Costs - in Summary

One of the first things I worried about, when I starting worrying that something wasn't working, was the financial cost of infertility. I just knew that it was going to get expensive, very expensive. 


Keeping track of the bills has become a chore. I have one binder with our medical records, and another to keep track of the finances.  Our insurance specifically excludes coverage for anything related to the diagnosis or treatment of infertility, including complications from any such procedures. Almost everything has been out of pocket expense, but I am still submitting it all to the insurance on the off chance that we might get a reimbursement. In order to submit a claim to insurance I have to get an itemized billing statement, which most often requires a written request. It ends up being a 4-5 step process to get a response from the insurance. It has paid off too - they did end up covering a few thousand dollars worth of bloodwork, and part of the cost of My Lover's first biopsy. 


I've been keeping track of all of this in spreadsheet, but was afraid to sum the total of our out of pocket expense. The Cade Foundation grant application asked for the total that we've spent, so the time came to add it all up. Keep in mind that we have not yet had an actual opportunity to get pregnant.


$14,399.66


Getting price quotes in advance of treatment decisions has been one frustration after another. I haven't found anywhere online that lists out the standard costs for infertility treatments and it seems like the costs can vary pretty significantly. Since I've got it all organized, I am going to post our costs here on my blog - on a page called "costs", so that anyone can see what this all costs. I have all the CPT codes too - and would be happy to share those as well with anyone who wants the details. 


Jeff at Don't Try This at Home is also posting their costs - check out his list too.
Please let me know if there are other infertility cost summaries out there, and I'll add a link. 

Little Bits of Advocacy

My employer's group health insurance plan specifically excludes coverage for anything related to the diagnosis and treatment of infertility. I live in California and work for one of the largest employers in my County. I work for the boss, well, one of the bosses. If anyone can fix our insurance, she can, right?


I told her about our struggles last summer, when I was in Zombie condition. She is wonderful, understanding and kind. She knew when she hired me that having a family was my number one priority and that I would likely end up working part time at some point to be with my kids. She says the nicest things when I apologize for being distracted by our struggle, like, "Foxy, you are more effective now than most people when they are at 100%." It is nice and I know that she would do anything she can to support me.


I am super private about our infertility with everyone else at work. I'd originally called HR to ask about the options for changing our insurance, but didn't feel comfortable going into any details about our situation. I work very closely with the HR folks on work related stuff, and really don't need them knowing my personal business. I've been pondering how I can help my boss ask the right questions without revealing that I am the reason why.


The RESOLVE website has a generic letter to employers, and encourages all of us to send the letter to our employer and encourage them to change their insurance policy. There is apparently good research to show that infertility coverage actually results in lower premiums, higher employee productivity, etc...  So I took the letter, customized it for my workplace, and drafted it as though it was coming from my boss at the request of an anonymous employee. I've had the draft letter on my desk for two weeks and finally took a deep breath and pitched it to my boss on Friday. She could tell it was a hard thing for me to ask her and let me change the subject immediately.


I'd worked with a state lobbyist in the past on maternal health issues. She called me earlier this year to see if I would be willing to testify about those issues in the Health Reform  hearings. I let her know that I would be happy to testify, but confided that it would be hard considering our current struggles. Apparently she is also a lobbyist for fertility doctors. She told me all about some efforts that were underway to try and convince insurers to include coverage for IVF as a way to save on NICU costs. An insurer who covers IVF can limit the number of eggs that are transferred, lowering the 'risk' (or so they call it) of multiples. Multiples are more likely to spend time in the NICU, which is significantly more expensive than IVF.  Someday I hope that I will be strong enough to testify in support of this rational and logical approach to insurance coverage.


The thing is I just know that My Lover and I are not the only ones struggling with this. If one in eight couples experience infertility, then there must be many more in my workplace who are silently suffering. I am in a position to change things. We are all in a position to change things, when we are strong enough to speak up and have our voice heard.

Cold Sores. Yuk.

