Monday, October 21, 2013

A Chinese Hospital Experience

**Thank you for all your emails, comments and heartfelt words in response to the news of our miscarriage.  We appreciate all your kind words and prayers on our behalf.**

One of the hardest parts of our miscarriage experience was the cultural stress that came from so many visits to the hospital.  I mentioned in my last post that the hospital visit and admission itself needed its own blog post - well, here's that post! In our city there is an “international” hospital.  Really, it’s Taiwanese, so it’s still Chinese but not as Chinese as a Chinese hospital (if that makes sense).  At the hospital, there is a VIP wing that you could compare to a clinic in the States.  All the nurses and receptionists speak English and the process to see the doctor is just like a doctor’s office in the States.  However, it seems at the VIP wing it takes about 2-3 hours for a normal appointment.  The first time we went we were there for 3 hours.  During which we saw the doctor, had an ultrasound (where we got to see the heartbeat, I was 7 weeks pregnant – pretty cool), and did a lot of waiting.  This is not how your average Chinese person sees their doctor.

For the everyday Chinese, you see your doctor at the hospital, not at an office or clinic.  In fact, there aren’t many clinics that I know of (my friend was telling me they are becoming more common where we live, but I haven’t seen one in our neighborhood).  To give you some cultural insight, here’s a quick breakdown of the hospital experience. 

When you arrive at the hospital, you go to the registration desk (where they don’t speak English), tell them which doctor you would like to see and pay the doctor’s fee.  This is the tricky part because you have to know who you need to see to get the right care.  Everything in China is specialized.  So, if you have an ear infection, you ask to go see the Ear, Nose & Throat doctor.  I am not sure what you do if you don’t really know what’s wrong with you.  Fortunately, we haven’t had to figure that out yet.  To see a doctor at the hospital, you don’t have to make an appointment, but you can.  I saw my doctor twice in the main hospital, once with an appointment and once without, but I couldn’t tell you the difference except that if you have an appointment you can skip registration.

After registration, you head to the waiting area of the doctor you are going to see.  This is where it is interesting, at the hospital they gave me an electronic card with all my information on it.  Once we got to the waiting area, my name showed up on the screen in some sort of order of when I get to see which doctor.  The screen is kind of confusing to understand, but when it’s your turn, your name comes up in big letters and they call it over the loudspeaker.  Since I’m not Chinese, they spelled my name out over the loudspeaker.  First, last and middle name.  Too funny. 

You head to your doctor's small office.  For the OBGYN doctors, they have a little room with their computer and an exam room next door.  It is private.  It was worried about this because I heard at some Chinese hospitals the gynecologist sees multiple patients, all at once, in one room with no privacy.  Yes, I know.  Sounds like something I never want to experience.  I think this is the difference between the Taiwanese hospital and other Chinese hospitals in the city, but I’m just guessing. 

If there are any tests you need done, your doctors orders them for you.  For me, because I was seeing my doctor as a follow up to a miscarriage, he ordered an ultrasound.  Instead of the nurse taking up to the ultrasound room, he swipes my card, gives it back and tells me to go back to the cashier to pay for the ultrasound, and after the ultrasound to bring him back the results. 

So, we head back towards reception and get in the cashier line; they swipe my card and I pay for the ultrasound.  After this we go upstairs where my name is now on the screen outside the ultrasound area.  They must do a hundred ultrasounds an hour.  I am not exaggerating.  I was in and out in less than five minutes and there are 7 rooms where they are performing ultrasounds.  It is crazy.  I had to go in alone, they wouldn’t let anyone come with me, and during the ultrasound they wouldn’t let me see the screen.  It was impersonal, but incredibly efficient.

After the ultrasound, I grab a printout of my results and go back to see my doctor.  This is where I really got confused because I couldn’t figure out on the screen if my name was in the queue to see him or in the “already seen the doctor” column.  So, instead I hovered by his office door to hand the nurse the results as she shuffled in and out answering questions.  Both times she pointed to the waiting area and told me to wait.  Anyways, eventually I was called back to see him.  

It is so interesting to me how this system works.  It’s impersonal, yet because it is impersonal, they are able to see a lot of patients every day.  And it’s cheap.  Really cheap.  To see my doctor in the VIP area is 300RMB (about $50) and an ultrasound in the VIP area is 300RMB.  To see the same doctor downstairs in the hospital is 32RMB ($5!!!) and the ultrasound was 160RMB (about $26).  The price difference is crazy.  In the VIP you are paying for English service, no lines, and the comfort of the environment.  Downstairs you get through much faster (even though there are more people), but because you are surrounded by people, you are also surrounded by germs, and you have to navigate the system yourself. 

