Insurance Impasse

It was about a joke and a half away from being a Saturday Night Live skit.

The three hours I spent on the phone with government officials, attempting to sort out the knotted ball of bureaucratic red tape that is health care reform.  The fact that the state didn't add my husband's income to my application, despite my reporting it with copies of his paycheck.  The friendly confusion of the three separate employees who agreed that my income should allow me a tax break, but who couldn't seem to understand why the system wasn't permitting it.  The frustration of trying to find an insurance carrier that my OB-GYN and PCP both accept (there isn't one within my price range, BTW).  

Yes, it was what those old-time folks would have called a "laugh riot".

And this all happened after the bugs were "worked out" of the computer system.

This isn't about President Obama.  Everything, both negative and positive, that can possibly be said about health care reform has already been said.  And tweeted, and blogged about, and liked and shared on Facebook.  My tiny voice, screeching about my awful experience, will be lost in the cacophony of compliments and complaints that are already swirling around the Affordable Health Care Act.  But I still feel like I need to speak my mind.

I don't consider myself a particularly political person.  I identify as a conservative individual, generally, but not always and not necessarily a Republican.  Something my pastor always says rings so true in times of bipartisan mudslinging: "Our answer lies in no party, but in Christ alone."  In fact, when "Obamacare" was initially announced, I was cautiously hopeful.  My mother was one of those people who kept "slipping through the cracks" of the healthcare system.  Unemployed due to medical conditions, she could never prove that she was physically disabled to the satisfaction of Medical Assistance (hiatal hernias do not often cause physical impairment, but hers had been so severe it did not respond to traditional OTC treatments and ultimately killed her). She applied for aid with Catholic Charities and other organizations but never "qualified" for any type of help.  Without insurance, she refused to go to a doctor, and never got the treatment she needed.  And then she died.

I'm not blaming the system for her death, not entirely.  Much of the fault, of course, was hers.  She could have gone to the ER and insurance be damned.  What were the bill collectors going to get from her?  She literally had nothing to her name.  No house, no car, no checking or savings accounts.  Nothing.  She had thought her daughters would be saddled with any bills she had when she died, so she refused to incur any. Sadly, she didn't know that legally, in the state of Kentucky, her bills would have died with her.  Her survivors (me, actually, since mine was the signature on all the documents) owed nothing to the hospital in which she passed away, despite their many hours of life-saving attempts and round-the-clock care.

I don't rightly know every effort my mom made to get financial help.  Maybe she just told me she tried, and never really did.  Maybe she didn't want to bother because she thought she would be denied anyway.  Maybe the process intimidated or frustrated her.  I will never know.  But it upsets me to think that she wasn't alone in her quest for coverage.  I wanted to think that an act of the government could have helped people in her position.  But how do you change the direction of a great big, lumbering, bloated and self-important beast that's been plodding along for dozens of years?  Can you reason with it?  Can you destroy it?  How do you even begin? 

One of the things I learned during my time as a mid-level manager with various companies is that, if you're going to point out a problem to your superiors, it helps to have a potential solution in mind to offer them.

This time, I don't.  I have no idea how to fix this.  I know that bi-partisan politics is making our country's health insurance woes much worse, because along with every "helpful" suggestion that is offered comes a heaping helping of stiff-necked pride.  No one's ever proud when compromise is reached and the country benefits.  Just when one side "wins".  

Guess what, y'all?  We're all losing here.  I am generally proud to be an American, but this whole debacle has us looking like a scrappy junkyard dog endlessly chasing its tail.

I feel like we - all of us in this country - are being required to eat at a certain restaurant, but the menu doesn't take into account people with allergies, or diabetes, or religious restrictions.  And the cook is on vacation.  And the waitstaff was just hired and isn't fully trained yet.  And there are rats in the kitchen.  And cockroaches.

I think you get the idea.

I just wish I knew how to make things better.  For all of us.

Multiple Choice

Today, my dad reminded me that I can choose fear or faith.

Not both.

The interesting thing about that statement is that it presents us with a concept that we don't often imagine.  Choosing something that is usually considered an emotion.  But faith, like love and forgiveness, is a decision we make.  A lifestyle.  Not a default reaction.  Not a feeling.

Which do you choose?

This week, I got some less-than-great news at my OB-GYN appointments.  It wasn't bad news; just disappointing.  Although the baby is developing just fine, he's measuring quite small.  I know that technicians can only imperfectly guess about the weight of a fetus, he's currently (barely) tipping the scales at just under 5 pounds, plus he's breech right now.  That, however, isn't my biggest concern - especially since I am only five feet tall and his daddy's on the short side of average, too.  My real challenge is my blood pressure.

