Sunday, January 22, 2012

atheists in foxholes

So I wanted to say this, and this post better be short because it is late and I am mildly unhinged (once I stay up a certain amount of late there cease to be any limits imposed by right reason, and I don't have to work tomorrow as I took the day off, thank God, but that only leaves a one-day buffer between this present insanity and reality, and I suspect that Tuesday will therefore be a mean day at work).

I complain a lot about the attitudes of Catholics (see interspersed through my last post); I think I am well justified in this. Catholic "former infertiles" seem to be some of the profoundest hypocrites; Catholic "homeschooling mother" types (excuse me, moms. It's not a vocation, it's a cultural trend) are the most profoundly vapid and obnoxious; Catholic institutions started recently and still run by the overtly pious are the most inept and corrupt. That is to say, not all Catholic former infertiles are hypocrites and insufferable; not all Catholic homeschooling mothers are insufferable either (there I think it's a majority, but then I suspect that I am such a rare species in their worlds that they can't even imagine what to say to me and in the absence of rational thought, the brain somehow switches into the "talk about junior's giftedness" gear); but I think pretty much all Catholic variants of worldly institutions are ineptly and corruptly run.

So while I have a mountain of evidence for all of this and believe that, if anything, I should complain more loudly and more often until or unless these messes are cleaned up, the contrapositive is also true.

Specifically: I know from my citizenship in blogdom that lots of IVF/typical fertility clinics are unhelpful, annoying, unprofessional, uncivil, and otherwise unpleasant. But it has been my experience that the most pleasant interactions I've had in the fertility-treatment-seeking nightmare that is still (but not for long!) a part of my life have been with decidedly secular institutions. Even when they're just about to tell me that they've never heard of treating someone without considering IUI or IVF and can't really imagine what that would be like, the phone-answering gals at IVF clinics are polite. They answer the phone when I call. They call me back promptly if for some reason they missed me. They give the overall impression that they want my business and my good opinion - rather than that they will be judged only by God Almighty, and they can consequently step on whomever happens to be in the way of their achieving what they perceive to be their divinely anointed purpose.

And I specifically want to give credit to one institution. Prosperity Specialty Pharmacy in Fairfax, VA is one outstanding institution. When they say "specialty," they apparently mean "fertility," and unlike just about every other institution I've encountered that deals with infertiles qua infertiles, they apparently don't see infertile women as a waste of good oxygen that could be used by expectant mothers. They answer the phone when you call; if you are on hold while you wait to talk to a pharmacist (yes! A real pharmacist!), you hear their marketing message, which is that specialty pharmacy requires specialized patient care. We all know that this is true; if you have to take your drugs on p+3, 5, 7, and 9, you need them today, or at latest tomorrow. Everyone understands this with cancer patients (of course) and pregnant women, but we are the black sheep in that fold and nobody cares if we ever get pregnant, or while our lives away wishing - just as long as we're not pregnant now. But Prosperity means this. (And BTW, they're not a Catholic pharmacy - the first gal I spoke to assumed I was using HCG as part of an IVF cycle, and was confused by why else I would be taking it. This assumption does me no harm, of course.)

I called them because my regular compounding pharmacy (which is also awesome, but less stunningly awesome) had no Novarel in stock and it was on back order, and I needed it in just a few days. I panicked. My regular pharmacy (which, again, is pretty darn good) told me what other pharmacies in the area carry the stuff. One had none in stock, but Prosperity had some. (Already a point ahead.) They weren't open late enough for me to pick it up, but they told me that they ship it. To my house. It arrives the next day. At no charge. Then of course my doctor (who wrote the scrip) had to tell the insurance company that she really means it and I should really have the drug before it could be paid by insurance. They suggested that I bill it to my credit card up-front, and then as soon as the insurance company had things straightened out, the pharmacy would refund the insurance company's payment to my credit card. So logical and helpful it's astounding.

