june5

Today I got awoken by the sound of a silent alarm. Uugh-uggh, uggh-uggh. Over and over. It was around 630am. Great. So I was trying to read one of the Japanese books that I brought. Which I didn’t think was very helpful anyway. Finally got up at 730am. I’m usually up at 715 and go to the bathroom to wash my face and brush my teeth. There are only 3 sinks. This morning I had to wait for someone to finish. Then I went I got dressed, ate my banana and went out the door. I was already down the hill when I remembered that I forgot my lab coat. I went and got it and took the train to keio. The train by the way is ridiculously busy in the morning and evening when people are going home. And when I say busy I mean so crowded that there doesn’t look like there is anymore room. People are jam packed in a train. Pushing. There is even a sign for no molesting. I got to keio before 9am and went to use the computer in the lab. I posted all my blogs for the last few days and checked my email.

Matsuyama sensei came in and asked if I was tired. And got me some coffee. Then it was time to go to our lecture with yamazaki sensei. He talked to us about insurance in japan. The system is very different than the us. Everyone can be covered and there is separate insurance for the elderly because it is becoming a growing population. 70% of medication cost is covered by the government and the patient only has to cover the other 30%. And it costs the same to visit a doctor for a cold as it is to visit a specialist. This makes people go to the hospitals and clinics 2-3 more times than in the us. It was an interesting talk. He spoke English well and was excited to talk to use. He lived in ohio? For 2 years. It was about noon and naoko, yoko, kana, and take came to take us to lunch, but yamazaki sensei wanted to keep talking. About 10 minutes later he let us go.

We ate in the cafeteria and I had hot soba noodles. It was very good. We ate with mari and yumi. We went back to the room and they asked us which actors and actresses we liked. I said Angelina jolie and yumi said she liked tom cruise. Naoko said she liked Orlando bloom. And they said a Chinese actress. And we said zhang ziyi. It turned out to be the same person. Brandon needed to go to the bank, so naoko and kana took us. We went to the 711 which we had no idea there was a bank inside, but they didn’t exchange foreign currency. We went to another and got some ice pops on the way back.

Next was going to the keio university pharmacy. It opened a few years ago to give students practice. They fill prescriptions for a nearby nursing home and people in the community can get their medicine filled. They keep detailed pt hx, soap, med hx. They have med diaries so if they go to another pharmacy they can give that to the next pharmacist. they separate medications by weak or strong. They have their own machine to package medicine but it is a digital version. They have a huge backer cell machine. They also lock up morphine and oxycontin. They have a counseling room and dexa scan. They have models for the foods that a diabetic patient can measure by. 80kcal = 1 unit of insulin. Every model was one unit of insulin. Interesting.

It was around 430 when we got back. Dinner wasn’t until 530 so we hung out in the room and I worked on Japanese and Brandon was on a computer. Miho came in later to tell us that they were almost done with the schedule. She was excited that I was studying Japanese. I got asked if I was tired again by take san. I must have bad jet lag. I was also thinking that maybe the allegro I’m taking is making me drowsy. It’s not 100% non-drowsy. So maybe. They went over the schedule with us and we are going to many fun places! Tokyo Disney land, Tokyo dome, odaiba, harajuku, akihabara, shibuya, kamakura, Shinjuku, tsukishima, tsukiji fish market, shiodome. Very exciting.

We went on our way to the yoshi restaurant to eat oden. We took the jr line (me, b, saori, miho, and yoko). We got a little turned around but we found our way. We had salad, oden, yakitori, pastry with blueberry sauce, and omelet. It was very delicious! Then we went bowling. Takeshi met us there. We divided into two team: team one – Brandon, miho, and yoko. Team two – take, me, and saori. It was a close game but my team ending up winning by one point 329 to 328! It was about 10pm and we had to leave because there wasn’t enough time to play another game and get home to the dorm. we were on the jr line when a drunk man bumped into yoko and saori. Yuck! We headed back and when we were about to go down daimon station and a another drunk man asked directions for oedo line. They were down the way when Brandon and I saw one trying to go down the up escalator. We went down the stairs instead very quickly. I caught the 1035 train and came in and took my shower. I was getting out when naoko was getting dressed and she saw me full on. Great! This is so awkward. Oh well. And miho is so cute and sweet. She said that she wanted to get along with us so she is trying to speak English more. I think her English is very good. They are really so good to me and Brandon. They have treated us so well and have showed us around and taken us to dinner.

no internet

i just want to let everyone know that i don:t have internet at the dorm, so my posts will be every couple of days. i:m going to post a bunch at a time. that:s the best i can do. so much happens in one day!

