Week's End

Well, it's the end of our 'Golden Week' here in China. While we had always intended to keep this week casual and low-key, we didn't realize just how low key it would turn out to be...until week's end, that is. We had planned three different outdoor activities, a day trip to Hangzhou, the Science and Technology Museum and the Wild Animal Park. Needless to say, we managed to squeeze in the day trip and that's about it.

We attempted to go to the Science and Technology Museum one day...however, it was SO packed full of people, we barely managed to get through the entrance. TOO many people for our taste! The kids would get swallowed up in no time and lost in the throng of the masses. Nope, no way. So, we walked over to the plaza that housed the Fake Market right next door and again, there were a ton of people about. This IS Golden Week after all...so I guess we shouldn't have expected less people milling about town. SO, we ended up going to a little playground in our community that had a large open field next to it. Some other child had left a soccer ball there and we had LOTS of fun kicking around the soccer ball and enjoying a little family time. The day definitely didn't go to waste! :)

In fact, we ended up doing lots of cool things this week...like make a homemade card for Brandon's teacher, make fall place mats with leaves the boys collected on a walk, and we even went fishing in the canal next to our house, using hot dogs as bait! Both Ayi and Mr. Chen would have been very happy to take the fish home with them to eat. Unfortunately, we didn't catch anything this time. I guess we'll have to keep trying! :)




The other field trip we had planned was supposed to be the Wild Animal Park on Sunday. However, once again, our plans were waylaid...

Now, let's talk about Hospitals here in Shanghai. Both Allen and I received a thorough education on navigating the Hospitals and what to expect from the local Health Care here in Shanghai. From day one on arriving here in Shanghai, I had been dreading the upcoming flu/cold season. In the first two weeks of school, two students were diagnosed with hand-foot-mouth disease. Classrooms were quarantined, the sick children were kept at home and notices were posted around the school about the situation. Ok...not a good start. However, you can't keep the kids from getting anything, so I could just hope for the best.

Ryan had what appeared to be a common cough/cold off/on since arriving here. The cough always sounded "moist", because of what I figured to be the intense humidity here. He would cough for a few days and then it would stop...and this has happened about 2-3 times since moving here. One of the times, he had a mild runny nose along with the cough. Nothing serious and, again, he seemed to be over it in a few days. This week, was one of the times he had that cough...and a green snotty nose. He would occasionally cough, but nothing to alert us that it was something more serious. However, Saturday, he very quickly developed a fever of 102 degrees. We gave him some fever reducing medicine which helped a lot and brought the fever down to about 99.1 degrees. By the time the fever came down, he was breathing very rapidly and wheezing...but wanted to keep playing as if nothing was wrong. We watched his breathing for a while and finally decided in the evening that it was time for him to see a doctor. We were worried about his continuously rapid heart rate, with his breathing so labored.

There are three kinds of hospitals in Shanghai. There are local Chinese hospitals, expat hospitals and Chinese hospitals that like to tell you they are for expats. The only TRUE expat hospitals are completely run and operated by expats...and they sometimes share facilities with a Chinese SIDE of the same hospital. There are also hospitals where they will tell you they cater to expats, but they are still run and operated by Chinese people/organizations, etc., and thus follow Chinese standards and procedures.

Expat hospitals have International based doctors and also adhere to more common western philosophy of health care. Also, they generally speak English, both doctors and staff...which of course helps when trying to make an appointment, get prescriptions, etc. The CON to expat facilities is that they charge a lot more for consultations, tests, medicines, etc.

Local Chinese hospitals are a whole different creature. Generally, the place is PACKED full of Chinese people...being triaged for hours on end. The halls are full of gurneys of people who are waiting to be seen. It is not as clean. I, personally, witnessed blood left on the x-ray backdrop of the machine as well as blood on the floor near it. Eck! Many of the people being seen for their preliminary tests can be viewed in the lobby area, with IV's, blood pressure machines, etc. in plain sight. The PRO to Chinese hospitals is that they are CHEAP! Unbelievably so.

TCM, or Traditional Chinese Medicine, is the medicine protocol of choice for the Chinese. This usually includes lots of herbs, roots, bark, etc to help heal different ailments. Also, acupuncture and acupressure...and don't forget [chinese] massage...are also part of TCM. There are a TON of other things TCM includes, but I don't have much of an education in it - yet.

Back to the Hospitals. Our own adventure included...

We ended up going to the Shanghai East Medical Center in Pudong, an expat hospital, on Saturday night. This is housed in a portion of what's called the Shanghai East Hospital which is a local Chinese hospital. We were able to make an appt for a time we thought we could be there. The signs on all the hallways and doors indicated that the "VIP" ward was on the 12th floor. We found out that the Shanghai East Medical Center, itself, is a VIP facility...as it's the "expat" part that makes it so. We were there after the usual clinic hours, so there was absolutely nobody there when we arrived. We were quickly shown to a room with two beds...not a typical examination room. The room had a couch and TV, and all the machinery involved in a long time stay...not a quick exam. The room was very clean and sterile, as was the nurse's desk, etc.

