K: So, today we’re starting off a little bit different with a content note. We’re going to be talking about hospitalization, medical procedures, and surgery. If those – if you find those things to be upsetting, please, you know, stop the podcast now. And now, our usual introduction. So, lately I’ve been thinking about the difference between having surgery in the United States and having surgery in Japan.

C: Now, why is that relevant?

K: (laughs) So, if y’all follow us on Twitter, or y’all are Musick Notes, you know that I’ve been dealing with a lot of health stuff. And I’m still dealing with a lot of health stuff. And I recently had surgery in Japan.

C: Yes. Your first one.

K: My first ever surgery in Japan. Not my first ever surgery.

C: Right.

K: I’ve had over 20 surgeries in my life.

C: but, since we moved to Japan, you haven’t had any. I think you had oral surgery when we went back to the U.S.

K: And I had oral surgery here in Japan.

C: Okay, yeah, you did.

K: Yeah. So, this is – I guess this is my second surgery. Wait, I think we did an episode on the oral surgery.

C: Yeah, I think we did.

K: But I’m not sure. So, in this surgery, I had a bunch of adhesions, and what my body tends to – I have an adhesion disorder, and what that means is that my organs tend to grow tissue that sticks to them other organs. And then it causes me a lot of pain, and it causes a lot of issues with the organ’s ability to function. Plus, I had over 50 gallstones. So, they removed my gallsto- my gallbladder, rather. And… snipped away at the adhesions and put some special gauze on it to see how my body tolerates that. To see if it’s something worthwhile for me to have done multiple times. Which I’m hoping the answer is no? Or maybe I should hope the answer is yes? Still on the fence. But the main thing that stuck out to me was that, for 2000 dollars – United States Dollars. 2000 USD.

C: Yeah, a bit less than.

K: I had a 5 day stay in a 4-room hospital. I had surgery, anesthesia, aftercare, two x-rays, and a CT scan. And that is just unheard of – like, I couldn’t get anything on the list in the United States for 2000 dollars.

C: I think the last time I had a CT scan in the U.S. – or an MRI – I had an MRI in the U.S. almost 20 years ago, and it was 4000 dollars.

K: Yeah, and the hospital room stay for a four room – a four bed stay, which I had to myself almost the entire time – was 30 bucks a night for the hospital room.

C: Yeah

K: Around 30 to 40 dollars USD.

C: And that’s the part that we pay.

K: Yeah.

C: Which we pay 30% copay, so that means it was around 100 dollars a night at full price.

K: Yeah, but you can’t get anything in the United States for 100 bucks at a hospital.

C: No.

K: You might be able to at a clinic but not a hospital.

C: You can barely get a hundred dollar a night hotel room here in Japan.

K: Yeah. So, something that was really different was that they checked me in the day before. And, at first, I was really skeptical about it, but the day I had surgery I was really thankful for it. Because my room setup is intense.

C: Yeah. So, you went in the morning of the day before for an afternoon surgery.

K: Yes, so I went in Tuesday morning for a Wednesday afternoon surgery.

C: Yeah. So, how was your room in tents? Because I thought it was in a hospital.

K:  It – oh, ha ha.

C: (laughs)

K: Y’all, give him some love on that.

C: You got the laugh. You got it. (laughs)

K: Yeah…

C: I got the laugh. Because you had it.

K: Yeah… in tents. Really, babe?

C: Yes.

K: Wow. Low hanging fruit, much?

C: You know.

K: So, I’m not laughing because it hurts to laugh.

C: Okay. Yeah.

K: (laughs) And I’m gonna laugh as soon as I say that – and ouch, it does hurt.

C: No, it’s okay. It’s low stakes humor.

K: Yeah. It is. So, I took a lot of stuff with me because they told me – because I watch YouTube videos.

C: That told you take a lot of stuff.

K: Yeah. So, the things that I took that I was happy I took, and the things that I took that it was annoying I took – the only thing that annoyed me that I took was a towel.

C: Mhm.

K: So, I’m glad I took jammies because I don’t own any sweats, so taking a pair of jammies to leave the hospital in was good because I can’t wear a bra.

C: Mhm.

K: Because one of the incisions is right where my bra is. And I can’t wear underwear because one of my incisions is right where my underwear would – my underwear line would be. So, I have to wear diapers. And they suggest that you wear diapers in the hospital because, with the surgery I had, sometimes people have leaky bowel syndrome afterwards. Which, knock on wood, thank goodness, I don’t.

C: Yeah.

K: So, for you, how was me going into the hospital the day before?

C: So, for me the whole thing was different because of quarantine.

K: Mhm.

C: But you going in the day before… It was kind of lonely, but it was also kind of a comfort. Because, when we did surgery in the U.S. – when you’d have surgery, they’d say, “don’t eat after midnight” or whatever. And then we’d go in the morning for your surgery, and they’d ask if you’d eaten after that time, we’d say no, and they’d say, “you sure? Because she’ll die if she’s lying.” Like, over and over.

