Tuesday, November 10, 2015

Nagoya, Japan Red Cross Hospital

So good news, I went to the Dr. at the Red Cross Hospital here in Nagoya like my Dr. at Kaseki asked me too and he said everything seems fine. My Dr. at Kaseki was worried that I might be at risk for a uterine rupture before the scheduled c-section and wanted me to get a second opinion to see if I should transfer to Red Cross or not.

My first impression of the Red Cross Hospital was that it was VERY large (It's the biggest hospital in Nagoya according to my Dr). It was also quite new looking. One of my friends told me that a very old Red Cross Hospital used to be on the same site, but it was recently completely rebuilt. It took me a while to find out where to go, but the staff I stopped to ask directions from were helpful and pointed me in the right directions. I first had to go to the New Patient desk and give them my Health Insurance Card. They had a survey form for me but when I told them I couldn't read Japanese very well they said it wasn't necessary for me to fill out. The rest of my info they must have received from Kaseki Hospital because they didn't ask me to fill out any registration forms or anything. After that I was sent to the Outpatient Obstetrics and Gynecology section (Luckily all the major desks had the section name written in English as well as Japanese). Once there I checked in and then waited... and waited... and waited a little more. I wasn't very surprised. It's a big hospital after all and the waiting room had quite a few patients in it. My appointment was scheduled for 3pm and my name was called at around 4pm. The Dr. and I spoke mostly Japanese, but he did know the English names for some more technical terms (Like uterine rupture, which I still don't know how to say in Japanese, mostly because my other Dr. always says it in English). The consultation room, unlike the one at Kaseki Hospital, was a private one. Just me, the Dr, and a couple of nurses. Similar to Kaseki Hospital the consultation room had its own ultrasound machine and area for cervical checks. I had an ultrasound done and then the Dr checked  my cervix. Unlike your typical chair with stirrups, however, this chair was more high tech and fancy, and comfortable! Instead of stirrups it was just like sitting in a recliner, but it had moving parts that just kind of moved you into position. It was much more comfortable than any other Drs chair I've ever sat in. Just like Kaseki Hospital, though, there was a curtain obscuring my view of the Dr. and nurses. I had a hard time moving it aside, but the Dr. saw me messing with it and asked if I wanted it out of the way. I said yes and he kindly removed it for me. Again, I have no idea if that's typical behavior for Japanese patients, but I just can't stand having it there. After getting checked the Dr. asked me if I wanted to transfer to Red Cross. I explained to him what my Dr. had said, which was that I only needed to transfer if there was a problem. The Dr. said he didn't think there were any problems and I could return to Kaseki Hospital if I wanted too. I told him I did. I'm already familiar with it (and I've already paid my deposit too!) so I didn't want to transfer if it wasn't really necessary. He said that was fine but he did advise me to keep taking the Utemerin (a medicine prescribed to discourage early labor). I'm not thrilled about taking it for the next two weeks (I still get bad jitters from it) but I'm willing to put up with it for everyone's peace of mind.

I had asked a friend to watch Clara for me during the appointment and so when it was done I took the train to her house to meet up. She invited me to stay for dinner too, which was super nice since it was getting late and I was really quite hungry (I hadn't had any snacks after lunch like I usually do). I called Kaseki Hospital the next business day and scheduled my next appointment, just a short one to get a refill of my meds, and then I have another regular appointment this Friday.

Well, that was my experience at Red Cross. Aside from the long wait it was a good day overall. Now I just gotta hang in there for two more weeks! Stay in there baby until then!

Sunday, November 1, 2015

34 Weeks Pregnant (in Japan)

So on Wednesday night last week I was feeling a lot of Braxton Hicks, and I had some pain in my lower abdomen. It was right before bedtime, so I took one of the Utemerin and promptly went to bed. The next morning I felt normal, but during my appointment on Friday I decided to mention the incident to my Doctor. He said that having pain in my lower abdomen was a concern since my incision from my last C Section is there, so during the Ultrasound he very carefully looked at the area around the incision. Sometimes my appointments feel a little rushed (there are always a lot of patients in the waiting room), but the Dr really took his time and looked at me very carefully. I also had a cervix check and the Dr took a look at my uterus from that direction as well with another ultrasound. It took a while but it was nice to know that the Dr is willing to take his time when there is a concern and not rush things.

