Category: advice and tips

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advice and tips kids Life Life Tips

Stay in the hospital in America – 在美国住院

Reading Time: 7 minutes

中文翻译（主要是谷歌翻译的，我做了一点修改）在这里。

This is probably the 3rd time we stayed in a hospital in America – if we count the time we spent in the Mercy for our 2 babies delivery (baby number 1 and number 2). Last week in my blog I talked about our little baby got sick. As she didn’t get better, we end up in the St. Louis Children’s hospital ER on Monday 9/9, and followed by inpatient care between 9/12 and yesterday 9/16. She is better and out of hospital now. The main concern was her fever and pneumonia.

Again it’s not the 1st time I go to hospital in America. I have been to ER once myself in year 2006 when I broke my chin at Stacy park and I drove myself to the Mercy ER shortly after. I recall when I was a teen, after watching some TV or movies, and sometimes I sort of romanticize “staying in hospital” (different TV or movies scene than the ER TV series here in the USA). Also probably I hoped for a break of school because my middle school and high school years are not easy.

In recent years especially last year, during my visit to China, I went to hospital everyday to see my mom (she was in the hospital). Also I saw her in IV infusion this year (note IV infusion is much more common in China than int he USA, even for the kids, separate topic); and I did IV infusion last year and a bunch of tests after falling from the ladder (advice: be careful when climbing ladder, using proper technique and safety cautions). I think my attitude towards hospital stay is more rational now: it’s a necessary evil we have to deal with. I am hoping to be away from hospital as much as practical.

Below is something new I noticed this time around.

Rounds

Doctors, nurses and personal care technicians (tech) kept families in the loop most of the time. Also, there are the morning “rounds” in which all the caregivers including the residents (the doctors in training) will have a discussion on the current status, and ask parents if there are any questions. This is somewhat like the “standup” in the agile world. I think it’s good.

Tablet

In year 2010 I recall the Mercy hospital room has traditional phone.

Fast forward 14 years, at the children’s I do notice the SamSung tablet in the room, and it can be used both for ordering meals as well as watching TVs (we didn’t watch this time). It also has some games similar to what we saw on Boeing 737 Max and 787 – our two kids played a bit together, and our little one played some alone too. I remember in the old days the meal is ordered from phone.

Electronic Medical Records

Another new development is Electronic Medical Records (EMR), and BJC (parent org for the Children’s) implemented Epic/MyChart in recent years. Adding my daughter’s EMR proxy access to my account took a few days: I simply requested for it and wait. I got my own MyChart set up at BJC a few years ago when I went there for the Covid vaccine (the Pfizer version). I received the access in about a week or so (thinking they may have manually looked into my relationship with my daughter).

Personally I like the electronic version of medical records much better than papers. Because I am not the best organized person for paperwork, as you can read from my earlier blog post – I need to better organize things.

I noticed our pediatricians office has a patient portal too. TAUC has a much simpler website but I recall once I downloaded the flu vaccine record for work. I also talked about my personal visit experience here last year – after an unexpected fall. Their wait time is quite long recently – the main reason we didn’t take our baby there this time. But I do have past interactions with doc there and I think he is good. This reminds me another thing: I need to look for a PCP again because the PCP I saw earlier this year moved away.

Customer Service etc.

Concierge (Customer Service Specialist): noticed concierge came to us when we were waiting at the ER waiting area on Monday 9/9, and she offered water, snacks etc. We saw customer service specialist during the hospital stay (inpatient) later as well.

Family Center: it’s at the 3rd floor of children’s hospital. I saw volunteers. They have coffee, drink, snacks and laundry services.

Ronald McDonald House

Education (missing school): the education specialist came on Monday 9/16 asked if we need anything school related.

Therapy Dog: this is probably one of the highlights during our little baby’s stay.

Appointment Helper for PCP (Primary Care Physician, or Pediatrician in this case).

Overall they are trying to make the place nice, welcoming etc. More like a hotel, vs a traditional hospital.

Parking, Meals, and Odds and Ends

Parking is free for the parents. One thing: don’t use the parent badge directly if you go in the 1st time using your car, which is more likely in the case of St. Louis metro area parents. The reason is if you come in using parent badge, you won’t have entry ticket – which is handy when you leave the hospital. Another reason is we need to turn in the parent badge when we leave. Today I had to use #lostTicket feature because I gave my entry ticket to my wife. It’s not a big deal, $16 is the cost of the parking fee. I noticed quite a few people (hospital workers?) parked along the Kingshighway Blvd across the street. Probably to save some parking fees.

Meal is included for the patients and two caregivers: it seems breakfast and dinner at the cafeteria, with some limitations; and lunch is available via a phone call. We didn’t order lunch btw. Our baby ordered her meals via the SamSung tablet.

There are some outdoor areas on the rooftop (8th floor) for kids/families to walk around.

The window view from the 10th floor room is also pretty good: we are facing kings highway blvd and can see forest park and nearby buildings in the area. I will attach couple pictures of the window view shortly. I also walked at the forest park once; and went to the shake shack at Euclid road once (I went there often when I was working at Cortex in year 2019 and 2020 before pandemic).

Bills

I just paid all the urgent care and pediatricians’ bills on myuhc.com via the HSA account (and SSO). Personally, I like this electronic version of dashboard/payments better than the good old paper-based approach. Guess how much I paid so far (note this is before the ER/Inpatient bills from the children’s hospital, which I estimate to be in thousands)? I paid about $900 so far.

Lessons learned

One thing I learned from all this, I think, is that choose urgent care place wisely, or try to see pediatrician 1st. On two occasions, Monday Labor Day 9/2 and Sunday 9/8 I took our little one to two urgent care places, and they cost about $300 per trip, and the 1st trip (9/2) didn’t diagnose the pneumonia (or maybe she didn’t have it at the time, but we didn’t do X-ray on 9/2, and she was diagnosed on 9/5 Thursday at Pediatrician office).

