Sunday, November 21, 2010

the week loometh

I continue to nest in my mind. Today I spent just a wee little bit of time in a thrift store and somehow still came home with an Asian-themed folding screen (due to the stupendous bargaining efforts of an IF friend, I got it for $35! All I seem to do with other infertile gals is eat chocolate and shop. It's a good life, really) and a really pretty ivory jacquard flat sheet that goes with my duvet.

We went to see the house in our neighborhood and the things the former owners did to it are bewildering and shocking. I'm not entirely bewildered that they decided to finish a cellar-type basement with serious dampness problems; that's just an extreme form of run-of-the-mill stupidity. But the resulting mold down there was really scary, and between the probably high cost to buy it, the high cost to fix the innumerable problems, and the fact that it would not be safe to inhabit for the first couple of months...just more than we can take on. So, it's out. The pretty Victorian that was similarly too much money we did not visit (someone who shall remain nameless was more attached to watching his football team play during the open house hours). The too-small house is...still too small.

My over-nurturing has found another target, however. I discovered a house which, on all the objective information, is a "middle ground" house - bigger than the too-small, smaller than the too-big; not over-finished, so it shouldn't be too expensive. Problem is, the owners refi'd it to the hilt and are (after a price reduction!) asking $220,000 more than the tax assessment (and $150,000 more than the highest independent assessment). It would be admirably suited to us if it were selling at market value, but how to make that happen? My realtor says we should go see it, and I'd be OK with that. Maybe I can pass the owners a note that says, "Talk to your bank about maybe doing a short sale! Love, the misfit (future owner of your home)."

Oh, and my DH and I have decided to spend Christmas here rather than traveling to see family (we will see some at Thanksgiving and visit others early next year). I'm touched that that's what he wants to do; that he has a special place in his heart for Christmas with us. (My sister will be with us too, I think, and my brother has been invited but probably will not come). And I'm excited about that - I love doing the holiday cooking and I love the idea of being responsible to find a tree and decorate everything and make sure home is ready for Christmas. Plus the traveling can all be so exhausting.

Of course, this causes me to daydream manically about closing on a house and moving before Christmas. That will never happen, so I shall have to pry myself free mentally from those images so I can focus my energies on getting the Christmas shopping (and packing and shipping) underway, cleaning the house, and taking stock of the decoration situation.

Daydreams I am not entertaining include celebrating a BFP at Christmas. I will have to make do with the babe in the manger.

Tomorrow I will be teleworking (somehow the opportunity to put in a productive day's work from a fluffy blanket on my beloved couch with a mug of whipped-cream covered chai always makes me feel better) so that I can head to my appointment at Tepeyac during the middle of the day. I've printed out my charts in color, and I still need to mark "ovarian pain" in the appropriate places to explain why I'm sure the cysts are back.

I talked to my DH about dealing with me if I take depo, and I think we will be able to make it work. (Hormone drugs make me psycho, and he generally reacts to that by trying to teach me a good lesson. I have explained to him that I will still have an obligation to be reasonable, but that can't happen until I calm down and the problem is that I have a very hard time being calm when I'm on this stuff - so he needs to calm me down first and then address the problem. I think this could work.)

Of course, I also need to talk to Dr. L/C about continuing with Tep.eyac. Right now my inclination is that I will not continue with them much longer. Finding another situation that would work well has not been easy thus far (though I have the number of a friend's doctor whom I should call). But since I have not spoken with her in person since all the nonsense happened, I would like to do that first.

I talked with the practice administrator there last week. He is very very nice (although, honestly, sometimes I wish Catholic professionals would not mention God at all but be ruthlessly competent. Wouldn't God be glorified by that so much more? It would at least make my life better). He said that the communication issues should never have happened and he was really sorry. Apparently there was a lot of Dr. L/C being out at the hospital on the day I would call, and then messages getting shuffled around and lost. And apparently she said that she had responded to my email earlier and it went to the wrong address (but no one has seen any evidence of this, I guess. It could be true, but it doesn't explain why she didn't re-send it when I kept calling).

He said that the practice as a whole is working on a general problem getting in touch with doctors who are on days at the hospital, since the GYN doctors never respond to each other's patients (but the OBs do). While I sort of understand why this distinction would exist, given that that's how OBs practice generally (i.e., when you go into labor, my understanding is that you get the on-duty OB, whether it's your doctor or not), it's just another way in which it's extra, and unjustifiably, hard to be an infertility patient.

Although I was frustrated that it took so long for me to talk to someone at Tep.eyac about all of these problems, I realized that it's a good thing I ended up waiting so long. I was much calmer when I talked to him, and I was able to listen to what he had to say and make my points with a minimum of emotion. But I said some things I'm very glad I got a chance to say, and I felt as though I was not only telling them things they needed to know about how to serve their patients, but saying things that infertility patients everywhere should get to tell their doctors.

I said that I understand why panicky pregnant women get calls back immediately and panicky infertile women who have to have a dosage clarified TODAY or they will have to wait an entire month before starting a new medication - might get a call back in several days. I understand it -but it's not fair that, in addition to being second-class citizens in society in general, when we go to get treatment so we can join all the lucky mommies, we're second-class citizens to our fertility doctors too.