I was really worried about trusting all of this to shipping, because what if they sent the wrong needles? What would I do? But they sent the right needles. I thought it hadn't shown up when I needed it, but it turned out to be tucked inside the door where I hadn't seen it. They were patient with this panicked phone call, too. I usually get Novarel, but they recommended I use Pregnyl (different brand, still HCG), because it costs less after insurance pays. I didn't even ask them to check. Then they sent me the 10mL bacteriostatic water instead of the 30mL I've been getting. Since I get 3mL syringes, and I take 2000 units per dose (10,000 total units of powder in an order), the most water I can use is 15mL, and I usually have to spend twenty minutes slowly draining exactly 15mL from the water before I mix it. This time, no such problem. Also in the bag of syringes they sent: a set of little alcohol wipes (one each for the top of the bottle and the injection site, for each day). For free. So I don't have to fetch out a bottle of rubbing alcohol and a tissue.

After all this, I was sure they would forget the insurance credit, so I figured I would call back in a few days to check, after checking my credit card charges. Not only did they remember and refund me the money, they called before I did - just to make sure I knew.

God bless the secular culture - sometimes the clearest reflection of divine love and respect for human dignity out there.

Friday, January 20, 2012

rage?

So today is p+17, and it appears likely that it will also be CD1. Two more months of HCG, and then I'm going to ask my doctor about depo shots. As previously mentioned, I am planning to retire from IF treatment around my thirtieth birthday (if I hadn't been moving and busy and that sort of thing, and had done all six months of HCG as soon as I got the scrip, I could have had my little retiring-from-treatment party on my birthday). Also as previously mentioned, I've already had two surgeries and don't plan on making that a regular thing; I promised myself that my very next surgery would be a hysterectomy. (And because some of these responses are just reflexes in the IF community at this point...no, another surgery would not help my fertility; no, the problem is not simply that the last surgery was done by my doctor rather than your doctor; and in fact, after the last surgery, my cycle didn't return for five months...five of the six months that would be my "best window" - for life, no doubt - in which to get pregnant. The only basis for more surgery at this point - other than a hysterectomy - would be insanity.)

But I'm only turning 30 - this is one of the few arenas in my life in which I wish I were much older - and I have a lot of time to go before menopause and (presumably) the natural remission of the endometriosis. As it is now, it is getting steadily worse - worse than it has ever been before. (SEE ABOVE ABOUT SURGERY. I WILL DELETE COMMENTS FROM PERSONS WITHOUT MDs RECOMMENDING THAT I HAVE MORE SURGERY!) Having a biological child is for me, at this point, not remotely realistic. I'm not particularly interested in adoption; my husband and I continue to discuss it, but while we're being relatively sporting about pursuing our waning options, both of us are expecting to live the rest of our lives childless.

So - please try to wrap your head around this; if you are infertile but have children, you might want to accept that that's just too difficult and go read another post (and no, I would not take this tone without a MOUNTAIN of evidence about people's inability to use their brains on this subject), by someone who has children or expects to have them - so: my future medical endeavors need to be directed to preserving my health and improving my quality of life, not having children, because I am not capable of having children. It's OK, go back and read it again. As many times as you have to. (It is difficult for me to accept that this is where I am headed, but it appears that for third parties, it is impossible. So, I'll wait.)

What I need to do, then, is halt the growth of the endometriosis before it gets far enough to cause uterine cancer, and put a stop to the cycle of inflammation so that I am no longer in daily pain for the first two weeks of every cycle. My life is not going to include children, but it includes a lot of other things, and none of those is improved by being in pain. Generally speaking, the way to halt - maybe even revert - the growth of the endometriosis is to stop one's menstrual cycle, since the upsurge in estrogen levels at the beginning of every cycle cause the endometrial adhesions (and the endometrial cysts - I would warrant I have several on my right ovary, since that area is frequently painful) to swell, causing an increase in the immune reaction that causes scar tissue to form on the internal organs. If I stop menstruating, I stop having estrogen spikes, the adhesions stop growing, and the scar tissue stops forming. With nothing to feed the adhesions, they may even shrink. Best of all, I wouldn't be in pain any more.