Also not all urgent care places are the same. In my old and current neighborhood, I recommend going to the Total Access Urgent Care (TAUC) at Creve Coeur (next to the Noodles co and Walgreens), and the St. Lukes Urgent Care (next to the CVS). The reason I didn’t go to TAUC 1st this time is mainly the wait time: 1st time it suggested about 7 hours wait time, the second time about 2 hours. But again sometimes, maybe a lot of times good things (and good doctors) are worth to wait.

How much will be overall bill cost? I am making a wild guess: between ER and the inpatient at Children’s Hospital, I am guessing I likely need to pay $5000 to $10,000, after the insurance discount. Over the years the US healthcare cost skyrocketed as well as the insurance premium. I recall back probably in year 2001, more than 20 years ago, I only paid about $10 or $15 for the tonsil removal surgery (for my then significant other). The hospital bills for our two babies are about $1,500 for normal delivery and hospital stay (2 nights, if my memory is correct) at Mercy St. Louis. Regarding ER, I mentioned I went to Mercy ER in year 2006, and the bill was about $800 then. The insurance company initially didn’t want to pay: I called them and they paid eventually.

Last but not least, if you like to read more, I talked about American Healthcare systems and hospitals in the past (here are post one, two, and three in a series, also this one).

(Update 09-19-2024) It appears that I got a scammer call yesterday (luckily, I didn’t give you much information). The number is 763 656 5847 (I just did a google search). Anyone the caller claims to be UnitedHealthCare (that’s also from the Caller ID on my iPhone). And the topic is around nurse line or nurse manager (the caller knows my kid’s name and my employer’s name; this leads to me think they are not total 100% scammers). I did some google around this topic too, and here is some of the reddit thread I found (one and two). I just blocked the phone number. Better to err on the cautious side 🙂

(Update 09-25-2024) The 1st batch of bills arrived at myuhc.com, and I paid them all – 9 bills total, and the total is under $1,000 from my side, the insurance company also paid some (after discount).

(Update 10-01-2024) The total for the hospital stay is $1,228.40 so far, per myChart – I paid all via myuhc.com

(Update 10-02-2024) Got the hospital bill, I paid $175.50 via myuhc while the uhc paid more than $1,579.50.

(Update 10-03-2024) I paid hospital $34.06. I think this is likely the tail end of the bills.

(Update 10-05-2024) I summarized my out of pocket expense for the hospital bills: $2,017.16 and the subtotal of pediatrician (3 visits total) and 2 urgent care visits: $959.49. Total is $2,976.65 so far. I believe most bills are created and paid. Again the most important thing is make sure we are healthy.

(Update 10-07-2024) One more bill from the children’s: Plan Paid $28,460.68; You (I) Paid $481.77 => this makes total hospital bill to $2,498.93; also this makes the total out of pocket pay (adding $959.49) to be $3,458.42. I think we may hit a limit or something like that for out of pocket expense for this year.

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advice and tips kids Life Life Tips math-and-edu

We survived two weeks of High School, so far :-)

Reading Time: 2 minutes

This probably should be the series 2 of Ladue high school, we are coming, series I is here and I wrote it about 9 months ago.

Now it’s real – which means, every morning, I have to be patient about the traffic on Warson road. And I am very proud to announce: so far I didn’t lose my cool ha ha 🙂 Though in one morning, I told my 14 year old it’s probably for her to ride bike when we were stuck near the stop sign at Warson and Conway.

Sports and schedule

This whole actually started in the summer, because my 14 year old took two online classes (health and PE), via Launch. Both are fairly intense courses, and more than once in our China and Hong Kong trip, including in Hong Kong, I had to walk with my 14 year old to make sure she gets enough steps or make the Garmin heart rate monitor happy. We actually started from St. Louis in late June 🙂

We encouraged her to sign up varsity sports. And I quickly realized the Cross Country program is more demanding than I thought. Btw, a little fun during the training (instagram :-).

At the same time, she decided (we ok’ed) her not doing the auditioning for YPOP (YPCO and YPSO) this school year at Webster University Community Music School. We don’t want to or try to hit at every pitch, as the old baseball saying goes (and Warren Buffett likes to say it many times).

What’s next

I can see she definitely has more homework. Also due to the Cross Country practice after school, she would feel tired and tended to do “doom scrolling” (I assume it’s TikTok and YT Shorts) instead of working on the homework right away. That would push her bed time to a time that her mom cannot tolerate.

Odds and Ends

There are a lot more of those in High School. One thing is about the volunteering and tracking hours – because it may help the college application/admission down the road. Also clubs and other extra-curriculum activities – I guess there may be implications to college application too, among other things. It basically create more work and put some more pressure on the kids/family.

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advice and tips

坑叔的英制;国泰有芝加哥到香港的直达航班

Reading Time: < 1 minute

来美国将近27年，很多方面已比较适应，包括她们这里(比较坑叔）的英制。英里，英寸，英镑等，不过我在心里换算一般还可以，因为换算相对简单。就是这个华氏的温度换算比较麻烦: (F-32)x5/9, 后来碰到一个当过海军飞行员的老兵说他们的一个简化的八九不离十的算法：(F-30)/2 好像也还可以啊。我告诉我小女儿：我的脑子里还是摄氏度。她们也知道，她们的理想室温是70华氏度，我们是75度。哪天等我做了美国总统（不过我做不了，因为我不是在这里出生的），要等我的女儿做了美国总统，我让她把这英制改了，我估计英国🇬🇧现在也是用国际的米制了吧：没去过英国 it’s on my list: no pressure girls 🙂

芝加哥到香港的直达航班

在小红书上听到这个，跑到她家网站一看，果然有 ORD to HKG 航班，价格也还公道。看来美国的航空公司短期内是不会开通 ORD to PVG 的航线了。

It looks like this flight started on October 3, 2023. Quote the article:

The three-times-weekly flight, operated by the airline’s state-of-the-art Airbus A350-1000 aircraft, will depart Chicago at 4:05pm on Tuesdays, Thursdays, and Saturdays. CX807 will arrive in Hong Kong on the following day at 8:45pm. The return flight CX806 will depart Hong Kong at 12:30pm (local time) on Tuesdays, Thursdays, and Saturdays, arriving in Chicago at 2:25pm on the same day (complete schedule below).

