Sunday, March 25, 2012

Medical Update

Ok, here we go. I went on Tuesday with my student to the hospital for the consultation with doctor whose English is very good.

As it turns out, they do not want me to have a "pot" CT, but a PET Scan. They are trying to either confirm the presence of cancer or rule it out. It seems that there are small lymph nodes  making an appearance in abdominal area, and they also want to better identify the small spots on the top of my kidneys.

I will have to say the gall stones were a blessing in disguise. As big of an emotional crybaby as I can sometimes be, I have a pretty high tolerance for physical pain. And let me tell you, those gall bladder episodes were as painful as anything that I have experienced. The pain got my attention and told me "YOU NEED TO SEE A DOCTOR!" If not for those gall stones, I would not have been going to a doctor, and wouldn't have had any of these tests done. So, God, in His infinite wisdom knew how to get my attention.

Now, this may turn out not to be cancer, but the doctor told me that is what they suspect. So, if it is, the gall stones have brought an early discovery, and that is always more desirable. I will have to go to Shanghai to have this test as the hospital here does not have the equipment to do it here in Zhangjiagang. Next weekend I will go to Zhenjiang and meet with Mr. Yang at the school and see about them helping make arrangements for the test in Shanghai. Until then, I will just place my trust in the Lord, and let Him be my peace, courage, and strength.

The doctor in Zhangjiagang Dr. Sheng, has given me his phone number and has told me to call him if I need any more assistance. He will help me to get all of my CT films put onto a USB so that I if needed, I can bring them back to the states. He has also recommended that if the tests do confirm cancer, to return to the U.S for treatment. Seems like and easy call, but I really still do need to pray about that for a number of reasons. I would ask you to also be praying. God is good. He put this doctor in my path. As  a side note, he is a cardiac surgeon, just goes to show you how different our health care system is, not many cardiac surgeons in the U.S. would be working on Saturdays seeing patients for ordinary internal medicine maladies.

As it "just so happens" there is a man who comes to the Thursday bible study who is also a doctor and whose English is also excellent! He has also offered his help to me. I figure between the two of them, I can get a good understanding of where to go in Shanghai, and then they can help me with interpretation of the results. Although, I figure that in Shanghai, I have pretty good chances of getting doctors with good oral English abilities.

Even as "bad" as all this may sound, God has given me quite a few opportunities to tell and demonstrate the "good" that is found  in "All things". One way you can know about this is at the end of my next blog(warning warning- if I was speaking, you would say it is long winded) that God has been prompting me to write for a few weeks now.  Other ways, is that I've also been able to share this with my students, telling of my trust and faith in God, and also with the Thursday bible study.  A dear lady named Nancy has reminded me several times that she is praying and that we are "marooned on the island of God's sovereignty" Think about that for a minute. There is no place I'd rather be. So, in closing, I just ask for your continued prayers, asking God to give the doctors ans me wisdom, for their are many things I need to consider. Ask him to continue to give me a Romans 8:28 foundation for my attitude. Healing, if it is in His will, and most of all trust and peace in His purpose. Thanks for reading. Until the next time...

Monday, March 19, 2012

To Visit A Doctor In The Peoples Republic of China Pt. IV

In Front of the Hospital
Ok, had the CT scan on Sunday and all went as expected. However, as my students ( this time ZhuZhu came again with Jia Hui, a girl who is my student and sits next to Zhu Zhu) and I were crossing the street for the bus, Zhu Zhu got a call and the CT department said we should come back right now. Back inside we go.

Ok, Time For One More Pic
Coming Out of the Tube
 Once there, the guy who looks at the scans (I don't know if he was a doctor or not, but I will assume he was)said he saw many "reactive" spots on the Pancreas and said I should go have some blood tests right away, and depending on what the test revealed, maybe I should be immediately admitted into the hospital. He apparently thought I was suffering from acute pancreatitis.

So, we went down to the registration window to register to see a doctor who could order the blood tests. Sunday apparently is a very busy day for seeing the doctor, because arriving to the waiting area we discovered that I was 60th on the list of numbers. But, that was ok, because there are around 6-8 doctor's offices for that particular area, and seems we only waited for about a half hour.

