Prayers for the People in Japan

Thanks to many of you, friends and family, who contacted me in recent days. Several of you wondered whether I know anyone who was injured or killed in the recent earthquake and tsunami in Japan. I don't. The area where we lived is quite far from the epicenter, and although our town felt the earthquakes, no one was injured in the shaking. The map below shows the island where we stayed in pink; our town was in the very middle, by the 1.

I am, however, concerned about the radiation exposure that could spread to affect more of the nation. If the nuclear situation worsens, radiation could even spread to mainland Asia or the West Coast of the United States. Blessings on those working to prevent further catastrophe! I imagine this danger of radiation exposure further traumatizes the people of Japan who have already experienced such horror.

For more information about Japan's experience with radiation exposure, please visit this site of the Hiroshima Peace Museum. The site is in English, and has lots of information for adults and children. There are even games and curriculum to share with young ones. (Here is a link to my previous post describing my visit to Hiroshima with mom and Nick.)

Celebration of an Anniversary, Alive

Two years ago yesterday, I was in an accident that I feel prompted to memorialise.

Nick and I celebrated Christmas of 2007 in a lovely Buddhist monastery on a un-toursity island near Bangkok. We traveled around Thailand with our friend Cat(herine). Then, for new year's, Nick and I took a romantic trip alone to an island called Ko Kood. In order to get to the island we were taken advantage of by a taxi driver, and then left marooned on a dock without the boat ride we'd purchased (infamous Thai 'travel agent' crooks). We begged and pleaded and insisted that they get another boat, and after a couple hours of waiting, hopped onto a little speedboat there with a few other sea-sick couples. But, oh, it was worth it! Some of the resorts on this remote island were fantastically expensive; the Russian tourists stayed there. Our 'resort' consisted of some spots to pitch tents, and some brick huts with grass roofs; perfect. The resort owners are a lovely and generous Thai family. We spent a couple days wandering around on foot before we decided to rent a small motorscooter to explore the other side of the island. Now, everyone knows that scooters aren't safe, but when you're on vacation you think "well, this is my only opportunity..."

THE ACCIDENT
Off we went, on adventure! Helmets weren't available. Bumpy, dirt roads. A crudely photocopied map written in Thai. A couple hours later, we were writhing on a wooden bridge. Some villagers ran out from the forest, put me on the back of a motorcycle, and we bumped along to the island clinic. I was in shock, watching my blood drip on the exhaust pipe. Nick, also injured, rode our rental motorcycle back to the resort for the English-speaking resort owners. There were two nurses at the clinic when I arrived. My left elbow was deeply cut with gravel in it. My left shoulder hurt. My left foot was broken and deformed and really nasty with very little skin on top. The nurses took an X-ray, looked at the image with puzzled expressions, and shrugged. I was given some very mild pain meds. Nick's left hip was deeply traumatized with a bruise that didn't fade for several months. Our friends at the resort provided saving grace as translators, cooks, and chauffers. Eventually we were sent back to the resort, but the last boat had already left the island for the day, so our option was to take the first boat in the morning to the mainland. Of course, if we were thinking clearly, we would have been life-flighted out, but we were in shock...

TRAVEL
The next morning the son of the resort owner carried me into a speedboat from the dock. Nick limped behind with our bags. Not such a romantic end to what was a lovely tour. After an excruciatingly bumpy 2 hour boat ride to the mainland, an ambulance met us at the dock and rushed us off to the hospital in Trat, Thailand. The ER docs tsk-ed and groaned as they cleaned our wounds. X-rays showed my obvious breaks. IV antibiotics pumped into my veins. We were checked into the most lovely, huge hospital room with fresh orchids on my hospital bed -- really! Jobby, the daughter of the resort owner again provided translation and emotional support. We stayed at the hospital for a couple days and then traveled back to Bangkok for our scheduled flight out of Thailand, back to Japan. Of course, if we were thinking clearly, we would have flown home to America, but we were in shock...