I hate cold sores. I was driving to work yesterday when I felt the initial tingle. I should have turned around right then and gone back home to search for the V.altrex pill I knew was in my medicine drawer. The real tingle started later in the afternoon, and I took the pill as soon as I got home. But alas I woke up this morning with a small but painful little cold sore. yuk. I remember when I got shingles a few summers ago. That was when my Dr filled that prescription. I told her then that we were trying and  I “might” be pregnant and was reassured that the medication wouldn’t hurt a pregnancy. 

I had a late start this morning. Some days it is just hard to motivate up and out of the house. Thank goodness that my lover found some coffee in the camping bin. We ran out  of our main stash earlier this week, and I keep forgetting to pick some up. Work was uneventful and I got to leave early to go to my weekly counseling session. We had a great conversation, as usual. I am so glad that I kept looking until I found this lady. (she’s the fourth counselor I tried!) I caught my lover for a quick kiss just before he went out for a bike ride. I hate so much that he is smoking at work, but that’s a different conversation for another day. I stopped back by work to pick up some projects that need to get done tonight, then headed home to find my sweet puppy waiting for me. 

Sweet puppy must spend a good portion of her day sitting on the couch watching the world pass her by through the front window. That is almost always where she is when I pull into the driveway. Her cute little ears, so excited to see me. I decided that she needed some new toys, so we headed out to PetCo. She was so well behaved! I got her a big bag of new balls and chewy things. It feels good to make sure that her play and chew needs are all met. Now that we are home she is trying to get all of the balls into her mouth at the same time. Four balls at once is her all time max, but tonight she can’t seem to top two. 

My Lover is working late again tonight. I am so grateful for this job, even if it is a short term thing. But I do miss him.

Happy Pills

Every night before I climb into bed I take a little pill. A magic little pill it is. I call these little pills my happy pills. They don’t so much make me happy, but they really do help me feel not quite so sad.

Seriously though, I’ve spent a lot of time reading the stories of so many other women who are living this life crisis and am a little shocked that no one else talks about this. Is it that no one else has a bottle of happy pills, or is it that no one else talks about it – even here where the most intimate details of our lives are shared.

The diagnosis of infertility is the worst news I have ever been given. It shook me to my core. It changed me forever. It was a trauma unlike any other that I have ever experienced. Everything about my life as I understood it, my purpose for being, my dreams my future, everything changed in that instant.

And yet I carried on, as best as I could, with my work, and my volunteer commitments, and my friends. Except, it was exhausting. I was exhausted trying to hold it together everyday. I walked around, going through the motions, yet the only thing I could think about was the overwhelming grief and the unspoken fears. Every time I got in the car, alone with the radio, I fell apart. I cried more tears in those first months than I have my entire life. But I managed somehow.

Waiting,

Appointments,

Waiting,

Tests,

Waiting,

Appointments,

Waiting,

Results,

Waiting,

Procedures,

Waiting,

Appointments.

Waiting.

It turns out I am stronger than I ever gave myself credit for being. I really am.

But it was so hard. And I was so tired. And the journey ahead felt like it was so far.

You know, we were seeing doctors, lots of them. But they were focused on the medical part of our infertility. The weren’t concerned with us, with how well we were handling the choices they kept giving us. And even if they had been, we were managing, we put on a good show, we were holding it together.

I suppose I could have gone on like that. Managing. Getting by. Going through the Motions. It sucked, but I was surviving.  We were surviving.

But then we got back the results of our second biopsy, the FNA map. I was hoping for good news that there was sperm and we could proceed with IVF. But I was also prepared for bad news that there was no sperm and we could proceed with DS IUI. We received the bad news, there was no sperm. But we also got a third option -6 months of hormone therapy to try and create sperm. I wasn’t prepared for the third option and it knocked me down hard. Six more months of waiting!?! Still no definitive plan!?! Thousands of additional dollars!?! I wasn’t prepared for this.

