Wednesday, November 17, 2010

all things...not necessarily either wise or wonderful

...or even connected to one another.

I spoke with the couple who lost the twins. It was more complicated than I thought. Since so many of you have been praying, I ought to provide an update. She was carrying fraternal twins. At nine weeks she started bleeding - from the wall of the uterus, the doctors thought. She was put on bed rest. At eighteen weeks, her water broke - only one amniotic sac. (I believe that child died in short order.) The doctors had a conundrum: maintain the status quo and risk that the dead baby (sans amniotic sac) would cause sepsis in the other baby or his mother; or deliver the dead baby, with the consequence that the live baby would also be delivered, before the point of viability. Because the mother has a history of staph infection, they chose the latter. Both babies were delivered (no anesthesia, ordinary delivery), and both babies died. They are burying them at Christmas.

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 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?

Oh, that's right, the moron couple that is spending the overwhelming majority of its social time with people who, in one year, will have no time for us. Why would I do that to myself? I already feel isolated. Why make myself socially dependent on people who will soon be able to talk to me only around feedings? Or if I want to accompany them to the park (I don't)? Worse, the infertile couple is in the "I still like other people's children" camp. I realize that's a really good thing for them, but I am not there, don't want to be there, and am not going to get there (I probably used to be there, when I still had hope. HOPE IS A LIE). Ergo, inevitably, both couples are going to have about one week's worth of understanding about how very little I want to see them with their kids (very, very little. Not zero, but close to that). After that, they will expect me to want to see the kids all the time. When I don't, they'll avoid me (because I'm an evil weirdo baby-hating freak), and then I'll need to make new friends - with people I have neglected while my husband devotes all our social time to people who are diligently pursuing babies that I am not going to have.

(At this point I will let you know that if you feel any inclination to respond, "Well, why don't you just adopt, too, instead of making yourself an outsider? Then you could come to play group with them, and go stroller-shopping together!" you are no longer welcome to read this blog, and also, you should probably schedule time to see a competent mental health professional, because you need it even more than I do.)

This is probably a good time to announce what I have decided is my greatest pet peeve (today) about infertility. It's nice and lovely and also convenient if you're infertile and still enjoy other people's children. What it isn't is typical. It's nice to be exceptional (unless by "exceptional" you mean "infertile," of course), but it doesn't make you a morally better human being. I mean, maybe it does if you're grinning through the tears, but then your use of "enjoy" is questionable and also I think you're a masochist.

See, I am nice to other people's children sometimes, too. Yesterday I held a two-month-old because I couldn't come up with a convenient reason not to. (That's right, I'm supposed to say that I've been exposed to someone with a cold - always true, this time of year - and couldn't risk getting her sick.) But I don't like it. And there's no law that says I have to. What I enjoy and what I think is absolute torture is not a matter of good behavior. Being nice when I feel like setting mother and baby on fire is good behavior, but feeling like setting mother and baby on fire is just how I feel - not morally shaded at all. (Not that I think nurturing those thoughts would be morally sound.)

For people to act as if some virtue inheres in wanting to hold the baby, or to conjure up masks of horror if I mention in strong terms that I want nothing to do with the baby - is tiresome. Get acquainted with the rest of this demographic. Thank God for the blessing that you don't carry that particular splinter of the infertile cross. Take stock of the dysfunctional infertile behaviors that you do have (some of which, possibly, I don't). Realize that it's a mixed bag, and you don't need your cross to be made any heavier, and that it's really, really tiresome to have someone who should actually know better pull a holier-than-thou on you because you're going through hell and have the audacity to call it what it is instead of managing a socially acceptable, "Oh, I love babies...that's why I'd really like to have one."

I generally don't approve of strong language, but INFERTILITY IS SHIT. CALL IT WHAT THE HELL IT IS.

OK, I feel better now. Anyway, I didn't say all of that to Father, precisely. But the part about the diversifying our friend time I did. He said that it was healthy to spend social time with different people. But he also said that I was pushing people away because I didn't want to give them a chance to hurt me, and that loving people meant being vulnerable enough to let them hurt you. And I should consider that.