K: Mhm.

C: It was a really intense process because their motto seemed to be, like, “we don’t trust patients.”

K: Mhm.

C: “And we’re going to try and scare you into telling us the truth” when we were already telling the truth.

K: Mm.

C: And I feel like you being in the hospital the day before, they knew where you’d been. They knew what you’d been doing. There was none of that.

K: So, the… weekly – the day before – the Monday before I went to the hospital to be checked in, I had – I went and got all of my tests done. I got my Covid test done, I got my HIV test done, hepatitis, and a couple of other tests done. And I went and saw the oral surgeon to make sure I didn’t have any loose teeth because that was the thing they were obsessed about. Everywhere I went, everyone I spoke to, for three days – even leading up to the surgery – they asked me if I had any loose teeth.

C: Well because they have a dentist on site. So, they could – they could glue those right in, or…. I think they’d probably ask to take them out if you had loose tooth. Be like, “let’s just pop them out real quick. We’ll put them back in after your surgery.”

K: The thing was for anesthesia.

C: Yeah.

K: And – because they have to put a piece in my mouth to keep my throat open because they put a breathing tube down my throat.

C: Yeah. That’s… unpleasant.

K: Yeah.

C: You were complaining for a couple of days after that your throat was really sore from it.

K: Yeah. So, we did – I did all of the testing on Monday, and then I came back on Tuesday, and they checked the results. And I was able to check in. And I’m really grateful that I did look at the videos because it let me know that I could have – the hospitals don’t have wireless internet, but I as able to take a pocket wireless internet and a pocket translator, which was fabulous, and my computer. So, I was able to chain the computer – because there’s a little port where you can put a lock in on your computer and wrap it around the tray table or the bed and have a computer.

So, it’s the first time I ever had internet and a computer because, in the United States, they just have – you can’t get cable or anything, and we have the most depressing thing to watch on television. So, one time I was watching just – on a loop – the story of this couple in a nursing home where one part of the couple is okay and the other partner gets dementia, and they’re separated by 7 floors. Because it’s an apartment building that has

C: It’s a manage care facility.

K: Yeah. And so, I would cry and tell you that you should just put me in a manage care facility.

C: Yeah, you would.

K: Every time you came to visit. Which was really depressing.

C: You’d say, “tell me you’re going to visit me even if I don’t remember you.” And I’d say that. you’d say, “promise me you won’t actually do that because I won’t know.”

(laughter)

K: Yes, I was very much that.

(laughter)

K: How was it for you, not visiting me?

C: It was hard. Like, when I would visit you in the hospital before, that was hard, too. So, I don’t know which one was harder. Physically, it was easier to not visit you for obvious reasons.

K: Yeah.

C: Like, not going somewhere is easier than going somewhere. I think it was a little bit easier because we could talk every day, even though we didn’t talk a whole lot. And because I could see you online. Like, you were too tired to really talk, but you would tweet out how you were doing.

K: Yeah.

C: And so, I’d be like, “oh, okay. I see how my honey is doing.” And we had talked about that before – that you would probably have limited energy. That’s what you would do, so that I didn’t have to talk to you and then turn that into tweets about updates and things.

K: Yeah.

C: Have to, like… people were just like, “we’re not going to pay you if you don’t tweet about your condition.”

K: No. Our Musick Notes care about us on Twitter.

C: Yeah. I know they do.

K: We have some really good friends on Twitter. A lot of people were concerned about the health stuff, so I’m not going to poopoo that. It was a nice way to get the message out to everyone who wanted to know.

C: Right.

K: Because there’s about 20 different people who want to know how I’m doing.

C: Right.

K: And contacting each of those people would be exhausting. So, putting it in a tweet

C: Oh, yeah.

K: With a thread.

C: And I don’t know all of those people, so it’s easiest if you just tweet it out and…

K: Yeah. And you and I talked for about an hour a day.

C: Yeah. But that’s way down from our regular.

K: Yeah, I tis. And so, that was really nice. Because of Covid, I couldn’t have visitors, but because I don’t speak English – I mean, I don’t speak Japanese – Rasta, our son, was able to come 3 or 4 times. Something that was comforting and sad and messed up and scary was that Rasta was able to go into the operating room with me.

C: Mhm.

K: In the United States, they tend to, as soon as you check into the hospital, put you on an I.V.

C: Yeah.

K: And that made me – always made me feel like a prisoner. I hated it.

C: I remember you contacted me after you checked in, and you said, “they said I could leave.”

K: Yes. Which was weird.

C: “As long as I’m back by 7” – I think it was 7.

K: Yeah. So, that was weird. And I was in my street clothes, and I wasn’t the only person in my street clothes. There was like a dude in his suit, there was another chick in street clothes. Like, everybody who didn’t have surgery just wore their clothes.

