Saturday, January 29, 2011

Health Care Reform? I Have a Better Idea

So with the whole "Obamacare" health care reform bill, a lot of us are finding that our insurance premiums have gone up. Ours went up so much that even after a raise, after insurance premiums our take-home is even less than it was last year. Of course, the government and media tools that "estimated" how our costs would change with the new plan told us that we should expect no difference.

As soon as the bill came out, insurance companies, as they are legally required to do, revealed the expectation of large financial losses. Not as some sort of retaliation, but because the effect of the bill on their finances made the losses inevitable, and the government insists on such expected losses being made public.

So our costs have gone up, our care has stayed the same, and the whole bill has done jack for me except make me wonder where the heck all of the deficit money that's paying for this BS is going. So I have a better plan that won't cost us anything, and requires the insurance companies to change the way they do things.

The government should, instead of becoming an actor in anyone's personal medical care (beyond what they already do with medicare/aid), make a simple legislation:

"Group plans" as provided through employers and "individual plans" that unemployed or self-employed people purchase can no longer provide differing levels of coverage or differing costs simply because of whether they are part of a "group" or "individual" plan. Employers may offer a monetary health care allowance (tax free) to employees as a benefit, but may not determine which insurance company or medical providers the allowance is applied to. Every US citizen will be able to choose any level of coverage from any insurance company, and will be treated as if they are on a group plan, and not discriminated against based on health, age, or on any other criteria currently protected from discrimination by the federal government for other situations, such as employment or financial services.


So that's my plan. I have a big problem with how where you work affects your costs of care, or even what care you can get. At IL, we had United Health Care. It sucked. We only had the option of using the one plan the company chose. The company was small, and couldn't afford much, so the plan was bad, and our premiums fluctuated a lot based on the health issues of people we worked with. They had no coverage for the only Rx heartburn medication that worked for me, and only covered $10 of my visits to a therapist.

On the other hand, with Tim working for GT, we had several options for plans, and knowing my needs and our plans to reproduce, we got the one with the most coverage. It's expensive, but it covers IVF to some extent, makes hospital stays cheap (which is good because our family had a total of four months in the hospital), and gives us a good knowledge of what our annual costs will be no matter what happens. None of this "80/20 split for that test your doctor says you need but we don't want to pay for" BS. It's lovely. And if we wanted less coverage, we could get that too, for cheaper.

Honestly, I think everyone should have access to whatever health care they want. The scaling up of prices works, because it's based on how much care you expect to receive, and how much protection you want from paying for big things (or small things!). I believe in government systems that subsidize or pay for plans for those who can't afford them. I also believe that completely "free" care will crowd our medical establishments and overburden doctors. Some monetary disincentive to go to a doctor's office needs to be there so that people reach a reasonable level of concern before they go asking for antibiotics or a hospital bed. Finding a balance between allowing the poor the care they need and keeping those with "free" care from overcrowding hospitals and clinics is not what I'm getting at here.

I'm just saying that if everyone had access to the same insurance options, no matter who they worked for or if they worked at all, we'd have a lot more equality of care than we do now. It's not completely solving the problem of those without care, but it will reduce costs for those not on "group" plans, and it helps people who work for small companies, don't get benefits, or do freelance work. And talk about a boon to the currently unemployed! Again, just a little government legislation, and the rest just means changing the way you buy medical insurance to more like the way you buy car insurance - you shop for the best deal on the coverage you want!

***A note on the "group plan": Insurance companies make "groups" to even out medical costs between people who use a lot of care and people who only use a little. They're all paying the same premiums, and the money for the care theoretically comes from that pool, but certain people draw on it more than others. That's how insurance companies decide on premiums for certain groups - how much the group as a whole is actually using, plus the part they skim off the top to make money. Individual plans cost more and cover less because the insurance company expects the insured to cover all of their own costs through premiums (plus pay the insurer's cut), which kinda' defeats the purpose. So I say insurance companies should make all of their customers one "group" and charge the same premium to everyone. And none of that BS about waiting for coverage even if you had prior insurance.

And with no restrictions as far as who you can buy your plan from, if your company is charging too much, you just go somewhere else. That'll keep prices competitive, rather than your insurance company having you by the balls if you feel like you're paying too much, as is the case when you can only get a group plan from your employer's chosen company.

