A Grieving Mom in Shanghai Learns Her Son May Not Have Pancreatic Cancer After All: Misuse of the CA-19-9 Antigen Test

A few days ago a grieving mom in Shanghai, a good friend of ours, shared some tragic news with me: her teenage son had pancreatic cancer, one of the worst cancers. Her son was likely to die soon, if the doctor was correct. Only about 20% of pancreatic cancer patients live past 5 years. She was almost overcome with grief and had been crying for a couple of days. But even though she had gone to an expensive hospital that caters to foreign clients, she wasn’t sure she should trust the doctor. The mother called me to see if I knew where she could turn for help. She didn’t know that one of my sons happens to be a doctor treating cancer at a leading US clinic.

I received a photo of the lab report for the boy and sent it to my son. The physical results reported that a scan of internal organs showed no unusual problems indicative of cancer. There were no other symptoms, just a slightly elevated CA-19-9 antigen level, 45 instead of a desired maximum of 37.

My son was greatly disappointed that the doctor would create such needless panic by telling the mom that her son probably had pancreatic cancer. My son explained that the CA-19-9 test is not supposed to be used for diagnosing cancer on its own. Absent other symptoms of cancer, it’s predictive power for cancer is less than 1%, he said, and when he learned that the son was just a teenager, he said it’s even less likely to be pancreatic cancer because that disease is almost unheard of in young people. The mother’s grief was turned to relief.

I later found scientific publications confirming what my son had said. For example, see K. Umashankar et al., “The clinical utility of serum CA 19-9 in the diagnosis, prognosis and management of pancreatic adenocarcinoma: An evidence based appraisal,” Journal of Gastrointestinal Oncology, 2012 Jun; 3(2): 105–119; doi: 10.3978/j.issn.2078-6891.2011.021:

CA 19-9 serum levels have a sensitivity and specificity of 79-81% and 82-90% respectively for the diagnosis of pancreatic cancer in symptomatic patients; but are not useful as a screening marker because of low positive predictive value (0.5-0.9%).

Other articles indicate that diabetics, such as this young man, can have inflated CA-19-9 values (this applies at least for Type 2 diabetes–I’m not sure if CA-19-9 artifacts from Type 1 diabetes has been investigated ), one of many possible alternative causes of elevated CA-19-9 values. Alternative causes for the elevated test result do not appear to have been  considered by the doctor who terrified a mom by declaring that it was probably pancreatic cancer. Again, the test can be useful in tracking the progress of treatment of a known cancer, but should not be used to diagnose cancer in the absence of other evidence, as in this case.




Keep this in mind when you have your physical in China. Don’t panic if a doctor reports that you might have pancreatic cancer based on a blood test result alone. Get a second opinion and understand why that value may be high, but don’t panic. Physical testing here can often include too many unnecessary tests in search of phantom problems that may be listed in your report by people who aren’t necessarily qualified to make such proclamations.

The family still needs to be cautious and follow up on the possible causes of the inflated test result, but it was only slightly elevated unlike the much higher scores that I’ve seen reported in patients who actually do have pancreatic cancer.

I am so grateful that my son was able to help bring peace to a mother who had been crying for a couple of days over the “fake news” she received from a generally good hospital. I suggest that here or anywhere else you should be open to the possibility that some doctors don’t know what they are talking about. And of course, that can apply to what I’ve said here. Do your homework, ask questions, and be cautious about what others declare.

 

By | 2018-06-20T16:52:56+00:00 June 17th, 2018|Categories: China, Consumers, Education, Health, Safety, Surviving|Tags: , |0 Comments

Jimmer, the “Lonely Master,” Might Be Doing Better and Doing More in China than the Deseret News Thinks

In the state of Utah, Salt Lake City’s Deseret News recently carried a touching but slightly downbeat article about China’s most popular basketball player, Jimmer Fredette, the impressive star who once stunned American crowds while playing for Brigham Young University. The article is “Lonely Master: From March Madness to Shanghai, the Unlikely Journey of Jimmer Fredette” by Jesse Hyde, published March 12, 2018. It has a lot of positive things to say about Jimmer and his accomplishments in China, but the general tone of the article is that Jimmer has missed out on his US dreams and thus has settled for something painfully inferior by coming to China, a grim and gritty place. I think there’s another perspective that ought to be considered.

Yes, the CBA is a far weaker competitive field than the NBA, and yes, it is disappointing that his NBA career did not give him the opportunities and satisfaction he sought. But don’t shed too many tears for Jimmer: things might not be as grim as the article implies.

The negative picture painted of China is quite disappointing. It’s a beautiful, exciting place where Jimmer is visible and influential to millions of people in ways that would not be possible in Europe or the US. I have met Jimmer and chatted a few times but don’t know him well nor can I speak for him. But what he is doing here is remarkable and has touched many people. His goodness, his honesty, his humility, and his high standards have also helped him touch people beyond what his athletic skills alone could do. For someone who possibly may have a sense of a mission higher than personal temporal success alone, coming to China brings many opportunities to achieve greater good, while also benefiting from a shorter season and excellent pay. Win/win from my perspective. His presence in China is part of something big, at least in the minds of many of his BYU-related fans here.