The Dr. said that my uterus looked like it might be a little thin in the area around my scar and encouraged me to take the Utemerin three times a day and to visit a specialist at the Red Cross Hospital here in Nagoya on Monday. He had the nurses fax the Dr and make the appointment for me. My C section date is only three weeks away at this point. I'm not too worried about it, I think my Dr is just being super cautious, but I guess it's better to be safe than sorry. The Dr told me that if the specialist at Red Cross feels it's necessary than all my care will be transferred to Red Cross. My current hospital, Kaseki Byouin, is a nice looking private hospital, but it is kind of small, and I don't think they have an Intensive Care Unit, which must be why my Dr is considering transferring me. Personally I hope that I am not transferred, since I am already familiar with Kaseki and it's closer to my home, but I guess we'll have to see.

So I've started taking the Utemerin everyday, and it's actually pretty awful. I didn't notice anything strange the first time, I guess since I fell asleep soon after taking it, but now that I'm taking it regular I've felt the side effects very keenly. The nurse had warned me about them and told me to endure it, for the baby's sake, but they are quite unpleasant. About a half hour after taking the meds I get terribly jittery. My hands shake pretty bad, my heart and breathing become more rapid, and I feel like I can't even concentrate on things. This lasts for about an hour and then starts to fade, and then I don't feel well for an hour or two afterwards. By the time I feel normal it's usually time to take it again. I'm putting up with it for now, but I really hope the specialist at Red Cross tells me everything is fine so I can stop taking it.

On a side note, I thought I'd talk a little about the examination rooms at Kaseki. From what I've heard and read they seem to be a typical set up in Japan, but it's a bit different from the US so I thought I'd mention it. The main consultation/examination room is divided into several parts using curtains. There is usually two women in this room at one time. For example, there is often a woman having a consultation with the Dr while I am being prepped by a nurse for my ultrasound. Doesn't allow for much privacy, which kind of surprised me (in the US I always had consultations with my Dr in a private room with just the two of us and the occasional nurse.) The other thing I found interesting was the curtain set up in the part where they do cervical checks, pelvic exams, etc. (Basically anything that requires taking your pants off and sitting in a chair with stirrups). There is a curtain that actually comes down right in front of your face, obscuring your view of the Dr while he does his examination. The first time I sat in this chair, naked from the waist down, with the curtain in front of me, I found it very... disconcerting. Without asking permission I pulled at the curtain and, to my relief, was able to move it aside quite easily. The nurses, and the Dr himself, did not try to put it back, and they didn't say anything about it either, they just continued as normal. Sometimes I wonder if I'm the only patient who moves it, but I haven't had the nerve to ask. The nurses didn't seem surprised so maybe they have other patients who do it. One time, just recently, a nurse who noticed it was open pulled it back in front of me (probably out of habit) and I just moved it again. Anywho, just a little cultural difference I noticed (in the US I never had a curtain separate me from the Dr during anything.)

On Monday I will have my appointment at the Red Cross Hospital and I'm a little nervous, because I don't know if the Dr there speaks English. Also my Dr. told me that it's the biggest hospital in Nagoya, so I hope I can find my way around it! I'll let you all know how it goes.

Monday, October 19, 2015

Braxton Hicks and Utemerin in Japan

Hi folks. I had my 32 week appointment with the Dr. on Friday and it was a bit hectic this time since I had to bring my toddler Clara with me. I usually try to make an appointment for her at the local daycare for the days I have to go to the Dr, but the daycare facilities here in Nagoya are crowded (there aren't enough of them) and I have to make appointments well in advance. If I forget or can't get a call through to them soon enough I have to take her with me to the hospital. I've only had to take her with me a couple of times, and it usually turns out okay because the staff at my hospital are very kid friendly, but it's nice not to have to bring her each time. The nurses at this hospital are very patient with children, and each time Clara tried to run away while I was consulting with the nurse or getting checked they would gently retrieve her for me and give her a toy or something to look at. I really do like the staff at Kaseki Hospital, and am glad that I chose it.