Lo and behold, the doctor I saw on this visit spoke directly to me in pretty good English! I mentioned that he was the first doctor that had communicated with me directly. He told me most Chinese doctors can speak English. I told him I suspected that but up until this point, they all spoke through my friends who came to translate and that I appreciated him speaking directly to me.

We told him why we were there and he ask me a few questions about my symptoms, reached over and poked me a few times in the belly and saw that caused no pain. He told me he did not suspect pancreatitis in that my symptoms were not consistent enough with pancreaits. I asked him what he did suspect,and like a good doc, he said that until he had more information he did not want to speculate. (At this point, we did not have the CT films). So to the "injection" lab we go (after paying for the lab tests 30yuan = $5 USD)

Ha ha, another great experience. We go up to the window where you give your information, and this time there is only a "Chinese line" that is everyone crowds around up front trying to be next.  So, I looked at my students and said do you think I should go Chinese on the line, and they said yes. So, I kind of worked my way through every little opens space and was in front of the window in no time flat.  Once there, I give my order slip to the nurse. Now, this is sort of like a Chinese Bank Teller window, where there is a piece of plexiglass between the teller and the customer and a small slot at the bottom, only this one had slots running horizontally across the bottom and a few more in the middle. I sit down in the chair on the opposite side and the nurse reaches through and straps my arm to find the vein. First the left arm. She can't find it. She calls her workmate over. She can't find it either. I am a little more "thicker" than most Chinese people so, they are probably not used to searching under a little more flesh for the vein. The ask for the other arm, strap it up, and viola! They find the vein, insert the needle (she did pretty good-on par with most needle sticks I've had for the purpose of drawing blood). Now, I can't remember if she took one vial or two. I was too busy looking at the little measuring cup and and test tube that I soon found out was going to be for my urine sample.

That's right, not your standard U.S. issue urine sample cup, but a small measuring cup with a tiny handle and a pour spout, more like a ladle. The whole thing is about as big as the 1tsp size in your cooking sets.  Yes, you had to fill the little cup, and then pour the sample into the test tube.

They told us that the results would be ready in about an hour. So, we went and got a boazi (steamed bun with a meatball inside-pretty tasty, even though it is pork, I can usually eat at least one with no trouble because none of it is fried and there is very little oil). Took a walk to the museum down the street, which was pretty much closed because the were holding a home decorating exhibition in the main lobby.

Jia Hui & Zhu Zhu at the Museum
An hour killed, we went back and picked up the results and proceeded back upstairs to see the doc. Well, the hospital lunch hour was not quite over and we had about a 45 minute wait. Besides us, there were only a few more people there and I kind of dozed off while Jia Hui made friend with the little girl and Zhu Zhu was surfing the net on his phone. When I woke up, they were sitting 3 chairs away from me and I asked if there was something wrong-didn't they want to sit next to the sleeping laowai?(kidding of course). Jai Hui told me the little girl was making noise with her play cell phone and did not want to disturb me. Never heard a thing.

Well, 1:15 rolls around and we were heading back to see the English speaking doc. Bummer, he was gone! The worker told us he was doing an operation. I asked when he would be here again and they told me he only works on Saturdays. ( I have no idea why he was there on Sunday, but glad he was).  I was not in any pain, and the doc indicated that he did not think the situation was as urgent as the other guy did, we decided that we would go see if my CT scans were ready and save some time for this week when we would go back to see the doc who had ordered them. They were still at lunch, so we had another 15 minutes to wait.

When they opened, they told us that they were not ready. Zhu Zhu asked to speak to the guy who'd called us back. So, he comes back out and tells us they probably would not be ready until Monday. Zhu Zhu showed him the blood test, but it was like he did not know how to read it and did not say anything about what he read. So, we left to go home. All told, we had been there for almost 6 hrs, arriving around 8 and leaving just a little before 2-the longest time I've ever spent on all my visits. But, that was ok, because I was really kind of wanting some blood test to be run anyway. I figured they would need to in order to rule out or in any other problems-especially concerning the spotting on the pancreas and the spots on the adrenal glands.