Tuesday, January 25, 2011

Assault Allowance

I think there should be an assault allowance. For special times when people say things that are insensitive or very hurtful. Like that scene in Parenthood when the dad of the autistic boy punches a man in the face in the middle of the grocery store checkout because the man called his son a "retard." That guy totally deserved it, because even if the child didn't have developmental difficulties, it's still never okay to say something like that about a child. If anyone ever said something like that about any of my kids, I would have trouble stopping at one punch in the face.

And I'd probably get away with it, because I'm a woman.

But so often I am too paralyzed by shock or pain to respond the way I find myself hours later wishing I had done. And it's one thing when strangers say something inappropriate made even worse by the personal history they don't know, but I keep finding myself in situations with people who, with two seconds worth of thought, could save me salt in the wound by keeping their mouths shut. Before they say things like, "Are you sure it's not twins? Did you want twins?"

So instead of saying, "Yes, I wanted twins. You remember the last time I was pregnant and did everything possible to try and keep my twin sons alive, but I only came home with a singleton? Yeah, that was when I wanted them. Now wanting twins would mean wanting to put two more babies in that same risky situation—a thought I find both terrifying and incredibly irresponsible." And instead of saying, in an inevitably sob-infused and probably incoherent voice, "What the hell is wrong with you? Why would you ask me that?" I come back with some polite answer and a smile, like "Nope, just one! Twins, ha!" and I sit there with that asinine laugh hanging in the air as if there were never anything a person could say to me that would make me sad.

And I kind of hate myself for that. Not for the not being bitter all the time, but when did I suddenly learn not to slap back? Self control is not my strongest personality trait; I'm not sure it makes the official list of my personality traits. I suppose it's a nod to my parents that they raised me not to slap people, even when they deserve it.

I wish I would at least give back that verbal slap people sometimes so deserve. At least to say, "Really? Do you really think that's an okay thing to say right now?" Gentle reminders as to why the question or comment is inappropriate might help too. Maybe people would stop asking infertile people if they're pregnant, or inviting someone on a diet to join them for dessert (okay, I'm really bad at that one), or telling someone whose dog just died all about their new puppy. I can tell you I appreciate it when people open my eyes to how to not bring them extra pain—I'm an accidental A-hole all the time. But I can't bring myself to do the same for others.

I guess I can ask you all now not to flippantly mention twins to me. If you are reading this, you probably know better than that anyway. Don't ask my if my son is doing things that your younger child is already doing months early. If you are not a pediatrician or therapist, you don't need to know if he is crawling yet or not, and I'm a bit sensitive about it. Cut your bragging teeth on someone else. I suppose those are my unique areas of sensitivity at the moment.

But if you're needing more help, here's a few more tips: Don't ever complain about being a single-digit pants size; you are only allowed to be happy. Never ask someone if they are pregnant or when they are due, even if they look huge, unless they mention being pregnant. Never comment on a woman's size, regardless of pregnancy status, unless you have something positive to say ("You look fantastic!") that isn't followed by a qualifier (". . . for a fat old broad!"). Don't complain about money, health, etc. in public places or to people you don't know to be in a better situation than you are in. Someone else always has it worse. Always. If you're feeling really poopy about yourself, maybe go find that person.

And as for me? I have it pretty good in the end. Wanting to slap people or not. I'm just hoping that a little slap now and then will keep all of us from offending that person we forget about that has it worse than we do.

Friday, January 21, 2011

TTC and NSAIDs

You know those non-steroidal anti-inflammatory drugs? They include Advil, Motrin, Aleve, Naproxen, etc., and you should probably skip them and just stick to Tylenol when you're trying to make a baby. My friend April's post sums it up pretty well, so I'll just quote it in full here:

Sorry, I don’t have any pretty pictures for this post, it’s a little break from my regular programming.

My public service announcement is about the little-known issue of NSAIDS and infertility. NSAIDS when taken on a regular basis can inhibit ovulation BUT it’s more than that. All tests will appear normal. Hormones will still fluctuate, rise, fall etc as they are supposed to. Fertility charts will look good and indicate ovulation. The follicle, however is unruptured. Meaning no little egg actually goes anywhere. And that’s not all (insert tv infomercial voice)…if it DOES go somewhere by chance, the NSAIDS may even contribute to failed implantation.

