Money For Nothing

Today I was hoping to write a happy post (we sure need one around here!) about our new insurance that kicks in on November 1. Before Q took his new job, we asked about the infertility coverage and were told that there is $5000 for medical. They refused to tell us if there was also coverage for drugs until we got a member ID#, but we were hopeful there would be some $ there as well.

The new insurance cards arrived today. I immediately got on the phone to see if there is any drug coverage. I have most of the drugs for next cycle, but still need more Follistim and Menopur. Can't get anywhere without those. Since I'm supposed to start those drugs on November 5, I was hoping I'd have some insurance coverage as of November 1 to help finance it.

As you know if you follow this blog, things are never easy around here. Not only is there no drug coverage, there is also NO INFERTILITY COVERAGE. None at all. Not even for blood work and monitoring ultrasounds. This is according to the representative at the insurance company. I, of course, am forbidden from seeing the actual policy myself until November 1. This really throws a wrench in our plans. Can we even go through with this cycle? We can't be throwing thousands more into this!

All the actual IVF is already paid for out-of-pocket, leaving our pockets pretty empty. It's the monitoring, bloodwork, drugs, and consults that are at issue. Our current COBRA policy has maybe $1000 left for infertility but the drug coverage is exhausted. It does cover the monitoring and blood work without a limit. So I looked into whether we could keep that policy beyond when Q becomes eligible for crappy coverage at his new job. Here's the scoop from COBRA's website:

If you start a new job and enroll in their group health plan, you can still qualify for COBRA if your new plan imposes limits, exclusions, or waiting periods on your coverage.

Well, it imposes an exclusion on coverage for my medical condition, infertility. So does that mean I can/should keep the COBRA? Or would I end up in jail or something? After all, infertility isn't a real health problem (please sense the sarcasm here). It's just an inconvenience. It's just a lifestyle issue. I know I often think so when I'm so depressed I wonder how I can go on. Or when I'm sobbing on the floor because of endometriosis pain, which can be put into remission by having a baby.

That "just relax" thing? Still not working out so well. It was all I could do to remain civil while getting the run-around on the phone with the insurance company today. It doesn't help that I already had a visceral hatred toward this particular insurance company. I used to do medical billing and everyone in the office hated this company because they are always finding ways not to pay claims. And now they're going to be my insurance company. [Bad word.] [Very bad word.]

I have two days to sort this out, because then we are off to exotic Illinois and I really don't want to take this worry on vacation with me. I've got plenty of baggage already, including that beastly endometrioma that makes it feel like I'm being stabbed repeatedly in the ovary. Also, it KILLS when I sit still for more than an hour. And we're driving to Illinois.

This blog noir phase is dragging on and on and on, isn't it? The next post will be #100. I promise it will be a happier one!

The Devil Inside

The year that Jeremiah and Miles died, 2007, I felt like I'd been run over by a truck.  For the last few years I feel like I'm getting whacked in the head repeatedly with a 2 x 4.  I get hit by bad news followed by more bad news followed by even more bad news.  It's better than being hit by a truck, but can't I get a break? 

Last Friday was my ultrasound to check the status of my evil twin cysts.  I went into it knowing I probably would not get great news (I've had a lot of pain the last few days - that's a bad sign) but I didn't expect to get hit with horrible news either.  That's what I got though, and I'm still reeling from the blow.

One cyst is resolving and is now 1.5 cm compared to 3.5 cm three weeks ago.  OK that part's good, but wait for it . . . The other diabolical cyst remains 3.5 cm and my doctor thinks it is an endometrioma.  If so, then the only way to get rid of it is surgery, which she strongly discourages.  She recommends proceeding with IVF anyway and she will try to work around it.  The cyst is likely to have a negative effect on follicle production.  I only got 6 mature eggs with my recent cyst-free IVF and just two embryos made it to transfer.  I don't feel very hopeful about my prospects with yet another handicap on top of all my other crippling handicaps.

Regardless of whether I proceed with IVF or not, one thing is certain - I will continue to face a lot of pain in my future.  What can I do but plow ahead as long as there's any hope of obtaining great joy to go along with that pain?  So I'm off The Pill for a few days and then will start back up and head into another long Lupron IVF cycle.  IF this all goes off according to plan [laughs bitterly] then stimulation meds would begin in early November, with retrieval right around my 35th birthday.