One of those fans, a Communist Party official, requested a chance to meet Jimmer last year. I was honored to be part of the little gathering where introductions were made. Jimmer with his characteristic class and humility brought gifts for the Chinese men who had come — framed photos of him as keepsakes. They were thrilled. Before Jimmer showed up, one man in the small group, a business leader in charge of the large complex where we rent some beautiful space to hold LDS services, chattered excitedly about Jimmer and quoted statistics from Jimmer’s games when he was at BYU and in China. Kid in a candy shop when Jimmer arrived. The official had gifts also, a terrific album of Chinese postage stamps. It was a beautiful souvenir for each of the foreigners at this event, which I’m proudly holding in the photo below.

With typical Jimmer class, Jimmer noticed a couple of keenly interested staff members from the little cafe where we met and invited them to get their photos taken also. It was a big day for all of us.

The Deseret News article makes numerous references to the pollution of China and Jimmer’s depressing situation here. The lead paragraph suggests he can’t see much of the skyline in Shanghai due to pollution (yes, we have pollution and some days visibility is noticeably reduced, but we have a lot of beautiful days too and air quality is improving). His apartment is “empty, lonely, a place he just crashes, so devoid of personal effects….” Regarding some reminders of his wife and daughter in his apartment: “Sometimes he needs those reminders. Like when he’s in Shanxi, a gritty industrial city where the gray dust blows from the cement factories and the grime is so thick he could scribble his name on the windows of parked cars.” And when he’s in Shanghai, in spite of the wealth and good food here, “even here, the air carries a slight whiff of chemicals you can almost taste. It’s hard not to want to be somewhere else.”

At this point in reading the article, I wondered if the staff of the Deseret News have ever been in Salt Lake City during the winter months, when the winter inversion traps air in the Salt Lake Valley and leads to painfully high levels of particles, nitrogen oxide, and other pollutants? Of if they have ever been near operations of the massive copper mine that scars the Valley? Or drove through Utah County in the days when the Geneva Steel works were cranking out massive whiffs of chemicals into the air? Or if they have lived near a paper mill in the United States? Shanghai air can get smoggy and is typically worse than most places in the US, but apart from an occasional painter using oil-based paint or a vehicle burning too much oil, as in almost any city, noticeable “whiffs of chemicals” are something I generally don’t experience here, unless those chemicals include the cinnamon aromas coming from Shanghai’s amazing Cinnaswirl bakery with world-class cinnamon rolls, or from the intoxicating smells of any of the hundreds of different cuisines available in Shanghai. OK, we do have stinky tofu, which does have a noticeable smell from its unusual natural chemistry — maybe that’s what the writer encountered here. But you can just take a few steps and be free of that.

China has pollution, certainly. There are spots that are gritty or grimy, just as in America. But it’s also one of the most beautiful and exciting places to live, especially Shanghai. For me personally, my respiratory health during my nearly seven years in Shanghai has been much better than it was in the US, where I would often get bronchitis or other issues in winter. Here it’s been great and I’ve almost never had to miss work due to illness. One or two days for an injury, but my health has been terrific. Part of that is from the food, which is high in fresh produce and generally quite healthy.

Come give China a chance. It’s one of the nicest places in the world, in my opinion. Anyplace is grim when you are away from family, but with such a short playing season, we hope that Jimmer can continue to thrive here and increasingly experience the beauty and wonders of China while here.

As a reminder of the surprising beauty and sometimes even miraculous nature of life in Shanghai, here are images of one of Shanghai’s secrets: its impressive angels rising from the ground to watch over this city. May Jimmer continue to be among them.

Finally, here’s a couple views of one of Jimmer’s favorite Shanghai spots.

Shanghai Disney Castle

The Shanghai Disney Castle

 

Cinderella’s Castle.

 

 

By | 2018-03-17T07:24:37+00:00 March 16th, 2018|Categories: Business, Career, China, Food, Health, Photography, Relationships, Religion, Restaurants, Safety, Shanghai, Society, Surviving|Comments Off on Jimmer, the “Lonely Master,” Might Be Doing Better and Doing More in China than the Deseret News Thinks

Your Shanghai Apartment and Construction Noise

One of the surprises many foreigners have after moving to Shanghai is how noisy things can be when a big construction project starts. That quiet vacant lot across the street o your building may turn into a volcano of noise that slowly rises one story after another, or the once silent or vacant apartment next to you may become a source of constant pounding and drilling as the owners remodel it over a period of weeks.

Before you select a place, it’s good to look around and see if adjacent lots or buildings look like construction will soon take place. The worse situation is an old vacant building that will be demolished prior to rebuilding. Demolition in China is not a sudden event. It involves endless hours of a giant mechanical woodpecker pounding at stray blocks of cement to break them into tiny chunks. This is one of the most annoying sounds. Much better is the constant grinding sound that occurs when foundations are being dug or poured, for it sort of becomes like white noise that you can sleep through.

Fortunately, Shanghai has strict laws on noise requiring crews to become silent at night, I think by 11 PM, and to stay quiet until about 6:30 AM, giving you a chance to sleep. But these laws apply to ordinary companies and private owners, not to government projects like building a subway. We have a subway site under construction next to our house. Loud grinding and clanking noises will keep going until about midnight and then they are at it again at 3 or 4 in the morning. Pretty much noise all day long. How does one cope?

