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Dr. Nishiyama's Q&As

 

1. I would like to get tested for standard Sexually Transmitted Diseases (STDs) other than HIV. Where can I receive such tests in Japan?
Rainbow No. : No. 323 (January/February 13)

The cause of STDs vary widely from viruses to insects, and their manifestations varies from local lesions to systemic symptoms and signs according to the style of sexual contact such as anal, oral, etc. Having multiple sexual partners increases one’s chance of becoming infected. Furthermore, a patient may have multiple STDs at the same time. Complications from STDs include infertility, mental deterioration, or even death. Yet, infected individuals are often unaware of their infection. For example, symptomatically, gonorrhea predominantly affects males, whereas Chlamydia mainly causes acute abdominal symptoms in females.

On the internet, there are many free sites in various languages where you can make a self-diagnosis by answering various questions. Diagnostic kits for each disease can also be purchased on the internet for 5,000 to 10,000 yen. The results are sent back to subscribers anonymously. These are a convenient way for those who want to know about their STD infection confidentially. However, any necessary treatment poses another expense. Examinations done too soon after the chance of infection may give a false negative result.

Some Health Offices, but not all, conduct free tests for STDs. Even in this case, all possible STDs cannot always be examined.

In conclusion, the best way to be diagnosed and treated for STDs is to visit a hospital or specialized clinic; a urologist for males and a gynecologist for females. By using your medical insurance, the total charges will be smaller than the self-made diagnosis and treatment stated above. Don’t be shy! A frank consultation leads to early and proper diagnosis and treatment at a relatively small cost.

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2. I think I've caught a cold. I don't have time to go to a hospital. Is it all right to use medicines sold at a pharmacy?
Rainbow No. : No. 322 (November/December 12)

It is safe to use cold remedies, which you can buy without a prescription from a physician. We call these OTC (over-the-counter) medicines. Proper use of these medicines is recommended for reducing medical expenses or for avoiding long wait times at the hospital. Most OTC medicines have the same ingredients as those for hospital use. For safety purposes, however, the dosage of the effective substance is reduced in these tablets, and sometimes you may have to take as many as nine tablets daily. Antibiotics or steroids, let alone other powerful medicines, cannot usually be obtained without prescription. Most OTC medicines are palatable, and effective ingredients are subtly combined in a tablet or capsule. Each medicine from the hospital contains a single substance, so you have to take several kinds to cure only a common cold. Eye drops sold at pharmacies will make your eyes cool and comfortable.

We sometimes hear the phrase "go to a hospital just for a cold?" A cold can appear as the first sign of any manners of illnesses. Do not underestimate a cold. However, you should be all right at home for the first few days using pain-killers or cough remedies, unless you have any other serious symptoms or signs. Even if you hurry to a hospital, various examinations may provide no significant findings. For example, pneumonia is usually evident after three days of continuous high fever. At that point, it is not too late to start the appropriate treatment for pneumonia.

Influenza, on the other hand, is recognizable a little earlier. The ideal time to test for influenza is roughly 36 hours after the onset of a high fever. The test will give you negative results at too early or too late a stage. Specific anti-influenza medicines are effective and allow for quick recovery. Remember these facts during the high season for influenza.

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3. I have itchy eyes. Should I try the eye drops sold at regular pharmacies?
Rainbow No. : No. 321 (September/October 12)

First, do not rub your eyes vigorously. If you feel itchy but have no further symptoms or signs, you can buy less expensive, mild eye-drops at a pharmacy without the prescription of a physician.

The drops will cool your eyes and mitigate the itchiness. There is a wide selection of eye-drops that run the price gamut. For first aide use, the plain ones with anti-allergic substance are preferable to those for special purposes. Eye-drops for hospital-use contain specific effective substances, yet will not make you instantly comfortable. Furthermore, such strong substances may cause secondary or more serious problems and should only be used under the control of a physician.

If you wear contact lenses, remove them immediately and wear glasses instead. Regardless of whether your contact lenses are responsible for your eye problems or not, your eyes are incessantly combating against the lenses as foreign bodies. Excessive reaction in the eye induced by a minor problem, in turn, sometimes causes opacity of the cornea, a clear membrane at the surface of pupil, which can cause eventual blindness.

