Tuesday, March 7, 2017

Ankle Surgery (1st Week)

January 19th, 2017
Hanna Central Hospital
Nara Prefecture

I returned to Japan from Minnesota after a month vacation home during Christmas and New Years on January 16th late at night.

With surgery on January 19th, it was decided for me to be hospitalized January 18th.

Without even completely unpacking my bags from returning to Japan, packed another suitcase and headed to Hanna Hospital in Nara Prefecture on the bullet train.

Needless to say, I was very very anxious to have surgery. Without being able to run the last 2.5 years I had struggled more that I had in my entire life. It would have been easier to go through any drug addiction withdrawl than what I had been through. Despite whatever I searching I did, how much rehab I did, how much I rested, I was unable to run, had no idea what was wrong with my ankle and did not know whether or not I would ever be able to run again. My schooling, job, friends and everything I did was connected with running and after spraining my ankle and losing that, I completely lost myself.

Took an hour and a half bullet train ride to Shin-Osaka Station and transfered to Namba station, then to Ikoma.

As I walked from Ikoma station, I realized that this would be the last time walking regularly for a while and enjoyed the feeling.

Alll the searching for answers to my problem of not being able to run lead me to this point. Up until now I had been to:

U of M sports medicine doctor for MRI/Xrays
U of M rehabilitation for several months
10+ Orthology visits in Eden Praire
Several acupuncture treatments from Jake Pitty’s mom
Once arriving to Japan:
10+ visits to Dr. Fukuhara in Ujina MRI/CT/Xrays/ Ultrasounds
2nd Opinion Mazda Hospital Hiroshima
3rd Opinion Kanda Clinic Hiroshima
Consult with friend/ortho surgeon Akihiro Ariumi and his friend Dr. Okada

I had also spent countless hours online searching for answers to the problem and I remember numerous nights staying up past 2AM reading about ankle sprains only to become more stressed out from not finding any answers and feeling like there was no solution to my problem.

The doctor who I was getting surgery from is Dr. Tsukasa Kumai. After going back and forth whether I should get surgery in Hiroshima from Dr. Fukuhara or Dr. Kumai, I figured with Dr. Kumai's reputation of working with many professional and olympic athletes, it was the best choice, despite being far from Hiroshima. One of the other things that intrigued me about Dr. Kumai was he did Arthroscopic surgery too, so I if needed, could have that done by him too.

I was introduced by him by both Dr. Fukuhara in Ujina and also Dr. Okada (Ari's friend). Both of the ankle surgeons, unknowingly recommended the same guy so I thought he must be good. Here is a pic to match a face to his name.
He's much more nice in person haha
I arrived at Nara Hospital on January 18th and checked into my "room".
It was a shared 4-person room that included a tiny bed, and a small desk with a stool. The other "rooms" were separated by a thin curtain. The antiquated rooming in addition to the rundown hallways made me skeptical or what I had got myself into. Being aware that you only get one shot a surgery, was beginning to doubt the place I selected. Was this really where the super ankle doctor of Japan did surgery?!

I was scheduled to see Dr Kumai at 3pm and killed some time by walking around the town a little bit. Visited the nearby Workman and stopped in to see the staff memeber whom I met the last time I had came to Hanna Hopsital for the first time.

Once 3pm rolled around, met Dr. Kumai and Kevin again. They checked out my ankle and Dr. Kumai said that he no longer wanted to cut the bone but wanted to shortened the joint capsule and trim some muscle down. This made me feel very uncomfortable as the procedure seemed to be changed so quickly. My surgery was at 9AM the next morning and I felt sick to my stomach. I felt so discouraged and sadly even contemplated leaving the hospital and not getting surgery.

I was too discouraged to even call and tell my family/friends at first about my concerns and worries about getting surgery. So many people have been with me on this journey and with leaving everyone in high-spirits that this would be the end of me complaining, didn't feel it was right to bring them down with me again. Ended up calling Kayla and talked to her about how I felt. Grateful to always have her to talk to.

After having been through so much and not being able to stand any more searching for answers, decided that this needed to be the time to get surgery and whatever the outcome was, I had to deal with it. It was a sobering feeling sitting in the quad room by myself, family and friends 14+ hours across the world and nearly 3 hours from where I call home in Japan.

The room's lights went out at 9PM and I was sitting there wide awake as the two old men beside me and across from me were snoring loudly. My mind was racing and I couldn't do anything to control it. Tried to listen and podcasts to fall asleep but couldn’t rest/relax.