Make sure you have an apartment where your sleeping quarters will be away from the most likely construction site. That makes a huge difference. Also, consider adding some noise shields over your window at night, like foam board to completely cover the window. Or consider buying a white noise generator to mask the street noise. Ear plugs might also help.

But the real key is knowing what you are in for, as much as you can, before you select your apartment. Then prepare appropriately. Good luck!

By | 2018-03-12T16:30:21+00:00 March 12th, 2018|Categories: Health, Housing, Shanghai, Society, Surviving|Tags: , , |Comments Off on Your Shanghai Apartment and Construction Noise

Surviving Your Bike Ride in China

Riding a bike is one of the best ways to get around big cities in China. I have my own large Giant bike purchased new for 800 RMB, and I love it. Fast and smooth, but just one gear. That’s fine for Shanghai. Many people ride rental bikes now like Mobikes or the yellow Ofo bike that I sometimes ride (the Mobikes are just too small for me, while the Ofo brand often allows the seat to be raised high enough to make it possible for a tall guy to ride, though not comfortably). I ride my bike most days when going to work in the Hongqiao area of Shanghai. It’s often faster than a taxi and much faster than a bus. You can join the pack of crazy motorcyclists who are not impeded by traffic jams, cutting in and out of obstacles while carefully observing all relevant laws — well, most of the laws of physics, I mean.

Bike riding is fast and convenient, but there are serious dangers. Not as dangerous as a motorcycle, where the higher speed means higher risk, but that higher risk includes collisions with you on your bike, and the results can be nasty. A friend of mine just badly crushed his hand in an accident with a motorcycle while riding his bike. He will need delicate surgery. Another friend was riding across a bridge when she hit a rock and fell from her bike, badly shattering her forearm. Painful surgery and months of recovery were required, but after a year has regained nearly all of her motion. But trust me, you don’t want an accident. Understanding the dangers is critical.

One of the biggest dangers comes from motorcylces and especially their nearly silent electric version, the ebike or electric bike. They can be zooming toward you from behind and you won’t hear them coming. They can be coming in from an angle from the back or side and you won’t hear them coming, unless you listen carefully. More important than listening is looking: you need to frequently make quick glances over your shoulders, especially over your left shoulder where faster approaching vehicles are likely to be coming, but also sometimes over your right shoulder.

Vision Trumps Everything

Peripheral vision is crucial. Frequent glances over your shoulders are vital. Understand that a vehicle may suddenly approach you from any side and any angle. A motorcycle or bike may dart out from an alley or from between parked cars on the side of the road. As you approach an intersection or driveway, someone may suddenly move into your path and it will usually seem that they never even looked your way before entering traffic. It’s amazing that some of them are still alive, but natural selection can be a slow and overly random process. I certainly have not seen any evidence that natural selection has been weeding out insane motorists and cyclists over the years in China. Evolution might work well for some species, but it seems rather inactive for species on the road. Never mind, just focus on not being the one who gets weeded out.

The key is being totally alert and aware of what’s happening in front of you, at your sides, and behind you. Listen carefully for horns, bells, rattling sounds, motors, snorts, cellphone conversations, or other indications of an approaching ghost rider. Watch for signs of motion between stationary cars. Anticipate taxi doors suddenly opening, usually on the right side. Note the protruding nose of a dog getting ready to make a dash for it. Anticipate the craziness of intersections where people may cross your path from all directions. Total alertness and attention is your key to survival.

Here’s the shocking news: for enhanced safety, I’ve given up wearing my helmet. Yes, terrible of me, right? But the statistics globally don’t show that bikers who wear helmets fare better than those who don’t, and in my Shanghai experience, I’ve realized that anything that hinders my peripheral vision or my ability to quickly look over my shoulders increases my risk. Avoiding collisions and falls is the first priority, much better than falling with a touch of added protection. Helmets limit my vision and slow me down when making rapid backward glances. Sayonora.

Alertness is also needed for coping with obstacles on the road. Manhole covers may be moved and the dangerous hole not well marked. Potholes may be large. Bricks or other objects can be in your path. With the rise of rental bikes clogging sidewalks, you will sometimes find a rental bike has been abandoned on the side of the road that partially blocks a bicycle lane. Dangerous! Be  good citizen and move it out of the way, but do this by stopping gradually and with clear signaling of intent. No sudden moves!

Speaking of rental bikes, they add a lot of danger to the scene. Not just because they might be barriers, but because they have brought many new cyclists onto the roads who don’t know much about cycling and safety. And they are slow. They go at about 30-50% of my speed, in part because the wheels are small, and as a result they are constant barriers in front of me I need to weave around. But their riders often don’t ride very well, weaving back and forth as they go. So annoying. Increases the risk for everyone. Be cautious and carefully plan how you can avoid them and get past them as soon as possible. Further, bike renters will often step out onto the road with their bike without even looking at incoming traffic. So clueless. Anticipate their stupidity and be cautious when you see someone standing by a rental bike, possibly getting ready to create a pile-up on his or her first ride.

