Some impressions after getting a herniated disc in Tokyo

So the last week and a half has been pretty harrowing. The morning after an official company function I woke up with excruciating pain running down my left leg, like something was stabbing me from my thighs down to my toes. It was persistent, constant, and intense. With the help of Mrs. Adamu I was able to just barely walk out to the street, call a taxi, and get to the orthopedist.

Because I had recently been on a long bike ride with my full weight on the seat for about 4 hours, I was sure I broke my tailbone. Turns out that was not the case—the doctor said I had a herniated disc! The prescription: a bunch of drugs, plus a regimen of stretches and an order to lose some weight.

By the time I reached the clinic, most of the initial pain was gone, reduced to mostly an aching in my Achilles area. Since then it has tended to be worst in the morning, easing off gradually from there. The pain has dulled a bit each day, and now I feel much much better.  According to the doctor, I am one of the lucky cases whose hernia will likely be eradicated by my white blood cells. Otherwise I could need vascular injections or even major surgery. Here’s hoping that won’t be necessary.

Since this happened in Japan, the experience is perfectly germane for MFT. So here are some observations:

  • The doctors were not the horror story I hear about – My doctors (I started with a young doctor and then switched to the clinic director) were patient, listened to my bad Japanese (and explained things to me and my wife very clearly in Japanese without making a big deal of it), and gave advice that seems to have worked perfectly.

  • Japanese painkillers are weak, on purpose – The pain drugs they gave me didn’t seem to do much. For those first four days I just basically ached without relief. This is by design, apparently. The clinic director explained that in Japan the consensus is that painkillers should not be over-prescribed to avoid their side-effects, specifically stomach irritation. This experience plus some other doctor visits have confirmed this tendency. It’s enough to tempt me to trot out that line about Japan having an “endurance” (gaman) culture. My mom was not happy to hear this and told me to take extra Advil if necessary, but for the most part I stuck to the doctor’s advice and toughed it out.

  • Japanese hospitals can be crowded – After hearing that the clinic did not open until 8:30, we waited until around then to show up. Big mistake. By the time we arrived, the waiting area was already packed with patients, mostly elderly (understandable in an orthopedist). Thankfully the pain had become more manageable by then, because we ended up having to wait hours and hours to see someone. Which brings me to my next point…

  • The iPhone rules (and so does the iPad) – On that first day, I used an iPhone app to call the taxi, e-mailed and called coworkers to let them know my situation, looked up possible diagnoses while I waited, and generally killed time. Then over the next few days when I was basically stuck on the couch, I used the iPad (and TV to a lesser extent) to entertain myself with My Chinese Bride, YouTube, and Twitter. A laptop would not have worked in my case because I needed to remain in one position to stay comfortable.

  • Commuting with a disability is NOT easy – After four days out of commission I was ready to try commuting to work, initially with a crutch for support. My office was very understanding of my situation and nice enough to let me come in late all last week to avoid rush hour, which was a godsend. I have a new appreciation for anyone out there riding public transportation with any kind of physical disability in Japan. The society is not built for them, and the infrastructure built to help them is generally not respected. Healthy people storm the elevators, meaning that slow people like myself always have to wait for the elevator to make a second trip.
    And that brings me to the train situation. As anyone following my Twitter feed will know, finding seats on the train has been probably the most frustrating part of this experience. Even with a crutch, it is a crapshoot as to whether anyone will offer you a seat. I counted four kind souls in total, which according to one of my Twitter followers is a pretty good batting average. Due to the pain, eventually I stopped waiting and just straight up asking people as soon as I got on. Usually people complied readily, but I could see how the disabled could feel worn down by having to grovel to strangers just to get from point A to point B.
    Eventually, I stopped needing the crutch but brought it around with me anyway to avoid confusion when asking for a seat. And speaking of seats…

