Doctors, hospitals and medicine in Shanghai are very different and I had hoped to hold out longer before needing to learn about it all first-hand, but unfortunately, I developed a sinus infection toward the end of last week and found myself in need of a doctor. For those of you who know me well, this does not come as a surprise. What is surprising that I hadn't had a sinus infection for several months.
Chris and I attended a program within our first month in Shanghai called Shanghai 1-2-3, an introduction to expat life which included a talk by a Chinese doctor that was terrifying. He told us that the 5 gallon bottles of water delivered to our home should only come from one of the three western companies (Nestles, Coke, or Watson's) if we want to ensure the water is clean. He said that we would always encounter a certain amount of contaminated food, so the best bet is not to always buy our food from the same vendors, in order to spread the risk. He warned that mold is a big problem (no kidding), as well as the air pollution - again, duh! He indicated that some OTC and prescription medications available in the U.S. are not available in China, such as Epi-Pens, Benadryl, and several types of cholesterol and high blood pressure meds. He told us of a good pharmacy locally, which can possibly refill a U.S. prescribed medication, although it seems smarter for us to go to a local doctor and get our medications filled there, so we have them on hand.
The doctor also told us some scary tales of trying to get emergency and regular medical care in Shanghai. He indicated that there are basically 3 levels of health care in Shanghai for expats, the local hospitals, VIP or Expat clinics within local hospitals, or Expat clinics. Each option has it's strength and drawbacks, but the reality is we might end up at any of them at one time or another.
The local hospitals are just that, local, Chinese hospitals, filled with Chinese-speaking doctors and staff and very few, if any, English-speakers. They are open 24/7. This is where the Chinese go if they need to see a doctor and no appointments are available - get there early and get in line. I have been led to believe that children in obvious danger can get moved to the head of the line, but mostly, it's all about waiting. And CASH!
Yes, the doctor who spoke to us told us to carry at least 2000 RMB (approximately $300) on us at all times and to have at least 10000 RMB (approx. $1500) in a safe at home- which you need to bring with you to the hospital - because you pay first and then get treated and they only take cash. There is little to no privacy, so don't expect a private room to discuss your problems with the doctor. Being seen by a doctor at a local hospital can be an all-day affair, as you wait and pay at each step, whether you need blood work, x-rays, or whatever. Most expats won't see the inside of a local hospital unless it's an emergency and the other clinics are closed. We were also told it would be better, in case of emergency, to take a taxi to the hospital, as it will be faster and the ambulances really don't have trained medical personnel anyway - and you have to pay cash to them as well! Peter checked out one of these local hospitals when one of the kids sprained a wrist and had a fairly favorable experience. The one he used is only 5-10 minutes away by taxi.
The VIP or Expat clinics within a local hospital are somewhat more familiar - the staff speaks English and there are private exam rooms. It is possible to schedule an appointment and their hours are slightly longer than those of the Expat Clinics, but not 24/7. Some of these facilities accept international credit cards and can even bill some health insurance companies. For us, I think the VIP clinic is an option for times when they're open but the fully Expat Clinics are closed and when inpatient hospital services are needed. For us, if we need this type of facility, we will most likely use Shanghai East International Medical Center, which is on our side of the river, but will be a 30 to 45-minute cab ride, depending on traffic.
The fully Expat Clinics are the most expensive, but direct bill most insurance companies and will take international credit cards. They offer a full range of specialists as well as all types of preventative testing as well as treatments. This is the type of place I visited last week, Parkway Health, which is about 2 blocks from our apartment. The reception desk and waiting are were just like an American doctors' office. I made an appointment in advance and was given my choice of male or female doctor and was told the doctor's nationality (and whether a native English-speaker) when scheduling. I arrived, filled out my paperwork, and, after a short wait, was shown to an exam room, where the nurse took my blood pressure and temperature, wrote down my symptoms, and took me to another exam room to meet the doctor.
My doctor, an Australian woman, was very nice and seemed very knowledgeable. Given my extensive allergies and medical history, I brought with me a listing of medications, surgeries, allergies, etc. When she looked over my allergies, she asked about epi-pens, Medic-Alert bracelets and was very impressed when I showed her my Select Wisely allergy wallet cards. Given my allergies to some antibiotics, she said she really only had one effective option for me, (Levofloxacin in China, but Levaquin in the U.S.) but that I should be aware that a rare side-effect was a ruptured Achilles Tendon - I've never heard that one before! She was also concerned that I am allergic to an antiviral frequently used for Shingles, even though I don't have Shingles right now. She wants me to call my U.S. doctor and find out what I was prescribed in the past for Shingles so I know what I can take should I get it again. While Parkway Medical accepts our medical insurance, apparently I needed to call first for authorization, so I had to pay by credit card and can submit to my insurance company for reimbursement. The doctor wrote my prescription, both for the antibiotic and some nasal spray, and the pharmacy right on site filled it, so I paid about $200 for the appointment and prescription and walked the 2 blocks home. The whole process was quick and easy, but I can't call them in an after-hours emergency.
Now, as far as Traditional Chinese Medicine (TCM), acupunture, herbal remedies, meditation, etc., I believe you can request practitioners in any of the 3 levels of facilities. I know that most of the medical facilities advertising for the expat community have both western-style doctors and TCM listed among their services.
Unfortunately, I saw the doctor on Friday and I'm writing this on Monday morning, still not feeling much better. I'm calling CVS in Elmhurst today to find out what type of antibiotic my doctor there prescribed for my last sinus infection, just in case the Achilles-heel rupturing one doesn't kick this infection.
Sunday, October 27, 2013
Sunday, October 20, 2013
Day Trip to Suzhou










