The Comfort Zone - April 1, 1998

Medical Care on Three Continents - or - How I Found Dr. Kelly Shanahan
Thank you OBGYN.net

It is exactly one year ago this month since I got my computer, found a provider and most importantly found obgyn.net. I live in a small town in Northern Japan. This is *not* Tokyo. Here elderly men still go for evening strolls, wearing their pajamas and walking up the middle of relatively busy roads! It gives new meaning to the hazard sign showing an elderly looking man and woman crossing the road! Some of the toilets here are still "holes" in the ground and I warn anyone who might come to Japan and find one to make sure the contents of their pockets are secure before their curiosity gets the better of them and they bend over to see just how far down the hole goes!

To get to the nearest university library it takes me 2.5-4 hours in either direction, depending on the weather. It snows a lot here in winter. Until about 3 years ago my town didn't even have an internet provider and even though it has about 6 now, the internet hasn't quite caught on yet.

I come from Britain where all medical treatment is free. This is fine if you need emergency treatment, but if you are not considered an emergency, the waiting lists can be quite long. If you are sick you see your G.P.-like a family doctor. You cannot see a "specialist" ie. a gynaecologist, dermatologist etc. unless you are referred to one by your G.P. So depending on what sort of G.P. you have, will determine a lot of the specialist care you get. In the States it seems, there are a lot of high quality specialists available, but not to everyone, only to those who can afford it.

In Japan, the high tech. care available in the States is also available but at a price affordable to all. If you want to see a specialist you can go straight to a large hospital with very modern equipment and be seen for a very small price. Most Japanese women, for example, have 10-15 ultrasounds before their baby is born. However, what makes Japan different from both the U.S. and Britain is, patients have very little say in what treatment they get. This is for two reasons: one, doctors don't explain diseases or medication to the same extent Western doctors do and two, the Japanese put their complete trust in their doctor, considering it both unnecessary and extremely rude to question anything a doctor may suggest or prescribe.

An example of this would be a colleague of mine who suffered some sharp pains in her lower back about 10 years ago and was diagnosed as having endometrosis. When I told her I probably have endo. too and we started talking about it, I found out she has absolutely no idea what endometrosis is, has been diligently taking the Japanese version of the Pill for more than ten years, has no idea what the brand of her Pill is, nor what hormones it contains, far less how many. Most brands of the Pill here have 10-50 times more hormones than their Western equivalent. She does not worry about this because she doesn't know what these hormones are or the consequences of taking them for so long. She leaves everything up to her gynecologists.

For me this just wasn't possible I need to know what the consequences of any illness I have are, the type of medication I am taking and any possible side-effects it may have. This is where obgyn.net really helped me. I have various gynaecological problems which require me to take medication every day. As one only receives 2 weeks supply of medication at a time here in Japan, I have to see my gynaecologist every two weeks! Thus my relationship with her is very important. She is very kind and answers any, or better still, the many questions I always have, but in order not to "bombard" the poor woman with my thousands of questions each time I go, I try to find the answer to all my questions by searching the various areas of obgyn.net.

Thanks to obgyn.net I could find out what was involved in a laparoscopy, what kind of medication I am taking and what its side effects are, and the various support groups available for endo etc. If I can't find the answer to something I needed to know and my doctor isn't sure either I post a question to one of the doctors on the forum, who very kindly answer each time.

I am extremely grateful to Roberta, Bruce (which happens to be one of my middle names!) and Barbara for all the effort and time they have put into developing this forum. Not only has it helped me find answers to all my medical questions, living "among the rice fields" of rural Japan, but it has also helped me find information about medical schools I want to apply to and research any assignments I have to do to enter medical school. I just received an "A" for my last Biology assignment that was researched completely on obgyn.net!

The story doesn't end here. Because my endo symptoms seemed to be getting worse and I had tried almost every form of treatment available apart from the Pill and because I would never take the high dosage version of the Pill they have here, I posted a question to the forum last month about the possibility of my being able to get the Pill in the States, when I went to visit my friend in Reno. As it happens OBGYN.net's one and only super woman, Dr Kelly Shanahan, has her surgery about 75mins from where my friend was staying. Through obgyn.net I was able to make an appointment with her and get the medication I wanted.

For those of you who know Dr Shanahan from the forum, she is even kinder, more considerate, caring, intelligent, and generous in real life than on the Forum. (If that is possible!) I was really nervous, but a really sweet nurse from Ireland soon put me at ease and even told me which way to tie the gown. I am an avid fan of ER and knew they tie the gown at the back, but couldn't quite figure out how one did a breast examination with it tied at the back! In Japan you wear your normal clothes and remove the necessary parts. As far as the British Isles go, the nurse and I both looked at each other and laughed, we had had several gynie examinations in various countries but never our own!

After that I saw Dr Shanahan and she was just wonderful. She explained everything before doing it, I always felt like I was in control and there was no curtain to worry about between me and my gynaecologist. In Japan women have a curtain between them and the doctor whenever an internal examination take place. For me, especially as I have endo, having an internal exam is often painful and rather like going to the dentist, so I like to see exactly what and just how big anything is before it is put inside me! I ask not to have the curtain when I am being examined in Japan, but often feel I am being a right royal pain in the you know what to everyone concerned- especially when I see the size of the speculum and practically demand to have a restraining order put on it! This was not a problem having the examination with Dr Shanahan.

So once more, Dr Shanahan, Roberta, Bruce , Barbara, thank you very very much for everything you have done and continue to do on obgyn.net. I really appreciate it.

Thank you
Sharon