Week 19 (March 11)

Posted: March 11, 2014 in Weekly update
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Sorry for the delay in getting this blog updated. I blame it on the pollen…..

Last week after a couple of days of work, I headed back to Dr. Tamura on Wednesday for a blood test and check-up. The results were good. My liver function is stable, but my INR is still too low. Time to bump up my warfarin dosage yet again. I have only one more check-up before the end of my TB treatment, and after that it’ll be a juggling game to get my warfarin dosage back to normal after the antibiotics run their course. He said it takes about 2 weeks for your body to fully eliminate all of the drugs from your system. I guess that makes sense if they’ve been running through your bloodstream nonstop for the last 6 months!

I still feel pretty tired after working half a day, so I’ve got in the routine of taking a quick power nap after getting home from work. That seems to help, and I pretty much go straight into REM sleep immediately after putting my head on the pillow. I think a lot of my fatigue is from my allergies. So far they haven’t been too bad. I mean, I do have a runny nose and sneezing, but it’s not nonstop like it usually is. My guess is that the pollen, in the words of the Carpenters, has only just begun and that it’ll continue to worsen along with the rise in temperatures. The antihistamines are on standby just in case. I usually don’t take them unless it’s a really heavy pollen day. Instead, I just rely on wearing a mask every time I go outside.

Despite the flowery discharge, I did make it out for a hike on Sunday. I went to Mt. Rokko, a local mountain that is only a 20-minute train ride from Osaka. Little did I know that they were hosting an event on that day, and the trails were overflowing with hikers. The event is known as the Grand Traverse. Participants start at the far end of the range at the inhumane hour of 4am and traverse along the entire mountain range, ending in Takarazuka some 53 kilometers later. It’s definitely not my idea of fun, especially when sharing the mountain with 1100 other masochists. Fortunately, we did a section of the trail near the end, so we were off the mountain before the majority of sufferers stumbled off the mountain after dark.

Speaking of sufferers, today marks the 3rd anniversary of the Tohoku earthquake and tsunami. I was actually in New Zealand when the earthquake hit, so I didn’t experience it first-hand. I have traveled to some of the areas hit by the tsunami, but it was many years ago, and I feel their pain. The Japanese government has done a pretty poor job on reconstruction efforts, instead focusing their energy, attention, and monetary resources on preparing for the 2020 Olympics. Living in Japan, you definitely get the sense that the central government only cares about Tokyo at the expense of the rest of Japan. If the quake was centered in Tokyo, you can bet that the city would have been completely rebuilt by now. Anyway, at least the government has paid for my TB treatment, so I there’s a tiny bit of moral fiber left in their aging bones.

This hay fever seems to have activated some facial muscles

This hay fever seems to have activated some facial muscles


Week 18 (March 3)

Posted: March 3, 2014 in Weekly update
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I can’t believe March is already here. It’s my last full month of treatment, so you know I’ll be counting down the days with a sense of joy and relief. Now, to recap the week:

Monday and Tuesday were spent teaching my new students. They are all around 24 to 25 years old and get along really well with each other. It’s a dream scenario as a teacher, as they all listen attentively and do what they are told. I still feel pretty wiped after work and have managed to sneak in a few early evening naps before dinner. The training facility has an employee cafeteria utilizing the latest in technology (designed by the company itself, no doubt). You pay for your meal after you eat by taking your tray to a sensor-lined counter. Your empty plates and bowls are instantly scanned and your total caloric intake is displayed alongside your total. After that you pay the cashier and take your tray to the conveyor belt that shuttles it back to the kitchen. I’ve been tempted to eat a high-calorie meal just to see if there’s some kind of alarm system built in whenever you overeat.

Wednesday was my day off and nurse Yohara came by to check up on me. These weekly visits are turning into a bit of a rehearsed routine. She is required to inquire about my progress and I’m obliged to hand over the empty medicine packages, which I’m pretty sure she uses to either decorate the office or repackage them with sweets to give to her children. Or maybe she just shows them to her boss to prove that she’s been out working all day instead of killing time at the local department store.