I will return tomorrow, Tuesday, the 20th, pick up my films, and take those along with the results from the blood test and urine sample to the do who'd ordered the CT. Hopefully, there will be some definitive answers. If it is just gallstones, I am still looking for the Lord's leading on how to handle them. My desire is to try the meds that will dissolve them, but surgery may be an option. As long as I stay away from the fatty foods, oil and such, I've been relatively pain free.

I do have a friend from my Teachoverseas days who is now working in Beijing for Disney. She is going to try and get me some contact info for the "expat" medical practice there in Beijing. China is testing in some of the larger cities the allowance of western medical facilities, which includes some small hospitals run by foreigners. They are a bit more expensive (how much more, I don't know) but the quality of care is such that many Chinese prefer to use them as well.

Well, that is it for now. As always, thanks for reading, and your prayers are coveted and appreciated. Main thing I look for in prayer is wisdom for the docs, and a Romans 8:28 attitude for myself. Healing would be nice, but His will be done not mine. Thanks again, and until the next time...

Friday, March 16, 2012

To Visit a Doctor in The Peoples Republic of China: Part III

Ok, I went back to the hospital on Tuesday, March 13th to pick up the MRI and see the doctor. First, sorry the update is a little slow in coming but, after the doc, I needed to go to the grocery store to get pizza ingredients for the Tuesday-Wednesday pizza parties, and then the bible study on Thursday evening, along with classes, just had me a bit tired. So, on with the story.

On this visit, I had two of my current students, Zhu Zhu, and Xu Han go with me. We arrived at the hospital at 7:30 a.m. and picked up the films. Then went back to the registration window and repeated the process of registering for a doctor. We went back up on the second floor, but this time to a different department ( I assume that these docs were a different sort of specialist), gave the receptionist our registration paper, and she confirmed our number to be called and the doctors office where I would have my consultation.

After about 15 minutes, my number was called, and back we went. Again, there was  someone still in the office with the doctor, but Zhu Zhu went in and confirmed we were at the right office. So, he came back out, closed the door and we just stood by the door. As, we were waiting a man came up, and I could sense that he would try to get in ahead of us, so I sort of moved over and blocked his way. He understood my subtle message and kind of backed off a bit, but I could tell that given the opportunity, he would try to slip by me, so I kept an eye on him.  About a minute later, a well dressed woman came up, and stood by me and knocked on the door. I gave way a little, and when no one answered,  she reached in and opened the door. I did not attempt to block her out. Later, I was glad I had not, because as it turns out, her mother was back in one of the examining rooms.

After about 5 minutes, the man who was being seen ahead of me opened the door and came out and in we went. The doctor appeared to be on the younger side (age is hard to tell with Chinese people, but he was definitely the youngest doc I'd seen yet). He pulled the images out of the bag, and even though they had one of those wall lights to view the image, he just held them up one by one to the ceiling light and looked at them that way. He asked me a few questions about whether I was having any pain or not, and when I told him not lately, that I had been trying to watch what I eat, he nodded his head. I should tell you, that again, this is all taking place through the interpretation of my students. I do suspect the doc could speak some English, but chose not too. However, when I said that I was trying to eat more fruits and vegetables, he was nodding his head in affirmation before my student translated and told my student that was good. After a few more questions, he confirmed the suspected cause of my pains: Gallstones and Cholecystitis, or inflammation of the Gall Bladder. His recommendation was to have the surgery, but first he wanted me to see another doctor down the hall and have him look at the films. He saw something else and wanted a second opinion. On the plus side, the gallstones are smallish.

So, we went down the hall and saw the other doc and he looked at the films and my medical book. He then told me they wanted to have another test, a CT scan done. What they saw in addition to the gallstones were some spots on the adrenal glands and wanted a better picture. Up to this point, my medical history has not been discussed much so, I thought that I should volunteer that I had testicular cancer in 1994. He asked me about the treatment and the follow up. I let him know that after about a year and half of follow up, I was released from coming back for more check ups. However, he did want to give me a quick examination, so we went around the corner to a more "private" examining room. (Yes, in both doctor's offices, people were milling in and out, and that is where  I saw the well dressed woman with hem mom, who had also received consultation by the doc I was now seeing). He gave me an exam, and asked a few questions and we were done, and there was no audience, ha ha, except for one of my student translators.