This appointment was much like my last appointment, complete with ultrasound and a cervix check. This time around the Dr. asked me if I had been feeling any contractions, and I said that I had been feeling Braxton Hicks Contractions. I learned about Braxton Hicks Contractions when I was pregnant with Clara and was told that they are normal in the third trimester. You can tell them apart from real contractions because they are irregular and painless, and my Dr. in America said that if they feel uncomfortable the best thing to do is just drink a glass of water and rest until they stop. I have felt them many times before and never had any problem with them during my other pregnancy. So I told my Japanese Dr. I had started having these Braxton Hicks Contractions and he immediately prescribed a medication for me. I was a bit confused and the appointment ended right then, so I left the consultation room only to realize I had no idea what he had just prescribed and why. I had one more consultation with the nurse before leaving so I decided to ask her about it rather than interrupt the Dr. who is constantly seeing patients. I asked the nurse what the medicine was for and she said it was to stop the contractions. I told her that I had felt them before with Clara and was told they were normal. She agreed that they were normal but said that having too many was not good and advised me to take the medicine if I felt them frequently. I asked her how much was too frequent and she said if I felt two contractions in an hour I should take it. So then I go to the pharmacy located in the hospital, and when I receive the medicine the package says to take 3 a day for 7 days. I spent several minutes trying to clarify with the pharmacist (using my broken Japanese, which seemed even worse then usual while trying to discuss medication :P) how much I was supposed to take since the Dr. said to take it when I felt a contraction, not everyday. I finally was able to get across what the Dr. and nurse had both said and figured out what the Pharmacist was trying to say, and then she changed the label on the medication to say basically take one as needed.

So then I go home. I was feeling very frustrated at this point, not with the Hospital necessarily but with my still inadequate Japanese, and I had been unable to figure out exactly WHAT the drug was or what was in it, and why it was being prescribed. (I am uneasy about taking medicine I don't fully understand). When I got home I did a little research online. I found a helpful website called "Kusuri No Shiori" at www.rad-ar.or.jp/siori/english/index.html that lets you look up Japanese names of drugs and see a brief fact sheet in English. I found out that the drug I was prescribed is called Utemerin in English and it is prescribed to halt preterm labor. It also had a list of possible side effects, one of which (heart palpitations) the nurse had warned me about. I did a little more research on other blogs and found a blog that said that Utemerin is rather common for pregnant women in Japan to take, regardless of risk factors for preterm birth. I asked a Japanese friend about the drug, and she said she had not taken it during her pregnancy, but she knew what it was and what is was for. She also told me that she had not had any Braxton Hicks Contractions while she was pregnant and that may be why her Dr. never prescribed it. But that fact that she knew about it tells me that it must be fairly common. She told me that women with a short cervical canal or who are having C-sections often take it. I am having a C-section so that may have influenced my Dr's decision to prescribe it. I understand the concern (if you're having a C-section the Dr. really doesn't want you to go into labor before the scheduled day) but I am still hesitant to take it unless I feel I really need it. Two Braxton Hicks in an hour just doesn't seem like a lot to me, but maybe I'm just too laid back about them? I don't really know. Anywho, I'm keeping the meds in my cupboard but probably won't take it unless I have several contractions in a row 0_o.

Five more weeks left before the big day. I've started buying nursing bras and nursing pajamas and collecting other little things I'll need for the lengthy hospital stay (In Japan, women typically stay at the hospital for a whole week after birth as opposed to the 1-3 days you stay in the US). Hopefully I won't forget anything! ^_^v


Saturday, October 3, 2015

Scheduling my Japanese C-section

Yesterday I went to my 30th week prenatal appointment at Kaseki Hospital. Once I hit 30 weeks it was time for me to schedule my birth. Most Japanese moms schedule their births, even if they are not having a c-section. Japanese people tend to keep to very strict schedules at work, school, etc. and so it's normal for Japanese women to have their births induced on a certain day rather than to wait for labor to start naturally. Since I'm having a C-section the birth was scheduled for a couple weeks before the baby's due date (which was December 6th. The birth was scheduled for Nov. 24th) The hospital knew I would have quite a bit of paperwork to do that day and so they called for the English speaking midwife so that she could go over it with Braden and I. She had given me a brief summary of the paperwork before but she went over it again this time to refresh us on the content. This was a great time saver for us since all the paperwork was in Japanese, and even though my husband can read quite a bit of Japanese it would've taken him a long time to look up all the medical terminology. 

