Health Care in Japan

This week I've been dealing with a minor health issue. Nate has impetigo, a skin infection, on his face. Luckily, Neosporin seems to be taking care of it but for a while I thought that I would need to take him to the doctor. In Cincinnati, that would involve calling our family doctor and making an appointment, driving to the doctor's office and waiting a few minutes and then stopping at the pharmacy on the way home. Things work much differently here!

In Japan, the lowest level of care is the general practitioner. People go to this office for cold and flu symptoms, earaches, etc. Kind of like one of the 15 minute clinics at home. For anything more serious/specialized or often in place of going the the GP, people head to the hospital. Matt is always amazed that his co-workers are constantly going to the hospital for various aliments! Some specialists do have their own offices, as well. However, all of the care is clinic style. There are no appointments (except at the dentist!). Instead, they have open hours from 9-12 each morning. Patients are generally seen on a first come/first serve basis and it is not uncommon to wait for an hour or two to be seen. Most offices also have late afternoon hours from 4-7. Often these are reserved for returning patients or specialized services.

Doctors tend to be very conservative with medication here. Generally you will only receive 3-5 days worth of an antibiotic. If your infection is not better, you are expected to return to the office at that point. This is especially true for children, as the doctors want to make sure that they are closely monitored. Doctors never prescribe medications over the phone. They definitely want you to come in! Also, Japanese mothers are much less likely to try to play "Dr. Mom" at home. At the first sign of a fever or other illness, they seek treatment at a clinic or hospital. I was very suprised the other day one when the mom of one of Katie's friends said she had taken her daughter to the hospital over the weekend because of a low grade fever!

Japan does have socialized medicine and the emphasis is definitely on prevention here. People wearing surgical style masks are such a common sight here that no one looks twice! The care is much less expensive than in the U.S. An MRI may only be $100 and an office visit plus two types of medication was about $45. (That was the entire cost, not just my copay!) However, the doctors and hospitals are cash only, so you have to make sure you always have enough money in reserve, just in case.

The thing that was the oddest for me was that you are expected to take off your shoes when entering a doctor's office. The offices have sterilizers with slippers inside. You take off your shoes at the door and put on the slippers. I don't know why it felt so weird but it definitely drove home to me that I was in another country! (I had a sinus infection that I had treated about 3 weeks after we arrived). Many of the doctors near where we live speak English, however the front desk staff often doesn't. This can make things very confusing!

Our plan is to try to take care of all of our routine medical care in the U.S., but we will need to use the local care for urgent things. Luckily, the consensus here is that the care is very good, just time consuming and the attitudes of the medical personnel a bit antiquated. I feel very lucky to be in a place where I can trust the medical care. I was talking to a nurse who lived in Shanghai for 2 years and this level of care is definitely not the standard in Asia as a whole!

Bumps along the way

The trip home was wonderful, although much too short. The wedding was beautiful. However, given the impact on the kids, it's just as well I didn't stay longer!

We've had a surprisingly easy transition to life in Japan. I've been shocked at just how well the kids have done. There really haven't been any tears or tantrums. They all enjoy school and seem to really like the benefits of living here. However, over the last week the tantrums and tears have arrived! They are sporadic and unpredictable but definitely forceful. I talked to the school counselor this week and apparently it is fairly common to have a few months of a "honeymoon" period, followed by a down cycle. Honestly, if this is as bad as it gets, we're very lucky, I just didn't expect the adjustment to hit 2 months later! I think the fact that I was out of town and that Matt left for a week long trip to Cinti today has contributed too. We've been warned that after 3-4 months most adults also hit a "wall" . Matt and I are hoping that a late October vacation to Saipan http://en.wikipedia.org/wiki/Saipan and a 3 week trip home in December will help ward it off!

I attended a class called "Bloom" this week, short for "Bloom Where You are Planted". It was an orientation for newcomers to the Kobe area. The topics covered were Medical Access, Cultural Differences, Essential Services, and Coping Mechanisms. We also had lunch at a Japanese restaurant. It was actually pretty interesting and informative. I've signed up for a few more classes from the same organization. It's called CHIC http://www.chickobe.com/Welcome.htm and is a great resource for new people in the area. I'm going to try a museum tour, a cruise and a Japanese cooking class to start. I'm also signed up to volunteer at school for around 6 hours a week. I also want to take an exercise class at the gym and Japanese language lessons. Combined with daily walks and trips to the coffee shop, I'm not sure if I'll have any free time at all!

This is Tully's Coffee shop where I spend waaaay to much time and money!

Our most important news for the week is that we've found a babysitter to watch the kids one night each week so that Matt and I can start exploring all of the interesting restaurants around! (The kids are not exactly adventurous eaters!) All three of them love Joanne. She is young (in her 20's) and loves playing games with them. The first time she met her, Katie ran up and gave her a huge hug! I think she reminds them of Sarah H. and Sarah G., their babysitters back home.

Matt and I started by having dinner at an Al Artisia, an Italian restaurant on the next block. The view from the windows was of a Porsche dealership...luckily Matt turned up his nose at the Boxters they had on display, otherwise we might have been in trouble!