  • The “priority seat” system is stupid and should be abolished – As visitors/residents of Japan know, almost all Japanese trains set aside a section of seats as “priority” meaning that the elderly, physically disabled, and pregnant women should be given priority to sit there. But this doesn’t work and is a misguided idea to begin with. For one thing, when the seats are full of healthy people and a disabled person comes on, you have the problem I described above.
    But the worst part about these is that it corrals the people who need the seats into one section of the train. For whatever reason, the train companies decided that the physically disabled etc. don’t deserve to sit anywhere else on the train. Why not just make all seats “priority”? In my experience, I never knew which section of the train would have priority seats, and in many cases they weren’t near where I got on. So instead of limping over to the priority area, I would just go ahead and ask someone in the regular seats to get up. According to Wikipedia, Hankyu and a few other railways have figured this out. And last but certainly not least…

  • Having a caring and understanding wife is the best – Mrs. Adamu has been my lifesaver through all of this. She accompanied me to the hospital and took care of me when I couldn’t get around freely. That was awesome.

So thankfully I seem to be getting better and might not have to worry about this stuff for much longer. But I have definitely gained a newfound appreciation for a lot of things, not least the medical system and the people who have to ride the trains with a disability.

I am interested to hear your Japan medical stories in the comments. Is my case the norm or more of an outlier?

20 thoughts on “Some impressions after getting a herniated disc in Tokyo

  1. Medical stories! I love to compare and contrast these in Japan. I’m full of them!

    I have three that I love to share, and I find that mine are pretty unique… first off, I have a rare eye disease and when I first came to Japan my American doctor didn’t think I would have a problem… cue six months into my first year and I have a major issue… luckily by random chance I found the best doctor in all of Japan to take care of me, and I’ve been under her care for the past 5 years. She’s head professor, studied at a bunch of ivy league schools, speaks fluent English and her area of specialty is my disease. I go to the best eye-care center in all of Japan, where she’s the head of her department, and have never had any problems there… just long waits and sometimes slightly rude fellowship students. So A+++ to Japan for getting my rare problem taken care of…

    This brings me to when I got bronchitis my 2nd year here… and I don’t think I’ve ever fully recovered from it. I went to THE Silent Hill hospital of horrors in Omiya and after they shoved hot, metal instruments up my nose I flat out refused to let them dangle a camera down my throat to see ‘why it hurts’. They gave me vitamins and told me to rest. I had a fever for about 2 days before someone from my company found me a clinic nearby (this was after having just moved to Saitama, so I didn’t really know much about the area) where the doctor spoke English and I was able to strong-arm some antibiotics out of him. This kept happening for 2 more years and no matter where I went the doctors would NEVER give me enough antibiotics to actually get the gunk out of my lungs… my mom finally saved me by being crafty with some left overs she got back home…

    And my last story was when I got milk-poisoned (I’m allergic) by a coffee shop and had a fever/ other problems associated with being allergic to milk and got severely dehydrated. I was living with a host family at the time and my host mom took me to the nearest clinic. The doctor was great, the nurse was a pro with an IV and they fixed me up with little issue… just the doctor didn’t believe that I was having an allergic reaction and labeled it as a virus :/

    Anyway~ glad that you had such a good experience at the hospital! And you know from twitter that the train seats thing was ridic, but you did get some good material! Yay for your wife too :D

  2. Glad to hear that you are feeling better. I wrecked my back a year or two ago and was down with a flu at the same time. Was off my feet for about a week and stupidly didn’t go to the doctor. When I was better, I started doing push-ups and squats regularly and haven’t had back pain since.

    Thoughts:

    Many older people use frequent hospital visits as a means of socializing. There is no getting around it.

    I’ve always had a good experience with Japanese healthcare and have been especially impressed at the speed at which x-rays can be arranged, even at an inaka GP. Weird the way that this kinda thing works out. Some people say that Japanese dentists are like butchers for the mouth, but a dentist friend of mine outside Japan (with no connection to Japan) says that she only sees amazing work from Japanese dentists. Online horror stories need to be taken with a grain of salt, just like super good anecdotes shouldn’t put you off your guard.