Was I going to be able to run again? Could I return to work alright after? What if it's worse than before surgery? Would it be possible to move on if I couldn't run? ect ect ect.

Somehow managing to get to sleep, woke up several times during the night and then groggily woke up to the lights being turned on at 6:00AM. Not long after waking up, changed into a medical gown and had an IV placed in my arm. Was getting more and more anxious.
With surgery being at 9AM was not able to eat breakfast. At about 7:30AM went to get numbed up for surgery by Dr Matsui. Received two shots of anesthetic just below my knee and only from the calf down would be numb. The doctor feed the needle into my calf and placed the anesthesia properly by using ultrasound imaging. Didn’t know they could do this and thought it was pretty cool.

After returning to my room in a wheelchair, found out the my surgery had changed to 12pm and was allowed to eat breakfast. Was not happy having to wait and just sat in my bed worrying about how the surgery would go. I didn't think once about if the surgery was going to be painful or not, but was only scared for the outcome of the surgery. At this point, I knew I could go through the pain to be able to run and just wish I knew for sure that going through surgery, I would be able to. Felt jealous for people who go through routine surgery generally knowing that they will have a positive outcome. The doctor was guessing about 50% chance of my ankle becoming better and being able to run again. Not the best odds but a risk I needed to take. Without running I felt like I had nothing.

Sat in my bed and couldn’t relax at all. Tried to listen to music and not think about anything but all I could focus on the surgery.

Was finally called to the surgery room and was wheelchaired from my room on the 3rd floor to the surgery room on the second floor. Things were all happening too quickly.

As we were waiting outside the surgery room I was so nervous that my hands were actually trembeling/shaking and I got super cold suddenly. This was probably the most anxious I had ever been in my whole life. All the searching for answers and worrying had led up to this point and was in the hands of Dr. Kumai and his team.

The surgery room’s stainless steel doors on either side opened up automatically. The outdated hospital rooms and worn down hallways had me a little scared leading up to this moment but entering the hightech surgery room was what I expected of a first class surgeon.

Was helped onto the surgery table and put on a little diaper thing. I wanted to watch the surgery but there was a sheet that blocked being able to see the upper half of the body to the bottom half.

Dr. Kumai and Kevin were both there as well as many other doctors and several people that seemed like students. All the doctors were dressed in blue and there was 2 nurses dressed in pink. The two nurses in pink looked like twins and I pointed at them and said “twins” and all the other doctors started laughing because they had thought so too.
Dr. Kumai had American music playing from the speakers on the left side of the hospital bed which helped calm me down a little but was also a little strange. Haha. One of Japan’s leading ankle surgeons and team was casually listening to American music during surgery made me giggle to myself. I wondered if he had decided to play American music for me but later found out that he always plays that kind of music during surgery.

Without being able to see anything or feel anything, I kept asking if the surgery began yet. I think after the third time I asked, they told me it had begun.

I was hooked up to a heart monitor, blood oxygen level measurer, and a heart rate monitor. My heart rate was hovering at about 65 bpm and it was fun trying to see how long could get it. With have the instantaneous biofeedback, felt like was able to bring it down while consciously trying to relax.

One of the nurses in pink was hovering around my head fiddling and adjusting some of the machines. I asked for her name and she said just “Okada”. Haha. Asked her to introduce herself in English and she looked into my eyes deeply, shook her head no with the surgical mask hiding her facial expression and walked away. I found out quickly that the surgery room was pretty serious.

I kept saying that I wanted to watch the surgery so one of the student-like doctors took pictures and videos with an ipad and would show me them. Even with looking at the pics and videos, couldn’t tell how things were going or if everything was alright. Didn’t want to interrupt their concentration so didn’t ask any questions and just kept praying to myself that they would be able to repair my ankle. They continued working away and I was listening to their serious toned communication with the American music playing in the background. I remember semi-singing one of the songs and one of the nurses laughing at me.

After about 45 minutes into the surgery, my right knee started to become sore from keeping it propped at a strange angle for so long. The nurse Okada got a towel and shoved it between my legs and made it much more comfortable.

It was awfully lonely being on the other side of the sheet that was dividing the upper half and lower half of the body. I wanted to know what was going on down there!

Was I going to be able to run again!? Is everything okay?!

After about an hour and a half things seemed to be wrapping up and some of the doctors began walking around the room a bit. Before I knew it my ankle was already casted up and I had no idea they had even began to cast it.