One of the really interesting things in the park was the large bushes, taller than us, by far, that had two different colored flowers growing on them. The flowers looked a little like roses, but there were both pink and white growing on the same branch - from the same blossom in some cases. It was pretty but very different.




As we drove through the canals, we enjoyed the pretty red paper lanterns hanging off the bridges and buildings in some areas, but also found the houses along the canals very intriguing. It was similar to Venice, where there are another set of stairs down the canal side of the house to allow family members to climb into a boat. Many of the stairs looked like they were in disrepair, as did the houses, but the occasional satellite dish and air conditioning units seemed to be working okay. Peter and I remarked on a set of stairs sticking off the side of one of the houses that didn't attach to a door at all and laughed when we realized it led up to the A/C unit - for when your A/C repair guy comes by boat!








After the boat ride, we found Gao, Peter & Nickle's driver, and piled back into the car. We talked about walking the streets to see the little shops, visiting the silk museum, or even stopping at what appeared to be an American-style outlet mall. But, it had started raining again and everyone was tired and we opted to just head home.

Sunday, October 13, 2013
Our New Apartment

Basically, a serviced apartment is somewhere between an apartment and a hotel, which may be a great choice for us, given that I will be spending about 1/2 of the year in Shanghai and 1/2 in the U.S. and Chris will always be traveling a lot. We are in a nice complex with a lot of services, including a health club, restaurant, bar, indoor swimming pool, and English-speaking front desk staff. This apartment is smaller than the last one, but given that we are still only a couple of blocks from Peter & Nickle's house, we chose location and convenience over size of the apartment.
We are on the 16th floor of a 19 floor building, which is wonderful because the top and bottom couple of floors have more likelihood of water damage, and the resulting mold and mildew. We have a wrap-around porch on 3 sides of the building, which gives us some wonderful views. In addition, at the end of the living room, there is a glass-enclosed porch, which, given the weather in Shanghai, is essentially additional living space. We just moved in last night, and haven't really gotten everything settled yet, but so far, I think it's going to be great.


The guest bedroom is pretty good sized and we are planning to make that into Chris's home office, once we buy him a desk. When our guests come to visit, they should be comfortable there, with their own guest bathroom, but we're also thinking our daughters may also abandon us sometimes to stay with their cousins.

The dining room table is a good size, although we're planning to buy another table and some chairs as we have the space and we'd like room to have Peter, Nickle & the kids over, as well as other company. The dining room and living room are in an "L" shape, so they are connected but also somewhat separate.


