Wednesday, May 18, 2011

Brief Update

First of all, I am feeling better every day and absolutely sure the worst of this is behind me.  On Monday I saw the specialist in HK for the second time.  I did not have Dengue Fever.  The hepatitis tests are not back from the lab.  One disconcerting thing was that he re-checked my immunity for Hep A and B.  I was vaccinated for Hep A before I went to Namibia (should last lifetime) six years ago, and for Hep B before I left for China.  I show immunity for Hep B, but no immunity for Hep A.  It is as if I never got that two-shot vaccination series.   I am returning to see the doctor on Friday and at that time I am going to get re-vaccinated for Hep A, and the results of the Hep E test should be back.  
I still get tired easily, but aside from that my only continuing symptom is some cramping in my legs. The doctor is not sure if this is from the original viral infection, or from the allergic reaction to the antibiotic I was given.  

Also, he said that after researching this antibiotic he learned that so many people have allergic reactions to this antibiotic ("Avelox") that current best practice is to not prescribe it unless there are no other options.  He then said, "Apparently Mainland China has not gotten this message."

My potassium levels are back to normal.  He also did an EKG to check my heart because the weird muscles spasms were not originally limited to my legs - my arms and sometimes my chest muscles felt strange.  All good with the heart.  

My liver function is improving, and he said to resume a normal diet just to avoid alcohol.  That I can do.  My colleague Victor accompanied me on this last trip to Hong Kong.  Due to the Ferry schedule, we arrived about an hour and a half before my appointment. In a high rise next to the building containing the doctor's office, we found a "360 Market" - which is a branch of "Whole Foods Market" in Hong Kong. I thought briefly I had gone to heaven.  They had a large "food court" on the second floor.  I bought a few things to bring home for Josh, and had a good lunch.  If I feel up to it, I plan to do some serious shopping there when I go back on Friday. 

Yesterday, I went to campus and taught my story class.  Really all I needed to do was sit and listen to students read stories.  That went well and I was happy to be back in the classroom.  I came right home after class, rested, did a little light housekeeping around the apartment and mostly took care of Josh, who came down with a nasty cold over the weekend. Given all he has been through the last few weeks, I am not surprised.  Fortunately, we arrived in China well equipped with Advil, Tylenol, Sudafed, and two “Z-packs” (zithromax).  Unfortunately, I had not taken this full arsenal to Beijing with us.  As his cough and congestion got worst, Dr. Mom decided it was time to start at Z-pack.  It was a good choice, and probably 12 hours after the first dose he started to show some improvement.  Today (Wednesday) we are both spending a quiet day at home, continuing to improve.

A number of people have suggested that I come home immediately, and I must confess that during the worst of this if there had been a Star Trek method to beam me home I would have taken it.  However, I really do not want this experience to be my closing chapter on China.  My general education class at UIC in The Theory and Practice of Story, has been one of the most rewarding teaching experiences in my long teaching career.  I did not want to leave without giving some kind of closure to this class. 

I will return to see the specialist in Hong Kong on Friday, and then hope to be done with this whole illness episode of the saga.  Bob will join us in about three weeks, and our family of three will spend the last three weeks in China together.  We are excited to share with him all that we have loved about our time here. 

One of my favorite poets, Mary Oliver, has a line in a recent poem that states, “I love this world even in its hard places.”  I cannot say I love the hard places, but I continue to love this world in spite of its hard places.