To Be Safe, Be Predictable

From my experience, a key safety tip is that you need to be predictable. Sudden turns, veering to a side, or a sudden stop can result in disaster. In China, car drivers and motorcyclists constantly forecast where others are going and then plan their sudden weaving in and out or other crazy maneuvers based on forecasting the routes of nearby vehicles. They expect you to just keep going and will time their move based on the forecast. But if you suddenly stop or turn without warning, you may end up where they are about to end up. Bang. Ugly. Notice this when you are in a taxi. Drivers are very aggressive and it all kind of works as long as people are somewhat predictable.

Hand signals aren’t common but are a good idea, especially for left turns against traffic. They aren’t going to stop for you in most cases to let you turn, but the signal lets others know what you are doing so they won’t crash into you.

When you stop, try to do it gradually. Recently I was riding along, thinking I was alone, and saw a person who was on the ground right after an accident between a bike and a motorcycle. I stopped quickly to help and then heard someone right behind me yell as he slammed the brakes of his electric motorcycle to avoid me. I was nearly taken down by that mistake. Be predictable. No sudden moves!

I hope this doesn’t deter you from riding a bike. There are dangers, but if you are alert and cautious, you can manage the risks and enjoy getting around town much faster than going on foot or with public transportation. But do realize that there are risks. Walking and public transportation have much lower risks, so weigh them as alternatives. Very few people have ever needed major surgery after a ride on the subway.

 

By | 2018-01-07T19:24:24+00:00 January 7th, 2018|Categories: China, Crazy, Health, Safety, Shanghai, Society, Surviving, Travel tips|Tags: , , , , , , , , , |Comments Off on Surviving Your Bike Ride in China

Milk in China: Try the Asahi Brand for Safe, Delicious Fresh Milk

Milk has been a problem for many people in China. Trust of Chinese dairies has been low after some past disasters. Large milk powder companies struggle tend to import the milk they use because of quality control problem among the numerous small dairies that provide milk to large providers. Foreigners who like to use milk tend to buy ultra-high-temperature (UHT) treated milk that does not require refrigeration until it is opened, but the flavor tends to be poor from the heat treatment and nutritional value may be lowered as well.

After struggling with various brands of UHT milk and shying away from Chinese dairies for fresh milk, I finally found a brand of fresh that impresses me: Asahi milk. This is a Japanese company using good Japanese dairy methods on their Chinese dairy. The flavor of the milk is better than anything I remember in the US and tastes like fresh milk I enjoyed in Switzerland long ago. Really delicious. A liter will cost slightly over 20 RMB, about the same price for good quality UHT cartons of milk. But so fresh and delicious. Also, I think, safe and consistent in quality.

Asahi brand whole milk: possibly China's best?v

Asahi brand whole milk: possibly China’s best?

By | 2017-10-24T06:52:38+00:00 January 21st, 2017|Categories: China, Consumers, Food, Health, Safety, Shopping, Surviving|Tags: , , , |2 Comments

Funny Red Beef in China: Treated with Sodium Nitrite?

I’ve noticed that beef sold in small shops in China is often a bright red color as if very fresh, maybe too fresh. It may have been sitting out for hours or days, and it is still that bright red color, never turning brown as regular beef does. We were buying beef from a local market for quite a while before it hit me that there was something odd about the color. It never turned brown until you cooked it. Finally it hit me that this beef has been treated in some way, probably with sodium nitrite or other chemicals that prevent the normal browning that occurs when beef oxidizes over time.

Some people worry that nitrites might cause cancer, especially when present in meet that is grilled or cooked at high temperature. Whether nitrites are carcinogenic or not, I don’t want chemicals being added to my beef to disguise its age and let old beef look fresh. This might be a good topic for further investigation because I don’t know for sure what is being added and who is doing the treatments, or of they are safe or not. But in the absence of assuring data, the strange absence of browning in some of the been being sold here has given me one more thing to worry about when it comes to meat in China.

Eat meat sparingly. Make sure it’s fresh and from a trustworthy source. Pork and chicken, which are sold in large quantities with high turnover, may be freshest and safest, in my opinion.

By | 2017-01-06T21:12:08+00:00 January 6th, 2017|Categories: China, Consumers, Food, Health, Restaurants, Safety, Shanghai, Shopping|Tags: , |Comments Off on Funny Red Beef in China: Treated with Sodium Nitrite?

Accident in Shanghai: The Ambulance Never Came

On my way to work each day, I usually walk or ride my bike, but on a rainy night recently, I tried taking a bus. The journey ended up taking longer than just walking. Part of the problem was a busy road (Gubei Road near Gubei’s elegant pedestrian street) was partly blocked by a traffic accident. As the bus drove by the scene, I saw a car and a little motorcycle-powered three-wheeled rig for a restaurant delivery service. There was a woman pacing next to the car talking to someone on a cell phone. And then I saw two feet pointed upwards on the ground. A man was lying on the asphalt near the car that had struck his little vehicle. Cars were passing near him. It was raining on him. Nobody seemed to be looking after the victim, with hundreds of cars steadily moving on both sides. Why was nobody helping?