We had to fill out 4 forms. The first was a survey about what I wanted to have happen at the birth. The midwife circled the C-section option, but then she did ask me if that was what I actually wanted, adding that she strongly recommended it. I said that the Dr. had encouraged it as well (which he reiterated when I saw him again later during the same appt). I told her that I would do what the Dr. recommended. I had talked to my sister the other day about VBACS and C-sections, and she had mentioned to me that a friend of hers had recovered much easier after her 2nd birth, which was a planned C-section, than her 1st birth, which was an emergency C-section during labor. I felt a little better about having another C-section when I heard that, because I felt like it took me a long time to recover from my first C-section and that was one reason why I didn't want another one. I'm hoping that since this one is planned I'll recover quicker. 

The 2nd form was an application for the birth and birth room. I chose the cheaper option, which means my room won't have its own bathroom. I'll have to use a shared one (which doesn't really bother me). The 3rd form was an application for financial aid from the government. The Japanese government offers a 420,000 yen benefit to new mothers to help pay for birth costs (since a normal birth is not considered a sickness it is not covered by the national health insurance). The last form was an application for government benefits should the baby be born with Cerebral Palsy. (Our baby is not at high risk for this condition or anything, it was just one of the routine papers we needed to fill out). 

After filling out all the paperwork I went through the rest of the appt as normal. Ultrasound, Dr. consultation (during which we scheduled the day for the C-section), and then this time I also got my cervix checked. After that I scheduled the next appt with the midwife and also asked a couple questions about the C-section itself. She told me that I would receive an epidural as anesthesia, that my husband could be present, and that they would cut in the same place as my last cut (which was horizontal). The midwife also gave me a list of things to bring to the hospital for the birth. It was mostly the expected stuff; clothes, toiletries, etc. But it did include a specific request for a certain type of underwear. I didn't know what it meant so the midwife showed me one. It looked like regular maternity underwear except that it had a little button up flap in the front. She told me that I could buy it at a regular pharmacy. I told the midwife that I had never seen one like it before, mentioning that in America the hospital had given me special, lightweight, mesh underwear when my daughter was born, but that there was no flap. We chuckled a bit at the funny little differences between care here in Japan and back in America, but despite the differences there are a lot of similarities too. 

Lastly I had to pay a deposit for the birth. The midwife had explained to me before that since Kaseki was a private hospital it cost a little bit more than the amount I would receive from the government, and that I would need to pay a deposit in the amount of 150,000 yen. She also said that since I was having a C-section that the Dr. considered medically necessary that the insurance would likely pay all of it back (here's hoping!). Although the deposit was quite a bit of money (at least for us :P), the prenatal experience in Japan thus far has been very affordable. I paid about 4,000 yen for my very first appt, but then after that I had gone to the Public Health Office in our area of the city and was eligible for Prenatal Care Coupons that basically make every prenatal appt free. I occasionally have to pay for medicine or an extra blood test or two, but so far I've never had to pay the hospital more than about 2,000 yen for any visit, and I usually pay nothing.

So far the pregnancy itself is progressing smoothly and I haven't had any complications :). I'm at the point though where I'm tired of being pregnant and I'm just counting down the days to the birth! Here's hoping it all goes well!


Monday, September 14, 2015

Ultrasounds, bloodwork, and VBACS in Japan

Hello all. So as promised I am going to talk a little bit more about my adventures in prenatal care here in Japan. I'm almost 28 weeks along now. We still don't know for sure if the baby is a boy or a girl. It seems that during every ultrasound the baby decides that his or her legs need to be curled up under him or her. Which brings me to my first topic, ultrasounds!

When I was pregnant in America I had a grand total of one ultrasound, at around 20 weeks. From what I know, this is typical in the States unless you have a health condition. Before 20 weeks my Dr. would check the baby's heartbeat with a specialized stethoscope of sorts, and that was it. Here at my clinic in Nagoya, however, I have had an ultrasound at EVERY SINGLE VISIT, (my visits so far have been monthly) including the very first when they were merely confirming the pregnancy. (In America the pregnancy was confirmed with a urine test). For the first few months the ultrasounds were done vaginally, and at around 20 weeks they started the belly ultrasounds. From what I've heard it is normal to have many ultrasounds in Japan. I suppose one reason might be because of the lower health costs here; if there are any other reasons I don't know them. It's kinda of nice to be able to see the baby every month, but I think it does increase the wait time for the appointment (I typically go in around 10 am and leave after 12 pm). Starting this month I'll be seeing the Dr. every two weeks, so I'm not sure if the ultrasounds will still be done at every visit, or just monthly.