The Porsche dealership fills the atrium floor of this building and the cars are left out without any guards once the dealership closes, even though the rest of the building is still open! Only in Japan!

Shopping in (and out of) Japan

I'm back in the United States for my cousin Marie's wedding...Congratulations guys! I didn't really notice any culture shock coming back this time, just an amazing feeling of being "home"! Of course, now the house is starting to feel kind of empty. It's not really home without my family!

One of the first things I had to do was hit Target for all of the "stuff" we didn't know we needed! (I definitely miss Target!) I even had a few orders from some of our new friends in Japan. Bringing an extra suitcase along on these kinds of trips is a standard practice. It's so much cheaper to bring stuff back in a suitcase rather than ship it!

The number of things from home that we're able to get in Japan never ceases to amaze me. We definitely live in a global economy! On our little Rokko Island there is a Starbucks (of course!), a Subway, Wendys, McDonalds and Tully's Coffee shop. Costco, Toys R Us and Ikea are all nearby.

However, some of things that we can't get are kind of interesting. For instance, there is no frosting in a can in Japan! I haven't been able to find cooking spray or garlic powder either. (This may be partly due to my Japanese language illiteracy!) The standard paper size is different in Japan as are the lightbulbs. Luckily, we knew about this in advance and stocked up! Printer cartridges for U.S. style printers are "Made in Japan" but are not available for purchase there!

Although the grocery store near us does have some Halloween decorations and costumes on display, it is definitely not the holiday that it is in the U.S. And the selection of Star Wars themed costumes is not great (although, I didn't check Toys R Us, I have to admit!) I've been shopping for Nate, Laura and Katie's costumes while I'm home. Our building does organize a Trick-or Treat for the kids. They publish a list of which apartments are planning to participate and the kids start at the top and work their way down!

My extra suitcase is now bulging at the seams and I may need to leave a few things here for Matt to bring back when he's here next week!

Anniversary -- Ritz-Carlton -- Conveyor belt Sushi water park and more...

The kids in front of a statue we found walking through a mini mall in Osaka

This was a very busy and eventful week. Thursday was our 10th Anniversary. I had a Japanese lesson in the morning and told my sensei that it was our anniversary. She made sure I was all prepared to order 10 red roses in Japenese from the florist.

I left at lunch and asked the old woman for 10 red roses in Japenese just as I practiced. She called over the younger woman who told me in English that red roses were coming tomorrow. I verified in Japanese, "tommorow?" and she replied in English "tomorrow." I then said, in Japanese that I would take 10 pink roses she had in the cooler and asked in Japanese how much they would cost. She answered, in English, that they would be 2000 Yen. She then asked, in English if they were a presesent. I answered, in Japenese, that yes they were a present. She told me, in English, an extra 200 for the wrapping. She wrapped them all up and charged me only 2000 apparently for me being cute and trying to speak Japanese. I'm paying 6090 Yen per lesson here -- about $72 USD.

On the upside, I did get to go home for lunch with my 300 meter commute (not counting the 19 floors down and 28 floors up) on to enjoy at least some alone time on our anniversary.

OSAKA at the Ritz

On Saturday morning we headed out to the Ritz-Carlton (with the kids, alas) for our best attempt at an anniversary celbration. Katie more or less hijacked it as a early lead in to what she believes should be a week long 4th birthday extravaganza on her behalf.

Before leaving Rokko Island, we went to the Price Club -- a local foreign-type store where you can buy (at crazy prices) all the comforts of home. We bought some Lysol (in English) a book, and a bottle of Chatenaue du Pape (E. Gugiel). As an aside, the Japense don't dintinguish much between the various flavors of "Western".

The Fitzpatrick Kids at the Ritz
We then took the train to Osaka for a night at the Ritz. The kids where very whiney and we got a bit turned around as we walked in the sun from the train station to the hotel. We finally checked in. We had a very lovely suite at the end of the hall across from a room with 2 queens for the kids. We had a nice bottle of Napa Cabernet (smuggled in) and headed out to dinner.

We knew enough to avoid the hotel resteraunts and headed to the Outback. Here again, we got lost and eventually had to take a cab just to figure out where the heck we were. They spoke pretty good Australian at the Outback which is close enough to American for us to understand, and we got a good dinner.

Back to hotel, we tried to get the kids in bed. The rooms were a great deal -- I had a pre-paid super discount on AMEX and used some points as well. We were only paying about $350 for both rooms and this was already paid on last month's statement.

Megan popped into some nuts and chocalate from the mini-bar for 1,200 yen, so we're doing pretty good so far. The kids finally conked out, but Katie was in our bed.

In the morning we ordered coffee (1,200 Yen) and toast. Toast was listed as 1,200 Yen, but 6 pieces was considered a double order, so that was 2,400. Anyway, we wound up with a 40 something dollar coffee and toast breakfast, but it was worth it, really.

Unfortunately, add to that the 4,200 Yen we paid for the Chantenau de Pape I left in the mini-bar when we left.