It seemed beyond my ability to do anything about it, but I got off at the next stop and thought I should at least walk back to the accident site and see if things were OK. I debated internally as I pondered all the things I needed to do and the shear improbability of making a difference because things were probably under control by then. But I felt drawn and so I went back. As I approached the scene, I was relieved to see two police officers had shown up. Things were under control. Still, I crossed the street near them to get a peak at the victim, whom I assumed would now be receiving some kind of help. He was still lying in the same place, rain falling on him, with no protection. Then I realized that, perhaps for the first time ever, I had two umbrellas with me that day. I had grabbed one when I went to work, forgetting that I already had one in the bag I carry. I had two, and since the officers didn’t seem to have any, I could offer them one to help them at least keep the victim dry until an ambulance showed up.

The officer I spoke to recognized that an umbrella would be useful, but he was busy directing traffic and said if I wanted to, I could hold it for the victim. Well, OK, the ambulance would be here any minute and so sure, I could help out a bit. I recognized that people passing by might think that I had been the driver of the vehicle that struck the man, but hoped that I would be doing more good than harm by being the volunteer umbrella holder. The woman driver who had been standing around doing nothing said something like, “Oh, right, good idea” when I started trying to protect the victim. But she didn’t offer to take over that role. I was disappointed that the driver didn’t seem very worried about the delivery man she had struck. He was about 50 years old and had a lot to say about the allegedly reckless driver who struck him while he was driving properly and carefully. Proper driving isn’t all that common here, so I can’t judge who was at fault. He worked for one of Shanghai’s best and healthiest restaurants, Element Fresh, which I would learn provides good health care coverage for their employees.

The man was in pain but it didn’t appear critical, but I was worried about the possibility of internal bleeding and wanted the ambulance to get there ASAP. After about 10 minutes I asked if ambulance was coming. “Yes, I called for one.” After about 20 minutes I asked again and she then said that the ambulance service she called had said all the ambulances were busy and that they would call her when one became free. Huh? I talked to the police and suggested that we should give up on this no-show ambulance and take him to the hospital in a taxi. There were taxis coming by all the time. Why not use one of them?

The police reminded me that moving the man could be dangerous. By then, though, the man was sick of lying on the road and said he was going to sit up, and would we help him. So the police helped him to sit up. And then he said that this was a bad place to be waiting and that he wanted to talk over to the curb where it would be safer and more comfortable, and could we please help him walk over there? So the police helped him as I held my two umbrellas above us, and continued holding both for the man and me as we waited. And waited. I again raised the possibility of a taxi. After about 40 minutes of waiting, the police saw that as a good idea and agreed. So I waved down a taxi and wondered if I would be needed to take the man to the hospital, but was relieved to see that the police arranged for the woman to take the man there and that I would not be needed.

The ambulance never came. A poor man struck by a car laid on the road for perhaps an hour or so waiting for am ambulance that never came. A Taiwanese friend of mine later suggested that the woman may have lied and never called the ambulance because in China it is the person who calls the ambulance that pays for it. Perhaps. But later another friend at lunch shared an even more painful story of a stroke victim he was helping in Shanghai, where it took an hour to get an ambulance and then when they came, the team had rough street people who moved the victim like one moves a bag of potatoes. In any case, in this, one of the most advanced and modern cities in the world, when you need it, the ambulance might not come for a very long time. This is a problem that can happen anywhere, especially in times of crisis, not just in rush hour.

By the way, I was able to reach the man later to check up on him. He’s doing well and is taking a month off from work to recover from the injury to his side. No surgery needed. He was quite upbeat. Element Fresh provides good health care benefits it seems and the responsible driver paid for the medical care. I also was impressed that the leaders at the Element Fresh restaurant at Yili Road/Yanan Road were aware of the man’s situation and care about him and helped me contact him to check on his status. To thank Element Fresh (and more selfishly, to enjoy delicious, healthy dining), my wife and I dined there last night and had a wonderful meal.

More and more, it seems that we need to be increasingly prepared to take care of ourselves and reduce our dependency on others. When it comes to health, we need to be doing more to reduce our future reliance on services that might not be there or whose quality might be far below what we need. Now is the time to exercise, lose weight, stop smoking, eat wisely with plenty of plants in our diet, and to reduce behaviors that put us at risk.

In China, by the way, preparedness also means carrying cash or an ATM card with you so you can pay for medical services. You often won’t be treated until you or somebody pays first.

Another health care tip is to beware surgeons pushing for surgery when it might not be needed.

A couple years ago I had a near-miss with a bad surgeon at a good hospital here who was going to “fix” a knee problem (he said he would repair my meniscus), but after I had checked in for the surgery, a comment from one of the staff about “removing the meniscus” raised my suspicions and I decided to just get up and walk away. I’ve been walking ever since. Had I succumbed to the recommended surgery, I think my mobility might have been impaired.

After I walked away, I called a physical therapist I knew for a second opinion. He said the way to check to see if I really needed surgery would be to go to another reputable hospital and meet with a surgeon there and show them my MRI scan, but tell them that if I needed surgery, I would not do it there so they would have no profit motive to sell their surgery to me. Surgery is the solution for everything in China, he explained, because that’s where the profit is. Something like 70% of all babies born are delivered with C-section. And I suppose a lot of knees get repaired unnecessarily as well.