On Thursday Kanako went to our local ward office to have her TB blood test. We haven’t heard back from them about the results, but are expecting a reply any day now. If it turns out she does have the disease then I guess I’ll be extending the life of this blog to include not only my recovery, but hers as well. Fingers crossed that it won’t be necessary. She does have a pretty bad cough that is leftover from her bout with the flu. Let’s hope that it will improve soon and that TB is not the culprit.

Friday was another day of work, where I went to bed at a reasonable hour after the fatigue of working a full work week (if you can call 4 half-days a ‘full’ week that is). I needed my rest to prepare for another exciting weekend. On Saturday evening I went to a Mardi Gras party at my friend CC’s restaurant. He’s a New Orleans transplant who serves authentic Cajun and Creole cuisine from his bistro that is only half a block from my apartment. To celebrate the occasion, he invited a swing jazz band to perform, which really livened things up. Despite the rainy weather, the group led a small carnival-style parade down the streets, blasting out their catchy tunes in much the same way a marching band belts out patriotic hymns on the fourth of July. Within minutes the cops showed up to put a muzzle in our conviviality. This was despite the fact that they had received written permission from the authorities to hold the event. It only takes one grinch to spoil the party, however. This country continues to defy logic: every Sunday a troup of right-wing vans meander the streets of my neighborhood belting out old Japanese songs professing their love for the emperor. They sometimes shout at pedestrians and make some very racist comments towards those of Korean and Chinese descent. The decibel levels are through the roof, yet the cops do absolutely nothing to stop them, but when a group of people want to gather peacefully and spread love and culture through music, their efforts are squashed immediately. Still, it was fun to see my neighborhood transformed into a festive vibe if even for a split second.

On Sunday I woke up at 6am to head to the mountains with my friends Tomomi and Baku. They picked me up from my apartment and we headed deep into the mountains of Shiga Prefecture to climb another snow-capped peak. Recently temperatures have been way above average and rain fell most of Saturday evening. The snow had all melted at the trailhead and we didn’t hit any white stuff until a third of the way to the summit. The snow was wet and rotten, turning our shoes into a soggy mess, but the beautiful beech forest made up for any discomfort. We followed one lone set of footprints, as well as the tracks of wild boar, deer, and bear, through the slushy slopes under cloudy but calm skies. The locals people we spoke with in the village at the foothills commented on the lack of snow so early in the season. Usually their hamlet is buried well into April. The pollen counts were low, and it was great to explore another new area of Kansai before the snows return for another encore (temperatures are back down to freezing as I write).

This coming week I have another appointment with my TB doctor. Stay tuned for more exciting adventures in the next installation of this blog, tentatively titled “Week 19”.

Rotting snow and fog in the early spring weather

Rotting snow and fog in the early spring weather

Week 17 (February 24)

Posted: February 24, 2014 in Weekly update
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It was another action packed week here in the land of recovery. Nothing exciting happened in the first part of the week, but on Thursday I started my new part-time job. I’ll be working for about a month at a very large Japanese electronics manufacturer. I’m teaching an intensive English course to a group of 10 students. They’ve all worked at the company for a few years and are now in the position to start moving up the managerial ladder, but before doing so, they need a crash course in English. This is where I come in: I’ve got this group for 3-1/2 hours a day, 4 days a week, and I’m preparing them to take the TOEIC test. Since I’ve never actually taken the test, it’s a good chance for me to learn about the types of questions that appear and to help arm my students with the proper linguistic ammunition.

The first couple of days went well. The students all seem to be happy so far and I’m sure it’s a much better alternative to standing in an assembly line all day. My only fear is that I will run out of things to teach them before the class finishes next month. After the first day of work I felt pretty exhausted and a little hoarse because it had been 4 months since I had seen the inside of a classroom. I’m fairly confident my body will adjust to the extra workout.