I said that no one who has not been here could understand how hard it is to be in treatment for infertility, and that just making an appointment and facing another round of testing or treatment can be emotionally exhausting. I often avoid making the phone calls for weeks. If I have to make five phone calls to accomplish one thing, my life becomes unmanageable.

I said that I often feel that my doctor has no idea who I am, has not read some of my charts ever, and does not remember whether I've had the surgery - that she performed. I forget the details of my clients' histories too, but it's only right to brush up before the appointment.

And I also said that I think the practice would be well-served by using email as the primary method for asking routine questions of the doctor. Their official method (patient leaves voicemail, nurse plays voicemail, nurse writes voicemail down, nurse reads notes to doctor, doctor gives answer to nurse, nurse writes answer down, nurse calls patient and reads answer, patient asks clarification question, nurse begins process again) is extremely ineffective and frustrating. If patients could send emails to their doctors, everything would work better. He didn't promise to adopt such a policy, but I hope I've planted a seed.

Finally, he said that they're in the midst of a review and improvement of their office communication policy. And, when I said that I didn't really care whether Dr. L/C cares about my treatment, as long as someone will tell me if she doesn't so I can find another doctor (believe it or not, I wasn't snotty at all. I wanted to him to understand that this is actually the bottom line for me), he said that he can't tell me what doctor to see, but he would like me to give them another chance.

I don't feel that that obliges me to stick with them if I don't think it's advisable (and right now, I don't), but I was surprised to realize that it actually made me feel better to hear that. My impression has long been that people who have to deal with infertile women, in their capacity as infertile women, think that we are worse than worthless, and deserving of every kind of disdain and inconsiderateness. That he would even think that they'd want to keep me as a patient is almost shocking.

So that was that conversation. And tomorrow, always, I am sort of emotionally bracing myself because it's so draining, but I'm as prepared as anybody in this state could be. And the week ahead. Oh - plus Thanksgiving :).


  1. Too bad about the house. We saw a lovely home last week that was in our price range, but backed onto power lines so it was crossed off the list. The perfect house will come, I know it.

    Good luck at your appointment today. I think you've given them plenty of opportunity to right their wrongs. You're the bigger person for letting them try one more time!

  2. My doctor will communicate via email but I have to send reminder emails so he'll answer the first one. It is very frustrating. I agree with you...If I was pregnant calling about some pain I'm having, I'd probably get a call back immediately. BUT since I was emailing to ask for some recommendations on a doctor for my DH to see, that seemed like a question that didn't need to be answered and it was the doctor that told me to email him when we were ready to send DH to get tested!!!!

  3. Mold = scary. My sister-in-law just had to deal with it and it took months (and $$$) to hopefully remedy it. I think that the note to the other owners would be funny and hopefully effective! Also, I am glad your doc's office is revamping their communication policy - it's about time!

  4. thinking of you w your appt today.
    and that is SO great you got to tell them all that and voice the issues.
    The simple email communication is such a good policy to adopt, and when you wrote out the steps like that, of their current policy, it just seems ridiculous.
    all the best..

  5. I hope your appointment goes well today. Ugh - how frustrating they've been!!!

  6. yes, mold is scary. we had that in our house - which we just bought a few years ago - and it all had to come out immediately. which was frustrating because it meant we're (still) renovating our gutted basement.

    i'm glad you got to voice your concerns. i'm cynical about the response you got (that's the way i am as soon as i hear that something is 'under consideration' or 'in review' because in my experience it's just a party line). do what you need to do for yourself.

    "I will have to make do with the babe in the manger." - What a powerful line. I wish you didn't have to write those words.

  7. I wonder if you put in an offer that was at what market value was if they would have to accept it. Banks aren't going to approve a loan for over what the house is worth so the sellers need to either lower their price, do a short sale, or not sell. Good luck, I hope you find your house soon. And thanks for your comments on my blog, I know it is probably not pleasant for you to read, but I appreciate your comments.

  8. Short sales don't usually excuse you from paying what's left of the loan amount. And they really eff up your credit score (not as much as a foreclosure...but still, not good). So, if the homesellers aren't desperate, there's no reason to take those measures.
    I hope your appt goes (went?) well!

  9. Callmemama - my understanding was that although a short sale doesn't necessarily excuse the seller from paying the deficiency, in practice, that is what banks most often approve (and then the issue is whether the buyer has to report forgiven debt as income on his tax returns). I have a friend who did a short sale in 2009 who used this arrangement (and was forgiven the deficiency), so that's what I'd be suggesting to these homeowners :).

  10. I am in AWE of your conversation with the practice administrator. You should hire yourself out to vent the frustrations we have all had with our doctors and their office staff. I never understood why IF doctors, of all people, didn't seem to understand that we needed the answer to our question TODAY or it wasted a whole month.

    Good luck on your house hunting. I say go ahead and try slipping the owner a note. You never know!!

  11. I am always perplexed by people asking far more than the market value. I don't know how you get people to see sense in those cases.
    Glad you got a chance to talk things through the with patient liason at the doctor's office. Even months later, I am not sure I could have been calm about it.