C: Mhm.

K: And that was weird.

C: So, you never got the hospital gown thing.

K: And then the hospital clothing that they give us, they actually give us pants. Which I was grateful for.

C: Yeah.

K: And a kimono style wrap shirt.

C: Mhm.

K: So, I was completely fully dressed and covered, and that was really nice.

C: That’s a lot nicer because I know, in the U.S., you were often trapped to your bed effectively.

K: Yes.

C: Once you had checked in.

K: Yes.

C: It was like, you couldn’t get up because of the I.V., and sometimes more than one pole, and… not wearing clothes, and… that was just not… didn’t seem comfortable.

K: Yeah.

C: And when I talked to you this time, you seemed really uncomfortable after the surgery because you had had surgery but not because you were in the hospital.

K: Yeah. That was the case. And the thing in the United States that was really hard for me is that if you don’t get up and walk after you had the surgery, the surgery is – as soon as you’re able to – and I had open surgery from my diaphragm to my pelvis. I couldn’t get up for several days, but they did… sort of a keyhole – they did partially open keyhole. Which I have a long cut, but I also laparoscopic cuts where they just put an instrument in. But even in an open surgery, they fill your body with gas to make space between the layers.

C: Yeah.

K: And if you don’t walk, that gras migrates to your soldiers and doesn’t migrate out – doesn’t disperse throughout your body so that it’s less painful. So, not being able to walk in the United States made things way more painful.

C: Yeah. Because you were up and walking pretty much the day

K: The day after.

C: Yeah.

K: Which I was really happy about. I was able to walk the unit – actually, the night after I had the surgery, a nurse came and woke me up and took me out of bed, and… had me stand up and then get back in bed. Because I had a catheter.

C: Mhm.

K: And the next morning, they removed the catheter and helped me walk around the unit. And helped me go to the bathroom, and I was – one – a major milestone in the hospital is having a bowel movement post-surgery. And I was able to have that the day after, so we’re really happy with my bowel functioning.

C: So, one thing that I did notice that we talked about before is that you couldn’t call in your room.

K: Yeah. Tell my roommate that.

C: (laughs)

K: I had one roommate that was just talking on the phone the whole time. It was like, “girl. Go to the space where you talk on the phone.”

C: Yeah. The designated phone area.

K: Yeah.

C: Yeah. So, that was always like, you’d message me and say, “I’m going to go to the designated phone area. Be ready.” And I’d be ready.

K: Yeah. That was really nice. Rasta being able – so, I think I kind of skipped over what was sad and messed up, which is this is going to be that kind of podcast. So, basically, our usual.

C: Yeah.

K: (laughs) Rasta was able to come into the… surgical theater and stay with me until they put me under. Which is my least – one of my least favorite parts of the surgery because I just cry and… look miserable and – so, Rasta described it looking at me as looking at me tired and pissed and scared. And so, I felt really bad that… our son was standing there while I did that, but he’s a better choice than you are because his Japanese is better, and you just get scared and angry because you mirror whatever I’m feeling.

C: Yes.

K: And so, you become really hostile in those types of situations.

C: I feel like they should do better.

K: Because going under, the gas that they use – I do prefer the American process for going under over the Japanese process because the Japanese do not have you go under by I.V., they have you go under – the first stage of surgical anesthesia is gas.

C: Oh wow.

K: Whereas, in the United States, it’s an I.V. drip.

C: Yeah.

K: But I also wasn’t… parked outside my room – outside of the surgical theater

C: For an hour.

K: Yeah. So, when I went down – so, in the United States, I go down to the surgical area – I’d be in my bed on an I.V. – I’d go down to the surgical area, I’d meet the anesthesiologist, and then he’d give me Valium. Then he’d come back around and see if that was taking effect and let me know what time sedation would work. And if the Valium wasn’t taking effect, then he would give me more Valium. And I could sit in the hallway in between one to three hours waiting for surgery to begin. Receiving regular intervals of I.V. Valium to keep me calm while I cried the entire time. Because as soon as I go down for surgery, I just start crying. And I don’t stop crying until I get put under, and I wake up crying. So, in Japan on the other hand, they don’t have you go down until your operating theater is ready.

C: Mhm.

K: And then you walk down, no I.V., and they start prepping you for surgery while they’re putting you under. So, the I.V. – I didn’t even know when my I.V. went in.

C: Mhm.

K: It went in sometime after I fell asleep on the gas, which is a facemask that they put over you. But if you’ve ever been put under from gas, it is nothing like they show on T.V. – at least not for me. They – the mixture has more gas than oxygen, so it feels like suffocating.

C: You’re saying they didn’t just put a cloth over your mouth and ten seconds later, you were knocked out?

K: Yeah, no. And I counted backwards from a hundred, which they didn’t tell me to do, and I got all the way to 89.

C: All the way to 89.

K: In the United States, they say, “count back from 100” and seriously at 98 I’m always out.