How many women know this? How many doctors know this? I can tell you that in the past 6 months, I have listed my medications on 5 different doctor’s information sheets(rheumetologist, OBGYN, GI doc, sleep doc and Naturopath) and told all FIVE that I was trying to conceive and NONE commented on the 2X daily prescription NSAID I was taking. Most likely none of them knew anything about it. Which is why I will be sending them copies of these studies.

OXFORD JOURNALS – RHEUMATOLOGY
CLin-Alert – Google Books
1996!!! Rheumatology Journal
MORE REFERENCES

I’m thinking this is a seious enough side effect that ALL NSAIDs should have this warning ON THE LABEL (which was NOT on anything I received with the prescription):

(found on Drugs.com)

Impaired female fertility:

The use of Diclofenac Potassium tablets may impair female fertility and is not recommended in women attempting to conceive. In women who may have difficulties conceiving or who are undergoing investigation of infertility, withdrawal of Diclofenac Potassium tablets should be considered.


So, now here’s my personal case study. After 4 weeks off of Diclofenac, I have positive pregnancy tests. Plural. Lots of them. Because of my previous failed implantations (aka chemical pregnancy) I tested for 8 days straight. No disappearing lines. I am definitely pregnant. ONE CYCLE OFF OF THIS STUFF. Coincidence? No way.

So, I am putting this out there for anyone who may not know: If you are trying to conceive…lay off the NSAIDs. Including creams, patches, pills, syrups. Tylenol and Excedrin Tension Headache have no NSAIDs. And in the spirit of helping people through social media….share! Pass it on!

Thursday, January 13, 2011

Confession of a Preemie Mom

Being premature isn't a disability. It's a disadvantage, for sure, but it's not something that will stop my son from doing the same things as other kids. In these early stages, it just takes longer. I hope.

In fact, when I talked to Finley's neurosurgeon about his brain hemorrhage (a not-uncommon occurrence among micro-preemies), she said that he may get straight A's in school, go to college, and play football. Or he may never walk or talk. And we can't know until he gets there. Or doesn't.

The pediatrician said at our last visit that he doesn't think Finley will face any big developmental delays or disabilities, and that we can just keep an eye out for some of the subtler stuff when he's in school. But really, what does this guy know?

Most of the time it is easy to live with knowing that my son might be different from other kids. I already know that he struggles with things like pushing himself up with his arms and crawling, where other kids do these things with little effort and no tears. And I know that he's not expected to be caught up to his chronological age, and those early months he spent with tubes all in and out of him he was struggling to survive when babies his age were practicing tummy time and learning to grab toys. He has worked so hard to catch up in the ways he has caught up.

But sometimes it's not okay. Like today, when we went to a playdate with a little girl Finley's age. She was so fat next to him, and strong. She could move wherever she wanted and sit and crawl and roll without a struggle at all, and without help. And the moment she got up on her fours and moved across the carpet, I had to hold back tears.

It's not anybody's fault, and I can believe these problems will be rectified with time, but it still isn't easy to watch your child drop sobbing in exhaustion from trying something that you see a baby his age doing effortlessly the next day. I wouldn't trade my baby for any super-coordinated, strong, genius baby. But I would trade my left and right legs for things to be easier for him.

Wednesday, January 5, 2011

I Remember

I didn't spend as much time on the infertility road as most people do. It still felt like forever. And honestly, I don't think it's a road anyone gets off of, children or not. And it's different, having a son. Being pregnant somehow unexpectedly. Because I remember vividly.

I remember the day one of my closest friends had a baby, and I got to cuddle that sweet, tiny newborn on the day of her birth. The next weekend I made Tim take me to the PetSmart and we adopted my cat, Coco.

I remember hiding from Relief Society for months so I wouldn't have to hear the inevitable pregnancy announcements. And sometimes avoiding church altogether so I wouldn't have to see so many "fat'n'happies" and hear them complain about how huge they are, because, you know, the have a frickin' BABY in them.

I remember pretty much having a breakdown the morning I got an email announcing a co-worker's pregnancy (as much as I love her), spending half an hour crying in my bathroom, and calling in sick from work. And then seriously spending the day in bed.

I remember hating women with babies, and learning not to hate the women with babies I wanted to stay friends with. I remember one of those friends letting me sit and hold her new son and stroke his fuzzy baby head for an hour without saying a word of complaint. I remember tears of gratitude for that.

