Pneumonia, Body and Mind

Two days ago, I was lying on a stretcher in a brightly lit and far-too-cool doctor’s office in Malaysia with an IV sticking into my right wrist. Antibiotics flowed from a bag above, down a long plastic tube, and into my veins. An old copy of National Geographic rested precariously in my one useable hand. I was reading an article about the claims various nations were making to territories in the South China Sea – the part of the world in which I happened to be located.

The article detailed the author’s travels through the area while he attempted to gauge the attitudes of those who will be affected by the conflicting claims on the region. At one point, he described his experience hitching a ride with a cargo ship and learning along the way of the risks of piracy in these waters. At that point, he stated something along these lines: ‘The romantic fabric of travelling sometimes does not stretch far enough to cover up the realities of what you are facing.’ I am paraphrasing, but that was the gist of his point. This point forced a deep sigh of understanding from my enfeebled lungs.

Tonight, I find those words resonating with me still. Soon, I will take four different kinds of pills, a sachet of dissolvable powder, and two teaspoons of cough syrup. After that, I will hook myself up to a machine that will pump medicine into my lungs. If I don’t, I may not be able to breath properly. Such is pneumonia.

A fever came suddenly three weeks ago. One minute I was running an errand and feeling a little sluggish, two hours later, I was in bed, hoping the sheets would not reach their flashpoint from the heat I was radiating. With the classic run-over-by-a-bus flu feeling, I lay in bed for a couple days, completely useless.

On about the third day, I woke to find myself in a puddle. No, it was not a nightmare that had forced me to regress and wet the bed. Instead, it was the fever breaking (or so I thought). Sweat had poured from every pore and left a darkened outline on the bed. The scene resembled a filled-in chalk outline of a corpse. After finding some replacement sheets, I went back to bed and soaked those as well.

The night’s perspirations brought optimism in the morning. ‘One more doctor’s office dodged,’ I thought since I felt well enough to actually step outside into the city. In comparison with the previous day, I felt like a marathon runner, but in reality, I was still quite under the weather. But optimism prevailed and I carried on as though delivering a clean bill of health to myself was a perfectly normal and medically-acceptable practice.

That’s when the cough started. First, a tickle. Then a wheeze or two. Then, a doubled-over, throat and lung spasm that left me whimpering after each attack. Oh yeah, and the fever and aches came back too.

When this worsened condition of mine persisted, I relented and went to the doctor. My determination that I could fix anything that was wrong with me had failed. My fears of doctors sticking sharp objects into me were pushed aside by my slightly greater fear that there was something genuinely wrong with me.

And indeed there was. My worried doctor pronounced right away that he thought I might have a minor case of pneumonia. Soon, those fears of mine of doctors sticking sharp things into me became true. My first experience with an IV had me grimacing the whole way thorough.

The clinic I visited was recommended to me by all the expats I had met so far here in Malaysia. Foreign patients are their specialty. This place has become my home away from hotel. The good doctors there have been slowly filling me with small puncture holes and with medicine. I have shown signs of improvement which gives rise to optimism, but still, I believe I have hit a temporary travel limit.

The mind’s connection with the body is obviously such that changes to your body affect changes to your mind. Do enough nasty things to your body and some of that abuse is likely to manifest itself in your thought patterns.

Where once an extended conversation with a charming cab driver about his indomitable passion for karaoke would have had me grinning the whole day, now that conversation is somewhat one-sided because I have to cough and wheeze my way through it. Where once the kids at the markets playing with their toys would have found a new playmate in me, I pass by because I’m on my way back to the hotel to sleep. Where once a sunset would captivate me and send me trotting off to find the best angle to photograph it, I can only watch from my hotel window because I don’t have the energy to haul my gear to a good vantage point.

This miserable attitude has no place in my luggage. I would much rather my spirit be lifted by all of the extraordinary experiences of travel, but when your body doesn’t enjoy the journey, your mind tends to follow along.

With that knowledge in mind, I am doing everything I can to heal this body of mine and with it, my attitude.

And soon, I will be heading home. After more than 13 months of being separated from my family and friends, we will be reunited. My head will rest on a familiar pillow and my lungs will breathe their native air. I have my fingers crossed that the air of my home will trigger a memory of health in my lungs and they will once again function normally. Barring that, I will rest.

I will rest knowing that all of this will soon just be another adventure tale to tell. I will sleep with the knowledge that as my body heals, so will my head. And after my convalescence is complete, I will wake up with itchy feet, wondering where I should go next.