I think earlier I thought about this route (also fly portion via Cathay Pacific):

STL => SFO => PVG => HKG => LAX => STL

Now I am thinking about

STL => SFO => PVG => HKG => ORD => STL

Just some more foods for thoughts.

Asia Miles

I flew Cathay Pacific CX 961 from Hangzhou to Hong Kong on 07/11. I registered the frequent flyer membership at Cathay a few hours before the flight. The flight was booked via trip.com on 06/17. I tried to look up for the booking at Cathay website right before the flight, and I was not successful. I just filed the missing miles claim on their website. Let’s see.

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advice and tips Edu-and-Ladue-School kids Life Life Tips

It’s a pleasure to be your cool dad

Reading Time: 3 minutes

Note: I also published this to Medium, and the friend link is here.

Our younger daughter turned to 10 the day before yesterday. And our older daughter is about 4 years older, so basically I have been a dad for a bit over 14 years.

Being dad is not an easy job. Last few years are getting a bit more challenging, as my older one is becoming a teenager, and also with pandemic, we were worried about the lack of social activities etc. Below is some of my observations and thoughts on the topic of “raising kids”, which is my main task or job at this stage of my life. In theory I can do auto pilot too, but I am just not that kind of cool or laid back dad. I was trying to stay away from the other extreme as well: aka the micro-management, or sometimes people call the practice “helicopter parenting”. I am by no means perfect, and I had my setbacks and failures in many aspects, from big to small. I recall in my recent trip to China, we met a dad, and he said he never missed or be late for the morning drop-off for his son (that’s 7 years of no late or tardiness).

I do believe he is a quite dedicated and meticulous dad, for me I tried but I think I failed here and there in terms pickup. Quite a few times: my 14 year old would text – dad, where are you? I would answer: 5 minutes away. And honestly sometimes I don’t know whether it’d going to be 5 or 10 minutes. But for the most part, my 14 year old still thinks I am a cool dad. And sometimes if I am not cool, she would say: chill 🙂

Adolescent / adolescence:

I have some reflections here on this topic, see below

Ankle Injury And Recovery – 从哪里摔倒就从哪里爬起来

Move Families And Kids To Better School Community

My Zhenhai Middle School Days我在镇海中学的日子

PS, corresponding to this Zhenhai Middle School; 镇海中学) piece above: I felt this summer our 14 year old seriously got into the math self-study. She wanted to do the math acceleration even since she got this idea from her 8th grade math teacher, and she was working hard on it since our summer 2024 China trip). From my perspective, I have zero complaints, and the main thing I need to remind her is “don’t sit in your room” for too long, go out and stretch, and “get some sleep” 🙂

(Update 08-09-2024 am) In terms of self motivation, and learn math on her own, I felt our 14 year old is at “friction point of the clutch“. But this morning, the hell broke loose. I think at about 6:10 or 6:20 am, I got up and heard my 14 year old sobbing. I didn’t go and ask why (as I know that alone may make things worse). Turns out she was studying for the math acceleration, and she planned to go to bed at 12 am last night, and again to get up at 2 am and study – except she didn’t woke up to the alarm. She slept through. I know she really could get some more sleep in last month, because she is exhausted studying math most of this time. I went out and was going to walk/jog in the neighborhood – but I had my 2nd thoughts and quickly came back home and went to Bread Co. and get some breakfast. A while later, I asked our 10 year old – did big sis wake you up early morning? Our younger daughter replied: yes, at 6:52 am, because I looked at the clock 🙂

So there is our 14 year old’s growing pain. Not to mention I dropped her off the high school (for test), and came back getting banana/water for her 🙁

I am not complaining actually – I think in terms of I enjoy what I am doing, if I compare myself to an empty nester: a lot of my high school or college mates are empty nester now, because I had my 14 year old when I was 39. But one day if I get lucky enough to be an empty nester, I would try to be happy too – just need to find something meaningful or interesting to fill my day.

(Update 08-09-2024 pm) So our 14 year old didn’t pass the day 2 session of the math acceleration (Advanced Geometry). But I am glad she is not giving up. She said: I am going to get the Algebra 2 book and study this year (aiming for a similar acceleration next summer). We just ordered the used book at eBay.

Each kid is different

What a novel concept or idea. Of course we know everyone is different, and child is no different. But at the same time, may I ask: don’t we used to do things like: for a guy (or a girl) with hammer, everything is a nail. No? Congrats that you already do much better than many other parents.

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advice and tips China Life Tips Travel

A quick review of our summer 2024 China trip

Reading Time: 6 minutes

Since pandemic, I have been back to China twice, last year in the spring break of school year 2022/2023, which was the 1st time I visited China since pandemic, when the PRC (People’s Republic of China) just relaxed in-bound travel in Jan 2023, and I booked ticket on Jan 29, 2023 via Expedia.com – refer to this blog post China Trip Spring 2023 – Logistics if you like to learn more. I also wrote another blog post China Trip Spring 2023 – Observations And Thoughts shortly after the trip.

This most recent trip is the 2nd trip since 2020.

