Friday, July 25, 2008
A brief (very brief, for reasons that will become apparent) rundown:
1. Oral argument on Tuesday went really well. I felt crappy about it right afterward, as I had a very time answering the judges' questions at the beginning. But as soon as I conceded defeat on the facts, and started focusing on the "big" picture, urging them not to make a broad ruling over such crappy facts, they stopped peppering me with cranky questions and started listening and nodding. And they've already ruled--I won the "good" loss, if that makes any sense. Lost on the facts, but no big, long-ranging rule for the future. So they did exactly what I asked them to.
2. NY presentation went horribly. I had hit the end of the road, maxed out on my adrenaline reserves, and was prepared only for things to go smoothly. When my c0-presented hogged most of our time, leaving me with only 10 minutes to cover 30 minutes worth of material, I was just too damn tired to think quickly enough on my feet to cut down my presentation properly. So instead I raced through it--I doubt I made any sense, and I'm suspecting I made a bit of a fool out of myself. Making matters worse, my co-presenter was this skinny, makeup-less, hot NY lesbian chick who was witty and interesting, and the crowd loved her. I felt like an overly madeup hick with a negative cool factor.
3. NY was otherwise kind of fun, but I was too tired to really enjoy it. I ended up picking kind of a crappy restaurant by the theatre, and had ridiculously overpriced tiny salmon in a place that was too loud for us to talk. Annoying. The show was pretty damn cool, though. We saw Spring Awakening, which is a rock musical about the coming-of-age sexuality of teens, set in the 1890's. The ending kind of sucked, but overall the show was really great. Kick-ass design, especially. Mad props to both the set and lighting designers. Wow.
4. Came home to discover my motion for more time to file my brief is going to be DENIED, even though plaintiff consented to it. So I'm basically fucked. It's due Wednesday, and it's just so nowhere near being written. Looks like another weekend of working at home. Haven't had a weekend off since JUNE now.
5. Oh, and my poor kitties have fleas. No idea how that happened, as they don't go outside. I've never had it happen before. Maybe McNulty picked them up in all his time at the vet in June? Anyway, poor little Val is horribly infested. She's old, and has worse resistance, I guess. So on top of my exhaustion I have had to traumatize my little kitty with nasty chemical sprays, lotions, and a flea collar. And we've been washing almost everything in the house. I guess I'm pretty traumatized as well. (Jason's comment: Just think, if all goes well, in 10 years we'll be dealing with head lice.)
6. I feel horribly inadequate. I think it must be hormonal, because I was feeling all right about myself last month, before I started this cycle. But I just feel self-conscious and fat and humiliated and incapable of coping with the harsh realities of life. I'm trying to keep telling myself it's not real, it's just the drugs. (I thought that was only something you had to repeat to yourself when tripping, but I guess this isn't all that different.)
So now I have to write my brief. I'll be back in touch on the flip side of all this.
Friday, July 18, 2008
In my years as a trial lawyer in a perpetually underfunded and understaffed government agency, I’ve had some experience with this. I call it “fuck-it nirvana”: that blessed zone where your concern about your workload just melts away. Your shoulders sink slowly down in relief, your brow uncreases, you find yourself humming or smiling as you work, joking with co-workers. While chaos swirls about, you are filled with a sense of calm and wellbeing.
Fuck-it nirvana never comes easy. Fuck-it nirvana cannot be achieved without considerable suffering. And you can’t force yourself to get there; you have to reach (and pass) your breaking point. The stress will be driving you up the wall––stomach churning, jaw clenched, head pounding, and let’s not even talk about the intestines––and you beg for relief, fantasize about fuck-it nirvana. “Why isn’t it here?,” you ask yourself desperately, shrugging your shoulders to try to shake it off, breathing deeply to try to find your inner calm. But it is all for naught. Fuck-it nirvana arrives when it wants to, and nothing will bring that blessed relief prematurely. You may think you’re at the breaking point, that surely it is just around the corner. But no, fuck-it nirvana says you’re not ready yet.
This morning I achieved fuck-it nirvana. And Holy Christ, did it feel good.
This week has sucked. Sucked hard. I mean, let’s face it, it’s sucked ass. Things on my appeal are not going well; things on my brief are going worse. And there was a day in the middle of this week where there was a good chance the court was going to continue my oral argument, almost a stay of execution, but then they didn’t do it. And that glimmer of hope made it so much worse.
In the meantime, on Saturday I went to my podiatrist’s office to pick up my $500 custom-orthotic sandals, which were finally done, only to discover that the lab ordered the wrong color. I wanted black—the lab seemed to think I wanted “metal.” Puh-lease. They were hideous. And well, for $500, I needed black.
