石垣島

After work, I headed to Naha airport to visit Ishigaki island. I was going to take a trip with my parent. We stayed at a five star hotel :https://kariyushi-ishigaki.jp/. We treated ourselves. The room is very large and comfortable. We can see the sea from the room. The breakfast is buffet style. They have many kinds of local meals of Okinawa, such as ジーマミー豆腐、さーたーアンダーぎ―、ミミガー. Every dish was so delicious.

 We rented a car to go around the city. We ate dinner at marusa: https://tabelog.com/okinawa/A4705/A470501/47001646/. We ordered 海ブドウ、ジーマミー豆腐、sashimi,and Ishigaki beef.　ジーマミー豆腐 is deep fried, which is like rice cake and taste good. The fish in ishigaki is lightly seasoned perhaps because the water from the sea is warm;they don’t need to be fat.  After eating dinner, we went to the dam to see the stars, but it was a full moon. The light of the moon was too strong to see stars. The light of moon made a shadow of us. I had never seen a shadow by the moon. I only ever seen shadows made by the sun, not the moon.Though the light of the moon was strong, I could see a shooting star.

08/06/2017

The patient is 89 years old, who have cerebral hemorrhage. The hemorrhage expanded from left Thalamus to Putamen, which caused intracerebral hemorrhage.

According to CT scan, the brain has already mid-line shift.  She has right hemiplegia and has difficulty to communicate due to the brain damage. She also has involuntary movement on her right side of her body, which is probably caused by midline shift.

She has a nasogastric tube for taking nutrition.

The hemorrhage is so huge that it is difficult to recover her consciousness and higher brain function. Her family choose DNAR.

Btw, She has high body temperature(around 38) when she come to this hospital. There is no certain source of infection and inflammatory reaction in L/D. Therefore, we consider this fever as central one due to cerebral hemorrhage.

We need to care about infection because she has some devices such as nasogastric tube and urethral balloons.

I played tennis. 07/06/2017

Every Wednesday, some medical stuff enjoy to play tennis at 那覇運動公園.

I was invited to this event. I didn’t have a racket,but the attending lent it to me.

Actually, I am in playing tennis right now, so I really enjoyed it.

I learned how to serve from him.

We played it for two hours. The temperature was so high, and it is so humid that we were sweating so much.

You can enjoy tennis every Wednesday if you want!

Btw, there is a swimming pool at 那覇運動公園. I haven’t swum for more than 1 week. If I had enough time, I might go swimming.

LOW BLOOD SUGAR 06/06/2017

What do you think from the title?

…Yeah. You are right! Ordinary, we predict one elderly person has hypoglycemia because of the drug(SU,insuline) or something. However, this expectation is not right this time.

So, who has low blood sugar? 

The answer is ,,, me…

In the afternoon:around 16 o’clock, I felt the feeling I had experienced 3 years ago. I had felt that kind of sense after the training of swimming. I began to feel rapid heartbeat, sudden mood changes ,unexplained fatigue and sweating. Yeah, that’s right. These are the symptoms of hypoglycemia.  I asked my attending to give me a break because I cannot stop sweating. Some gentle nurse and PT give me some snacks（ちんすこう等）for relieving hypoglycemia. Thanks to their help, cold sweating and unexplained fatigue were quickly disappeared. I checked the level of blood sugar by the simple kit; it tells that my blood sugar is 90. I should have looked up when I had felt the sense of hypoglycemia; It must be 70 or so.

Btw, what causes this low blood sugar? I am not sure,but it is perhaps because I didn’t eat breakfast very much though I ate lunch as usual. I again realized how important breakfast is.

My first day of the training of community medicine. 05/06/2017

Today is my first day of the training of community medicine.

Basically, we work with two attendings.

What is remarkable about this hospital are the age of patient(most of them are more than 80 years old) and the kindness of paramedical.

I have two patients today.

The first patient is 84 years old female, who had a right femoral neck fracture.

She said she was blew away in the strong wind when she was wanting for the bus.

The wind of Okinawa might blow not a leaf but a person away.

She had a pain but it was tolerable, but it was gradually getting worse. She went to the hospital near her house. She was diagnosed as right femoral neck fracture.

She got a Bipolar Hip Arthroplasty(Direct anterior approach) at the other hospital.

She come to this hospital for rehabilitation.

Her D-dimer was 12.1. We ordered the leg vein echo to check DVT( the echo found out that she has thrombosis at flounder vein.). She started to take Edoxaban.

The next patient is 86 years old female, who had cerebral infarction.

She lived with her family. Her daughter realized her mom ‘s way to talk is different from as always. She was taken to the ER and diagnosed as cerebral infarction.

According to the letter of reference, it says she had watershed infarction caused by dehydration.