Visting China mainland is a bit more challenging since pandemic, overall. One main factor that people often talk about is the cut back of the direct flights between two countries: I recall it used to be in the range of 150 weekly flights. This Reuters article has more details, and I will quote some content below. Keep in mind that the regulator approving more flights does not mean the airlines will add them. This is especially true in the USA, because all the airlines are private owned, profit driven. 油管上弘哥有关于这方面的分析，我觉得比较客观。

Chinese passenger airlines will be allowed to boost their weekly round-trip U.S. flights to 50 starting on March 31, up from the current 35, the U.S. Transportation Department said on Monday, returning the market to nearly one-third of pre-pandemic levels.

……

More than 150 weekly round-trip passenger flights were allowed by each side before restrictions were imposed in early 2020 due to the COVID-19 pandemic, but until August 2023, Chinese and U.S. carriers could each fly only 12 a week between the two countries.

The number rose on Sept. 1 to 18 weekly round-trips and then to 24 per week starting Oct. 29. The USDOT approved 35 for Chinese carriers in November.

FlyChina.com

If you happen to know Chinese 如果你会中文, the flychina.com website has a complete list and collection of updates (for example, you can click on this “今年已增航班班详细公告” on the up to date US/China direct flights. The website has English version too, but I have not checked or verified how good are the English content there.

Anyway, amid all this aka the new normal (reduced direct US/China direct flights), we booked air ticket quite early and I talked about it in my blog post here too – Bought Air Ticket For Summer Trip To CHN. We were somewhat nervous because this is complete new route to us, and there are some uneasiness of going this route: STL <=> ORD Chicago <=> YVR Vancouver <=> HKG Hong Kong. We took Amtrak for STL to Chicago union station (and took Uber from the union station to the ORD airport or hotel near airport). We also built in some sleepovers in hotels (Chicago one night, Vancouver 2 nights, and Hong Kong 3 nights. We also tried to use the hotel airport shuttle bus when I stayed at hotel near airport.

Note both my wife and I are from mainland, so there is one more leg after reaching Hong Kong. We took the air route. There are land route aka the high speed train (Gao’tie) as well. We book those separately via trip.com.

Places we visited in China

Both my wife and I are originally from Zhejiang province (you may be interested in this blog post Hometown Is Always Special). In addition to seeing families in Zhejiang, we also stopped by Shanghai, where my wife and I met in 2006, to see her side of families and friends. I also still have families and friends in Shanghai too: but I kept my head low to focus on my supporting role. Also the few days we were at Shanghai we had quite high outdoor temperature.

Overall score: pretty good

Now that we are back, and I am happy to report that the trip is a success in terms of the new route and the overall experience. We didn’t have any major hiccups. We do have one minor thing when we leave Hong Kong hotel for the airport. Right out of gate at the taxi, our 14 year old said: I forget my hoodies in the hotel (in the closet). Let me emphasize at that time we already checked out the hotel, and we are in the taxi, and the taxi was about to leave 🙁

Minor hiccup

To say I was annoyed is definitely an understatement. First let me say after this is all over, this scene is not new to me, and I recall at the 宁波北仑世茂希尔顿逸林酒店 (note the local people call it 希尔顿逸林酒店) that I stayed since 2017, and I saw this scene in the elevator video (they haven’t changed the video since 2017 🙂 Let me repeat, in the scene the hotel staff tried to catch the minivan in which the guests are leaving for airport, and make sure the little boy has the “lost” stiff animal. Sweet, ah? The real life is not usually like that.

Anyway, let’s back to the topic. I immediately asked the hotel reception desk, and she suggested I go up to the 22nd floor lounge, and asked for help there. The lady at the lounge listened to my issue patiently, and typed something in her system, mainly notifying the house keeper. And my 14 year old and I waited there, for about 25 minutes, with my daughter much more composed than me. Eventually the house keeper showed up, and delivered the missing hoodie to us, in a nice bag. We tipped him the housekeeper $100 (Hong Kong dollar, worth about $13 USD). We offered tip to the the lady assisted us at the lounge too, but she didn’t accept. After we got back to the taxi, I immediately tipped the taxi driver 100 HKD. The driver was happy and he drove very well in terms of the time it took us from the hotel to the #HKG airport.

Lost and Found

As a postpartum or post mortem review with our 14 year old, I told her that we (my wife, her little sister, and myself) are not going to be her “lost and found department” forever. She needs to step up her game and be responsible for her own belongings and so on. I said that in the light of two “thew away retainer” incidents last semester – read this blog post I Am Exhausted, But I Will Soldier On if you are interested to know more. I guess I may have ranted too much there or here – but my intension is help her be responsible. Personally I don’t think physical things are do or die, but if one does not pay attention to his surrounding, especially as a girl at a wrong place or wrong time, things can get bad pretty quickly. That’s my main worry as a parent. Not an broken iPhone or missing stuff animal or hoodie 🙂

Things I learned or relearned: some odds and ends

When leave Vancouver for Chicago, the “entering US immigration and customs” are done at YVR. After we landed at ORD, we just exit and get our luggages like a domestic flight.

In China it’s still best to have a local mobile phone number with cellular data. We need it for WeChat pay (or Alipay), rideshare apps (Didi Chuxing or Gaode Map), as well as ordering food and drink in many places via WeChat Mini Program 微信小程序. I actually documented some of all those tips and tricks in my Twitter (X) thread. I think FlyChina.com has some quite practical advices on those related topic as well, such as this one and that one.

Get cash in HK, which is needed for taxi and the MTR (subway), I used Schwab debit card, and it has no foreign transaction fee, and offers unlimited ATM fee rebate. I had this card for a few years now, and I am glad I put it to good use for International travel eventually.

Must see places in Hong Kong: Victoria Peak aka 太平山(day, tram starts near Hong Kong Park), and Victoria Harbour (night view, looking from Tsim Sha Tsui). Please refer to my other blog post – Some Random Thoughts During My Recent China Trip – 我2024年夏天中国行的一些观察 if needed.

Starbucks are everywhere. But in China they don’t have cake pops that my 14 year old like. In YVR Tim Hortons is as popular as Starbucks. I used credit card for the purpose at YVR, the Starbucks US app does not work at YVR.