Luckily, the footbed is removable, so we pulled out the orthotic insert and had the lab rush the right color sandals to the office. So on Wednesday night J picked them up for me. That night I got my first look at the finished product, and I was seriously underimpressed. Certainly not $500 impressed. Not even $50 impressed. For starters, the orthotic footbed wasn’t cut to match the length and shape of the shoe—about ¼ inch of gap was at the end. Just completely shoddy workmanship. And to make matters worse, the lab had made the top of the orthotic black, but had not covered the edges of the orthotic, which showed layers of brightly colored foam. And because there was a this crappy-workmanship gap, you could see this edge. UGLY. And the orthotic made the sandals too tight and uncomfortable, even though I was assured I should order the sandal that fit me right and the lab would take care of the rest. They gave me blisters.
Oh, but we haven’t gotten to the worst part. The orthotics don’t work. It’s almost as if the lab didn’t even bother to shape them to my feet (of which they have fancy 3-D digital scans). While my orthotics for my sneakers push hard on my arches (thus keeping me from pronating), these don’t even touch my arches. I could tell within a few hours (and that mostly seated at my desk) that these were not giving me the support they are supposed to. Essentially, I just paid $500 for a little bit of extra arch support.
I knew this was going to happen Wednesday night as soon as I tried them on. Anyone want to guess what happened Wednesday night? I guess it’s not so hard to figure out: total meltdown. I was fine through dinner. Fine through TV-time. But when I started doing my stretching I got this insane rage. And then I tried to go to take that rage to bed with me and it was all over. I took a tranq and cried for about 20 minutes. I was just at the end of my fucking rope with everything. And so, 5 days into IVF Cycle 4, I had my first serious breakdown. (Which isn’t even a record, sadly enough.)
Thursday I became resigned to the fact that I was going to have to return the sandals and demand my fucking money back. (And maybe even switch doctors, as each doc apparently only has a contract with a single lab, and this lab sucks.*)
And then on Thursday I worked my ass off some more.
Last night I took a tranquilizer as a prophylactic (not THAT kind of prophylactic, of course, because I’ve now learned that my years of devoted birth control efforts were all a fucking joke). Which seemed to work.
And today I hit the jackpot: fuck-it nirvana. I’ve got a moot court on Monday. Oral argument on a brutally hard issue on Tuesday. Trip to NY and presentation in front of hundreds on Wednesday.** Complex bitchy brief due a week later.
What-the-fuck-ever. I just don’t care anymore. And not caring is the best feeling in the world.
All I can ask for now is that my fuck-it nirvana holds through the rest of the storm. Because you never know when fuck-it nirvana will abandon you and leave you out in the cold, blinking back tears and hanging on by a thread.
* I can’t be the only woman out there who needs orthotics and sandals at the same time! Now that I’ve tried throwing money at the problem, and even THAT failed, I am feeling so helpless. I’ve been trying to get out of my ugly-ass sneakers for well over two years. Does anyone know how I’m supposed to resolve this???
* Every time I tell someone at work that I’m really stressed about not being prepared for this presentation, they tell me “oh, you’ll be great, you’re always so good at that sort of thing.” I’m ready to rip the face of the next person who says this. You want to know why I’m good at oral arguments and presentations and trainings and such? Because I prepare, asshole! I’m anal and like to be prepared. That is why I generally seem prepared. Sheesh.
Sunday, July 13, 2008
At this point, I’m of two minds about the issue. On the one hand, I feel vindicated in my vehement reaction. I have now heard apologies from Favorite Nurse (the head nurse), my RE, and the office manager. Clearly, I wasn’t totally nuts to freak out over a nurse’s failure to return my call (a call seeking instructions on my cycle). All agreed that this was a huge trust issue, and I was right to be upset.
On the other hand, poor New Nurse has had plenty of grief now for this. (And she really is nice, though occasionally misguided.) I know that Favorite Nurse talked to her about it, and the RE probably talked to her, this after I talked to her about it. And I was kind of … well … forceful (I didn’t yell or anything, but I did insist that it was unacceptable not to return a call for instructions, even if she had no new information). So now I feel kind of bad. I mentioned this to the office manager––told her that I probably scared New Nurse myself, and that I didn’t want to get her in trouble. I was assured that she was not in trouble, but that there was another patient this week that had had the same problem, and that New Nurse was very good and they wanted to make sure everything worked out for her.
At this point, due in large part to my comfort with the office manger, I decided to tell her what New Nurse had said to me the first time I met her. I made sure she understood that I wasn’t lodging a complaint, but I wanted her to know what had happened in case anyone else had a problem with this.
