Saturday, November 27, 2010
Tuesday, November 23, 2010
Dr. L/C was focused on getting me a new prescription to stimulate ovulation, but I managed to drag the focus back to doing something about the ovarian pain, which I believe to be cysts. She did an exam and said that there was no indication of cysts, and also noted that the pain doesn't appear in my cycle where an endometrioma would cause pain. (I already knew that, but darn it, it feels like cysts to me.) She didn't have any specific ideas - possibly scar tissue around the ovaries that tightens leading up to ovulation, she said, but she wasn't sure.
So, the plan is that I will get an ultrasound right before ovulation and see whether the culprit can be spotted. If it is something cyst-related, we can make a treatment decision then. She didn't think depo would be all that helpful (lupron and the like shrink adhesions, but endometriomas are more serious and she would not expect them to comply). If there's nothing wrong with me (you know, other than me being in pain), then I have various treatment options...she proposed tamoxifen, clomid, or femara (oh joy! Apparently, femara is now an option without a fight).
I also asked about HCG shots, and she said this supports good hormone levels post-ovulation, rather than a strong ovulation. She seems more concerned with the latter (I mean, fair enough, since I'm not pregnant). Because of the premenstrual spotting, it seems to me that the only thing obviously in need of remedy is my post-peak progesterone level. So maybe I will lobby for femara and HCG, or something. But only after seeking out the cysts (I still believe they're cysts) and doing post-peak bloodwork to check on the hormone levels.
My husband is very relieved to hear that the doctor does not think I have cysts. While I cannot argue with the reasonableness of this response, I disagree completely. I have had lots of cysts. If the prognosis is that surgery could (temporarily) fix the problem and something else might perhaps help in the meantime, and the problem is a serious impediment to fertility (but hardly the only one), that doesn't seem so bad to me. If the prognosis is that surgery probably will not help the problem and would not in any case be advisable, and that no medication (including analgesics) will do anything whatsoever to limit it, and I will be in pain for years (but there's no impairment to my reproductive health) - then I'm not happy. At all.
I guess this means I'm not just kidding myself when I say that I no longer hold out hope for a child, and just don't want to live the rest of my life in pain. I know there are people with much worse problems, but that seems like so little to ask.
Oh, and I didn't actually discuss my historic problems with Dr. Lorna. She appeared in a massive rush from her last appointment (mine was late because some pre-op patient decided to show up three hours late and the nurses had committed to seeing her "whenever she could make it," which I don't hold against the doctor). And she didn't seem hostile. And she offered the femara,* which is what I had originally wanted. Some people like to hash things out, some don't...some (like my crazy family) prefer to make nice by making up for problems rather than talking about them.
For now, I am going to accept that that's where we are and proceed with the next round of diagnostics. And, at the same time, I need to be looking into other options. At some point, I will gather my courage to make the requisite phone calls.
*For some peculiar reason, I initially wrote "tamoxifen" here. As I have documented thoroughly elsewhere, I DO NOT LIKE TAMOXIFEN.
Sunday, November 21, 2010
Friday, November 19, 2010
I tell myself that this was going to happen either way, and that while I probably delayed the spotting with the progesterone cream, I was never going to prevent it altogether. One late application wouldn't make that big of a difference. And if getting back up to speed hasn't made the spotting stop, then it was definitely coming either way.
Of course, the other side of this is that, since (thanks to the spotting) I start having symptoms of my next period as much as a week in advance, it shortens my available period of denial (AKA the 2ww). Or, alternatively, it just makes that denial much more severe. I.e., I know perfectly well what this means; but I come up with all sorts of secret theories about why this isn't inconsistent with a BFP this month, even though the same symptom didn't lead to pregnancy for the last several months. Infertility: a nuanced study in mental illness.
Also, even though he is no longer traveling internationally or for long periods of time, my DH is scheduled to miss my entire "fertile" phase in the upcoming cycle (the one that I was going to time perfectly after I figured things out with this cycle - this cycle that's already a bust, that is). I am pissed. I haven't told him yet. I probably have to find a way to do so with less hostility.