In Vancouver I tip in USD. It seems USD cash is fairly widely accepted there: as I saw a sign in the hotel lobby talkong about taking 25 CAD or 20 USD for the shuttle to the cruise ship. You got the idea.

I knew in Vancouver there are a lot of ethnic Chinese people: some moved from HK to Vancouver around 1997. I also noticed there are quite a few Indian (or south asians) immigrants at hotel and at the airport as well. Canada is q quite diverse country. The YVR has 3 languages for most signs: English, French and Chinese.

Last but not least, the Boeing planes. I noticed the Boeing 737 Max 8 of Air Canada has a very quick acknowledgment of flying over native people’s land and water. Some may say that’s “woke”, I say that’s good. Also both Boeing 737 Max 8 and 787-9 have modern infotainment system, and I played chess a lot during my trip. This is aso the 1st time I rode a 737 Max, I believe. I rode 787-9 once on American Airlines ORD to PVG once before pandemic.

Summary

Overall this is a decent route if we want to save some $ and have some extra time to spare. An added bonus is we took kids to see places we normally don’t go often: Vancouver and Hong Kong. Although I admit it’s still hard to persuade my American girls to try Tim Hortons over Starbucks 🙂

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advice and tips Life Life Tips

人到中老年少折腾

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好像有个说法，人生在于折腾。

Zhihu: 人生的意义在于折腾

晚读 | 人生在于折腾，而不是年纪轻轻趋于平静 (新黄河 via qq.com)

我想对年轻人来说，这个基本上是适用的。比如说前几年流行的创业，我们年轻时（大学毕业时，九十年代初）去南方，广东，深圳等。With some exceptions, of course. The main thing is we all need to listen to our body – doesn’t matter whether one is young or old.

We want to avoid things like below

Another death at BoA (X)?

A 25-year-old Bank of America credit trader died suddenly at an industry event on Thursday night

不单是万恶的资本主义才有这种现象。I heard about similar cases such as

拼多多员工猝死 (Baidu)

拼多多年轻员工“996”加班后猝死 官方账号“冷血”回复引发众怒: BBC

我妻之死 || 华裔丈夫悼念长文《我妻之死》引争议！把妻子当工具人，又一个林生斌？！

从国内搬运来妻子后，《我妻之死》的翻版

6月2日，浙江台州，在黄岩布袋山石人峡景区发生-起悲剧事件。一支来自宁波的户外探险小队，因涉水过横切面，结果发生悲剧，有两人不幸被冲走，至今下落不明。有后续成员拍下了事故发生的全过程，我来分析他们到底犯了哪些错，才导致付出了生命代价，以此供大家警醒。

Andrew McAuley (Wikipedia, Twitter/X): quote wikipedia – Andrew McAuley (born 7 August 1968; presumed dead 9–12 February 2007) was an Australian mountaineer and sea kayaker. He is presumed to have died following his disappearance at sea while attempting to kayak 1600 km (994 mi) across the Tasman Sea from Australia to New Zealand in February 2007.

身边的例子

我想到我的一个老乡，比我大几岁，大学毕业后，当时闯深圳可能比较流行，他也去了。后来没多久，他得了不轻的病，回到老家休养了。现在应该有三十多年了。也不知道现在他的情况-他是我大哥的同学，也是镇海中学高中毕业的。

其实更早些，我有表哥表姐上山下乡，有去黑龙江，新疆，云南，贵州。她们大我十几岁，二十岁。后来她/他们都回老家上海了。

我自己97年香港回归那一年夏天来的美国中西部，一晃就有快27年。前两天看油管，有一对华人夫妻，也是大陆过来的，油管上的网红北美天马行：频道名是英文 BestYears2BestPlaces. 大意是在走不动之前到处走走-这个想法本身没问题。下面是她们频道的介绍。

“北美求学, 毕业, 工作, 安家，养娃养房养花种草, 生活像陀螺 … 突然因为疫情蹲家工作，带你一起分享我们在北美的生活，旅行，旅居，和考察退休地。
*** 原创不易，谢谢您的关注和鼓励! ***
联系：一个 gmail 的邮箱“

折腾

我看了一下她们的频道，主要还是关于旅行，养老，房子等等。看她们经济上基本上是自由的。她们也讲到断舍离，和搬家等带来的emotional drain.

油管是个无底洞。后来我看到，有关于哥斯达黎加，和马拉西亚移民的视频。后者（马来西亚留学移民）的视频非常多，因为天气方面两个地方都不错（不冷，年纪大的人一般怕冷），马来西亚在地理位置，饮食，文化等方面更有优势。

说到折腾，让我想到我的一个表姐，就是我上面说的情况里的一个。她当年回城其实是跟当时在乡下的情人被迫分手的，因为男朋友不是上海人。这种情况当时应该不少。但是我的感觉也是留下一个后遗症。多年以后，她的老公已去世，小孩结婚后关系也不好。最近我听我爸爸说，她开始了网恋，其实就是应该是单恋抖音上一个类似秀才，闻神这样的人。我爸爸很不以为然。

最近我高中同学独自驾车去西藏旅游，结果高原反应，现在还没出院。后来大家才知道，他的身体其实不太好。我可以理解他想去驾车独行，但是不管怎样身体是革命的本钱。

我后来想，有可能我的同学看抖音或微信短视频多看了一些219国道怎么好玩。这类的视频一般容易一边倒，主要是抓眼球和流量，不会讲究质量，科学，严谨等等。

不折腾

其实很重要。我记得，大概二十年之前，因为我的个人工作生活不是太顺，我想过要不要去读一个 Master of Financial Engineering, 然后跟我在罗拉时的师弟那样，去华尔街做几年。我好像当时申请了纽约的哥伦比亚大学。她家没要我。某种程度上，我觉得是庆幸的。

(05-19-2024) Now I think about it, both (late) Charlie Munger and Warren Buffett stayed in their respective houses for many decades. Once Charlie joked, if people offered money to move across the street, he would not do it (the context is a question came up re: some rich people in California moved to Texas to avoid high tax).

