Archive for January, 2014

Week 13 (January 26)

Posted: January 26, 2014 in Weekly update
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As usual, nurse Yohara stopped by to check on my condition. Nurses here in Japan are actually pretty well-trained about medical problems. They know just about as much as the doctors do, and have more ‘hands-on’ training than most of the doctors, some of which are little more than prescription fillers. She seems to think my stomach problems are related to my medication, so I wanted to test this hypothesis out with Dr. Tamura.

I visited his office on Thursday and showed him my latest blood test results. He said there are generally three types of TB patients: 1) those whose liver function is not affected at all, 2) those whose liver is affected but the effect stabilizes over time, and 3) those who liver function worsens in direct proportion to the number of months on the medication. Let’s hope I’m not the latter case.

He decided to reduce the dosage of Rifaampicin from 4 capsules to 3. While not a huge difference in dosage, every little bit should help reduce the load on my liver. This reduction will likely have an effect on my INR, so I need to get that tested again next week sometime. I hope that the little hospital around the corner from my apartment can do it easily. Here in Japan the hospitals are the only ones allowed to analyze blood work: all of the local clinics and specialists can take blood samples, but they need to be sent off to another facility for analysis, which usually takes a week. Not the most efficient system if you need results quickly. I could go to a larger hospital but the wait times are very long and I’ll likely end up leaving there with a few ‘souvenirs’ such as influenza or pneumonia.

The later part of the week offered a sneak preview of spring, with temperatures reaching 15 degrees Celsius. I managed to get out on two different hikes this week, and my lungs are feeling a bit better. I’m going to continue this bi-weekly schedule for the next couple of weeks until the cedar pollen starts to fly. I’m severely allergic to the pollen, so I’ll need to stay indoors or travel to colder areas of the country where the pollen has yet to be released. I’ll try to visit my allergy doctor to pick up some Claritin before the pollen really sets in (Claritin is prescription-only over here).

Next week is the last week of January, which means I only have 2 full months of antibiotics left. The treatment is scheduled to cease on April 21st, so let’s hope my body continues to strengthen and my liver finally decides that this drugs aren’t so bad after all.

The views on one of my hikes

The views on one of my hikes

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Week 12 (January 19)

Posted: January 19, 2014 in Weekly update

It’s been nearly 3 months since I started my antibiotic regimen and my body is starting to feel the effects (both positive and negative unfortunately). The stomach has settled down a bit but I still get some pain and discomfort whenever I eat. I’m going back to my TB doctor this coming week and I’ll get his opinion before seeing a digestive specialist.

Last Friday I had my cardio check-up and the heart is looking good. My INR is slightly out of range (on the low end of the spectrum), so my warfarin dosage was upped yet again. When I went to the pharmacist to get my 3-month supply she simply handed me an entire box of the medicine. Each box contains 1000 one-milligram tablets. I’m very fortunate that I don’t have to pay for any medication over here (due to my ‘disability’) because otherwise I’d be out quite a bit of money. My blood test showed elevated levels of enzymes which may be a sign of liver damage. I’ll get another blood test on Thursday so we can compare the results, but it looks like the antibiotics are putting a lot of strain on my liver. This could be one cause of my stomach discomfort.

My lungs don’t seem to be getting much better either. I’m still coughing up a lot of phlegm, so not sure if it’s related to the TB or another respiratory disorder. The cold weather probably doesn’t help much, and I’ve decided to wear a surgical mask whenever I take the train in Osaka to help protect me from those unwanted germs. There are an awful lot of sick people walking around everywhere, and since companies rarely offer sick days, the majority of Japanese people just ‘grin and bear’ it, exacerbating the problem.

