Wednesday, August 14, 2013

The holy grail of doctor's notes

As per the policy of Emirates Airlines, I obtained a "fit to fly" note from my OB in Sharjah before traveling from DXB to SEA back in July. The policy, by the way, is to present at the airport a mandatory Fit to Fly note from 29 to 36 weeks for a singleton pregnancy; after 36 weeks, clearance may be granted but the form to fill out is much more extensive. The basic Fit to Fly template is here. Basically, it lists your name, DOB, LMP, "estimated date of confinement" (so cute, what they mean is due date), and the credentials/signature of the doctor.

Well, this is a round-trip vacation, meaning I plan on heading back to the UAE in about 48 hours. Of course, I will have to obtain a new Fit to Fly note for this return journey since Emirates Airlines requires that it be dated within 5 days of the intended travel. Never did I imagine how difficult it would be to obtain this simple note.

Plan A was to schedule an appointment with either my mom's or my SIL's OB, both of whom work at the same practice. I spent probably 20 minutes on the phone with the main scheduling coordinator, explaining what I needed. She was very nice and as helpful as she could be, but you would have thought no one in all of history had ever dared step on a plane while pregnant until I came along. A nurse later called me back and said no doctor at that practice would be willing to sign such a paper since I wasn't an actual patient of theirs. "If you had been seeing one of our doctors all along," the nurse helpfully volunteered, "they would be happy to do it." I had to suppress an eye-roll because the whole point of me needing a note to fly is that the airplane is headed to where I live, which is not here, where your doctor's office is. QED.

Plan B was to call another nearby practice, to which I have no connections. I talked to their receptionist and then billing specialist for a while and they said they couldn't help me, either, but for an entirely different reason: insurance. She said they do not have a system set up for single appointments. They would only see me if I was a long-term patient who they could then bill insurance for at the end of the whole pregnancy/delivery process.

Plan C was to go to a ZoomCare clinic and have one of their doctors complete the note. I knew they would be set up to handle a one-time, cash-paying customer. A few weeks ago, I took in the Emirates Airlines form and a copy of the policy and asked if it was something they could help me with. They said yes, they could, and to just come in a few days before my flight. Except then I actually went in for my appointment today and they said no. Hmph. Basically, they don't touch pregnancy with a ten-foot pole. At least they didn't charge me for the visit.

At this point, I'm on Plan D, which is to stay up really late tonight and call my OB back in Sharjah to have her fill out the Fit to Fly form and fax it to me. The ridiculous thing is that while this woman is my primary care person for this pregnancy, she has not seen me in a month. I was trying to play by the rules by seeing a doctor in the US so that the note could be an honest, in-person assessment of my actual fitness to fly, but instead it looks like I'll have to try to get the signature of someone who is thousands of miles away.

I'm worried that upon checking my doctor's note at the airport on Thursday, as they are sure to do (it was checked three times when I flew here), Emirates Airlines will ask me how a doctor in Sharjah is able to declare my fitness to fly from the US. And I'll have to tell them that I am persona non grata among OBs in the US. Nobody is willing to see me.

Sometimes I get so tired of being the exception and always falling into these weird loopholes. There is no way that I am the only person who has ever had this happen, and yet, here I am, depending on Plan D but not at all sure that it will work out. Because of course, OF COURSE, we're on the tail end of Ramadan/Eid in the UAE, which means that people are only slowly trickling back into work, and if my doctor isn't in yet, then I am up the creek without a paddle.

Or trying to board an airplane without a Fit to Fly note, as it were.

Update: I was able to get in contact with my doctor in the UAE, hooray! She will email me the note tonight/today (time zone difference). I won't feel at ease until I'm safely on the plane headed home, but I am relieved that I will at least have a note. Now let this be a lesson to you: never, ever leave home while pregnant.

25 comments:

Jen said...

Is it possible/ethical/legal to have Plan E: Go to JennA's uncle (who is an OB...is that right, Jenn?) and explain the situation? Maybe he can help you?

Bridget said...

Her uncle is my mom's OB and is part of the Plan A practice. We think the nurse may not have personally talked to the OBs, or at least not all of them (such as my mom's), or if she did, it may have come off as "some random lady from Dubai wants your signature on some random form" instead of in the proper context.

Jen said...

Ah. Well. I've got nothin' then.

OH! Wait!

I recognize that the UAE doesn't quite smile upon midwifery, but Florence's sister is a midwife and owns a birth center in Portland and another one in Tualatin. I bet you a dollar that she would do it! It's the Andaluz birth center---Sarah had her baby there!

Bridget said...

Well, the Emirates form DOES say it can be from a midwife. If I can't get in contact with my doctor tonight then I may be touring midwifery practices tomorrow. And I really hope I owe you a dollar at the end of it. :)

Crys said...

It just says doctor or midwife. Is there a family practice doctor you use to see when you were a kid, or could you go to or a hippie midwife kicking around, or a resident your family knows you could call up. I'd volunteer dr j up the one thing he actually doesn't cover is maternity. Could you forge it or pretend you are less Preggo then you are. I knew a couple who just walked on a plane 38 weeks Preggo to fly home from china! Obviously they lied :-/. Maybe you could call him personally instead of the office. Seriously such a bummer :-/

Bridget said...