For those of you just joining us, New Nurse joined my RE’s office in May (coming straight from being a maternity nurse). The first time I met her was my first day starting an FET cycle after a failed IVF cycle, and I was feeling really low. In an effort to comfort me, while she was drawing my blood, she said, “Did you ever think that maybe this is just God’s way of giving you a break? Kids are a lot of work, you know, and maybe He just thinks you need some rest.”
If I hadn’t been so fucking depressed that day, I would have read her the riot act. Rest from what? Rest from not having kids? Not only was it offensive as hell, it made no sense! Not believing in God, this remark actually didn’t do too much damage. But I know that a lot of infertile women worry that it might be God’s will, that maybe they are being punished. Even being reminded of that thought––or hearing someone else voice it out loud––can be very hurtful. Frankly, I was appalled. But I didn’t want to come out of my shell and set her straight that day. I just didn’t have the energy.
So I told the office manager about this. She was shocked. Of course, her first comment (and I could not agree more) was that it was inappropriate to bring God up in any kind of professional medical setting. But she also agreed with my adamant position: never suggest to an infertile woman that God has anything to do with it!
This leads me to the point of my post today. I told the office manager that, a few months ago, I had come across an incredible post that listed all of the things not to say to an infertile couple, and that if I could find it, I would send it to her. She seemed really excited about this, and said she would make such a list required reading for her entire staff.
I have tried in vain to find the blog, but I didn’t save it and I don’t know where it is. I’ve found a lot of articles (and blogs quoting articles) that list such things, but each one has different items on the list. While I might use those to compile a master list, I thought it would be better if we made our own list.
Comments, please? I want to include stuff that you would tell your friends and family, but I’m also looking for stuff specific to the medical profession. This is our chance to EDUCATE those fertile assholes, and maybe save another poor woman from sitting there with a needle in her arm hearing how she’s lost three years of her life because God is simply taking pity on her.
Saturday, July 12, 2008
This cycle I’m going to try a novel approach: stress. “But IVF is already so stressful,” you say, puzzled at my naiveté. And you would be right. But what I find the most stressful about IVF (aside from screwups by the nurses, or the RE, or, most often, myself) is the waiting and wondering and depression and exhaustion and roller-coaster hormones. So maybe, just maybe, the ticket to a successful cycle (in the emotional sense, not the “it’s a boy!” sense) is to just be so freakin’ busy that you can’t even come up for air to think about it.
It looks like I’m about to find out, because I am totally screwed at work. I’ve been spinning my wheels on a brief for several weeks, unable to even make a dent in it because I can’t figure out how the statutes and the case law fit together and what the hell I’m going to argue (it involves administrative exhaustion in the area of labor law). Then last week I got assigned an emergency motion in another appeal, and somehow, after a marathon briefing period, the case was scheduled for oral argument in just over a week! (Which never happens, and probably is due to the fact that I did a really good job on the motion—serves me right.) So now I’ve got oral argument to prep for, a brief due at the end of the month, and I’m taking a 2-day trip to NY in the middle of all of this. Oh, and I’m teaching a class in NY and have to prepare for that, too. AARGGHH!
Panicked, I filed a motion for more time for my brief. But this court is very stingy about extensions, so I could only ask for two weeks. And then I looked at the calendar and started kicking myself, because the second of those two weeks is going to be all wrapped up in my retrieval and transfer and bed rest and such. So I am truly and completely hosed. I’m pretty sure I’m bringing home work every weekend for the next month.
So okay, this is stressing me out pretty badly. But a thought has occurred to me: what if this is exactly what I need? Now if this were my first IVF cycle, and I didn’t know what to expect, it might be way too scary to be on deadlines like this at work. But I pretty much know how my body is going to react to it all. And while it will suck to be this busy, at least the stress will keep me awake and alert at work, rather than face-down on my keyboard (here’s hoping, at least). And as long as the work is going well (I do really like my job, you know), maybe this will be exactly the kind of distraction I need.
Of course, if things don’t go well, I’ll be a weeping hormonal puddle on the floor of my office, begging the gods for mercy. I’m kind of hoping to avoid that scene.
Or I could just end up buried in socks. (Don’t laugh! It could happen to you.)
Thursday, July 10, 2008
I went in for my sono and bloodwork on Tuesday morning. The way it is supposed to work, the way it always works, is that the nurses call that same afternoon with instructions. So on Tuesday afternoon, the new nurse (the one who, BTW, told me in May that maybe my infertility was God’s way of giving me a chance to rest before having a child) called me and told me that the nurses would be talking to my RE the next day (yesterday) about my plan for this cycle, and they would call me then. Fine, no biggie. I think, though I’m not sure, that in my last cycle I didn’t start the pill until cycle day 5. As yesterday was cycle day 4, I wasn’t worried.