We were loaded onto a luxury (almost) bus for a bumpy 7-hour drive from Trat to Bangkok. Then taxis to the airport. Blessed wheelchairs at the airport. Jobby met us in Bangkok, helped us communicate with the airlines, and bid us a teary adieu. Some saintly businessman traded his front-row seats so that I could prop my cast up on the wall for the flight from Bangkok to Osaka. No, the airline didn't give me any special seats despite our injuries and protestations. Then we flew Osaka to Sapporo. Of course, if we were thinking clearly, we would have gone straight to the hospital when we arrived in Sapporo, but we were in shock....

So instead Nick bought us tickets back to Furano. The island of Hokkaido, I should clarify, is thought of like Appalachia is to the USA. And Furano is, well, in the middle of that wilderness. (Lots of bears in the woods. Not a lot of healthy teeth in the children. You get the picture.) From the Sapporo airport we got on a train into the city center. And then, shocked by the Siberian snow and icy streets, I tried to maneuver on crutches to the busstop. I was sobbing with pain. A young woman ahead of me backed up directly into my wounded leg; I freaked out and actually hit her with my crutch (not proud of that moment).

JAPANESE MEDICINE
Japanese healthcare, though internationally famous for its quality, is not all it's cracked up to be. Sure, there is more focus on preventative medicine, which is an excellent idea. And it's true that they do incorporate traditional effective medicine (herbs, acupuncture). And, of course, there is nationalized health insurance. I've already written a blog post about some of my medical care for my broken foot here. It was shit, to put it succinctly.

A couple brief notes about my understanding of Japanese medical policy, as it's been explained to me. A note about physician's medical assignments: In Hokkaido, all governmental employees like doctors and teachers and city workers are moved around from job to job every few years. It is systematic and not based on the wishes of the workers. So a doctor in Sapporo may work in a hospital for 4 years, and then be transferred to Wakkanai, and then be transferred to Furano. All around the island. S/he changes hospitals, and her/his patients get a new doc. This means that, ideally, the best docs are not in the big cities because they get moved around. But also, the docs do not have much quality of life or active commitment in the communities. Another note about medical education: I hear that Japanese doctors don't do residency to declare a specialization. Once they finish med school, they just get to say "I'm a cardiologist" or "I'm an optometrist" as their interest lies. Then they start practicing their new profession; you can imagine there is some learning curve. A note about nurses' training: Twice a month, I taught English classes at Furano's nursing college to students in their final year of school. It was shocking to me how little these students knew about healthcare. One example: in a lesson we asked the students what they should say to a patient who comes into the ER saying he has the worst headache of his life, and he's felt this pain for three days. The nurse's response? Take these pills and come back next week. Shocked, we asked the question again in both English and Japanese to make sure they understood the scenario. We clarified and discovered the nurses had not been trained on aneurysms. (My co-teacher and I subsequently vowed not to get sick in this town.)

MY MEDICAL EXPERIENCE
The nurses in Furano, charged to change my bandages every few days, were instructed to rip off the old bandages. With lack of training and supplies, they re-opened the wounds on my foot every couple days, to replace the bandages with new ones. I gave them these plastic screens to put over the wounds (I'd received the screens from the Thai hospital), to put directly on the skin before the gauze, but the undereducated doctors and nurses would not let me use the screens. So their solution was to rip me open. The wounds didn't close for six weeks.

The X-ray techs didn't have lead aprons to protect me from the many x-rays to which I was exposed. Or, when there were lead aprons available, I had to ask for them specially, and the protective aprons were literally dusted off for me.

The dermatologist who removed stones from my skin was a butcher who refused to wear rubber gloves and worked in a filthy, crowded storage room-turn-operating room. (My physician sister-in-law says the stitches look like they were done by a child.)

I did receive a CAT scan and an MRI to look at damage to my shoulder, but I'm not sure if anyone was trained to understand the pictures. After about two months complaining of shoulder pain, exacerbated by the wheelchair and crutches, I was prescribed physical therapy for my shoulder and foot. I would say that my physical therapy was the only effective treatment I received in the hospital.

