Post-operative care in China

[LiMo]

Hi guys,

 

I'm writing a speculative post to find out how much experience people have with hospitals in China, specifically in terms of post-operative care for a surgical wound which has been left open and needs daily dressing. The process is fairly simple and at most I may need some antibiotics if there's a minor infection. Here in the UK I go to my local surgery and just book lots of appointments with the nurse. As a short term student in Hangzhou, is it possible for me to continue with this, or should I delay my trip until I'm fully healed up? 

 

I've heard a lot about the horrendous lines at hospitals which wouldn't work for me at all, I may as well stay at home if I'm going to be queuing all day. Are there smaller surgeries where this might be treated? Can I pay upfront or is there some labyrinthine registration process? Would it be safer to go with a private “expat” hospital or would public services be OK? (I can imagine that private ones would be astronomically more expensive.) 

 

I normally wouldn't take the chance at all but I'm on a tight schedule.

[abcdefg]

LiMo, Is there a way you could do the wound care yourself?

 

Must admit up front that I have no first-hand experience with obtaining post-operative care here in China. But I foresee problems in setting up something here similar to what you currently have at home in the UK.

 

The wound care treatments, even though actually rendered by a nurse, would need to be under some degree of (loose) supervision by a physician or surgeon at the same hospital. They would need to be "prescribed services." You would need to first be evaluated by the local hospital's doctor, who would then tell the nurse what to do.

 

Not all doctors would be willing to do this, because it effectively has them taking over your case and assuming some degree of responsibility for the overall outcome when they don't know much about what already transpired. If something goes wrong on post-op day 25 or 30, it becomes partly their fault even though the problem might have actually have its origins upstream, back in the UK.

 

The more I think about it, the more I would suggest that if it's something major, just stay home in the UK until it is healed. If it's something minor, then you could continue the post-op care yourself in China. Wound care supplies are not difficult to obtain in large pharmacies here.

 

This latter course of action (do it yourself) sacrifices the "safety net" aspect of the post op care in which a trained nurse might spot something going wrong at an early stage and get you back in to see the doctor for antibiotics or whatnot.

 

As a footnote I should add that hospitals in China, public and private, are not known for streamlined efficiency. You can expect to spend a lot of time getting any kind of care. Cannot count on being able to just zip in and zip out. Lots of 挂号 and lots of 排队。

[ChTTay]

I'd add that you can find hospitals where you can zip in and out but you pay for the privilege. Foreign expat targeted hospitals are prohibitively expensive unless you've got insurance that covers it. However, some hospitals set up foreign or international clinics where the doctors speak English. On the one hand, these help cater to foreign residents and, on the other hand, some middle/upper class Chinese prefer to go there as the price is a lot more reasonable that an expat hospital and the doctors are Chinese, usually trained in China. The main difference for us is that they speak English. The fact it's an "international clinic" I think makes some locals feel the doctors are better. On top of that, because the cost is higher, there are often either small or no queues. The one in Beijing I go to you can also book a head if you want. I've always just turned up and been seen straight away.

To register at a public hospital might be up to 10rmb. At the international place I go, it costs 200-300rmb. The biggest issue I have is that everytime you go back you've got to pay this fee to be able to see a doctor. So first you go to see a doctor with a problem and they do some tests, when you go back you can't just get the results, you've got to pay to see a doctor again who gives you the results. I imagine everytime you went back you'd have to register again like this.

Aside from this, I would probably follow ABCDEFG's advice above. I'm not sure how doctors would react in this situation.

Why are you coming to China? If it's a University summer program of some sort... Larger Universities have their own clinics sometimes. You could try and find out some info from the Universities. If it's something to do with work then you could ask your company to enquire.

Maybe you can also check if Hangzhou has any international clinics. Not expect hospitals... But departments that are part of public hospitals.

[Lu]

Can't comment on the situation in China, but perhaps consider discussing this with your current doctor at home. They can possibly give some insight in how much care you'd still need at the time you'll be in China, whether it's feasible to do it yourself, or perhaps whether there is a different solution that also resolves your injury in a way that fits your plans better.

[johnk]

It is funny the way in which Chinese-Forums catch up with me in real life

 

I live in the UK and I  am just 5 weeks post surgery. 

My sisters wanted me to return to Ireland immediately after surgery so they could do the 'sister thing' and look after me. 

I refused to go even though the medical systems in the UK and Ireland are broadly similar and the family doctor in Ireland is also a family friend. 

I reckoned the local UK hospital is familiar with my case. If I showed up there with complications, then they should be able to get access to my files, know my history and provide continuity of care. 

 

I might be a wimp but I would not be keen on going to another country with a  'foreign' medical system when I may be in need of post-operative care.

 

BTW. I was told I shouldn't do short haul flights for 6 weeks and no long haul flights for 12 weeks. That alone would put paid to any plans for going to China.

 

As Lu says, speak to your current doctor, he should be able to advise.

[Flickserve]

It would probably be ok if the healing went smoothly. The hassle comes if the wound gets infected or other complications develop. It must be a fairly large wound or in difficult position if a nurse needs to look after it so frequently.

[Angelina]

Water quality in Hangzhou is better than other parts of China, yet, I am not sure what exactly is there (you can't drink it) so, on the odd occasion when I have a minor accidental cut, I am careful with having a shower. I would trust UK water quality more. 