You Are Lazy

At least, compared to Dean Karnazes, you are. He has run a marathon at the South Pole. He has run the equivalent of ten marathons back to back. That’s about 262 Miles. It took him 75 hours to do it.

My heart wants to explode just thinking about that.

Recovering from Convalescence

With my eye on the mend, my medication has dropped significantly and I am now returning to a normal level of physical activity. Not feeling exhausted every moment of the day has allowed me to once again enjoy basic activities like walking and breathing.

Really, I had been doing that for a while. Last Monday, however, it was time to get my butt moving a little. Blue skies beckoned and I decided to ride northward into the hills. With no idea where I was going or how long it would take me to get there, I was excited just to explore someplace new.

I criss-crossed roads on the Western side of Route 4 and eventually found myself scaling a hill that my now enfeebled legs and heart didn’t appreciate. But, only twice was I forced to dismount: once when the uphill rise was just too long to bear and again when the slope was too steep for me even on the best of days.

When I finally crested the hill, expansive farms and rice paddies greeted me on the other side. The wind whipped cotton clouds past the pastel blue sky and gave me more momentum than I needed to descend the rural road. My brakes threatened to start smoking, but never failed me.

I stopped for a few photos of the landscape and noticed a secluded hillside cemetery in the distance. This peaceful place was my next stop. There, I spent most of my time photographing the small Buddha statues placidly keeping watch over the graves.

Continuing on my uncharted path, I quickly departed my hard-fought high ground and again was skirting the base of the hill. The road home followed Route 4 up the hill once more, so my daily exercise only ended when I sped down the other side into Ichinoseki.

But Monday was only a warm-up for yesterday. The Japanese school year ends in March and re-starts in April. During that time, I am left to my own devices in the Board of Education offices. This has, in fact, been a boon – I’ve been able to work relentlessly on my new website. But, in an effort to get me out of the office and interacting with students during this month-long break from teaching, the office has suggested I go play basketball with the kids at Hagishou.

Considering how often I play with them when I teach at the school, it only makes sense that I should want to go and shoot some more hoops with them. They’re great kids and good little ball players. (I’m loathe to admit it, but there are actually a couple 15-year-olds there who are already better than me. One boy kept hitting threes and I pretty much had to give up on defending him – he just wouldn’t stop hitting them!) The only problem was that, in my weakened state, I like an octogenarian. I was panting like a husky in desert heat after only a few minutes of one on one.

Focus! Focus!

10:00 am

I’m fairly tired of being preoccupied with my eye. I would like to be able to move on and resume a normal life (insofar as that is possible for me here in Japan), but every time I look at something, I am reminded of my niggling concern.

In a way, becoming focused on this one worry has been beneficial. All my other cares fell by the wayside and healing myself became my one and only priority. The only real stress I’ve felt has been related to my health. Problems that once kept me awake at night have been swept off the table.

But now, as my eye begins to heal, I have to find some way of tidying up the messes without getting overwhelmed again. This ordeal has brought in a little perspective, so I hope that will sustain me for a while. I do feel a certain carpe diem drive that hasn’t been present for a couple months, so maybe I’ll be able to ignore the door when my troubles come knocking.

Of course, as soon as I write about getting better, I notice a new symptom. I’m now seeing small spots. Maybe one at a time will dance through my vision like a fly on potato salad. When I try to look at them, they dart off and can only be found in the periphery. Let’s hope that’s a symptom that doesn’t last long.

I Wear My Sunglasses…

I’m sure I must look like a bit of a curiosity right now. I’m melting in my chair from exhaustion and wearing sunglasses inside the teachers’ room at Hagishou Junior High. The teachers all now seem to know of my eye’s condition, but any student that sees me today is just going to think I’m hungover or something. If only there was an equal part of pleasure to go with this pain’

I have had my one and only class today and managed to stumble through it without too much trouble. If I didn’t have Prednisone coursing through my veins at present, I would be feeling chipper and playing basketball in gym class with the kids right now. That’s a bit more fun than chronicling this dreary disease afflicting me.

Metamorphosis of a Cyclops

I seem to have forgotten that I like writing. Actually, for the last few days, I’ve been a little preoccupied. I’ve had some health trouble. My left eye is now an inflated disk of blurry evil. So, I was also a little worried about looking at the bright, blank, white page that comes with each startup of Word.

But, it’s not so bright that I want to scream. And a little writing might keep me occupied until my next set of eye drops (which, considering I have to put them in every hour, won’t be long).