Of course, once realizing that the Furano hospital would not be able to provide me with good medical care, I could have traveled to Sapporo, or better yet, just gone home to the US. But we didn't. I didn't prioritize my health. I felt compelled to finish out the year for various complex reasons, mostly to please others. I regret that decision.

My Japanese acupuncturist worked overtime on my biweekly appointments to ease out my pain. I saw him the entire year I was there, and he was perhaps the only person (other than my saintly fiance) who understood the trauma my body had experienced. He tsk-ed with empathy while pummeling my shoulders and needling my crown. He was an excellent caregiver. It's only now, two years later, that I let Reiki and acupuncturist practitioners touch my foot. So much pain and trauma is stored there.

STEPPING FORWARD
But, dear readers! Since the accident I have hiked, run, moved my household twice, practiced countless downward-dogs, performed ballet-style pilates, danced the polka, and challenged my body in many other ways. I'm scarred, but I am healing. Most adults have broken bones; others have succeeded. We are lucky to be alive. I am determined to release the inner scars and trust in my body's innate aptitude to heal and be well.

Healthcare and The Economy: My two cents

I'm thirty-one. I graduated from college in 2000, did a year of "national service" in AmeriCorps, and then 9-11 happened. I tried to get a real job, thinking that someone would surely hire me with my expensive education, blond(ish) hair and tailored suits. Surely. But, no, I scrapped a few dollars together in the next few years, working in a dirty restaurant and lowly social-service jobs. Health insurance? Not even an option. I could barely make my student loan payments. In desperation, I moved to Colorado and got a job working in the fancy Ritz-Carlton world. I learned how the upper crust thrive, and I received dental care from a guy who fixed movie-stars teeth. Six glorious months of health insurance; awesome.

Returning to the Northwest greys, I got a job at another hotel but had to wait 3 months for health insurance to start. Two weeks before my insurance kicked in, I got a horrible spider bite which became so infected that my leg couldn't fit into pants. Despite the nasty wound and visible infection line up my femoral artery, I refused to go to the doctor. I feared the huge emergency room bill. I could've died, but a friend-of-a-friend, a natropath, saw me for free and got me on a cheap antibiotic and homeopathic meds. I survived and the wound healed. (Now I wouldn't think of sacrificing my life for the fear of an ER bill, but at the time I felt terrified and desperate.)

Around that same time, also uninsured, my brother had a terrible ear infection. He didn't go to the doctor until his eardrums were literally bleeding. The ER visit and antibiotics cost thousands of dollars, which he faithfully paid off in small increments over many months. His hearing never fully recovered.

Several years later, I decided to leave Portland and move home to Omaha for a couple months before Nick and I moved to Japan. I quit my job (with great benefits) and figured that I could coast without health insurance for the two months before my Japanese insurance began. A week later, I found out I had a situation that needed surgery and biopsies. I had no insurance. If I did have cancer, I would be screwed. Blessedly, the Creighton Medical Center completely covered all my expenses, supported by some national funds for low-income women needing treatment for breast or gynecological cancers. The surgeries were traumatic, but the costs were covered. I am grateful.

As I think about my early adulthood, I know that the timing of the post-9-11 economic crash and the increasing costs of healthcare has affected my life in real ways. Some 40- and 50-somethings complain about the difficult economy, and for good reason. But my entire adulthood (a decade so far) has felt like a recession. I think that many people my age feel this way.

In a NYT Op-Ed about being "thirtysomething", 31-year-old Porochista Khakpour writes:

"I’m part of the Peter Pan-ish Gen-X final trickle — and what do we know about growing up? My friends are all broke, say “whatever” too much, still live in Converses and constant hangovers, still yell at their parents on the phone and two seconds later ask for money and possibly a place to crash, are still deferring college loans and say everything is the new something-else, including the 30s, which are the new 20s. The economy is in crisis, and they don’t care; they have become Zen about debt, having been impoverished, if trust-fund-less, since they got out of college at the beginning of the millennium, a time of tragedy and war and turmoil, their entire 20s devoured by someone they refer to only by a twangy iteration of his middle initial."