If the medicine has little effect after one or two days, and/or if you have further problems such as pain, red eyes or discharge of mucus from the eyes, you need to consult an ophthalmologist.

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4. I feel like I’m suffering food-poisoning. How can I treat it?
Rainbow No. : No. 320 (July/August 12)

Should I go to a hospital? Food-poisoning can be explained by the manifestation of bacterial or viral infection. Viruses may cause severe diarrhea and vomiting. If you can take in sufficient fluids, the disease should subside in a few days. If you suffer a longer course of diarrhea and/or vomiting, and cannot eat or drink, you must visit a physician and have a drip infusion of an electrolyte solution to prevent dehydration. At the same time, you must have your body examined for another cause or secondary disease.
There are also many cases of foodborn bacterial infections. Salmonella, vibrios, campylobacter, eschelichia coli (E.coli) can cause severe gastroenteritis.
Fever or bloody stools are ominous signs. Trial use of antibiotics or binding medicine should be avoided, as those modify and complicate the clinical course, and eventually delay proper treatment.
The best way to prevent food poisoning is to avoid improperly cooked meat or fish. Always keep in mind that any foods or cooking materials or kitchen tools have already been contaminated with certain pathogens. Careful washing, heat treatment, or if possible, disinfection of materials by chlorinated agents are helpful for the prevention of food poisoning. Be careful! Your beloved pets may sometimes become the source of pathogens, which can lurk in their excretions.

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5. When the site of an insect bite becomes reddish, warm and swollen, what should I do?
Rainbow No. : No. 320 (July/August 12)

If the bite feels itchy, that is a typical allergic reaction. A lotion containing an anti-allergic agent and menthol can mitigate the symptoms. If the swelling is progressive, that means there is a concomitant bacterial infection. You can buy an ointment with both steroid and antibiotics at a pharmacy in town.
If further aggravation occurs, visit a dermatologist. In Japan, especially in a mountain areas, there lives the buyo, which looks a small hybrid of a mosquito and a bee. Their bites cause more severe skin lesions, which are resistant to treatment, and sometimes leave a scar. Treatment itself is the same with the above. To prevent their bites, wear a shirt with long sleeves, and apply antiinsect spray on unprotected skin.

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6. What should I do when I visit the doctor in Japan?
Rainbow No. : No. 319 (May/June 12)

Anybody may feel uneasy about getting sick in a foreign country, wondering whether he or she should visit a hospital or just stay at home. Don’t be worried. There are many hospitals and clinics all over Japan. Most of them do not require an advanced appointment. Doctors and nurses will be glad to be at your service. Medical standards and charges are almost always the same at whichever clinic you may visit, thanks to strict governmental regulations.
Here are some practical tips for visiting a Japanese clinic or hospital:

  1. The FCIF website's Hospital Guide provides a link to the Fukuoka Medical Information Guide, which allows you to search medical acilities by language, medical specialty and location. You can also make use of the site's convenient medical application form, as well as a glossary of medical terms and a hospital conversation guide.
    http://www.rainbowfia.or.jp/hospital/
  2. Take your medical insurance card, if you have one. Medical charges can be quite expensive without insurance.
  3. On your first visit to a hospital or clinic, you can expect to be charged 5,000 yen or more.
  4. You may feel reassured at the hospital if you are accompanied by a Japanese friend.

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7. I want to consult a doctor, but where can I go that I can inquire comfortably?
Rainbow No. : No. 319 (May/June 12)

If you want, I offer free medical consultation in a casual atmosphere.
I am available every Wednesday evening from 5:00pm to 7:00pm at Fukuoka City International Center in the IMS building. Although I will not provide practical treatment or prescribe medication, as an English-speaking physician, I can give you suggestions as to which hospital to go to or which doctor to see, by writing a letter of referral that matches your specific problems.
Also, I can give you advice for a variety of health problems. Some minor cases can be treated by non-prescription medication from a local pharmacy.
Please feel free to visit Fukuoka City International Center.

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