Why self-medicating is an essential China expat skill

Maybe everyone should take an interest in what pills and pokes their doctor is giving them, despite how frowned upon it is by House. But in China, figuring out what’s really wrong with you, on your own – armed only with Google and Wikipedia – is a tragic, but essential, fact of expat life.

Over the years I’ve been here I’ve avoided the hospital at every turn. I hate hospitals in a sterile “True North” kinda country, but the dirty, muddled mess of a space that passes as medical facilities in China is a sick, sick joke.

Which is why I prefer to roll the dice with the Internet. Either option, Chinese hospital or Google search, is likely to result in mis-diagnosis; but I rarely leave Web sites with viruses I didn’t enter with. Never mind an inflated bill because the doctor has more interest in his pharmaceutical commissions than my health.

Not sure if you should go to a Chinese hospital? Read David’s excellent post at Silk Road International, and contemplate no further.

And so it was that I spent much of the morning tracking down cures (holistic and medicinal) for gout. Yeah, I’ve got gout. I take little, but some, comfort in the fact that it was once referred to as the “Disease of Kings”.

Gout, for anyone that doesn’t know, is a right pain in the … foot. Well, really it can affect any joint, and is caused because uric acid crystals get stuck in your joints/tissues and make them to hurt like hell.

Turns out I’ve had gout for a while, but just didn’t know it. Back in ’05 I was hit with it and was certain it was a soft tissue infection, and then in ’07 I decided to get an expert opinion, and he agreed (as did a doctor the night prior) it was a soft tissue infection, and forced me to endure a week of IVs.

I had it one time since then, but can’t seem to find mention of it in my archives. It would have been around that last time that I mentioned my love of foot infections to a friend, also a suffer of the Royal Pain, and he said, “Hey, sounds like you’ve got gout.”

Not sounding at all like something I wanted to have, I got home and read up on the causes and symptoms: excessive drinking of alcoholic and caffeinated beverages [check], poor diet [check], overweight [check], lack of exercise [check], male [check], excruciating pain in a joint (often your toe or ankle) [check]. Gout seemed like a pretty obvious diagnosis.

In the many months since, I’ve changed my diet, watched what I eat and drink, etc. and I’ve not had a single problem. Until last night. It’s amazing the memory-wiping ability comfort brings. The lack of problems recently left me feeling gout-free — but the five cups of coffee and four beers yesterday was enough to give me a painful lesson in memory retention.

But now, having consumed my body weight in water (and lemon juice) and also ingested some OTC NAIDs (yeah, that’s right… look it up), I’m feeling decent. So what have I learned.

Well, that first diagnosis I made back in ’05, where I tied the pain in my foot to the fact that I had strep throat (instead of the late night at the bar) was wrong. That’s one for the hospitals. But then I went to two different doctors, at two different hospitals, and neither of them labeled it as gout either. Both just suggested antibiotic IVs. That’s two for Google searches.

Sadly, none of this leaves me with any level of comfort. Not having a reliable medical safety net to fall upon is easily one of the toughest and scariest parts of living in China long-term. All I can say is – just as the Silk Road Intl. post linked to above ends – good luck, and don’t get sick.

14 Responses

  1. you’re making me suddenly rethink my own chronic foot pain.

    most of my family has worked in hospitals for pretty much my whole life. i had 3 years working in a CNA position before coming to china. recently having accompanied a couple different friends to hospitals to provide moral support, i more often found myself visibly wincing at every step. the silk road article is spot on as far as my experiences go.

    at least we know enough to look at things like webmd in such cases. though frowned upon by medical professionals in the west since then everyone is convinced they have ebola, it’s pretty useful here given the circumstances. i’m pretty sure most of my friends here don’t have the slightest idea of how to go about researching a health issue. i know i’ve done it at least three separate times for them, followed by an intense dictionary/nciku session to find the best translation for whatever the hell it ended up being. though, now i know how to say ‘tibia’ in chinese, so that’s cool.

  2. I recently had a surprisingly good experience at a local hospital here in Beijing, though admittedly it was a military hospital (which all of my friends now tell me should never have been allowed to treat me!).

    I had a suspected broken bone in my foot, so went to see the orthopedic doctor. He sent me down for an x-ray (110 RMB) and then came back for his diagnosis. He wasn’t 100% certain whether it was broken or not, and not wanting to unnecessarily have my foot in a cast, I didn’t know what to do.

    The Chinese friend who’dbrought me told me to sit down and wait for a minute and he’d be right back… He came back with a ticket to see the specialist.
    “But how much is the specialist?”
    “14 RMB. Yeah, I should have really just paid the extra 10 RMB for you to see the specialist in the first place.”

    Anyway, turned out it wasn’t broken after all! Admittedly, if it had been an internal medical problem, I would never have gone to a Chinese hospital, but I think for problems like this, you can’t beat a 14 RMB specialist!!!

  3. I have been sick enough to go to the hospital only once since I came to China back in ’06. I had a fever of around 103 F (39+ C) when my normal body temp is around 96 F, couldn’t sleep, couldn’t eat, and I was making frequent trips to the bathroom. So, I figured that was enough for me to visit the scary looking hospital I had only been to a couple of times with friends. I spent about 20 minutes with a doctor and he told me I had a cold and I just needed to take some Contact (cold medicine). The Contact took care of the fever, getting down to something resembling normal, but I was still sick as a dog. So, suspecting a flu and not knowing of a good Chinese flu medicine, I self medicated with lots of hot soups, hot water, and citrus fruits and got better in 3 or 4 days. There were two things that got me at this hospital; 1) even before my temperature was taken, they wanted to hook me to an IV. 2) I ventured into the men’s room at this hospital and saw a giant, human turd right in the middle of the floor on top of glass from the broken mirror.

