Flex Spending Revelations

A few months ago, our Communications Director, J., said that she had something small to tell us. "About the size of a lime," she said. She revealed that she was pregnant, and my heart fell. It's not that I wasn't happy for her--I really was. It was just that I felt like every woman my age or just a little younger in the office was a mother. We recently had a spate of pregnancies in my office--one development person, two staff attorneys, our deputy director, and an administrative assistant. The joke was that the pregnancy was contagious in our office. I would always think in my own mind when I heard this: "Except I'm immune." So when J told us, I felt like I was the only one who was struggling with this.

Well, I'm not. And this is how I know.

Our office offers Flexible Spending Accounts (FSAs) that allow you to set aside a certain amount of money for health-related expenses pre-tax; meaning, you put money into an account through paycheck deductions that reduce the amount of taxable income you earn. It's a great tool if you manage it well. One year, I had about $1200 left in my account and I convinced my dermatologist to give me a prescribed chemical peel ($1000) and stocked up on band-aids and cough syrup. Last year, I missed the deadline so I didn't have one. You can use the money for co-pays, expenses not covered by insurance, eyeglasses and supplies, counseling, and over-the-counter medical supplies.

This year, I wanted to estimate correctly, so D and I counted up all of the chiropractor visits we expected to make, the crown he wanted to replace, the prescriptions that we thought we might need at $20 a pop, and . . . then I remembered that if I got pregnant, there would be a load of expenses. How to estimate THAT?

Well, we're planning to find a midwife and see if we can do a home birth, so I knew the expenses would not be easy to determine with a web search. I decided to confide in J, who has also chosen to deal with a midwife for prenatal care and to have a home birth, and ask her for an estimate of what she was paying. J and I aren't close, but I like her and I trust her. When I went to her office to talk to her, she immediately confided in me that it had taken years for her to conceive. She did the whole fertility treatment dealeo . . . innumerable visits, shots, medication, etc. She said it took quite a toll. She said this pregnancy was a long time in the making. She spoke of how hard it was to see all of her friends get pregnant one after another. She talked about the expectations that people had of her, assuming that she was waiting until her career was more established before choosing to have a baby. She told me that she didn't talk to anyone about this while she was trying.

I was grateful to hear all of this. I was grateful that I wasn't alone among the people I knew. I wonder how many other women I know are struggling and not talking. I think it would be helpful to talk about it. I have to admit that on some level, it feels like a giant female failure to not be able to get pregnant easily.

At any rate, we did get to discuss expenses, and while I'll write about this in another blog entry, I should say that the estimate for a home birth (including prenatal care from the midwife) is about $7,500. A lot less than I thought it would be, and it seems that Cigna might cover 80% of that. They better, cause I think that's probably a lot less than what it would cost in a hospital.

Drugs

A few weeks ago, I started getting a series of calls from Cigna saying that I had ordered some drugs and where did I want them delivered. I'm like: "what drugs? I didn't order drugs! Put me on your 'do not call' list." Then I find out that the drugs my doctor prescribed were supposed to be delivered to me, and Cigna was calling me to confirm delivery address and get my credit card number for the copay. Fed Ex next day delivery to my office the next day allowed me to start this course of treatment this month. Thank you Fed Ex. Except one more problem: they didn't send the pre-filled syringe of hCG that they were going to--the shot that releases the eggs. Apparently it's a controlled substance and they only fill it upon a written scrip. So I call the doctor back, and they say that Cigna is notorious for this kind of screw-up; of course they mailed the scrip. Cigna just always loses them. So I ask to speak to the doctor to see if I can figure out whether the rest of the drugs (the clomid, the ones pictured here) will boost my chances enough so that I can risk maybe not doing the shot this month, or whether the hCG shot works in tandem with the rest of the drugs such that I should fork over the $90 out-of-pocket expense. The doctor's assistant got back on the phone after about 15 minutes and said that the doctor just happened to have an extra shot in the office and they'd administer it for free. Bingo. So, off to the doctor I go again, shot in the butt, and I'm off. Doctor advised us to make love that night, and then again Friday morning. (The math is just crazy: shot releases the eggs in 40 hours; sperm lives for 72 hours; egg lives for 12-24 hours unfertilized; sperm takes 30 minutes to reach an existing egg...) Unfortunately, I was so exhausted from work and running around all week that I just could not muster the energy for seduction. Thankfully, D knew what he had to do, and while it didn't work out that night, he dutifully performed the next morning. We were prescribed one more try on Friday morning (several hours after the eggs are supposed to have been released), and I've already arranged to go into work a little late, so we're cool. Pregnancy test on December 1, and if we're not successful, we try again in December. It's super exhausting to deal with all of this, but I feel like we're taking the right steps.