At my last visit to the Dr. I asked him when I would be doing a blood sugar test. In America I had to take a test where I was told to fast in the morning, come to the clinic for a blood draw, then drink a disgusting sugary drink, wait an hour, and then get another blood draw. The purpose of the test was to see how well my body handled the sudden sugar rush. I wanted to know when I would have the test at my clinic in Japan so I wouldn't forget to fast in the morning. (If you forget to fast, you have to come back a different day to do the test.) Well the Dr. said I had already had a blood test for blood sugar (obviously not the same test, and when I described the test mentioned above he seemed unfamiliar with it). He asked if I had a family history of diabetes. I said yes. He sent me to the blood draw room and my blood was drawn again for another blood sugar test, but it was just a blood draw, no sugar drink. It appears that the sugar drink test doesn't exist here. I told my husband about it and he mentioned to me that he had taken a class in college that had a section on genetics and he remembered something about diabetes being more prevalent among caucasians than other races, so maybe that's why the test is not done in Japan. Anywho, I'm pretty sure I'll be fine with a plain blood test, I only hope my Dr. doesn't think I'm weird for asking for sugary drinks at his clinic. XD

My husband came with me to my most recent appointment, and while there, the midwife asked him if he was planning to be present at the C section. I was a little surprised by the question because I had planned to have another talk with the Dr. about having a VBAC (Vaginal Birth After C Section), but I guess he wasn't planning on it! When I talked with him about it before, I told him I wanted to try for a natural birth, but he had given me a sort of wishy-washy answer involving the risk of uterine rupture, and had ended it with "We'll see". I asked the midwife about it and she just said "Leave it up to the Dr." I had read before that in some other countries patients don't have as much say in what treatments they get and they are basically expected to just go with what the Dr. says and not question it. I suppose the same goes here (at least at my hospital). I suppose I could still argue about it, but I also don't want to ruin my relationship with my Dr. which I think is pretty good at the moment, and I feel like it is too late to change Drs. I had actually tried to schedule my birth at a public hospital when I was about 3 or 4 months along, but was denied, and told that their maternity ward was booked for the winter. It seems that here in Japan one must schedule the birth very early in the pregnancy. The typical hospital stay for a natural birth in Japan is one week (in the States, it's only one day), and I suppose the longer hospital stay contributes to the need for early appointments.

Sorry for the long ramble, I hope it was educational at least :P. Here's hoping that next week the baby won't be so modest and we'll be able to figure out if we're having a boy or a girl :).

Monday, August 24, 2015

Prenatal care in Japan

Hello all. Sorry for the long wait. I've been updating my Facebook page with the occasional pic and video of Clara and life in Japan, but I've been sadly ignoring the blog. I guess it seems a little redundant at times, but I've decided to give it another shot and see what happens.

Braden and I are expecting baby #2 (Or Baby Chan 2.0 as we like to call him/her) in late November/early December. This will be my first (as long as nothing happens earlier 0_o) hospital stay in Japan and I've learned a bit from reading other people's blogs and comments in forums. Perhaps I'll be able to join this conversation with this blog and share my experiences and advice for other foreign moms in Japan.

First off, it is true what I've read in other blogs, and that is that Japanese Drs REALLY don't want you to gain hardly any weight while you're pregnant. I lost weight during the first couple of months of pregnancy due to morning sickness, and when this happened with my first pregnancy in America my Dr was full of advice on how to gain weight. My Japanese Dr, however, said nothing about my weight loss, and when I finally got my appetite back around the fifth month or so and gained the weight back, he warned me not to gain too much! I was surprised that I actually felt annoyed at his comment, which he tried to share in a jovial manner, but it wasn't completely unexpected. I have a Japanese friend who said that HER Dr told her to gain NO weight during her pregnancy, which she found impossible to do, and she said the Dr kept chastising her!

