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Thursday, Feb. 24, 2010

WORDS TO LIVE BY

Dr. Arihisa Fujimaki


Dr. Arihisa Fujimaki, 67, is the director of Ishikawajima-Harima Heavy Industries (IHI) Hospital in Tokyo. An expert in reconstructive microsurgery, this orthopedic surgeon regularly performs operations to re-attach fingers, toes, hands and the occasional foot. Fujimaki is a hero to many, from construction workers who get nails stuck in their hands to ramen shop owners who slice off their fingers. On a typical morning, Fujimaki sees more than 80 elderly patients, who visit him for injections to help heal their aching knees and backs. Conversation is a large part of treatment as many of his patients live alone, and to them Dr. Fujimaki is like the son they always wanted to have — even if it's just for a few minutes every other day.

Dr. Arihisa Fujimaki
Dr. Arihisa Fujimaki JUDIT KAWAGUCHI PHOTO

Old age doesn't have to stink, especially if you can hold your nose! Every day we have the chance to make old age better for us. Exercise is key, but so is nutrition. Hip fractures are a lot less common in the Kanto and Tohoku areas than in Kansai, the western part of Japan. The reason is that more people in Kanto eat natto (fermented soybeans). Natto contains lots of Vitamin K, which helps make bones stronger and prevents osteoporosis.

Neighborhood hospitals are social clubs. We operate like a community center for the neighborhood elderly, who stop by daily to chat with their friends and to do some exercises in our rehabilitation rooms.

Our hospital is like a stand-up comedy club, except our comics are sitting or lying down. Here is a typical conversation between three of our regulars, who are in their late 70s and 80s: "Gosh, where is Tanaka-san? How come she's not here yet?"

"I know. I worry about her, too. She never misses a day."

The following day Tanaka-san comes in and apologizes: "Sorry Doc. Yesterday I was feeling sick so I couldn't come. I stayed at home all day. It was terrible!"

Every day is like this!

If you ever chop off a body part, don't put it on ice! A common mistake is to put the body part on ice but that's the last thing you'd want to do. Let's say you just sliced off a finger. First, stop the bleeding by wrapping cloth around the hand and applying pressure. Lift up the hand so the blood stops flowing there. Next, rinse the chopped-off finger in lukewarm water, wrap clean gauze around it and put it in a plastic bag. Then put the bag into iced water. Never let the chopped-off body part touch ice, as that would damage the blood vessels to the point that reattachment could be impossible. After an accident, the golden number of hours is six, so you want to get to a hospital as soon as possible. Within 12 hours, you're probably still OK and the body part can be attached without nerve or muscle damage.

Exercise now so you'll be able to move later too! Unless we keep our muscles strong, we're jeopardizing our chances of long and independent lives. Half squats are the perfect exercise. I do 100 every day, and I don't take elevators. In our hospital, we have two staircases and some sections of the floors are not connected, so if I want to go from the doctors' room on the 4th floor to see some patients, first I must go down two floors and then walk up two. I do this a dozen times a day, so my legs get plenty of exercise.

It's easy to lose something, but it's very hard to get it back. Fingers are not so easy to attach. I need two hours per finger so a whole hand is a 10-hour operation. We must connect the bones with wires, maybe add stainless-steel parts, some screws and a plate here and there. Then we continue with tendon suture, stitching the arteries, veins and nerves. It's all done under the microscope, so you need good eyes. Once done, the hand is as good as new!

Sometimes pronouncing the unbearable is the nicest thing one can say. "There's nothing we can do. I'm sorry." This is the worst thing for a patient to hear, but we must tell them. People want to know the truth because they need time to prepare for death.

Cancer is not a death sentence. I had colon cancer 19 years ago, but, knock on wood, I'm perfectly well. The key is to detect cancer early, so going for yearly health checks is important. You also need some luck and a positive attitude.

When given a choice, most people would prefer to pass away in their own homes. This is the biggest challenge Japan faces now: How to deal with the increasing number of people who prefer home care and refuse hospitalization. We need more doctors and nurses to make house calls.

Find a sport you can love for as long as you're alive. I've been skiing since childhood, but it's only recently that I've been competing. It's fun! Since 2001, I've been participating in the Japan Masters Ski Championships, where with some luck I might end up 30th among 90 skiers. In the giant slalom of smaller local races, I can finish between third and 10th place in the over 65 age group. Since 2005, I've been volunteering as the official medical doctor for the National Winter Sport Festivals, so I travel all over Japan with the teams. As I age, life gets easier and more wonderful.

Judit Kawaguchi loves to listen. She is a volunteer counselor and a TV reporter on NHK's "journeys in japan" Learn more at: morinoske.com Twitter: judittokyo



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