Nearing the end of her tether...
We have both good and bad news, depending on where you live. The good news is that the local Simao doctors are pretty good at dealing with basic gastric problems. If you're worried about having some nasty intestinal bacteria or tropical disease, best to visit Simao's ren min yi yuan (People's Hospital). The bad news is that we had to travel several thousand miles to discover this. Fortunately for us VSO medical insurers paid for the 400 RMB consultation fee. The good news? The Bayley & Jackson paediatrician (who shall remain anonymous, thanks to the face mask) knows of a gastroenterologist who has a clinic at the even-more-expensive Hong Kong International Hospital. We have a 9 o'clock appointment, which means joining the tens of thousands of commuters on the Beijing Metro.

The consultation was interesting. I guess my last encounter with B&J left me slightly sceptical of their general professionalism. Given that it was 18 months ago, however, I was hoping things had changed. Only slightly. Although I was reasonably happy that this was a doctor (the last person I saw was a private practitioner who was forced to squeeze into a white coat for appearances) we spent an hour going in circles. I presented all of Freda's symptoms and tried to avoid mentioning any of our own specific ideas/concerns. Who am I to say? As it happens, given the fabulous advice and support we have had from VSO London Medical Unit and another UK doctor, it seems I was better equiped to guide the consultation than I thought. In fact, after 45 minutes I ended up whipping out an email with the information on the basic tests for coeliac, basically a gluten intolerance. I'll give you some snippets...

[after 20 minutes of describing the symptoms and Freda's medical history]
Doctor: Over the last 3 months, while Freda has had diarrhoea, has she ever had a fever?
Lesley: No, never.
Doctor: Really? Are you sure? No fever?
Lesley: Really, it's always the first thing we check. No fever.
Doctor: That's strange.

Doctor: Has Freda been innoculated against TB? It's not done in many European countries but in China we give it to babies.
Lesley: Yes, she was innoculated in 2005, just before coming to China. I believe we refer to the vaccine as BCG.
Doctor: Freda, I need to see your arm. Can you take your top off. [Inspecting the arms] I can't see a scar here. Are you sure she's had it?
Lesley: Yes, in 2005. Her sister's vaccination site took several weeks to heal and she has a big scar but Freda had no local reaction, it healed quickly and left virtually no scar.
Doctor: Mmmm. Where did she have it? Is that the scar? I can't see a scar. So, did she have it?
Lesley: Do these symptoms really fit TB? Apart from the diarrhoea, tiredness and mood swings, she's been well. I didn't realise TB presented itself like this [i.e. no fever, no bloody phlegm, no cough (since the Spring).
Doctor: Well, if a child has diarrhoea for this long, we have to consider some special diseases....

[After 45 minutes, more perplexed]
Doctor: Well, Freda's weight is normal. She should weight about 26 kilos by this age and she weighs 28, which is unusual for someone who has had diarrhoea for so long. So, what is the diarrhoea like?
Lesley: Water
Doctor: Really? Like water? And does it have anything special in it?
Lesley: Apparently undigested food. Fairly typical, acute, diarrhoea.
Doctor: And how often does she go in a day, 2 or 3 times?
Lesley: About 5 to 6 times?
Doctor: Really? Freda, how often do you go a day?
Freda: Well, about 5 or 6 times, it depends. Sometimes more.
Doctor: And it's diarrhoea?

[And so we went on, round and round in circles. I was beginning to doubt my own sanity, judgement and memory.]

Lesley: Freda's symptoms have been much worse the last 3-4 months but she has had similar symptoms for years, now that we think about it. Each time she's been unwell, however, we've been able to find other reasonable explanations so we never made any connection.
Doctor: So, when did it start?
Lesley: Well, if what I said is true, I can't remember. She could have been like this for years but we thought it was 'normal'.
Doctor: So, before you came to China, how often did she go to the toilet (No 2) a day?
Lesley: I can't remember, that was four and a half years ago. Had I realised at the time it was significant I would have counted, but I didn't. All I am sure of is that there are certain patterns....
Doctor: So you can't say how many times she went to the toilet before you came to China.

[55 minutes into the consulation]
Lesley:....and that things are worse now. We've had to take her to the hospital twice this term  for a saline drip...
Doctor: Oh yes, because you were worried.
Lesley: No, primarily because we couldn't rehydrate her orally, she was losing too much liquid.
Doctor: Really, so you needed a drip?
Lesley: Yes, she was dehydrated.
Doctor: Oh, I see. So she really did have diarrhoea?

Lesley: Can you test for gluten intolerance here?
Doctor: Yes, we can run several food allergy tests, like beef, fish, eggs and so on.
Lesley: What about for gluten - I believe the test is for specific enzymes [showed email]. Could you please check.
Doctor: [after calling the lab] No, we can't do that. I think you'd better see a doctor in the UK.


You think that was long-winded? That's not half of it. Sorry to off-load. I need to rant to someone. I must finish by saying, however, that I am EXCEPTIONALLY grateful to VSO for bringing us to Beijing to find a doctor. If I'm a little frustrated it's as much as wanting a reasonable service for VSO (given that they are paying) than for ourselves. I shall remain optimistic, however,  about tomorrow's consultation. The other good news is that whatever is wrong with Freda, she's thriving on her gluten and dairy-free diet. Regular as clockwork, perhaps for the first time in her life. Yes, really.....

B&J's 'small children's play room.'
Receptionist: Hello. We have a small children's play room. Would you like to see it?

Freda: Hey, mum! Does she mean a playroom for small children, or a small room for children to play, hee hee hee?

Receptionist: It's this way....

Freda and Lesley follow in excited anticipation.

Freda: Ha ha! I guess both are right.

18/11/2009 12:02:46 am

I can just sense to frustration building!!


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