Saturday, May 14, 2011

Did Not Turned Out As Planned

On Thursday, April 28th, Josh and I set off with Yanyan and her parents for Chongqing for her wedding.  From Zhuhai we took a bus to the airport in Guangzhou, which was about a two-hour trip.  Yanyan’s parents had never been in an airplane before and I enjoyed their excitement in the whole adventure.  Weddings in China are really all about the groom.  The groom’s family plans the entire wedding, pays for the entire wedding and the guests are almost all from the groom’s family. The groom’s “English name” is Ryan.  (Just as I have a “Chinese name”  -Lu Xin Mei – most younger Chinese people have an “English name.”)  We arrived in Chongqing at close to midnight, and Ryan’s family had dinner waiting for us at the apartment.  It was the first time Yanyan and Ryan’s parents met each other.  It was perhaps 1:30 AM when we finally got to sleep for the night.
Ryan’s family was very excited to host “westerners” as guests at the wedding and, being very proud of their city, Chongqing, wanted Josh and me to see as much of it as possible.  Li Li, the groom’s sister, and the best man (who’s name I never quite got) took us to the old market streets, to dinner at a “hotpot restaurant” and out on boat ride on the river to see the lights of the city.  It was all very interesting, but also insanely hot and humid.   And, I was exhausted.  We arrived back at the hotel where we were staying after midnight.   We had thought someone would be getting us at about ten the next morning, but at 6:30 AM, Li Li knocked on our door and told us we needed to be ready to go in an hour.  We were taken back to Ryan’s apartment, where we were encouraged to have some breakfast at the little noodle shop on the street, and then the wedding party was loaded into decorated cars and set off to get the bride.  Yanyan was staying at a friend’s apartment.  We all arrived at the apartment door, where Ryan, carrying the bridal bouquet, needed to beg and plead to be let in.  Once inside the apartment, Ryan needed to continue to work to receive his bride.  Yanyan was tucked away in a bedroom, and Ryan had to sing for her, and slide red envelope containing “lucky money” under the door, until finally the door was opened and Ryan was able to give Yanyan the bridal bouquet and they were united.  Next, we all traveled to a park where photographs were taken.  Ryan and Yanyan were one of six bridal couples we saw in the park that morning.  And from the park, we went to the restaurant where the actual ceremony was to be held. 
There were about 200 people in the restaurant, and with the exception of the bride’s parents, Josh and me, and two of Yanyan’s close friends, all were friends and relatives of the groom.  There was a decorated raised platform at one end of the restaurant, fairly loud disco type music played the entire time, and a young female M.C. directed the ceremony.  Yanyan entered with her father and was handed over to Ryan.  The four parents sat close to the raised platform.  There was a very simple exchange of vows and rings.  “Someone” needed to give their approval to the couple’s marriage and I was asked to be this someone.   I just needed to say a few words in English, saying I approved this marriage then say “Zhu ni men xin hun kuai le,” which means “I wish you a happy marriage.”  Of course everyone applauded my effort to sputter out a few words in Chinese.  Each of the fathers said something, which I assume was wishing the couple a happy marriage, then the couple served tea to their parents, and the ceremony was over.  Yanyan changed out of her white wedding dress, into a beautiful red dress (red for good luck) and the guest ate their meal while the couple greeted guests at each table.  
Yanyan and her  parents - at airport

Light show on the river

Ryan and Yanyan

Me and Yanyan after the ceremony.