That letter also said it was multiple infarction. It was considered as A to A infarction.

Dehydration was corrected, and Anti-platelet therapy was started. After taking antiplatelet (Aspirin)drug, she had melena and nosebleed, so it was stopped. However, she also has past history of angina, so taking Plavix or Pletal instead of Aspirin may be considered.

→Some days later, the doctor who treated previously sent the image of MRI. That MRI says she has not watershed infarction but infarction at both cerebral cortex. These are the multiple infarction. There are at both side not one side, which means it could be caused by Paf. There are no sign of Af at EKG. We ordered echocardiogram to check her cardiac function.

She also has difficulty in hearing, which doesn’t have relationship with cerebral infarction. She said deafness was proceeding after she was exposed to the sound of raid. That is thought to be noise-induced hearing loss. The loss of hearing is proceeding recently perhaps because of elderly deafness.

She came to this hospital for rehabilitation, too.

What a stinky room it is! 04/06/2017

Hello there! How are you?
It’s my turn. I will write about my daily life in Okinawa from now.
I will try to write it in English, so I would be happy if you made a massage in English.

First of all , I will tell you how to get to the place we stay.
After you arrive at Naha airport, you should take a bus bound for Nago.
Then, you should get off the bus at Kishaba喜捨場. I think you may surprise at the place because that station is located at the middle of the highway. I thought I got off at the wrong station at first.
After that, you can go to the place(I refrain from saying the certain name) on foot or by a taxi. It will take 30 minutes to get there on foot, so I recommend you to go there by a taxi. However, it is difficult to get a taxi in the middle of street because here is rural area. TT advise me to call a taxi, but I am a lucky man!  When I tried to call a taxi, the one came in front of me suddenly! Thanks to the miracle event, I arrived at the place safely and quickly. In the taxi, I was relieved probably because I am too familiar with the taxi of foreign countries. As you know, taxi of foreign countries sometimes dirty, dangerous, and inaccurate.
You will stay at the five floor of the building. On the weekend, security guard will guide you.

Finally, I reached the room we stay. Mmm,,,, what is this smell…
It is soooo stinky!!! I heard of it from Sh@mp@i,but that smell is much more stinky than I had expected…　If you are lady, I think it could be a good choice to stay at monthly hotel or something.
It is too stinky to get rid of the smell by air freshener.lol
I will tell you how to use air freshener effectively. The point is to spray it on the wall!
I also check the air conditioner. As I expected, there is mold growing….
I washed it and decided to buy a spray for air conditioner.
After the fight with dirtiness, I drove to ライカムイオンモール, which is huge shopping mall. Local people say that ライカム is deprived from  Ryukyu Command headquarters:Rycom.
In that place, I bought some groceries and everyday items including deodorizer “消臭力“, of course. 
I ate dinner there, “麦とろハラミ＋島そば”. They have a campaign, so I got the bottom less drink-bar and the dessert for free. I am a lucky man!

This is my first day, see you soon.

黒島〜ハートと牛の島〜

本日は朝から雨。特に決まった予定もなかったので、雨が止むまで民宿でゆっくりと過ごすことに。

11時を過ぎると雨も止み、晴れ間が見えて来ました。民宿“内盛荘”を後にし、フェリーで石垣島に戻ります。昨日のゆんたくでのアドバイス通り、そのまま黒島行きのフェリーに乗船。30分ほどで黒島に到着しました。黒島は人より牛の方が多いという放牧が盛んな島で、その形からハートの島とも呼ばれています。

自転車をレンタルし、“パーラーあーちゃん”で昼食。閉店間際で、そばぐらいしか作れないよとの事で牛そばを注文。美味しいかったですが、いわゆる沖縄そばの味。やはり個性に乏しい印象。まあ毎日食べている自分が悪いのですが。

その後は島をぐるっと一周。黒島はこれまでの二島と比べて観光客が少なく、牧草地を1人で駆け抜ける爽快感がたまらなかったです。まさに離島に来ているんだと実感させられました。途中、伊古桟橋に寄りましたが、ここからの景色は本当に素晴らしく、思わず声を上げてしまいました。西表島、小浜島、竹富島、石垣島が一斉に視界に飛び込んで来て、桟橋、空、海と共に目の前に広がる景色はまさに今回の旅のハイライトでした。

その後は“黒島研究所”で地元の生物を鑑賞。ウミガメが沢山いて意外と面白かったです。

18:10発の最終便で石垣島へ。夕食は“海人居酒屋 なつや”で。串焼きと海鮮料理が美味しいお店で、カウンター有りのこじんまりとした雰囲気。料理、お酒共に美味しく素敵なお店でした。

明日は午前中の便で那覇に戻るため離島めぐりはこれにて終了。大満足な4日間でした。