My First World Problems

• There are evenings when I become distraught attempting to decide which restaurant to eat at.  I cannot describe the anguish of craving a Chili’s appetizer, Outback entrée’, and Olive Garden dessert. I know in my heart that no matter what I decide I will always be haunted by what could have been.

• For whatever reason, there are three albums that refuse to transfer their cover art to my iPhone. Despite multiple attempts at alleviating the issue, I am still forced to stare at a generic visual placeholder each and every time I want to hear “Back in Black.” I can hardly even bring myself to listen to the song anymore.

• A cell-phone upgrade credit is the source of unspeakable torment because regardless of when I choose to utilize it a better phone will be announced within the month. Sure, it seems like a good idea to get the iPhone 5, but what if there is some validity to the reports of a new iPhone? What if I pull the trigger and two days later Apple announces the iPhone 6Q with a cerebrally-activated Craigslist app and iSqualor?

• I recently purchased Triple Shine Armor All to apply to the dashboard of my car but was chagrined to discover it was too reflective. Imagine my dismay when I discovered the Armor All company doesn’t produce a Double-Shine variety leaving me with Original as my only alternative. What company is reckless enough to triple the dose of its reflective polymers without attempting to see what would happen if they simply doubled them?

• I am conflicted as to whether or not I should trust the “Most Helpful Critical Review” on Amazon.com if it is not classified as an “Amazon Verified Purchase.” Sure, it seems unlikely that someone would randomly pen an in-depth review of a wireless router they have never used, but at the same time what if I am basing my purchasing decision on the seditious output of some technological anarchist. Even more unsettling, what if this sadistic degenerate did purchase the router just to cover his tracks but purposefully avoided familiarizing himself with the interface in order to preserve the inaccuracy of the review while giving the impression of integrity.

• My TV has a limited number of HDMI inputs which means I am forced to connect certain devices at an inferior resolution. How am I supposed to sleep at night knowing that I pay for HD cable but my pristine picture is being tainted by the clearly inferior component video cables I use as a stopgap? At the same time, I cannot justify connecting a Blu-Ray player at anything less than 1080p and it would be downright negligent to connect an Xbox 360 with an RCA tether.

• Why in heaven’s name would Netflix allow someone add disc 2 of a season to their que before disc 1? Shouldn’t there at least be a warning that reminds the customers that their indicated preference will wreak havoc on the show’s continuity? And while I am at it, how is it possible to develop a smartphone app capable of accessing thousands of movies from anywhere in the world but still cannot allow me to alter my DVD que? Do you know how inconvenient it is to find a computer each and every time I change my mind about my entertainment preferences? 

• My Dilbert M&M’s dispenser features a non-standard capacity. This means that one small bag of M&M’s is inadequate to completely refill it but two small bags leave me with an unnecessary surplus. I tried purchasing the medium bag in the hope that it would eliminate this discrepancy but it also leaves me with a surplus as it slightly exceeds the volume of the two small bags. Either way I am forced to eat the excess or affix a rubber band to the partially depleted bag.

A Baby Story Part 11

At the time of this writing, I have been a parent for exactly three weeks and here are my thoughts:

1. It is imperative to inform your neighbors that you have a newborn so they will not suspect clinical depression. The symptoms are the same: fatigue, problems concentrating, feeling overwhelmed, erratic eating, and a loss of interest in activities or personal appearance. Each and every time I trekked to the mailbox at noon still wearing my robe and two day stubble I felt the need to remind everyone I encountered that I had not given up on life, just uninterrupted sleep.

2. I am fairly certain that the most traumatic aspect of my son’s circumcision was my unskilled attempt to remove his bandage. For whatever reason, the physician had affixed his bandages using an alpine butterfly knot and cautioned us that if we met any resistance in its removal to “apply a little water.” I am here to tell you that I came close to water-boarding his waist and that bandage was not going anywhere. I felt that like an Egyptian archeologist attempting to unravel a mummified frankfurter.

3. Diaper reward programs are borderline insulting. I signed up for both Pampers and Huggies “rewards” which involves divulging personal information and then entering a series of cryptic codes hidden on somewhere on the packaging. I spent $45 on diapers and I have now earned the ability to be entered in a drawing to win a pack of crayons. Not crayons; a chance to win crayons. I am used to being slighted, but I rarely have to complete a form and enter a 14-digit code to earn the privilege. The good news is that after a few more children we might become the proud owners of a $25 gift certificate to Starbucks.

