Surgery is no joke. No matter where you live in the world, there’s simply nothing fun about it.
Having surgery in a foreign country where you may only speak some if not any of the local languages can be downright terrifying.
Several years ago, I had to have hernia repair surgery in Japan. Luckily my experience was a good one, as far as surgery goes. Some lessons were learned and I wanted to share them with the Just Japan Stuff readers.
I was living in Kobe, Japan at the time and was initially misdiagnosed by a local general practitioner. I thought I had all the symptoms of an inguinal hernia but was clearly told that I did not. I suffered for months more as my hernia got worse. I finally found myself in the emergency room at Kobe City Medical Center on Port Island.
I had been going to that hospital regularly for years. Both of my children were born there and my daughter, who has severe allergies, would regularly visit an allergist there. I was familiar with the facility and knew they normally had English-speakers on staff.
Sure enough, a young doctor who spoke fluent English tended to me and she said it was pretty obvious that I did indeed have a serious hernia.
I was booked to see a surgeon the following Tuesday. I went through a battery of tests. Blood work, thorough ultrasounds in the injured area, visit with a urologist and eventually the surgeon himself. Many of the technicians didn’t speak English, nor did the nurses, but all of the doctors did. I’m sure it would be the same at any major hospital in a large Japanese city.
There was enough English signage in the hospital to navigate the corridors by myself and Monday to Friday during business hours they had translators on duty.
The surgeon said I would definitely need surgery to repair my hernia. I learned that a hernia can’t be healed. The can only patch it up. Using laparoscopy, they would make two slices, one on the side of my abdomen and one in my belly button. Through those slits, a camera and surgical device would be placed. They would then place a Kevlar-type mesh over the hole in my abdomen and attach it. Once upon a time, this was done as open surgery, but the recovery time was far longer and the procedure far more painful than laparoscopy.
Surgery went without a hitch. When I woke up my wife and kids were there. I was in extreme pain so I was given an anesthetic via a drip. I went to sleep for a few hours. When I awoke again, I was still in pain. They gave me “painkillers” that didn’t help me very much. They would strictly adhere to the “once every six hours rule” and that was a little upsetting. I personally found that extra-strength Advil was a more effective pain control than what they gave me.
I have heard from other foreigners who’ve had surgery in Japan that they too felt the pain medicine was extremely weak.
I was in the hospital for two days in total and was able to work five days after that.
The day I was released I had to pay the bill before I could go home. Since I had national health insurance through my employer, Shokai Hoken, I only had to pay 30% of the bill. That turned out to be 160,000 Japanese yen which is about $1,800 Canadian Dollars.
My wife later learned that there were some forms she could get from the City of Kobe which, when filled out and submitted would guarantee that you would never have to pay more than 80,000 yen out of pocket. She filled them out and we got that money back a month later.
On top of my Shokai Hoken, my wife was very wise and had arranged a private health insurance policy. She is always thinking ahead and wanted to make sure all the bases were covered.
Japanese private health and life insurance companies normally prefer not to deal with foreigners. Although I was in Japan on a spousal visa, three or four companies refused to sell me insurance before we finally lucked out with one. Don’t take it personally, if you get turned down because you are an expat. This sort of thing happens in Japan and its best to grow a thick skin then get really bent out of shape.
We paid the 160,000 yen as we left the hospital. We got 80,000 yen of that back a month or so later from the City of Kobe and shortly after that, we got money from the private health insurance company. That was about 240,000 Japanese yen. In the end, we made about 160,000 yen or $1,800 profit from my surgery!
We were excited about that, but I don’t recommend having surgery as a part-time job!
After my experience, my wife and I learned some important lessons. If you are staying in Japan long-term as an expat, make sure you have proper Shokai Hoken insurance. Shokai Hoken is essentially, health and employment insurance as well as retirement pension. Your employer, by law, is supposed to arrange that and pay for 50%. If a potential employer ever tells you that they cannot arrange Shokai Hoken for you because you are a foreigner, that is a lie and is illegal (some dodgy language schools will try to pull that).
On top of that get a small private health insurance policy. The one I had cost about 3,000 yen ($35 CAD) a month and was well-worth getting.
We also learned that it is important before-hand to contact your local ward office or city hall to find out if they offer financial support for residents having surgery. In our case, the City of Kobe did. Each city offers different things. Do the leg-work and you’ll be thankful!
I learned first-hand that pain-relief treatments in Japan are nothing compared to Canada or America. They’ll never really drug you up so you feel no pain. The pain-killers they give you are very mild and basically take the edge off. In typical Japanese style, they want you to GANBATTE your way through the pain. (It is also almost unheard of for a Japanese mother to use an epidural when giving birth.) Be strong and take it! I got through it. It was uncomfortable, but I suppose I am stronger for it.
I also suggest having your surgery in a large, if not the largest hospital in the city you live. There is a better chance for modern facilities and staff who speak English.
If you live in a more rural area, it would probably be worth the trip to book your surgery in a nearby city.
My overall experience was a good one. The hospital was modern, clean and comfortable. The staff was friendly, supportive and all of the doctors could communicate in English.
If you plan things well and in advance (if it isn’t an emergency surgery), the experience doesn’t necessarily have to be a negative one.
In episode 66 of the Just Japan Podcast, I discuss having surgery in Japan.
I also vlogged about my experience.
Kevin O’Shea is the host of the Just Japan Podcast. He is also the guy behind JustJapanStuff.com. Kevin is a Canadian educator who lives in Beijing, China with his family. Kevin called Kobe, Japan home for 10 years.
Follow him on Twitter: @jlandkev