Finally, the spotting also means one other thing: I am PMSing. For me, this means an intensification of all my negative emotions, the suspension of my ability to be reasonable if I don't feel inclined to, and the amplification of any kind of emotionally immature fixations to the point that they drown out all other aspects of my personality.
It's November. It's almost Thanksgiving. In the last week or so, it finally got cold-ish. My yard is covered in leaves (no, I am not contemplating raking just now. Life is difficult enough). I have already made pie this fall (three apple pies, to be exact). I am wearing boots on a daily basis. Today is casual Friday, so I have wrapped myself in cozy layers of wool. I can make some defense that the outfit is stylish, but I'm basically wearing blankets and sitting in my office chair. All I need is some cocoa. (Actually, I really do need some cocoa. Note to self: carefully schedule afternoon...)
All of this adds up to one inevitable conclusion. I want a house, and I want one now. A big house - OK, not unnecessarily huge (though some of the things on the market now do fall into that category). I always think of the beautiful Chicago home (er, mansion) in the first Home Alone movie. That was a house. And a house at Christmas - as all houses should always be. I don't want one that large or that expensive (there's only two of us). But something with that sort of feel. So though there are no really promising options out there just now (well, none that haven't been vetoed by my husband), I am madly going over and over the rejected options to find one with potential.
There's a handsome house in my neighborhood that's in foreclosure, which my DH loves. It's priced above what we'd be willing to pay, and I know there are other offers on it, so getting it for the price we want might well be impossible. Two other problems: (1) I have never seen the inside. It could cost more to repair than we could afford. And, it was built in 1938. While it's got an older look, given my preference for Victorian-era architecture, I may just be unable to love it...I'll have to see. (2) It's right in my neighborhood. While this is a nice place to live, part of me really wants to move somewhere else - near to a parish with a real community, and, frankly, a little farther away from all our friends who have kids or are about to have them. I need a polite reason to put down roots in a new community and not spend all my time visiting them and their kids. I think a new town would give us a fresh start.
There's a really adorable house in the area I'd prefer. It's in a plenty nice neighborhood, it's adorable, it's in good shape, it's a really good price, it's got a lovely yard, it's commutable, and it's near a church that is acceptable. But it's so little...we've been thinking that since we're grown-ups some day we should have a queen bed. This house has three bedrooms, and none would fit a queen (they're all miniscule, and we can't combine two - there would only be two left!). Only one room even has a closet. The full bath also has a mini (not even standard-sized) tub, and no room to expand to fit a bigger one. We'd like a decent-sized bathtub. Is that so much to ask in a home we own? And it has no room for a dining room or a study. I keep trying to convince myself that it's perfect, but I just don't think it would work.
And...there's a giant (way, way more space than we need) gorgeous Victorian-style home as well. It costs too much (same as the one in our neighborhood, actually). And it would be a pretty inconvenient commute. Some of the decor is really weird and should be changed, but it's in good condition.
At another time, I would reject all of these options. But I cannot bring myself to let go right now. I must nurture whatever possibilities exist. I want to throw a (formal-dress) New Year's Eve party this year, and my rental house is not big enough to swing it, so I am at the mercy of others; others who are wonderful people, but will not understand that New Year's is a formal occasion. And I think we may be staying home for Christmas (and inviting some of the family to join us if they wish), and I could do wonders with a house with multiple bedrooms. And a dining room.
It's Christmas. I need my own house. More expensive than the tiny house would be fine. Less expensive than the other two is necessary (and smaller would be just fine). I don't mind if it has an insane kitchen and ludicrous decor and things falling off as long as, underneath, there are wood floors and real fireplaces and antique casements and working radiators and strange useless nooks and crannies. Why doesn't the real estate market understand this???
Wednesday, November 17, 2010
Because the doctor induced labor before the point of viability (I think the measure was actually "before 21 weeks"), the requisite medical billing code is one that references "abortion." It is not the code for an ELECTIVE abortion - that's a different code. But the insurer (Ci.gna) does not cover abortion, they say, and so they refuse to pay it. I'm pretty sure their health plan is not a sea of billing codes...like mine, I bet it talks about the types of procedures covered. The health plan is the contract between the individual and the insurer, and is what gives the insurer an obligation to pay claims. The codes are just an administrative method for fulfilling the obligation. They are not binding (though the insurance companies try to pretend that they are).