Last but not least, I like to share something I heard – “We don’t know if we will die from overworking but why take chance” – probably said by Ronald Reagan (per Charlie Munger or Warren Buffett). Btw, I ran at Olivette this beautiful Sunday morning.

Categories
401k and Personal Finance advice and tips finance Life Tips

American Healthcare System III – 美国医疗系统之三: the medical bills are confusing

Reading Time: 2 minutes

(Update 12-08-2024) 我今天录了一个油管视频：I created a YT video today and it’s in Mandarin Chinese. I can create an English version later, if there is interest.

My street credentials (qualification) for writing this: besides as the consumer of US healthcare system (employer sponsored plans most of the time) since fall 2000. I also worked for 2 large healthcare systems (hospital chains) in the USA, Mercy Health and Ascension Health. Here is my LinkedIn profile.

(Original 04-07-2024) I talked about American Healthcare System I 美国医疗系统之一 and American Healthcare System II 美国医疗系统之二。Recently due to my older daughter’s ankle injury, I learned a bit more about the medical bills.

I received 5 bills total, one paper bill didn’t come because I turned on paperless billing inside MyChart

We had two visits at Shriner’s hospital near the BJC at central west end: the initial encounter (encounter as in medical billing) and the followup encounter (to make sure her ankle is good). She was not seriously injured per Shriner Hospital but I am still glad that we had professional to check her out to make sure.

There were 5 bills or 5 payments from my side. Two bills for the X ray which although it says the doctor’s name in the insurance company website’s benefit explanation section. For those two bills I paid on the Shriner’s hospital MyChart website. Talking about MyChart, personally I liked it very much as it’s electronic. And recently I switched my primary doctor to Mercy partially due to this. I can see the appointments, messages and test results, as well as billing info in one spot. I didn’t realize or recall until very recently, all the insurance and billing information are in the MyUHC website. More on this in the next section.

More paper bills and that’s the confusing part

Later on there are two bills for the nurse practitioner who looked at S. And one bill for therapist’s work who came for the 2nd visit. Because I don’t see the bills inside MyChart, and initially I didn’t go to MyUHC website (the benefit explanation website) I only see one paper bill came after another, and I didn’t know what’s going on.

Eventually I paid off all 3 bills online by following the website address on the letter (the paper bill), because I prefer to get refund check instead of get the collection letter.

I still didn’t fully understand is why those bills don’t show up in the MyChart website. Last but not least, after I paid all the bills, I found out I can pay all those bills from the MyUHC website too. There is some integration between UnitedHealth (insurance side) and its subsidiary Optum (HSA account, payment side). Now I recall I used that functionality a few years ago when I had the United Health insurance from my previous employer Mastercard.

Out of pocket cost

The total out of pocket for Shriner’s hospital is about $450 for us: which seems okay for me at least. The UnitedHealth plan do have some decent discount from the initial charge.

The main lesson again, if I can quote my former colleague at Unigraphics, don’t get sick 🙂

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advice and tips Life Life Tips

Colonoscopy 肠镜

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Colyte Jug – mine is similar – prepping for the liquids and drinking it is quite some work (the day before)

Colonoscopy is a routine exam recommended by doctors for adults over 50 in the USA: as a precaution checkup for the signs of colon cancer. 在美国一般医生会建议50岁以上的人去做一次肠镜，以检查是否有肠癌的迹象。I heard colon caner is among the top two cancer in the US. I did mine at Mercy St. Louis – it’s the hospital both my girls were born and I also worked for Mercy in the IT department for about 18 months between Nov 2013 and May 2015.

It takes some efforts and courage to take the exam. First some Overview by Mayo Clinic. Also, it’s not the only way to detect colon cancer. There are 2 ways. Both have pros and cons. I did this Fecal occult blood test about 13 or 14 months ago, partially because it’s less invasive, and partially because my doctor then is also a bit soft spoken, and he agreed. This time I am not this lucky. I got a new doctor and when I mentioned testing for colon cancer, and he directly chose the colonoscopy.

Prep

The doctor performs colonoscopy will usually provide the prep instructions. Alternatively, because this is a quite common procedure, there are lots of resources online: I shared some below. One common question is the low fiber food before and after (see below), also the liquids to drink the day before, as well as the special medicine (liquids) to drink about 12 to 15 hours before the procedure.

Day -3 and Day -2

Low-fiber diet do’s and don’ts – Mayo Clinic || Also note Mayo Clinic and Kaiser Permanente are both highly reputed hospital chains in the USA.

Day -1

Clear-Liquid Diet for Colonoscopy Preparation | Kaiser Permanente 

I did drink some chicken broth (sold at Costco): I drunk a few cups. I added a bit salt to the broth and microwaved it. I also drunk coffee and sprite that day, because I need to start the Colyte liquid (prescribed medicine, power mixed with water, see below) at about 3 pm my time (due to my schedule). I took a break between 6 to 8 pm, and resumed it until about 11:30 pm to consume about 3 L (or 2.75 L to be precise). I finished the rest in the early morning before procedure.

– Very important: You may not eat any solid food or drink alcohol for 2 days! In the morning on day 1 of your prep (2 days before your colonoscopy), fill 1 jug of Colyte as written on the jug and place in the refrigerator.

The Day

Today I went. The results are out and they seemed good.

Btw, the GI lab at Mercy seems quite busy, and they are a few steps and a few things to keep in mind (or tips, if I may).

They have a sign says don’t bring any valuables. I understand where they come from, but if you think you like to read on phone, I say bring it (I didn’t bring, and was somewhat bored during my about 45 minutes wait in the waiting room/bed). Don’t take any picture or videos due to privacy concerns.

