Last month, I was hospitalized for the second time in Japan, this time for gallbladder surgery. Just like before, I was very happy with my care, and I’ve been meaning to write about my experience. Also like before, I understood Japanese, and so most of the hospital experience was in Japanese unless my friends were visiting, which means that I can’t comment on the English side of things. In this piece, I will:
- explain when the gallstone problem started
- describe the surgery and aftereffects
- reveal what it cost on Japanese national health insurance
- share my thoughts as a whole
The surgery is called a laparoscopic (keyhole) cholecystectomy (in Japanese: 腹腔鏡下胆嚢摘出術), in which the entire gallbladder is removed. The older kind of operation, an open surgery, involved making a single, longer cut and removing the gallbladder that way; here’s a small illustration of the differences between the two. In the keyhole version, they make four small incisions and “inflate” your middle with gas to do the operation. They put me under general anesthetic, and so I was completely out from when I was told, “We’re going to give you the anesthetic now” to the second I woke up.
The last time I was hospitalized in Japan, I had pneumonia, and I think the reason I had a private room is because that was the only one open. This time, I shared a room with three other ladies, in a newer area of the hospital. I think there were options that cost a little less, but when my doctor asked what I’d like to do, I asked for his recommendation and he recommended the newer rooms, so I took him up on it. More on the costs below–but compared to the US, it wasn’t bad at all.
Since I can speak Japanese, I didn’t have any trouble communicating with the nurses. I asked my friend Rei if she could come as my stand-in “family member” throughout the surgery process. I thought that if I had any trouble in Japanese or couldn’t communicate what I wanted, she could help, since she’s bilingual. Even right after my surgery, it didn’t turn out to be a problem. (Good to know that even post-anesthesia Stephanie can still use her Japanese, even if English felt easier for the first couple of days).
The Start of the Gallbladder Problem
My gallbladder pain started three years ago, after a car accident took my mom and my grandma in 2014. I was rushed home for a month when that happened, and when everything had settled down I went back to Waki to continue teaching on JET. A month or two later, I had this pain in my gut like food poisoning–or at least I thought it was that, although I’d never had food poisoning before. I went to the local doctor, and he checked me for gallstones and found that I had a lot of them. Long story short, the type of gallstones I had couldn’t be fixed with medication, only eased a little. I didn’t want surgery and I didn’t want to keep taking medicine indefinitely, so I ended up stopping the medication when I ran out, and hoped the gallstone problem would just go away after I’d “readjusted” to my life.
However, the pain didn’t just “go away,” and so this year I finally decided to do something about it. My coworker introduced me to a hospital where her friend works, and it was through that connection that I chose Toho University Medical Center, Omori Hospital (東邦大学医療センター大森病院) for the operation. I went back for more visits, tests, and scans; I got claustrophobic on my way into the MRI machine and couldn’t complete the checkup, but a CT scan I took was enough to show the doctors that I had inflammation from the gallstones and needed surgery. I was so relieved to get the phone call about that, I jumped up and down outside after the call.
We scheduled a date, and a month or so later, I was being checked into the hospital to get surgery. I wasn’t really worried about getting surgery “in another country,” because I’d been to the hospital in Japan before and had a really positive experience. I was sure that I would be able to get lots of rest and be well taken care of.
The Day of the Surgery
Starting at midnight the night before the surgery, I couldn’t have any more food. From 5 am until 7 or 8 pm, I couldn’t have any liquids, including water. My surgery was early in the morning, with the initial procedures starting around 8:30 am. My friend Rei came to the hospital, and the nurses took us to the room where my doctors and surgeons were waiting on a lower floor. I said goodbye to Rei in the hallway, had a nice conversation with the doctors as I lay on my back in the well-lit surgery room, and then went off to sleep after they gave me the anesthesia, which I don’t remember feeling at all.
When I opened my eyes again, I felt suddenly sick, and my legs were shaking, an aftereffect of the anesthesia. Like I said before, to do the surgery, they make four small cuts, puff up your stomach area with gas, and remove the gallbladder. I didn’t like the smell or taste of the gas, and so I felt very nauseous for much of the first day. The doctors quickly wheeled me back up to my room, and my legs stopped shaking a few minutes later.
Right after the surgery, I felt too sick and in pain to even talk for the most part, and so when Rei came in to see how I was, I had to gasp out that I was sorry, I knew she had waited like 6 hours through the whole surgery process for me, but I couldn’t talk. She understood, and headed home. After that, it was just a matter of how to sit on the bed in the least painful way possible. My bed came with a handy remote control, so I could move it up and down, and raise the head or the feet. The nurses had hooked me up to an IV and given me a button that I could press when my stomach area hurt, to release more painkiller. I’m sure there was a limit on it. but I pressed it a lot.
