Frustration

All I want to do is focus on getting strong and healthy for cycle #2. But I have been spending hours dealing with the insurance and bills from the first cycle. Despite the fact that we properly obtained pre-approval, the insurance company has denied all but about $600 of the $10,000 charges!!! They paid $600 to my doctor (of the $2500) he billed, with no explanation for the denial of the rest, then proceeded to deny all of the charges from the hospital and the anesthesiologist. At different times I've received different explanations: 1) once the doctor was paid, no one else could be paid for the same services (ridiculous, don't doctors and hospitals bill separately all the time???); and 2) the name of the facility of the preauthorization was the clinic not the hospital (even though the clinic is just a subsidiary of the hospital). Happily, the hospital appears to have absorbed its costs and is taking responsibility for the mix-up. But not so much the doctor's office, and I still haven't heard from the anesthesiologist.

I have a call in to the business office at the doctor's office to see what explanation they received for the denial, and I have an email in to the insurance company about filing an appeal.

And in the back of my mind I keep worrying about how to make sure this doesn't happen next time.

Adoption update

That was fast! We got a call this morning from the adoption agency. Good news: "The review committee loved y'all!" Bad news: they won't let us proceed until we've stopped IVF. Not every agency does this, but my sense is the very best ones do. One point the woman made was that it's very hard on birth mothers, who are already in crisis, when parents they've selected discover they are pregnant. And that makes sense to me. I wish I could pursue multiple channels at once because of my need to have a plan B and C ... and Z. But we're in their system, they like us, and we just have to let them know we're when we're ready.

Next steps

Well, I am certainly glad the last week is over! After a rough couple of days, I woke up Sunday feeling all better physically. A long night's sleep in a luxurious hotel bed without a snoring partner (love ya' babe!) after delicious alone time with my brother and his GF, my BFF, and my parents was just what I needed. Not surprisingly, perhaps, Sunday was a more difficult day emotionally. At brunch with my parents, brother, and his A, the hostess presented a rose to my mother. I LOST it and ran out of the restaurant in tears. It was the first time I had really cried about this miscarriage. It was probably good for me; my practical stoicism is not always healthy. After a hug from my dad and some whining about the unfairness of it all, a mimosa perked me right back up. And I was fine the rest of the day, focusing on my mom and grandmother.

And at Mother's Day dinner, all the women got roses. And it's appropriate, I think, because don't we all "mother" somebody or somebodies?

Then we were on to the next hurdle, having some early skin cancer removed from my back. The procedure went smoothly, though the incision now alternates between stabbing pain, burning, and itching. It's fun ... or not. The stitches will be in for three weeks, which seems interminable. But it's for the greater good, and I'm relieved to have the spot gone.

Today was my post-op visit with Dr. R. Mostly he wanted to talk about politics and the Dead Sea Scrolls. I was like, "Dude! You have other patients waiting. This is not a social call!" But we get good treatment because he likes us, so I can't complain. As I expected, he isn't particularly concerned that we've found only bum embryos so far. He said, "The class of July 2010 is different from the class of March 2010" and made an analogy to my law school students. And it's true, some years are better than others. He also reminded us that only 30 percent of fertilized eggs ever turn into babies and we just need to keep trying to find our 30 percent. He did send me for some bloodwork for autoimmune issues and an updated check on my thyroid. But none of us think that's the issue. We're just dealing with old eggs and bunk sperm and we have to be patient.

He said to call when my cycle starts again. The nurse was, again, horrified, "Aren't you supposed to wait SEVERAL months? He's bending the rules!" Aaah, yes, but it'll be fine. After all, there's a rumor that women are more fertile in the months right after a miscarriage. So shouldn't we capitalize on it? Given how quickly I'm recovering, though, I anticipate that we'll wait two months, starting the birth control in early July and doing retrieval and transfer in early August, just before school starts.

In the meantime, we bit the bullet and filled out our first adoption application, for a very old and apparently well-respected agency in Fort Worth. They have a domestic infants of color program, as well as an Ethiopia program, which are our top choices. Even if we are ultimately successful with IVF in the next six months, we are very interested in pursuing adoption for child #2, so we figured it couldn't hurt to get the ball rolling. But I think we should probably fence the swimming pool if we have any hope of passing a home study. The to-do list grows longer.