Lots of you know that I was diagnosed with hypertension about four years ago.  I saw my PCP and a cardiologist, both of whom determined that my weight at the time, while high, would not have caused the numbers they were seeing.  After exams and bloodwork, the frustrating conclusion was that it was simply "unexplained".  Genetic.  Ugh.  Last year, I worked very hard to change my eating habits, exercise frequently, and reduce my sodium intake.  I was doing about 50 minutes of cardio four or five times a week, and I ended up crossing something off my bucket list that I didn't even know was on it - I ran in Pittsburgh's Great Race!

All in all, I lost a total of about 19 pounds from my curvy but small frame.  I wanted to lose another 10 more, but then (wonderfully!) got pregnant and put that goal aside.  Still, though, my blood pressure was high.  I was deeply frustrated.  I'd followed all the "rules" to reduce it naturally, but my efforts were met with the same ugly numbers every time: 140/100.

I was given medication during my pregnancy to maintain my blood pressure, which has helped thus far - especially given my 4-month stretch of doctor-ordered abstaining from all exercise.  After I was cleared for exercise, I found that I was so short of breath that I could hardly move without my inhaler anyway.  So it was basically a no-go, and I'm not thrilled to say that I've gained around 40 pounds so far.  Everyone insists it's "all belly", but I'm not so sure.  Still, that's another story for another time.

My doctor has been both optimistic and realistic with me.  He had celebrated every little victory with us along the way - hearing the heartbeat, feeling the kicks, passing the glucose test.  Yet he has also gently reminded me that, due to my chronic hypertension, I'd have to be closely monitored the further along I was.  No truer were those words than today, when my non-stress test results apparently disappointed the other doctor in the practice, who ordered two more in the next seven days.  The baby's heart rate is normal, but I guess he's not moving as much as they would like.  

Now, if you compare him to other babies, you're right.  However, since the beginning, he's been on the "lazy" side, if you will.  Unlike many babies, he doesn't keep me up at night kicking.  He actually sleeps at night and seems to wake up around 10 in the morning.  He has some flurries of activity around then, right before lunch, around 2:30, then after dinner.  That's sort of his schedule.  It has been since I felt him kick on Valentine's Day this year!  

My pregnancy hasn't matched up with "the norm" either, though!  The subchorionic hematoma I suffered happens only 10% of the time.  I'm eight months along after three unexplained, consecutive miscarriages.   I didn't break out in acne like most other moms-to-be.  I didn't have much morning sickness at all, and I never threw up once (except for a brief bout with the stomach flu).  So I'm different, I guess it stands to reason that baby might be, too.

Still, we're moving forward with tests for the dreaded but as-yet-unspoken diagnosis of pre-eclampsia hanging over my head.  I'll hear soon enough, as I'm pretty sure the technician at Quest drew enough blood today to keep Nosterafu fed for a week.  If I do have it, my already uber-flexible birth plan will just have to morph yet again.  They will likely have to deliver the baby early for his sake and mine, since pre-E, as it's called, can truly be deadly.  Even if I don't have it, they might want me on bed rest since the baby isn't doing much to impress them right now.   

So I'm left at a crossroads.  As I'm finishing packing up my hospital bags and determining what cute little onesie my baby will prefer to come home in, I can choose faith or fear.

It seems like fear is the more reasonable option.  It makes more sense, after all.  I should be afraid, shouldn't I?  Of an emergency c-section, of my baby winding up in the NICU, of having to leave him behind for testing once I am discharged. 

But fear won't get me through the next month.  It will cripple me, then trip me, then laugh when I can't get back up.  It will stifle my breathing and disturb my sleep and whisper "what if" in my ears a thousand times a day.  It will invite me to play out the worst possible scenarios in my head over and over until I'm convinced they are the unalterable future.

Faith, however, will give me breath each morning - just enough for the day.  Faith asks no more than to allow tomorrow to be tomorrow, and let today be today.  Faith reminds me that God has not abandoned me, that my friends are with me.  That my husband was by my side for all three of our losses, and he is here now.  Faith instructs me to do what I can and put everything else in the hands of my Maker.  And, with a shy smile, faith gently admonishes me that worry adds no years to my life and no strength to my journey.

I choose faith.  It's not a feeling.  It's a decision.  Even if I feel fear, I don't have to choose it.  