June 4

Today we were supposed to meet Suzuki san at 1030pm which meant we didn’t need to be at school until 930am. Well I got a message last night from naoko that we were to meet taka and yuka at 9am. Ok. I get there and matsuyama said he thinks I’m am too tired. I should get some rest. Very important. I didn’t think it really showed when I was at the university. I just get so tired at night. We get there and I brought my Japanese book to kill some time. And everyone was kinda impressed. Taka said hard worker. Hehehehe. He is very funny. So Brandon arrived and we were off.

We met shurr san and he said I didn’t think you were coming until 1030am. “ so did we.” Oh well. We started early and went to the surgery satellite pharmacy. We talked about what they did and then they started making iv stuff. Two main pharmacists and new pharmacist. we told them that we found a place that makes a stamp. And they were amazed that doctors and pharmacist’s actually signed their name. it would take them too long. Then we went to go meet shaori and takayuki. Shurr san wanted to eat lunch with us. I think we were supposed to go to shinjaku and eat, but that would be too far away for him so we ate at oasis. I got katsu don. Pork with rice and soup. It was good. We talked about boyfriends and girl friends and maid café.. shurr san wants to go with us. He got taka’s number. They were fighting over who would pay for the check. Funny.

Then we had 30 minutes to wait. Taka and yuka went back to class, which they were late for, sumimasen! We went across the street to the bookstore and look around a bit. Then Brandon asked for a bank and there were none around in the area. Banks are only open from 9am to 3pm. But there are atms everywhere. Time to go back. I needed to go to the bathroom but never got a chance. We waited in an eatery. Shaori and taka warmed up after a little while. I was kind of wary of them at first.

We went to meet kenoke ken san in the basement. We actually visited that room on Monday and shurr san explained the machines that packaged powders and granules. We even tasted some cephalosporin and it tastes sweet with strawberry. Ken san was very nice. He floated when he walked too. He told us that pharmacist get a consultation fee when they explain a medication to a paitent. About 3500 yen per patient. They can only charge a fee on one day. He showed us the locked cabinet for narcotics. And they had many many fentanyl patches. They even have a narcotics manager that rechecks the prescription after the other pharmacists. To keep track of amount. They do not have a government agency for narcotics.

Ken san is a urology pharmacist. he took us up to the ward and it was very busy, isogashi. Then a doctor who worked in new york for a while came and talked to us. Asked us what the regimen was for renal cancer. We did not know. Then another doctor was telling us about some cancer patients and the regimens that they use. We would have seen a patient if it was not so busy. We finished up and went back to the basement. We asked to see yamaguchi sensei to give him a gift. He was in a meeting so we waited a little bit. He came and we gave it to him. Kore oh ageru. Shaori told me later that it was the informal version and we should have said kore oh agemasu. Whoops! Well it should be ok, I hope.

We get back to university and we get our things and almost leave, when shaori comes in and asks "where are you going?" Hehehe. No where. We sit down and drink coffee and look through our Tokyo books. ｍａｔｓｕｙａｍa ｃｏｍｅｓ in and asks me if i:m tired. Then we go eat dinner in the cafeteria. Chicken, rice, miso soup. Tasty. We had to buy a ticket in a vending machine and then give it to him. Good idea. We ate with shaori, takayuki, taka, miho (who is super cute), mari (who didn’t talk much), and yuka. Miho asked me if it would be ok if we went out on Saturday and Sunday. She didn:t want me to be too tired. Geeez. He told everyone that i:m tired. I must look like ass. If they saw me without my makeup, what would they think then???

They had class at 630 so we go back up and takayuki said he would take Brandon to get an ironing board. I wasn’t sure if I should go too, but Brandon said to come along. We took the jr line for the first time and went to bic camera. It is a HUGE store. Something different on each floor. We found the ironing board but no messenger bags. Then taka takes us to a shopping center. Very high class and up scale. Bags were takai desu (very expensive)! But we did find handkerchiefs. Brandon got some burberry, ck, and something else. I got some nice cloth ones. Because I am sweating up a storm sometimes. We went to nearly every floor. Very nice stuff. To many clothes and shoes and bags, and everything. Then we left and taka took us back on jr line to the daimon subway. He ended up going back to the university. Back at home and I’m always tired. I need to start drinking coffee in the morning and evening to keep up!

Mechi mechi uma – very very good?

Ike man – good guy

June 3 2008 1152 pm

So this morning I wake up at 715, get ready, meet naoko at 820 and head to university.
We get there around 845. wait for Brandon to get there and head out with naoko and yoko. They don’t speak much English so talking is limited. Naoko doesn’t really want to try and yoko kinda does. She’s really tiny but has a deeper voice. She’s really pretty. They had never been to the keio university hospital so Brandon and I needed to remember which way to go. And today started the rainy season in japan. Yippee.