We had a much more enjoyable train ride back to Kobe (got the express and the kids were much better) and then headed out in the car.

HOME IMPROVEMENT AND CONVEYOR BELT SUSHI

There is a definitive heirarchy of shushi in the world. You have at the low end, ordinary American (sucks), good American (you think it's good, but it is slightly better than sucks), Japanese convenience store, Japenese airport, Japense Conveyor belt, Japenese counter shushi.

So far, Megan has only had the convenience store. I've had the airport and conveyor belt. Unfortunately, the conveyor belt place on Rokko Island is now out of business. For perspective, this the best sushi I've ever had in my life. The Japanese say, "it's OK" -- translation -- "it sucks."
The airport sushi at Narita (Tokyo) is quite good and is pretty much the only sushi place in Japan where you can get by mostly in English. The sign there says something like "this is your last chance to get decent sushi, Gaigin."

Today, we were determined to move up from supermarket to conveyor belt (counter requiring hard core Japanese skills). We drove over to a local place just off of Rokko Island. I maged to use the automatic machine to put us on the waiting list for a table. Doing this properly was truly a miracle as it was all in Japanese. I got lucky and picked a non-smoking table when I guessed between two choices I couldn't understand.

Once at the table, I knew how to mix the tea and we started to play with the ordering machine. We called the waitress over at one point to show us how to use it, and her Japanese explanation was more confusing than pushing the buttons at random the ordering screen. Eventually, we wound up with several plates of nigiri, some rolls, and some ice cream and juice for the kids.

It was much better sushi than anything we've had outside of Japan. We then did a quick stop at the adjacent home improvement store. It's pretty good, but the big attraction was the complete pet store above it. They had numerous puppies and kittens, and birds, and fish, and ferrets, and -- you get the picture. After talking the Fitz kids out of buying a puppy and several other pets for the appartment, we headed back.

We spent the afternoon at the big water park on the Island. Laura and Nathan insisted on waiting on the 40 minute line for the big water slide. Laura was finally first when we got to the front. About 5 feet down the slide, she fell out face first, lost the tube as was on her belly. As the lifegaurd called on the radio to the bottom, I raced down the steps to meet her. Apparently she manged to stop herself somehow and got back on the tube. She finished with a smile on her face, but Nathan was now stranded at the top with a 2 man tube. They would not let him go alone, so Laura -- fresh from this drama -- decided she could go back up the steps and go with Nathan. My heart is still pounding, so before I could think to say yes or no, she is off. They both came down 2 minutes later as Megan and Katie walked over wondering what was taking us so long.

All in all, a reasonably quiet weekend -- and we've just finished making Katie cupcakes for her class at school tomorrow.

LAST WEEK POSTCRIPT

Matt was in Beijing last week on business. It's a toally different city after the Olympics. I was staying by the Olympic park. The water cube and crows nest are much more impressive in person than on TV. The polution is better, but still pretty bad. China is completely different from Japan, but is definately dymanic. Unforunately, all of my pictures from Beijing are blurry and obstructed.

I'll get some on my next trip -- now scheduled for first week in November, along with a trip to Korea.

Party Weekend!

This weekend was a lot of fun! We began the weekend by hanging out on the River Mall with the other expats from the Entente (our apartment building). The kids spent the time running around and biking in the plaza with the other children, while I enjoyed several Chuhai...an alcoholic drink made in various fruity flavors. http://en.wikipedia.org/wiki/Ch%C5%ABhai They are a bit like a wine cooler, but stronger! Matt joined us when he arrived home from China. We stayed out until about 9:00 p.m. The kids were completely worn out. Laura fell asleep taking off her shoes and Katie passed out in the bathroom...hopefully not a foreshadowing of her adolescence!

Saturday, we headed off to Merikan Park and visited the Kawasaki Good Times World http://www.khi.co.jp/kawasakiworld/english/index.html. It was devoted to the history and products of the Kawasaki company. They actually had a number of video games and robots and planes/trains/motorcycles that were interactive exhibits. It was a fun way to spend a rainy morning. The weather cleared up and we decided to take a boat tour of the bay. It was interesting...but we didn't learn much since the commentary was all in Japanese!

When we got home it was almost time for the Rokko Island Summer Festival Parade. Each apartment building on the island makes a float and the residents dress up in matching jackets or in traditional Japanese kimonos. Matt and I didn't dress up, but the girls wore their matching Japanese outfits and Nathan wore one of the jackets for our apartment building. Matt did help carry the float! Afterward we stayed and enjoyed the festival. It reminded me of a big church festival with lots of food booths, a few vendors, game booths, a bouncy castle, the fire department with their trucks, and dancing and singing exhibitions. Katie was fascinated by the dancing and she and I spent about 2 hours watching it. The main differences between this festival and the ones in Cinti was that there wasn't any gambling and that half the women and some of the men were wearing kimonos! The little girls looked so cute! Laura and Katie are insisting that they want one for next year!

Laura and Katie topped off the weekend by joining the children's choir for Mass on Sunday. They had no idea what they were doing, but they loved it!