The idea of using donor sperm is so hard to accept. I started out thinking that it wasn’t even an option that I would ever consider. I even told my mom at one point early on that if we couldn’t use My Lovers’ sperm we were finished trying. Smart me, I reserved the right to change my mind about any decision at any time. At this point in our journey, I knew that we had to exhaust our options for full biological children before we could accept donor sperm.  I knew that I, we, still had some emotional work to do before actually moving forward with DS IUI, but it felt like an acceptable option for building our family, if we knew that My Lover’s sperm really wasn’t an option.

I wasn’t prepared for this third option and I just fell apart. I wasn’t strong enough to keep going through the motions. I just completely lost it. And I couldn’t pull myself back together. It was a combination of the sadness over the FNA results, the uncertainty of our next steps, and partly that I had just run out of energy.

My Lover and I had been seeing a couple’s counselor since we got the initial diagnosis, and she finally suggested that I ask my Dr. for a prescription for an SSRI anti depressant. Finally. Finally someone saw that I was suffering. Someone saw that the pain was overwhelming. Someone noticed that I could only tread water on my own for so long. Someone threw me a floatie.

The happy pills are my floatie. I’ve still got to tread water out here in this vast ocean. But I’ve got a little help. I’ve got a little more energy. I’ve got a little more perspective and the ability to feel beyond the pain.

It’s been at least a couple weeks since I cried. (I take that back, actually, because Dory’s comment about the Father’s Day cards had me going yesterday, but before that it had been at least two weeks.) Let me tell you I am so grateful for this break from the tears. I’ve spent time with friends, smiling and laughing, and ohhh is that nice.  I feel like me again, a changed me for sure, but me.

So, I suppose that this really long post is really to ask if I really am the only one with a bottle of happy pills, and if so why?

If the reason is that no one has noticed and offered a floatie, I hope that you’ll consider taking the one I am offering right now and make an appointment to talk to your Dr. I personally wish that I hadn’t waited so long.

the celebration society

One of the most wonderful things about being a part of this blog community is being able to read what others have written. I've discovered some of the most incredible amazing posts by the most talented writers. Your stories are so often my story, and your fears are my fears. Seeing the words already written down, articulated so beautifully is the most comforting reassuring experience. For the first time I don't feel quite so alone. I feel validated. I feel like I've found a safe place to explore my thoughts and emotions and fears and hopes. I feel understood in the most wonderful way, by you and by myself. 


I love leaving comments. I love leaving comments, even more than I love receiving comments. I love being able to say how a post makes me think and feel. I appreciate being able to express my appreciation to the author, to let them know that their post, their writing, their story has touched me in a meaningful way. 


Apparently I am not alone in this desire to appreciate my fellow bloggers! One of Mel's special projects right now is the Celebration Society.  Mel describes it as one of the most interesting delurking projects you'll ever participate in.  You can read the whole background story at Mel's celebration society post. Basically, the celebration society is a way for you to tell me what my blog or comments mean to you.  Really what I am hoping is that you will do the same on your blog - join the celebration society and create a place on your blog where I can tell you how much I appreciate YOU.


Ohhh - BTW - I just discovered that there are a few follow-up comments waiting for me at posts I have visited recently. I stumbled on a few of them, and can only assume that there are others that I might have missed.  As I said before, I love leaving comments, and would love to read your follow-up post, however I don't know that you replied to me unless you let me know. There must be a better way to keep track of comments, like a gadget or something that keeps track of the posts I comment on - if you know about something please let me know!

Cards at Target

Okay, so I am going out on a limb here. My Lover is one of only two people IRL who know that I have this blog, and the only one who has the web address to read it. I wanted him to know that I was writing about our private story in this public yet anonymous space, and I wanted him to be able to read what I had to say, if and when he wants. 

So anyways, he might be reading, I don’t know. Babe - this post is about something that I am planning for you, so be warned that you might spoil the (little) surprise if you keep reading. 