On Saturday I went for another snow hike. This time is was in rural Hyogo Prefecture, north of the old castle town of Himeji. The snow was quite icy because the tracks that other hikers had made were frozen over. Light flurries blew around in the morning, and the weather cleared just as we made it off the mountain and back to the bus stop. That was likely the last full-on winter hike I’ll do this season, since temperatures are supposed to skyrocket this coming week and turn all of that powder snow into a soupy, slushy mess. It will also likely send the cedar trees into a pollen-making frenzy.

Sunday I went to a photo exhibition here in Osaka. It was a one-day fare, and I had a couple of photographs on display. Kanako accompanied me part of the day before heading off to taichi practice. I saw a lot of people that I haven’t seen for a long time, and several people who did not even know about my ongoing battle with TB. I met up with Jean-Yves as well (he was one of my many hospital visitors from back in October) and I was finally able to return a couple of books I had borrowed. That was a relief since I really don’t have enough space in the apartment to keep all of the books that people lent or sent to me. If anyone want to borrow a few dozen books, then my apartment is your oyster.

I still haven’t been able to gain back the weight I lost since being hospitalized. I think the antibiotics may be holding me back, because my appetite is through the roof and I continue to eat like someone who has just spent the last several years on a deserted island. Hmm, maybe I should start lifting weights? Ok, you all can stop laughing now.

A friendly greeting from the top of the mountain

A friendly greeting from the top of the mountain



Week 16 (February 17)

Posted: February 17, 2014 in Weekly update
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Well, it looks like I am quickly approaching another waypost in the long road to recovery – 4 months! That’s right, I’m now two-thirds of the way through my treatment. My body has handled 4 straight months of antibiotics, and now only 8 more blog posts stand between me and the return to my ‘normal’ self.

Last week was a very active one. On Tuesday I climbed Mt. Kongo, Osaka’s highest mountain, with Kanako and two other friends. We were fortunate because the recent cold spell brought a lot of fresh snow to the peak. The mountain itself is only about 1100 meters (3600 feet) high. Usually the snow that settles there is quite wet and heavy, so we were all surprised to find dry, sugary powder. It made for great hiking in that none of our gear got wet, and the crampons helped in the more traveled areas that were iced over.  Mt. Kongo is a bit of a sad mountain due to the gondola that was built to carry lazy visitors to the summit plateau. Tuesday, being a public holiday, brought throngs of tourists which spoiled the scenery somewhat. Fortunately we took refuge in a small restaurant near the top and enjoyed a bowl of hot noodles. The hoarfrost on the trees was breathtakingly beautiful, leaving Kanako utterly speechless at the natural ice show surrounding us. We loafed about for a few hours until 4pm, when 99% of the visitors had scuttled down the gondola to end their day. We had the mountain pretty much to ourselves, descending the steep trail just as the sun vanished behind the horizon for the day. Mt. Kongo is one of the peaks I could see from my hospital bed, and every day in isolation I dreamed of being on its slopes. It felt gratifying to see my dream turned to reality, as back in October I really didn’t think that it would be possible.

On Thursday I went back to the doctor to get my blood test results. My INR was still way too low (1.7). Usually they want you to keep it between 2 and 3, so my dosage was bumped up yet again. I’m now on 13mg of warfarin a day. I’ll get retested when I go for my next TB checkup in a couple of weeks. On a positive note, my ALT and AST readings came back normal, which means my liver is doing a lot better. I think the reduction of Rifampicin seemed to do the trick. My IgE readings are still through the roof but hardly surprising considering all of my allergies. Fortunately for me the cedar pollen has been delayed by this recent cold weather spell.

On Saturday morning I caught the bullet train to Hiroshima for a weekend of winter fun. As you probably know, Hiroshima was where one of the atomic bombs was dropped. My friend Tsubasa and I were headed to the mountainous north for a couple of snow hikes. Tsubasa drove up from Kumamoto city in Kyushu and picked me up at Hiroshima station shortly before 9am. Our first target was a secluded gorge called Sandankyo. It features spellbinding rock formation and a couple of impressive waterfalls. Since the area was completely snowed in, we strapped on the snowshoes and carefully navigated the steep sections of rock and snow for a couple of hours. The going was tough in places: if you slipped you would tumble into the icy waters of the stream below, so we took extra care with each of our foot placements. Light snow fell down all day, transforming the gorge into a spectacle fit for a Chinese inkwash painting. There wasn’t a soul in sight but the route was easy to pick up using my GPS device and we could just make out the edge of the concrete walkway that makes navigation a cinch during the green season. After our hike we soaked in the warm waters of a nearby hot spring bath and headed to the trailhead of our hike the following morning.