Promptly at 8 pm, the doctor on call walks in to examine Ryan. The doctor ordered some tests and personally escorted us through them on the first floor, along with a nurse. When we got back to the room, that same doctor personally stayed by Ryan's side for the next 2.5 hours, constantly monitoring him. Ok, so far, I'm really liking the personal attention...something which is likely to become extinct in some cities in the US, if not already.

We paid more money for the consultation because it was after regular clinic hours AND in an expat hospital ward. However, we didn't have to deal with any other people AND got the docs personal attention. Ok...not so bad.

However, there is always a catch. When dealing with International doctors who may be able to speak English...you are also dealing with doctors who have as varied an educational background as (like my sister likes to point out) VP candidate, Palin herself. So, you should always exercise your own common sense when it comes to the actual diagnosis.

This doctor insists that Ryan has acute Asthma. I'm not so sure. There is no history of Asthma being prevalent in our family histories, as far as Allen and I both know. Moms...dads...this is the time to step forward and tell us differently, if that's the case. Ryan also has a [minor] bronchitis infection, which the x-ray result indicated. I realize that the symptoms for both of these can be similar. So, could it be something in between? Like a bronchial infection with asthmatic-like symptoms? Could it be a one time attack brought on by a bronchial infection we may not have detected for a couple of months, thus bringing acute symptoms to the surface all at once? Could it be fungal? Or is it truly acute asthma? And if this is the case, is 2.5 months of exposure to increased air pollutants long enough to develop such a thing? We moved from a place where the air was much cleaner.

The doctor, while attentive, is not a pediatrician. He is a General Practitioner. He is absolutely certain of his diagnosis..."It could be nothing else." Again, I'm not a doctor, but it just doesn't add up in my mind and my gut tells me we may have received a misdiagnosis, even if partially. He proceeded to admit Ryan for the whole night. It was a very long night for mom and dad. ;) Ryan, bless fully, slept most of the night without a problem. The doctor monitored his blood oxygen levels and his heart rate, which was very high...because his blood oxygen levels were so low. It took THREE rounds of nebulizer injections (through a ventilator) to get his levels to a more normal rate. Basically, he is being treated for full blown asthma, but the doctor did concede to give him additional medicine that will treat a mild bronchitis infection.

I have absolutely no history or any knowledge (except from what I've read online) about asthma. Should it take 3 or more nebulizer injections to open his passageways in his lungs? I have a hard time understanding that if it IS truly asthma, why it should take so many nebulizers to make things work right? And he is STILL breathing heavy and wheezing! The nebulizers helped...but shouldn't he be completely stabilized by now...after 2 full days??

Again, on the flip side, the doctor still continues to give us his personal attention in the efforts to monitor Ryan. He has given us his personal cell number, has asked us to visit his office at his other hospital job, told us to call him at 10 pm (on his personal time) so we can give him an update, and told us he wants us to call him directly next time we plan on visiting the hospital after regular business hours.

Just a side note...everyone here visits hospitals for basic ailments. There ARE private practices, but they are generally in or next to hospitals and the calls are often directed via the hospital.

It's not so foreign to me to doubt a doctor's diagnosis. After all, they are just as human as we are and nobody knows your body like you do. This theory extends to your child as well. Nobody knows their history or idiosyncrasies like you do, as a parent. And, in this instance, I'm not so much doubting the diagnosis completely...it just doesn't add up, from history, to symptoms, to diagnosis, to Ryan's reaction of his treatment thus far. Some of it makes partial sense. And it may be due to a lack of education on my part. Who knows. But, I'm trying to follow my gut instinct while still trying to adhere to the advice of something I'm uneducated about. We'll see...

This doctor also practices at Renai Hospital International Medical Center on the Puxi side. Wow! We stumbled upon it only because the doctor requested that we follow up with Ryan at this facility. What a difference! This hospital has definitely been flying under the radar for any of the other expats I know and talk to...it has never been mentioned. If we can, we will be going to this hospital in the future. It was SO clean, the admin parts were walled up behind glass, the lobby to the International office was extremely well organized and clean, the doctors speak English, their clinic has good hours during the day, it is MUCH cheaper than Shanghai East and they provide service 24/7...like an urgent care. Again, wow. We loved it. And from where we live, it is about the same distance and time to get to this hospital as the other one, even though it's on the Puxi side. It's only a year old and Shanghai East is 5 years old...but WOW, it's the difference between night and day in cleanliness and overall atmosphere. We're happy to have found it.

How is Ryan?? Better! We are not AS worried, but we are still keeping an eye on him. He will be missing the next few days of school, of course. He is still breathing heavy-ER and the wheezing seems to be much more intermittent. He has gunkiness in his nose and eyes. He is currently taking asthma meds as well as the meds for the bronchial infection. So, I really won't be sure which set of meds truly made him better, thus not really knowing WHAT, exactly, his true diagnosis was. We think he will recover completely and move past this episode. However, we will be keeping a closer eye on him and his symptoms in the future, being sure to look out for a more chronic condition...if it's there.