I won't let it speak for me.  Or to me.

This Is 17 Weeks

Today’s topic: pregnancy woes - and wows.

Other than the terrifying bleeding brought on by my subchorionic hematoma, I’ve had a fairly uneventful pregnancy.  Nausea during the first trimester was pretty minimal.  I never threw up, although there were a few smells that made me a little sick.  Shockingly, coffee was (and still is) one of them!  Ultimately this was probably a blessing since I’ve had to be pretty careful with my caffeine intake, but I never, ever thought there would be a day when a co-worker’s  innocent cup of Folger’s sitting next to me would cause me to heave and cast evil glances her way.  “Don’t worry,” my friend Jaime insists, “That java-love will return to you eventually.”  She would know – she’s working on kid number #4 right now; she’s due a few months before me and she’s pretty much a professional pregnant lady.

Like many women, I got the dreaded “baby bloat” within a few weeks of learning we were expecting.  Of course, that’s too soon for maternity clothes, so I turned to my heroic standby gear: tunics and leggings.  It doesn’t look like I’ll have to alter my personal style too much during the next five months, as many of my dresses and tops are either stretchy or flowy anyway.  I’ll sort of end up retro-gypsy-chic these next several weeks, I guess.  Whatevs.  I keep poking at my belly, waiting for it to fully “bloom”.  I’ve always had some extra weight on my tummy, so I’m anxious for it to turn into a “real” bump” that doesn’t go away when I suck it in.  (Chubby-ish mamas - you feel me, I know this.)

This past Monday was possibly my first experience of heartburn in my life.  I was on the late shift at work and enjoyed a great morning, writing and relaxing.  When I sat down in the office, there was suddenly a dull achy pain under my sternum.  I wondered if it was related to my asthma – I hadn’t had chest pain in years, but with a tiny human squirming around inside me, who knew what could change?  Then I thought – ah, probably gas.  (I won’t be discussing that topic in too much detail; I’m still mostly a lady and there’s no reason to expound on that.)  Finally I asked one of my co-workers what heartburn felt like and we figured out that’s what it was.  Thanks, little baby.  Ironically, it would have been my mom’s 59^th birthday, and she told me that she had heartburn every single day she was pregnant with me.  Hmm…maybe a loving little reminder from her on that very special day?

I’m grateful that I have a lot of friends who have had kids already.  Not just because I know I’ll be getting loads of awesome hand-me-downs (thereby saving us tons of money), but also because they’ve gone through this.  They’ve given birth, they’ve been in recovery.  They’ve tried to breastfeed; some have failed, others succeeded.  Very few books I’ve encountered have been totally honest about this process.  Or, they are so blatantly honest that they’re vulgar and they make you wish you had never even had sex to begin with.  My friends have been a perfect balance between the two. What to Expect When You’re Expecting has been my go-to book but, actually, it doesn’t really impress me.  Especially in the area of my hematoma.  Medically, it happens to about 10% of women, but it’s never once mentioned in the 300+ pages.  Really?  I also decided to go cold turkey when it came to the internet and chat rooms this time around.  I never got a lot of reassurance from them; instead, reading about all the things that could possibly go wrong made me sicker.  Plus, let’s be honest.  I’ve lost three pregnancies.  I don’t want to play the comparison game, but there’s not a whole lot worse than that, relatively speaking.  I’m not trivializing stillbirth or any other type of terrible trauma – not by any means.  I’m just saying that, at 8 weeks, the worst thing I could imagine was losing the baby, and it happened.  So, yeah, I don’t do chatrooms.  I do have an app on my phone that tells me what fruit my baby is, and gives generic pregnancy tips, which is cool.  But that’s about it. 

We’re a sweet potato this week, if you were wondering.

Now, as for the gender – yes, we do plan to find out.  We’re scheduled for our anatomical sonogram in just over three weeks.  We have happily settled on a name for a little girl, but are still toying with boys’ names.  I will be honest, I’m 99% sure it’s a girl.  Motherly intuition tells me this, plus I admit I peeked at all the goofy old wives’ tales, and, surprisingly, every one of them has turned up “girl”.  Most of my friends think it’s a girl.  (A few, including Ross, are holding out for a boy.)  Of course we would be thrilled with a baby of either sex.  Regardless of gender, this child will be raised by lots of proud geeks.  Our first purchase for the child will very likely be the bib that reads, ‘These fools put my cape on backwards.’

Can’t wait.