  4. My experience in Chinese hospitals hasn’t been all bad. They are strikingly efficient in many ways compared to US hospitals.

    1) Check-in, pay, and be directed to a doctor.
    2) Stand in line for a doctor sitting at a desk.
    3) Talk with doctor, get lots of pieces of paper for tests.
    4) Go pay for tests, and get directed to where to get tests.
    5) Stick your arm under a walk up window, like it was a bank, and give blood for tests.
    6) Wait for test results (maybe the next day.)
    7) Pick up test results.
    8) Stand in line for doctor and show doctor the tests.
    9) Doctor says what’s wrong and give prescriptions.
    10) Bring prescriptions to pharmacy and pay.

    Unfortunately, these days it’s hard to get antibiotics without a prescription. They used to be over-the-counter.

    It’s kind of like renewing your vehicle registration at the DMV.

  5. Ryan, unfortunately too many people (immigrants from different countries) complain about doctors in Canada. Maybe Canadian hospitals are sterile and stuff but when you are sick you need a treatment.

    I told Canadian optometrist that my eyesight was going bad for last several years. His answer was: “At your age I would be surprised”. Several months later I felt that his prescription is no good anymore. Maybe he couldn’t prevent it anyway, but if he doesn’t believe it’s happening then I wouldn’t call him a good doctor.

    Or what about Canadian dentists who can’t garantee that their filling will last for longer than a year? And they still use film X-ray instead of computerized X-ray. Is it great western medicine?

    By the way, a lot of doctors in Canada are of Chinese origin.

    Alex N, is that sequence of actions describe US doctors or Chinese doctors?

  6. the other thing which alex reminded me of is the amount of self-service at hospitals. in the states, for basic outpatient treatment, you go, check in, and are directed to a bed to sit on. then everything from bloodwork to prescriptions comes to you. if you need surgery, they cart you to the OR and cart you back when you’re done.

    when one of my friends had a pretty serious problem, we were the ones walking all around the hospital for the whole morning to take paperwork and vials of blood to different offices that were related but not at all in the same area.

    維特利: sounds like you got a bad dentist. the one i went to in the states was very high-tech and had great bedside manner, if you can call it that. sorry you had a bad experience.

  7. “By the way, a lot of doctors in Canada are of Chinese origin.”

    I think you may have just answered your own questions.

    Good comments all around. And I really should stress that visits to hospitals in any country suck. Nature of the beast I guess. And Canada is certainly no exception 維特利, long waits, mis-diagnosis, etc. But when comparing the two – (in my case) Canada vs. China – they’ve both given me the wrong diagnosis (China more than Canada, but still), but brushing away the sanitation issue in favour of faster turn-around is a bit like saying, “Yeah, I don’t really care if my surgeon washes his hands as long as he cuts me quick”.

    Sanitation still seems like an entirely foreign concept in China. I can’t understand is why the clearing aiyis in China seem completely unaware that disinfectants have been invented. And this isn’t just hospitals – can’t count the number of times that I’ve been at a restaurant and had the waitstaff wipe down the table with a rag that looks like it was just used (and probably was) to wipe down the toilets.

  8. “can’t count the number of times that I’ve been at a restaurant and had the waitstaff wipe down the table with a rag that looks like it was just used (and probably was) to wipe down the toilets.”

    Had to laugh at that – here’s a snippet from one of my own posts about hospitalisation in China:

    “Emptying the bladder was possible with extreme focus and determination. However, if you are anything like me, the prospect of taking a very open dump in cold, damp, unsanitary conditions surrounded by curious onlookers is enough to close the door of even the most relaxed orifice. Inadequate numbers of urinals and only a couple of holes in the floor drove patients and visitors (not that they need much encouragement) to do whatever, wherever. Every receptacle was overflowing with the sludge of a thousand mixed samples. Cleaners periodically soaked up the excess with their mops before using the collected moisture to wipe footprints from the corridor, a most effective way of killing two birds – and possibly a few patients – with one stone.”

  9. I once looked after a loved one with cancer in a chinese “specialist tumor (read: cancer) hospital” it was the most miserable place i’ve ever experienced and having had been through the experience before I was horrified at some of the voodoo they were masquerading as care to empty the poor family’s wallets. On the plus side if you want and can afford a transplant or stemcells injected into your brain, with fewer ethical concerns and red tape, you’re in luck

  10. G,G,G, Gout ? The curse of Kings ? Are you living high on the hog in Suzhou ?

    Nah, seriously – I agree with your theory of self-diagnosis & self-treatment. Wikipedia and Google are valuable tools to establish what’s wrong and how to fix it.

    Laowai Patient, heal thyself !

    My own little vignette on health “care” in CN.


    Mrs. Jamieson has organised accident and 100% hospital care with AIA but no medevac for 900 kuai.



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  12. Bejayzus Ryan,

    Are you trying to scare the livin’ sh.t outta me? Oh well I’m a well seasoned 73+ and I’ve eaten more than my share of dirt in Algeria, Kuwait, Spain and China. So I shouldn’t fare too badly. Your rule about not darkening the halls of any Chinese Hospital will likely be mine, unless I discover some accetable private clinic in Dalian! My plan is to spend 20 days twice a year in Vancouver to replenish my meds to unless there is some untoward emergency needing a quick trip to Hong Kong, I’ll do all my doctor stuff in Vancouver.

    How be ya? How’s bizness?

    Do you know http://www.abt247.com, name Hodge Zhou in Dalian? Do you know any good lawyers who speak Anglo in Dalian?

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