Consultation done, we needed to go schedule the CT. I thought I had the procedure down, so I led my students to a registration window on the second floor where the lines were shorter. However, we found out that we had to go arrange the CT first, so they would know how much to charge us. Apparently, there are different levels of CT's and the lab has to read the docs instructions and then give us a slip of paper detailing the type of CT to be billed.  Downstairs we go.

Back in the radiology department, we take our place in the line.  They have those line makers, like the ones in the banks, but they only had it pulled out for a short line. So, as we stood there, another guy did try to slip up ahead, but I aligned my students to stand 3 abreast of each other, effectively blocking a rear attempt at line hopping. Ha ha, you have to be on your guard. As we moved up to be second in line, a lady appeared to our right. She did stay on the other side of the rope, but was trying to lean in to get the attention of the clerk.  Before she did, we moved up to take our turn. The clerk was still typing is some information from the last patient, and as she was, the lady was now kind of leaning up against my student and trying to get her papers in front of the clerk. I leaned forward and help my papers out in an attempt to block her efforts, but she was faster and better! The second the clerk stopped typing, the lady gave her papers a little toss and they landed right on the clerk's keyboard! Ha ha, gotta hand it to her, she came, she saw, and she conquered.  The clerk took up her papers and began to process her. ( Chinese people are kind of use to this, and even though most of them don't like it when it happens, they usually will not begin a confrontation.) I just let it go. It did not take long for the clerk to process her and she soon was processing us.

Type of test in hand, Zhu Zhu, and I headed back up to the registration window. I turned around and saw that Xu Han had gotten back in line. Because, the paper we had was just for billing purposes, we would have to come back with the paid receipt to schedule the actual appointment so, Xu Han, was "holding" a place in line for us. I started to say something, but Zhu Zhu told me it was alright, that Chinese people do that all the time. I don't know if I had mentioned this, but on my first visit, Tuo had wanted us to stand in two separate lines in case one was faster than the other. I have also seen this in the grocery store, where a husband and wife will stand in separate lines, and then when once  reaches the cashier the other will come over. I had picked a line once on the basis that the person in front of me seemed to have very little groceries, but then when it was his turn, his wife comes over with a full cart of groceries. I tried to block them out, but the husband just reached over and his wife handed him stuff from her cart. Realizing that I had lost, I relented and pulled my cart back a bit to let her get her cart to speed up the process. I wonder how all that plays into line theory management courses. Ha ha.

CT scan paid for, WOW!, much more expensive than the MRI, 2700rmb ($427 USD)! Again, I am fortunate that I am paid rather well. For a person employed as a street cleaner that is 3 times their monthly salary. For many English teachers, that would be 90% of their monthly salary, and for recent college graduates from a non-famous school, that would be almost, and in some cases, equal to their monthly salary. I am not sure how many people are actually covered by some type of insurance plan. But, if not covered, these charges would be a real burden on them and their families.

So, the CT is scheduled for this Sunday at 8:15 a.m., and again two students will go with me. I invited anyone who wanted to come, but that is rather early for students to get up on a Sunday morning.

To wrap up a few things, I did go back to the first doc I saw that day, and we asked about getting some medication that, in about 15% of the patients, will dissolve the gallstones, and he said sure we could try that first as long as I was not in too much pain. And I have been emailing my sister back home who is a nurse and has some connections with some really good doctors and she has been talking with them a bit. From the information relayed so far, they seem to be in agreement in the course of action. Lastly, it is possible that the spots on the adrenal glands could be scar tissue from my cancer treatments and the massive operation I underwent.