Obviously, I cannot be on depo forever (well...some people are, I gather), so I think I would talk to my doctor about doing six months or a year, then coming in for an ultrasound to see what's going on with the cysts. If it appears they have shrunk, I would maybe even consider doing another month or two of HCG; I understand that after knocking out your cycle, there is again a potentially "fertile window." That one might even be non-fictional in my case, in the sense that I might be both in the magic window and ovulating. Wouldn't that be nice. And as soon as the pain came back, I would go back on the depo; wash, rinse, repeat, until menopause, or the hysterectomy.

There are other inane things people say about this. One of which is that I shouldn't take depo (or should call it something else? It's high-dose progesterone, BTW), because it's a contraceptive. Hahahahahahahahahahahahahahahahahahahaha. Go ahead, take a look at my URL. See? Up there at the top of the page, in the address bar? I know, there are no spaces, it's hard to read. After the "http://" there's a four-letter word, then a five-letter word, then...you see? Yeah. So, that's what I have to say about me taking "contraceptives."

And for those who have hangups about giving money to the companies that manufacture contraceptives - do you know where your non-ART, super-holy, Catholic-approved drugs come from? What about the over-the-counter medicines you take? Where do you buy your jeans? What about your computer equipment? I took lupron before I was married because I didn't want to take depo shots because I would be giving money to those terrible people. Never mind that the exact same company probably makes both of them. I've never had such a bad reaction to anything ever. Surgery was pleasant by comparison. And I don't need the bone density loss, either. Plus, so far as I know, the sole perk of lupron (besides way more aggressive and harmful levels of hormone drug) is that it's not technically contraceptive - in a healthy person, it would probably prevent conception but not definitely. In the event of conception, however, it would certainly cause severe birth defects. If that seems morally superior to anyone, I recommend a course in basic bioethics. No, forget that - intro philosophy. Just start with logic.

Also, I don't want to hear about my diet. I eat some healthy food and some food that I enjoy although I know it is not healthy. If food makes me sick, I stop eating it. No doctor I have ever visited has suggested that I am allergic to gluten or dairy (or anything else), nor do I have any symptoms that suggest I am (endometriosis doesn't count until you can show me a peer-reviewed, published, duplicated, blind study - I believe they call that "science") and I am not taking medical advice from a non-doctor who has performed no tests on me nor even met me. I'd have to be an idiot - and, if you're taking medical and dietary advice from the internet, you are an idiot. That's not more judgmental than what people (and I mean specifically infertile people and usually Catholics, though there are others) say to me about my diet and health; it's just a whole lot more accurate.

So, moving on. I spend a lot of time concerned that I am guilty of immoderate rage. Things make me really angry on a regular basis. On the phone just now - for example - I was furious that the city utility bill site was incompetent and wouldn't read my address right. It was super-picky, but I had actually missed a digit of my seventy-digit account number, so it was my fault. The real problem is, though, that I was clearly exasperated when the woman picked up the phone, and I was short with her. I felt bad about this after I hung up; I tried to be nice and polite and thanked her after it got sorted out. But, of course, the reason I was so irritated when she answered was because I had then been on hold for over 15 minutes.

And ten minutes before that call, I opened a letter from my mortgage servicing company, telling me that the state refused to allow it to pay my property taxes out of escrow, saying that they were not due. The letter instructed me to call and inform the company if I had not separately paid the taxes, and it would track the problem down. So I called Wells Fargo. Menu #1 was stupid but it offered an option to do with mortgages. I chose that. I entered my loan number and the last four digits of my SSN. I got another menu. All options stupid again; one offered "property tax information." I chose that. It played me a recording that said no taxes had yet been paid and offered to let me listen to the menu again. (I am not omitting any relevant menu options from this narrative, and yes, I called the phone number in the letter.) I dialed zero repeatedly and eventually got a guy. I told him that I got the letter, and I hadn't paid the taxes myself. He asked me to confirm my name and I did. He then said that the mortgage servicing department could help me, and he would transfer me. At this point I informed him that I was not calling to seek his help, but offering mine; I was merely answering a question and I had now done so; I had already been through two sets of menus (following the number that I was directed to call!) and I had things to do today other than be on hold with the bank; and he could pass along the information I had provided, and I hoped he had a nice day. Then I hung up. I inspected the letter to see whether there was anywhere I could email this information. Since there wasn't, I decided to let it go. I may call the state property tax people; I haven't decided. As far as I am concerned they are all in the wrong, and they can jolly well sort it out.