Now, he has some points. And in the abstract I concede that he is right. But in practice, that sounds like pretty dangerous advice. First of all, these are my husband's friends of ten or fifteen years - not mine. Before 2.5 years ago, I'd met one of them - once. If any of them needed my help (other than to babysit), I'd be right there, but love? That's a pretty strong word. Second, this is not a matter of whether they'll betray me. This is a matter of which month in 2011 is going to be the lucky month. And, whether you believe me or not, this is not a matter of a self-fulfilling prophecy. Who do I know who has kids and prioritizes my friendship over those kids? Seriously now. (Not that they should; the kids need them more. But it means my friendship is now marginalized, and that in itself is a betrayal, if I need that person.) What about finding time for me that's not interrupted by kids? Won't happen. What about getting through an hour in my company without bringing up the kids? Don't think it's ever happened. Will never happen. Regardless of what kind of week I've had.

Oh, and I can't tell them what kind of week I've had - because if I say something that would make them uncomfortable (not pained or suffering, not like me; just awkward) in the event they do talk about their kids, then I am a Bad Person. I would find this deal almost effortless if it came from someone else. If a girlfriend told me, "I just got dumped by a guy I thought was the one, and it's everything I can do not to cry my eyes out right in this restaurant, and I think your husband's a great guy, but I just cannot hear about one happy marriage right now, OK?" I think I could make that work. In fact, I would be touched that she had been that honest with me. I'm not less of a wife if I don't talk about my DH for an hour. And there's so much else to talk about if I want to.

But can you imagine an infertile woman trotting out that line? I think the earth would spin backward on its axis. The sky would turn an angry yellow and implode toward the earth, and the seas would rise up from their beds to engulf the land, and the voice of an angry God would thunder down from above, "YOU ARE A BAD FRIEND." Because if you're infertile, it's not your loved ones' job to make your cross lighter for you. It's your job to make your cross lighter...for them.

(I guess I wasn't quite done ranting.)

Anyway, I think Father is wrong, because they are going to betray me, and I don't do this "vulnerable" thing any more because even when I do it by accident, it makes the betrayals really, really ugly. Like where I contemplate homicide ugly. Because this world I live in is very ugly and cold already. You do additional violence to its wretched inhabitants, and I want blood. And how does Father know what kind of emotional resources I have to deal with needing someone, who will then turn around and make my life more miserable and wretched, rather than buoying it up? Not a lot, I can tell you. Part of the problem is that fertiles can't win. But for me, the problem is that almost nobody tries - and nobody tries hard. And if I expected that person to "love" me (I'll use his word) and care about my life and my broken heart, and she doesn't even try, because it's so much easier to open the mouth and let the stream of consciousness on the difficulties of potty training roll out, and not make eye contact with me, because she seriously knows better - but still can't be bothered to make the effort? Blood.

On from this, to the truly mundane...look at my chart for this month! First, dumb FF acknowledges that I ovulated this time. Ha. And that it can even be pinpointed to a specific day. Ha. And realizes that it's the same day that I know was peak day. HA! Unfortunately, I didn't realize that it was peak day until afterward (I was focusing on the "E" days, which are so much more dramatic, and had to re-read TCOYF before I realized that the "W" days deserved more attention), so I'm not sure how good our timing really was this month. The rational (but living in the past) part of my brain is reciting the fact that sperm live for up to five days in fertile CM, and the cynical (but up-to-date) part of my brain is noting sardonically that clearly, I should always assume the best-case scenario applies to me, in light of past experience.

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 another post.


  1. I am with you on the kids thing. My dear friend who has gone through IF tx, and she and her hubs have decided to stop - and not adopt - and pray for a miracle but not expect it - she does not seem to experience the envy and sadness in the same way as I have. I would have a hard time seeing random pg women or women with babies on the subway, let alone friends & family. Didn't want to hold a baby or see one or anything. I couldn't enjoy it at all. But my friend could do all of those things, as far as I can tell, whole heartedly.

    When I asked her about it, she said that for her she really wanted a baby from herself and her dh - so any random child was not a problem for her, she could play and hold etc. without being tortured. But adoption isn't on the radar screen for them, at least not as far as I know.