So, there you have it. Whichever way it goes, it is in God's hands and I trust him. Of course, I would rather this be a simple case of gallstones and scaring, but as Jesus prayed "Abba! Father! All things are possible for You; remove this cup from Me; yet not what I will, but what You will.” (Mark 14:36)and so it shall be.  You can pray for wisdom for the docs, continues respite from the pains (avoiding certain foods has all but eliminated the most severest of pain) a little more energy and rest for me, and most of all that I would allow this to be a practical demonstration of Romans 8:28 " And we know that God causes all things to work together for good to those who love God, to those who are called according to His purpose. Thanks for reading, as always, feel free to ask questions.  May you experience all the blessings God has for you. Until the next time...

Tuesday, March 6, 2012

To Visit a Doctor in The Peoples Republic of China Pt. 2, And A Few Tidbits

A an update and a couple of interesting tidbits.

First, I went to schedule my second test today. Looks like it will be an MRI. Same process, arrive at the hospital and and wait for the registration window to open to register and make a small payment of 9.8 yuan ($1.55 U.S.,not really sure what the payment was for), then over to the doctor's office. Again, we just walk right in despite another patient receiving a consultation. Different doc this time, but he takes my book, reads the notes, and then writes up the order for the test. Order slip in hand, off we go to the payment window. The fee is 980 yuan ($155.27 U.S.). Ha ha, the two payments are just different by two decimal points. The only time I could get an appointment is on Sunday the 11th, at 8:00a.m. So, in and out in less than an hour. The process has been pretty smooth so far.  For you guys back in the states, that would be around 8:00p.m. Central time.

Now for the interesting tidbits. As things go, my little sister Molly back in the U.S. has also just been recently diagnosed with the same thing. She says for the time being, she is going to try and managers hers with dietary changes as well. Going to more fruits and veggies, more fiber, tuna, and a little grilled chicken among other things.

So, for the second tidbit, I'll let you decide how much God was involved (I already have my opinion and you guess what it is ha ha!). The other day I went to the grocery store to see if the mozzarella & pepperoni had come in for Ma Long's Pizzeria. The mozzarella made it, but no pepperoni, but that is ok, I still have another package of pepperoni left. Funny thing is the dairy and the red fatty meat is supposed to be a no go for me. Hadn't thought about it, but as I write, comes to mind that could be the God thing too! "} Anyway, I will just have to limit myself to a slice or two and let the students enjoy their creations. I get most of my fun just watching their faces as they make and eat their first personally made pizza.

But, I digress. While in the store, I spotted a small bottle of pomegranate juice. As I am not really supposed to take in a lot of citrus, I thought why not give this a try. I have heard that pomegranate juice is supposed to be really healthy. However, not having my glasses with me, I could read the ingredients, and I did not know if I would like the taste, but decided since it was a small bottle, I would "have a try".  I put it in my basket, went home, put it in the fridge and promptly forgot about it until today. I put on my glasses and read the label. Only 25% juice and a lot of sugar. So, that is no good. I left to go meet Tuo to go make the appointment.

Here is where I believe God was working on this situation long before I had the first symptom. Every year, most cities host a "Christmas Party" for all the foreigner teachers and businessmen and their Chinese counterparts. I really don't like to go to these things because they are not really about Christmas and usually a lot of drinking takes place, and it is a little awkward for me because I no longer drink, and part of the culture is the toast. In Zhenjiang, after the first year, the school official just came to accept that and it did not bother them anymore.

Ha ha, I remember the first dinner I attended with Tami Kirby, my teaching partner at the time. When they came around to pour the bijou (wine) in my glass, and I covered my glass with my hand, you could have heard a pin drop! We explained that we did not have an objection to them having the wine, it was that I just no longer could. There was more awkward silence, and then after a minute or so, they had the rest of the wine taken out of the room, and replaced it with juice and yogurt milk. But, everything went well, and at the next function, they drank, and we did not, but we toasted with our juice and nobody seemed to mind. The drinking culture here is very strong. Ha, but I digress again!

So, after we made our appointment, Tuo went back to the school, and I went to another grocery store to find green and yellow peppers. While there, I also decided to see if I could find some organic, or 100% juices, and maybe pick up some more fruit. Then it dawned upon me, at the Christmas party, I won pretty nice juicer as a door prize. I had even tried to give it away as I thought I really did not have the counter space for it, and being somewhat lazy, did not relish the thought of cleaning it after I was done. ( I had not even opened the box to look at it yet) So, I bought a few more bananas, some strawberries, and some nice looking carrots and went home.

