Subsequent trip down memory lane back to when I lived in Japan made me think about managing diabetes while living in Japan. At the time, I didn’t put a lot of thought into how my diabetes routine would differ from the one I’d only recently established in the United States. But looking back, a few aspects have become quite clear. So here’s a quick list of pros and cons about managing diabetes in Japan from 2002 to 2004:

Pro: Public health care. I didn’t keep up with the politics of this, but I knew that I’d always get a supply of test strips (for a decent co-pay) and I’d always be back for another appointment with my internist after six weeks. Here in America, if I call to make an appointment, the next available opening is usually six weeks or further away (or six or more months for a new patient).

Con: Explaining to people in Japanese that I had diabetes. At first they assumed I didn’t know what the word for diabetes meant. Then they would laugh in my face and say, “You’re not old and fat… well, you’re not that fat.” Not a fun conversation to have over and over and over with limited language capacity.

Pro: To ensure confidentiality, medical records in Japan are kept in English. So I could usually read what was happening. Only problem is that most the doctors I interacted with were only able to write medical English – it was rare they were comfortable having a spoken conversation in English.

Con: Not being able to make enough small talk with the phlebotomist to take my attention off getting my blood drawn. Because of this, I would sing. But I wanted to sing something they were familiar with enough to not think I was having a nervous breakdown, so I sang the ABCs. Many, many times.

Pro: Going to the hospital and having the entire team of internists know who I was. Chances are good I was the only blonde person with diabetes living within several hundred miles, so I was memorable, to say the least.

Con: Being expected to eat rice three times a day. Honestly, telling people I tried to have low-carb meals was kind of using my diabetes as an excuse. The fact is, my metabolism simply isn’t fast enough to process that much white rice!

Pro: Comfy shoes. Okay, maybe not all the shoes were comfy, but they were almost always slippers! Rather than standing in heels all day in front of classroom after classroom, I followed tradition and wore slippers and other “indoor only” shoes. I don’t remember once having a blister or sore or anything from uncomfortable shoes the whole time I was there, which is good for people with diabetes, right?

Con: Explaining to my younger students that it was not a cell phone in my pocket, but a “medicine machine” – my language skills were a little too limited to explain my insulin pump to second graders.

Pro: Squatty potties. This was actually one of the best things about managing diabetes in Japan. Every time they needed a urine sample, they’d send me to a bathroom that only had the traditional Japanese toilets, which are, essentially, a porcelain-framed hole in the floor. For us ladies, a typical urine sample is not the easiest thing to collect in a neat and tidy way, and I found the squatty potties to be incredibly useful when it came to this.

Side note: As you may know, Japanese culture is excessively polite, with a weird balance between basic things that are implied rather than spoken (such as telling someone “no” or talking to them and referring to them as “you” instead of their name), and things that are over-explained in a single phrase (such as when you leave work at the end of the day before your colleagues, you must say a phrase that translates to “I am rude for leaving ahead of you.”). When it came to requesting a urine sample, it was the latter of the two extremes. I was always handed the paper cup with the words, “yorushiku onegaishimasu!” which literally translate to “please look favorably upon this situation.” I always giggled a little to myself when I heard this.