The center of the table was covered with dishes containing food, and the wait staff continued, and continued, and continued, and continued to bring more dishes to the table.  I will guess they served at least twenty different dishes.  All the food is placed on a large “lazy Susan” in the center of the table, and you just take from whatever dishes appeal to you.  Fortunately, Yanyan’s friend, Jessica, was sitting with us.  She spoke excellent English and explained what each dish was. 
After the meal, Josh and I were taken back to the hotel where we were able to rest for a number of hours, before being picked up and taken to another “hotpot restaurant” for dinner.  Chongqing is known for its hot and spicy food and Josh, who loves spicy food, was really enjoying it.  I am not such a big fan of spicy food, and I was trying to be very selective and eat only what I thought would sit well with me. After the meal Josh went with the groom and bridal party to a Karaoke bar, and I returned the hotel to rest.  Josh got home about 11 PM, and about the same time, I started feeling like I was running a fever.  I took some Advil, felt a bit better and went to sleep for the night. 
The next day, I was clearly feverish, but suppressing the fever with Advil, we got on a plane and flew to Beijing.  I knew we were staying in a nice hotel in Beijing, and I thought if we could just get to the hotel and I could rest, I would be okay.  Unfortunately, it all turned far more complicated.
I ran out of Advil, and sent Josh out in search of a pharmacy to find something to suppress a fever.  He came back with a kind of aspirin that you dissolve in water like “alka-seltzer.”  I tried this and it did not help.  I decided I needed to seek medical help.  The hotel said there was an excellent hospital, five minutes away by cab, which had special emergency services for foreigners.  We got in a cab, and were taken to a spot on the street and told to walk down about 100 meters to the entrance.  We found the entrance and went in.  In Chinese hospitals you must pay for everything first.  Josh quickly mastered the system.  You are handed a piece of paper, you take it the cashier, you bring the receipt back and then the medicine is provided, or the test is run.  I had blood drawn, and when the results came back the doctor asked if I had a history of liver disease.  He said my liver counts were abnormal, and my white blood cell count was very low.  He thought I had a viral infection, with perhaps a secondary bacterial infection.  He prescribed three days of an antibiotic, gave me two different kinds of Tylenol, and then sent us back to the hotel.  For some reason they do not allow taxis within 100 meters of the hotel, so we walked to the main street and then tried to hail a cab.  The temperature had dropped, I was cold and feverish, and finally we got a cab and returned to the hotel.  That evening, I took the antibiotic, the Tylenol, and dropped off to sleep for the night.  The next day when I woke up I was dizzy, and had a great deal of trouble seeing clearly and thinking clearly.  I remember thinking “I really am sick.  Good thing I got that antibiotic.”  I slept on and off most of the day.  Later in the day I took the second antibiotic pill, and a short while later – vomited.  We just had room service send food up and in my befuddled state I continued to think if I just rested I would get better.  The third day, my lips started to swell, and I knew something was really wrong, so Josh and I headed back to the hospital.  I met with another doctor, who immediately realized I had an allergic reaction to the antibiotic, and wanted me to stay in the hospital for the night.  More blood work was done, and I was hooked up to I.V.’s to treat the allergic reaction.  Once again, I was told my liver was not functioning properly. 
To understand this situation more completely I need to explain a little more about Chinese Hospitals.  Doctors see patients, and prescribe treatments.  The nurses carry out the doctors’ orders, give injection, hook up I.V.’s, draw blood etc.  And the family does EVERYTHING else.  No food or even water is provided in the hospital.  No one helps you with your I.V. etc, when you need to use the bathroom.  No one really even checks on you.  If there is a problem, your family informs the nurse or doctor. 
I knew this was the system, but I thought since this hospital had “services for foreigners” they might be a bit more accommodating.  I was not going ask Josh to sleep on the floor next to my bed in the hospital, and sent him back by himself to stay in the hotel.  Kattie, the tour guide we were supposed to work with in Beijing, came to the hospital with her boyfriend.  They brought apples, and stayed with me for a few hours.  She assured me that the hospital where I was staying, Peking Union Teaching Hospital, was one of the best in China.  She also told me that on the other side of the hospital, not the special entrance for foreigners, there were many, many people sleeping on the floor, waiting to see one the doctors the next day.  It was one of those moments, when my privilege as a foreigner was very evident to me.
Needless to say, I did not sleep very much if at all that night.  The next day, Josh returned at 7:00 AM, they did more blood tests, continued to talk about my liver not functioning and hooked me up to more I.V.’s.  I this point I felt I really needed to sleep and drink lots of fluids as I was feeling dehydrated.  With the doctor’s permission, I returned to hotel to rest for the afternoon, and then returned to hospital for one last I.V. in the evening.  We got back to the hotel quite late that night and drank lots, and lots of water and went to sleep.  The next day I was feeling quite a bit better but my legs were cramping and I felt quite fatigued.   I was feeling so bad that Josh had not gotten to see anything in Beijing besides the hotel and hospital and decided we could at least go see Tiananmen Square, which was only about a ten minute taxi ride from our hotel.  We did that and returned to the hotel, where I just rested, drank lots of water, and knew I had to get back to Zhuhai where I had more support. 