I opened the box and had a look, and it is really not all that big. I could probably figure it out for myself, but I decided I would wait until tomorrow and try it out for the first time with my students. I think they will enjoy that as much as the pizza. So, whatcha think, did God have His hand in that or what?

I will update you further next week after the test. So, until the next time, keep me and my students in your prayers. Thanks for reading.

Saturday, March 3, 2012

To Visit a Doctor in The Peoples Republic of China

Well, as some of you may know from my newsletter, and for those of you who are just now finding out now, I've had the opportunity to experience a doctors visit in China in the same way that everyday ordinary Chinese citizens do. For my Facebook friends who do not receive my newsletter, let me give you a little background.

Shortly after returning from Australia on January 31st, I began to experience some discomfort in my upper abdomen, and on two occasions, some really severe pain.  Because this occurred while the students and staff were still at home for Spring Festival, I decided that if this did not clear up by the time they returned I would find someone to take me to the doctor. Upon their return, I had not really experienced any more sever pains, and had only some minor discomfort, so I told Tuo, a friend and an administrative worker about it and said if it did not go away in two weeks I would like him to go with me to help interpret. As you probably have surmised by now, it did not go away, and we made arrangements to have the visit on Friday March 2nd.

Early in the morning of March 2nd, around 4 a.m., I was awoken with pain in my upper abdomen, severe pain! After about an hour and taking some aspirin, which did not help. I decided maybe I should try to get Tuo to call 120 and go to the emergency room. So, I got dressed and went into the living room and sent him a text message telling him my pain was severe. I then sat down and opened my bible and came to 2nd Chronicles 19;20 and began reading about Jehu's rebuke of Jehoshaphat, and Jehoshaphat's reformation, and calling on the Lord when Judah was about to be invaded.  Oddly enough, as I read, the pain subsided, and I fell asleep. Since I had sent a text message, Tuo did not hear the message tone, but when he awoke around 6:30 and called to ask if I wanted to go to the doctor right away. I told him no, as the pain had subsided and that we would just follow our plan and go after lunch. On with the visit!

In China, you just don't go to the doctor, because there is no private practice so to speak (that may change in the next few years), you go to the hospital to see the doctor. Our plan was to arrive at 2 p.m. because like most government institutions, offices shut down around noon and then reopen around 2 p.m. That is not to say that in an emergency you would not be able to see a doctor, just if you are seeking a regular visit you have to wait for the normal time.

Back of My Chinese Medical Record Card
Front of My Chinese Medical Record Card
So, we get there and pick a line to stand in to wait for the registration- payment office window to open. When the window opened Tuo went to the check in desk to give them my personal information so that I could get my medical card. Every Chinese person has a card similar to this, but it also has their picture on  it as well. On the back of the card as you can see is a magnetic strip similar to the one on the back of our credit, and bank cards. Right now, it just has basic information such as name, age, place of residence, and is used to record your visit and payment information. The plan for the future is to have all information recorded to the card so that the required medical booklet can be eliminated. Right now, all of your medical records are recorded in this book:
My Chinese Medical Record Book
With the exception of your basic information, all the medical records are kept in this book, and all citizens are responsible for keeping the book safe and to bring the book with them for each medical visit.

Well by the time Tuo returned with these I was almost next in line. When it was my turn, I gave the lady my card, book, and passport (for I.D.) and she slipped the card into a reader, typed in some information to the computer, and then popped the cover of the book into a printing device, and it put my name, my patient record number, and age on the front.  I paid 5 yuan (.80 cents U.S.) for the card and after we told her the nature of my problem, she gave us a slip of paper that assigned me to see an internal medicine specialist on the second floor. So, we arrive on the second floor, give the receptionist our paper and are assigned a number and the office number we would go to when the number was called. Even though there were about 20-30 other people in the waiting room, my number was called after about 15 minutes. We made our way back to our assigned office. The doctor was still with another patient but Tuo walked right in and asked the doctor something as I stood in the doorway. You should know, there is no expectation of privacy in the Chinese hospital. That is just the way it is, and the Chinese people are use to it and don't seem the least bit phased by it.