I was at Target this morning, picking up ink so that we could finnish printing our Cade Foundation grant. I walked in, through all of the kids clothes noticing how cute all the little outfits are, but thinking that even if I had kids, I wouldn’t be spending tons of money on new clothes (since we’ll have all those hand me down, but also because we are pretty frugal.) I walked through the baby isle, those things get me every time, but then I thought about how fast babies grow and decided to put on a pretty pair of IF glasses and think that it was kind of nice that I get so much time to admire these sweet baby clothes without being sad that my baby is all grown up. 

I found the printer ink and headed back to check out, and walked past the cards isle. I love cards and always stop to look at the cards isle. The whole row was Fathers Day Cards. I sighed. I found a card for my dad. It was perfect and talked about what a great dad he was for me growing up and how much I still love him. I may have my issues with my dad, but I do love him, and nothing can change the fact that he was a great father while I was growing up. 

Then I saw these cards “to my husband on fathers day.” I have never seen a card like that before. I was stopped in my tracks. I pulled one of the cards up to get a closer look. I can’t remember exactly what it said, but I was hooked. I looked at every single one. 

and then I bought one. 

For My Lover.

I do love him, so much, especially on Fathers Day, because he is the only person I could ever want to experience parenthood with, because he has been so wonderful dealing with this IF journey, because he is willing to undergo examinations, and procedures, and injections so that we can become parents together, because he is patient and kind and loving and will be a most wonderful father someday.

I am going to have to edit the text of the card a little bit, since he is not a father, yet. But I am going to give it to him on Father’s Day, in celebration of our journey, and anticipation of the wonderful father that he will someday be.  

So I guess the limb I am going out on is that i feel a little like maybe this might not be an appropriate thing to do. Maybe he doesn’t want to be reminded that it is fathers day. Maybe this, Maybe that...  

As I am writing this, I am catching myself trying to guess what he might or might not want.  I was going to ask for your thoughts and ideas about how to deal with Fathers Day, and these “to my Husband on Fathers Day” cards. 

The reality is that I want this, I want to give him this card, I want him to know that I am thinking about him on this day and loving him with my whole heart. 

Sweet, its settled. and I feel great knowing that someday, My Lover will be a wonderful father. 

Foxy's Favorite Posts Shout-Out #1

In the spirit of Stir-up Queen Mel's Weekly Blog Round-up, I'd like to give a shout out to some of the awesome posts that I stumble across. So many of these posts say the things I am thinking with such beautiful and elegant prose. They are posts that I want to bookmark and visit again.  I am going to call it
Foxy's Favorite Posts Shout-Out.


Without further ado...


* * * * *
I discovered a new blogger this morning - Jackie from Beyond the Brick Wall. She has a great post about a late night Facebook conversation with an old friend. It is a great commentary on the extremely limited background knowledge that our fertile friends have about infertility. It is a great reminder that people are not intentionally cruel when they ask us questions like "when are you going to have kids?" or "why don't you just adopt".  Check it out, and let Jackie know you stopped by.


Megan at Bottoms on and Off the Table has the most incredible Infertility Art Journal. Really. Incredible. I have to keep going back to look at it, because I can really only take in one piece of work at a time.  It has been awesome to be able to read so many stories, but there is something so powerful about seeing those stories expressed visually.


Katie at her blog From IF to When wrote a great post about 'the waiting place'. Remember the Dr. Seuss book that everyone got as a graduation present, Oh! The Places You'll Go? Katie reads to us an excerpt about The Waiting Place and remind us that we need to watch out so as not to get stuck.  


"You can get so confused that you’ll start in to race down long wiggled roads at a break-necking pace and grind on for miles across weirdish wild space, headed, I fear, toward a most useless place.

The Waiting Place…for people just waiting."



* * * * *
I am so grateful to this amazing online community. Thank you all for being so awesome, in spite of the challenges. With love and appreciation, Foxy.

