either Okinawa or abroad, but weekly nurse visits mean I must stay in Osaka and ‘grin-and-bear it’ as the old saying goes.

Friday was the spring equinox, and luckily for us it is a public holiday. We don’t prescribe to the clock-turning customs over here, which makes keeping track of the time much easier than back home (though it does make the time difference fluctuate). To herald in the coming of spring, Kanako and I headed out for a hike with a few friends. Someone forgot to tell mother nature that spring had arrived because we fought our way through fresh snowfall and blustery conditions that had us wishing we had packed the down jackets. While it was refreshing to get out in nature you can just about guess how my immune system responded. Upon returning I downed an antihistamine and let nature run its course. It usually takes a couple of days to recover from a spring outing and I can say my system has finally calmed down.

Nurse Yohara was busy last week so she couldn’t visit, which means she will have a lot of empty medicine containers to count when she comes this coming Wednesday. We worked out a schedule of visits for the remainder of my medication schedule (less than a month to go luckily). I’ll start working again from April which doesn’t leave my schedule very open except for Friday afternoons.

I’m ready to finish off March and enter my final month of treatment. Unfortunately that means there are only a few more blog posts left before I move on to another chapter in my life, so I’ll try to make the final few a little more interesting.

Suffering from the pollen but enjoying nature

Suffering from the pollen but enjoying nature

Week 20 (March 16)

Posted: March 17, 2014 in Weekly update
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Twenty weeks of TB treatment and I can truly say that I feel pretty “normal” now whatever that means. A little over a month of antibiotics left until my urine will finally return to its usual color (remember the medicine turns my pee a reddish orange color).

Some of you were waiting with bated breath about the results of Kanako’s TB test. Sorry to keep you all in suspense: her blood test came back negative and her cough has dissipated, so you can exhale with a huge sigh of relief. I’m guessing that our air purifiers helped exterminate the airborne particles before they had time to implant themselves in her lungs, or maybe her immune system was strong enough to deal with them on its own. Of course it could have been the Tai Chi power running through her veins….

It was an uneventful week at work with the exception that Thursday’s classes were cancelled because my students had another training session. I didn’t mind having an extra day off (with pay) and celebrated by watching the rain pour down all day. Later that evening we had a minor earthquake that woke us up but otherwise caused no damage. Despite living in a seismically active country, we don’t feel temblors all that often. Folks in Tokyo experience them all the time, but down here in Osaka it’s been relatively calm. Of course, experts predict the great Nankai earthquake will cause great destruction here in western Japan but we’ve all got our fingers crossed that the fault slip won’t occur for a few more centuries.

On Saturday Kanako had a rare day off, so we celebrated her negative TB result by frolicking with the Elves and Orcs of Middle-earth. Despite the fact that the movie is about to be released on DVD, here in Japan it’s just come out in the theaters. The main reason for the delay is so that the dubbed version could be made. Yes, they’re still behind the times here and every Hollywood movie gets overdubs done by famous Japanese actors. When you go to the movies, you have a choice of subtitles or overdubs, so we always go for the subtitled versions, which are certainly less crowded that the ones with all of the actors speaking perfect Japanese. Generally speaking, movies are about 2 to 3 months behind the west, so that the movies you can watch on the airplane are the ones currently being shown in Japanese theaters.

On Sunday, I headed out on yet another hike. Both the pollen counts and PM2.5 were unusually high, but a visit to the deciduous forests could not be put off any longer. As you may recall from earlier posts, I try to hit the trails once a week to give my lungs and muscles a much-needed workout. Today temperatures were well above freezing, resulting in a purging of my skin pores that usually only happens in the humid weather of mid-summer. The cool breezes meant that any lingering breaks brought a chill to the bones. It’ll still be some time before T-shirt weather will officially prevail, but it’s nice to have a sneak preview of things to come.

As a result of exposing my nasal cavity to the elements, my immune system kicked into overdrive after returning from the hike. I called in the back-up troops hidden in the white powdery depths of the Claritin and all returned to normal except for a bit of irritated eyes. Hiking during this season is always a precarious undertaking, but it sure beats the alternative of sitting at home and watching the dust collect on the bookshelves.

My friend Paul navigating the sandstone maze

My friend Paul navigating the sandstone maze