医療保護入院
The patient is a 96 years old male. His wife passed away 5 years ago.After that, his son’s family began to help with his everyday life. 2-3 years ago, he started talking to himself. He would suddenly say “ Tanme, Tanme, Tanme”, which means his grandfather, according to his son. The son says he liked his grandfather better than his parents.
At around the same time, he gradually began to forget how to do the everyday thingｓ. He sometimes forgets to stop the water after he washes his hand, for example. Since last year, he has difficulty using the toilet correctly. Instead, he has often been incontinence and sometimes urinates or defecates outside probably because he has forgot where the toilet is.
In addition, he began to forget where he puts the things. He was also having difficulty dealing with money.
This year, he happened to be hospitalized due to a lumbar compression fracture. He did rehabilitation for 2 weeks. His cognitive functions worsened further because hospitalization is so stressful as you know. The psychiatrist assumed(reckoned) that the changes to his situation-his wife’s death, living with his son’s family, and hospitalization- was affecting his present state. This case is so difficult for the psychiatrist. That is because he has been already medicated by the previous doctor, who uses many anti-depressed drugs, anti-psychotic drugs, and sleeping pills. It takes a long time because stopping using drugs, especially psychotropic drugs, suddenly is so dangerous.
The psychiatrist believed that he needs to be hospitalized considering his condition. Medicine adjustment is also needed for his current state. However, he refused to be hospitalized. Therefore, the psychiatrist take a step of medical protection hospitalization by family’s conse
宮古島
I visited Miyakojima last Saturday. It takes around one hour from Naha by plane.
I went diving on the first day of the stay in Miyakojima.
The diving shop picked me up at the airport. There were 4 people, aside from me. They said they belong to the same Rotary Club. I am ashamed, but I didn’t know very much about Rotary Club . According to the website, a Rotary club is a place which people from all continents and cultures come together to exchange ideas, form friendships and professional connections while making a difference in their backyards and around the world. When I asked them later, it turned out that they all are the presidents of various companies.
Leaving that aside, we started diving. The was very clear although Hateruma is better. The water temperature was warm enough. There are many types of tropical fish, and the shape of the sea floor was interesting, like a heart shape. There were no rare fish or creatures, but I was satisfied with dive very much.
After diving, I went to eat dinner by rental car. The place I planned to go was already full, so I had to find another place. After a few minute-walk, I found a restaurant which had been the stage of the NHK TV drama,“純と愛“. The advertising board said we have shamisen performance every night. I decided to go there, without any hesitation, because I was looking for a place where I can listen to 三味線.They were almost full, but I could enter the restaurant since I was alone. The food was so delicious and the concert was relaxing and comfortable. I thought it was good that the restaurant I planned to go was already full.
Later, I went to the beech to see stars because that Saturday was the new moon, which is a good environment to see stars.. In addition, Miyakojima is famous for star gazing because the number of the neon light is restricted. I could see the sunset and milky way( and shooting star, of course) from the beech. It was so beautiful and made me feel purified.
美ら海水族館
It is Saturday today. However, the weather was so bad. It was raining heavily. The winds blew violently as well. Like I said before, it is the rainy season now. After working the night-shigt, I decided to visit 美ら海aquarium because it wasn’t affected by the weather. Tyuraumi Aquarium is famous for its Kuroshio water tank because there are whale sharks in it. You can see how sharks eat. Whale sharks eat krill by inhaling one ton of water. It was much more dynamic than I had expected. They can filter them using their gills. If they swallow a fish, they usually exhaled it back out because they don’t usually eat it. However, the guide there said that there are no krill in Okinawa. It is not yet clear how whales live in the wild.
After that, I went to see a dolphin show. It was held as scheduled although the heavy rain and strong wind were continuing. The dolphins completed the show as usual in spite of the bad weather. I don’t know why but we are always attracted to dolphins.
The rainy season of Okinawa.
The rainy season of Okinawa are May and June. Okinawa’s rainy season is a little different from the one on the mainland of Japan. It rains suddenly and violently in Okinawa, but it usually stops quickly.
However, this year is definitely different from ordinary. It had been sunny during the first week of June in Okinawa, but it’s been raining during the second week of June. According to the newspaper, the total typical amount of the rain in June was surpassed in just these 2 days, though people in Okinawa had been anxious about a water shortage a few days ago. TV news said the amount of rainfall on 14th in June was the largest daily amount of the one in July in recorded history. It also said landslide disasters happened in some rural regions. Some houses were flooded due to the heavy rain. I had difficulty driving because the height of the rain was almost the height of the wheels. Have you ever experienced the situation where the car is not moving well if you press the accelerator? It was so scary…
P.S. The rainy season was over on 21 th June in Okinawa!
波照間島
On Sunday, we visited Hateruma Island.
You can go to the island by ferry, but half of them usually are cancelled because of the weather or sea condition, so luck is also necessary if you want to get there.
Hateruma Island is the southernmost island where people live in Japan.
There are about 500 people living in the island. We rented a car because it was too hot to go around the city by foot or bicycle. At first, we headed to the viewing platform of the island.
What a beautiful scenery it is!
There is a scenery which we usually see on TV as a remote island below us.
Time goes by slowly in a remote island unlike an urban place.
Next, we visited the monument, which indicate the southernmost place in Japan.
We took a picture with it. In the middle of the road, there are some wild goats.
They were scared of us when we approached them.
However, they tried to follow us when we left there…lol.
On the east of the island, there is an airport.
Hateruma Airport was refound in2016, but it is closed due to the accident.
They don’t have a clear idea when they will restart the airport though it is new and clean. We ate lunch at あやふふぁみ. https://tabelog.com/okinawa/A4705/A470502/47002290/ TT recommended me to visit this place to eat lunch. らふてー of this is so delicious.
We were satisfied with everything at this restaurant.
After eating lunch, we went to snorkeling at 北浜 Nishihama.(we usually read 北 as kita which means north, but people read 北 as Nishi which means west in Okinawa. It is a kind of dialect.)
Nishihama is one of the most beautiful beaches I have ever seen.
The clarity of the water in the sea is like in the swimming pool!!
There were many types of colorful tropical fishes.
The sea water is warm, so it seems a paradise for them.
If you have some pieces of bread, fishes are gradually gathering, and you could be a magician of fish!
西表島
On Saturday, we visited Iriomote Island. Iriomote island is one of the big islands among yaeyama islands. 90% of the island is surrounded by nature: forests, rivers, falls and so on. People live in the remaining parts. We headed to Iriomote island by ferry. It usually takes 50-60 minutes. The island has two harbors: Uehara and Oohara. We got off the ferry at Uehara harbor. We joined an adventure tour which included canoeing and snorkeling. First, we went to ピナイサーラ falls by a canoe. ピナイサーラ falls is the tallest fall on Iriomote island. We went up the river, which is located in the mangrove forests . It was such a so sunny day that the wind and the sounds of nature were so comfortable. After reaching the shore, we began to climb the mountain. We finally reached ぴないさーら fall after 20-minute walk. At the falls, there is a natural pool. We jumped into the water. It was so cool and comfortable. I stood under the water fall. It made me feel refreshed. We ate our lunch boxes near the fall.
Next we visited バラス island by ship. バラス island is made up of corals, so we can only see the island during low tide. The white coral island, surrounded by the sky-blue sea waters, was so beautiful. We enjoyed snorkeling around the island. There were many types of tropical fishes. We saw a sea turtle as well. The way the sea turtle swam was really attractive to us.
Cerebral hemorrhage
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.