I tried explaining this, but I don't think they were really looking for legal information. They've got the matter on appeal, and the doctor's office is really fighting for them, and they are planning to sue if the insurance company denies the ($11,000) claim after appeal. That's probably the right move, under the circumstances. It may be rotten in particular cases, but insurance companies are perfectly justified in denying claims for services their plans say they don't cover. But for services they do agree to cover - well, that's something else again. Sometimes (VERY RARELY, but this is the sort of thing the legal system is actually good for), a nice lawsuit helps to straighten things out.
In more mundane matters...I talked with Father again on Friday. I explained to him, among other things, how I get upset with bloggers who "cross over" to the pregnant or adoptive camp and say things that I (and sometimes only I) think are insensitive; and especially upset with people I know in real life, who say things I think are rotten. (I am so convinced that I try to be supportive of other people's decisions, or at least, if I can't be, to say nothing, that I get very upset when people don't do that with me. But I bet if I could see my behavior through others' eyes, I would be enlightened as to just how supportive I really am.)
And I told him about an argument I had with my husband. We spend a lot of time with two other married couples. Of this group of six, five (including my husband) went to the same undergrad. I didn't. I try, on occasion, to persuade the group to incorporate new members (such as a newly engaged couple we know), because, for one thing, insularity is annoying, and for another, I have no motivation to insulate myself in with a bunch of undergrad groupies who aren't from my undergrad. And for yet another thing - as I pointed out to my husband - one of the couples is presumptively normally fertile (and I am fairly certain they have just recently gotten pregnant and are lying about it to the rest of us. That would even be a brilliant move on their part, except that infertiles always know. Nice try, guys). The other couple has started the adoption process. In one year, both couples will have young children. Guess who won't?
Nevertheless, this might be my best cycle ever (so far, so far - I could pass an ovary tomorrow. Do not underestimate my reproductive system). Also, since peak day was obvious as soon as I hit p+1, I started the progesterone cream on p+1. And no spotting yet! Granted, I'm only p+7, but I'd been having 3-5 days of pre-menstrual spotting, and last cycle I think I had 9, so I'm calling this an achievement. Anyway, I am pleased with myself. In another week, I will be decidedly displeased, but weeks...can be like that.
Also also. You know, this post is too long. So, a teaser: I have an appointment with Dr. L/C on Monday, because I need a prescription or three to set up my next few months of treatment (and hopefully remission of the cysts that torment me so) before I begin the long journey of starting out with a new doctor. And I knew that before that, I finally needed to talk to the powers that be at Tepe.yac (even though Dr. B never called me, contrary to his promise), so that I didn't spend my whole appointment ranting about administrivia (and loathing. I have so much loathing). And today, I got through to the practice administrator, and had what may have been a productive conversation. But that...is another post.
Tuesday, November 16, 2010
Friends of my husband's have miscarried twins. All that we know so far is that they are having trouble with their insurance company because of how far along they were in the pregnancy, and (since we're both lawyers - um, completely useless for almost all legal questions, including this one, but other people don't realize that) they've called us to ask for a bit of advice. I am told that insurance "won't cover it" because they were earlier than 18 weeks along, and that "it" costs $15,000.
What I don't know is what "it" is, whether "it" has already happened, what their policy says about it, who their carrier is, or how much before 18 weeks they were. Obviously, these are all the important questions. (Sigh...they're important from the legal perspective. Of course, to this family, all that's really important is that their babies are dead.)
Anyway, here's what I need to find out, insofar as you know, or have heard:
- How late is it possible to deliver naturally after a miscarriage (rather than getting a D&C)?
- Are you aware of a post-miscarriage D&C having been covered by insurance (and, if so, by what insurance company)?
- How much is a D&C (for miscarriage reasons; I understand that the prices on aborting a live baby are completely different) supposed to cost?