My shoes were really wet on they way there. We found our way and made it to the hospital. We went to the service desk and got directions to the pharmacy. We went and met yamaguchi sensei and inoue. She took us to the peds room and we had to walk round about to the floor because the levels are different. That is where she usually works. She gave us two handouts about peds and about chemo. She got done talking really early because her presentations were max 20 minutes. So she said her mom taught foreign students and she brought origami patients. I made my paper crane and taught inoue to make it fly. Then Brandon made a cup. Inoue made a frog for Brandon. She’s very sweet. she said that it was hard for her to come back to japan because she was used to talking in japanese and english and she didn:t know the kanji. she said it was hard to make friends.

Then we left around 12 and met in the lobby macura and isawa. Naoko and yoko left so then we went to the hospital restaurant and cooked. I had Mexican rice pilaf. It was good. We learned many things about swedan and japan. In Sweden colloge is free and they have 9mil people. I discovered that m1 and m2 students are already pharmacist after 4 years, but decide to do masters course.

Wow just fell asleep and it’s 1am. Must go to bed..

Must continue story before I forget…. Sweden also has many immigrants from waring and arab countries. Pharmacies are monopolized by the government and so are liquor stores. They are only open til 7pm. And in japan now the pharmacy program is 6 years. They only do one month intern. Isawa said they are trying to make everything like us. We finished lunch, our two hour lunch breaks by the way. And went to meet Suzuki shyur san.

He talked to us about drug information. He went through the steps that we would normally go thru. Look up pt information, pub med, drug recources. They use micromedex a lot and they have the same reference books that we do. Like lexicomp and briggs pregnancy and lactation. We went thru a patient case about actos and getting edema. We looked up the terms in pubmed and went to micromedex. He asked us what we would do. Based on clinical evidence we should stop the drug before using furosemide.

Then his boss came. Very loud in your face, his English sounded very westernized. About mtx and dose. Normal concentration at 24 is 10mcg/mol? But this kids value was 120. it was ok, because kids metabolism is higher and needs to be that high. So it’s ok. He talked about oatp receptors and poor and normal metabolizers. Isawa left early on. Then we started talking about manga and what we liked. Shyur san said he would tell us where a manga kisa is. We saw a 3.5” floppy on a desk and we asked if they still used it. We said that japan is supposed to be the best in technology. He laughed and said that some nobel prize winner said they should use something til the end kind of. So japan takes that to heart and keeps using something if it works even if there are new things. We went to look in a giant walk through refrigerator and a pharmacist was talking to shyur, then she said that macura was very handsome. The look on his face was really funny. He said well you are cute too, and she said thank you. It was really funny. He said he was really cool guy because he was from Sweden. I said that was a corny joke and she didn’t understand. He’s pretty funny.

Then we came back and were telling macura that we didn’t really know what our schedule was. They we met nakashima when we first came up on the floor and isawa. Then they talked with matsuyama. And he talked to us for like 5 minutes about our schedule and the presentation. And then we asked taka who was coming with us because we only had family names, not given names. Then we left and went to mcdonalds. I got a teriyaki burger, which was ok, grape drink, and fries. They taste the same.. mmm… then we walked around. We went to Tokyo tower but it was closed. We took some pictures and I saw the cutest hello kitty bus! Then we came back to daimon and went our separate ways. I’m so tired at the end of the day. Crazy!

June 2nd

Woke up around 7am. I was up til 1am last night writing in word because I wanted to keep my thoughts but have no internet at dorm. I was worried I wouldn’t be able to get up in time. I got ready for the day and ate my strawberry yogurt, which had a soupy consistency, but it’s only Y105. took my shoes to the cubby, met with naoko. She doesn’t talk that much, but I can’t say much either. Went to keio university and went to the M1,2 room. Met matsuyama-sensei and shiba, yoku, yuka, taka, ?. then came in chinotsu and Brandon. Then we (b,m,taka,chinatsu, and matsuyama) went to keio hospital.

We met with yamaguchi sensei, and inoue san. Inoue translated and took us through a powerpoint. She went to elementary school and middle school in the us. She lived in san diego and pennsylvannia. Her English was great but she was so quiet it was hard to hear. She told us about the iv preparations. They have a glass that slides down so you can put your arms underneath, but nothing else. Everyone is a pharmacist. There are no technicians. They all sign off with a stamp when they make or check something. They all have separate stations. The doctors all write the prescription on the computer and it gets sent to the pharmacy. Much easier to read things. No confusion on what they mean. Very nice. She kinda reminded me of olive oil, because her upper teeth stuck out a bit.