I took a taxi to another hospital and minutes later was meeting with a surgeon. He checked my knee, looked at the MRI, and said this was not a case where surgery was needed. “Try physical therapy.” I went to that physical therapist and after the first treatment, my problem was significantly reduced, and ten treatments later, I was pretty much back to normal. There is a damaged meniscus, but better damaged one than none at all. I came so close to reducing my long-term mobility, and I remain grateful every day that I can walk or ride. It’s exhilarating to move and to be independent. I will greatly miss this freedom when it is gone or limited someday. But for now, my mobility is one of my most cherished gifts, and I recognize it all the more as a gift since that near miss, and from some accidents that could easily have given me a broken bone or worse, where I am just so grateful to have been able to walk away.

Our health is so precious, and it is up to us to protect it. With the strains on the healthcare system and the increasing difficulty of paying for medical insurance, coupled with the decreasing quality of coverage in many places, it is imperative that we do more to preserve our health and to be able to cope with our problems on our own or with our own resources. We can’t always assume that the help we expect to get will be available. And when we do get it, even from good doctors at good clinics, things can go wrong. Prevention must be our first line of defense. Being prepared to render first aid and take care of basic problems is also vital. For more serious things, doing our own research so we understand the issues can make us less dependent on one person’s opinion and can often increase our ability to guide outcomes in the right direction.

By | 2016-11-25T16:54:36+00:00 November 25th, 2016|Categories: China, Health, Shanghai|Comments Off on Accident in Shanghai: The Ambulance Never Came

One Nutritional Supplement You Probably Need in China: Vitamin D3

The medical literature tends to suggest that people waste a lot of money on the vitamins and other nutritional supplements they buy. But here in China, there is a vitamin that I think you may need: D3. Vitamin D3 is normally created in our skin by sunlight, but sunlight is sadly lacking in typical Chinese cities because of the air pollution. Even when there is sunlight, there is not much UV light getting through the haze. In the US, people also get some Vitamin D in dairy products since it is routinely added to milk, but I haven’t seen evidence of that being standard in China and dairy products tend to be a much smaller part of one’s diet here.

Lots of people here have lingering colds and coughs. In a couple of cases I know, giving the sufferers regular vitamin D3 helped them get back to normal. D3 is said to play a role in strengthening the immune system and other systems. It’s something we really need in China. You can buy it here, but it’s much more expensive than in the U.S., so I recommend that if you are coming to China for a long time, bring a good supply of Vitamin D3 with you and stay healthy.

By | 2016-01-11T17:19:15+00:00 January 11th, 2016|Categories: China, Health|Tags: , , , , , |Comments Off on One Nutritional Supplement You Probably Need in China: Vitamin D3

Food Poisoning: Beware of Hamburgers and Other High Risk Items

food poisoning shanghai burgers hospital preparation

Was it the meat? The mayo? the lettuce? Or maybe the shake? It’s hard to know with food poisoning.

I had a call at 2:15 AM this morning from a victim of food poisoning, a friend who had just been taken to one of Shanghai’s many hospitals with quaint names. This one was the Armed Police Hospital of Shanghai on Hongxu Road near Yan An Road in Hongqiao, not far from where we live. He had been out with some friends eating at Munchies, a popular joint serving basic Western food like hamburgers, shakes, and fries. I ate there once a few months ago and thought it was OK but not interesting, and avoided the hamburgers due to my concerns about the risks of food poisoning. Hamburgers are already a common source of food poisoning in the States, and I think the risks will be higher here.

My friend had eaten a hamburger, shake, and fries. He guessed that his food poisoning came from bad oil in the fries or bad cream in the shake. My guess is the hamburger was the culprit. Hamburger is so often contaminated with bacteria and is too easy to undercook or recontaminate with sloppy handling. But who knows, it could have been bacteria on dirty lettuce in the burger. I doubt that bad oil would give the violent food poisoning reaction he had, with hours of pain and loss of everything in his digestive tract.

He eventually became so dehydrated and weak and in so much pain that he realized he was in medical trouble, so he called for help and soon was being carried away in an ambulance. In his weakened state, he forget to bring a wad of cash with him. Mistake! Bring lots of cash when you go to the hospital. Bringing an ATM card can work, but if there is trouble, then what? He was so weak when he got to the hospital that his fingers kept slipping as he tried to enter the long password code for his bank card, and after 3 tries, his card was locked and unable to be used at all. He called the bank to clear it, but was told he had to come in personally when the bank opened again later. Not good at 2 AM when you need to pay now for urgent help.

In China, if you don’t pay upfront or have proof of adequate insurance (that may not work in many cases), you aren’t going to get treatment, as far as I know. Understand that and be prepared. The hospital staff suggested he call a friend. I normally put my phone in silent mode when I go to sleep to prevent unwanted calls in the middle of the night. Last night was an unusual exception, and I’m glad I didn’t. I was able to rush over and help out, handling the payment. 650 RMB is all it cost for him to get a lot of good attention (once payment was made), an IV with several bags of fluid, medication, etc. The kit of supplies I received for him after payment was really impressive. Treatment was good, the place was clean, and the staff were efficient and friendly. Pretty good for a public hospital in the middle of the night. Remarkably low cost. Not bad.