In truth, I expect I won’t be returning to this text anytime soon. These are not days upon which I will look fondly in the future. Monday may have been my worst day here in Japan and I spent a good portion of it in tears. I can only talk about this now because I believe the worst is over and the worst never got as bad as it could have.

It began on February 12th. After taking a trip out to Geibikei Gorge with Sarah to meet up with some slightly more Northern Iwateans, we ventured back to Sarah’s for dinner and a movie. While viewing the film, I grew fairly fatigued and when it was over I was ready for bed right away. I had also had a headache centered around my left eye. Nothing too spectacular, but enough for me to reach for a couple pills to dull the ache.

As I was leaving and turning to say goodbye to Sarah, I got a shot of pain in my eye as I turned from the dark exterior of her apartment to the brightly lit kitchen. She also noticed that I had a rather bloodshot left eye. I suspected it was just yet another symptom of my chronic fatigue of the last few months, so I went home to rest and, hopefully, take care of the problem.

The next morning, however, did not bring the relief I desired. Prying open my left eye revealed a world of fog. A photographic trick for achieving a certain kind of blur is to smudge some Vaseline onto a filter in front of the lens. That’s how the world appeared to me.

I hoped that the feeling would pass, but while I went through my morning rituals, the improvement was minimal. I called Sarah and she, in turn, called her friend Sayumi who happens to be a pharmacist. The Sayumi cavalry arrived with multiple eye drops in hand and a recommendation for an eye clinic on Monday.

Never having been a fan of inserting anything into my eye, the drops proved to be a bit of a challenge at first. I treated myself and hoped this was a one-day freak occurrence.

St. Valentine brought no love for my fuzzy vision. I woke and saw no improvement in my condition. I prepared to make my first visit to a Japanese health care-professional. I had hoped to avoid the experience, but that was not in the cards.

To try to break down the inevitable communication barrier, I first stopped at the Board of Education and got Aya to write down my symptoms so that I would be able to tell the doctor what was wrong with me.

I trudged over to the clinic, handed them the sheet of my problems and hoped this wouldn’t be too much of an ordeal.

They patiently dealt with me and my horrendous Japanese while administering basic eye check tests. Soon, I was in the doctor’s room where he did some more checks on the culprit eye. Routine checks with lights pointed into my eye were no problem, but then, I was asked to keep my head and chin pressed against a support. Slowly, some kind of instrument approached my reluctant eye and they told me to look down.

A gooey lens of some sort was being pressed up against my cornea. Not having a clue what was going on combined with my eye phobia and I became a little bit panicked. My eyelids kept pushing the instrument out from its intended target and I had to fall away from the test to relax.

They calmed me down and I eventually completed the test. I’ve later learned that it was a fairly routine way of checking the pressure in my eye, but considering the circumstances, I think my apprehension was completely understandable.

Aya was kind enough to write down her phone number on the sheet of symptoms and the clinic was quick to call her to try to relay information to me. They wanted to put drops in my eyes that would make it difficult for me to see, so they wanted someone to come to the clinic so that I would be able to safely return home. Thankfully, Aya was able to join me at the clinic and serve as a translator for the rest of my time there.

After administering eye drops a plenty, the doctor went in to inspect more eye issues. Eventually, he diagnosed me with Acute Anterior Uveitis (AAU). Of course, I didn’t really know what that meant, but he tried to explain what was going on. Essentially, my iris and parts of my eye near the iris had become inflamed. He said that it can happen when a patient suffers a trauma to the eye (which I hadn’t) or when the patient has recently battled an infection (again, I hadn’t).

So, the cause was a mystery, but his prescription was three drops I had to take four times a day. They were to take down the inflammation and things should get back to normal. I would see him in a few days and we would check my progress then,

Thursday rolls around and it feels as though my eye has improved. I go back to the clinic and he affirms my self-diagnosis. The iris was still inflamed, but not as badly as before. He showed me photos he had taken of my eye on each doctors visit and in the first photo, there was a streak of white cells in the cornea that were no longer present in the newer version. My vision was getting better, so I was pleased that things were going smoothly.

I continue along on the same course of medication and I am scheduled to return to the clinic in a week.

Up until Sunday, I believe I was progressing. My vision continued to improve ever so slightly, so I was content to continue on the same path. But then, Sunday rolls around and I open my eye a sheath of impenetrable murk. I could hardly make out any shapes at all. This was not good. This was scary. Why wasn’t this getting any better?