    She has come so far in her battle with IF. I asked her about it once and she said it was like trudging through a hot dry desert, day after day after day of dryness and despair. And then one day it was like rain falling. She can still recall the sensation of lifting her face to the rain. And life is good. It is not the life they would have chosen and hoped for, there are no children for them in the forseeable predictable future (though I keep praying for their miracle). But she has come, somehow to a deeper connection with God and to a way to find happiness and joy in life - although there are still struggles and sorrows.

    I don't really undertand this and I hope to experience a grace like it. I still fight and question and pity myself for the struggles I face that seem to deconstruct me, and wish I didn't have those struggles. I know I am missing out on joy that can be present in the face of sorrow ... guess I'll keep praying and hoping.

    I am so glad your friends have you to advise them re: their situation. How tragic and heartbreaking. And regarding the social scene, while I'm not saying you should cut ties with these friends ... I do think you'd be in a better place to cultivate other friendships as well. Isn't it crazy how IF touches so many things in our lives.

    Keeping you in my prayers ...


  2. I think you have EVERY right to protect yourself (from unsupportive friends, uncouth bloggers, etc.). Self-preservation is not selfishness.

  3. I am absolutely guilty of being a (self-proclaimed) masochist. Ever since I was a teenager - I would listen to "I Can't Make you Love Me" after my worst college bf breakup, read old break-up letters in HS, and now, I find myself seeking out the (as someone else so awesomely put it, no names mentioned) "shitting rainbows" blog posts, just to make myself feel bad. I am, at times, certifiable.

    BUT that being said, I tend to engage in the masochistic behavior in the comfort of my own home. Where I can, at the same time, have a good ol' ugly cry. Sometimes you just need one. Or two or eight.
    When I spend time with friends' babies, I choose to do it, and choose to do it on a day when I can handle it, and actually do enjoy it. (Now I'm lucky that I have not had a "sneak attack" here hold and love my baby moment in a long time if ever... that is different.) But when I plan to see a friend's baby, it's the real deal. And it's not cuz I love babies. It's cuz I love the friend and THAT baby. (Some babies, and "friends," I don't love. Therefore, I don't make plans for them ;) )

    I do have a perfect match-made-in-heaven for you, though. A friend for your circle who will, and I promise, NEVER talk about her daughter, and I doubt you'd ever even see her kid... my SIL!! Hahahaha! If you want, I can set it up. You may still want to shoot yourself afterwards, though.

  4. Given that I am dealing with shit (you said it, so I can too, right?) from my college "friends" right now, this really reasonated with me:

    "Who do I know who has kids and prioritizes my friendship over those kids? Seriously now. (Not that they should; the kids need them more. But it means my friendship is now marginalized, and that in itself is a betrayal, if I need that person.) What about finding time for me that's not interrupted by kids? Won't happen. What about getting through an hour in my company without bringing up the kids? Don't think it's ever happened. Will never happen. Regardless of what kind of week I've had."

    And I do feel like a bad person for deciding to let their friendship(s) go quietly because I feel abandoned by them.


  5. Hubby and I were talking about the fact that we needed new friends recently. Not dropping the ones we have, but picking up some new ones that don't have kids. Problem is, the only safe new friends are singles. Unless they're sexually active, and then they're not safe either (and they most undoubtedly will get pregnant despite being on bcp as soon as they become a close friend of ours). There's a new guy at my husband's work who moved from the west coast, came to the house briefly the other day, and seemed pretty cool. His wife hasn't made it out here yet, tying up loose ends with their house, so we haven't met her but are hoping she's equally as cool. In the back of my mind though I start thinking, "well, if they've been married x years, just got a new job, buying a house, then I can expect them to pop out a kid oh, maybe 2011 or 2012". Or maybe she's already knocked up and they haven't told people yet. Who knows. There is no safe place to turn for friends, unless you know they are child-free by choice.
    Even infertile couples aren't safe, as you pointed out. Hopefully, most of us will either be pregnant or adopting soon and moving on. There is no friendship that you can guarantee won't hurt you ever. Sad, but true. I agree that maybe your husband's friends aren't the ones to put yourself out there for though. If you're going to have good friends who are fertile or parents by adoption, you should at least have a deeper connection to them than just some people your husband went to school with.
    And about FF - I think to me it's obvious that you ovulated last month and FF would probably have agreed if you had a couple more temps pre-ov for it to go on :).