Tuesday, October 8, 2013
Studying Mandarin
I am about a month into my Mandarin class, which I am enjoying much more than I thought I would. Don't get me wrong - it is a very difficult language to learn, even when you're not trying to learn the characters. The sounds the letters make are not sounds easy for an American tongue to create - at least, not this American tongue. Of course, the Austrian and German women who sit next to me in class would say the sounds are not easy for a German-speaking tongue to make either. :)
While I don't think any of the 7 people in my beginner level Chinese 1 class will be proficient by the end of the class in a month, we are having a good time struggling through the pronunciations and rules together. It makes me feel better that everyone else seems to have the same difficulty as I do remembering what the words are and how to say them. I'm very much a visual learner, so it's hard for me to study a language that I can't really read. But, I do think I'm making a little progress.
After only a month, I have given some thoughts to the things that strike me as most unusual so far. Here goes, in no particular order:
* There are 21 vowels and 16 consonants. In English, we have 5 vowels and 21 consonants, so there are a lot more letters to remember how to pronounce.
* For each of the 21 vowels, there are 5 different tones that the vowel can make and each word, depending on the tone, has an entirely different meaning. The first tone is flat, the second tone rises from low to high, the third tone drops and then rises, and the fourth tone falls. I say 5 tones because a vowel can have no tone at all, which is different from the flat (first) tone. Then, throw in rules like the 3rd tone followed by another word turns into a descending tone similar to, but not exactly like, the 4th tone, or that if 2 3rd tones follow one another, the 1st one is turned into a 2nd tone, and it really becomes overwhelming.
* A lot of the time, I have thought that the Chinese people speaking to each other, or to me, for that matter, were angry a lot, because the 4th tone is very abrupt and sounds a bit like yelling. On the other hand, the first tone is high and sounds a bit like singing. I feel self-conscious saying both of these tones, for separate reasons, so it makes it even harder to get the pronunciation right.
* Because the tone on the vowel changes, the tone of the sentence doesn't change if you're asking a question or making an exclamation. You can tell someone is asking a question if they include a question word in the sentence, such as "ma" at the end. Not because their voice goes up at the end of the sentence.
* In Mandarin, unlike horseshoes and hand grenades, close is NOT close enough. If I want to say the number ten, shí , which has the 2nd tone, I might mistakenly say shi with no tone, which translates to the verb "to be," such as "is" or "are." If I say shì, with the 4th tone, it means something altogether different (although I don't know what yet) and the Chinese person I'm speaking to will have no idea what I'm talking about, which is usually what happens. Our Mandarin teacher says that many Chinese people, native-speakers, pronounce things differently or, in her words, incorrectly, so no wonder they can't understand me either.
* After weeks of class, Chris asked me how to say "yes," and I couldn't really answer him. In Mandarin, the way to answer a question is to reply in the affirmative or negative form of the verb. So, the answer to "do you want something?" is not "yes" but "I want" or "I don't want." I've heard a lot of English-speakers here using "méi yǒu" (pronounced may yo) when they want to say "no," but it really means "I don't have." Often, this will suffice, such as "Will you have the chicken feet?" Definitely méi yǒu!
* While I am learning pīnyīn, which is the phonetic system for transcribing the sound of Chinese characters into recognizable alphabet, it is not how the Chinese learn to read their language, so whatever I write in pīnyīn will not be able to be read by the average Chinese taxi driver. If I want to print out the address for where I'd like him to take me, I have to translate to characters and pray that Google translate knows what it's talking about. Fortunately, many businesses, housing complexes, and even individuals have address cards made up with their addresses printed in English and Chinese characters, in addition to a crudely-drawn map, to help taxi drivers get you to the right place. Nearly everyone I know has a business card manager app on their smart phone to keep all of these cards organized, so you can simply pull it up on the phone and show it to the taxi driver.
This is just the first level of Chinese classes and, as I said, I am only a month into this class, but I am finding the language interesting. I don't know that I'll ever be very conversant, but at least, right now, I can give the taxi driver basic directions, such as turn right or left, do a U-turn (you have no idea what a common occurrence this is), go straight, or stop. Of course, when my nephew Peter, his wife Nickle, and their daughter, Kennedy, were here 8 years ago, Kennedy, who had just turned 2 at the time, could say these things to the taxi driver as well. I'm not sure I should be bragging about my language skills as of yet.
