One of the few "perks" of being employed full-time in Japan is the legal requirement for an annual health check. People get to visit a designated medical clinic to get poked, proded, and quantified in as short a period of time as possible. This year was my 11th exam and there were a number of positive results that show I've been able to lose a bunch of weight and keep it off, which has helped in other areas. Despite the relative good health, though, there were two areas that were highlighted for follow-up, with one being marked "urgent": a low white-blood cell count, and a possible renal condition.

The white blood cell count has consistently deteriorated by about 15% every year since I left the classroom and the most recent test shows the numbers to be about half of what they were in 2014. Fortunately there are a number of foods that a person can consume in an effort to raise the number, such as yogurt, ginger, spinach, garlic, and broccoli — all the things that I could enjoy as a meal in an of itself. Despite the low number, I'm still within the thin band defined as "marginally safe", meaning there is time to do something in a natural manner. The renal condition, however, is a bit different.

Last year's medical checkup showed some problems with my urine and there was a recommendation to have it checked again within six months. Between 2012 and 2015 the uricological tests all came back with scores of A+ or A, meaning there was nothing to worry about. In 2016 it was a C. Last year it was a D. This year the result is classified as an F. Being someone who consistently puts other things ahead of personal medical matters, I ignored the suggestion to get a second opinion. This year's F is forcing my hand to go and get checked out. What's interesting is that the medical summary for this year contains more specific information explaining why I scored an F with the urine test: CKD Stage G3.

Not knowing what G3 means in plain English, I went and looked it up:

Patients with CKD stage G3 have impaired kidney function. Only a minority of patients with CKD stage G3 go on to develop more serious kidney disease. Cardiovascular disease, the umbrella term for diseases of the heart and circulation (e.g. heart attacks and strokes), is more common in patients with CKD. It is important to try and identify which patients may go on to develop more serious kidney damage and to try and reduce the chances of patients developing cardiovascular disease.

So I have impaired kidney function and a very slim chance that it'll continue to develop into something that might result in an earlier death. Considering how quickly the tests went from A to C to D to F, though, I wonder if this is a sign of something a little more serious than the medical website outlines. Some additional documentation — supplied only in Japanese — explains that the tests showed my kidneys operating at about 50% of what they should be given my age and general health.

Tomorrow I'll be setting up an appointment with the family doctor to have some more tests done on my blood and urine. If he agrees with the assessment that something needs to be examined more closely, then he'll provide the necessary referral to the regional hospital down the road that can diagnose the issues with greater accuracy. This F grade will likely amount to some pills and maybe a slight adjustment in the diet, which will be fine so long as I'm not asked to reduce my coffee intake.