Photo by Hu Chen on Unsplash

Table of contents

1. Preface

2. Main Article

3. OMFS World

4. Stuff (App, Gear)

Preface

What a week!

It started as a family of four and ended with a tribe of five.

Having gone through this twice, we knew the ropes of having a baby.

However, this time it was in a different country.

So here's our story. Dedicated to my beloved family.

Enjoy number 29!

“And above all, watch with glittering eyes the whole world around you because the greatest secrets are always hidden in the most unlikely places.
Those who don't believe in magic will never find it.”
— Roald Dahl

Main Article

“Are you ready for something unpredictable?” my dear wife texted me.

📅June 24th, 2022.

📖I'm studying in my crappy hotel room, nine days after relocating to the US.

My Boston fellowship is about to start, and my family is still in Israel.

"You're running to the parliament!” I answered.

She replied with a picture.

It's a pregnancy test.

It's positive. 🤰

Fast forward.

📅March 2nd, 2023.

"I'm seeing some drops of amniotic fluid,” my dear wife texted me.

I'm in the OR, about to scrub in for surgery. 😷

Knowing it could happen any day, my fellowship mentors were prepared for this moment.

So 30 minutes later, I was meeting my dear wife as she entered the hospital.

📁The first stop was the administrative office.

👩‍⚕️The second stop was the triage nurse.

The third stop was the midwife.

She completed her assessment and explained that we were better off waiting at home. She just wants to do a quick ultrasound, and we can leave the hospital until the contractions are more frequent.

🐥Then she placed the ultrasound probe on my dear wife's lower abdomen. No baby head on the screen.

She moved the probe to her upper abdomen. Baby’s head is on the screen.

He's breech.

In non-medical terms, our thirdborn decided to flip himself at the last moment. Head is up, legs are down. 🙃

My wife was immediately admitted.

Fast forward, we're scheduled to go to the operating room and try flipping him back into a head-down position.

If it works, vaginal delivery it is. The natural way.

If it doesn't, C-section (cesarean delivery).

However, thirdborn had other plans.

💉 His heart rate suddenly dropped and was dangerously low, so my dear wife was rushed to the OR for an emergency C-section.

Thirdborn was out in a matter of minutes. Ten fingers, ten toes, and a good cry. What a relief.

As for my dear wife, things got complicated.

Her blood pressure sunk, and she lost 2.5 liters of blood.

Thirdborn and I waited outside the operating room, not knowing whether her massive bleeding was controlled or not.

In the future, I might write about what happened in these critical 3 hours.

But for now, I decided to let it be.

Both are home now, feeling well, and healthy.

“My fingers are tickled to delight by the soft ripple of a baby's laugh.”
— Helen Keller

Today I will take the opportunity and share what we learned from having a baby in the USA.

There's so much to write about, but I’ll keep it focused.

🔵 Medical insurance

When you're a fellow, you must have medical insurance that meets minimum standards.

Your employer may pay your medical insurance for you, and in some cases, for your whole family.

If it's not the case, it will be your responsibility to pay the medical insurance.

It can reach 2000$ a month for a family of four.

That's a huge expanse, and you should consider it when applying for a fellowship position.

Take home message:
Familiarize yourself with the medical insurance, preferably before signing your employment contract. See what's included and what will come out of your pocket.

🔵 Medical Bills

The more comprehensive your insurance is, the fewer bills you will have to pay.

HOWEVER, you will continue to receive bills for anything your insurance is unsure about. Even if it's supposed to be covered.

Your medical insurance should authorize every appointment or procedure. In some cases, they require you to pre-authorize it beforehand.

If it's not authorized, you will get billed for it.

These bills can be scary. They arrive in red envelopes with warnings written all over them. The bottom line is usually thousands of dollars. And then it becomes your problem. You must submit papers to your insurance to prove it should be covered.

So how can you prevent it?

I find the following questions the most productive: “Is this going to cost me?” and, “who should I talk to IN THIS CLINIC in case I get billed?”

You might feel embarrassed to ask your doctor questions about money. But as time goes by, you will learn that it is better to ask now instead of panicking later.

Take-home message:
Ask direct questions about billing, and be specific.

🔵 Prenatal care

The prenatal care in the US is similar to the one we know back home. But we did notice two substantial differences:

1. NIBT is covered by insurance. NIBT is a blood test taken from the mother to diagnose fetal abnormalities. In the United States, it's considered a standard of care over 35. Hence, it must be covered by your medical insurance. Having fetal information might save you from amniocentesis, which is an invasive test.
   
   

2. The frequency of ultrasound tests is lower than what we are used to. Our flipped thirdborn made us wonder whether another ultrasound would have made a difference.

Take-home message:
It's great to have NIBT as a standard option. Pay attention to your ultrasound schedule.

🔵 Baby bracelet and alarm

Shortly after birth, our little one had three bracelets on him. One of them had an anti-theft chip that plays an alarm once he leaves the room. My dear wife found out about it when she tried taking him for a stroll in the hallway.

That didn't end well 🔊 📢 😱

Take home message:
Don't kidnap your own kid. It will be loud.

🔵 Citizenship process

The citizenship process is similar to the one we know back home. A day after birth, the hospital registrar came with all the paperwork. The next day we got a paper stating our thirdborn’s data was submitted for a birth certificate and a social security number.

In about three weeks, we will find out whether it went smoothly or not.

”I love these little people; and it is not a slight thing when they, who are so fresh from God, love us.”
— Charles Dickens

OMFS World

🥼For the OMFS resident - Studying for the boards is extremely challenging.

Unlike dental school, you're juggling 80-hour weeks, studying, and sleep-deprivation.

My advice - introduce Anki into your study routine as early as possible. I’ve used this application every day (and I mean EVERY SINGLE day) for two years. It got me through med school and the USMLE.

If there's something I regret not knowing during residency, it’s Anki. Do yourself a favor, and check it out.

If you want to get all my tips and tricks for residency (including my study system, Anki guide, how to deal with sleep deprivation, and more), you can sign up for my 7-day email course titled “How to survive residency.”

Stuff

📱Application I use - My very own up-to-date OS. I just submitted a literature review that was written entirely using this system. That was the most enjoyable and efficient writing process I had. If you haven't checked it out yet, I highly recommend you try it. You can access it by clicking here.

💡Gear I use - Avent Soothie Pacifier. Yes, it looks weird. But thirdborn loves it.

Epilogue

That's it for this issue.

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Have a great weekend!

Shay