4. No topic is off-limits in a pediatrician’s waiting room. On our second visit, I heard two total strangers go from polite introductions to breast firmness within the span of about fifty seconds. Apparently woman A had experienced a severe case of mastitis with her first child which resulted in the surgical draining of some fluid. Conversely, woman B’s milk ducts function like a Wisconsin dairy farm. And while I am on the subject of pediatrician waiting rooms, does anyone else find it perplexing that the online only self-diagnostic juggernaut WebMD.com has begun publishing actual magazines? Given the current trend toward a paperless society this seems like a regressive business model. Would anyone visit a website called PaperOnlyAmishPhyisicans.com?

5. Trimming my son’s fingernails is terrifying. I feel like a bomb technician because each time I cut one I close my eyes and hope that a loud noise doesn’t follow.

6. If there is an inexhaustible resource in this world, it is unsolicited parenting advice. This is a double-edged sword, because with a first child you need all the advice that you can get but no one seems to agree on any of it.

• You should never wake a sleeping baby under any circumstance. Unless you are trying to enforce specific sleeping/eating habits in which case they should be awakened every three hours.

• A small amount of baby powder is essential to preventing diaper rash and should be applied at each change. Unless the child inhales it in which case they will develop mesothelioma and be unable to conjugate verbs.

• You should always warm your baby’s bottle to room temperature. Unless you wish to prevent unnecessarily-picky eating habits in which case you should give to them cold.

• A two week old child’s stomach cannot hold more than three ounces. Unless they are eating more than three ounces at a time.

7. There is nothing like having your infant smile at you, especially once you realize that the smile is an involuntary reaction to the evacuation of their bowels and not an indication of their psychological well-being.

The Price of a Miracle

One of the great milestones in the birth of a child is anxiously awaiting the medical bills said birth had generated. Recently, I sat down and attempted to determine the amount of billable services that one vaginally-delivered healthy child could generate. The total, from the in-office pregnancy test until hospital discharge, was $15,677. Now in our case my wife suffered from post-natal pre-eclampsia and had to be readmitted to the hospital within the first week which generated another $6,110.07 so in our particular case the total would be $21,787.07.

Of this total, $10,577.45 was for use of the hospital facility. Since the physicians and anesthesiologist bill separately this meant that I was paying more for the structure itself than the medical talent utilizing it. Now I fully realize that this fee includes nurses, equipment, labs, meals, utilities, and apple juice but it should also be noted my wife was housed in a non-critical care unit at a not-for-profit hospital in an area with a low cost of living. 

As outrageous as the cost of inpatient care has become, the real cash cow is outpatient surgery. When my wife had her tonsils removed at a local outpatient facility, she spent a grand total of six hours within the building for a 30-minute procedure. The surgeon billed $550 but the facility billed $8,100. For those keeping score at home, that works out to $22.50 per minute.

I have to wonder how it got so expensive to spend time at a not-for-profit medical facility. For instance, had my wife and I reserved the 1,100 square-foot Premier Suite at the Central Park Ritz Carlton in New York for the same dates it would have only cost us $4 per minute (and that include cocktails, hors d'oeuvres and valet parking).  I say this not to suggest that they provide comparable services, but to provide a point of reference for value. How is it that a not-for-profit medical facility in the south can cost five times more per minute to operate than a decidedly for-profit luxury hotel in the most expensive metropolitan area of America?

As for the medical professionals, no one is stacking paper like the anesthesiologist. For the twenty-eight minutes he spent in my wife’s room administering the epidural he billed $2,448.00 which averages out to $87.43 per minute. To put that in perspective, the per-minute rate for the OB that actually delivered the baby was half that.

Fortunately, my wife and I were only responsible for about 17% ($3,724) of the total cost of our son’s birth because we have deductible health insurance as part of a sizable risk pool administered by a large insurance company. This is important because our company is large enough to negotiate service discounts that I as an individual would be unable acquire. For that privilege, we pay $3,912 per year in premiums and administrative fees and I consider that a deal because I get several discounts for being non-smoker and submitting myself to an annual physical.