My point? I'm not saying that I deserve to live on the dole because my life has been tough. I'm not blaming W for everything. But I am saying that this country needs healthcare reform. We need single-payer health insurance. And, without question, there should be a public option for health insurance as part of this healthcare reform. I have traveled to many countries that have successful nationalized healthcare models (Australia, Japan, Germany). I've been all over this globe and I can tell you that my international friends find our quality-of-life absolutely shocking. Most countries of the world have nationalized health insurance. Most people in the developed world do not fear illness like we do. European, Australian and Canadian students are not weighed down by inconceivable college loan payments for two decades after graduation. There are better ways to do it. Wake up, America. Stop bombing other people. Start spending the money to help our people live.

Food

The following is an excerpt of an interview of Winona LaDuke in YES! Magazine. LaDuke is one of my biggest sheroes and I am very excited to move back to Minnesota and be nearer to her wisdom/action. I like what she says here about work, food, and celebration.

"Sarah van Gelder: Can you tell me about how wild rice is harvested?

Winona LaDuke: We go up on the lake and we put our asemaa, our tobacco, on it. My son is my ricing partner, and we canoe through our rice beds. I used to push him, but he got too big, so now he pushes me out there, and I knock rice into the canoe with two sticks.

The rice grows on our lakes and rivers—some is fat and some skinny, some short, some tall. Some grows in muddy waters, some looks like a bottle brush, and some looks all punked out. That’s called biodiversity. It means not all the rice ripens at once. Some gets knocked off by wind. Some gets a blight, some doesn’t get a blight. The Irish potato famine should have taught us that agricultural monoculture is dangerous—but so is a social monoculture (or you could say, mall-culture).

The anthropologists used to come out and watch us manoominike—harvest the rice. After we rice in the morning, we bring our rice in and let it dry. We parch it over a fire, and we dance on it to get the hulls off, and then winnow it in a basket. We pretty much do the same thing today using wood fires as we’ve always done—we’re an intermediate technology people.

Ojibwe is a language of 8,000 verbs. The word for “work” is a strange construct for us. It doesn’t mean we aren’t a hard-working people, but in our language, the word is anokii, which means that whether you are fishing or weaving a basket, what you are doing is living—which is not the same thing as being paid a wage to do something.

After the harvest, we have a big feast, and we dance and tell stories. The anthropologists watched us, and they didn’t like that. They said we would never become civilized because we enjoyed our harvest too much. We did too much dancing, too much singing.

When you no longer enjoy your relationship to your food, to your plant relatives, to the harvest, to the dancing and singing—when you end up with a harvest that has no relationships or joy, I think that must be the mark of civilization and industrialized agriculture."

Arrrg.

My friend Mad(eline) has a very clever blog to which I would like to draw your attention. The link is here to the right: "Mushroom City". Good stuff. Very descriptive of our day-to-day life on the job here. Japan is crazy.

My rants are less clever-funny than hers, but I think perhaps we share similar frustrations. Frankly, sometimes I am appalled.

Last week my orthopedist, Dr. Birkenstocks Tightpants, decided to put on my hard cast. We had been delaying that process because of a nasty wound on the top of my foot, the result of being dragged over a rough wooden bridge. But we put the hard cast on, finally, so that I could return to teaching in schools; it wasn`t safe for me to run about the city with a splint and an open wound. Well, the wound wasn`t quite healed when he put on the cast. So he put a bandage on my foot, under the cast, and drew a little box on the top of the cast. The plan was for me to return to the hospital yesterday, to see another doctor, who would change the bandage inside my cast. What fun.


Yesterday morning I arrived to the hospital early. Furano has a nice shiny clean new hospital with multiple stories and English signage and lots of people scurrying about. There is even a little vending machine, near the front door, to purchase your anti-microbial paper face mask. And a Lawson`s convenience store in the hospital, in case a patient gets the munchies. すごい! I went for X-rays (weekly), and this time didn`t need to remind the X-ray tech to give me a lead apron. He`s getting to know me. Apparently using a protective lead apron is not a standard offering to most patients. After X-rays I visited the crazy accessible restroom (Japanse toiletrooms and bathrooms are so different, and very strange).