If hearing about vomit makes you feel sick, skip to the next paragraph. Otherwise, you can highlight it: So, I pressed the button a lot because it hurt a lot, and then the painkiller made me sick and I threw up into a bucket; actually, I called the nurses at the moment when that happened, and nearly threw up into the speaker. They rushed to my room to make sure I was okay, and rubbed my back until I felt better, and sympathized with me. And later, when I accidentally overturned that bucket and it landed on the floor and splattered my stuff, they cleaned the floor (of course) but also my bag, too. I really admire nurses. Nothing is too disgusting for them to handle.
That first afternoon, I had very little energy, and mostly sat on my bed staring at the curtain. I didn’t have the strength to sit up and read a book, or think, or send Facebook messages to people, so it really helped that Rei was taking care of hospital news and prayer updates for my church family. At night, I didn’t even feel like asking the nurse to dig around in a bag for my eye mask and earplugs, so I kept waking up whenever anyone moved in my room or opened the bathroom door in the hallway. Also, the nurse kept coming to take my blood pressure and check on me every couple of hours, so I didn’t get much sleep my first night.
Hospital Recovery and Costs
The next day, “Day 1” after the surgery, I still couldn’t move, but I wasn’t feeling as nauseous anymore. I was a teensy bit better, so I was able to start feeling bored. I’d left the Ethernet cord I’d brought (I think rentals were available) on the shelf next to my bed, but I couldn’t even turn myself over far enough to reach the plug and insert it. I called a nurse, and she generously got out my laptop, headphones, cords, and everything, and hooked them all up for me according to my instructions so that I could watch movies. Apparently, that was the moment she learned that our room even had internet. (That was the number one thing I’d wanted to know about this room!) I finally saw Beauty and the Beast (the live action), La La Land, Fantastic Beasts, and そして父になる Like Father, Like Son. Fantastic Beasts was my favorite. I’ll have to give the other ones a chance someday when I’m not sitting in bed in pain from surgery, but it says a lot of Fantastic Beasts that it can be your favorite even after surgery.
I spent a lot of time in bed the day of the surgery and the day after. Little by little, I worked on trying to finish all my food and walk around more. I had some odd shoulder pain that I didn’t understand, but apparently that’s also a side effect of the gas, and it went away after a day or two. At first, it was hard to take a full breath, because my lungs expanding meant that I was pushing down on my insides and stomach area, which still hurt. That meant that talking took effort, and I mostly avoided it. It hurt to laugh for the same reasons, so when my pastors came to visit with Rei on Sunday, I was doomed, because they’re so funny. I should’ve known that would happen! But by Monday I was much more mobile, and I spent so much time out of my room that when the nurse came in later she said something like, “Oh, you’re here!”
But with beautiful views in the day room (デイルーム) like this after the typhoon passed, why would I want to stay in my room? You could see the trains coming and going in the distance. When my friends came to visit, we sat in the chairs at those tables. There were vending machines (of course) and a tea dispenser. You have to bring your own utensils, cups, clothes (unless you rent a hospital gown) and other necessities to the hospital, but you can fill up your cup as many times as you want for free from that dispenser. I used the same cat cup, I still have it!
When I googled “gallbladder keyhole surgery recovery,” the summary at the top that I got from NHS.uk reads:
Most people who have keyhole surgery are able to leave hospital on the same day as the operation. It will usually take around two weeks to return to your normal activities. After open surgery, you’ll usually have to stay in hospital for three to five days and your recovery time will be longer.
I can’t believe people have to leave on the same day, or at least be on their own. I felt so nauseous my first day, and it was painful to move. Even though mine was keyhole surgery, my doctors determined the length of the hospital stay, and it was from Friday to the following Tuesday. I know someone who got open gallbladder surgery, and he was in the hospital for a whole month here, let alone “three to five days.” As for being able to return to work around two weeks later, I was back to work on Wednesday (five days after the surgery), although I got tired much more quickly. It might have been better to wait 2-3 days, but part of me thinks it was better to be moving around for the sake of helping myself heal faster. I used a PDF (first link) from the Royal College of Surgeons to keep track of how I felt after my surgery for the two weeks after. It was very helpful.
I don’t often name prices explicitly in this blog, but I think people should realize the huge difference between health care in Japan and in the States. The four-person hospital room that I stayed in was about 7500 yen per night, for four nights (67 USD today, or take off two zeros to estimate). The rest of the costs were surgery, food, and tax. The total came out to 106,560 yen altogether, for the surgery and the hospital stay. That’s about $947. My dad looked up the same surgery using a site called Healthcare Bluebook, and found a “fair price” with everything included to be around seven times that much in the States (for an outpatient procedure, not a hospital stay). I don’t know all the details of how that works out, but I know that my surgery went well and that I was in the hospital with an IV and medications for a few days and that was all covered in that price.