After this I felt bad for being harsh, and pondered my immoderate rage again. And then I thought of something.

What if it isn't me?

Sure, I have an option, as a Christian, to take these small torments and offer them up as mortification. But in my view that is, in fact, an option. Offering them up wouldn't mean that they are just. They are not. It is my perception that I am increasingly surrounded by injustice, absurdity, and plain incompetence and stupidity on the part of many - almost all - of the people and entities with which I am constrained to deal. While I do not do my own job perfectly, I endeavor to be prompt, thorough, and accurate, and I encourage my clients to call me if they need any assistance. I answer my phone, messages (at work - I do not listen to voicemail messages on my own cell phone), and emails promptly. I also endeavor to behave logically; if, for example, I am informed that someone's address has changed, I understand that that applies to all places where I might use the address. I don't require seventy forms to effectuate the same address change.

Regrettably, I cannot say this about all the offices at the place where I work. And I cannot say this about almost any company with which I do business. If they can be reached by phone (which is rare), they will immediately inform you that you have contacted the wrong person and (despite their own representations about their phone system) you must call someone else and wait another twenty minutes. That person will require you to provide again every piece of information you have previously provided, to his colleagues and to his automated system, and he will be unable to understand the spelling of your name on the first three tries, and, ultimately, unable to help you. He will then suggest that you use a web-based system to which you do not have access, and in order to access which you will have to place yet another call for information. Partway through this exercise, it will occur to you that your life would be substantially improved by foregoing this service altogether so that you may avoid dealing with the intractably incompetent - even if that service is water, electricity, a home loan, or health insurance.

In short, what I'm saying is that the world is getting substantially worse, and the problem is not a loss of faith, war, famine, dairy, gluten, "global warming," or any of the other scourges we're taught to fear more than the fires of hell. It's customer service. Which I think is probably actually in hell; and, consequently, whether I'm right or wrong about the rage thing, I'm probably well-prepared for the next life.

Tuesday, January 10, 2012

a word

Layla at The Lettered Cottage (which I first encountered by saving pictures of her outrageously awesome house to my ideabooks on houzz, before I ever found her awesome blog) is running a little thing on an inspiration word for 2012. She chose "Up," inspired in significant part by the movie of that name, which I understand is already something of an icon (whether you love it or hate it) for infertiles (and which I still need to watch). Given that their adoption plans are one of the occasional features on their blog, I assume that Kevin and Layla count in our oh-so-exclusive ranks. (And in fact, though Mormon mommy bloggers may be a significant minority among decor bloggers, I am beginning to suspect that infertiles are also over-represented in that category.)

Anyway, I was initially a little skeptical, but I have been pondering whether I would like to have a word for 2012. I already made resolutions, with which I am happy. But, for some reason, when I think about a word, the idea appears in a whole different light. Why this should be, I don't know. I don't think there's anything wrong with my resolutions...but when I think about what words I might like to use, they have just about nothing to do with the list I made.

Maybe it's that the words I'd like to use have something to do with what I'd like to be, but I suspect that even the best efforts in all the world will not even get me closer to there. I think my resolutions represent my sound, sensible analysis of what I ought to do, need to do, and am theoretically capable of doing. (A good basis on which to craft resolutions, if I do say so myself.) When I think about words, I find myself spinning off into what I hope will happen, and it's not things I could bring about by my own action - or, even if I could take actions that would in theory lead to those things, there's not even a remote guarantee of success.