What is bad is food poisoning. It can really hurt and make life miserable. Staying hydrated when you are hit with it is a real challenge. Drink lots and lots of fluids, even though you might lost them swiftly. Gets some salts also. Gatorade might be a good beverage to keep on hand for such cases. But do your own research to prepare. Keep some cash in your wallet or in a handy place at home to take with you to the hospital, along with one or two bank cards, your cell phone, and a cell phone charger, etc. Be ready. And especially be careful about what you eat. It’s a key to surviving in Shanghai, China.

By | 2017-10-24T07:20:17+00:00 July 6th, 2014|Categories: Consumers, Food, Health, Shanghai, Surviving|Tags: , , , |Comments Off on Food Poisoning: Beware of Hamburgers and Other High Risk Items

American Beef and Chinese Standards: Got Ractopamine?

Americans coming to China often have the notion that American food is pure and high quality, while Chinese food is made with low standards. While there have been some highly publicized food scandals in China, the regulations for food can be quite high. So high, in fact, that some American foods are not allowed in the country. This is particularly the case with beef. The problem is not politics and petty officials seeking vengeance as part of some trade war, but a legitimate problem with American beef. Cattle in America are fed a chemical to make the beef more lean. This chemical is RACTOPAMINE (chemical structure shown to the right), and it appears to be a legitimate concern. It is not a growth hormone (though the widespread use of growth hormones is another concern many people have with American beef and dairy products). China, Europe, Russia, and many other nations have banned ractopamine. It’s used in the majority of beef in the US. I’m happy to avoid it over here in China.

Some people are concerned about beef in China as well. If so, the imported beef over here is very high in quality. Much of the butter and imported beef here comes from New Zealand, where a generally high-quality and safe dairy industry flourishes.

By | 2017-10-24T07:24:14+00:00 May 12th, 2014|Categories: China, Food, Health|Comments Off on American Beef and Chinese Standards: Got Ractopamine?

Update on the Farmer’s Son, Recovering from Surgery #1

I’d like to introduce you to the most self-reliant people I have ever met. Noble people who have a message to some of my readers and friends: “Thank you for helping our son!” This is the family we met in Shanghai, where destiny and, in my opinion, the hand of the Lord brought us together. It is the family I previously discussed whose son has long been in need of surgery to correct a serious deformation of his leg (see the story here). We came to visit and see how their son is recuperating from a first flawed surgery. He is recovering well and is now able to stand, with the help of his friends. With a future surgery, we hope he will be able to walk more normally.

We left our comfortable, convenient city of Shanghai Friday night and flew out to Nanchang in Jiangxi Province, a smaller city with just 5 million people. From there we took a train to a much smaller town that many people here have never heard of, though it is about the same size as my hometown of Salt Lake City.  From there we took a car into farm territory and arrived at a tiny little farming village of just 180 people, with a handful of cement and brick buildings clustered together.

After living two years in one of the world’s largest cities, spending some time in a tiny farming village was a completely different experience, and probably our most magical time in China so far. Along with some gifts, we brought them some cash that some of you donated to help them pay the debt they have for the surgery their teenage son had in Shanghai. And now we are preparing for the next surgery that he going to need, this time the most important surgery, the operation to rebuild his knee that has been grossly deformed ever since a severe infection when he was a toddler.This family may be poor in monetary wealth but they are rich in the the things that matter most like love, integrity, and, as we also discovered, good food. Lots of good food that they planted and prepared themselves. The rice, the peanuts, the bitter melon, the various greens, the two kinds of herbal tea we tried, the beans, the chicken, the eggs, etc. I didn’t ask where they got the water snakes that turned out to be one of the especially delicious parts of our second meal in their home (I’m serious–I was really surprised), but I suppose they captured them out in their rice paddy. A small fraction of our feast had been purchased or traded with neighbors, but the vast majority was the work of their toil.

This rugged, self-sufficient family was impressed us with their love, goodness, and their competence in what they do. When we spent time with them in Shanghai, they seemed lost and confused, truly in need of someone to help look out for them, but on the farm, in their environment, they stood as masters, savvy, wise, competent, and fascinating. They were not the ones helping and lifting us.

They took us around to the various parts of their territory to show us the many crops they raised. We met relatives and friends with whom they share and cooperate, a wonderful example of what a community based on solid family values and love for one another can be. This was a happy place with the elderly and children spending time together, passing on values and principles. I saw no televisions. Water came from a well requiring a rope and a bucket. Luxuries were scarce. Chickens were abundant and roamed freely in some of the homes.

They were poor by our standards and by Shanghai standards, but they had everything they needed, with the obvious exception of competent health care for serious issues. Another child there was in need of surgery for a foot problem (I think it is clubfoot). With some additional help (use the PayPal button at the right if you wish), we can assist our family in getting the surgery they need for their son. If by chance we get more than is needed, I think this village will be a worthy target for ongoing external support. And perhaps some of you can join me one day in a future visit to this little piece of heaven on earth, hidden in the middle of China.