And then I was wheeled into my appointment. For about a half-hour a nurse huffed and puffed over my cast, trying to saw open a tiny square of plaster over the bandaged wound. She used the saw and pliers; I prayed fervently that she wouldn`t accidentally stab me, and attempted breathing exercises to calm myself. My heart raced and my palms sweat. Thanks bejesus, she finally finished her task and I had a small box open around the wound. Ew -- I'll spare you from that pic. The inner bandage was hastily changed by a new physician, Dr. Chubby Noeyecontact. When I asked him about the weakness and pain I am still experiencing in my left shoulder, he recommended exercise. Hmm.

A day later, my foot hurts even more, and the flakes of plaster are getting into the hastily-bandaged wound. I think the whole cast needs to be removed, and the bandage redone entirely. I asked my supervisor to call the hospital this morning, so that I can have the bandage properly redone today. Hemming and hawing. I don`t quite understand why things are so difficult here. . . After an hour and a half of deliberation, my sup called the hospital and heard they cannot see me today but that I can come in tomorrow. Tell me, why can a hospital not see me?! Because I am telling the doctor that he needs a do-over? Because the hours of operation are limited? Because some committee needs to meet and write up a report about my bandage, prior to my next appointment? Arg.

All of this would be a lot more fun if they gave me some decent pain medication. Mom gets perkaset for her knee, and I get the equivalent of children`s tylenol.

Japanese Work Culture, an Update

I`m learning, but I do not like what I am learning. Apparently the situation I am in is not unusual in Japanese culture. Although I have felt threatened and isolated recently, I am learning that this does not need to be the case; they do not have anything against me as an individual. My office has been very clear that they will NOT help me get to work, and that I must give proliferate and profound apologies for the inconvenience of my injury. I was forced to promise that I will pay for TAXIS to and from schools (prohibitively expensive), although previous to the injury I drove the work car every day. Bewilderingly, ever since I promised that I would pay they have been giving me rides to schools. I am so confused. . .

From what I now understand, the Japanese cultural rule is this:

If one is injured at work or school, then the school or employer will assist the injured person, including paying for medical expenses and anything else needed. (Similar to our "worker`s compensation".)

If one is injured outside of work or school, whether on vacation or just after hours, then the school or employer is not obligated to provide any assistance at all. The injured person must do everything "by one`s own strength" -- and expense. The injured person must be responsible, and apologetic, for any inconvenience the injury might cause anyone else. Shame and suffering are side-effects of any off-the-clock injury. In this culture, the good of the group holds primacy over any individual experience. Of course there are benefits to this system of community-over-individual, but the system is a challenging shock to this American girl.

Now that I am returning to schools (hooray!), people are kind and sympathetic. Kids, especially, are sensitive and helpful. But, I do notice that when people hear the story of my injury, they break eye contact when they know it was off-the clock. (Why would anyone stop working?) Especially because I was out of the country. (Why would anyone ever wish to go outside Japan?) It is likely my interpretation of their reaction is over-sensitive and inaccurate; the result of what feels like a month of severe beatings and prostrations. Certainly, I have lost my rose-tinted glasses.

The positive is that my wounds ARE healing. My two broken bones are fusing quickly. The top of my foot has almost finished growing new skin, and my elbow and shoulder are getting better. This hard cast on my foot will be off on February 12. Nick's hip is also healing and he has almost no pain. We are on the mend!

Cervical Cancer Screening Month

On a long list of stresses for me right now, the time approaches when I need to return to the doctor for another cancer checkup. (See my November 3 blog post, "Cervical Dysplasia: How to Heal", for more details.) Please keep me, and my cervix, in your prayers.

This is from the good people at Planned Parenthood:



This is your cervix writing.

I know, you might've forgotten I existed until you got this e-mail just now (what with vagina and clitoris always hogging all the attention). I bet you wouldn't even recognize me if you saw me — me, your very own cervix!