On a positive note, I did manage to go hiking yesterday, and my lungs have felt a bit better since. So perhaps it’s just all in my head and the best remedy is just to get out there and do some exercise. I finally bought another air purifier for the house (this one with a HEPA filter and a negative ion charger). That has seemed to cut down on the dust accumulation in the living room. Now if I could just trick my body into thinking this dust is harmless……

My very own box of Warfarin

My very own box of Warfarin

Week 11 (January 12)

Posted: January 12, 2014 in Weekly update
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The week started off great but went all downhill from there. Spying a break in the wet weather, I used a small window of high pressure to scale a snow-capped peak in Fukui Prefecture near Tsuruga city. This was my first full-on snow hike since nearly dying on a mountain last winter, but I can assure you I took every precaution imaginable and was rewarded with some of the best views and what the locals referred to as the “best January weather in 5 years.” I don’t plan on scaling any more wintry peaks this season, but it was nice to get one of the way just to prove to myself that I could do it safely.

The following day, Kitaguchi-san came for her weekly visit and brought along Yohara-san, a middle-aged nurse who is taking over the pill-counting duties. We decided that Monday mornings are generally the best day to get the task over with. It’s not too much work on my part – all I have to do is open the door, show her my medicine, and answer some very basic questions. After this appointment, I had a job interview for an intensive TOEIC class starting next month. They offered me the job, so it looks like I’ll have a little income to make up for what I lost while being hospitalized. I just hope the cedar pollen doesn’t completely destroy my immune system before then.

On Thursday everything was going pretty well until the evening, when I left home after dinner to teach a private lesson. I was feeling unusually bloated on the way to the station, with an incredible case of indigestion that would’ve made Mr. Wilson gasp. I survived the lesson and somehow made it home before heaving a bile-tainted concoction into my porcelain throne. The retching continued most of the night, accompanied by an uncomfortably high fever. Friday was a complete write-off, and I even had to cancel my regular appointment with my cardiologist because I didn’t even have enough energy to leave the bed. Luckily the fever broke on Friday evening and now as I write on a Sunday afternoon things have settled down quite a bit. I should be back to 100% or so after a couple more days of suffering through a bland diet of crackers and noodles. During the entire ordeal I’ve managed to stay on track with my medication.

Let’s hope next week will be much less dramatic. I really need to avoid all contact with sick people and germs. Any more illnesses this season and I may have to go into hibernation completely.

The highlight of my week

The highlight of my week

Week 10 (January 5)

Posted: January 6, 2014 in Weekly update
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The year of the horse is officially here, which hopefully means the bad luck of 2013 is now behind us. We had a quiet one and actually fell asleep before midnight on the 31st for the first time in years.

Kitaguchi-san from the Osaka city health department did not visit this week because of the holidays, but she’s coming on the 8th for the next installment of my weekly medicine checks. I’ll also go to my heart doctor on the 10th to get my warfarin checked. It was way too low the last time I got it checked, so hopefully my INR has risen to a better level. The medication has become much easier on the body now that I’m down to just two antibiotics. I can feel my strength returning and no longer need afternoon naps to help me through the rest of the day. My cough has gotten a lot better as well, but isn’t gone completely.

Kanako and I have been waging a tough battle over house dust, but I think the dust is winning. Both of us are allergic to dust and spend most of the day wiping our noses with tissues. It’s a bit of a catch 22 – stay home to try to save money but suffer in the process, or go out where there’s less dust and you’re more likely to buy things you don’t need. We both agreed that getting another air purifier for the living room is essential, but they don’t come cheap. Looks like I’ll need to dip in my savings a bit to weather the storm before steady income flows in again from April. I may pick up some work in February and March to help buffer the situation, so I’ll know a little more next week.

I did manage to go on a hike a couple of days ago with my friend Paul. We chose a tough mountain to test my strength and stamina, and the snow on the path made things treacherous, and the weather changed in route so we had to descend in a tempest of sleet and fog. Fortunately there was a hot spring awaiting us at the end of the trail, and we both survived the ordeal. We were never in any real danger, but it was one of those trails with zero margin for error.

My first hike of 2014

My first hike of 2014