Then we went to lunch. It was really great that the menus are pictures. You can see what you are getting and the price. Very easy to order. We had two hours for lunch, so we went to the park. We went by a temple and the baseball field. We went to a batting cage where you could try to hit 20 balls for Y400. it was fun. I hit one good one. Brandon was too tall. It was really life like because they have a video of the guy pitching and the ball comes out where it would if he was real. Very cool. Then we walked back and I got my suica card at the bus station. Then we went back to the hospital. ]

We went to the outpatient pharmacy and they were really busy. They have tablets,capsules, and granules. The granules and powders are packaged on site. It’s really cool. Then we went do the inpatient pharmacy with t,c,g, they showed us where they make topicals, bulk powders, suppositories, the clean room. Shurr translated. Then we left and came back to keio university. We got done early so we had time to kill.

Then we went to mahana, loco’s table. Hawaiian food for farewell dinner with dr. crystal and her husband joe. It was also the welcoming party for me and Brandon. The food was really good, made me full. Then the picture’s started and felt like they wouldn’t stop. Then we went home, me and naoko. Stopped by the convenience store and for yogurt and banana and calorie mate. Unwinded a bit and took a shower. I was nearly done and was alone when another girl came in.. and a girl was in the antechamber. Oh well. And I weighed in at 55kg. about 121 pounds. I’m sooooo tired. I need to sleep!

June 1st

Day one continued….

So they fed us once again. Fruit, stuffed tortellini and milano cookies. This time I made sure that I got coffee. Needed cream and two sugars. Had to wake my ass up. We finally arrive at the gate of narita airport at 430pm. Get off the plane and take a picture of a ‘welcome to japan sign”. go thru customs where a tourettes guy is spouting off. The girl in front of me is chatty and tells me that she is on her way to see her soon to be inlaws. She’s half Korean. Go downstairs and get my bags and leave thru customs.

I get out and I see naoko and mari. I get my travelers cheques changed out and go buy a ticket. They offered to carry one of my bags which is still quite heavy. We get on the train and start talking a bit. I don’t know much Japanese and they don’t know much English. Mari knows more than naoko but they still need their little dictionary/translator. Mari wants to go to America to see a mariners baseball game. I told them I want to see Tokyo street fashion and they weren’t sure what that was. I said it was when you dress up goth and they were like ohhh harajuku. They asked if I wanted to dress up and I said I would. They laughed and said to take a picuture. The ride seemed like forever.

We get to the dorm and had to walk up a hill so I felt bad they were carrying my bag. We check me in and I get the key and have a cubby for shoes. We don’t have time to eat at a restaurant and mari had to go back to her apt. naoko and I go to the convenience store and get dinner and breakfast. I get a strawberry yogurt and and udon noodles. We come back and eat and I need to blow my nose. I try to find the bathroom and find the shower room and am perplexed. It is a big open room with shower heads around the wall and no curtains. Naoko comes to find me and I ask if everyone gets naked all at the same time and she says yes. Hhhhmmm.. ok.

Well we finish dinner and then go to our rooms. I ask if she is going to bed and she said she has to take a shower. Oh yes. Well I’m going to unpack and then shower. I didn’t want to be awkward and see her naked since we kind of no each other. Well I try to wait it out and hope that not many will be in there if it’s getting closer to closing time. I was wrong. Suck it up. I get in there with one bucket with my things in it and open the shower door and realize that you use the other bucket to sit on. Ohhhhh. And I was walking around in my towel. So I get the other bucket and get to it. Naoko walked in the shower at the same time also. I’m quick, I wash my hair and my bits and rinse. I kept the towel in there, which I don’t think I was supposed to do. Wrapped up and went out. Got dressed in my room and brushed my teeth.

Then phon knocked on my door and gave me and rail map and we started talking. She is a pharmacist from tailand. She spent the day with Brandon at a fun park. She said she knew who I was because I kept myself wrapped up. We were talking about how we were not used to such practices. She said that in Japanese culture it is rude to shower standing up but it is polite to sit down. Okay! Well she is going to kyoto tomorrow and I’ll see her again on Saturday. Finally Brandon called back and we shared our last few days.

Man I really need to find some internet!

on the plane to japan

they fed us a lot. drink and snack, two snacks for me. it was tasty. then dinner/lunch: noodles, roll, potato salad, cabbage, i think a piece of pork, and tuna. then eel over a bed of rice. the eel was ok, but i could feel the little bones in my mouth. and it was fatty. i tried cold green tea, it was gross. then a lil hagendas icecream, more oj. then chicken sandwich. i'm really full. its 12p tokyo time, 4 more hours to go.

sat next to a big guy, maybe vietnamese and a high school grad. the big guy smelled weird.

and my japanese is not on par at all. we'll see how's it goes.

think i might go to sleep again.