For reference, if it matters, I believe the family lives in the Pacific Northwest.
I'm sorry to add so much sadness to everyone's Tuesday. Believe it or not, if only in a very little (and not nearly making-it-worth-it) sort of way, the sufferings experienced by so many of the women I've met through these pages may be able to lighten the burden of another family in this case.
And of course, I am sure they would not turn down your prayers.
Thursday, November 11, 2010
She sounds very warm and enthusiastic about how positive and fulfilling these arrangements are - i.e., she does not feel that she's settling because this is as good a deal as she can get. I am certain she is sincere in this; she is always enthusiastic when starting out on new adventures and relationships, and "settling" is not really in her vocabulary. That's definitely something I admire about her, though it leads her to some very odd conclusions.
I know nobody can really help with this situation and I am hardly asking for advice. I can't necessarily ask for prayers for her situation (other than comprehensive prayers that the situation changes entirely); I can't say that a happy healthy family born to these people would be a sound intention either (I expect their relationship to last 2-5 years and I think that she would not disagree); and I'm not sure she's in good enough health to carry a pregnancy. And prayers for her previous marriages to be reconciled would be equally pointless; the most recent husband didn't want to be married to someone who was sick (she is) and his predecessor was apparently crazy and harmful. Not sure whether either marriage had any canonical validity, but that's getting rather ahead of things.
In other words, I have no ideas. No ideas at all. I am bewildered and sad, but then, I am often bewildered and sad. I do have one thing to say...someone who is categorically infertile would be harmed less than anybody else by an IUD. Obviously such a woman's children would not be harmed, because she will never conceive any. I'm not saying that my friend should be infertile so that I can be fertile and have a family. I'm not going to get lucky enough to trade, obviously. But if there were any method in doling this accursed condition out - any method - it would work a lot differently. That's all I can say.
Sunday, November 7, 2010
Or what man is there among you who, if his son asks for bread, will give him a stone? Or if he asks for a fish, will he give him a serpent?
God sent His own Son to die on the cross, and I can hardly demand better treatment for a wretched sinner like me. But the things we've all asked for are as simple as bread and fish - healthy bodies, to bear children to our husbands, not to bring shame and sorrow to our parents and families. We've gotten little else but stones and serpents and scorpions.
When I think about it, there are some prayers I can say every time with great sincerity. The line in the Lord's Prayer - Thy kingdom come, Thy will be done - resonates with me every time. At some intuitive level, I must believe that the will of God for which I'm praying will entail good things - maybe not sunshine and roses, but a reality that I would love rather than hate.
I reread the pamphlet I sent you. I remember you said you were seeing a spiritual director to get out of a funk. on page 6 of the pamphlet there is a statement that made me think of you. Under the heading "the Little King's Rule in Catholic Homes", end of the first paragraph. All who approach..., recieve....light in spiritual darkness, streams of grace in dryness of soul...hope in despair.this is the last time I am going to bug you and tell you to pray to the Holy Infant of Prague. I think He could definitely get you out of your funk. He has been really great to me. I don't know the status of prayers answered per se but I have definitely seen an improvement in my attitude on many things. I would also say I have had prayers answeredSo this is your reminder to pray for me this weekend. Also say the prayers for yourself. You can have multiple intentions for every prayer. if you ask Him to help you with your prayer life I believe He will help you. Please don't give up!!Also St. Gertrude PrayerEternal Father, I offer Thee the Most Precious Blood of Thy Divine Son, Jesus, in union with the masses said throughout the world today, for all the holy souls in Purgatory, for sinners everywhere, for sinners in the universal church, those in my own home and within my family. Amen.the holy souls will be praying for you if you but ask themhave a great weekend with your husbandtalk to you later
No colic is so painful, no fever so violent, no tumour so malignant, no insanity so raving, no complaint so irritating, no assault of Satan so furious, no pestilence so infectious, no swelling so serious, as not to be dispelled or cured by this blessed Child. The Holy Infant puts an end to enmities, frees prisoners, saves those who are condemned to death, brings obstinate sinners to repentance, and blesses childless parents with offspring. In short, He is become all to all.