On Sunday morning we woke to blue skies and calm winds. Again we strapped on the snowshoes, but this time instead of a constricted gorge, our targer was the highest mountain in Hiroshima Prefecture. It sits at an altitude of 1346 meters (4416 feet), and despite the low altitude, there was over 2 meters of snow clinging firmly to the steep slopes. We had planned to start hiking at dawn, but by sheer luck we overslept and thus were offered the luxury of following someone else’s snowshoe tracks. Breaking new trail is exhausting work, and since we had never been to the mountain before, we were happy to follow in the footsteps of a local who knew the way up the mountain. Tsubasa had his skis strapped to his pack, while I opted for my snowboard. Walking with a 180cm-long board on your back is a lot tougher than you might think. It’s not the weight that gets you but rather the high clearance needed. Countless times I would neglect to duck low enough to avoid the branches overhead, sending shockwaves through my body and knocking me back a couple of steps. At one point my wool hat caught on a branch and was flung on the far side of the forest by the sheer force of a bending branch. After two hours of sweaty slogging we reached the summit, rested, and strapped on our skis for a quick ascent down the mountain. Because of the sun and warmer temperatures, the snow became wet and heavy and we became stuck more times then we could remember. At one point we spied a shortcut to one of the ski slopes and cut into one of the groomed runs: after so much work in the deep wet, sticky snow, it was a great relief to reach a path where we could actually carve. We reached our car about 1pm and after a quick lunch we hit another hot spring bath before I took the train back to Osaka.

All in all my lifestyle is becoming a lot more active, but my free time will soon come to an end this Thursday as I start working again. The school year doesn’t start until April, but I’ve picked up a part-time teaching job that lasts 1 month. I’ll post more details in next week’s update but keep your fingers crossed the first few days of work will go smoothly. It’s been such a long time since I did any teaching that I’m starting to wonder whether I’ve lost my touch or not.

Tsubasa leading the way though Sandankyo gorge

Tsubasa leading the way though Sandankyo gorge

Week 15 (February 10)

Posted: February 10, 2014 in Weekly update
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Ok, so perhaps this is another stage of recovery: a lapse in my weekly update! Thanks for the reminder Dad. The good news is I was actually out having fun, so my excuse for being late is a positive one!

This week was much better than the last one. I went to my regular asthma doctor on Thursday to get a blood test and also a month’s supply of Claritin. I’ll get the blood test results this coming week, so hopefully my INR is within range and my liver function tests are also better.

My stomach has felt much stronger. I think a large part is due to my vigilant consumption of yogurt every morning. I think the probiotics are starting to win the battle against my medicine. I had a bit of a scare this morning because I had completely run out of the bacterial milk, but a quick trip to the store remedied the situation. Believe it or not, it’s hard to find yogurt here that isn’t laced with copious amounts of sugar. I specifically search out the sugar-free varieties and supplement the taste with natural sources of sugar, otherwise known as fresh blueberries from Chile.

A cold front finally moved back in to replace our spring-like weather and we were rewarded with a small snowstorm on Friday evening. The snow started sticking to the roofs and bushes and I was hoping to wake up to a world of white. My dream, however, was quickly ruined when I was jostled awake around 4am to rattling windows – a strong wind had moved in and brought heavy rain. No white Valentine’s day for me. Other areas of Japan got heavy snow, but here in the port city of Osaka the weather stays ‘warm’ enough to mean that snow hardly ever accumulates. In the 12 years I’ve been here I’ve seen it stick once.

