Friday, October 19, 2012

I Had to Have an Injection





The Chinese are staunch believers in the benefits of intravenous medicine. It appears there is no ailment or discomfort that cannot be alleviated by ‘having an injection’. I wonder how that ties in with the whole ‘drink more hot water’ philosophy.

Nearly from the first moment I arrived in China I have heard the dreaded phrase: ‘I had to have an injection.’ It is generally uttered with proper gravity, reflecting the seriousness of the occasion. A long time ago Carrie Ann had warned me how Chinese doctors love prescribing ‘injections’. At the time I believed she meant giving shots of medication. Even her ominous tone convinced me I did not want any part of ‘injecting’. In my mind’s eye I’m picturing vicarious doctors and venomous nurses, chasing their charges around with loaded needles, all set to give injections.

Since those early days, Martin, Claire, Winnie, Rebecca and even Sam’s baby girl Erica had to ‘have an injection’. Truth to tell I’ve long wanted to write an entry devoted to the ‘injection’ phenomenon because that intonation is so profoundly uttered but once again something stayed my hand. Now I have a good reason to write that entry.   

I am now in the aforementioned Transfusion Room, ready for my first experience with ‘getting an injection’. Before I could get my actual IV drip started I had to have a TB tine test. Small stick to the wrist; wait fifteen minutes. No reaction? Good. And then I had to have another test, one I presume for allergies. Another stick to the wrist, close to the TB stick. Wait another fifteen minutes. No reaction? Good. Let’s have a shot of who knows what to the butt (done in full view, behind the low counter) and then get that IV prepped and started.

The nurses in the Transfusion Room are Masters of Injecting. Whether it is because they use ‘butterfly needles’ – tiny needles designed for children’s veins, or because they stick people twelve hours a day, six days a week and have been doing so for as long as they have been working there, I do believe these competent professionals could take first place in any ‘sticking needles in hands’competition. After receiving ‘injections’ for three consecutive days in the same hand, I did not even have a bruise to show for it.

The good news is those blue chairs in the Transfusion Room are as comfortable as they look. They may just be the most comfortable chairs I’ve sat in since moving to China. The bad news is that I had to occupy one for over two hours. We’d already been at the hospital for close to four hours. Now we had to endure the agony of just sitting while some unspecified fluid flowed into my veins. All three of my companions insisted on staying by my side in spite of the late hour and their early schedules the next day. They sat triangulated around me as though in protection, and dozed.

While they’re catching some shuteye, I’ll tell you about my elbow. After attending to my head the doctor directed us to the next stage of my treatment: injection. Before we left I mentioned my elbow that, in the meantime had grown a substantial knot. I knew it was not broken, nor was a bone chipped  - no pain and full mobility, but the doc insisted on X-rays. Another prescription form, another cashier stamp and off we go, again to Radiology, this time for pictures of my elbow.

Again no waiting. This tech was none too gentle about positioning me. I do aver that my elbow did not hurt… as long as no one palpated it or forced my arm into unconventional poses. Fortunately I am a good patient and did not scream or cry out when he manipulated me into position. Ten minutes later we returned to the emergency room. This time it was Sam who bullied his way to the doctor’s desk, proffering the film. Doc concluded the results were inconclusive but wanted my arm in a cast and an MRI done the next day, just in case.    

Now in orthopedics, ready for a partial cast to immobilize my arm. First the docs needed to treat a little girl. I don’t know what was wrong with her because she kicked her legs vigorously and her arms seemed to move just fine. Once they took her into the treatment room she howled bloody murder. It broke my heart.

While we were waiting a woman rushed into the office, her shirtless son following a few steps behind. He had dislocated his shoulder. His was a simple procedure; no cast required. Still, I did not want to be in the room when they popped his shoulder back into place. It only takes a second but causes a monstrous bolt of pain. I didn’t want to see and hear that young man shriek when the doc tugged on his arm.

