It’s 11:00AM local time Monday and we’re on a shinkansen bound for Tokyo from Kobe. [EDIT: That’s when and where I wrote the following entry. I’m actually posting it at about 7:30PM on Wednesday, i.e. a couple of days later. I needed some time to get the photos put in.] This represents an alteration of our original itinerary; the original plan was to go to Matsue after staying in Kobe, then to Kyoto, then back to Tokyo for a night before flying home. Circumstances now compel us to return to Tokyo, where we’ll stay for about a week before flying home.
The circumstances, as you might guess, require a somewhat lengthy explanation.
On Thursday night, while happily ensconced in hotel our room in Tokyo, Tracie started developing a skin rash similar to the one she had in the morning several weeks ago which prompted our visit to the nearby fire station and hospital emergency room. While this was just as mysterious as that occurance–and no apples could be blamed this time–the reason was somewhat beside the point. We needed to get her to an ER post haste, which is a slightly complicated undertaking when you’re in a country where English is a secondary language. We got in touch with our travel agency and they directed us to Tokyo University Hospital, and helped pave the way for us by speaking directly to the hospital to inform them of our situation. Tracie’s biggest concern was that she was experiencing a reaction to carbamazapine, the medication she was prescribed in late December for trigeminal neuralgia. One of the adverse reactions to carbamazapine is a histamine reaction which causes a worsening skin rash which can spread to mucous membranes, including those inside the lungs. If something isn’t done before this happens, your lungs stop working and you die. Thankfully Tracie did not seem to be worsening rapidly, so the taxi ride to the hospital was distinguished by concern rather than near panic. (The significance of this distinction will become apparent later in this story.)
The doctor at the ER, one Dr. Gunshin, turned out to speak very good English. (Eventually he mentioned that he had done his residency at UCLA, an experience which presumably had a lot to do with this proficiency.) After he and his “colleagues” (who were probably his students, judging from their relative ages and the context) assessed her condition and listened to her descriptions of her situation, he administered IV steroids to get her immune system to calm down, and prescribed predisone (i.e. more steroids) and histamine blockers to keep things from flaring up again. It was his opinion at that time that Tracie was not experiencing direct side-effects of the carabamazapine, but an allergic reaction to some environmental element, or possibly a sensitivity to sunlight. We had been outside quite a bit that day, and Tracie probably got more sun on that day than she had on any day previously since starting to take carbamazapine. Dr. Gunshin was a very personable sort of doctor and we had a fine time talking with him, even under the circumstances. Eventually, confident that Tracie’s situation was stable and would remain so while aided by the meds he’d prescribed, he sent us on our way. The bill for this visit, including the medications, was about US$125. We paid it using a machine that sort of resembled an ATM, except that it received money rather than dispensing it.
So, we finally got back to the hotel around 1:00AM, feeling pretty confident about the resolution of the situation. Unfortunately we had to get up at about 4:00AM because we were already scheduled to take a train to Kobe for the next leg of our vacation. We left at this early hour so that we could stop in Kyoto en route to poke around the station a little. It’s possibly worth mentioning at this juncture that it had been a long day even before we were compelled to go to the hospital, and I was rather in need of more than three hours of sleep.
Despite the stress of the previous evening and the lack of sleep, we arrived in Kobe in good spirits.
While in Kobe, we stay at the ANA Crowne Plaza hotel, a veritable lap of luxury. Also, we were looking forward to the next evening, on which we were scheduled to have dinner at the home of our friends who live near Kobe.
If this was a movie rather than a blog entry, and I was the soundtrack composer, I’d cue the ominous strings about now.
After we’d settled into our room, and shortly before we were going to sally forth in search of a nearby grocery store to obtain dinner, Tracie’s face turned an alarming shade of red. (Yes, again.) Had we still been in Tokyo, it would have been simple enough to return to the same hospital, but we were now in Kobe. So, same drill: we got in touch with our travel agency and were directed to another hospital, where someone who spoke English was informed of our situation. Also, they’d spoken to the front desk of the hotel and someone there would direct a taxi to the hotel on our behalf.
It didn’t work out quite that way.