Well, that's exactly why my pals at Planned Parenthood have a few ideas for you on how to show me some love. They've been helping women screen against cervical cancer for decades, and right now they're offering a few easy ways you can take care of yours truly (or, for you guys out there, how you can make sure your sisters, spouses, daughters, and friends stay healthy, too):

Top Three Ways to Love Your Cervix
(or the Cervix of Someone You Love)

1. Get a Pap test. I know, I know, this seems obvious. But think about it: When WAS your last Pap test? Start taking care of it this very moment. It couldn't be more important, and Planned Parenthood couldn't make it easier for you to find your nearest health center and make an appointment. Please don't put it off; you owe me a Pap and a cervical cancer screening at least once a year: Make your appointment now.

2. Get the HPV vaccine. You may have heard about this one in the news — well, now it's time to take advantage of it. Protect me from the types of human papilloma virus (HPV) responsible for 70 percent of all cervical cancer cases, not to mention genital warts. Check out these YouTube videos to learn more about me, HPV, and the HPV vaccine.

3. Have safer sex. Okay, duh. But seriously, when I say safer, I mean using protection every time. Add HPV and cervical cancer to the long list of reasons why safer sex is sexier sex, and remember: your cervix cannot protect you, so please protect your cervix. Find out more about protection and safer sex here.

Did I mention making your appointment — now?

Happy National Cervical Cancer Screening Month!

Love,
Your cervix

Cervical Dysplasia: How to Heal

This is a bit off-topic from my typical blog posts, and more personal than what I usually share, yet I feel it is important. In the interest of assisting those who may have to face this frightening diagnosis, I will tell you a bit of my story.

In June I was diagnosed with severe cervical dysplasia. Abnormal cervical cells are very common, especially for smokers and/or women on the Pill. In June I had a biopsy, colposcopsies, and a LEEP procedure. In August we moved to Japan anyway. In addition to packing, moving, and the culture shock of adjusting to a new country, we've been dealing with the worry. . . what if it had progressed to cancer? This October I had follow-up examinations that determined my cells are normal and healthy again.

Some helpful sites, if you find yourself in a similar situation:

http://www.milliesays.wordpress.com/2007/09/16/hands-on-health-for-hpv/
http://www.torihudson.com/?p=33


My list of integrative, helpful healing aids:

1. I asked for loads of love/support/prayers from my community. At times when I've felt overwhelmed with worry and was unable to just "be positive", I knew someone else was doing the positive thinking for me. (Many thanks, my people.)

2. I chose a loving, emotionally supportive, stable romantic relationship.

3. I made some major changes in my life, removing myself from situations where I felt blocked/unproductive/limited. I chose my own destiny, instead of my previous habit of taking the 'best of bad options' or 'whatever came up'. According to Dr. Christine Northrup, women who experience vaginal/uterine cancer are often simultaneously struggling with feelings of disempowerment.

4. I received several treatments with a Rife Electromagnetic device, while focusing positive thoughts toward my healing. You can read more about Rife at:
http://www.rife.de/
http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Electromagnetic_Therapy.asp

5. Nutritional supplements are good for everyone, but especially helpful for overcoming abnormal cervical cells:
*Folic acid (important for all young women, especially if you're on the pill)
*B6
*B12
*E with selenium
*Zinc
*Calcium with D (important for all women)
*Mushroom supplements -- reishi, shitake, himematsutake, maitake
*a good Multi-vitamin

6. Regular acupuncture for immune system support. If you live in Portland, I highly recommend Inner Gate Acupuncture.
http://www.innergateacupuncture.com/
Since arriving in Furano, I have been receiving Japanese acupuncture which uses less needles and more acupressure.

7. I challenged my body with some serious exercise. I breathed in good air and felt proud of my strength.


I don't know which factors contributed to my healing, but I am grateful for all of it.

If you have any questions, you can email me or leave a comment. I moderate my comments, so if you wish for your message to be private, please indicate so and I will keep it so.