One of the doctors came up to me and padded me on the shoulder twice saying “naoreru” meaning “able to be fixed”. Hearing him saying this, I started to tear up. All the emotion that was built up and the worry/anticipation/fear leading to this surgery and one of the surgeons saying my ankle would be alright were some of the best words I’ve ever heard. Even started tearing up writing this again.

Kevin came up and described some of the surgery to me. He could tell I wanted to know more and more information about the surgery and I’m very grateful for his genuine concern. Almost broke down crying while talking to him too and I think he could tell how happy I was.
The divider sheet was still separating being able to see the bottom half of my body and I noticed all the doctors gathering around my ankle looking, pointing and seeming quite concerned. What in the world was going on that they were all worked up about?! My concern got the best of me and I sat up and leaned over the sheet to see them all looking at a take-out food menu and were picking out things for their lunch. They all laughed to see my reaction to this scene and asked if I wanted anything to eat. I told Dr. Kumai that I want to have lunch with him someday.

Was helped off the surgery table and brought back to my room.

Until this point, the only pain medicine I had was the anesthetic to the knee and they told me I could take the pills whenever I wanted to. Decided to try and wait until the pain came to take the medicine.

Ate a late lunch back in the room and hung out the rest of the day with the ankle propped up.

Managed to get to sleep after some time with no major difficulties and the ankle was just a bit painful.

Woke up at 2AM and was surprised how painful the ankle was. Pressed the nurse call button and they brought a single little painpill and said that it would take about an hour and a half to kick in. Took the pill and knew there was no chance of getting back to bed anytime soon.

Wheel-chaired out to the nurse station and talked to the two overnight nurses Maekawa-san and Sharyo-san for about an hour before returning to bed. With them helping me relax the first night, had an affinity for the rest of the time at the hospital.

Woke up the next morning and the ankle was still pretty painful. They gave another small pill and I told the guy next to me Nakaichi-san that it was pretty painful. He told me the next step of painkiller is “zayaku” which is a pill they shove in your butt. I guess they do this so that your digestion system does not get messed up from the pain drugs. Despite being in pain, was not in enough pain to have the cute nurse on duty Yoshinaga-san put something in my butt. Haha. It became a joke between Nakaichi-san and I to try the “zayaku” but I never did.

The first day after surgery I was limited to moving around by wheelchair only and anytime I wanted something, I was supposed to push the nurse call button. I was caught hoping over to my shelf without hitting the nurse call button and one of the older nurses wrote a sign that said “Do not stand up! Press nurse call button!” in English and taped it to my wall. Haha Felt like lost all autonomy but realized it was temporary and kept hitting the nurse call button to go to the bathroom, buy coffee, brush teeth, ect.

The daily schedule would go like this:

6AM-Lights on
Would be handed a hot towel not long after this
7:30AM Breakfast
9AM stretch in rehab room
Sometimes morning rehab
12PM Lunch
Sometimes afternoon rehab
5:30PM Dinner
7PM English conversation
9PM Lights out

Would of the biggest things I looked forward to was meal time. There was so much time sitting around and waiting that alot of the time was spent thinking about food.
The meals at the hospital were better than I expected. Lunch and dinner were always well balanced and consisted of rice, veggies and other nutritious foods.
Breakfast, lacked calories and nutrition. Hah
The second day was able to graduate from using just a wheel chair to being able to use crutches. This made things much more enjoyable and I could at least get around where I wanted to, when I wanted to. It became an exciting thing for me to just crutch down the hall to buy a can of coffee from the vending machine.

I had so much free time that decided to see if anyone wanted to do English conversation. With everyone studying mandatory English here in school, thought would be fun to see if people wanted to actually speak it. I put up a sign in the hallway outside of the room and the nurse took it down and said we couldn’t hang things up in the hallway.
Taped it to my desk and pushed my desk right to the edge of the door so that everyone walking by could see it. Most people would stop while walking by and laugh. One of the girls in the room next to me named Masami became the first student. The first time she came we just did self-introductions and decided on meeting the next day at 7pm in the conversation room. After that, more and more people kept coming and even some of the rehab therapist came on night. It was fun to have something to prepare for each night. Kind of did the same format conversation class as at the Carp office.
Thanks to starting the English class was able to become friends with many of the other patients on the floor. Just having the class made people of different ages and backgrounds be able to get together and enjoy speaking English together. It’s funny how rigid Japanese seem to be in their conversation regarding the status of the people they are talking to and how that seems to disappear when they speak English.
The third day I was able to go outside of the hospital on crutches which was very nice. Just stepping outside and breathing the fresh air felt like getting released from prison. Haha. It was nice to go to the convenience store down the street down the street named Circle K.