Fascinating isn’t it?  It was stressful the first time I went in, but by the second time (in the same week) I had it almost figured out. 

The really fun part was when I had to be admitted to the hospital for the D&C, that was a bit different.  After I got back to my doctor with the ultrasound results, he took one look at the printout and told us that I needed a D&C.  He could do it that day, but I needed to decide right away because it was already 11:30am and he could get me into the operating room at 3:00, but I would need to be admitted now.  

So, after we agree to the procedure, he gave me some paperwork and pointed in the direction of the inpatient admission registration.  We went up to the desk and the lady directed us over to a number machine (you know, like you use at the bank or the DMV).  Our number was 190, currently they were seeing number first thought was "how long is this going to take?"  And then, after looking around at all the empty chairs, "Where are the supposedly 120 people in front of me?" There were five total other people in the waiting area.  After 45 minutes of waiting, they finally started calling lots of numbers, without waiting for 190 to show up, we went up to the desk and they checked me in.  They didn't even ask what number I was.  There are some things in China I will never figure out...

During admission, they had us pay all the money up front.  I can't remember exactly how much it was, but apparently in China you prepay for surgery and then any money you don't use gets reimbursed afterwards.  They couldn't charge my US credit card or run my debit card and the hospital didn't have an ATM, but fortunately my friend with me had her China bank card and they were able to charge that, otherwise, I would've had to go ATM hunting.  After registration, a nurse took me upstairs to prep me for surgery and get me into my room.  They put me in the maternity ward.  Does anyone else find this strange and, maybe, a bit insensitive for someone receiving a D&C?  Fortunately, several of the nurses recognized me from when my visited my friend who had her baby there a week earlier, so I felt at ease.  But I still think it's strange they put me in the maternity ward to have a procedure that was the result of losing a pregnancy. 

After the blood work and I signed all the paperwork (that I couldn't read and they couldn't translate - too many technical words, I guess), they said I needed an EKG to make sure I was healthy for surgery.  No big deal.  Except the EKG room is on the other side of the hospital.  After a 20 min excursion to the furthest wing of the hospital (ok, maybe it wasn't that far, but it felt really far), I was able to receive the 30 second test (which I passed) and then walk all the way back to my room.  Different, right? 

3:00 rolls around and they wheel me into surgery.  The operating room nurse remembered me from when my friend had her baby the week before (she ended up having a C-section), which I thought was amazing since I literally saw her for two seconds after the baby was born.  After surgery, I was back in the room by 4:15 or so.  They kept me on the IV until 6:15 when my doctor graciously broke protocol and let me go home.  Usually, women are kept overnight after a D&C.  I think all the nurses thought I was crazy for not wanting to stay overnight, but two hours on the hospital bed were enough for me!  Steven had to go back the next morning at 10:00am to officially check me out since I left after the registration desk was closed (or something like that, I didn't really understand the reason).  

So there you have it, a Chinese hospital experience!  I think mine really wasn't that bad.  I've heard firsthand accounts of others waiting four hours to get an MRI. It was stressful at times and definitely different than what we would have experienced in the States, some part goods and some parts not-so-good.  Overall, the nurses were great and very sweet and my doctor was as accommodating as he could be.  And it was so inexpensive.  When it was all said and done, the total cost for the D&C was 2,350RMB or $385.  That included the surgery and a night in the hospital (that I didn't use).  I think a room alone in the States is more than that. 

I am thankful to have this experience behind me.  And I'm thankful that I'm at a place where I can blog about this without getting upset.  God has definitely provided peace in this area - especially because it was all such an emotional and stressful experience.

On a side note, another friend of mine just had her baby last week at the same hospital (a month after my surgery).  We went to go visit her and the nurse on duty was the same one who checked me in for my D&C.  She remembered me and was excited to see me.  I feel like I know half the staff of the maternity ward between my surgery and visiting two friends who had babies recently.  Maybe next time I won't have to take a number. 

Monday, October 7, 2013

Experiencing Loss: Our Pregnancy Story

**This blog post was difficult, yet important for me to write.  I am writing this not because I want to expose our hurts for the sake of exposure, but because I feel it is significant emotional event and sharing about this is part of the process of healing.**

We had just decided to tell "round 2" of people we were pregnant.  Our immediate families found out at the end of July just after we did.  We found out one week before we left to come back to China, and were excited to share the news with our families in person.  After trying for only a few months, it seemed very surreal.  Even more so when my family took us to Target to go shopping just an hour after hearing the news.  Needless to say, everyone was excited there would be a baby in April.