C: They don’t even say count back by 7?

K: No.

C: That’s weird, maybe they don’t want your brain working that hard.

K: When have they ever said count back by 7?

C: That’s what they say to me. “Count down from 100 by 7.”

K: When have you been – when have you had surgery?

C: It’s not when I had surgery. It’s when they do the neurological assessments.

K: Yes, which is something completely different from what we’re talking about.

C: I refuse to believe this.

(laughter)

K: So, what’s the neurological assessments you’ve had done?

C: I’ve just had a lot of neurological assessments because of my epilepsy. That’s the whole thing of it.

K: So, when I woke up from… surgery, in the United States, they use the anti – the thing that you put up the nose to get you completely awake. Which is horrific because it means you have no pain medication on board.

C: They use Narcan or smelling salts?

K: Narcan.

C: Okay.

K: And so, it backs down every single thing you have, so you have absolutely no pain management on board at all.

C: Yeah.

K: So, you wake up feeling every ounce of pain from the surgery, which is horrific. And then trying to get it backed back down is horrific. Whereas, in Japan, they – the anesthesia they use is… it wakes – you wake up naturally from it.

C: Yeah, it’s pretty short acting.

K: Yeah. And I had I.V. fentanyl already on board. So, when I woke up, I had pain management on board… I was in my room. I was being transferred from – no, I didn’t transfer because they just rolled the bed – they transferred me in the emergency, in the surgery room sorry. Onto a medical bed, and I woke up – I don’t know how much afterwards. And I was like, “where’s my computer?” And Rasta was like, “the doctor said you need to rest today.”

C: Uh-huh.

K: And I was like, “no, but I want my computer.”

C: (laughs)

K: And he’s like, “you need to rest.” And I was like, “but I want my computer.” And he said, “okay, here’s your computer.” And then didn’t actually move my tray table.

C: Uh-huh.

K: I could see it. And then I fell asleep.

C: (laughs)

K: And he was gone. So, apparently

C: And you didn’t get your homework done. (laughs)

K: Right? So, apparently, I didn’t need my computer. He was like, “no, the doctor said you couldn’t have it and you needed to rest.” And they don’t let you have any pillows. They want you laying flat – they have a specific position they want the bed to be in.

C: Uh-huh.

K: And that was different than the United States as well.

C: When did you get your pillows back? Because you brought pillows as instructed by the YouTube videos.

K: Which I was really happy for because the Japanese pillow is short – it’s like the size of the back of your head. And it’s filled with either plastic rings or – it used to be filled with seeds, but now it’s filled with plastic rings to prevent allergic reactions.

C: Mm.

K: And super tiny – but they didn’t even let me have that one.

C: Wow, they were just so mean. Okay, so something I didn’t remember to ask you after surgery is did you wake up from surgery speaking Japanese?

K: No, I did not. In the United States, I wake up from surgery speaking Japanese.

C: Yeah.

K: But this surgery, I woke up, and the first person I saw was Rasta.

C: Okay.

K: And Rasta was talking to me. I don’t know if the medical staff asked me questions or not.

C: Right.

K: I may or may not have spoken with them in Japanese. I don’t know.

C: Because one of the last surgeries you had – one of the first surgeries you had in the U.S. after learning Japanese

K: Mhm.

C: They came up, and they told me, “we think she’s got brain damage or something from the surgery.”

K: Yeah.

C: “Can you… see what’s going on?” And you were just speaking Japanese.

K: Yeah.

C: And you were insistent that, “no, I’m speaking English.”

K: Yes. Which Japanese, if you haven’t heard it, it does – if you’re not expecting someone to speak it – it does very much sound like they have brain damage. I think any foreign language in that context, right?

C: Yeah, I think so.

K: And so, I think that was a big bonus for you not being there. Because you have lots of medical trauma from the doctors coming out and talking to you while I’m in surgery.

C: It just feels cruel, what they would say. I don’t feel like it’s the same as medical trauma because I wasn’t undergoing the medical part.

K: Okay.

C: But it just felt like… cruel. Like, they’d come out and just say, “well, we killed her.” Before letting me know that they had resuscitated you and you were okay.

K: Yeah.

C: And even then, it was like, “why did you kill her? Why did she have to be resuscitated?”

K: Mhm.

C: And they’d come out, and they’d say it’s going to take 90 minutes per surgery, and they come out 6 or 7 hours later.

K: Yeah.

C: So, that was very distressing. And not knowing, this time… I guess I did know because our son contacted me after you were out of surgery to say you were out and you were fine.

K: Yeah.

C: Which that was a relief. But… I think my life just kind of… kept going this time because I wasn’t there. And I don’t know how different it would’ve been if I had been at the hospital with you.

K: Well, Rasta wasn’t at the hospital with me. I told him, “no matter what, leave. It’s going to take at least 2 hours.”

C: Yeah.