Now I don't want to give the impression that I don't like my Dr, I actually do like him and the clinic that I go to. The staff are very helpful and are always willing to show me where to go and what to do if I look lost. The nurses, who don't speak any English, read forms out loud to me (since I can't read Japanese very well, but I can understand quite a bit of spoken Japanese) and they try to speak simply so that I understand. The Dr himself actually knows English (not super fluently, but enough), which was why I chose that hospital in the first place, and that makes things a little easier for me.

The only other complaint I have about this hospital is that they seem totally unwilling to let me attempt a VBAC (vaginal birth after C section), and I don't know if that is simply their policy or if I'm a special case. I hate to argue with them about it, but I do want to investigate the matter further...

Anyway, some of you are probably tired of all the pregnancy talk, so I'll give you a break and let my husband make an entry about what HE's been doing lately.

Braden:

Hey folks. So I'm on my second year as a JET working as a Coordinator for International Relations in the International Affairs Department of the Aichi Prefectural Government. I translate and interpret things every once and awhile, but mostly I native check things that've been pre-translated by non-native speakers of English. It's kind of mind-numbing and boring at times. But whatever.

Recently I've been trying to go to karate and the weight-lifting gym more often. Today while lifting large pieces of metal and then putting them back down repeatedly, one of the guys in the gym asked me, "but hey, if you get too big and muscly, won't that make your karate technique a little slower, and thus weaker?" (in Japanese of course). I told him I dunno, but I guess I should ask someone about that. Maybe Shihan in Ellensburg. I guess I don't care too much either way, as I don't really have any plans to become a world famous karate tournament fighter or anything like that.... I just wanna do different kinds of exercise throughout the week. And you know, if I get big and buff looking instead of fat and lumpy looking, I guess that'd be kinda cool too.

This weekend I'm gonna be helping out a friend who is coming to Nagoya with her Yosakoi dance troop with some other friends by carrying stuff around and taking pictures during the big DOMATSURI festival that's gonna be held here Friday through Sunday. So yeah...... pretty excited for that......

I guess Melissa didn't mention this above, but the doctor said that he thought Baby Chan 2.0 was gonna be a boy according to ultrasounds up until a few weeks ago, but now he's not sure, so now we gotta think of names for both genders, or gender neutral names. How about, like..... Godzilla?

Peace out folks!

Tuesday, December 2, 2014

Apples

I see it's been a month since my last update. I don't know how those daily bloggers do it! XD

It's apple picking season here in Japan, and Braden and I have been the recipients of some delicious apples this week. We got some from a friend at church and some from our neighbors. Really big, yummy apples. And since the apples at the store are about a dollar a piece (yeesh) I was glad to get some free ones! I had a hankering for apple pie, but I don't have a conventional oven, so I decided to cook them on the stove. Found a simple recipe online. Couple TBS of sugar, a tsp of cinnamon, a dash of nutmeg, a TB of butter, and voila. Yummy, sweet, warm cooked apples. :) Clara liked them too, gobbled them right up. Braden is away in Tokyo right now for some training so he missed out, but I promised him I'd make it again when he got home.

We put up our little Christmas tree this weekend. Clara has a hard time leaving it alone. She keeps wanting to grab the tinsel or branches and shake them as hard as she can. Rather than take her away every time I've been trying to go over there and show her how to gently pat the tree branches while saying "gently", hoping that she'll learn that it's okay to go over there, it's just not okay to be so rough with it. When I'm over there saying "gently" I feel like I'm teaching her how to pet a dog or cat or something XD. Here's hoping I'm not doing it all December long. Fortunately we didn't put any breakable ornaments on it. In fact, we haven't put ANY ornaments on yet, though I was thinking of making some origami ornaments to put on. But I'm a little afraid if I do she'll just keep pulling them off, so maybe we'll just be ornament-less this year.

Right now I can hear the yaki imo truck going by. Yaki imo is a cooked sweet potato, and in the winter there are vendors that go around in trucks selling them on the street like an ice cream truck sells ice cream. They play music too, but not "The Entertainer". The song I'm hearing right now is just "yaakiiiii imoooooooo!" over and over again. Not exactly the most 'entertaining' song ever (see what I did there?) but I guess it could be worse.

No pics this time, but maybe next time. Sorry!