I am decidedly middle class and the fact that I am only on the hook for 20% of the medical bills* I generate prevents me from filling bankruptcy. However, if the cost of routine medical procedures continues to outpace middle class income even 1/5 of my bills could be financially catastrophic. Perhaps I am being too critical and these prices scarcely allow hospitals to keep their doors open, but if that is the case I have to wonder why they are so eager to continue expanding them.

*Even that 20% only applies to charges incurred at in-network facilities by in-network physicians. Were I to go “broken arrow” and find myself at a hospital out of the approved network my financial exposure would be much greater.

A Baby Story (The Relapse)

The first week after the birth of our son was an interesting one. My wife was running low on the pain medicine they had given her at the hospital so she called the prescribing physician to get a refill. Now I realize that anyone requesting a controlled substance must be properly vetted, but I must admit that we were both floored when the nurse asked my wife, “Now exactly where does it hurt?” One can only assume that when a new mother calls her OBGYN six days after a vaginal delivery the answer would be somewhat self-evident. Despite this, my wife calmly replied that the majority of the pain seemed to be radiating from her recently traumatized nether regions. This apparently satisfied the nurse (I suppose if my wife had slipped up and said “my husband’s knee” the screening process would be deemed a success) who agreed to call in the refill.

While on the phone, my wife mentioned that she had a nagging headache and that her feet were still extremely swollen. They asked that we check her blood-pressure and when we discovered it was north of 160/110 a chain of events was set into motion that would end with us spending the evening in the emergency room. Like many medical trauma centers, this one was a dangerous combination of understaffed and overwhelmed. It took several hours to see a doctor and in the interim we met an interesting woman I will call Dottie. You see, it was Dottie’s job to draw blood from each and every patient who visited the ER that evening and she accomplished her task with unparalleled skill and spontaneous outbursts of evangelical fervor.

Each and every statement she made was punctuated by the verbal affirmation of God’s wisdom and/or mercy. Our conversation went as follows:

Dottie – “What brings you to the ER this evening?”

Us – “Well, we just had our first child and…”

Dottie – “Thank you Jesus!”    

Us –“…indeed… and they fear that my wife is suffering from post-natal pre-eclampsia so..”

Dottie – “Lord be with her! Glory! Glory!”

Us – “…we were told to bring her here to get checked out.”

Dottie – “Little boy or little girl?”

Us – “Boy”

Dottie – “Little boys are straight from heaven! Praise the Lord! So how long have you two been married?”

Us – “Almost ten years.”

Dottie –“Father, be with ‘em in Jesus’ holy name!”

It deserves to be said that during this short exchange Dottie had filled at least four vials of my wife’s blood with such prodigious skill and efficiency that for a moment I suspected she had taken a few samples from me when we initially shook hands. At any rate, we were eventually assigned a room within screaming distance of an ill-tempered woman who insisted that she wished to see “a f-----g doctor.”

After six hours, we were admitted to the hospital and given a room in Labor and Delivery while we awaited the counsel of the on-call physician. When he finally arrived and ordered my wife be given a 12-hour dose of magnesium, a rather sensible question arose from her assembled family: “What exactly are the side effects of subjecting the human body to high levels of an alkaline metal normally used in the manufacturing of sparklers?” Such a preposterous question did not even merit eye contact from the good doctor who dismissively replied that magnesium treatment was “better than having a seizure.”

One can only hope that Dr. Sunshine’s side job was not as a hostage negotiator. I realize that you went to medical school and get to use the word “sabbatical” in casual conversation, but I don’t feel that listing the side effects of a rather specialized treatment falls outside you purview. I can only imagine the packaging on Tylenol if this guy ran the FDA:

Directions: Take 2 capsules every 8 hours

Side Effects: Better than an aneurism and no worse than disembowelment

Fortunately, the nurses assigned to my wife’s care were warm, informative, and went above and beyond the call of duty to make her as comfortable as possible. Aside from Dr. Sunshine, the only other complaint I have concerning our second stay in L&D would be the provided “napping chair.” I do not know which state penitentiary the hospital commissioned to build this monstrosity, but it has all the features a worried spouse needs. In addition to creaking like a drawbridge each time you recline, it is equipped with wheels that somehow only move when you are attempting to sit and a leg rest that simulates an old football injury. I informed the nurse that I would be willing to pay cash for the privilege of taking an ax to the chair at the moment of my wife’s discharge.