K: And we live 10 minutes away from the hospital, literally. A ten-minute drive, so I was like, “dude, go home. Come back.”

C: Mhm.

K: He’s like, “what if I’m not here right at the moment you wake up?” And I said, “you won’t be.”

C: Right.

K: “It’s guaranteed you won’t be. You can’t come in the surgical room after.”

C: Yeah.

K: And so, we didn’t know what type of surgery I was having. There was 5 different options. I could have a 4-punch laparoscopic surgery, up to an 8-punch laparoscopic surgery. So, there’s like 4, 5, 7 or 8.

C: Mhm.

K: I don’t know why 4, 5, 7, or 8 – I don’t know why not 6. But whatever on that. A hybrid laparoscopic / open surgery which is kind of what I have where the cuts are much bigger. They’re not keyhole. And then – or open surgery where they would, again, cut me from diaphragm to pelvis. Which I don’t have, and I’m so thankful for. Those have a different set of how long the surgery will take.

C: Yeah.

K: So, my surgery was about 3 hours. It took a little bit longer than just the 4-keyhole punch would’ve taken. And a lot less time than the long one – which the long one is 7 to 8 hours of surgery.

C: Mhm.

K: So, I was really happy for that. And I – so, I told Rasta, “go home. Relax. Take a nap and call in 2 hours to see if I’m out of surgery.”

C: Yeah.

K: There’s no point in sitting in an uncomfortable seat. Like – and the driving was already damaging his body. I’m like, “they’re not gonna let you chill in my room. You’re gonna sit in some awkward, strange place in an uncomfortable chair.”

C: Yeah, I think that was part of what made it harder in the U.S. as far as length was that the hospital was about 90 minutes’ drive from our place.

K: Yeah. That was really bad.

C: Because of traffic, which meant that it was 3 hours to go home and come back. So, I never did.

K: Yeah.

C: Because I didn’t wanna drive for 6 hours on surgery day. And… here, it’s – like you said – it’s 10 minutes by car. I think it’s about 20 minutes by subway.

K: Yeah.

C: Not doing the subway right now because Japan is not doing well with Covid.

K: Yeah.

C: But who knows? Maybe it’ll all be fixed by the time the Olympics come.

K: Okay? Like, go Japan with that optimism.

C: (laughs)

K: So, after my surgery – the night before my surgery, they had me take a shower. And then after my surgery, I was just in my room. The day of the surgery.

C: But you’re skipping the minty belly.

K: Oh, yeah. I forgot to say about that. It was so weird and so uncomfortable. They cleaned my bellybutton. I don’t have one, to be clear.

C: Right.

K: Because of the open surgery, I have a weird shape you could tell was once a belly button. So, they put this minty stuff in it and cleaned my bellybutton. And it was so stinky and gross. I was really happy I did my shower after.

C: the stuff was.

K: Yeah, my bellybutton doesn’t have any odor or anything.

C: Because you don’t have a bellybutton.

K: It’s like a divot, not even an impression now.

C: Yeah.

K: It’s about an inch – it’s an inch long divot.

C: Yeah.

K: Rather than like the tiny little – I had a really, really cute bellybutton.

C: You did.

K: I was really bummed that I lost my bellybutton. But now I have a badass scar that, whenever someone sees, they know I’ve been through some shit.

C: Yes.

K: Because it’s big.

C: It’s big, and it’s got scars radiating off of it from all of the staples.

K: Yeah.

C: Every staple left two scars.

K: Yeah. I used to call it my zipper.

C: Yes.

K: And… I don’t wall it my zipper anymore. And it’s actually shrunk over the years.

C: Yes.

K: Because it used to be up like right underneath my breasts, and now it’s like two inches – it starts two inches below my breasts.

C: Mhm.

K: My cleavage. So, it has shrunk over the years. It’s like 15 years old, right?

C: Yeah, that’s right. Yeah… yeah. 2006 – 15 years. Yeah.

K: Yeah. My doctor was really straightforward and honest and awesome, which was a completely different experience than… my doctors in the United States. I felt really humbled and honored that my doctor… practiced and learned English for – to talk to me when Rasta wasn’t there. Which is totally not on him to do, in my mind. Because I’m in Japan.

C: Right.

K: And Japan is not an English-speaking country. Even though they study it – there’s people who have rants about it. I don’t. I have humility. And so, even though I can speak a little bit of English – I mean Japanese, rather. I keep mixing up Japanese and English. I can’t speak any… medical Japanese at all. Like, at all, at all. So, he came by, and he explained things to me in English. Which was really sweet that the surgery went well, and all of that. And every day that he would come by, he’d ask for an English word of the day.

C: Mhm.

K: and a phrase I taught him which just tickles me is, “Amber says what?”

C: Oh. (laughs) You mentioned this to me.