The Upside of Azoos

I think about our fertility all the time. Seriously. All the time. Sometimes there are specific thoughts, other times the thoughts are generalized mobs of wordless emotions. Its like I am looking out at the world through a set of infertility glasses.  I wear the glasses all the time, but sometimes the lens of IF is much thicker than other times. Its been my goal to try and pick out the prettiest most positive frames for this pair of glasses. I think that I’ve been doing a pretty good job.

Every now and again I think to myself, gosh, there are silver linings with this Azoos. Rather than focus on all of the sad thoughts, I want to take this space to celebrate the benefits - the Upside of Azoos. Maybe you have a few to add to my list.

Career Advancement. I can do a job I really enjoy without feeling like I am giving up the ability to be with my kids. I spent so many years setting up a career that would let me work from home, but then this job opportunity came along and it was so special that I couldn’t say no. It requires so much of my time and energy, but the work is so important and I would feel so lucky that I can give so much of myself to it without feeling like I am cheating my family.

Birth control, smirth control. We’ll never have to worry about that! I can remember being on vacation once and realizing, at the wrong moment, that we hadn’t packed our bc. We’ll never have to worry about that again!

Love Children. Have you ever wondered if someday a kid will show up claiming that they are your husband’s love child? It’s the kind of thing your hear about every now and then.  I know that My Lover had a lot of fun before I met him, so I sometimes wondered… It is nice to have one less thing to worry about these days.

Hand me Downs. Bring them on! By the time we finally have kids, we’ll be getting hand me downs from everyone we know. They will all be long done having their kids and we’ll get our choice of all their best gear.

Longest Love Making Session Ever. Some guys brag about being able to last for hours. They’ve got nothing on us! I would argue that I’ve been in the most intense love making baby making session with My Lover for almost a year now. Other people brag about the love making toys they use. Yeah, well, you wouldn’t believe the love making toys that we are using.

Cocktails & Coffee. With Azoos, there is no monthly 2ww. My Lover and I relied on the pull and pray method for years before we actually started trying to conceive. I was always very aware of where I was in my cycle and cautious about the beverages I consumed during the couple weeks every month that I might be pregnant. I take delight now in every cup of coffee and every cocktail I consume knowing that I've got nothing to worry about. 

* * * * *

I've been looking at the beautiful flowers at Farmers Market for weeks. There are these little bunches of sweet peas. They are so beautiful and delicate. At my girlfriend's house the other day, I admired her sweet pea bouquet and told her about how I've been seeing the flowers at the market recently. She laughed at me and suggested that I buy myself a bunch. We laughed together when she said, its okay, you can make that decision, it's not such a big decision. With so many other big decisions consuming us lately, somehow I ran out of power to make such a simple little choice to buy myself a $3 bunch of pretty flowers. 

So yesterday, in between two fairly intense work meetings, I stopped by the farmers market and picked up a little bunch of sweet peas. I brought them to my final meeting of the day, so they wouldn't wilt in the car, and felt so proud of myself. They are sitting with me now, in a pretty little vase, emitting the most sweet subtle fragrant smell. 

So beautiful. So simple. So sweet. 

A trip to Australia by Diane Armitage

I've seen this posted here and there. I think it was originally written about adoption, but sure seems fitting for all of us grieving the ability to conceive naturally.