The foreign friends they wish to thank include some of you from the States and also some friends from Taiwan living here in China who have been wonderfully generous. Thank you!

A few photos follow. Note the fireworks exploding in the second picture: we got the fireworks treatment when we arrived and when we left. I think fireworks help drive away evil spirits. Did it work? You’ll have to be the judge. Maybe it takes two applications to be effective.

I should also mention the sweet woman in blue. She was so curious to meet us and so warm. After she met us, she went home and wrote a letter that she brought to us later in the day expressing her happiness to have us as new friends. It was such a kind letter. Really one of the sweetest, most gracious people I’ve met. She apologized that she only had two or three years of education and wasn’t cultured, but I wish everyone had that much culture.

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By | 2016-10-24T05:58:01+00:00 June 26th, 2013|Categories: China, Health, Photography|Comments Off on Update on the Farmer’s Son, Recovering from Surgery #1

Apparent Disaster: Heartbreak at Xinhua Hospital

I’m in shock after my visit to Xinhua Hospital tonight. Disaster. Heart break.

As I explained earlier in my posts on the case of the poor Chinese family who came to the big city of Shanghai to finally get surgery for their son’s deformed leg, I felt that my primary mission in being involved was to help them get the second and third opinions that were needed to dissuade them from unnecessary hip surgery and instead focus on the knee surgery that they boy really needed. So I was relieved when I got the text message saying that they had decided to get the knee surgery only. Whew, I thought, I made a difference. I was sad to see that they were going with the first hospital they had gone to instead of the high-quality one I had taken them to for their second opinion, but I couldn’t make all the decisions for them and didn’t want to challenge the father on everything. Maybe I should have. Why? Because my mission looks like a complete failure. I should have been a little more aggressive, a little more paranoid, a little more helpful in guiding the family toward different options.

Surgery was last Friday night. It took several hours and was more complicated than expected, but I was relieved that it seemed to have gone well. But what I didn’t understand until tonight is that the surgeon didn’t touch the knee at all. He operated on the hip. A hip operation–the unnecessary, costly thing that was my mission to prevent. The hip, not the knee. Contrary to what he told the father, contrary to what three difference doctors had recommended, it appears he decided that the hip was where he needed to operate. It makes no sense. I’m in shock. Maybe there were good reasons for that, and I’ll give him a chance to explain it to me tomorrow morning when I see him at last (I’ve seen almost no trace of doctors or nurses in the crowded room with 6 beds and a couple dozen people where the boy is recuperating). For now, though, I’m thinking it’s a huge mistake. Perhaps the knee surgery suddenly seemed way out of the surgeon’s league. I don’t know. The father was as surprised as I was to learn that it was hip surgery, not knee surgery given to his son.

Actually, the hip surgery didn’t go well, the doctor has told the family, and the son will need another operation next week, and another 40,000 or 50,000 RMB to pay for that one, and it still won’t address the real problem, in my opinion. And if they don’t want to pay up front for that surgery now, then it’s time to pack up and leave this weekend because other patients need the hospital bed being occupied by the boy. The family, out of money and hope, is planning to pack up and leave. The son’s knee is the same disaster, and I fear that the leg will be in worse shape because of the incomplete hip surgery which may take a long time to recover, just to get him back to his normal painful, partially crippled state of abnormality.

Also to my horror, I learned tonight that the father has already paid in full for the surgery by going heavily into debt with relatives who had put money on a card for him to borrow, if needed. The cousin who translated told me that only 10,000 had been paid as a down payment, and I expected to still have some bargaining power with the hospital. I’m not sure when that changed–maybe today? Instead of waiting to make sure the hospital has done their part, he apparently had to pay already. The money I’ve been collecting for him will reduce his debt, but it’s gone for the wrong operation. A disaster, I’m afraid. I’ll try to see if he has any legal recourse, but recourse for the peasants from distant provinces is often a challenge here. I fear he’s been taken advantage of. Maybe unintentionally, maybe in good faith, but the result looks ugly and unfair. But I need to give the surgeon and the hospital a chance. Maybe there’s a good reason for the change in plans and the apparent complete waste of a poor farmer’s money and the slicing up of a young boy’s hip for nothing, it seems.

I’m offering refunds to everyone who donated because I don’t want people paying for disaster, and I can’t ask for more because it’s such a lost cause right now. Is this the right approach? Your feedback is welcome. They still need help–they just took on hopeless debt to help their son and have used all their funds. But it seems like it’s a cause that loses its appeal given what has happened. We’ll try to understand their options and their needs and figure out what to do, but ouch. Ouch. Ouch.

What is the future for this boy? I don’t want to give up, though part of me does when I hit these kind of frustrations, these ugly surprises that this beautiful country sometimes offers. Eventually, I’d like to help the family come back to a good surgeon in a good hospital and reconstruct the knee. It’s not happening this week, though. Wish it were. Your advice is welcome. They are determined to leave this weekend. I think we’re going to have to take the long trip to Jiangxi Province and help prepare them to come back later and do things the right way. We may need your donations and prayers even more then. Please keep Zhiwei and his family in your prayers now as well.

By | 2013-03-28T06:12:14+00:00 March 28th, 2013|Categories: China, Health|1 Comment