K: Yeah, because I was watching Amber Says What, and she was doing her – she was doing a “what” song. So, Amber Says What is part of the Late Show where she talks about cultural things that are happening that’s like, “what?” And says what with different intonations. And not every time she does Amber Says What, but every now and then, she does a “what” song, where she does the entire lyrics of the song is the word what. And he listened to it, and he thought it was hilarious. And he’s like, “what is this?” And I said, “Amber Says What?” And I explained to him that Amber was her name, and that “what” is the name of her show.

C: Mhm.

K: And he put the earbud near his ear, not in his ear which I appreciated, so we kinda went ear-to-ear.

C: Mhm.

K: You know, in the era of Covid. And then I – I sanitized it before and then sanitized it after. And we just had a lot of those bonding moments along with the medical stuff. And then the day that I packed up to leave the hospital – because I was feeling super optimistic – he came by and told me that he thinks that I’m having… soft-tissue… organ damage and failure. So, I stayed another day in the hospital to see if my numbers would change, and they did change toward the positive. And so, now that’s kind of where we’re at. We’re seeing if my numbers continue to improve, or if I’m having some sort of organ failure with it. So, it’s kind of up in the air with that.

C: It’s a little bit tricky because even your normal numbers are about double what it’s recommended that the numbers be.

K: Yeah because of my lupus.

C: Right.

K: And hereditary coproporphyria. And so, he’s using the inflammation chart to see if he thinks it’s lupus. It’s really complicated.

C: So, you had another doctor here in Japan.

K: I have several doctors here in Japan.

C: You had another surgeon because you talked to the surgeon at a different hospital, and they recommended – they referred you to this hospital.

K: Yeah, and that guy was smoking more crack. He told me he was gonna do open surgery.

C: We’re talking about doctors here. Was he literally smoking crack?

K: No.

C: Okay.

K: But he told me that he was gonna do an open surgery and only give me Tylenol for pain management.

C: Mhm.

K: Girl, are you kidding me right now?

C: (laughs)

K: Because your worried about my liver function – and Tylenol is like the worst thing.

C: Yes.

K: So, I got I.V. fentanyl for the first day.

C: Which doesn’t affect the liver.

K: And the second day, I was on I.V. fentanyl, and then the third day, I was on… I only know the name of it as “Swedish Milk.” But it’s an anesthesia, but they water it down to be… pain medication.

C: Interesting. Like low dose propofol.

K: Yeah, I don’t know what you’re saying to me. I don’t know if propofol is the name of

C: Yeah, it is.

K: Okay, yeah. Very low doses of that. And then… on the fourth day, they wanted me to be completely off pain medicine to show that I could go home.

C: Mhm.

K: And then I’m home

C: So, that didn’t

K: So, I guess I went home the 6^th day, but

C: Yeah. So, that didn’t change between the U.S. and Japan – that they want you to be like, “I’m completely cured. I’m 100% healed from the surgery I had a few days ago” to go home.

K: Yeah. But in the United States, I had way more pain medication. It was a different surgery. I was on… Dilaudid.

C: Right.

K: For it. For like three weeks?

C: Yeah.

K: And then, after I – when they sent me home, they sent me home with morphine tablets, methadone tablets, fentanyl patches…

C: The whole mix was confusing.

K: Yeah, and a couple other things. I had like 5 or 6 – oh, and Vicodin.

C: Yeah.

K: And I was told that this is the… when you’re done with your morphine, start taking the methadone to help with the withdrawal, and leave your fentanyl patches on – it was like a whole recipe.

C: Yeah.

K: And then I went to a pain clinic, and they were just like giving me whatever I wanted. I don’t know if it would be like this now, but I much prefer the Japanese way. I don’t want to be on a bunch of narcotics.

C: Yeah.

K: And I don’t want a life of addiction. I didn’t get addicted from the other surgeries. So, for – I don’t remember the cost of the – I think the U.S. surgeries for a week-long stay is about ten thousand after… after the insurance pays its portion?

C: Okay, so the cost here before the insurance paid its portion was about six thousand dollars.

K: Mm.

C: And we’re 30%, which put us just a little under two thousand dollars. The cost in the U.S. was four hundred thousand dollars before the insurance paid. And then I think we ended up paying almost fifty thousand dollars because the hospital bill was… around ten thousand, and then y our insurance – the deductible made it five thousand.

K: Mhm.

C: But then none of the doctors who saw you were covered by insurance.

K: Mm.

C: They were like, “no. These people are out of network. You should’ve chosen a hospital with only in-network doctors” which doesn’t exist, at least in Northern California. And so, we spent, I think, nine months clarifying – there were some doctors who had never actually come and seen you who had billed.

K: Yeah.

C: Thousands of dollars for consults. Sometimes on days that you hadn’t even been in the hospital.

K: Yeah.

C: It – it’s hard to actually say how much money we spent because it happened over a very long period, and there was a lot of back and forth about how much you should actually be paying.

K: It was a year. It took us a year to get to double-check everything. And they were also charging us for things I didn’t receive.