  6. Thank you for clarifying your friends' situation. How heartbreaking. I will keep praying for them.

    Re: social circle. I think you are completely justified in seeking out new friends - diversifying :). I would argue that the having kids bit isn't a betrayal and the feedings aren't either - but the conversation situation would be and you may be right that it's inevititble (sp?) - and I definitely did the "protecting your heart" thing. It left us with few intact friendships with folks with children - which is difficult now, but was necessary then.
    I was lucky enough to stumble onto a group of significantly older women, whose children are grown or who are single. (They're "safe". Yes, they talk about their kids, but teenagers are a different emotional story, and I think it was a year before one of them asked about our plans.)

    Thank you for the reminder to try to be less of a donkey's rear and yey for potentially productive discussions. I am glad that the cycle is looking better.

  7. I understand this. I am so sad to understand this.

    We literally had 3 couples that had no children. In Sept two of them announced pregnancies. The last couple will start trying soon because she will be done with her education in April and they want to have children shortly thereafter. In fact, they may have already thrown their cares to the wind and stopped "avoiding" (a laughable concept in my mind). And actually, I have the impending feeling she may already be pregnant. This feeling just came this morning. I'm scared.

    Despite the fact that I am on the waiting list for adoption (which makes our situations different, I understand) the wait will be long. It just will. I have uprooted any expectation in my mind of being a parent within the next year. So I decided I needed new friends too and the single people are where I'm trying to find them. I've found one, thank God, and she's definitely waiting for marriage; hopefully for my sake she doesn't get married anytime soon... Infertility makes me egocentric.

    As far as what Father said about vulnerability, etc. He's right on paper. However, do these friends "love" you? Do they show you even the most miniscule expressions of sensitivity? Probably not. You can still "love" them (ie. will the good for them), but you need not be vulnerable, in my opinion. It's just irresponsible to be vulnerable to people who you know won't give a damn about your feelings. And you'll suffer even more if you do. How many of us have walked away from a conversation where we bore even the slightest bit of our true struggle either crying or enraged because of someone else's stupid comment? All of us.

  8. I think I mostly knew what you meant - I just paraphrased badly.

    I agree with you - I think there IS always some degree of pain for infertiles and the childless-not-by-choice (even if they were once fertile, like I was...and then I wasn't...but that's a whole other story) when they're around children. I can't fathom that it's any other way around it.

    As for me, there is joy with the pain when I'm with kids that I love - sometimes in equal amounts, sometimes not. Often I just shove off the pain and deal with it later because for me the pain is worth the joy - but there's no denying that there IS pain.

    All the time, really.

    Anyway, I'm sorry if I paraphrased poorly - and misunderstood the bit about never wanting to be around children. Sometimes I'm a simpleton.

  9. I think I mostly knew what you meant - I just paraphrased badly.

    I agree with you - I think there IS always some degree of pain for infertiles and the childless-not-by-choice (even if they were once fertile, like I was...and then I wasn't...but that's a whole other story) when they're around children.

    As for me, there is joy with the pain when I'm with kids that I love - sometimes in equal amounts. Often I just shove off the pain and deal with it later because for me the pain is worth the joy - but there's no denying that there IS pain.

    All the time, really.

    Anyway, I'm sorry if I paraphrased poorly - and misunderstood the bit about never wanting to be around children. Sometimes I'm a simpleton.

  10. Wow, there's so much here. But my initial reaction is to say self-protection is a good idea. I'm hugely in favour of it. I didn't particularly like other people's kids before I started ttc. The fact that I still don't now, when I live a childless life, is just a reflection of that.

    Unfortunately though the kids I want to be around (my nieces and nephews) do bring pain. Unlike other parents, I'm not "qualified" to comment on anything. I have to bite my tongue. That's what makes it painful, as much as taking pleasure in the tiny little people who do love me, and in some ways who reassure me that I would have been a good mother after all.