Lui Yu Ming lets you know you’re not alone

When we move to another country, some of us are lucky to leave behind the old and embrace the new: “I’ve lost weight since I came to Japan eight months ago,” declares lawyer John Livingstone. He’s found the Japanese diet to be less fattening and walks everywhere because he doesn’t have a car, so he’s “never felt better”. Another expat managed to shake off a per­sistent two-year athlete’s foot problem within weeks of moving to Japan from tropical Singapore.

However, there are those of us who aren’t so fortu­nate and suddenly find ourselves battling afflictions we never had before living in Japan. Skin disorders, tooth problems, alcoholism, and dietary concerns are among the myriad of health woes expats face in Japan. The medical experts we interviewed all say it’s common to face some physical disturbances and adjustment issues when one changes environments.

Tokyo’s fierce summer heat finds some wilting from the weight of the humidity, especially those who come from cooler climes. Shares Oscar Milewski, an internet marketing consultant, “I know that there are many oth­er cities that are even hotter, but coming from Poland, Tokyo totally blew my mind in terms of the temperature which gave me headaches. I also suffered an overall lack of energy that slowed my life down to a mere crawl.”

Being unaccustomed to Tokyo’s air pollution could also be a problem for those who come from countries with purer air. Another air-related sore point is hayfever. Michael Sheetal, who runs an interactive creative agency, complains, “For the first time in my life I was hit by hayfever two years ago. I have heard it is com­mon to develop it within four to five years of living in Tokyo, even if you’ve never had it before. Perhaps it has something to do with the air quality?”

Skin disorders are also a distressing annoyance, but the problems expats tend to face aren’t merely physical. Mentally, Tokyo’s corporate culture takes some getting used to, especially the required after-work entertaining which makes it easy to indulge in excessive drinking. Notes Scott Neville, who works in the fast-paced in­ternet industry, “the drinking opportunities required when you do business, as well as long working hours, do have an obvious impact on the ability to maintain fitness and health levels.”

What do the doctors have to say?
General practitioner and surgeon Dr. Leo King of The King Clinic suggests, “Tokyo is a busy city to live in, but also, living in a different country may just be as stressful. Stress does change one’s susceptibility to al­lergy or other health and immunity issues.”

“Stress can manifest itself in physical problems,” says Shane Clinic’s family physician Dr. Peter Shane. “Usually these symptoms are headaches, diarrhea, asthma, and general aches and pains.”

Facing new allergies is another issue as you may encounter unfamiliar vegetation and pollen. For exam­ple, Dr. Shane had an expat patient who broke out into an angry skin rash when he came into contact with a soba plant.

The change in weather, plus extremely humid summers in Japan, does indeed bring on a host of skin problems. Dr. Rene du Cloo from the Tokyo Skin Clinic says the typical ailments he sees are acne, allergy and irritation based skin rashes, and fungal infections, like ringworm and athlete’s foot. Dr. Kota Kanematsu of Smile Dental Clinic reports, “In the summer, there is a marked rise in inflammatory diseases such as root canal and gum problems because bacteria tends to be more active in humidity.”

If relocation stress is the culprit of your troubles, Dr. du Cloo encourages taking on a more relaxed at­titude, “Don’t make stress out to be more than it is. In other words, try not to focus on the physical symp­toms, but stay calm and give your body some time to adjust gradually.”

Other health concerns include the quality of Jap­anese water, which has been a long contested issue. Dr. Shane clarifies, “If you’re talking about 30 years ago, Japan did have water quality issues, but now, it is purified and can be safely drunk and used for cooking.” Some expats, though, still prefer to rely on bottled water. On those who take that kind of precaution, Dr. Shane advises, “If you stick to a cer­tain brand of mineral water, you could be missing out on other essential minerals, so it would be wise to take supplements. But having said that, we only need very minute amounts of such minerals to be healthy.”

But what about our teeth?
The lack of fluoride in the water is another hotly de­bated concern. In many internet forums about living in Japan, some expats worry about their dental health. To dispel any panic, Dr. Kanematsu reassures, “While children require more fluoride, adults only need a miniscule amount that they can get from using tooth­paste.” Some expat families buy fluoride for their kids to drink with water, as it is essential for growing teeth.

How about the amount of fluoride in Japanese toothpaste—is that enough? Again, this is a controver­sial issue and depends on the personal dental needs that vary from individual to individual. For example, if you go through a whitening treatment, your teeth tend to become more sensitive to disease so it is in such a sce­nario that more fluoride would help stave off bacteria.