C: Right.

K: Like, medications I didn’t receive – I didn’t receive any tissue, I didn’t receive any over-the-counter medication which they were charging us for… and I was keeping – we were keeping track of how many I.V. bags I had because we’d already been down the road where they would charge us – like, if they had given me the amount of I.V. bags they were charging us for, it would’ve killed me.

C: Yeah.

K: Because it would’ve diluted my blood too much.

C: And they tried to say, “well, we had to hold those in reserve just in case.” Like, no. We’re not paying 95 dollars an I.V. bag.

K: For an I.V. bag you didn’t touch that was never put into my body.

C: Right. That you used on somebody else. Come on.

K: And then they were trying to charge us for the medication that I got prescriptions for, so we had to prove that I got them from our pharmacist.

C: Yeah.

K: And getting that prescription from our pharmacist was a trip because we’d had the same pharmacist for years and years, and he was like, “wow. This is a lot.”

C: Well, and this is before insurance covered medicine. Because now, under the ACA, insurance covers at least a part of medicine.

K: Yeah.

C: So, I think the medicine from that was… well into the five figures.

K: And the pharmacist was like… they gave us a couple days – they did give us a couple days of doses for pain management at the hospital. And it was a good thing, too, because we had to order them, and he had to contact the DEA.

C: Yeah.

K: And it was a whole thing. Because of… the narcotics that they were giving me. And then we had those, and I lied and said I had a lockbox for them. But I didn’t, and I didn’t like… feel the need to have a lockbox. We weren’t going around bragging about all of the medication I have.

C: Now, if somebody came by, we’d be like, “the jeweler lives down the street.”

K: Right?

(laughter)

K: We lived in a cul-de-sac, and there was a jeweler that had millions of dollars of jewelry in his home all the time. And went around telling everybody.

C: Yeah, that was the part.

K: He’d bring over

C: He was like, “look at this bag of jewelry.”

K: Yeah, we went over to his house, and he literally – it wasn’t in a safe or anything. He was like, “heh, heh, check this out.” And he pulled out like five or six bags of just like… filled to the brim with jewels. Like, properly packaged. And it was like, “who did you rob, dude?”

C: (laughs)

K: “Like, this does not look safe. Do you have a safe?” And he was like, “no. A safe would be suspicious.” I’m like, “do you think you should be telling people and showing people?”

C: (laughs)

K: And he was like, “ah, but you guys are good people.” “How do you know that?”

C: How do you know that, yeah.

K: “You’ve only known us for two months, dude?” “Well, you bought the house my wife grew up in.” And I’m like… “what does that mean about anything?”

C: Okay? That is such a bizarre string of logic.

K: It tells you nothing. Yeah, other than

C: You live in the house that Jack built, so you must be fine.

K: Right? So, overall, I think that… the – one thing I was surprised about is the Japanese hospital was ay cleaner than an American hospital. And that is so strange to me.

C: Well, and you’ve been out of the hospital long enough now that I feel comfortable saying it without jinxing – I don’t believe in jinxing, but I know that

K: You know I do.

C: Yeah. But you did not pick up any community-based infections while you were there.

K: Yes. Oh my gosh. I got MRSA from the hospital in the United States. I would get the flu. Like, everything – I would catch whatever was going around, so that was really scary for me.

C: Yeah. The time you got MRSA, you got it. And then we went to the E.R. because you had a fever and everything.

K: Yeah.

C: And you had a big cyst. And we said, “she’s got MRSA.” And the doctor’s like, “no. You’re being hypochondriac and ridiculous, and I will humor you and take a sample.”

K: Yeah.

C: And then came back like an hour later and said, “would you like to enroll in my MRSA drug study?” No.

K: No. And it was the same doctor that, when I was admitted in the E.R., I refused her as my doctor.

C: Mhm.

K: Because she just was so unprofessional, and I didn’t trust her to do surgery.

C: Yeah. And I think, like, that

K: And I think it was a good call.

C: I think it was a good call.

K: Because she was just – had a horrible bedside manner and was like, “I can’t guarantee I will find anything or fix anything.” I’m like, “then I don’t want you for my surgeon.”

C: Okay.

K: Then why do I need surgery?

C: And here they gave you the disclaimer because you told me about it

K: No, here, they told me that he would definitely – they said, “we’re definitely going to do this and this at a minimum, we may do this and that as a maximum. But I don’t know what your condition will be afterwards.” It’s much different than, “I don’t know if I’m even going to do anything.”

C: Yeah. That was different, but didn’t they go through a whole like thing, you might lose your eyes, you might lose your limbs, you can’t sue us if you do…

K: You’re talking about the medical disclaimer, and in Japan you cannot sue in the way that you can in the United States.

C: Yeah, that’s what I was saying

K: But they went through a 7-page medical disclaimer of possible things that could go wrong. But it was not like in the United States at all. It was just calmly explaining what each thing was and then asking me if I still consent to surgery.