And I remember feeling alone among all of the mothers, and despising the way whenever I tried to join a conversation about babies from what little I could gather from the internet and personal experience, they looked at me like I was an idiot, or pointed out how I was wrong and wouldn't know anything anyway, or just ignored me and my useless non-mom comments.

More recently I remember feeling sad as my belly grew big enough to show, because I knew others would see it and mourn not having one of their own, like I so often did. And I hated that my presence could bring someone so much pain, and how intimately I knew that pain.

And now, there is a baby. He's here. I am a mom in every sense. I was a mom the moment I began to carry those babies. I was a mom when each of them was born. I was a mom when I took home my survivor. And I am a mom again, to someone totally new.

But I'm still as infertile as ever, some days. It's hard to stop being mad at women who get pregnant in a snap and have all the babies they want, when I, at 22, was told that I had only a few (sorta) fertile years left. Even when that means being mad at me for how easy I have it with my living son and living fetus. I remember being angry and sad and jealous and confused and depressed.

I remember how unfair it felt, and from this side, I'd say it feels just as unfair. But that's easy for me to say now, isn't it? Some days I hate myself for how easy unfairness is when it's in my favor.

Tuesday, January 4, 2011

And They Say Motherhood is Thankless!

I let Finley play independently for a few minutes so I could get in a little internet time-wasting, and when I joined him on the floor he looked up at me and clapped. Just for being mom, I got a personal round of applause.

I keep hearing motherhood is a thankless job. Obviously not! Well, not until your kids are old enough to realize how totally uncool you are. I get a cheery smile with almost every diaper change, and sleepy gazes during feedings. Finley is getting old enough to copy my nods and dance when he sees Daddy dancing. He giggles at my dumb jokes and squeals when I pretend to eat his feet when we're out shopping.

I've never had a job where I was so appreciated. Maybe if my bosses hadn't had teeth their smiles would have been more meaningful. But seriously, this baby costs money and produces poop and is still the best job I've ever had. Getting pregnant = my best ever career choice.

Monday, January 3, 2011

Since November

I technically have a pregnancy start date of October 3. That being the day I would have had a period had I even had one before the extremely unlikely occurrence of unassisted conception. If you want to know how unlikely, let's do the math:

Out of 42 eggs (that's 3.5 years' worth for a regularly ovulating woman), I have one baby, and 4 surviving embryos. Let's say those embies statistically equal about 1 live baby. So that's 2 out of 42 eggs. And I have been pretty fantastically anovulatory (I don't spring eggs every month like you fertile hens). A doctor once estimated that I might ovulate 2-3 times in a year. That sounds about right. So that makes it like 20 years worth of eggs for me to make 2 babies, right? And then I was breastfeeding the baby at least 5 times a day, which adds up to maybe 90% protection from pregnancy. And then I didn't have a period. Who knows what that means. Oh, and my uterus got cut open and wrung out this year. That doesn't help anything.

I'm no statistician, but I'm thinking that if I stayed under the same conditions I wouldn't conceive another baby for like 500 years.

So when I was late and nauseated in late October I figured I'd send Tim out for my favorite hobby since I stopped gluing glitter to crap: pee sticks! Safe thing, since they always come out negative, right? But then on the first flipping Wednesday in November, my FMU came out differently. That second blue line didn't take its time to show up at all. There was no squinting or guessing or hoping. There was just my fate on a little strip of paper soaked with my urine.

So here are all of the would-have-been blog posts you've missed out on since then:

"Wait, What?"
"WHO IS EFFING WITH MY LIFE?!"
"Wait, I'm 4 weeks pregnant instead of 8? GIMME THOSE DANG NAUSEA PILLS NOW!"
"Everything is Miserable" - Come to think of it, I did write this one.
"I Have a Headache"
And
"OMG I am Going to Die"

But here's the summary: I apparently get morning sickness VERY early. Missed periods make getting a due date difficult. The moodiness goes away right before the misery sets in. It is okay to have two babies under two years old. This both is and is not going to be like having twins (my OB said it would be just like having twins, and I wanted to slap him). Being pregnant this time hurts more.

I am craving egg drop soup and salt like nobody's business. My nemesis during my first labor, Dr. Jones, wants me to get a cerclage, but the doctor I trust thinks I can go without. I am getting a third opinion from someone I neither particularly love nor hate. It's stressing me out a bit. I am planning a VBAC. I'm getting all kinds of concerned care to prevent preterm labor.

So that's what I haven't told you since November.