After arriving back in China, morning sickness set in.  Actually, it was more like all day sickness with the worst time being after dinner.  We made appointments, saw the baby's heartbeat and started planning for the upcoming arrival.  Baby was dubbed "Little Bear" and we talked about Little Bear a lot.  I was nervous and excited, however, had I not been so sick I don't think I would have even felt pregnant.  But I was, indeed, pregnant.

On September 17th that all changed.

I woke up and discovered I was spotting and also had cramps.  As I sat in the bathroom trying to understand what was happening, fear started to set in.  The Hubby was asking, "What should I do?  Should I go to class?  Do you want me to stay home with you?"  Not knowing myself what to do, I told him to go to class and I'll call the doctor.  I was hoping if we went on with life as normal, it would be normal.  Ayi was coming in 10 minutes, he had class at 8:00 - just continue on with life and everything would be fine.  I called the doctor's office and 15 minutes later my doctor returned my call.  He wanted me to come in at 11:00.  The Hubby came home because he couldn't concentrate in class.  When he walked in the door, it was one of those moments where you don't realize how much you need someone until you see them.  I was glad he came home early.  

On the way to the hospital I knew what was happening, but deep down I kept holding on to hope.  It was, after all, just spotting with cramps so far, maybe Little Bear is still ok.  Maybe this will all be a bad dream, a scare we have.  

We got to the office and waited a half hour for the doctor to show up.  He had to squeeze us in between other appointments and a Caesarean he performed that morning.  We walked back to his office where he asked me some questions and then walked us over to the ultrasound room.  As we stared at the screen, there was no movement, no heartbeat, nothing.  The doctor was speaking with the tech in hushed tones (and in Chinese), but I already knew.  When he finally stammered out the answer (I think he had just as hard a time grasping what happened and how to say it), I couldn't contain the tears any longer.  It was heartbreaking.  I don't really remember the rest of that appointment, except that he wanted to perform a D&C but since my blood type is RH negative I needed Rhogam (if you don't know what that is, RH negative mothers carrying RH positive babies can build up antibodies to RH positive blood. To prevent the antibodies from forming, RH negative mothers need Rhogam after birth, or miscarriage, so subsequent pregnancies are healthy), and we didn't have the medicine yet.  The doctor wanted to wait until we got the Rhogam to do the D&C.  

One of God's sweetest blessings was the fact that some of our closest friends had just had a baby the week before and were still at the hospital.  We were able to go upstairs to see them, cry together, pray together and take comfort from them before getting back on the subway to come home.  It was such a blessing to us to be able to share in our grief with them immediately after finding out.

After we left the hospital, I called an American doctor in Shanghai I had seen at an appointment earlier in September.  I'm so thankful we had went to see her.  Talking to her about what was happening was comforting.  She gave us great advice and was very soothing.  After we got home, I started heavy bleeding. I will spare you the details, but if you have never experienced a miscarriage, or known someone who has, it is incredibly painful.  Basically, you go into labor (depending on how far along you are).  I was 11 weeks along.  It was the worst pain I have ever experienced.  

The rest of Tuesday and Wednesday I was bleeding a lot.  Thursday it slowed a bit.  Friday I went back for a check up.  We had received the Rhogam on Thursday (we had to order it from Hong Kong) and I went in on Friday to have my doctor give me the shot.  I was expecting to be there for 30 minutes or so, get a shot and go home.  That is not what happened.  The ultrasound showed that I still had 90% of the conception tissue intact.  How that is possible, I don't know, because I can tell you on Tuesday and Wednesday I saw more blood and clotting than I have ever seen in my life.  The doctor wanted me to schedule a D&C for that day.  I was devastated.  At this point, I had a very emotional, perhaps hostile, response to his recommendation.  After my wonderful husband calmed me down and prayed for us, we decided to go ahead with the D&C.  Being admitted to a Chinese hospital and having surgery is its own blog post, I won't expound on that experience now, but it consumed our entire day and a lot of energy to get admitted and navigate our way through the system.  I had the procedure and thankfully they allowed us to go home that evening (although the Hubby had to go back on Saturday to finish all the paperwork - like I said, it needs its own blog post).  Staying overnight is normal after a D&C procedure in China.  I think the nurses all thought we were crazy for leaving, but I was thankful to be able to be home and sleep in my own bed.

That was all three weeks ago.

How are we now?  We are doing much better.  The days following the D&C I was highly emotional.  Anger, frustration and mood swings abounded.  I had several melt downs over non significant events and mostly felt like a terrible person (for my actions and behavior).  I have since learned that it was a normal hormonal response, much like postpartum depression.  We have come to peace about Little Bear's loss.  Obviously, we are hurting, sad and confused; but God has shown us His grace even through this very difficult time.  We see His handprint upon it all and are thankful for His abounding love for us, even in suffering.  