The first thing I thought of was "home." I immediately dismissed that as shockingly uncreative (given a participating audience of almost 100% homekeeping/decor bloggers). Its attraction is that it reflects not only my concrete projects (fixing up our house) but also my more ethereal ones - I have a terrific longing for a home, someplace warm and welcoming and full of people I love. I love my husband, of course, but as the years pass, one of the saddest things about living childless is that there will only be two of us. It's going to be quiet. I am just as happy (actually, might be happier) in the company of other adults as I am around small children (even accounting for the fact that these days other people's children are usually a cross), but try as I might, I cannot get any of the adults I know to let me adopt them. Rarely can I even get them to let me feed them, which would be something.

The next idea I thought of was "joy." That's something I'd like to embrace in 2012. I know someday it will be there. I even know that there are things I could and should do to make it possible in my life. I also know that between me and the "unbearable lightness of being" that one lovely lady just posted about is a very long period of healing still. Sure, God can zap you and decide you're all better in an instant, but He rarely does, and with healing, one good reason is because the process is important in itself. I understand that, and while I do not enjoy it and am impatient for a happier chapter, I accept that I'm here and I'm not getting there for a while. For me, given where I am, "joy" would be farcical as an inspiration word for 2012.

The next idea that popped into my head was far scarier: "family." As far as I'm concerned it doesn't have to be a biological family (and, no, tiresome people, that does not mean I'm called to adopt). I would love nothing more than to have my home open, all the time, to whatever person I know just wandered by. It's the principal reason we bought a house: to have more room to share with people we love - guest bedrooms for visitors to the area, space to entertain. Of course, we also moved out of the heart of the close-in suburb and into the boonies (it's nice out here!), so in some ways we also undermined that goal. And nobody has to hang out at my house to fulfill my unfulfilled dreams. What I have to do is find something that people need me to do for them that will bring me closer to them - not figure out how I can force them into my idealized fantasy of the life I really lead.

Of course, there's also my actual family, and I should see more of them. That would be one way of living out the word, and something I should certainly do in the coming year, but it's not the part of the idea that brings joy. It means travel logistics and dealing with crazy people and needs to happen, yes, but...it's got its significant hardships. It's more an item for my to-do list than an aspiration.

But I do need to do something in 2012 to bring myself closer to the people I love. One big element of that needs to be forging new friendships. I have predicted with relentless accuracy the toll that others' newly-welcomed children will have on my friendship with them. Sometimes it's because of the massive and unavoidable change in time and social priorities that having a baby causes in their lives. Sometimes it's because they're self-absorbed and immature, and can't figure out a way to spend time with me that doesn't revolve around their parenthood and children. And sometimes it's because I just can't deal with their parenthood and children and can't bear to spend much, if any, time around them. And, what the heck, all three of those things often play a role. The bad news is, that has been especially and unexpectedly true of late.

The good news is that this bad news looks like it will finally be enough to shove me into doing something about it. I need to make new friends, already. Preferrably at least some who are (and will for some significant period remain) childless. (My husband points out that we cannot insist only on hanging out with people who will never have children, because that demographic is tiny and how do we know we would get along with them? I think he is totally wrong; the demographic is less tiny than he thinks and we should actively seek it out. Plus, I already know at least one permanently-childless couple in the area whom I really like, but he is unwilling to make efforts to hang out with them because he is a ninny. And he is ignoring that there's at least one marked demographic which presumptively will never have children, which tends to be well-educated, interested in culture, and a lot of fun at parties, and which we've made no special efforts yet to seek out. A good goal in itself...) At least if I make good friends who have no kids now, not because they want to hang out with my husband, if they have children in a few years, we will have a basis to continue our friendship, in that I'll know they actually care about me (and, of course, vice versa). That would be something.

I'm not sure anything will convince my husband that we need to move on from our friends with new babies, and relegate them to people we see sometimes but not all the time. Maybe spending a lot of weekend evenings alone will get the message through. In the meantime, I am going to work on broadening my horizons.