Now it is my turn. In China they still use the old fashioned plaster cast. Fortunately I did not have to have a standard cast totally enclosing my arm, just one that would keep my elbow at 90 degrees. Doc soaked the rolled plaster material and then molded it to fit. He then wrapped enough linen gauze around it to make a mummy proud.

Fast forward back to the Transfusion Room where my companions are snoozing. A pesky fly keeps buzzing around my head, no doubt attracted to the smell of fresh blood just under the gauze. Shooing it away is nearly impossible, seeing as one arm is half encased in plaster and the other currently hosts an IV line. Sam draped a tissue over my head in an attempt to discourage the flies. There I sit: exhausted, bloodied, plastered, stitched and now adorned as though I belong to some weird cult that worships tissue paper. Someone! PLEASE drop the curtain on this spectacle I’ve become!

The last of my IV solution is dripping into the metering device; soon we’ll get to go home. ‘Soon’ is a relative term of course. It was now nearing 3AM. We’d been there since about 10:00 the night before.

After being finally released Sam staggered home. He lives only 5 minutes away. The girls and I took a taxi back to school, the buses having long stopped running. On the way home Vanessa and I made plans to come back the next day – well, later that day for my ‘injection’, and also for a better evaluation of my elbow film.    

In all we went to the hospital 3 days in a row.

I didn’t know my head sported a total of twelve stitches till I had to have the dressing changed, two days later. “Hah!” I thought to myself. “I took a dozen stitches to the head with no pain killer and didn’t utter a single whimper. Rambo has nothing on me!”

Speaking of whimpering…

It seems that, in China the louder one is the more profound the need or feeling. Take sneezing, for example. In America one tries for a discreet ‘at-choo’ into a tissue, behind a hand or into the crook of one’s elbow. In China nothing short of an all-out bellow signifies health and the expulsion of whatever had plagued the sneezer. Mouths and noses are not covered but it is common practice for the sneezer to turn his/her head away. At least there is that.

 Same thing with vocal expressions of pain. Presumably the louder and more frantic the shrieks the more severe the injury. I learned of this custom on my second visit to the hospital. Doc had to change the dressing on my head. Vanessa bullied her way back in front of the Emergency Room doc’s desk. He told her to escort me back into the same room I had visited two nights ago with the gurney and the soiled hygienic pads.

Meanwhile, Emergency Room Doc #2 was escorting a boy of about 10 years into that same room. The boy seemed fine: ambulant, no visible blood or bone, well fed, judging by his girth. Once in that room he started: “OH NO!!! SOS!!! PLEASE SAVE ME!!! THEY’RE KILLING ME!!! MOM!!! DAD!!! MAKE THEM STOP!!!” It was as though someone had flipped a switch on inside this child, who was so perfectly calm in the antechamber. We were all doing our best to not laugh but it was hard not to, so comical were his pleas.

Again, as though a switch were thrown the boy shut up when I entered the room. Remember: there is no privacy so he and I were attended to in the same small room, within a meter of each other. I had a hat on my head and a jacket covering my arm when I walked in, so that I didn’t appear injured at all. When the boy saw my head, especially after the doc removed the gauze and cleaned my stitches, he appeared struck dumb and he didn’t howl anymore for the duration of his treatment.

In all, this episode cost me 3 trips to the hospital, 3 two-hour stints in the IV room, 2 sets of MRI and one set of X-rays, evaluations by ER docs, an Orthopedic specialist and a tech to set my arm, the services of Radiology and, of course those expert nurses in the Transfusion Room. What was my cost in actual currency? 

How much would all this cost in the States? Tens of thousands of dollars, probably.

I hope this does not cause you to fall down, strike your head against a sharp object and bruise your elbow.

My total cost was…

2,700Yuan. The school absorbed only 1,000Yuan being as I was not injured on campus, making my out of pocket cost only 1,700Yuan.

That would be about $300 to have my head examined and get plastered. I couldn’t believe it.   



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