While I don't think any of the 7 people in my beginner level Chinese 1 class will be proficient by the end of the class in a month, we are having a good time struggling through the pronunciations and rules together. It makes me feel better that everyone else seems to have the same difficulty as I do remembering what the words are and how to say them. I'm very much a visual learner, so it's hard for me to study a language that I can't really read. But, I do think I'm making a little progress.
After only a month, I have given some thoughts to the things that strike me as most unusual so far. Here goes, in no particular order:
* There are 21 vowels and 16 consonants. In English, we have 5 vowels and 21 consonants, so there are a lot more letters to remember how to pronounce.
* For each of the 21 vowels, there are 5 different tones that the vowel can make and each word, depending on the tone, has an entirely different meaning. The first tone is flat, the second tone rises from low to high, the third tone drops and then rises, and the fourth tone falls. I say 5 tones because a vowel can have no tone at all, which is different from the flat (first) tone. Then, throw in rules like the 3rd tone followed by another word turns into a descending tone similar to, but not exactly like, the 4th tone, or that if 2 3rd tones follow one another, the 1st one is turned into a 2nd tone, and it really becomes overwhelming.
* A lot of the time, I have thought that the Chinese people speaking to each other, or to me, for that matter, were angry a lot, because the 4th tone is very abrupt and sounds a bit like yelling. On the other hand, the first tone is high and sounds a bit like singing. I feel self-conscious saying both of these tones, for separate reasons, so it makes it even harder to get the pronunciation right.
* Because the tone on the vowel changes, the tone of the sentence doesn't change if you're asking a question or making an exclamation. You can tell someone is asking a question if they include a question word in the sentence, such as "ma" at the end. Not because their voice goes up at the end of the sentence.
* In Mandarin, unlike horseshoes and hand grenades, close is NOT close enough. If I want to say the number ten, shí , which has the 2nd tone, I might mistakenly say shi with no tone, which translates to the verb "to be," such as "is" or "are." If I say shì, with the 4th tone, it means something altogether different (although I don't know what yet) and the Chinese person I'm speaking to will have no idea what I'm talking about, which is usually what happens. Our Mandarin teacher says that many Chinese people, native-speakers, pronounce things differently or, in her words, incorrectly, so no wonder they can't understand me either.
* After weeks of class, Chris asked me how to say "yes," and I couldn't really answer him. In Mandarin, the way to answer a question is to reply in the affirmative or negative form of the verb. So, the answer to "do you want something?" is not "yes" but "I want" or "I don't want." I've heard a lot of English-speakers here using "méi yǒu" (pronounced may yo) when they want to say "no," but it really means "I don't have." Often, this will suffice, such as "Will you have the chicken feet?" Definitely méi yǒu!
* While I am learning pīnyīn, which is the phonetic system for transcribing the sound of Chinese characters into recognizable alphabet, it is not how the Chinese learn to read their language, so whatever I write in pīnyīn will not be able to be read by the average Chinese taxi driver. If I want to print out the address for where I'd like him to take me, I have to translate to characters and pray that Google translate knows what it's talking about. Fortunately, many businesses, housing complexes, and even individuals have address cards made up with their addresses printed in English and Chinese characters, in addition to a crudely-drawn map, to help taxi drivers get you to the right place. Nearly everyone I know has a business card manager app on their smart phone to keep all of these cards organized, so you can simply pull it up on the phone and show it to the taxi driver.
This is just the first level of Chinese classes and, as I said, I am only a month into this class, but I am finding the language interesting. I don't know that I'll ever be very conversant, but at least, right now, I can give the taxi driver basic directions, such as turn right or left, do a U-turn (you have no idea what a common occurrence this is), go straight, or stop. Of course, when my nephew Peter, his wife Nickle, and their daughter, Kennedy, were here 8 years ago, Kennedy, who had just turned 2 at the time, could say these things to the taxi driver as well. I'm not sure I should be bragging about my language skills as of yet.
Thursday, October 3, 2013
Touring Bangkok


