I noticed I may not be the youngest in the patients group. Obviously they are people who are a bit older. And they seems to be people who are younger than me as well. I did see a lady brought her phone.

The anesthesia: I believe this is the 1st time I was knocked out completely. The drug is actually is from the needle, rather it’s from the IV infusion (挂盐水/葡萄糖), which I did recently (see this American Healthcare System II – 美国医疗系统之二). Btw, it’s a smaller punch or less pain for me this time, as the nurse put the needle at a spot that’s better, I guess.

Serious matter/Q: do you have a will or living trust?

I got this question asked many times. I actually started this “will” process but my wife didn’t sign. Later I learned Warren Buffett let his wife and kids view the will before official. Probably something I will do too as my 13 (soon to be 14) year old can understand some of that.

This reminds me of a related question – We each have an average of 100 online accounts. Here’s how to make sure they aren’t a nightmare for your family if you die. Btw, my wife and kids know my iPhone passcode, but that’s probably not enough. I told my wife investing in S&P 500 index funds when I die. Hopefully she take notes or registered in her brain. Otherwise she can come to this blog (wait, I probably need to renew the domain as well as pay the hosting fees in advance 🙂

Waiting

Most time seems to have been spent on waiting. Fairly routine procedure. Felt a bit drowsy after being woken up. But I feel I can drive after probably 4 hours of this. Again a smart phone may help, if you have the energy. Or just rest instead of doom scrolling 🙂

The people and humor

“You got another 10,000 miles” (this is actually from nurse at primary care office, after the annual physical)

“Just take a nap” (today’s nurse, referring to the anesthesia).

“What you want to eat after this? (a big meal :-)”

Because usually people were on the “liquids only” food the day before. And no food on that morning. || My answer: I am going back to the low fiber diet as I read it from What to Eat After a Colonoscopy

I think it’s always the people and the humor made the difference.

PS

Why Mercy: in St. Louis area there are a few large hospital chains, in the order of size, they are BJC, Mercy, SSM and St. Luke’s (not to be confused with the Kansas City St. Luke that’s going to merge with BJC), respectively. BJC (and Washington U Physicians) is nationally recognized, and it appears their service sometimes could be a bit expensive than others (not quite scientific, just a recent observation). Mercy is the closest for me, and it also has some unique strength. For example, they were the 1st to using Epic EMR in the region. A while ago I worked at MyMercy patient portal, and now I got to use it as a consumer (customer). Btw, the patient portal is based on MyChart. BJC is also using Epic software now. And both BJC and Shriner Children’s hospital used MyChart. One thing though: each MyChart is standalone, you cannot share credentials between the different hospitals.

Back to the topic, I think the prep part: both physically and mentally is the hardest part. The low-fiber diet, the liquids only diet, and the colyte (too much water to drink in a short duration of time). Then there is this unknown part of “short nap” 🙁

Categories
401k and Personal Finance advice and tips

Two credit card and Digital Wallet tips

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Digital wallet and credit card expiration and automatic extension

Investopedia : What Is a Digital Wallet? Also quote Investopedia

There are several digital wallets available. Here are some of the most well-known:

Cash App
Apple Pay
Google Wallet
Samsung Pay
PayPal
Venmo
AliPay
Walmart Pay
Dwolla
Vodafone M-PESA

Personally I use Apple Pay (in store) and PayPal (online stores). I know some investors or speculators like to dunk on the PayPal stock $PYPL. But I noticed in recent years that both Apple Pay and PayPal do CC renewal (extension) automatically: at least for the Chase CC. This is good – one less hassle. When you think about this automatic renewing feature: it’s very similar to the “opt-in” feature in some of the apps or websites.

On the contrary, credit card stores on e-commerce website (let’s say MSD or Spire Gas company payment section is also e-commerce) usually just let the stored credit card expire: from Amazon to Panera. Basically if we want to use the credit card again, we need to either edit or delete/re-add the card.

Apple Pay

For me I didn’t use Apple Pay extensively until I got the Apple Watch. I saw it first hand at the “Daily Grind” coffee shop at Mastercard O’fallon campus: I noticed my colleague was paying via Apple Watch. One thing I didn’t try: I may try next time if I get a chance, I heard the campus only accepts Mastercard. So what if I pay via a Visa card on Apple Watch? 🙂 Anyway I pay mostly via Apple Watch nowadays at grocery stores: Aldi, Dierbergs, Trader Joe’s and Schnucks. One more tip: for PayPal, I encourage you set up multi-factor authentication (YT Video).

I have used the Square (now Block) Inc’ Cash App and Google Pay in the past too. I liked Cash App. It seems to me Google Pay (chrome web browser version) seems a bit half baked for me 🙁

Back to the credit card expiration, I noticed, on many automatic payment websites, e.g., MSD, CCRC and the J etc., I need to manually update the expiration date or re-type in the CC information on their website. This is okay, as I don’t have to a ton of places to update. Although I appreciate if they can just automatically update themselves. I had some glitches with MSD website after updating the card – had to try a few times to make sure the auto pay is still setup and work as intended.

This reminds me of the e-wallet for kids. We have seen those in the Scholastic book fair at school – e-wallet for teachers or kids. However, debit card or Apple Pay (on Apple watch) has much wide usage.

Kids debit card or CC

I found Chase offers a kids debit card. There is a caveat though: I found I cannot fund the account online. So I still need to stop by the branch sometime to put in some money there so my 9 year old can use at her Dragon Den (LFGCPA spirit wear/swags store) this fall 🙂

Also I noticed Amex offers CC (additional cardholder) to kids 13 and older. I gave my 13 year old this card. Btw, not too long ago, she had it lost from theft. Amex texted me right away – and I was able to remediate quickly. Thinking this is somewhat like safety or security feature: I mean shopping credit card. It provides a digital trace. For example, I know at which store my card was being used.