Ravings

I know they've all been talking 'bout me
I can hear them whisper
And it makes me think there must be something wrong
With me
Out of all the hours thinking
Somehow
I've lost my mind

Even though we've switched clinics and are cleared to proceed with IVF barring any bad news at Thursday's appointment, I am still upset about last week when The Other Clinic convicted me in absentia of being too nuts to do IVF.

Prior to our last meeting with the counselor, I told hubby that I was afraid of prejudicial treatment simply because we've had so many difficult situations to deal with in a short span of time. Turns out I was right. The counselor views IVF only as an additional stressor and therefore concludes it's "unethical" for me to pursue it. I view IVF as a route to long-term peace and closure, though I recognize it will be additional stress in the short term.

Here's a recap of our meeting: The counselor started by going over the results of our personality tests - the notorious MMPI. I generally see personality tests as little more than an interesting diversion. Call me crazy, but I don't think it's ethical to use them as the sole determinant in making life-altering decisions on behalf of others.

She showed us our MMPI results, which are graphed as in the photo below. Hubby falls entirely in the "normal/subnormal" range. My graph fell completely in the "normal" range except for a higher than average level of "depressed mood".


She then spent a few minutes harping on the fact that both hubby and I answered the following question in the affirmative: "Have you had strange or unusual experiences?" We now know that psychologists see this as a red flag that you are nuts. I contend that most everyone has had some strange or unusual experiences by mid-life and that you are strange and unusual if you have not.

We explained that we are not nuts and have actually had strange and unusual experiences, particularly having to bury two of our children just six months apart. I would certainly hope this counts as unusual. In addition, we noted that we've both had unusual experiences during our adventurous pre-marriage years, including but not limited to:

• swimming with sharks
• traveling full circle around the world
• eating a rat
• engaging in public nudity
• being threatened with a bayonet at the end of a machine gun

Even though it's a great story, I did not mention that I once had an imaginary Chinese fiance because that sounds a little crazy!

Next she pointed out that hubby is very much an extrovert and I am an introvert, but "not TOO much". I definitely got the impression that extrovert = good and sane but introvert = bad and mentally unbalanced. This seems to be a pervasive view in our society and it has always annoyed me. Introverts are good and sane people, too!

Near the end she brought up BMI (body mass index). This apparently is the only area in life where I compare favorably to hubby. My BMI is perfect thank you very much, but hubby has long been afflicted by a gut which is only getting worse thanks to stress-induced overeating. We are both aware that this is not a good situation, but it affects IVF not at all, so why bring it up? I suspect this was an attempt on her part to soften what had been a barrage of criticism about me.

In summary, I feel misjudged, underestimated, slandered, and maligned. Also, I have a much dimmer view of psychology in general. But I am delighted that we flew right over this roadblock at high speed by switching clinics and believe that doing so is ethical, pragmatic, and eminently sane.


I'm not crazy, I'm just a little unwell
I know, right now you can't tell
But stay awhile and maybe then you'll see
A different side of me

Lyrics are from "Unwell" by Matchbox 20.

Analyze This!

Thanks for all the kind comments and emails on last week's post. Today I had intended to finish and email a letter in advance of The Committee's Big Meeting about My Life. Imagine my shock when the counselor called me today to say the verdict is already in and The Committee ruled against me. This surprised me even though I've come to expect that nothing ever goes my way!

Needless to say I am livid, especially since the decision was based entirely on a "personality inventory" graph and not on my actual medical history (which they don't have) or on any of the facts as listed on my last post (which of course they didn't have because of the early meeting).

Ironically, then, I got screwed because of people NOT making me wait. Even though the decision is made, I still engaged in civil debate with the counselor and my only consolation is that she didn't sound so damned sure of herself at the end of the conversation. Hmphf.  I'm not crazy. I've just been in a very bad mood for four years.

But there is good news to be had as well. Hubby and I have learned a valuable lesson from being dealt such a crappy hand in life these last few years . . . Always play your cards close to the vest and have a little something up your sleeve.

As you may recall if you've been following this blog, we switched clinics back in April in an attempt to save money on IVF. So immediately following last week's shocking development, hubby (brilliant strategic planner that he is) suggested simply switching back to our old clinic, referred to here as Clinic One. As of last Friday, we have dates for an IVF cycle! Two can play at this waiting game. Screw you Clinic Two!!