Dr. Kanematsu also points out that the amount of fluoride in dental products differs from country to country. In Tokyo, some dentists, like Dr. Kanematsu, can get permission to import foreign dental products that have higher fluoride content, but the process is long and expensive. In fact, he advises patients to buy them online or stock up when they travel home as cheaper, faster alternatives.

On top of suffering from an assortment of ail­ments, many expats express doubts about the stand­ard of medical care here. Dr. King recognizes this is a source of frustration that compounds the stress of be­ing ill, “Although more doctors and dentists speak flu­ent English in Tokyo, that does not always mean they share similar cultural patterns, logic, and feelings you may have. It is also more likely that the further away from the central part of Tokyo, the less chance you will encounter a Western-minded provider.” As for insurance…

Many expats will be familiar with the Kokumin Kenko Hoken or the National Health Insurance (NHI) scheme as it is compulsory to have this if you live in Japan for more than a year (provided you aren’t covered pri­vately). Dr. Shane reveals that Japanese medical care is heavily intertwined with what the NHI provides. As it is a very cost-effective system, you may experience lower dosage prescription and shorter consultation time than you’re used to.

Not only that, some may be peeved at the lack of in­formation about their health problems from a Japanese doctor. Dr. King offers a reason, “The stereotypical Japa­nese patient will not discuss, ask questions, nor be big enough for heavier dosages of medicine.” But he’s quick to point out, “This disparity is not a matter of the ma­turity of the mentality or logic, but more to do with the culture, and at times deeply rooted in the NHI scheme.”

“Japanese hospital and clinic bedside manners under the hoken system can be a shock to some expats,” men­tions Dr. Shane. For example, consultation rooms are de­marcated with mere curtains and not walls, which mean the intimate details of your malaise could very well be heard by everyone else in the clinic. Modesty is also an is­sue where dressing gowns open in the front not the back, and you often won’t see changing rooms, so some may find it disturbing to strip in front of a doctor.

Should we then abandon the NHI altogether? Dr. Shane suggests, “I think the NHI system can satisfac­torily treat more straightforward illnesses that can take five to ten minutes to diagnose and treat. But if you have a more complex disease, then I would recom­mend seeing a non-hoken health provider.”

Even if it’s just a matter of getting the comfort level you’re used to, you still benefit from a non-hokendoc­tor says Dr. King, “You have the freedom of having the doctor give stronger and longer prescriptions, perform all necessary tests, and consuming longer conversa­tions with your physician, in contrast to all the limita­tions and obligations of the NHI scheme.”

If the health problems which can crop up from liv­ing in Tokyo seem daunting, take heart. Not only is it increasingly possible to receive top-class Western-style care (in English) here in Tokyo, but being in Asia, ex­pats have the unique opportunity to explore tennants of Eastern medicine as part of their personal health­care regime. For instance, accupuncture, Shiatsu mas­sage, and herbal treatments are just some of the op­tions readily available to expats in the city.

Remember, no matter what affliction you might find yourself with after coming to Japan, chances are, someone else is going through the same thing, and with the help of one of the doctors listed above, you’re sure to be right as rain in no time.

Expat clinics
The King Clinic

Mon, Tue, Thu, Fri, Sat (morning only) 6-31-21, Jingumae, Shibuya-ku, Tokyo
tel. 03-3409-0764 (by appointment only)

Tokyo Skin Clinic
3-1-24, 2F Roppongi Minato-ku, Tokyo
tel. 03-3585-0282

Tokyo Surgical and Medical Clinic
2F 3-4-30 Shiba Koen, Minato-ku, Tokyo
tel. 03-3436-3028

Don’t forget your pearly whites!
Smile Dental Clinic

Kawai Bldg., 2F, 5-14-4 Minami Aoyama, Minato-ku, Tokyo
tel. 03-3406-8041

Nakashima Dental Office
Roppongi U Bldg., 4F, 4-5-2 Roppongi, Minato-ku, Tokyo
tel. 03-3479-2726

Counseling and therapy services
Ikebukuro Counseling Center (ICC)
tel. 03-3986-8316

Meguro Counseling Center
tel. 03-3716-6624

tel. 03-5976-1842
[email protected]

International Mental Health Professional Japan (IMHPJ)
[email protected]