Don’t lock in the foreign exchange rate

Use credit card internationally: make sure use no foreign transaction fee card; no need to lock the rate – it will be more expensive to pay the fees for “locking the rate”. Many years ago in Shanghai, at the Courtyard Xujiahui – I locked the rate after the receptionist 店小二 told me about this feature, and later on I realized the rate (the fees) is not favorable to me.

I used CC in Shanghai in 2016, as well as shopping at Amazon Germany store (and maybe, Amazon Canada, and some other online store in UK), and I chose not to lock in the rate from then the Courtyard Xu’jia’hui stay.

Note in China, the Visa, Mastercard, Amex and Discover credit cards are not widely accepted. The most popular payments methods in China are Alipay and WeChat Pay. It seems from the Merchant perspective, the latter 2 are much cheaper (source: X).

……顾晓敏还提到，外卡刷卡手续费高昂，单笔费率基本上在2.5％到3.5％不等，而支付宝单笔费率仅为3.8‰，因此很多商户更愿意让外国人使用现金或支付宝、微信，外卡刷卡率仅为23.19％。……”

A related topic, is the profit margin of Stripe. Quote:

Stripe’s EBITDA profit is $100M, and they processed roughly $1 trillion in 2023, which means their profit margin is 100m/1tn = 0.01%.

I actually agree with Cristina Cordova: processing volume ≠ revenue

This got me thinking, what is Stripe’s annual revenue? Per Backlinko: Stripe’s gross revenue reached $14.4 billion in 2022. So the math is 100 / 14400 = 0.69%

Last but not least, make sure you get a “no foreign transaction fee” credit card: Chase offers quite a few cards with this feature, namely, Chase Sapphire Preferred, Chase Amazon and Chase Hyatt. Amex Gold doesn’t have foreign transaction fee either.

Categories
advice and tips kids Life Life Tips

Ankle injury and recovery – 从哪里摔倒就从哪里爬起来

Reading Time: 3 minutes

I don’t know about you, but I was fairly enthusiastic about sports when I was in the middle school and part of the high school. At one time I thought I should join the Chinese youth soccer team (under 16), which looking back I don’t think that’s possible.

A few months ago I also talked about Tennis 网球. Recently (to be precise on Jan 7 Sunday evening) my old daughter injured her ankle during a tennis clinics session. I only saw her injured after the fact, as I didn’t see her fall on the spot, which is a few minutes towards the end of clinics. So we got the ankle wraps and tapes etc. from the Walgreens. But she still jumps on one leg – because she could not use any force on her injured ankle. The second day was Monday (school day), obviously we cannot go to school under this condition. And because “wait and see”, as well as “my wife’s reluctance go to urgent care” that day, I went ahead and bought Crutches from Walgreens (I posted it on CL recently).

Urgent care and specialists

The following Tuesday we still went to the Total Access Urgent care (TAUC) next to Walgreens at Creve Coeur (cost: $175.00 not too bad). Then it’s following up. I chose and went to the Shriner’s Hospital for that: 2 trips, the cost to us is only $102.13, plus they have magicians on site sometimes. This seems very reasonable. This is much cheaper than the X-ray service fee (more than $400) from BJC for scoliosis (false positive, but nonetheless the checkup/x-ray and followup with specialist (not too bad there).

(Update 03-18-2024) It seems the Shriner’s Hospital changed their billing in the month of February. Since last time I paid them inside MyChart, I received 2 more bills and I paid them online (a new bill pay website, not from MyChart). The total is about $250. Btw, BJC sent one more bill from the doctor who reads the X-ray, it’s not a lot – but overall cost seems high to me.

(Update 03-26-2023) Okay, I think now I understand most bills now. There were 5 bills or 5 payments from my side. Two bills for the X ray which although it says the doctor’s name in the insurance company website’s benefit explanation section. Two bills for the nurse practitioner who looked at S. And one therapist who came for the 2nd visit. The total out of pocket for Shriner’s hospital is about $450 for us.

4 Bills from the Shriner’s hospital, I think I turned off the paper bill in MyChart and one of the paper bill didn’t come

Btw, I am selling a few gentenly used items on eBay to recover some of the costs.

Set of 2 Theraband Resistance Bands – Green and Blue

Ovation Medical Walking Boot Adjustable Support, Black, Size Medium, Adjustable

Walgreens Ankle Support, Antimicrobial, Adjustable One Size Fits All

Below was written on 02-04-2024 从哪里摔倒就从哪里爬起来

Our old daughter back to court after 3 weeks break, at CCRC.

几个礼拜前她的脚踝扭了：现在已恢复。我几个礼拜之前说了买网球鞋的事：大家如打网球，可以参考一下。A side note is our 13 year old got to hang out with her friend in the mall on Saturday. I recall when I was her age: I like to hang out at the bookstore by myself, and also I saved some changes and bought snacks such as 金团 一种糯米做的甜点。美国中西部没有金团，类似的甜点有mochi 应该是从日本来的。Anyway I am quite happy she is back to her normal routine, and also enjoys some “chill time” with her friend.

Adolescence

Our 13 year old is soon going to be 14 year old. And recently she started to pick up her own clothes, and I think some of it (the style) is likely influenced by the TikTok and YT shorts, her friends (again TT and YTS), and some stores such as Aerie (American Eagle).

In contrast, I recall I started to pick my own clothes around similar age.

Performative Society

Other related topics: how hard should parents push adolescent kids on sports, for that matter anything.

I felt we increasingly live in a performative society, thinking applicable to me (or my work) as well. This is a bigger topic and I will come back to it sometime soon, hopefully.

PS: personally I haven’t had hurt my ankle that bad, when I was a teen. I did get my ankle hurt once during a soccer game, in which my teammate accidentally kicked my left ankle (using his dominant foot, right foot), he and I was trying to kick the same soccer ball.