The tentative dates with Clinic One are Lupron starting July 11, Follistim starting July 23, and retrieval around August 2! This happens to work out beautifully with the kids' summer schedule and we could use our current fabulous insurance for the first round of drugs.

There's still the cyst issue to consider, though. I have an ultrasound next week on Thursday, so we'll know more then. A couple of weeks ago the pain got much worse and I was popping pain killers and snuggling up with my massager at bedtime, but it's much better now.

On another happy note, hubby had lot of interviews last week and this week. Next week he has multiple in-person interviews. He may have a job very soon!

What If This Is As Good As It Gets?

What if this is as good as it gets? This is a terrifying thought, especially after yesterday's follow-up visit with the counselor at the fertility clinic. I was expecting to clear this last hurdle and move on to IVF. Instead she says she needs to meet with a committee consisting of doctors and another counselor to decide if it's "ethical" for us to proceed because my levels of depression and worry are above the norm. Duh. Who among us could endure such an abnormal period of pain and loss and still maintain a normal level of cheerfulness and optimism?

My future is in the hands of people who I feel do not have a complete understanding of the situation. I'm so distraught over this! What to do? Perhaps send very clear and concise letter for their consideration?

The counselor waited until the very end of the hour to drop this bomb on us. I had only a few minutes to make my case for proceeding and although I believe it was well-reasoned and well-made, I do not believe she truly listened or understood.

I explained that waiting is the very reason for most of the worry and depression for the past couple of years! It's been 2 1/2 years since we started "trying" again. In that time we've tried for 13 cycles - 6 natural cycles followed by 7 treatment cycles (Clomid, then Follistim). For the other 1 1/2 years I've been on The Pill waiting - waiting for appointments, waiting for tests, and mostly waiting for cysts to resolve. I've spent ten of those waiting months in constant pain because of large cysts, which has led to anxiety about losing my only ovary and with it any chance we may have to complete our family. It could happen anytime - I want to use it before I lose it! I feel I am waiting away both the potential life of a child who could complete our family and my own life. Additionally, all this extremely stressful waiting adversely effects my ability to fully enjoy the life and family I do have.

The months spent trying have been much easier to cope with than the months spent waiting. It is frightening to think that this last chance could be snatched away after I've invested so much blood and treasure in seeing this through to the end. At least when I'm able to try, I am moving closer to the final resolution of this problem. All the stresses involved with infertility treatment are relatively easy to deal with compared to the paralysis of waiting. Win or lose, I need closure so I can put down the burden of infertility and move on!!! Waiting means more aging (I'm 35 in November) and thus more expense ($3K more), vastly more out-of-pocket expense if we don't end up with great insurance, more cysts, more pain, and more possibility of losing my ovary altogether and ending up with a lifetime of regrets. Waiting adds up to more stress, not less!

I need to know I've tried everything I can - whether I end up with a baby or not. Especially since painful endometriosis and cysts mean that I face a lot of pain in my future and very possibly also drastic and destructive treatments. I cannot imagine being able to cope with the pain, depression, sterility, and nasty side effects of more surgeries (hysterectomy? oophorectomy?) or harsh drugs (early menopause with Lupron?) unless I first exhaust all possibilities for completing my family. Pregnancy could give me a baby AND put endometriosis in remission! This is a no-brainer!

Also it would be very helpful if we could at least get the drugs for the first cycle and if necessary aspirate my current small cyst while we still have stellar insurance that covers all of this! Hubby has four job interviews this week (YAY!) but once he gets another job we may end up with no infertility coverage (BOO!).

Their decision about my life will be announced on June 18. I think this will be the most difficult 2 week wait I have ever faced.

The Weight of It All

Currently the rest of the family is at church and I am home alone, having fallen ill last night. This is, I think, a great blessing for certain members of our congregation because if ONE MORE PERSON comes up to me and tells me that our latest misfortune is all part of God's Beautiful Plan and that He Really Loves Us, that person had better run away FAST.



We are now struggling under the strain of five major problems, any one of which is enough to put immense strain on a marriage and family. We of course have them all at once, and each problem added to the load not only adds its own weight, but impacts all the other problems so as to make them even more burdensome and difficult to resolve. All of these problems are interrelated - to solve just one of them would set off a positive chain reaction and bring our family some desperately needed relief. But instead, more keeps getting added on, making it even more difficult to resolve anything.