Well, it became my turn and I sat down across from the doctor as Tuo told her my symptoms. She asked a couple of questions and through Tuo I gave my answers. She then had me lay down on the examination table and began to examine my abdomen and lower stomach, apply pressure at various points and asking if it caused any pain. (just like a U.S. doctor would do). Meanwhile, other patients who were waiting to see her were milling in and out asking questions and inspecting the fat laowai (by the way, I have lost 4 more kgs=8.8 pounds) being examined.  This is very similar to my experience when I first arrived in China and had to take a physical. People would come in and out of the exam rooms where I was being seen and asked the docs questions and take a peek at the foreigner being examined. So, I was not totally surprised that this would be happening during this visit.

After the examination, she wrote something in the medical book. I presume it was her findings based on the answers to my questions and her physical examination ( I have not asked Tuo for a direct interpretation yet). She then sent us to go have a sonogram of my abdominal area from the top, and both sides. But, first we had to go pay. The cost was 136 yuan (about $22 U.S). We made our payment, and then went to the wing of the hospital where the sonogram would be performed. We go to the reception window and show the lady our instructions and payment record and she sends us directly back to where the sonogram would be performed. Up until this point, I did not feel I was getting any preferential treatment because I was a foreigner, but kind of did so when she sent us back first while there were quite a few people in the waiting area. However, they could have been waiting for some other type of testing. Maybe I was just fortunate and the Lord opened the path because he knew Tuo had to be back at the school before 4:30 in order to catch the bus back to his hometown in Zhenjiang.

Anyway, we go in and I am instructed to lie on the table and the specialist begins her work. As she takes her pictures, she tells the person next to her what she is seeing and he types the notes into the computer. I commented to Tuo that this is the type of procedure that is often performed on pregnant women to see the fetus. I was under the impression that Chinese women were not allowed to have this procedure, but as I was getting up, a very pregnant Chinese woman was in the room waiting. So, obviously, they can have the procedure. However, my understanding is that it is against the one child policy  regulations to inform them of sex of the child. ( If any of my Chinese readers would like to clarify this, right or wrong, send me a comment and I will publish it in the comment section.)

With the sonogram complete, and picture in hand, we head back to see the doctor. As we arrive, I see an older couple waiting outside and see the doctor consulting with another patient. Tuo walks right in as I protested that we should "wait our turn". He informs me that there is no need to wait, that you don't get a new number and you have the right to see the doctor once the test is done. Reluctantly, I just followed his lead. After the doc finished with the patient in front of her I sat down across from her while she looked at the sonogram and read the notes. She then wrote her opinions in the medical record book, and then informed me that I had gall stones. She said that she would like to have another test done to determine whether there is any blockage in the main duct leading to the gall bladder. However, that test would have to be scheduled in advance. I am assuming it is going to be some sort of x-ray, or possibly a ct scan. So, next week, I will go back and schedule an appointment that is convenient for Tuo to go with me.

My First Recorded Chinese Medical Record
In the meantime, she prescribed some medication and gave me two options for taking the medication. I could come back next week for several nights and take the med by IV (for my Chinese readers, the drip, or drop), or I could take the med in pill form. The popular option is the IV because it works faster, but, I really don't have time to come back each night, so I chose the pill form route. So, with this portion of the visit concluded, she gives me back my book with her notes, and an order slip for the pharmacy and off we go. At the pharmacy window we pay 26.5 yuan ($4.20 U.S.). As some added information, your really don't need a prescription for most medicines like in the U.S. You can just usually go to a pharmacy store and by what you need over the counter. I have purchased penicillin and amoxcylin many times for my annual bronchial infections.

Overall, a pretty good experience. Total time invested from start to finish, an hour and a half. Total cost of the visit: 167.5 yuan ($26.59 U.S.). I should mention here that there are no fees for the doctor or the specialist performing the test. They are paid government employees. While I did have as good as experience as possible for a medical visit, I feel the need to add a few caveats.