The phones at my RE’s office get shut off at 4:00, which is a constant source of frustration for me. So at 3:30 I called in to let them know I still hadn’t heard from anyone about what I was supposed to be doing, and that I still needed a BCP prescription. The receptionist said the nurses were doing call-backs and would call me back later. They’re usually really good about this, so I was fine with that. At the time, I even though it would be fine if I talked to them today, because I’m pretty sure my first pill would be tonight.
But when 7:00 rolled around last night, and I still hadn’t gotten a call, I suddenly freaked out. Not so much about my cycle, because I think it’s still okay, but because I need to be able to trust that they WILL call me when they say they will. I was so goddamn mad, and so freaked out. If I can’t know that they’ll make their calls after 4:00, I’m going to feel like I always have to call them before that time. Even though usually my calls with instructions usually come after 4:00. (This is because, as I’ve surmised over the years, they prioritize their call-backs. Beta tests rightfully come first, around 2:00 when the tests come in. Then they start doing the IVF calls, which can take from 2:00 to 5:00. Then they do the other calls, which are a bit less time-sensitive.)
So I got home and e-mailed my RE. I didn’t bitch her out or anything, but I was really upset and said so, and mentioned that if I can’t trust the nurses to call, I’m going to need an after-hours phone number where I can actually get through. I’m telling you, I was totally freaking out. My heart was racing, and I was filled with bitter rage. J leaned over my shoulder as I was re-reading my e-mail and said softly, “Remember, don’t e-mail mad.” Hitting “send,” I said, “too late.”
Then I got all stressed out about the e-mail that I sent, but you can’t call those back. I finally ended up taking a xanax last night to settle down.
Today I’m feeling sheepish about the whole thing. Part of me thinks that it’s just that they know I’m a veteran, so they assume that I can be told what’s going on at the last minute and not freak out. They’re wrong. I do know what’s going on—I’d lay money on me starting the BCP tonight. But that doesn’t mean I don’t freak out. I’m kind of the Freak Out Queen. (Not as fun as being Kick-Ass Lawyer Chick, I assure you.)
So now I wait. I’ll call after 10:00, when they’re done with morning monitoring, and see what the hell happened.
Tuesday, July 8, 2008
"Twenty-One Thousand, Seven Hundred Fifty and 00/100 Dollars." You try writing that out on the not-so-long line of a check.
That’s right, today Operation Shared Risk began. Coincidentally, Operation Second Mortgage kicked in at almost exactly the same time.
I’m finding myself surprisingly calm about laying out this kind of money. Probably because it’s too much to wrap my head around. It’s like Monopoly money—not really real, you know?
Then I went to work and finished writing an emergency motion that has had my nose to the grindstone for the past week.
And then, at 3:00 in the afternoon, I had a complete meltdown. You know what it was that set me off? Shoes. You heard me. Shoes.
Here’s the deal. I have a crap-ass lower back that’s been hurting since I was 20, and hurting like hell since I was 30 or so. I’m a pretty active girl, and like to think of myself as even more active than I really am, so having back problems at such a young age has been incredibly frustrating. I am convinced that nothing makes you feel prematurely old quite so much as having a bad back.
Except, of course, having a bad back in ugly shoes. In the past few years, through various visits to chiropractors and podiatrists, I have figured out that a lot of my back problems can be traced to my feet. I pronate, and I have to wear orthotics––all the time––to keep my back from freaking out. Mind you, this is not a complete cure. I still have pain, but it’s much, much, much better.
So for the past 3 years I’ve pretty much been stuck in sneakers or low-heeled boots while I try to figure this out. In the past year, even the boots make my back hurt, so I just wear running shoes all the time. And I mean ALL THE TIME. In my dress pants, in my pretty skirt, in the office, going out with my husband. Unless I’m in court, I’m in sneakers. Last summer I mail-ordered some sandals with orthotics built in, but because I didn’t go through a doctor, the orthotics didn’t work well enough and I can only wear the sandals for an hour or so before my knee and lower back give out. Then it hurts for a week.
Since November, my podiatrist and I have finally worked out the best orthotic for me, and I am ready to lay out cash for sandals. And I mean SERIOUS cash. I spent $500 fucking dollars on a pair of Naot sandals with built-in custom orthotics. That’s right, five hundred dollars. And they’re not even all that cute, because they can’t be high heeled and they have to have a wide enough footbed to support my saggy arches. But they’re a fuckload better than sneakers, and every day I have eagerly awaited their arrival. Seriously, I think about them every day.