    Tokyo and other big cities are crap for respect for priority seats (although my pregnant wife never once had someone give up their seat where I am now so I don’t think this is a Japan thing). Inaka local trains can be even more crowded than commuter trains in Tokyo (as they don’t come along nearly as often) but people give up their seats more readily in my experience. Pregnant women seem to get much better treatment in small regional cities.

    I find that pedestrian light durations are far better for people with disabilities in Japan than anywhere else that I have lived. Did you find non train station getting around to be okay?

  3. Great write-up! Always good to hear about some of the positive experiences. Mine were overwhelmingly positive. I caught pneumonia my first winter in the-middle-of-nowhere Fukushima. There was only one clinic, but both doctors there were excellent, and one of them, a relatively young doctor, was one of the nicest and most concerned doctors I’ve met anywhere. It took him a while to make the diagnosis, but he eventually figured it out and wouldn’t give up until he did (through chest X-rays). The BOE was very understanding and let me take time off to recover.

    While in Tokyo I went to an ENT who was also very nice. This guy ran an old school clinic – one of those places where everyone sits around in the same room. He was always interested in explaining what was wrong.

  4. M-Bone: Agree with your point on socializing. The ENT where I went had a crew of regulars that would hang out in front of the building and chat before it opened in the morning. Made it very difficult to get in and out in time for work, but once or twice I made it there early enough to beat them!

  5. Clinic waiting rooms rival lineups in front of pachinko places as social spots for the elderly. Maybe there is a solution to the “paying for health costs of the ageing society” problem in there somewhere.

  6. The quality of treatment you get here varies greatly between doctors. I came down with a nasty infection a couple of months ago. The only doctor I could find during the weekend was a guy in his 80’s running a grubby clinic where it seemed like none of his equipment or techniques had been updated since the Vietnam War. After taking a bacteria sample, putting it on a slide and viewing it under a microscope (biology class style), he prescribed some antibiotics which were totally ineffective. I went to the ER at a big and gorgeous hospital (Tokyo Joshi Idai) a couple of days later, and ended up getting treatment there the next day, where they put me on an IV drip and a regimen of stronger antibiotics that eventually killed everything.

  7. Don’t all JR trains show position of priority seats as markings on the platform? (along with low aircon car, green car and the likes)

  8. On the subject of painkillers, I cracked a rib playing rugby a few years back. Fairly run of the mill, in that it only hurt when I moved or breathed.

    I’m well over six foot, and at the time was comfortably over 100kgs as well. When weighing up the dosing options for painkillers the doctor chuckled and said something to the effect of, ‘Well, you’re not only big, but foreign too. Try doubling the dose, and if that doesn’t work, double it again.’

    At least that’s what I understood him to say, and bugger me if it didn’t work like a charm.

  9. It’s my experience that local clinics are a total crapshoot; I have seen everything from total quacks (such as the doofus ENT who actually knocked me unconscious while failing to extract an insect from my ear canal) to seeming geniuses who nail issues down with a single visit. I think the key to successful healthcare in Japan is a willingness to get a second (or third, or more if you aren’t satisfied) opinion, which admittedly is a lot easier if you live in a major urban center.

  10. As far as I could tell the labels are only on the cars, maybe because it varies by train model and where each train stops on the platform

  11. You have my sympathy, as one who has also spent time hobbling through the subway in severe pain. Two bits of advice: don’t go to any chiropractors, they are rank charlatans in my experience. The last one I saw in Tokyo (in Nishi Azabu, I can’t recall the clinic name) didn’t diagnose a herniated disc and did a lot of extra damage. Two: if the pain down your leg persists, get an MRI scan to check the extent of the herniation. If it’s pressing on your sciatic nerve then a discectomy may be advisable… (Actually this is probably the best money my insurance company ever spent: instant relief and only a few weeks’ rehab.) But I hope it doesn’t come to that.

  12. Priority seats have always kind of confused me. I always feel awkward if I sit in one even when there’s nobody around who needs it, and so I end up standing, which then ends up being just as awkward because there’s a perfectly good seat available.

