Last week I discovered that untreated appendicitis does not always lead to a burst appendix, peritonitis and death. Apparently, it sometimes goes away.
This is important because this may have been what happened to me back in April. I think this because the symptoms (stomach cramps, vomiting, fever) were almost identical to those I had in Tokyo, although they came along in a slightly different order. They were even the same down to the stomach cramps being across my stomach rather than being on the right-hand side as they “should” have been.
On both occasions I ended up in an ambulance. Over here, on arrival in hospital, they took a fairly cursory look at me (blood test, if that, I can’t quite remember) reckoned I just had constipation and sent me on my way. Now, no one knows for sure what I had first time around (though it definitely wasn’t constipation), and I do have an axe to grind (if it were up to me I would abolish the NHS tomorrow), but by comparison to what happened in Tokyo the NHS’s performance doesn’t look good.
Staff at the Urayasu Ichikawa Community Hospital. The bloke on the centre-right saved my life
In Tokyo, on arrival at hospital (in the early hours of Sunday morning) I was given a blood test and an X-Ray. The doctor reckoned (in excellent English) that if I was lucky it was colitis but it was probably appendicitis. He couldn’t operate there so he sent me to a second hospital. The second doctor, looked at me with ultra-sound, showing me the display. I couldn’t see a sausage. He could see a dead-cert appendicitis. He explained that although they could do operations at the second hospital they couldn’t do emergency operations. I would have to move yet again.
By this time, I was getting rather used to travel by Japanese ambulance. They seemed to have pretty much the same equipment as in London even down to that annoying clothes peg thing they attach to your finger to take your pulse. The only difference was that it was a bit more pristine. Oh, and for some reason, despite it being the middle of the night and the roads being empty, they had the siren on the whole time.
At the third hospital, they gave me another blood test, another X-Ray and a CT scan. I wasn’t quite sure why they were doing this when the second doctor had been so adamant but the answer came back the same. The doctor, Dr Kitasato, explained what he was going to do to me and gave me some sign-your-life-away forms for signature. By this stage I had spent about 7 hours in the company of Japan’s health services which seemed rather leisurely to me.
And then, a general anaesthetic, of which I remember not a thing.
I came round in what they called “High Care” (= high-dependency care?) after which I drifted in and out of sleep. I can’t remember all that much about it other than being given periodic doses of “pain-control medicine”. I must have slept a lot because I was very surprised when they wished me a good morning on the Monday.
I was taken to a normal ward later that day.
So, what was the care like? Obviously, it is difficult for me to say, I am not a health professional and the only comment I have had so far from a health care professional is that the scars were in an unusual place. So, I can only judge on superficialities. Not that I think that superficialities are unimportant - I think they can tell you rather a lot about the general health of an organisation.
The building itself was about 25 years old. It had the sort of wear and tear you would expect over that time but everything seemed to be reasonably well-maintained although the automatic talking urine sample collector had clearly seen better days.
Unlike the NHS signs were on sign boards and notices were on notice boards. I mean, really, every time I wander into an NHS building there are hastily cobbled together notices strewn all over the place. You don’t get that in Tescos.
Oh, and it had spare beds.
People of Britain: this is what spare beds look like
The nurses were fantastic. Well-turned out, charming, efficient, responsive, (dare I say it) pretty. Every time they managed to hurt me (not difficult, given the two tubes going into and three tubes coming out of me) they would always offer a strong apology. Totally unnecessary, of course, but it all added up.
The routine rarely wavered. The cleaner, the checks, the dressing changes, the ghastly brown tea and the meals always turned up at the same time every day.
Mind you, I may have been getting some special treatment. As one nurse explained to me: “Mr Patrick, we are really into you.” Yup, I had become the David Beckham of the Fifth Floor.
The meals themselves were pretty unexciting but then Japanese food on the whole is pretty unexciting. But there was more food than I could eat and the meals were always served nice and hot.
I got the impression that the doctors had a plan and that I was expected to follow it. Therefore, I did get to my feet on the Monday, the drip did disappear on the Wednesday and the stitches were removed on the Sunday. I reckon they probably kept me in about a day longer than strictly necessary.
It was not quite faultless though my only serious criticism was with the filthy drip stand.
Oh, and the bill? Well, if my insurers get any change out of £4,000 they’ll be doing well.
Update 11/01/06 A warm welcome to Grand Rounds readers
A few years ago I was sitting on the platform at Chippenham railway station minding my own business when a petite Japanese woman approached me to ask where the second-class carriages would pull up. I explained as best I could that the likelihood was that she was in the right place but with our trains almost anything could happen.
She sat down on the next bench which was an invitation even I couldn’t ignore to try out my recently-acquired Japanese language skills. I said: “Nihonjin desu ka” which means “Are you Japanese?” She reacted by leaping about three foot in the air. I guess she wasn’t expecting to be spoken to in her native language. When she recovered from the shock we got talking. Akiko Ishikawa and I have been in contact ever since.
To say I was glad of our friendship when I fell ill is (my) understatement of the year. Although, I tried to keep a stiff upper lip about things eventually even I could see I was going to need help. Akiko then phoned for the ambulance, acted as translator between me and the ambulancemen and nurses, bought all sorts of supplies, lent me her phone so I could phone home, “persuaded” the nurses that a shampoo and blow dry are in fact right up there with dressing wounds and taking blood pressure readings, got her husband to clear out my hotel room, booked me a new hotel when I was discharged, (quite rightly) bullied me into looking after myself and did a hundred other things many of which I can only guess at. I am not sure if I should mention this or not but she even (in the first instance) paid the (not insubstantial) bill.
And every time I said “thank you”, which was a lot, she just replied: “It is my pleasure.” (Bet it wasn’t.)
I do not know (as in, I really don’t know) what I would have done without her and Kazuhiro.
So, Mr and Mrs Ishikawa, I thank you again. I just wish I had the words that could express how desperately grateful I really am.
Tokyo: as I saw it
The plan was simple enough: go to Tokyo, take a shufti, come back. Unfortunately, at about the same time as I had been planning to take a leaf out of the Michael Jennings Book of Gratuitous Offence I was instead lying on a hospital trolley listening to a doctor explaining to me how he was going to whip out my appendix.
Not that I was worried. I was in far too much pain for that. Nor should I have been. Let’s face it, when it comes to slicing open bellies the Japanese are the universally-acknowledged experts.