So I am still working on my word for 2012, and will update this when I feel I've achieved some sort of clarity. But I do need to contribute something to Layla's link-up (this coming Monday - gives you a little time to think), so until or unless different inspiration strikes, my 2012 inspiration word will be "gay."

Sunday, January 1, 2012

2012

It feels odd to write that, doesn't it? I'm not going to do a retrospective on 2011. While many had a far worse time of it than I did, and I frankly count myself lucky to have got out of it as painlessly as I did, there are a lot of episodes from this year on which I'd do better not to dwell.

On the other hand, I embark on my ideas for 2012 thoughtfully, but in good spirits, and for that, I have last night to thank. Yes, I am so tired now I'm nearly catatonic; I needed to sleep until noon, at least, after getting to bed not much before 5AM, and didn't get the chance to do that. But I can sleep in tomorrow. Last night, I went to a New Year's Eve party hosted by some friends of mine - several dozen people, party at their house, nothing really out of the ordinary. But in the many hours of that evening, in addition to sampling some delicious treats and getting a kick out of getting all dressed up and seeing others in their finery as well, I got to enjoy a number of blessings on which I don't reflect enough.

One friend turns out to be a truly accomplished pianist, and spent an hour playing accompaniments for every Christmas carol, Auld Lang Syne, and one Journey hit, while a roomful of people sang along - three, four, and five verses of some of the loveliest carols, including the first verse of Adeste Fideles in Latin. When I looked around and realized a good dozen of my friends have those words memorized, it warmed my cold little heart. I got to get to know better some truly lovely people, and catch up with some people I already know to be wonderful. I got to be at least a spectator to little bits and snatches of innocent intrigue as new romances may, perhaps, be formed, which I always find so delightful. And after the bulk of the revelers had gone home, a small group of us sat around and chatted for an hour, making predictions for 2012, pondering our resolutions, and generally enjoying one another's company.

The gathering was notably lacking a number of people - that is, all the ones with children. I believe several of those couples got together to hang out with the kids asleep all in one house, which is just as it should be - babysitters are prohibitively expensive on New Year's Eve, I know, and that sounds like a nice evening too. But the 5AM bedtime, rousing rounds of carols, and tuxedos and gowns were particular to the party I attended. While everyone's favorite comments about childlessness affording blessings like sleeping in and time to oneself are of course empty and therefore obnoxious, there are real advantages that I often forget.

Because I don't have to dedicate my time and energy to raising children, my time is always available for the other adults in my life whom I love. The joy of spontaneous small gatherings is available to me in ways it would not be if I were a mother. I've developed friendships with wonderful people whom I would never even have met were I home taking care of children. I've gotten to remain a part of the lives of my single friends whom I would nearly never see if we had a family to attend to. I'm not sure why the mommy crowd says things like, "Be glad you get to sleep in," instead of, "Be grateful for the opportunity to get to know wonderful new people," but perhaps they simply are not aware of the blessing they're missing in that regard. Today, I am, and I'm grateful.

So, on to 2012. I think I've screwed up every resolution I've had in the past, so quickly and so badly that I've never even gone back to check how I'm doing. I'm sure this year will be no different. Nevertheless, I'm doing it again:

1. Finish my HCG shots, quit fertility treatment, and go on a drug regimen to manage my endometriosis.*
2. Get to daily Mass before work - maybe not every day, but a whole lot more than not at all.
3. Write and submit for publication at least one law review article.
4. Fit into the formal dress I bought in 2008, and find an occasion to wear it.
5. Remodel my kitchen.
6. Persuade my husband to throw a party at our home at least every other month.
7. Be more punctual for work.
8. Be a better wife.

That probably covers enough things (that are moderately within my control) to cover what I'd like to see in 2012, and to ensure that I will make no serious pretense of completing the list.

*If you feel even mildly tempted to suggest that I should consider a third laparotomy instead, I invite you to ponder the fact that only a raving lunatic would find major surgery preferable to medication, and I am crazy, but not that crazy. In some ways, the IFosphere is seriously cracked.