    That was really touching about your wife! Feel better. :)

  13. I have been to doctors in Japan a number of times for various things, and while I have never had a particularly bad experience I have also had results that were better than others.

    But Adam does mention what was possible my biggest all-time complaint: pain-killers. I have mentioned on this blog before how I broke my arm in a bike accident just a few days before flying back home from Japan, and while the doctor in the ER (right after I broke it, Saturday around midnight) and followup visit Monday morning were perfectly competent and gave me a pretty much identical prognosis and treatment to the orthopedist I saw after coming back to the US, I was astonished to find that they were unable to prescribe me any remotely effective painkillers.

    I broke my right upper-arm just below the shoulder, in a way and location that has doctors merely put it in a sling rather than a cast. This means that there is very little support, and moving around is FAR more painful than it would be if there were a cast in place. And yet, all the doctor could give me was some crap anti-inflammatory that was basically equivalent to taking one more ibuprofen than normal. The doctor actually apologized for not being able to give me anything genuinely effective, like a narcotic, and only after I explained how I was flying all the way back to NYC three days later was I even able to persuade him to give me a few sleeping pills.

    I went to see a doctor in the US the very next day after getting home and immediately got some percoset or vicodin or something, which was made the next couple of weeks before the bone started to heal WAY more bearable.

  14. I haven’t had a painkiller issue in Japan so I don’t feel the pain like some obviously have, but I think it is worth mentioning the massive problem of prescription painkiller abuse in the US and Canada. One type has even earned the nickname ‘Hillbilly Heroin’ (I know an addict). Japan is obviously being too conservative, but the ‘painkillers for all!’ approach probably isn’t the right one either.

    I did a bit of Googling and it seems as though it is concern about addiction, based on US cases in the 30s – 50s that has left Japan conservative on painkillers.

  15. Narcotics are absolutely overprescribed in the US, but the extreme in Japan where it’s virtually impossible for a doctor to prescribe ANY narcotic for administration outside of the hospital is also nuts.

  16. It’s interesting to hear about them being stingy with painkillers in Japan. It’s like that here in China too, but I had always assumed that it had something to do with opium addiction being so bad here in the past. Hearing it’s the same in Japan makes me question that.

    Thinking back to when I broke my foot, I don’t think I got any painkillers at all, and when my friend had knee surgery they gave him some sort of epidural, and no painkillers afterward unless he specifically asked for them.

    Watching shows like INTERVENTION when I was back in the US kind of made me wonder if this approach to pain management is actually sort of a good idea. With so many people getting addicted to prescription painkillers, maybe it’s better for hospitals to give something just to take the edge off and make things bearable, rather than something stronger that can be addictive.

  17. Sorry to hear about your condition – I hope it continues to improve and you’re 100% soon.

    I suffered a herniated disc last year, while living in Aomori. I didn’t need crutches but was in constant pain and found riding a bicycle excruciating. This was unfortunate as it was my main mode of transportation. I have no complaints about my diagnosis and treatment. Though the age/decor of the hospital was somewhat reminiscent of Silent Hill, it seemed to be one of the – livelier spots in town most days. Lots of waiting room time.

    The staff and my doctor were always friendly and on point, and I never doubted I was in good hands. I wound up getting an epidural nerve block, which was like a new dimension of pain during the short procedure – you only get a local anesthetic as you must provide feedback to the doctor as he makes the injection.

    This helped greatly and over the course of a couple months the pain completely disappeared. As noted in some previous comments, the weakness of painkillers as I recovered was frustrating. Being a “big” foreigner I was given what’s considered a strong dose but I may as well have been eating tic-tacs for the good it did. I wound up gobbling ibuprofens from the jumbo bottle I’d brought back from my last visit to the States.

    The ibuprofens were only for emergencies, as they make my stomach queasy. I wound up losing a fair chunk of weight during those months, as the tradeoff for pain relief was no appetite.

    Everything returned to normal after about 3 months.

    Good luck with your recovery!

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