On Sunday the low pressure system moved on, so I headed for a snow hike with a couple of friends. The climb was tough, as we gained over 1000 meters of vertical elevation (for those on the English system, that’s a big climb!). There were about 50 other hikers, so the trail was easy to follow and the scenery was beautiful. My lungs held up pretty well until close to the summit, when the subzero temperatures had me gasping for air. A quick cup of hot coffee eased the bronchial spasms. Coffee provides natural relief for an asthma attack. No, it’s true, look it up. Take it black and as hot as you can handle it and it works about the same as an inhaler.

This week I have another snow hike planned for tomorrow, followed by a snowboarding/snowshoeing trip this coming weekend in Hiroshima Prefecture. I’m trying to get all of the ‘fun’ exercise in before the pollen starts flying. Fortunately I’m surrounded by wonderful friends with the same thirst for adventure as myself.

This is the peak we climbed. We walked all along that snowy ridge.

This is the peak we climbed. We walked all along that snowy ridge.

Week 14 (February 2)

Posted: February 2, 2014 in Weekly update
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The week started off nicely, but went downhill from there. On Monday nurse Yohara stopped by to check on my condition. I asked her a little about her job, since she is visiting sick patients all over the city. She said only a small portion are TB patients. That seems about right, since the disease generally attacks elderly people who are usually hospitalized for the entire duration of the medication. She generally does home visits for bedridden patients who need assistance with daily needs. I try to keep our visits brief since I know how busy she must be. I try to keep the mood light as well in hopes that a little positive energy can help make someone’s week a bit better.

On Tuesday I woke up to find that Kanako had a high fever. I made sure she was ok before heading out on what has become my regular Tuesday routine: hitting the trails with some friends. The hike was exhilarating and highly refreshing, and I can definitely feel a difference in my lung capacity pre/post tuberculosis. When I returned Tuesday evening Kanako was still in bad shape, so I made some soup and played the role of nurse. It was turning out to be a busier week than I had hoped.

The next day Kanako’s fever continued, so we searched for a clinic nearby that would take her. We found one with an open slot in the afternoon so she could rest most of the morning. Around noon I left the apartment to grab some lunch for us and found my next-door neighbor’s apartment door ajar. Outside, there were 5 pairs of shoes lined up. At first I thought he was having a party or some kind of meeting, but as I approached closer and peered inside I noticed a foul, nauseating smell wafting through the air. Growing up in a rural area, I can recognize the smell of a dead animal immediately, and the lump in my throat grew as reality started to set in: this was a forensics team sent in to deal with a corpse. Our neighbor lived by himself in his small apartment that doubled as his office. Judging by the odor, he must have been dead at least a week. I hurried down the elevator and escaped outside to the fresh air, my heart pumping full of adrenaline. I grabbed the wall of our building as the blood left my head and I very nearly fainted. I had to take a few deep breaths before slowly walking away to grab food that I no longer had an appetite for. I knew it was only a matter of time before the cops finished up their investigation and wheeled out the body bag to the unmarked van out front. I was hoping that I could get lunch and return in that small window of time.

Fortunately I made it back without having to see the body. I told Kanako what I witnessed and we spent the rest of the day talking about the young man who lived next door. He was in his mid-40s and lived a very unhealthy lifestyle: overweight and diabetic. The cause of death must have been natural because the cops did not come over to interview us. We both stayed in the apartment until Kanako had to go see the doctor. Fortunately the cops had finished the clean-up job by then. Anyway, Kanako tested positive for type-A influenza and was told not to work the rest of the week. When it rains it definitely pours.

The medicine worked pretty quickly and Kanako fully recovered by the end of the week. I was extremely cautious and worried about catching the illness from her, but it looks like I have actually dodged the bullet for once. My new strategy of wearing a mask every time I board the subway seems to have helped somewhat. I just may keep this up year round.

On Saturday I went out for another hike in the unseasonably warm temperatures. Apparently the cedar pollen has started being released, so if I get a chance this week I will definitely go to my allergy doctor. I figure I can get one or two more good hikes in before the pollen becomes too strong.

Enjoying my time in nature as much as I can

Enjoying my time in nature while I can

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