00:00:00 Dr. Abraham Sheffield shares his background, including growing up in the Midwest, completing his undergrad at BYU, and pursuing a medical degree in otorhinolaryngology (ENT) and a PhD in genetics at the University of Iowa. He expresses the importance of prioritizing family amidst the demands of a medical career. During the conversation, they discuss the challenges of pronouncing Dr. Sheffield's medical degree and delve into his motivations for choosing ENT and genetics as his fields of study. Dr. Sheffield mentions that his diverse interests made it difficult to make a decision, but his exposure to various medical specialties and a fascination with research influenced his choices.

00:05:00 Dr. Abraham Sheffield discusses his personal journey of pursuing a combined MD-PhD program, which allows individuals to train as both physicians and scientists. He applied to the University of Iowa, where he grew up and had strong connections, and was accepted into their program. Dr. Sheffield emphasizes the importance of choosing the right mentor for the PhD portion of the program, and he joined the lab of Dr. Richard Smith, who studies hearing loss and genetics. Although they have not yet cured hearing loss, Dr. Sheffield gained valuable experience and knowledge during his PhD training. After completing his PhD, he returned to medical school for clinical rotations, where he explored various specialties with an open mind. Ultimately, he chose to specialize in ears, nose, and throat (ENT) medicine due to his previous experiences and the excellent training opportunities at the University of Iowa. Dr. Smith served as a significant influence in this decision.

00:10:00 In this section of the podcast episode "Sometimes The Journey Takes Longer Than Expected," Dr. Abraham Sheffield shares his personal experience during the residency application process, comparing it to National Signing Day in college athletics. He explains that once applicants submit their rank lists, they cannot easily change their minds, and the programs do the same. Dr. Sheffield shares that he initially applied to a few different specialties before ultimately deciding on ENT, but the process involved difficult conversations with mentors and role models. Despite the challenges, he emphasizes that good mentors want the best for their mentees and support their decisions, even if it means pursuing a different path.

00:15:00 Dr. Abraham Sheffield shares his experiences with mentors and making difficult decisions in his career. He expresses gratitude for the valuable mentors he's had throughout his journey, from leaving corporate America to become a financial adviser, and later starting his own private equity company. Dr. Sheffield then discusses his path to becoming a doctor, completing an MD-PhD program and an ENT residency, only to realize during his fifth year that he enjoyed pediatric ENT the most. Despite already having plans to move on and start a general ENT practice with his wife, Dr. Sheffield was offered a spot in a pediatric ENT fellowship. After much consideration and a sleepless night, he ultimately decided to take the opportunity, even though it meant delaying their plans and starting their family later. Throughout his career, Dr. Sheffield has learned the importance of finding good mentors and making tough decisions, even if they come with unexpected twists and turns.

00:20:00 Dr. Abraham Sheffield discusses his decision to pursue a fellowship despite initial reservations. Having been exposed to academic medicine his whole life, he was on track to become a researcher and academic doctor. However, he and his wife decided to go into private practice instead, making the fellowship seem unnecessary from a career standpoint. Yet, Dr. Sheffield saw benefits in taking the extra year for training and family support. He felt it would make him a better surgeon and doctor, keep his options open for a future return to academia, and provide an opportunity to observe private practice life. Dr. Sheffield's father, who was a pediatrician with a research background, offered guidance during this decision-making process. Despite his father's passion for research, he emphasized the importance of patient interaction and the impact it could have.

00:25:00 In this section, Dr. Abraham Sheffield reflects on his experience in pursuing a PhD in genetics, specifically in the field of hearing loss. He expresses his enjoyment of learning new things during his PhD years but also the frustration and setbacks that came with it. Despite his father's influence in medicine, Dr. Sheffield realized he didn't have the same passion for research as others do and instead found his passion in patient care and making a difference in a shorter time frame. He was drawn to a cervical specialty and acknowledges his father's support and influence in his career choices. When asked about what attracted him to the genetics of hearing loss, Dr. Sheffield mentions his search for a good mentor and the cutting-edge nature of the gene therapy projects in Dr. Smith's lab.

00:30:00 Dr. Abraham Sheffield discusses his growing interest in the field of genetics and hearing loss. He explains that while genetic hearing loss is not common, it is still important as people get older and a significant number of them require hearing aids. Dr. Sheffield then talks about the technology behind cochlear implants, which are used for individuals with little to no useful hearing. He describes the surgical process of implanting the electrode into the inner ear and how it sends sound to the brain. Cochlear implants have been in use since the early 1980s, and there have been significant improvements in the technology since then. Looking forward, Dr. Sheffield mentions that the technique and devices continue to innovate, with children being implanted at a young age and older people also receiving implants due to age-related hearing loss.

00:35:00 Dr. Abraham Sheffield discusses advancements in technology related to hearing loss and gene therapy. He mentions the potential for restoring natural hearing by either causing regrowth or implantation of sensory cells. While this may not be achievable in the next five to ten years, Dr. Sheffield expresses optimism about the possibilities. The conversation then shifts to genetic testing for hearing loss, with Dr. Sheffield confirming that such tests exist and can identify around 50% of the genetic causes. He also mentions ongoing research to identify more genes and improve testing accuracy.

