Your Health Concerns While Living Abroad: A Guide

Recent discomforts in the body?

Hello, doctor! I have been working in Japan for a long time and, due to the pandemic, I have been unable to return to Taiwan.
Recently, I have been experiencing various discomforts and I am unsure whether they are psychological or physical issues.
Being abroad without health insurance and facing communication difficulties makes me anxious about the possibility of serious health problems.
I thought it would be helpful to consult online.

Currently, my height/weight/body fat percentage is 185 cm / 102 kg / 26%.
Below are the examinations I have undergone in Japan this year:
1.
Basic health check: Results (abnormal findings): High blood pressure (133/85), waist circumference issues, and positive urine protein (+).
2.
Gastroscopy: The doctor said there were no issues, and I was sedated during the procedure, so I was not aware of it.
3.
Colonoscopy: The doctor reported no issues, stating that the colon muscles were strong.
A small polyp was found in the small intestine and has been removed.
I was awake during this procedure and did not receive sedation.
My concerns are as follows:
1.
Decreased energy: Since this year, I have felt a significant decline in my physical strength and energy.
I only exercise occasionally, and this fatigue is something I have never experienced before.
After work, I lack the motivation to play games or cook; I just want to eat and lie down to sleep.
I often feel panic and worry that I might suddenly experience a heart attack or aortic dissection, especially since I live alone and cannot seek help quickly.
2.
Back pain: I experience discomfort constantly (except when I am asleep).
I wonder if this is due to poor posture over a long period? This issue has only started in the past two years.
It’s not unbearable pain, but it is an annoying sensation with persistent soreness and numbness in my back.
3.
Weakness: I used to chat normally with colleagues and friends, but now I often find myself struggling to catch my breath when I get emotionally charged during conversations, accompanied by sharp pain in my shoulders and neck.
This issue worsens in the evening when my energy levels decline, and I am unsure what might be wrong.
Regarding self-management:
1.
I bought a blood pressure monitor: I measure it every morning, and it is usually below 120, which is normal (though it may not be as accurate as in a hospital).
2.
I try to maintain a light diet and reduce my food intake (due to panic, I often feel chest tightness and cannot continue eating).
3.
When I feel overwhelmed, I go for a jog or walk.
I would like to ask for your advice on these three points! I apologize for the lengthy message, but I needed to express my concerns.
Thank you, doctor!

Shang Quan, 30~39 year old female. Ask Date: 2021/08/18

Dr. Liu Hongxiang reply Family Medicine

Hello Mr.
Shang-Chuan,
Based on your height and weight, your BMI is 31.4, which falls into the category of moderate obesity.
Your systolic blood pressure readings of 133 or 120 are within the normal range.
It is recommended that in addition to dietary control, you incorporate exercise and weight management, which can help with energy levels, neck and back pain, weakness, and blood pressure.
For emotional distress, talking with friends or a mental health counselor can also provide relief.

Thank you for your inquiry, and I wish you good health and well-being!
Dr.
Liu Hongxiang

Reply Date: 2021/08/18

More Info

Navigating health concerns while living abroad can be particularly challenging, especially when compounded by language barriers, lack of health insurance, and the stress of being away from home. Your situation reflects a common struggle faced by many expatriates, particularly during times of uncertainty like the COVID-19 pandemic. Let's break down your concerns and explore some strategies to help you manage your health and well-being.

Understanding Your Symptoms
1. Fatigue and Lack of Energy: The fatigue you're experiencing could stem from several factors, including stress, anxiety, and lifestyle changes. It's not uncommon for individuals living abroad to feel isolated, which can lead to emotional exhaustion. Additionally, your recent health checks indicate some physical concerns, such as elevated blood pressure and protein in your urine, which could also contribute to feelings of fatigue. It’s essential to address both the physical and emotional aspects of your health.

2. Back Pain: Chronic back pain, especially if it has developed over the past two years, may be related to poor posture, particularly if you have been working long hours, possibly in a less-than-ideal ergonomic setup. Consider evaluating your workspace and incorporating regular breaks and stretches into your routine. Strengthening your core muscles through targeted exercises can also help alleviate back pain.

3. Shortness of Breath and Emotional Distress: The sensation of not being able to catch your breath, especially when speaking, can be exacerbated by anxiety. When we are anxious, our breathing patterns change, which can lead to feelings of breathlessness. Practicing deep breathing exercises can help calm your nervous system and improve your overall sense of well-being.

Strategies for Improvement
1. Seek Professional Help: Given your symptoms and the stress you’re experiencing, it might be beneficial to consult with a healthcare professional. Even if language is a barrier, many hospitals and clinics in Japan have staff who can communicate in English or provide translation services. A thorough evaluation can help rule out any serious conditions and provide you with peace of mind.

2. Monitor Your Health: You mentioned purchasing a blood pressure monitor, which is a great step. Keep track of your readings and any other symptoms you experience. This information can be valuable for healthcare providers when you seek help.
3. Lifestyle Adjustments:
- Diet: Continue focusing on a balanced diet. If anxiety affects your appetite, try smaller, more frequent meals that are easy to digest. Incorporate foods rich in omega-3 fatty acids, such as fish and walnuts, which can help reduce anxiety.

- Exercise: Regular physical activity can significantly improve your mood and energy levels. Aim for at least 30 minutes of moderate exercise most days of the week. Activities like walking, jogging, or even yoga can be beneficial.

- Sleep Hygiene: Ensure you are getting adequate rest. Establish a calming bedtime routine, limit screen time before bed, and create a comfortable sleeping environment.

4. Mental Health Support: Consider reaching out to a mental health professional, even if it's through online therapy. Cognitive-behavioral therapy (CBT) can be particularly effective for managing anxiety and stress. Many therapists offer services in English, which can help bridge the communication gap.

5. Mindfulness and Relaxation Techniques: Incorporate mindfulness practices into your daily routine. Techniques such as meditation, yoga, or even simple breathing exercises can help reduce anxiety and improve your overall mental health.

6. Connect with Others: Isolation can exacerbate feelings of anxiety and depression. Try to connect with other expatriates or locals who speak your language. Engaging in social activities, even virtually, can provide support and alleviate feelings of loneliness.

Conclusion
Your health concerns are valid, and it's important to address both the physical and emotional aspects of your well-being. By seeking professional help, making lifestyle adjustments, and incorporating mindfulness practices, you can work towards regaining your energy and improving your overall health. Remember, it's okay to ask for help, and taking proactive steps is a sign of strength. You are not alone in this journey, and with time and support, you can find a path to better health and well-being.

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