After the flower market, we walked through a produce market and saw some interesting fruits and vegetables before heading on to the Grand Palace.
The third stop on our Bangkok tour was The Grand Palace & The Royal Temple of The Emerald Buddha - an incredible sight. While it was really starting to get unbearably humid, and Chris at least, was sweating profusely, we kept going through some very cold water to drink and the incredible sights and history of the palace. It includes 3 different areas, one designated for the Temple and various ceremonies, which is open to the public, then one where governmental offices are located. This area is also open to visitors, but my guess is you have to have some official business to get inside of the buildings. The third area is the royal residences, which are not on the tour and, in fact, no longer the residence of the King and Queen.
Each portion of the palace compound has a distinctly different architectural style. The first area, where the Temple and ceremonial buildings are, is very traditionally Thai and Buddhist. The center area, where the office buildings of the King are, is a combination of European and Thai architecture. The third area, where the royal residences were built, looks very European and very like Buckingham Palace.


1851–1868.

The Outer Court or Khet Phra Racha Than Chan Na (เขตพระราชฐานชั้นหน้า) of the Grand Palace is situated to the northwest of the palace and the northeast being occupied by the Temple of the Emerald Buddha. The "guards" of the temple (at least, those made of stone) are extremely large and colorful and Hindu in origin, not Buddhist.







The largest and most important court is the Middle Court or the Khet Phra Racha Than Chan Klang (เขตพระราชฐานชั้นกลาง) is situated in the central part of the Grand Palace, where the government offices are located. I was really impressed to see the combination of European and Thai architecture that King Rama V had built (son of the king from The King and I) as a way to shown European countries that there was no need to colonize Siam, as they were already learning the modern ways of Europe. He cleverly used a European type of architecture and modern conveniences, but also put on a traditional Thai roof - so that the Thai architecture was "on top."
Thais are very proud of the fact that there are the only nation in this part of the world never to be colonized by Europeans and attribute much of that to King Rama IV and V. As a result, the country remained a buffer state
between parts of Southeast Asia that were colonized by Great Britain and France. The original name of the country was Siam, thus the book on which The King and I was based was entitled Anna and the King of Siam. However, in 1939, the country's name was officially changed to Thailand, with Thai meaning freedom.
I really enjoyed this part of the tour, even more than the beautiful Flower Market, because the history was so interesting and so visible on the progression of architectural styles of the buildings. I found the whole palace fascinating and would definitely recommend it as one of the top tourist sights of Bangkok.
However, by the time we finished, we were too hot to go on to the next stop on the tour and convinced our guide to take us to a local traditional Thai restaurant for lunch. We had delicious Thai food, meat, vegetables and rice, and Chris asked for his to be spicy. The restaurant owner, who was taking our order, wasn't sure he really meant spicy. When his food arrived, it was spicy, but not overwhelmingly so. Our guide said they must have toned down the spice some for him. However, the owner came back while we were eating to make sure that it wasn't too spicy for Chris - she really seemed worried about him. He loved it and felt much better after sitting in the air conditioning for a while and drinking two Diet Cokes.
So, on to the next part of the tour. We caught a taxi and headed for the next temple, Wat Pho.
Wat Pho is situated right next to the Grand Palace near Tha Tien Pier. It was built in the early 18th century and originally called Wat Photharam. It is also assumed to be the first university of Thailand.
This is the Temple of the Gigantic Reclining Buddha, which is about 105 feet long and 50 feet high, The soles are inlaid with beautiful mother of Pearl scenes elaborately depicting 108 auspicious signs in Buddhism. The main chapel houses a beautiful Buddha image under which the ashes of King Rama I was enshrined. It is considered King Rama I ‘s royal temple.
Wat Pho was also a school of Thai traditional massage. There are many areas showing pressure points and techniques for Thai massage and many people are still getting massages there. I don't think the school is in the Temple any more, though.