The sandals were supposed to be in last week. So this afternoon, when I come up for air after filing my motion, I call the podiatrist to see what the holdup is. She calls the lab, then calls me back and tells me the lab didn’t get the order. Meaning it’s going to take another three weeks to a month for the sandals to come in. It’s already JULY, for fuck sake, and I’m so fucking tired of wearing ugly-ass sneakers with my attempt-to-be-stylish clothes. In the meantime, our office is crawling with 20-year-old interns in their skinny skinny outfits and their high high heels. And I’ll never even wear medium-high heels again. I’m only 36, and I’m already limited to frumpy orthotic-supporting shoes, and now even those aren’t here.
And in two weeks I’m going to New York do to a law training and J and I are going to go to dinner and a show and I am desperate to be able to look pretty, just one night, on a date with my man. We’ll be on foot, and I can’t afford to throw my back out in the middle of IVF. So if they can’t expedite the sandals I’m screwed.
Yup, I started crying. Right there in my office. Over sandals. I wish I were kidding.
That’s me. I can handle IVF. I can handle multiple miscarriages. I can handle a second mortgage, and an emergency motion, and the horrible backlog this motion has caused at work. But apparently I can’t handle ugly shoes.
Tuesday, July 1, 2008
A short version of what's been going on:
1. The Boring: I've been sick. Got a brutal cold at the beginning of June. Gave up on healing on my own and got a doctor to give me antibiotics in mid-June. But my chest is still a mess. Don't know if I've managed to suddenly develop asthma (possible, given that I have had allergies since I was 20), or if the cold is hanging on. Now on another round of antibiotics.
2. The Complicated: I've worked out the contract for the shared risk program at my RE's office. This got complicated because I never told you that it was a problem, so explaining that I've solved it seems odd. But I solved it. Contrary to what my RE originally told me, the contract I was shown had an early-out penalty. Essentially, I thought I was going to sign up for a shared risk program that gave me the option of doing 6 fresh IVF cycles plus any FET cycles, but allowed me to drop out before that was done and get a full refund. After all, I've already done 3 IVF cycles and 1 FET. I can't imagine doing another 6 plus god-only-knows how many FETs. I figure if this hasn't worked after another 3 cycles, it just isn't going to work. But the whole point of laying out $21K is that I get that money back if the IVF doesn't work, so I have some money left to put toward adoption.
But the contract I was shown had this clause that said that, if the patient wants to pull out of the program before completing all fresh cycles and any FET cycles, she loses $5K of her refund for every cycle she's done. So this means after 2 cycles, half of my refund would be lost. And after 4 cycles, I would get next to nothing in a refund. Can you imagine having to do extra IVF cycles, not because you want to or think they would work, but because that was the only way to get your adoption money back? Insane. Medically unconscionable.
I wrote to my RE and told her that the contract didn't match what she had told me, and that if we couldn't work it out I would have to go Giant Factory Fertility Clinic in the area, which I know has the shared risk program I want. But I really don't want to go to GFFC! I love my RE, and I get individualized treatment. And the last thing I want to do is start all over again with a new clinic.
Anyway, (see why I thought this was both boring/too complicated to explain?), she talked to the other doctors in the group, and they all agreed that the early-out penalty was crap. I think the funny part is that patients have been signing this contract for years, but the early-out penalty has "never come up." Apparently, all but one couple has come out of the program with a baby, which is a good sign.
Then I had to deal with the office manager person, who manages the contracts. But the short version of this story is that they basically let me re-write the contract. How cool is that? I felt like Kick-Ass Lawyer Chick, my favorite superhero. And I felt like they were kind of foolish to not run it by a lawyer. Not that I screwed them; I was very careful to protect them. Basically, my RE trusts me and the contract was with her.
See? Not an interesting post at all. But that's what's going on. As soon as my period starts I'm jumping into another cycle. Which will be soon. So right now I'm in the calm before the storm, or the "quiet before the plunge," as Gandalf would put it (I think that's how he put it). Too bad I wasted my entire month off being sick and cranky.
And, I might add, I'm very scared of having to buy my own drugs. No idea how much that's going to cost me. I have a decent supply of Gon.al-f, because we over-ordered (deliberately) while I had insurance. I won't have to buy much more of that to get through one cycle. But the mena.pur and ganarel.ix are going to cost a lot, I think.
For those of you who think I'm spoiled (I have been) because my insurance covered my drugs until now, help me out here. How much should I expect to spend on drugs for one cycle?
All right. Back to work. That's what they pay me for, theoretically.