I start doing some more research on this affliction of mine and learn something startling. The AAU plaguing me is most likely caused by another condition from which I suffer: ankylosing spondylitis (AS). Now, AS affects my back and hip. I never thought it could somehow be related to an eye problem, but apparently, 30% of people who suffer from AS end up suffering AAU. In fact, many people are diagnosed with AS when they are first attacked by AAU.

I started looking up more information about AS and learned more about what causes it and the effects it can produce. I won’t go into a bunch of medical jargon that I don’t really understand anyway, but the easiest way to put it is that I got blessed with an unlucky gene that makes a naturally-occurring bacteria in my digestive system do nasty things to me.

One of the weird things about this particular bacteria is that it feeds off starch. So, one of the means of combating the symptoms of AS is to go on a no-starch diet (NSD). Often, this is preceded by a three-day cleanse diet during which the menu features nothing but apples. The apple thing seemed pretty extreme to me and the NSD is nigh impossible for a vegetarian living in Japan (not to mention my total incompetence in the kitchen).

But I was getting desperate. Instead of my favourite food, pizza, Sunday night’s dinner would be a salad-oriented affair.

The next morning, my vision had not improved, so I became even more desperate and decided I might give the apple diet a try. Two apples for breakfast later and I was off to city hall to get further translation work done by Aya. I wanted to be able to tell the doctor that I suffered from AS and perhaps this would help in guiding my treatment. Aya, however, was able to join me in my visit to the doctor and Michiko-san tagged along as the third member of team Darby.

After the initial tests, I went back into the doctor’s office and he began taking more photos of my eye. Well, I was no longer making progress. Just the opposite, actually. The inflammation had gone up and I was now hosting some disgusting looking white fluid at the base of my iris called hypopyon. I believe it is actually an accumulation of white blood cells that drifts down from the middle of my cornea. When he showed me the picture, I was shocked and terrified. ‘What is that? Please tell me what that is,’ was all I could stammer out and he couldn’t really explain it to me fully.

And the panic came back. I started to get really worried about the state of my eye and if I was going to be okay. Also, I detected a hint of desperation in his voice that didn’t exactly inspire confidence in me. I got the impression that things were not exactly going well here.

He wanted me to go to the hospital to get a complete physical to better determine what was going on. I started to get terribly worried and one glance at the disgusting photo of my eye up on his computer screen was enough to drive me to tears.

The doctor wrote down all of his findings and we were sent off to the hospital. After a series of maneuvers through the hospital’s bureaucracy that would have baffled me completely without Aya’s help, I was eventually admitted to the eye unit. There, the same tests repeated themselves and I was again administered some slow-acting eye drops.

Lunchtime was rolling around and my two-apple breakfast was hardly sustaining me. We went downstairs to the snack shop where we were accosted by a bizarre English speaker who thought I would really want to chat with him in the middle of my hospital visit. Since that wasn’t exactly the case, we diverted our course to the nearby convenience store where my search for apples to continue my cleansing diet was fruitless (sorry for the pun).

A few snacks later, we wandered back to the eye ward where I was promptly ushered to the doctor’s desk. Here’s where it gets a bit ugly.

After blazing what felt like concentrated sunlight into my eye, he started giving me the bad news. I was in danger of losing my eyesight. With an inflamed iris, fluid from behind the iris cannot escape to the front of the eye. Thus, pressure can build up inside the eye creating strain on the ocular nerve and eventually damaging it leading to glaucoma. A cataract was also a possibility.

Now, if the pressure got really bad, I would likely feel a sharp pain in my eye or a bad headache or severe nausea. If this occurred, I was to return to the hospital with all speed and I would be given emergency surgery that involved blowing a hole through my iris to relieve the pressure.

Not eager to face that prospect, he told me one of the steps that might be necessary to halt the inflammation and pressure before it got to such a critical stage: I would have to get an injection of steroids into my eye. Yes, into my eye. Not around it. In it.

This qualifies as, literally, one of my worst nightmares. Now, I’m an incredible coward when it comes to needles in the first place. I’ve passed out from blood tests and vaccinations and yes, during my tattoo session. It’s not a pain issue. I’ve felt pain far worse than any needle I’ve experienced and came out conscious. It’s psychological. I can’t really explain it, but I simply cannot relax properly when it comes to needles.

I already told you how awful I was when it came to eye problems, so just imagine how petrified I became at combining these two phobias. I asked if it was going to be possible to knock me out for such an endeavour and the answer was no. He told me that a local anesthetic would be dropped into my eye and then the injection would follow. I didn’t even understand how this could be possible. In all seriousness, I couldn’t see a way for me to allow this procedure to be done to me. I would freak out, perhaps punch someone and run screaming from the hospital bed. Huge doses of Valium or something were going to be required.

