Holiday Dialysis in China – maybe next time!

My wife, Julie and I have wanted to go to China for years.  There were two impediments: money and dialysis.

Eighteen months of saving took care of the first, but dialysis was much more complex.

Early in 2009 I met Rebecca, a PhD student in Melbourne (via the Chinese Meetup club).  For about nine months we spent each Saturday afternoon teaching: me teaching Rebecca English, Rebecca teaching me Mandarin.  This worked quite well, though I think I got the best end of the deal.  Rebecca speaks and writes pretty good English, my Mandarin is a bit Ma Ma Hu Hu (so so).

On her return to China, Rebecca promised to find a good dialysis unit in Beijing for me.  And she did.  It is at one of the most famous Chinese hospitals, the Peking Union Medical College Hospital.  You can arrange dialysis at their international medical care department for foreign visitors.  Their website is at:   http://ims.pumch.cn/lxfs.aspx.  It is best to call the dialysis centre first (direct to the unit: – +86 10 6529 5055) to find out the procedure and schedule the visit.

Since this was to be my first Chinese dialysis experience, and I was unsure of what it would be like I decided to arrange one session, flying in from Hong Kong for three days, then returning to Hong Kong.

In the interim, my health became a bit variable.  My fistula developed a stenosis, which was repaired the week prior to our leaving.  In addition, I developed AF – Atrial Fibrillation (an erratic heartbeat), which made me feel a little weak and unfit.  My heat doctor put me on some meds designed to get my heart back into rhythm, and Warfarin, a blood thinning med designed to stop clotting around the heart (ie a stroke) because of the reduced blood flow from the AF.

Two days before I was due to leave, my heart went back into rhythm and I could go off the Warfarin in two weeks.

So, feeling fairly fit, with a newly reworked fistula, a normal heartbeat and thin blood, we set off for Hong Kong.  I had arranged to dialyse at the Renal Dialysis Centre in the Sanatorium & Hospital at Happy Valley.  We booked in to the Cosmopolitan Hotel, also in Happy Valley, about a 10 minute walk from the Dialysis Centre.

All went well at the Sanatorium & Hospital.  They are very friendly and the dialysis is not too expensive.  We did the usual shopping, touring and eating after the BigD.  The trams and buses are great fun and a real bargain.

However on day 2, disaster!  The mornings were very humid, like being inside a warm, very wet cloud.  Nothing was dry; everything was coated with a film of wetness which makes walking on slippery surfaces even more difficult.  Our way to the Dialysis Centre, was via a subway with marble brick flooring.  It was very slippery, and I fell.  As I hit the ground I banged the flat of my fistula arm hard on the ground.  At first all seemed OK, then the area around my fistula ballooned before my eyes, a giant throbbing bruise.  I clamped my other hand around the expanding fistula and we started walking again to the hospital.

We were both really worried.  Had I burst open my new fistula?  Could I stop the internal bleeding?

We arrived at the hospital about 5 minutes later and went straight to the unit.  I showed them my fistula and they wrapped a strong bandage around the area.  They said I would need an operation.  Did I have hospital cover (I can’t buy overseas cover, so no), could I pay for my treatment (credit card OK?).  There are no first class beds available, would a second or a third class be ok (yes…).

We sat there stewing for what seemed an hour, then one of the renal doctors came to see me.  He looked at my fistula, felt it (it was buzzing merrily), prodded and poked.  I told him I was on Warfarin and steroids for my non-working transplant.  He said he thought the fistula was OK.  If it was damaged, it would have filled my arm with blood like a fire hose.  My arm was bloated, but not enough for a fistula blow out.  It was probably the Warfarin and the steroids weakening the blood vessel walls and hemorrhaging over the area that hit the ground.

Great relief!  No operation, no second or third class bed.  But I would need to dialyse without heparin (the filter must be flushed every 20 minutes or so, to make sure it does not clot).  With this added complexity and the uncertainties of Chinese BigD, perhaps I should rethink my trip to china, just to be on the safe side.  I agreed.  It seemed a small price to pay for peace of mind.  All I really wanted to do was go home.

So about an hour after I arrived, I began dialysis.  It went well, and I had some chance to recover, though I think I was in shock for a day or so. Julie spent the afternoon letting people know, cancelling and rearranging flights and accommodation (both Wotif.com and Hotels.com were very good).

I dialysed again the next day, and on the fourth day, at about 9am, we caught the plane home to Melbourne.

While I was relieved to get home, I am still very disappointed that we didn’t make it to China.  We were looking forward to seeing Rebecca again, and other friends we knew from Melbourne.  I was keen to try out dialysis at the Peking Union Medical College Hospital (they were good to talk to).  I had the feeling that my Mandarin was shaping up well (though the Cantonese-speaking Hong Kongers looked at me twice when a tried it out on them).  And we were looking forward to seeing the Forbidden City, Tiananmen Square, etc.  Big dip-out all around.

But all is not lost.  I have learned my lesson.  Things have a time and a pace of their own.  Don’t rush them.  Travel when you are healthy, not recovering.  I already have my eye on a new suitcase…