C: And that was my point is that it wasn’t like it was in the U.S. at all.

K: Yeah. And, in – she wasn’t doing the medical disclaimer.

C: Oh, this was just her own

K: She just randomly volunteered

C: That she’s not skilled enough to even do surgery.

K: So, I was like, “so, why do I need surgery?” And she was like, “because I think you do.” And I said, “I think I’d like another doctor. I think I’d like a second opinion.”

C: Okay. Just like I think you do – based on what? Tell me why.

K: And the big threat in the United States is “against medical advice” – AMA

C: Right.

K: If you do anything AMA, your insurance company will not cover your stay. And… I was – she said, “well, if you don’t let me do surgery, you’re AMA.” And I said, “no, I’m not. It is completely – I am completely within my medical rights to ask for a second opinion. You can check me into the hospital, or you can release me. Those are the two pieces of medical advice that you can give me that would determine whether or not I’m AMA.”  She said, “I’m going to check you in the hospital.” And I said, “crack on.”

C: Mhm.

K: “Check me in. I’m not afraid of you. I’ve good insurance. You’re not going to intimidate me into allowing you to do surgery. And even if you do surgery, I will have to be checked into the hospital.”

C: Yes.

K: So, there wasn’t that aggressive… anger. That – so when I went in, there was no aggression, there was no anger. The nurses didn’t bump my pain to cause me pain.

C: Mhm.

K: the nurses didn’t resent me. The nurses pretty much left me alone except for taking my temperature and blood pressure. They didn’t come in and harass me or anything.

C: Except when you were working.

K: Yes. They didn’t like me working. They wanted me to stop working.

C: Yeah.

K: Can’t stop won’t stop.

C: (laughs) Can’t take a computer away from Kisstopher.

K: It’s locked to the table.

C: (laughs)

K: They’re like, “you need more rest.” They’re really obsessed with my sleeping.

C: Yeah. They don’t know how little you sleep normally.

K: Yeah. And I sleep now – now, I sleep way more and at irregular intervals. And so, now, I have no idea when I’m going to be awake or asleep.

C: Yeah.

K: So, that’s different.

C: So, and because we spent more than a hundred thousand yen, we should be getting money back on our next tax year because the… deductible is a hundred thousand yen for medical insurance.

K: So, we spent more than ten thousand dollars USD on medical.

C: More than a thousand.

K: Yeah. So, when you say a hundred thousand yen, that’s such a big number.

C: Oh, yeah. Sorry.

K: So, a million yen is around ten thousand USD. A thousand yen is around

C: Ten dollars.

K: And a hundred thousand yen is around

C: A thousand dollars.

K: So, those aren’t strictly

C: Yeah.

K: There’s give or take a couple hundred dollars based on the exchange rate.

C: And it depends, too, like… we make enough money last year that you didn’t qualify for an in-advance cap on the amount that you pay.

K: Yeah.

C: But if we were poor, then we could’ve applied in advance to say we’re not going to pay more than this amount.

K: Yeah.

C: And because we have paid over the limit for the year, then on our next year’s taxes, that will get settled up.

K: So, I hope you find this interesting. I know some people had been asking for the episode, and so we did it because everyone’s curious about what it was like. And we kinda haven’t been talking about it.

C: Yeah.

K: At least, not on the podcast. And so… this is, you know, I think we’re in June, so I think it’s been like

C: It’s been like 5 or 6 weeks.

K: Yeah. Of when the surgery happened. And the reason for that being is because I needed space.

C: Yeah.

K: To get my head around getting surgery and get my head around my diagnosis and get my head around… my new medical condition. And so, basically, my medical condition is maybe I’m having massive organ failure, maybe I’m not. I have an adhesion disorder, I still have lupus, and I still have hereditary coproporphyria. And I still have POTs. So, my level of disability has changed. I am more disabled than I was before, but that’s not because of the surgery. I had the surgery because increasing levels of disability, and lupus is a degenerative disorder chronic illness, so I’m degenerating.

C: Yeah.

K: And I just don’t know how… serious it is. So… from time to time, we may do medical updates. I don’t know. Hit us up on Twitter if you want us to do more of these and leave a comment. And if you follow us on the Musicks – on Twitter @TheMusicks on Twitter – I do health updates on a regular basis. Well, fairly regular. And they’ll always have a content note, so you can skip over those if you don’t want to. Today, I am super excited because I know what the take two is about. Whoop, whoop. Today is about… rejection as a publisher. It happens.

C: It does. It breaks our heart, but we’ll tell you more about that on the Patreon.

K: (laughs) So, follow us on over to the Patreon and check out the take two. It’s just… for two bucks a month, and there’s over – well over – a hundred different things that you get for just two bucks a month.

C: Yeah.

K: And if not, we’ll talk to you next week. Bye.

C: Bye.