Needless to say, when informed of this horrendous prospect, I was back in tears. My fright got the best of me.

With my adrenaline still pumping like mad, he gave me orders to double my eye drop dosage and to take steroid pills. If the eye hadn’t improved in 24 hours, I was to have the injection.

I went home in terror and spent much of the afternoon in a panic. Calmed ever so slightly by friendly visitors and phone calls, I was able to get some sleep. Sarah was kind enough to remain at my house in case of emergency and as soon as I finish writing this, I’m going to have to burn a CD thank you gift for her.

I woke the next morning with the most minor improvement from the previous day and set out to arm myself with as much knowledge as possible. My research suggested that I was actually being under-medicated (possibly a first in Japan). I took it upon myself to up my dosage of steroid drops that morning.

A couple hours later, my vision seemed to have improved a little and I was feeling a bit more relaxed. While I was feeling more confident, that relaxation didn’t last long when I arrived at the doctor’s office in the afternoon. A few tests preceded my trip to his darkened desk where he peered into my afflicted eye once more.

No injection! I can’t express how relieved I was. The pressure was down. The inflammation was down. My pupil was wide open and the fluid from the back of my eye was properly draining. I actually raised my fists in triumph and yelled a celebratory Japanese ‘Sugoi!’ in the doctor’s office, which prompted giggling from the members of team Darby.

Things were looking better. He decided to keep me on the raised dosage of steroid drops and I also got him to give me a nighttime ointment for my eye that was recommended to me. Also, I was to keep up the steroid regimen. He said I would be able to go back to work as well. In my excitement, I said I would try to go to work the next day – I was feeling great at the time, so why not?

I felt great when I got home. I talked with Sarah who was now suffering from a bad headache, so I figured I would repay her previous night’s kindness by fetching something from the grocery store for her. I quickly experienced one of the side effects of the steroids: fatigue. By the time I had purchased the milk and shuffled to Sarah’s I was exhausted.

Today, my vision seems to still be improving by small degrees, but when I woke, I felt quite exhausted. I told the office I didn’t think I would be able to teach today. Aya responded that when I said I would be able to work the previous day, the schedule at the school had been changed to accommodate me and making all the changes was difficult for them, so could I please go and teach the classes?

I conceded and grumpily prepared to amble through the snow. Unfortunately, the previous night’s fatigue promptly invaded and the walk to school left me spent. Ready to collapse, I entered the teacher’s room at Yamanome elementary school and tried to prepare myself for a couple hours of teaching.

All the present teachers, however, saw my wretched state and quickly cancelled my visits to class. I was driven home with a bit of an ‘I told you so’ attitude being projected in the general direction of the Board of Education.

Tokyo Bound

Air Canada flight to Narita.

The fog of my sleeping pill is keeping me from particularly cohesive thought – pardon my scrambled brain. But, this proves it, I can’t sleep on planes. Maybe if I took the whole pill instead of half, but the fraction has always been enough when I needed to sleep at home. Perhaps desperate times call for the ever-so-desperate measure of a whole sleeping pill.

Obviously, I’ve managed to make it onto the plane and I’m off to Japan. I had a nice little freak out two nights ago when the soft bed at my uncle’s house prompted my back to violently lash out at me. At three in the morning when I could hardly move, I panicked. ‘What if my back just keeps getting worse? My health is deteriorating and I’m only bound to follow my Dad’s course of constant pain or medication. I’ve already shown symptoms of his ailments, but I’ve shown them at half his age.’

And the paranoia continued, ‘If I’m in this much pain now, it can only get worse. If it gets worse while I’m in Japan, not only will I be known as the gimpy gaijin, I’ll be pretty damn miserable.’

But back to the predominantly pain-free present. As I write this, conversations buzz through the plane’s cabin and the pursuit of sleep has been abandoned by all but the most stalwart snoozers. I did manage a one-hour nap, but that half of a little blue sleeping pill seems now to have exited my system. No more rest for me. I just hope I don’t pass out in a salad as has been related by some former JETs. Wait, maybe if I had a drink of wine, it would mix well with the sleeping pill and I could pass out for the rest of the flight.

I should mention the fantastic teamwork of my father, my uncle and I as we exacted revenge for an earlier seven-beats-all defeat at the hands of mother, aunt and cousin. It was such a formidable rout, it deserves and out-of-context journal entry.