Hubby is now unemployed. We have no income or insurance. To add insult to serious injury, it remains unclear exactly why he was fired, as he's never committed what any sane professional would consider a firable offense. I won't go into the list of petty offenses he's been accused of, but they're laughable! All we know for sure is that his boss is a jerk of the highest order and although it's good for hubby to be out of that toxic environment, he needs another job to go to! We had high hopes right up until Friday that it wouldn't come to this. It seemed plausible even in the midst of this major recession that hubby could transition into another job within the company - it's gigantic and he has lots of connections. But now that he's been fired and is no longer an insider in the company it's all a lot more complicated.

On top of that, we were just six weeks away from being able to try IVF and there's no way to do it without income and insurance. Has anyone out there been desperate and insane enough to do IVF while on unemployment and COBRA insurance?

Although IVF may not result in a baby, trying it would mean being able to say "We tried everything we could". It would mean being able to put the issue of infertility aside because there's just nowhere else to go with it. And even though I know the pain will never really go away, it would be easier to bear without "what ifs" and regrets that we didn't go all the way. We have only six months left to make it happen before I turn 35, after which it gets a lot more expensive and success rates decline sharply.

The lack of insurance means we likewise cannot deal with my recurrent cysts and pain problems - if we could figure that out I suspect we may get at that darn infertility problem, too! Being in pain so much of the time makes me depressed, irritable, impatient, and unable to think clearly. I simply can't function in a normal way, which makes me feel like a horrible failure as a wife and mother, which in turn makes me even more depressed.

And of course there are other big problems not mentioned here, besides the normal every day stuff. You can just imagine what a fun couple hubby and I are right now. The passion. The romance. Not. We've weathered storms together before, but how can we ever survive and rebuild ourselves when they're this bad, this long, and this frequent? I love hubby and I know he loves me, but we need something good to happen for us right now.

As Expected, Not "Expecting"

Words cannot convey the magnitude of this depressing news, so I won't even try. This was our last chance. *

* Unless something fabulous happens quickly for hubby on the job front, because health insurance = IVF

Beware the Ides of March

There are still four days left of The Wait as I finish up my last cycle on Follistim. I fully expect the results to be negative thanks to the relentless attack endo has been waging for months near my one and only tube and ovary. That's the only place that ever hurts, and boy does it hurt. Also the sperm count was pretty rotten at IUI this time around. A few hours after the IUI, during church, I could swear I felt an egg popping out! So I seduced hubby there in the pew. We ditched the kids at church and I made him take me home immediately to make another (hopefully better) deposit before he had to rush back to church to teach a lesson. I'm a desperate woman.

I've been passing the time researching IVF and hoping to find out before Beta Day whether it's a viable option for us. I needed to know if bad news on Friday means The End For Good or just The End For Now. After much research and many phone calls, I was shocked - shocked, I tell you - to get accepted for the Cost Sharing Program at my clinic despite my losses and one ovary. Things were moving along at breathtaking speed so that we could get started next month! This might really work! Of course it might also be an even more painful and expensive way to fail, but I was cautiously optimistic. Recent years have turned me into a big pessimist and it felt good to have a little optimism, even just the small cautious type. Yes, I dared feel a little bit happy about the possibility of Something Good finally happening. That, of course, is the cue for Something Terrible to occur.

Hubby got fired! At this point, it is unclear exactly why he's fired or exactly when he's cut off as he's expected to work until the replacement is brought on. Since he works for a very large corporation, there's some hope (though not a whole lot in this economy) of finding work within the company by using the many contacts he's been cultivating in anticipation of this very event. But for now we are in survival mode (wait - isn't that where we've been for years already?!) unable to plan on ANYTHING - not income, not insurance, not spring break in exotic Illinois, and certainly not stressful and expensive IVF. No future plans of any kind. Now there's even more stress piled on when we already felt stressed nearly to the breaking point.

On second thought, I don't think I'm a pessimist at all. I'm just a realist - and life really, really sucks right now. Oh, things could be worse. We know that because they've been getting progressively worse for years now. But . . . at least we have some savings and aren't tethered to a house, which we're absolutely giddy about. And we're all reasonably healthy with no deadly diseases - just endo which sometimes makes me wish I were dead. See, I can look on the bright side. I'm a pessimistically optimistic realist.