First, as you can see that health care in a socialist country is not entirely free (neither is a college education as some of those OWS people think they have a right too). In fact,  Each year, the Chinese people are paying more and more for their health care. I am fortunate to have a good paying job, so my expenses were minimal to me. But for those without health insurance, and that are making minimum wages the expense can be somewhat of a burden. I have been told to save my receipts and turn them into the school and they will submit them to the insurer for reimbursement.  So, when I find out how much the insurance covers, I will update this and let you know. By the way, I am told that the second test will be a bit more expensive, a little over a 1000 yuan (around $158 U.S.). Again, for someone like me with a good paying job, this is not a great expense. However, with some one with no insurance, and at minimum wages, (depending on the city, this can be anywhere from 900-1200 yuan a month, and I would suppose just like everything else, in larger cities like Beijing and Shanghai these fees would be substantially higher) these fees could be quite burdensome.

Secondly, even though there are no doctor fees, I've been told that if you want to get excellent service, you need to slip the doctor a "hong bao",  a red envelope with cash in it. The more cash, the better the service. Altough, during my visit, I did not see this happening, nor did I give my doc a hong bao. I have some friends who related to me that at the birth of their child, they slipped the doctor two envelopes with grocery  cards. They would not tell me how much money they had put on the cards, but they did so as payment for the doctors special attention. Right or wrong, this is just the way it is, and I am told that it is common practice and the Chinese people are use to this method. As I said earlier, Chinese medical workers are paid government employees and are not generally paid as well as their western counter parts, and also have the expense of their schooling to pay for, as well as probably putting in more ours than their western counter parts. Again, if any of my Chinese readers would like to clarify this, or add their commentary, please do so and I will publish your comments.

Thirdly, even if some of the medical expenses are subsidized by the government, the sheer number of the population 1.3 billion and growing, along with the aging of the population, places a greater burden on the government resources, and this is getting harder and harder to balance. Not to mention the burden on the people who pay the taxes, from which the government derives its resources . I know that everyone talks about how great the Chinese economy is and all that, but there are many problems underlying the economy that are not readily visible or often reported by the press. State subsidized health care is one of them.

Finally, I don't want to be political in these blogs, and this is as political as I will ever get, (well, besides the OWS reference mentioned earlier) but a socialist health care system is not the panacea that it is made out to be, and with the current legislation recently passed in the U.S, this is where we are heading. Now, I know that our health care system is in need of reform, and that millions of uninsured workers need a safety net (by the way, in the U.S, I am one of those uninsured) but I believe that the bill rammed through congress will eventually only make our health care system worse, and not better. The bill has not even gone into effect and there are already problems associated with the implementation, and major questions are now arising about the supposed savings this bill would bring.

 There is an old saying, "you get what you pay for". So, to that end, if we are not paying for anything (except insurance premiums) what kind of treatment are we going to get? Will we be slipping "hong baos" to our doctors? I believe we should have attempted to bring reforms to the practices associated with insurance and the actual medical practice itself. Insurance companies do have a right to make profits, and doctors should have the right to practice without the worry of some frivolous lawsuit that forces them to order every test imaginable to protect them from malpractice claims (an insurance issue). Yes, there are bad doctors out there and everyone knows it. Part of that solution would be for the AMA to rigorously pursue and enforce medical standards and ethics. The trouble is, there is too much protection afforded and too little punishment meted out to the bad doctors, all because they are "one of their own". Doctors protect doctors, and lawyers protect lawyers. It is time they are reminded that they are to serve the people that pay them, and not protect the profession at all costs. Punishment would only enhance the reputation and increase the peoples confidence in them...Ok, end of the rant, and that will be all the politics that you will see from me on this blog.

So, there you have it, my experience with the Chinese medical system. Thus far,  speaking as someone who has the resources to pay without feeling of being burdened by the expense, and as someone who has now experienced both eastern and western healthcare, I must say twas an excellent experience. If any of my Chinese readers want to share their experience, I would love to hear from you.  As always, feel free to ask questions or comment, and I will do my best to respond to your questions. All comments will be published and of course you can comment anonymously if you desire. And, if you are so inclined, please say a few prayers for me. Thanks for reading.