Yesterday, I sat down with Jesus to spend some time with Him.  I needed a promise.  As I waited upon Him, Revelation 22 was impressed upon my heart.  I knew it well, but initially thought it was a strange place for the Holy Spirit to send me after what I experienced.  It was exactly what my soul needed.  It is a promise.  A promise for us, for humanity, for Little Bear - a promise of redemption and reconciliation.  A beautiful future full of hope.  That is what I see for us.  And what I see for Little Bear.  Little Bear will never have to know the struggle of this life; the sin that so easily entangles.  Little Bear will only know perfection in heaven.  For that I am grateful. 

I am still processing all of this and will continue in the coming weeks and months.  I'm reading a helpful book called "What was Lost: A Christian Journey Through Miscarriage".  This book is a great resource and has been incredibly helpful to me to process through such a difficult loss.  

We covet your prayers.  Thank you all for lifting us up before the throne. 

Friday, October 4, 2013

Hubby's Birthday Tribute

The Hubby had his 30th birthday earlier in September.  That week was super crazy for us (more on that later), so I didn't really get a post up.  Actually, we didn't really do anything for his birthday.  Next week, the Hubby is traveling to Chiangbai mountain in Northern China with a friend - and he requested that be his birthday present.  On his actual birthday, we celebrated by the two of us going out to dinner at Element Fresh. The weekend after, our friends invited us over for cake because their son also had a birthday the same week.  So, yes, The Hubby did get cake. :-)  My contribution was magic relighting candles.  It was funny. 

Attempt number 4, 5? on blowing out the candles. Ha!
I'm so thankful for my wonderful Husband.  He has been such a blessing to me, from his spreadsheet skills to his willingness to help with laundry, I appreciate him everyday (even if I don't do a good job showing it).  I am thankful for his insight and wisdom, desire for transparency, conflict resolution style, passion for learning language, desire for God to use us in dynamic ways, loyalty to me and his friends, passion for community, the way he brings people together, leadership of us and others and many more amazing attributes.  I am one lucky lady!  And we are very blessed.  

Happy (belated) Birthday to the man of my dreams!

Wednesday, October 2, 2013

National Holiday (signs of fall)

It's National Holiday in China this week (国庆节), which means that our city is being flooded by tourists.  Yesterday, I went walking with my friend and we had the added bonus of maneuvering around tourists slowly making their way towards Purple Mountain, with the occasional map thrown in.  Since it's National Holiday, we don't have class this week - yay!  Currently, the Hubby and I are at Starbucks, and there are people everywhere.  The crowds are the main reason we don't travel during this time (though many others obviously choose to), however the crowds come to us so we choose, as much as possible, to stay close to home.  

National Holiday means it's October, which means that fall is slowly making it's way in (and likely in two weeks time will be headed back out).  The weather is gorgeous now.  About two weeks ago it finally started cooling down (and by cooling down I mean it's not in the 90's anymore).  Today it's around 80F with lots of sun and a nice breeze, coaxing even more people outdoors.  I'm thankful to finally be able to wear jeans.  I feel like I haven't worn jeans in four months...oh wait, I haven't. 

This time of year also means it's orange season.  I have no idea why that's a fall fruit, but over here it is. It started at the end of August with the green oranges (I have no idea what they are called, I just know that they are green), and soon the tangerine-like oranges will be out.  Fruit in China is awesome and there is an abundance at certain times of the year.  My favorite is buying fruit from the guy with his cart at the subway stop.  Yesterday on my way home I bought a pear and some apples, and then about a block later found the 米变花 guy (mi bian hua - it means rice or grain that changes into a flower, i.e. popcorn) and bought puffed rice and puffed wheat.  When I throw those together with some milk it reminds me of my favorite Kashi cereal, just instead of 7 grains I only have 2.  Needless to say, fall is starting to feel like fall and I'm thankful that the heat is going away.   

On a random side note (and because I feel I should include a picture in this post), we have been hosting Duck Dynasty nights at our place once a week.  Friends from across the city flock to our apartment for a night of entertainment and fun.  When I make popcorn or cookies everyone is happy, happy, happy.  Ok, I'll stop now.  But I feel you all should see this picture.  

Going back to the topic of fall, Starbucks here may not have Pumpkin Spice Lattes, but they do have Salted Carmel Mochas (and I might be enjoying one now as I type).  And I am determined to track down some pumpkin in the next couple weeks - both canned and an actual pumpkin, if I can find one. 

What are the signs of fall where you live?