Everything at the hospital is extremely organized, and paying was as simple as receiving the invoice from the nurse, going to the entrance floor of a different wing, paying with my credit card at a self-checkout machine, and returning to show my nurse the receipt. The entrance floor, or the main lobby, usually has one or two hospital workers who stand near the self check-in/check-out machines and help direct people who are lost or confused. There’s also a Tully’s on that floor with very pleasant staff, and a covered piano. The hospital has a machine selling cards that you could charge and then use to pay for the services in your room, like the fridge and TV. You can re-insert the card when you leave and get the remaining balance back. I only used it for the fridge, because who needs TV when you have a free internet connection?
Below is one of the meals I had the night before my surgery. Later on, just like last time, I wouldn’t have much of a stomach for rice, but I finished off all of this meal! The pink receipt on the bottom left has my name (last name hidden), and the menu on the right. On the left, there are two little x’s that indicate not to give me natto or umeboshi. I was so happy that they asked about food preferences, and then specifically marked down not to give me any. Speaking of organized, they give you a plastic wristband like the ones at water parks, and whenever a nurse comes to take your blood pressure or test something, they scan the bar code on your wristband. For meals, they might have just asked me for my name.
I was truly being held up by the love and prayers from my friends at church. Rei stayed throughout the surgery, visited every day (even just for a little when it was hard to talk above a whisper), made the lovely decorations above, and brought things I’d forgotten. Rei took a few pictures, and wrote updates in English and Japanese on a private Facebook page for my friends at church to read, and so when I realized that I was a lot more tired than I thought I’d be and couldn’t take all the visitors I’d been planning to, it was her messages and help that lifted a lot of the burden of communication. She also snuck in a muffin and some madeleines for me, before we realized that we weren’t supposed to sneak in muffins and madeleines. Worth it.
My friends came by later and brought manga for me to read and a CD to listen to. I loved the flower that my pastors brought, and ended up setting it by the shared sink when I left so that everyone in the room could enjoy it. My church’s pastors and Rei prepared several meals for me for the days after the surgery so I didn’t have to worry about cooking and diet. I can’t tell them enough how much I appreciated all this, although I tried.
Reflections (after the hospital)
Only Rei saw this, but I actually cried when we got in the elevator to go down and leave the hospital. It’s not that I wanted to stay in the hospital forever–no one wants that–but I was surrounded by the care of the nurses and held up by the prayers and messages of my church family, as well as my family in California. Another part of that was the closing of a chapter of my life which caused me a lot of physical pain.
I’ve been given a new body and a new life! That’s what it feels like. The first couple of weeks after the surgery, I would look down at the cuts that were healing, and be filled with happiness that my gallbladder was gone. Now, even if I have something stressful happen, or cry, or eat something unhealthy or oily once, I only have to worry about the normal effects, not that and pain.
Not being able to do anything yourself immediately after the surgery is a humbling experience. Starting my first day, it took all my effort to walk one “lap” around the corridor on my floor. Holding my IV drip machine in one hand while I walked, in a way I felt like I was experiencing what it feels like to be elderly. Like Sophie from Howl’s Moving Castle…or maybe not. There were certainly many elderly people around me in the hospital.
Today’s medical technology is truly amazing. Even though it was explained to me more than once, I can still only understand rudimentary things about the function of my gallbladder, where it was, where specifically all those gallstones were in my system, and how exactly they form. By virtue of being on Japanese health care, I was able to have a complete surgery to remove it and get rid of the pain; the CT scan that led to the surgery was completely painless, and the stomach camera that I took later was extremely uncomfortable but took beautiful, clear pictures of the inside of my esophagus and stomach juices (I got to see the images later). I guess I thought it would be fuzzy, or black and white like an ultrasound. I felt like the Councillor in the Matrix, talking about his minimal understanding of the machines that keep him and the colony alive.
Because it was a keyhole surgery and not open surgery, I will have little to no traces of the surgery once my stomach area heals up. This is great, because then I won’t have a big scar to show off whenever I go to a hot spring, for example (you have to take off all your clothes). However, it got me thinking about the value of scars. The evidence of the surgery has been a reminder that I have a lot to be thankful for–affordable health care, as mentioned above, the care of the nurses and doctors, my coworker/friend who referred me to this hospital, and the friends and family who came around me when I needed them. My second week, as I started to fully heal, I noticed myself focusing less on how thankful I am to be alive without gallstones and more on the daily worries of life–work, the future, and the things I was focused on before. I think that’s sad and a waste. Of course, I don’t wish for the scars to remain forever, so I’m hoping that this blog will serve as a reminder of God’s provision for me through the doctors, and my friends and family.