One building is dedicated to the large number of Buddha statues one of the kings had brought into the capital from all over Thailand. They work hard at reconditioning them and repairing them, first covering them in black enamel and then covering them in gold. There were different faces on the Buddhas, depending on what area of the country they came from, but most all were in the tradition lotus position, with one had facing down and one facing up. We were told this signifies the transient nature of life; one shouldn't worry about troubles or relish good fortune too much, as everything will pass.

While our tour guide was planning another temple for us to visit, we told him that this would be the end of our tour for the day as we were so hot and sticky, we just couldn't wait to get back to the air conditioned coolness of our hotel. He taxied with us back to the hotel and gave us a good recommendation of a restaurant in the area, in case we wanted some traditional Thai food. We collapsed in our hotel room, showered, napped, and recovered from the heat. That was all the touring we were up for on Sunday.

Monday was a work day for Chris, but we made it back out to see some sights on Tuesday. We took a taxi to the Jim Thompson House, which is a fascinating part of Bangkok history as well. The Jim Thompson House is the home of James H.W. Thompson, a self-made American entrepreneur who was the founder of the world renowned Jim Thompson Thai Silk Company. Jim Thompson was born in 1902, graduated from Princeton and joined the OSS during WWII. He ended up in Thailand just as the war ended and decided he wanted to live there. He found that the tradition Thai silk trade had fallen off and he revived it, among other ways, by taking Thai silks to the U.S., where they were included in the movie and stage production of "The King and I," and bought by U.S. fashion designers.
He had his beautiful home built from traditional Thai houses brought together and completed in 1959. In 1967, Jim Thompson went on holiday with friends to the Cameron Highlands in Malaysia, went for a walk, disappeared, and has never been heard from again. His home is a lovely exhibit of traditional Thai architecture, which he also helped revive, as well as a beautiful display of silks.
After touring the Jim Thompson House and visiting the shop, we took the Sky Train back to Sukhumvit, the street our hotel was on, and stopped at a restaurant our tour guide had recommended in our area. We'd thought we'd misunderstood the name of the restaurant, but it really was Cabbages and Condoms.
The local style Thai food was delicious and the restaurant itself was very comfortable. We were a bit surprised when we received free condoms, one male and one female, at the end of our meal, when one might expect to get mints. We went to the gift shop and found out that the restaurant and shop, like the affiliated ones in the U.K., support a charity designed to curb population growth in Thailand. Apparently, the average Thai family has 7 children.
According to their website: "As one of the most
unique restaurants in Metropolitan Bangkok, the Cabbages & Condoms
Restaurant has attracted international attention. Conveniently
located near one of Bangkok's main business districts, C&C is very
popular among local and foreign clients. Our
restaurant was conceptualized in part to promote better understanding
and acceptance of family planning and to generate income to support
various development activities of the Population and Community
Development Association (PDA)."
It was a delicious lunch and the hand-crafted items in the shop were beautiful, so definitely a good recommendation by our guide. We returned to the hotel happy and full and took a swim in the pool before a little more work for Chris, some more U.S. TV for me, and a room-service dinner. Our flight home was Wednesday, so we headed to the airport fairly early and made our way back to Shanghai.

So, on to the next part of the tour. We caught a taxi and headed for the next temple, Wat Pho.

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He had his beautiful home built from traditional Thai houses brought together and completed in 1959. In 1967, Jim Thompson went on holiday with friends to the Cameron Highlands in Malaysia, went for a walk, disappeared, and has never been heard from again. His home is a lovely exhibit of traditional Thai architecture, which he also helped revive, as well as a beautiful display of silks.


It was a delicious lunch and the hand-crafted items in the shop were beautiful, so definitely a good recommendation by our guide. We returned to the hotel happy and full and took a swim in the pool before a little more work for Chris, some more U.S. TV for me, and a room-service dinner. Our flight home was Wednesday, so we headed to the airport fairly early and made our way back to Shanghai.
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