Monthly Archives: November 2015

Becoming Superman, Part 1

I moved to Japan to live in Nagano in October 2000 and at first my only transportation was a bicycle I bought shortly after arriving. However, in the spring of 2002 one of my students graduated from university and got a job in Tokyo, and so was looking to sell his scooter that he had used when he was a student. I asked him why he wasn’t going to take it with him to Tokyo and he said it was too expensive and the scooter wasn’t worth that much money. He asked if I was interested in buying it, and when I asked him how much he was selling it for, he said, 20,000 yen, which I thought was quite reasonable and so I ended up buying it.

We went to the motorcycle shop he had bought it from to change the ownership registration to my name, and then I started driving it around Nagano. Before long, I was using the scooter to drive back and forth to my classes, although eventually December came and I realized that snow was going to be an issue as far as transportation with the scooter was concerned.

Not wanting to spend the money to buy a car, I started asking around about what my different options were, as by now the scooter was an important part of my ability to get back and forth to work. Someone eventually suggested I change the tires to snow tires. I asked if there really were such things for scooters and was assured that yes, indeed there were.

So I went back to the motorcycle shop that had changed the title for me and asked if they had snow tires for scooters there. The man working there was really advanced in years and replied that yes, yes they did have snow tires. I asked if I could buy them that same day or not, and he said that yes I could, and so I asked how much they were and when I should come back. He said it would take 90 minutes to change the tires on my scooter.

I spent the next 90 minutes walking around downtown Nagano, up to Zenkoji Temple and back again, and then stopped in at the shop. My scooter was up on their service stand with back tire off. The old guy working there says, “Come back later! Come back later!” I ask how long should I wait, and he says 90 minutes.

By now it’s lunch time, so I head somewhere for lunch then kill another hour or so wandering around. When I get back into the shop, this time the back tire is on but the front tire is off, and he says, “Come back later! Come back later!” I ask how long again and this time he says an hour. And so I kill another hour of time.

After this last hour, when I get back into the shop the guy is furiously tightening the bolt on the front tire and says, “I’m almost done! Please wait.” Once he finishes, we settle the bill and then I get my scooter to drive back home.

All of my walking has made me hungry, and so I decide to stop on the way home for a small snack. After I finish, when I get back on my scooter I think the handling is a little strange, but figure I just bought the snow tires, and so perhaps the handling is a bit different with the snow tires on it.

I start on my way home, and as I’m approaching a crosswalk I see a lady waiting to cross the street. I make it a point to stop for people in crosswalks, so I hit my brake, and the front end of my scooter collapses out from under me and I go over the handlebars, striking a Superman pose for a brief moment before hitting the pavement.

The question I ask my students at this point in the story is what happened that caused the front end of my scooter to collapse and me to become a very short-lived Superman? Please feel free to share your thoughts in the comments. Want to know what happened? Part 2 of the story is here.

My Asthma Story Part 3: Moving to Toyama

The Tateyama Mountain Range from Shiratori Castle, Kureha Mountain

If you haven’t yet read part 1 and part 2 of this story, I would recommend you start there.

There didn’t used to be a part 3 to this story, but when I took my current position at the University of Toyama, I had to change doctors, from my pulmonologist in Nagano to a pulmonologist in Toyama. I asked my Nagano doctor to write a referral letter for me and presented it at the University of Toyama Hospital, and was soon assigned a pulmonologist who took over the management of my asthma medicine. After seeing him a few times, he said that my recommendation letter mentioned high cholesterol, but that his speciality is pulmonology, and so rather than try to manage my cholesterol, he wanted to refer me to a lipid specialist.

I reluctantly agreed, and the lipid specialist first wanted to do another blood test to check my cholesterol levels. I went in and had the test done, and when I met the lipid specialist, he said that yes, my cholesterol levels were high, which made feel rather upset, but then he asked if I had eaten breakfast the morning that I had my blood test done. I replied that of course I had eaten breakfast. I eat breakfast every day. It’s supposed to be healthy. He said that the cholesterol levels should be a person’s fasting cholesterol, not their cholesterol after they’ve eaten, and so he asked me to have the blood check done again.

At our next appointment, he checked my fasting cholesterol levels and said they were borderline high, but not so high that I would need to take medicine, and recommended that I keep trying to eat healthy and exercise.

So in the end, after I finally saw a lipid specialist, the final verdict was that my cholesterol wasn’t that high after all. The problem was instead that no one had told me I shouldn’t eat breakfast on the day my cholesterol levels are checked until I finally met the lipid specialist.

I wonder what the message of this story is? That specialists should stay within their field of speciality when treating patients, as my pulmonologist in Nagano never mentioned seeing another doctor about my cholesterol, while my pulmonologist in Toyama said it wasn’t his speciality and so he didn’t want to try to treat it? That very simple miscommunications, such as the directions to not eat breakfast in the morning can have a huge influence on test results? I think that certainly doctors and pharmacists should explain the potential side effects of the drugs they prescribe and dispense, especially considering my experience.

Overall, I’m glad my first pulmonologist in Nagano pushed me to do exercise. Cycling has been an overall boon to my health, although I certainly could have done without the episode of drug side effects that I experienced. My guess is that my cholesterol really was very high around the time that he first checked it, but I ate breakfast every time he checked my cholesterol, so I’ll never really know what the numbers should have been.

If you’re interested in the topic of the treatment of high cholesterol, the US recently overhauled their guidelines. There’s a really engaging explanation of the new guidelines and their implications for treatment on the UCTV website presented by Dr. Robert Baron, UCSF Professor of Medicine.