Was losing weight and started to feel fatigued a few days into the hospital stay. It was a combination of late nights with interrupted sleep, early mornings, not being able to nap well at the hospital, as well as lingering jet lag. Started buying baked sweet potatoes at Circle K Yes, the convenient store sold baked sweet potatoes! USA please copy!
One thing that was entertaining to me was watching the nurses help the old man across from me who was about 85 years old eating and doing other things. His name was Takagi-san and couldn’t do much on his own. His wife would always bring some treats for me and ask if I was lonely. How sweet.

The guy next to me and I talked quite a bit and started to prop the curtain in between us open so their was not as much of a division. He would rant about politics, life’s lessons and just about anything. hah
Nakaichi leaving the hospital

Everyday I looked forward to getting the wounded part of the cast opened up and having the wound cleaned. It always felt so good to have the cool cotton balls wipe the inflamed cut. Dr Horiuchi was my favorite doctor to do this.
I also looked forward to doing rehab. My rehab leader was Yusuke Kobayashi and others that assisted me that first week were Higashi, Tomemori, Oku, Chiba and some others prob. After a couple days after surgery they would open up the cast and lightly massage around the cut area. Boy that felt good. It was also nice to do the toe stretches and core exercises.
My friend Tommy came and visited a few times and it was nice to see a friendly face and have the suprise of a friend coming. We walked to the other section of the hospital and chit chatted.
Spending too much time standing or not having the ankle propped always lead to more pain and the ankle throbbing. It was always best to have the ankle propped up. I made the decision to go to the sports club too quickly in addition to spending too much time standing up and the ankle hurt more the next day. Decided needed to take it a little more easy and just give in to needing to relax and let the ankle recover from the surgery.

Only took two showers the whole week that was at the hospital. Was a burden to tape up the cast with a bag and crutch around and hop into the shower. The shower at the hospital was comically small and had two small steps just to get up into it. Reminded me more of a budget hotel shower rather than an orthopedic inpatient hospital. Should have taken a picture. Hah. Took the other shower at the sports club which was much more spacious.

Morimoto-Sensei, his wife and daughter Fumiko were in town in Osaka and were able to stop by the hospital and visit. It was very nice seeing friendly faces from Kurahashi and we sat and chit chatted inside the conversation room.
They gave some oranges from Kurahashi and I ate them with the mindset that they would help heal my ankle.
Towards the end of the week, started talking with the 4th member of the room, Yuuya Izumi who was a rugby player for the Osaka Police team. His wife and 3 kids would often visit and it always cheered me up to see them.

Studied quite a bit of Japanese each day at the hospital and was learning alot of hospital terms. Each day wrote a simple diary in Japanese to recap what I did during the day. Will post that at the end of this diary too.

The week went by surprisingly fast and after adjusting to the daily routine. The last day had the stitches taken out by Horiuchi-Sensei and it felt good to have them out.
It was actually sad packing up and leaving but was already excited to be coming back in two weeks for rehab. Some of the English conversation people walked me down to the lobby as I left the hospital. Too cute.
Taxi’d to the station and road the first subway to transfer to another. While riding the subway, wasn’t able to prop up the ankle and all and realized it was pretty stupid to have left the hospital after just a week to take public transportation back to Hiroshima. Sat with my foot down for about 30 loong minutes hoping for it to go by quicker and praying my ankle wasn’t having any damage from sitting through this pain.

Finally made it to Shin-Osaka station and decided to buy a “Green Class” First class ticket back to Hiroshima. It was my first time riding the first class on the bullet train but the leg room was actually more narrow than the regular class seats because of some legrest thing that hung down. Thankfully I requested the first row seat and could prop the ankle up the whole ride home.
WIth a final taxi ride back to the dorm, made it to my bed and could prop my leg up. Ahh it felt nice to be back in my own bed.
Japanese Diary Entries from each day at the hospital:

1月19日(木) 手術の日











1月20日 (金)









1月21日 (土)





4時半に小林さん病院に併設されているスポーツセンターに見学へ行った。小林さんがまた英語勉強したと言い自らヘルスケアトレーナー に名乗り出た。



1月22日 (日)






1月23日 (月)













1月24日 (火)











1月25日 (水)











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