On Friday, we took a taxi to the airport, boarded a plane and headed back to Guangzhou.  Our mantra was “a taxi, a plane, a bus, a taxi.” Getting home would not be easy – but I knew I needed to get where we had more support and where Josh would not have to handle everything by himself.  I was feeling weak, my legs were cramping, and no matter how much I was drinking my mouth was incredibly dry.  The weather was so bad in Guangzhou, the plane could not land, and it flew to the Zhuhai airport.  The Zhuhai airport is actually two hours away from where we live, but I convinced the flight attendant that I was very sick, and we were allowed to get off the plane, instead of sitting on the plane until the weather cleared up and it made the twenty minute flight back to Guangzhou.  I could not get my bag, which had been checked, but I decided to sacrifice the bag and just get home.  I filled out many forms for the bag, we hailed a cab and two long hours later, we were in our apartment. 
My friend, Kris Ho, came over the next morning and brought rehydration salts that you add to water and drink.  She also cooked simple food for me that I could eat.  I rested, and let my friends take care of me for the weekend.  I knew I was no longer feverish, but I was extremely fatigued, and the cramping in my legs was persisting.  I suspected my electrolyte balance was messed up and was concerned my potassium level had dropped too low.
I informed the international education office at UIC what was going on, and made the decision to return to Zhuhai Hospital #5 on Monday morning.  Kris Ho accompanied me to the hospital, where Olivia, a nurse who speaks very good English and helps westerners negotiate the system, met us.  Olivia escorted us to the admitting doctor, who said, I needed to see a psychologist because I just thought I was sick.  Olivia convinced the doctor I needed further treatment, and I was directed to get a chest x-ray.  The admitting doctor looked at the x-ray and concluded I had pneumonia.  He then ordered a CT scan and to have me admitted.  I needed to make a deposit of 2,000 RMB, and then I was taken to a room with three beds, that I would have to myself.  I even had my own bathroom with  “western toilet.” Luxury.
By this time Jessica from the International Education office at UIC, and Yanyan had joined Kris and me at the hospital.  Jessica brought fruit, and Yanyan volunteered to spend the nights with me.  The CT scan showed I did not have pneumonia.  But, as I suspected, my potassium was very, very low and blood tests continued to show my liver was not functioning well.  I spent two days in Zhuhai Hospital #5, having I.V.’s to rehydrate me and restore my potassium levels, and some kind of “anti-virals.” The second day, Jessica, from International Education, returned with Dr. Jane Liu, the UIC health service physician.  Dr. Jane was able to speak to the doctors at the hospital, and was very reassuring that many kinds of viruses could affect my liver, and that my other blood chemistry numbers were better.  After spending two nights in Hospital #5, I was given the choice to stay an additional night or be discharged. I chose to be discharged. 
Meanwhile, on the other side of the globe, my husband, Bob, has spoken to my brother Mike who travels internationally on a regular basis.  My brother’s company, Accenture, has a contract with an international emergency medical organization – International SOS.  Mike had contacted this organization, and a physician from Hong Kong called me.  Based on our conversation, this physician suggested I see an infectious disease specialist in Hong Kong as soon as I felt well enough to make the trip.  She also suggested that I may have contracted Hepatitis E, a food borne form of Hepatitis for which there is no vaccination, and is prevalent in extremely warm climates.  She said Mainland China did not have the technical sophistication to make a specific diagnosis of this kind, and the specialist in Hong Kong did. 
I decided to spend Thursday resting, and make the trip to Hong Kong on Friday.  Charlie O, a colleague who began at UIC at the same time as I did, heard about my illness and called Wednesday evening.  He offered to escort me to the doctor in Hong Kong.  The trip to Hong Kong went very smoothly, and I felt very good about the doctor, Dr. Lai Jak Yiu, who I saw there.  He spoke excellent English, and was also able to read all the notes from both the hospital in Beijing and Zhuhai.  He was very encouraging and said that I was clearly in recovery from the viral infection that had brought me down almost two weeks earlier.  

He is running a great deal of lab work to pinpoint more precisely what happened. Frighteningly, his first hypothesis is that I contracted Dengue Fever from a mosquito bite.  The other possibility was as the International SOS doctor suggested - Hepatitis E.

What ever it was, I am past the worst of it.  Today, Saturday, I feel about 80% recovered.  I am still weak, but I feel so much better than I have felt since this all began.  I will spend a very quiet weekend at home, and on Monday I will return to Hong Kong to meet with the specialist again, and go over the complete lab results.  
I am still in awe of how Josh took charge and handled the situation in Beijing.  I told him he could write his college entrance essay exam on how at age 14 he saved his mother’s life when she became seriously ill in Beijing, China. 
During the long days in the hospital I needed to keep my mind occupied so I did not dwell on negative outcomes. I was thinking of the six-word memoirs featured in Newsweek magazine. In terms of our holiday trip to Beijing, “Did not turn out as planned,”  was my six-word memoir.