Thanks, Crys. I can tell you haven't seen me in person because there is no way I could fake being not as far along as I am (almost 34 weeks). As it is, I look full-term. Or, as a random passer-by on the beach put it a full FOUR WEEKS ago (when I was 29 weeks), "HOLY PREGNANT!!!!!!!!!!!!!!!!!!!" Thanks for the self-esteem boost, random lady on the beach!

Crys said...

And seriously I'm not usually one for lying but it isn't like you aren't trying!!!! I used to be such a rule follower and just this last year something snapped inside of me. Power to the people, or in this case the pregnant lady who doesn't want to spend her last four days at home frantically looking for a signature!

Crys said...

Holy Rude! My friend asked me if I was pregnant with twins when I was 12 weeks pregnant with peach, and not a skinny friend, a friend I felt sure saw herself in my same chunky boat, but I guess not! Well that's it, time to lie ;). Just forge Dr J's info if you get desperate! I'll cover for you ;)

Crys said...

Oh yeah and I forgot to mention that when my water broke with cheetah at 27 weeks people were congratulating me on being in labor because I was full term...so lady I feel your pain :)

Yvonne Anderson said...

I still can't get over Plan B not being willing to accept CASH! Come on people!!

Bridget said...

I know, right??

Aimee said...

I one of my babies there too. The owner is LDS and there are lots of midwives. They could probably even give you a once over before signing. Question, do you have your records with you? That would make it easier. I flew a few times very pregnant and I don't envy your trip back.

P.S. I have been meaning to say congratulations and haven't managed to make it on to the computer. Ha. I can't say I am surprised. I don't remember what it was that made me think it was a possibility, but I remember thinking, "she sounds pregnant." That's super exciting!

Aimee said...

*I delivered one of my babies there.

Nancy said...

Where are you, Bridget? Oregon? My friend's father-in-law is an OB...somewhere in Oregon. I actually contacted him from Egypt when I was freaking out about some hemorrhaging when I was first pregnant with Miriam.

Also: I HATE INSURANCE.

Also, where else do you have layovers? Do you? Because surely between us all we'd be able to drum up an OB somewhere... ;)

Glenda The Good said...

So I was talking this morning about your plight with Dr. J and he said, "Is she crazy, of course no one is going to want to sign off on that, it is a medical liability". So there you go, even baby doctors are already worried about being sued. "While I'm sure Bridget isn't like that, putting your name on that form just opens you up for all kinds of hassles should anything go wrong." So I looked it up and found this nice little paper on malpractice risk (http://www.nejm.org/doi/full/10.1056/NEJMsa1012370) and saw that OB/Gyn doctors run a risk of being sued around 11% a year. So while they aren't neurosurgery, still a little more then 1 out of every ten is getting sued every year and 5% are having to pay out. :-/ What you need is someone whose obligation to you outweighs their fear of potential insurance/liability hassles. Do you have any doctors in the family or old family friends?

Susanne said...

Hooray for coming back and seeing the update! I read this last night before bed and wondered if one of your forthcoming posts would be "how I actually ended up being stranded in the US and having my baby boy here since I could never get that danged doctor's note!" ;)

Safe travels back to Sharjah!!

Glenda The Good said...

PS neither of us think you are crazy...it's just the whole system that is crazy :)

Bridget said...

Yeah, that's what I'm figuring out - no one wants to put their name on this paper! So my question is, WHY OH WHY are airlines asking for these notes if they're so impossible to get in the US? It's very frustrating for me (and I'm sure others like me), obviously. Common sense says that nobody, not even the smartest doctor in the world, can guarantee that anybody, including a pregnant woman, will not have a health problem on an airplane. So why ask for a doctor's signature??? So frustrating. Thanks for your thoughts and for letting me vent.

Crys said...

Bridget that is the worst! I wish there was something I could do :(. You are in my thoughts and prayers!

Ariana said...

Pres. Bair is an OB...

Craig said...

Update: Bridget is on the plane back to Dubai, but only after being denied boarding, and then getting aboard the last minute after intervention by the flight's captain. I'm sure she'll have a fascinating, if aggravating, story to tell soon.

Bridget said...

(Bridget's Mom speaking) Yes. His clinic said the docs there would never sign such a note. And once she got her doctor's note from Sharjah, there was no need to call on him personally. Then later I wish we had.

Cait said...

I am glad delta didn't need this. I flew 38 weeks pregnant and 4 cm dilated from DC to SLC with Atticus. I was soooooo nervous but it turned out fine and he wasn't born for a week.

Jen said...

WOW.

Yes. We anxiously wait for the story! So glad she made it on the plane!

Bridget said...

A blog post is coming. I am home now. It was a miracle that I made it. Literally, a (small) miracle. I'm glad I'll be telling the story from this side of the Atlantic!

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