 

Also, your immune system is not used to the local environment, it would be more difficult for you prevent infections. This is more important than trying to see if you can trust Chinese antibiotics and hospitals. 

 

People have had surgeries here, or went somewhere else to do it, the choice is yours. One downside to delaying your trip is that you might end up thinking too much about the wound, whereas if you come to China you can study and not worry about it. Universities do have their own infirmaries on campus. 

[LiMo]

Thanks for the replies everyone. As I suspected, it will probably be more hassle than it's worth.

 

@Flickserve: You're devastatingly correct.

 

@Angelina

You make a very good point about water quality. All the more reason to be cautious.

 

 

For clarification. I'm doing a 2 year masters program, and the second year we spend 5 months in Hangzhou. I need to be able to get there in good time or I'll have to defer and spend an entire year twiddling my thumbs (purgatory), or transfer onto a different program (hell). Either way my FOMO (fear of missing out) will be unbearable as my buddies party it up and travel the world. 

 

I'll ask the university about their facilities (it's ZheDa by the way), but I think that's definitely the last resort. My nurse was very confident, "they have clinics out there," but whether or not they exist is only the first hurdle. I trust you guys more.

 

Anyway, there's been a recent development and it looks like I'll be able to fly out a month later in October, so hopefully it should be all healed up by then. @johnk This should take me past the 12 week mark for a long haul flight; I hope you're own healing goes well.

[Angelina]

I need to be able to get there in good time or I'll have to defer and spend an entire year twiddling my thumbs (purgatory), or transfer onto a different program (hell). Either way my FOMO (fear of missing out) will be unbearable as my buddies party it up and travel the world. 

 

 

well... 

[Flickserve]

@LiMo

Is there anyway you can get the nurse to teach you how to dress the wound yourself?

Also, what sort of timeframe is the healing? Still need a few weeks or a matter of two weeks.

If you can get away with dressing the wound yourself ie smaller wound, you will need a supply of sterile cotton, gauzes and antiseptic solution. The solution can come in small packets. The nurse may suggest other materials.

[Guest realmayo]

Don't big universities still have their own campus hospitals? Might eliminate some of the hassle/cost factors assuming all is healing nicely.

[Flickserve]

Don't big universities still have their own campus hospitals? Might eliminate some of the hassle/cost factors assuming all is healing nicely.

No. Every student needs to go through the system like any public person. I can't think why a student would be fast tracked.

There might be a University health service (GP clinic) that caters for staff and students in providing health services if it is a largish University. Up to LiMo to search it out and ask them directly about the logistics from UK.

[Guest realmayo]

There might be a University health service (GP clinic) that caters for staff and students in providing health services if it is a largish University.

 

That's what I mean. It's nothing to do with being fast-tracked. I've been to two in different Chinese universities. They catered for students and teachers and others living on campus and were much less busy than full-on outside hospitals. My guess is they could handle the basics.

 

Edit: to be clear: they functioned as small hospitals, with wards, blood-test facilities, etc etc. Chinese university campuses can be on the scale of a mini-town so it's not surprising they'd have their own hospitals. I don't know if this is still generally the case or, more relevantly, if Zheda has such a place.

[Flickserve]

My bad. You used the word campus hospitals which I thought meant the main teaching hospital attached to the University

[roddy]

If you're going under the auspices of a UK (?) university, I'd speak to staff at your end about it, or whatever staff you have based in Hangzhou. They'll have had to do pretty rigorous health and safety assessments and will know what medical care is available where. Also, what are you doing for insurance? I can't see anyone covering you for an existing open wound, and if things don't go according to plan...

[LiMo]

Flickserve, it's in a hard to reach area and I don't know that I'd be able to do it properly myself, but it's healing well according to the nurse and once it gets smaller this may be an option. I've received two different opinions. One nurse was very confident that it will have healed by October, but the other one was very non-committal and just said to wait and see. I think the uncertainty with these things is too large and the second nurse doesn't want to get my hopes up only for them to be dashed later on. 

 

Roddy, I'm am of course also talking with staff at my university (SOAS) and Zheda. I have to admit my confidence in the administrators at Zheda has already been significantly shaken. The students who went last year said it was a complete fiasco, and this year they've already succeeded at losing one application entirely and sent acceptance letters half way across the world when they were specifically told that the recipient would be in China. Naturally I'm now very suspicious of pretty much anything they offer or say is available without an independent person to corroborate it. Still, I'll ask what kind of campus medical facilities they have in my next email, realmayo has kind of got my hopes up now 

 

NB. Actually, Roddy, I have already checked the condition on a travel insurance website and it did give me a fairly reasonable quote. Admittedly it was using the online form which is a bit vague, and knowing what insurance companies are like they'd probably weasel their way out of it if I ever claimed, but there's still hope!

[Flickserve]

I had a wechat conversation with a doctor from China. It seems there are three different levels of hospitals which seem to correlate to the UK system of University Hospital, large District General and small District General. The small hospitals don't have such a good reputation and therefore less busy. The good thing is your wound only really needs basic care. But if you are having to wait another six weeks, it really sounds like a significant wound.

Another thing I thought is if you can find somebody medical on wechat who lives or works where you will be. If you were able to communicate with somebody medical there in your future locality, that possibly might help.

I was around Zhenjiang over a year back. The small hospitals really are back to the 70's style.