00:40:00 Dr. Abraham Sheffield details genetic research related to deafness and its connection to other health issues. He explains that some types of deafness are syndromic, meaning they affect multiple body systems, and identifies the importance of early detection and subsequent testing for various organs. Dr. Sheffield expresses excitement about advancements in genetic technology, such as CRISPR, which could potentially correct genetic abnormalities and prevent related health issues. He also shares a personal story about having twins during his residency and the challenges that came with it.

00:45:00 In this section, Dr. Abraham Sheffield shares his experience of raising twins and later having a third child with his wife, who is also a medical professional. They tried various ways to manage their responsibilities, with Dr. Sheffield taking care of one child while his wife rested, but eventually, they settled into a system where they each took care of one child. Dr. Sheffield reflects on the exhaustion and bonding time during those early years, comparing it to the challenges of medical training. He also mentions how having multiple kids brings its own unique experiences, from the chaos of the first six months to the benefits of built-in playmates as they grow older. Dr. Sheffield and his wife, both being medical professionals, also discuss the challenges of juggling their careers, moving to a new city, and the impact on their marriage.

00:50:00 Dr. Abraham Sheffield shares his experience of transitioning from academic medicine to private practice, influenced by his wife's career and their desire to maintain a balance between work and family. He explains how they found a solution in joining a multi-specialty group in Quincy, Illinois, where they both could find employment. Dr. Sheffield and his wife, who is an oral surgeon, now work flexible schedules, allowing them to juggle their professional and family commitments. Private practice has provided them with the flexibility to manage their work-life balance and understand each other's demands better. Their marriage has benefited from this arrangement, as they appreciate the challenges and demands of their respective careers and continue to put effort into maintaining a strong relationship.

00:55:00 Dr. Abraham Sheffield discusses the importance of understanding and communicating with one's partner, particularly in the context of balancing work and family life. He shares his personal experience of trying to prioritize regular dates and conversations with his wife, acknowledging the challenges of parenthood and the need for an understanding partner. Dr. Sheffield also emphasizes the importance of avoiding work-related conversations during date nights and being mindful of what is discussed in front of children. He concludes by mentioning his passion for treating sleep apnea, which he describes as a more medical term for snoring.

01:00:00 In this section of the podcast episode "Sometimes The Journey Takes Longer Than Expected," Dr. Abraham Sheffield discusses sleep disordered breathing, specifically obstructive sleep apnea. He explains that snoring is a milder form of the condition, while obstructive sleep apnea involves obstructions that cause pauses in breathing, leading to drops in oxygen levels and rises in CO2. These interruptions prevent deep, restful sleep, impacting both mind and body health. Sleep apnea is more common in people with increased weight but can also affect those without much weight to lose. Symptoms include loud snoring, waking up feeling unrested, and morning headaches. Home sleep tests are an option for diagnosis, and the standard treatment is Continuous Positive Airway Pressure (CPAP) therapy, which uses a mask to push air and keep the airway open.

01:05:00 Dr. Abraham Sheffield outlines various options for individuals with sleep apnea who have difficulty using Continuous Positive Airway Pressure (CPAP) machines. He mentions oral appliances, nasal Airway openings, positional therapy, and surgery as potential alternatives. For mild sleep apnea, oral appliances made by dentists and nasal Airway openings can be effective. Positional therapy, such as using a tennis ball on a shirt to encourage sleeping on one's side, can also help. For more severe cases, he introduces the Inspire implant, a hypoglossal nerve stimulator that moves the tongue forward and tenses the soft palate, addressing multiple levels of sleep apnea. The Inspire implant, which has been highly effective, is a favorite of Dr. Sheffield's and has been implemented in thousands of people worldwide.

01:10:00 Dr. Abraham Sheffield discusses the importance of addressing weight loss for sleep apnea patients undergoing implant treatment. He shares a personal story of a patient whose weight gain negatively impacted the effectiveness of the implant. Dr. Sheffield explains that he collaborates closely with a sleep medicine doctor who specializes in obesity medicine to ensure patients receive comprehensive care. He emphasizes that the treatment works better when patients are less heavy, and insurance may require a certain Body Mass Index (BMI) for qualification. Dr. Sheffield concludes by mentioning that while high-tech solutions are popular in medicine, the basics such as good sleep, nutrition, exercise, and avoiding smoking are essential for overall health.

01:15:00 Dr. Abraham Sheffield concludes by discussing his son's potential need for ear tubes and compares it to Super Mario Brothers. He also shares his excitement about the Iowa Hawkeyes football team and women's basketball, particularly the performance of Caitlyn Clark. Despite tickets for less popular games being sold out, he expresses his hope to attend a game next year. Dr. Sheffield also mentions his oldest daughter's love for basketball and the possibility of Caitlyn Clark staying for another year in college instead of joining the WNBA. He concludes the conversation by expressing his gratitude for the opportunity to chat and looks forward to future encounters.