It was easy enough, as usual, to get a taxi, but the doorman had no idea where we were headed, and I didn’t remember the name of the hospital well enough to tell him–and I certainly didn’t want us to be taken to the wrong hospital. So, he went back inside to talk to the front desk while I tried not to pace around too much. Once underway, it became apparent that Tracie’s reaction was progressing more rapidly than it had the night before. (Astute readers will now be asking themselves, “what the hell is triggering these reactions?”, but at the time we were far less concerned about the cause than about the effects.) We didn’t want to be rude by asking the taxi driver to do his job in a more expedient manner than usual, but Tracie did eventually ask him how long it would take to get to the hospital. He must have noted something in the tone of her voice because he said, “five minutes”, picked up the pace considerably, and got us there in half that. Nonetheless, Tracie had her Epi-Pen out and we were considering whether it was possible to use it within the confines of the back seat of a Prius that was taking corners somewhat briskly.
Once at the hospital, it took a few tense minutes to pay the driver, get her wheelchair out of the trunk, put the wheels back on the wheelchair, and get to the ER. Once there it became apparent that there wasn’t anyone handy who knew who we were, or who spoke much English. Hence it wasn’t at all easy to convey the gravity of Tracie’s condition to the person at the desk who was asking us to fill out forms that we couldn’t read, or a lengthy multiple-choice form in both languages with numerous check boxes for numerous complaints and ailments. I was trying to play along for the sake of harmony, but Tracie took the pen away from me, scrawled ALLERGIC REACTION across the top of the form, and handed it back. We were directed to wait briefly.
So we waited.
Tracie got worse, and told me that I was going to have to stick her with the Epi-Pen because she wasn’t sure that she had the strength or coordination to do it herself. Drat that MS.
If you’re not familiar with them, an Epi-Pen is kind of like an oversized marking pen, but instead of ink it has over a gram of epinephrine, and instead of a fiber tip it has a spring-loaded needle. They’re carried by people with severe allergies and used only in the event of a severe reaction. They’re what you use to tide you over long enough to get to a hospital. To use one, you hold it with one hand and ram it against the side of your thigh, holding it for ten seconds while the needle goes right through your pants and injects you with something that’s more or less like adrenaline. Tracie has described this process to me on more than one occasion, but has never needed to use one during our 13 years together.
I’m not wild about needles on good days, but there wasn’t much else to do. She showed me where to aim, I read the directions twice, and verified the target with my own finger. She then mentioned, somewhat causually, that she might scream when I stuck her with the thing. I thought about the dozen other people in the waiting room, ranging in age from infant to elderly, considered that if she did scream, at least it would get some much-needed attention from the staff, and punched it against her thigh.
She didn’t scream.
She did kind of go rigid, though, and sort of reared up out of her wheelchair. I counted off ten seconds, pulled it back out again, and watched her, wondering what might happen next.
From my perspective, not much happened. Once past the initial shock, she actually might have calmed down a little because she at least knew that her allergic reaction was probably not going to run away with her and her life, at least not for the 20 or so minutes that the epinephrine was going to be effective. Perhaps for my amusement, she tried to explain that it felt somewhat like being filled with pure energy. She also mentioned that it does interesting things to her hearing, including pitch-shifting and spatialization effects. I made a mental note to name a preset “Epi-Pen” the next time Audio Damage builds a pitch-shifting or delay effect.
Apparently some part of these events did attract someone’s attention, because shortly thereafter a nice woman (another visitor, not a staff member) directed us to a chair at the end of the counter, where a staff member took her vital signs. Her pulse rate was impressive. Somehow they still didn’t really appreciate our sense of urgency, so Tracie dropped the used Epi-Pen on the counter. The staff member apparently read English well enough to understand what it was, because after reading a bit of the label her eyes got about as large as Tracie’s had when I stuck her with it.
The pace picked up a bit at that point.
We were ushered into the ER. They got Tracie onto a bed and started talking to her about what was going on. It became evident that the doctor’s English was somewhat limited. He did understand that we weren’t there just for the fun of it, but the stilted nature of the exchange of information led to some maddening circularities. Tracie’s situation was not a simple one, but it was frustrating to be asked to dwell on seemingly tangential points such as why she used the Epi-Pen or why she even had it in the first place. read more
