Medical disparity in this symptom, where to rely on “nearly deadly illness” December 2, 16:07

"I don't know which hospital will see me. It won't heal forever. What should I do?" The

woman I met during the interview suffered from an illness that is said to have more than 200,000 patients nationwide. I did.

But I couldn't get treatment for a long time and didn't even know I was ill.

There are large regional disparities that can be life-threatening in the medical care of serious illnesses, also known as the “most mortal mental illnesses”.

(Kanazawa Broadcasting Station reporter Sawa Sonoyama)

Brain atrophy / actual condition of serious illness

"The black part in the photo is where the brain is thin. Nourishment does not reach the brain and there are many grooves."

A CT image of the brain of a teenage girl diagnosed with a severe eating disorder.

When the girl was taken to the hospital, she had lost weight to 32 kilograms and had atrophy not only in her whole body muscles but also in her brain.

Dr. Nobushige Naito, a psychiatrist at Kanazawa University Hospital, who was in charge of treating the inpatient girl, pointed out that eating disorders may also affect human cognitive function.

Dr. Nobushige Naito

"In this state of the brain, thinking and concentration do not work. Even if I say,'Because I'm too thin, take a little more nutrition,' but when it gets so serious, the words don't come to my mind. "

Diseases with high mortality

Eating disorders are mental illnesses in which the act of "eating" cannot be controlled by one's own will.

There are symptoms such as anorexia nervosa, bulimia nervosa, and alternating between them, and in addition to various complications, there are many cases in which patients die from suicide.

Dr. Nobushige Naito

"

Some

people

lose their

hair, they

tend

to break their bones, and if they are really terrible, they may not be able to sit on their necks and walk. The mental part is also very problematic. When the symptoms get worse, I think it's easier to die. "

Medical team

Kanazawa University Hospital is one of the few hospitals in Ishikawa Prefecture that has a medical team for treating eating disorders.

In addition to psychiatrists such as Dr. Naito, nurses, psychologists, dietitians, social workers, etc. form a system of 5 or more per patient to provide continuous care even after discharge.

Nurse

"I've seen many people re-hospitalized even after being discharged. Eating disorders are mental illnesses that cannot be cured with drugs. It is important to continue to support recovery."

Dietitian

"Many people are wondering what to eat at home. When they leave the hospital, they will meet with their families and tell them how much food they should eat at home."

Unevenly distributed hospitals

Eating disorders that require treatment for both mental and physical symptoms.

Currently, the number of hospitals that can receive specialized medical care and recovery support is very limited in Japan.

There are only four prefectures, Miyagi, Chiba, Shizuoka, and Fukuoka, which are said to have a well-established "eating disorder support base hospital," and the number of specialists is smaller than that of other mental illnesses.

The result is “concentration of patients in specific medical institutions”.

At Kanazawa University Hospital in Ishikawa Prefecture, the inpatient beds are always full and waiting in line.

It is said that there are situations in which even severely ill patients who would otherwise need to be hospitalized cannot be treated immediately.

Eating Disorder Treatment Medical Team Dr. Nobushige Naito

"Pediatrics and internal medicine introduce patients who are underweight and

unable to receive

nutrition every day, and we have no choice but to order them according to their severity. The situation that can be said to be a “medical collapse” that he has been waiting for and cannot be hospitalized has continued since before the new Corona. ”

Patients wandering with symptoms

There is also the issue of regional disparities.

"Even if I go to the hospital, I always see a doctor for a minute or two. Just take the medicine, yes, then come back. I don't feel like my symptoms are getting better at all."

A female in her 40s in Toyama Prefecture who has the symptom of "overeating vomiting", which causes her to stuff a large amount of food and spit it out.

The symptoms that started about 20 years ago gradually worsened, and I "laddered" two or three stores and forcibly stuffed them with food, spit them out in the bathroom in the neighborhood, and then went home.

Such days continued.

“I'm just not good at dieting. I'm bad.” The

woman didn't even know she was ill and put up with it for about 10 years without being able to talk to anyone.

It was painful and painful, and I went to the psychosomatic medicine department near my house, which I searched for on the Internet, that it should be a little better if I went to the hospital anyway.

The only prescription there was a drug that was "effective for depression."

He said that he still couldn't find a hospital that could treat him satisfactorily, the examination was always completed in a short time, and his symptoms did not change much.

Why can't you make a system?

Eating disorders are said to have more than 200,000 patients in Japan, and it is a disease that can be said to be "close" to anyone.

Why is the medical system not in place?

Atsushi Sekiguchi, director of the National Support Center for Eating Disorders, who is conducting research on treatment programs for eating disorders, points out that the lack of an education system to train medical professionals is a major factor.

Atsushi Sekiguchi, Director,

"Treatment of eating disorders requires knowledge of internal medicine and psychiatry, but in the current Japanese system, there are hospitals that teach diagnosis and treatment of patients, and there are also no-touch places. The current situation is that it depends on the individual's experience, and even if there is an enthusiastic doctor, if that person collapses, another doctor will not be able to see the patient instead. "

According to a survey conducted last year at "support base hospitals", which are only in four prefectures nationwide, about 30% of the nearly 1,400 consultations were received from "outside the prefecture", from people who have never visited a medical institution. It means that many consultations were also included.

Atsushi Sekiguchi, Director of the Center

"There have always been situations where patients with eating disorders do not know where to access or where to go. It is a national policy to create a system where they can receive treatment properly wherever they are. We need to correct the current situation. "

postscript

In October, medical personnel from Ishikawa Prefecture held an online meeting.

Participants included doctors, visiting nurses, social workers and psychologists from university hospitals and private hospitals involved in the treatment and care of eating disorders.

The members of the meeting wanted to improve the situation where patients tend to be biased toward specific hospitals and specific doctors, and the level of medical care varies depending on the area where they live, through the “cooperation” of medical staff.

After the expansion of the new corona, it is becoming more difficult to receive support from the surroundings, and the number of patients with eating disorders that worsen their symptoms due to mental stress is increasing.

In addition, "eating disorders of children" such as elementary school students are also a problem.

There is an increasing need to create a system that can connect as many patients as possible to medical care as soon as possible.

Kanazawahosokyoku reporters

Sonoyama shower

Ryowa two years He joined

was assigned to Kanazawahosokyoku second year of the current, the cap of the case trial in charge.

I have a driver's license, but I refrain from driving for safety reasons.