Nagging worries

Physically, recovery has been a lot harder than I anticipated. I'm still having a fair amount of pain and other discomfort. Although I haven't done anything silly like go to the gym, or even walk the dog, I did have to get right back to writing my final when I probably should have taken a day or two to sleep this experience off. I don't think there's anything wrong: no fever or other signs of infection. It'll just take time. I'm heading to San Diego for Mother's Day. I know the travel will be physically draining, but I think running away to beautiful SoCal will be worth it for the soul.

As committed as I am to moving forward and doing another cycle, I have begun to have a nagging worry. In two years, we've had two pregnancies, both of which have ended in miscarriage. There doesn't appear to be anything wrong with my uterus, lining, or hormone levels; in fact, my body was showing no signs of letting this pregnancy go before the d&c, even though the fetus had passed at least a week before. Almost certainly, both miscarriages have been the result of bad embryos with chromosomal problems. I worry that maybe we can't make a healthy embryo. I worry that even if we get twice as many eggs next time, they'll still be bad and we'll have to go through this again.

I'll probably talk to the doctor about this next week. I suspect he'll tell me it's just been bad luck and we have a good chance of getting a good one next time. But I'm still curious about what he'll say.

I found a cool new blog today, with an awesome video for infertility awareness week. (Warning: if you have epilepsy or are otherwise prone to seizures, don't watch it. The choppy editing is a bit discombobulating.) The video is cool, and I love that the author named her blog after two of the barren matriarchs.

HT: Mo

Recovering

The d&c went smoothly today, with no complications. Dr. R was his usual charming and sweet self. He and B had a long talk about some book about the Dead Sea Scrolls that he is reading. They just adore each other! I had some pretty significant pain and nausea after I came out of anesthesia, but some pain meds and a nap had me feeling much better. I still feel a little bit like I got hit by a truck, but it's manageable. I've got Rx pain meds if I need them, as well as 5 days of antibiotics to ward off any future complications.

We'll go back in to the office next week to make sure everything is healing properly and to map out our next cycle.

I'm still waiting for the video from Brittany, though happily the state AG agreed not to enforce the laws while litigation is pending. After having been through the d&c today, I have some more thoughts about choice and abortion that I'll share when I have more energy!

Confirmed

We were able to confirm today that there was no heartbeat. And the fetus had again not grown at all. Although sad, it was also a relief to know that we can move on and get ready to try again. Unless I miscarry naturally before then, we have scheduled the d&c for Tuesday afternoon.

Our friend Brittany got lots of footage, so hopefully she'll be able to use it. I'm excited to see how it turns out!

If you're the praying kind, please send up good thoughts for our sweet friends M&J who also got bad fertility news today.

Making lemonade

After a pretty good weekend, where I felt okay with where we are, accepting of the impending miscarriage, and eager to try again, this week has been hard. Usually school is a good distraction, but I feel sluggish and tired. I'm sure part of it is normal end-of-semester exhaustion, but I also know that it's harder and harder to act like everything's normal.

But I'm determined to ensure that something good comes out of this ordeal. The state this week enacted very strict abortion laws, over the governor's vetoes. One of the laws requires women to have ultrasounds and listen to detailed descriptions of the fetus prior to having an abortion. Although emotionally painful, this may not sound particularly invasive until you realize that a first-trimester ultrasound is done internally, with a large wand. I have these done regularly to check for follicle development (and more recently, to check on the fetus). And fortunately, I have never had much discomfort. But many women find these ultrasounds to be painful and even violating. The basis of the governor's veto of the law is that there is no exception for victims of rape or incest. I just can't imagine a woman who has already been sexually assaulted being forced to have an internal ultrasound. I don't expect to change anyone's mind about abortion, but I wish my fellow citizens knew what this law actually requires. So a local politician friend of mine is accompanying us to our appointment tomorrow to videotape various aspects of the procedure (preserving as much privacy and dignity as possible, of course). She had expressed a desire on Facebook to make a video about the law, and I just happened to have this appointment already scheduled. I emailed my awesome doctor yesterday to make sure this plan was okay, and he's totally on board. I don't yet know how the video will turn out; but if I can use this experience to educate people, then I will feel like I made the best of a bad situation.

I'm turning comment moderation on. I have had an influx of readers from yesterday's posting; and I assume most of them are conservative Christians who will object to this project. If I get unpleasant responses, you don't need to read them!