Offbeat Mama

I just read an amazing blogpost on Offbeat Mama. The founder of Offbeat Bride, the book and accompanying social networking site that helped me keep my sanity during our year-long wedding planning process, started Offbeat Mama, right around the time of our wedding last May. I check back every now and then to see if she creates a feature, like the Waiting Room on the Offbeat Bride Tribe website, for women who are trying to get pregnant. I don't think she did (yet), but I did find this post, by Ariel, the founder herself. She introduces her own story of problems conceiving with a video by a woman who poses a series of "what if" questions...questions that have been swirling around in my mind about infertility for the past year. I have been searching for something to read, something that I could identify with, around all of this for the longest time. My husband is so certain that it will all work out in the end, he insists on speaking in terms of "whens" as opposed to "ifs." Ariel's story was poignant, and scary . . . I hope I only have to go partway through the course of action she had to take in order to become pregnant. But I've already gone farther than I thought I would in order to conceive.

Two parts of Ariel's post particularly resonated with me:

the weight of the trying and failing got heavier and heavier. After a year of trying to conceive, it's not so much fun. It's depressing. It starts to mess with your head. I started feeling like a core part of my body had become an untrustworthy stranger. A breech of trust with your own body is emotionally brutal.

And this one, which describes so many things in my life about which I've harbored fear and loathing:

IVF was this terrible awful procedure that I'd invested a lot of fear in. It just didn't fit with my identity — who's heard of offbeat infertility? Offbeat IVF? Pshaw. It was the expensive invasive terror that desperate people indulged themselves in. It was like gambling: this thing that you keep tossing money at hoping that this time you'll win but ultimately the house always wins and you always lose. Of course you lose. It makes you crazy, and worst part? It doesn't even work most of the time.

. . .

What I want to say is this: I was wrong. I invested years of my life living in fear, seeing something (in this case Western fertility treatments and especially IVF) as the awful boogey man in my hippie closet, the terrible admission of defeat that would forever turn me into a person I hated myself for being. Ultimately, I was wrong. This makes me wonder ... what other massive fears of mine are completely unfounded? What other things that I see as the worst WORST case scenario could actually lead me to a place of profound happiness? What other paralyzing grief and fear could I release?

WTF.

So I had the HSG test on July 28, where they shot radiation goo through my innards to see what was goin on all up in there (everything was all clear!) and I leaked for like a day and a half. I did ovulation tests every day since then (19 days now) and no freakin' LH surge. WTF. They say that this HSG test has a chance of resulting a smoother journey for the sperm, so there are some women who get pregnant after the HSG test. Well, we didn't take advantage of this extra boost this month, unfortunately. We should be doing it like bunnies right now, but instead, I waited for a positive LH test, and heat, exhaustion, and other diversions kept us from the job at hand and the LH surge never came. I totally don't understand it, and I am getting very frustrated with how little I know about reproduction, and how little it actually out there in a coherent, public way about conception. July-August was a bust. My doctor says not to worry, try again next month, but I feel really stupid. Not only did I waste a huge amount of money on these ovulation tests which were all negative, we also kept getting ready for the right moment to have sex, which never came. I am going to have to try to plan for less stress this coming month and just get myself ready for sex 24-7.

Finally, a surge!

Well, already our zero dollar baby is not a zero dollar baby. I've spent well over $50 on ovulation tests so far! ($15.99, $23.99, and $22.99 respectively)

Yesterday, I almost became hysterical when the test, again, failed to show an LH surge--the sign that you are about to ovulate. I let out one of my banshee yells (which David hates), spent about an hour googling things like "Does no LH surge mean that I'm entering early menopause?", and then finally made up my mind to be calmer and go through with the plan--have sex anyway and just cross my fingers. I didn't get to the stage where I attempted to make peace with the fact that we might not be able to have children--I'll save that effort for a more desperate time.

This morning we tried again, and after breakfast I walked up to the drugstore to purchase yet another kit. This time, I bought the one with 20 test strips (I've been testing 2-3 times a day).

I waited a few hours, tried not to drink too much water, and when I finally tested at around 2 pm, voila! The test line was darker than the control line, which means that there is now an LH surge. I think this morning's attempt was perfect timing. Now we just have to keep at it for another day or so and hope for the best.

Airplane headphones

So we were at the airport walking to the gate and passed by one of those little stores that sell travel electronics. I stopped in saying I wanted to get a new set of headphones before we got on the plane because I'd forgotten to pack mine from home. D says to me: "Zero Dollar Baby, Dear." I replied: "Yes, honey, Zero Dollar Baby, not Zero Dollar Mommy."