Nanjing: Zhonghua Gate, Snacks, and brush with Healthcare in China

After the snack banquet, we walked (well, I limped) around the Fuzi Miao (Confucian Temple),  a major shopping area in Nanjing.

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That's when the Missus saw the Tanghulu (冰糖葫芦), candied Haw. This was a childhood favorite of the Missus, so She just had to get it; even though it wasn't the right season for this (it's a winter snack). Unfortunately, this didn't live up to Her memories.

From this stand.

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The Missus got this:

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Looked delicious, but the Missus said it was terrible.

We slowly walked back to the hotel. My foot looked terrible when I removed my shoe. The Missus and I knew what it was. The joint before my big toe was three times it's normal size, an angry red and purple and hot to the touch. I felt a stabbing pain with every step. Gout runs in my family, and though I've never had an attack, I'd seen it before. The Missus also knew exactly what it was, and knew exactly what would resolve this; the drug Colchicine. I'm thinking all that seafood and meat I ate in QingDao and Jinan pretty much put me on the gout fast track. I did later learn that diet is only the cause of about 10% of gout cases, with genetics causing about 65%…. of course statistics, diagnosis, etc, really don't matter when you're in pain. You just want to get past it…. We did find out that there was a community hospital two blocks over with a small ER/Urgent Care. So headed off…..

So here's my experience with Chinese Healthcare in a nutshell. It's pay as you go. I was registered, I paid, then saw a physician. I paid, then got labs drawn. I paid then saw another physician. I paid, then got my meds. "In Mao we trust, all others pay cash……." Next, you're given your medical record. You are responsible for keeping track of your healthcare.

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So after the blood tests, we saw a "foot specialist". He took a look at the foot, and told the Missus that it is possibly gout. The Missus asked for Cochicine, but the physician said that it's very "toxic" and he wouldn't prescribe it without a uric acid test. Now I had just had blood drawn, so the Missus asked why they didn't do a uric acid, we were told that "the technician who does the test is off on weekends." Okay, how about an NSAID like Indomethacin? The answer? "No, no it's very toxic to the liver, we can't do that unless we do a complete liver panel." And guess what, "the tech who does those tests is not working today. Look like I picked the wrong day to have a gout attack! Among the nuggets of wisdom imparted to the patient was, "stay away from bean curd" (yeah, right….. I'm in China), "don't eat spicy food" (we'd be in Chengdu in a couple of days, so mark that one as a no-go"), and "don't walk too much" (the Missus would sooner cut my leg off and replace it with a broomstick than cut down on our activities). As a consolation prize, I was prescribed three meds, a circulatory drug (??), Cefaclor, an antibiotic, I guess there was still a small chance this was cellulitis, and a mild NSAID, which, combined with my ibuprofen helped me to survive the trip. It was pretty painful going at times, but I survived. We walked back to the room, I took my meds, elevated my foot, got a couple of hours of rest and felt better.

Later on that afternoon I felt a bit better, and the swelling had descreased, so we headed off (on foot of course) down Zhonghua Road…..

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Vacation 2010 02 884During the Ming Dynasty, Nanjing was the capital of China. Emperor Zhu Yuanzhang had the Ming City Walls built. The grandest gate is the South Gate, the Zhonghua Gate, which was formerly known as the Jùbăomén – "Gathering Treasure Gate".

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It really didn't look all that impressive at first. But then I noticed that there wasn't just a single gate, but a total of four arched entrances…. making it quite formidable.

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Between each gate is an open courtyard that the enemies would have to pass through.

When looking up at the arch in the gateway, you'll notice slots cut into the arch.

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Vacation 2010 02 897Apparently, these slots were used to lower and raise a "thousand kilogram" gate up and down.

From the top of the walls you see the other side of the slots, now covered with glass.

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Vacation 2010 02 941There are also 27 tunnels built into the walls of the gates. These tunnels were used to store supplies and shelter troops.

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While walking up the stairs to the upper levels of the wall……..

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I noticed that there were inscriptions on many of the bricks.

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I mentioned this to the Missus, and wondered what it was. The Missus said it looked like some names and locations. A few minutes later we had our answer. In one of the tunnels was a display of the various bricks and inscriptions.

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We learned that the Emperor had the names of the builders and brick makers inscribed on the bricks as a way of ensuring quality and responsibility. I'm guessing that this system worked ratherVacation 2010 02 929  well since the wall is still standing, and you can still read the inscriptions on many of the bricks.

Along with the stairs, large ramps line each end of the gates. I'm guessing so that soldiers on horse back could make their way up the gate quickly.

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Making your way to the top you get a better idea of how imposing this wall was.

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Vacation 2010 02 924Taking a look from the top of the wall you see that the river flowing in front of the gate acts like a natural moat, making it even more formidable.

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I'm guessing because it was later in the day, all the tour groups were gone and there was hardly any one around. You could really let your imagination go to work. I was really enjoying our time here, but it was starting to get a bit late in the day. It was time to leave.Vacation 2010 02 946

Walking back toward Fuzi Temple was passed by one of those "food streets". On the taxi ride from the bus station the driver told the Missus that this was pretty much a tourist trap, and the food didn't reflect Nanjing food. Still, it was fun walking around and checking things out.

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The Qinhua River looks quite nice during dusk…….

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We decided to head back to our hotel and find something to eat near by……..

Stay tuned!

Postscript:

The day after returning home I went to see my physician. Of course he took one look at my foot and prescribed Colchicine and Indomethacin without waiting for my lab results. Two doses of colchicine and I was good as new. Well, almost. Unfortunately, the Xrays revealed some permanent damage to my foot, probably due all the pounding it took. My PCP, who has a dry sense of humor told me, "well, look at it this way, there aren't any triathlons in your future. And you don't plan on climbing Mount Kilimanjaro." (Of course I didn't tell him that Kilimanjaro was on the Missus's "bucket list") As a parting shot, he chuckled when I displayed the boxes for the meds I was prescribed in Nanjing. Especially this one:

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He told me, "you know we prescribe this for hemorrhoids". I wonder where they thought I'd stuck my foot?

9 comments

  1. yeesh! i can’t imagine the pain you went through while doing all that walking!!!!
    btw, what were those “pig” things? (cute) and the vegetables in the buckets? what was that for?

  2. Hi Kirk, I remember you telling me about the gout incident during our meal at Que Huong. What a story! And can’t wait to hear about Kilimanjaro one of these days. 🙂

  3. Wow – how awful to have a bad foot like that in another country ! I can ONLY imagine the smirk on your PCP’s face when he made the hemorrhoids comment 🙂
    What are those cute little piglet things? Is that mantou?

  4. I’m trying to think of a witty comment concerning a foot up you-know-where but I’m drawing a blank…
    I have to know what those piggy steamed buns are! They are almost too adorable to eat.

  5. Hi Kirk,
    Longtime lurker and gout sufferer here.
    You might be interested to know that you can handle the gout issue w/out the heavy drugs.
    An herbalist in Portland gave me a dose of tea that was then followed by a regimen of tumeric, vitamin c, and a whole host of foods containing antioxidants. It took 3 months of occasional attacks before the gout subsided. It has been a year since my last flare up.

  6. Me too! I want to know what the little piggies are! hopefully you were still able to enjoy the rest of the vacation, despite the pain.

  7. Awesome post Kirk, just think what your medical experience would have been like without the Missus. Thank goodness you had your wife with you to check up on things.

  8. Hi Kat – It was interesting to say the least.
    Hi CC – Those were pork filled buns.
    Hi Dennis – Kiliminjaro…….. boy that’s going to be a tough one.
    Hi Faye – Those piggie’s are pork filled mantou.
    Hi Rosa – What, you can’t come up with anything witty? Now, I seen it all! ;o)
    Hi Mark – Welcome, and thanks so much for sharing.
    Hi Lynnea – We still had a great time.
    Hi Jeff – It would have been even more strange……

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