"Deciding to have a baby is like planning a trip to Australia. You've heard it's a wonderful place, you've read many guidebooks and feel certain you're ready to go. Everyone you know has traveled there by plane. They say it can be a turbulent flight with occasional rough landings, but you can look forward to being pampered on the trip. So you go to the airport and ask the ticket agent for a ticket to Australia. All around you, excited people are boarding planes for Australia. It seems there is no seat for you; you'll have to wait for the next flight. Impatient, but anticipating a wonderful trip, you wait--and wait--and wait. Flights to Australia continue to come and go. People say silly things like, "Relax. You'll get on a flight soon." Other people actually get on a plane and then cancel their trip, to which you cry, "It's not fair!" After a long time the ticket agent tells you, "I'm sorry, we're not going to be able to get you on a plane to Australia. Perhaps you should think about going by boat." "By BOAT!" you say. "Going by boat will take a very long time and it costs a great deal of money. I really had my heart set on going by plane." So you go home and think about not going to Australia at all. You wonder if Australia will be as beautiful if you approach it by sea rather than air. But you have long dreamed of this wonderful place, and finally you decide to travel by boat. It is a long trip, many months over many rough seas. No one pampers you. (Isn't that the truth!) You wonder if you will ever see Australia. Meanwhile, your friends have flown back and forth to Australia two or three more times, marveling about each trip. Then one glorious day, the boat docks in Australia. It is more exquisite than you ever imagined, and the beauty is magnified by your long days at sea. You have made many wonderful friends during your voyage, and you find yourself comparing stories with others who also traveled by sea rather then by air. People continue to fly to Australia as often as they like, but you are about to travel only once, perhaps twice. Some say things like, "Oh, be glad you didn't fly. My flight was horrible; traveling by sea is so easy." You will always wonder what it would have been like to fly to Australia. Still, you know God blessed you with a special appreciation of Australia, and the beauty of Australia is not in the way you get there, but in the place itself."

By Diane Armitage printed in the April 21, 1995 "Dear Abby" column.

My dad

Sitting in a coffee shop right now. It is a beautiful day. Unusually beautiful and warm. The music is so upbeat and the cafe is bustling. My mocha is delicious with whip cream and chocolate on top. I like days like today. 

I saw my therapist this morning. I really like her and am really glad I found her. I feel like she is so kind and gentle and understanding. and she doesn’t waste my time either. I have so much to get out, and she has been great at helping me frame my thoughts and fears in such a way that I can get my head around them. As opposed to the free-floating wordless emotions that are so overwhelming. I wish that I’d found her a year ago, and am glad that I kept looking and didn’t settle for someone who wasn’t a good match for what I need right now.

We talked about my dad today. A great man. Who i love dearly. But who has chosen his addiction over me and our family. I never would have brought him up, but she did, and I am glad. My issues with him have come up in strange ways as we consider donor sperm, and the role of a father. 

I’d never really thought that the things I project onto “My Lover” (yep, I’ve been thinking about what name I can use for my husband on this blog, and My Lover is perfect) might have their roots in my relationship with my dad, but it sure explains a lot to think about it like that. 

My dad is a great man, really. He was a great dad. Loved me and my sisters and my mom with his whole heart. I’ve never doubted that, not for one second. 

But he is an alcoholic. He has always been. I didn’t see it growing up, but I suppose that I knew there was something. 

I suppose that my mom did a lot to hold out family together and keep my dad held together over the years. Interesting family dynamics when I stop to think about it. My mom was our primary caregiver, the one who was in charge of everything. My dad however was the provider and definitely the man of the house. His was the final word, respected by my mom, and us girls. 

Things changed when he had his heart attack, and heart surgery. My mom decided that he could no longer smoke inside the house. And we were all more vocal about his continued drinking, since the doctor had been very clear that this incident was a warning and the repairs would only last a decade or so if he didn’t change his ways. For us it was black and white - he had to stop drinking and smoking. For him it was black and white - he wasn’t making any changes. A few years later he and my mom separated, then divorced, and he cashed out his retirement and moved across the county. Without my mom to hold him together he has made a lot of bad choices. Maybe I’ll write about that more one of these days. 

I gave up trying to call him about a year ago. He rarely answered his phone and never checked his messages. My attempts to contact him became an exercise in futility. So I quit trying. Months passed. He called me on christmas eve. It was great to hear from him, but hard to talk. He promised to call again more often

He didn’t come to my sister’s wedding in February. I don’t know if I can ever forgive him for that. Really. It is so hard to reconcile that this great man who was a great father can just walk away from us like this. Sometimes I think that it would have been easier had he just died. 

And them he called me a few weeks ago. We talked for a little bit. I told him that things have been really hard for us, with My Lover still being out of work, and that we are having a hard time starting our family. It sounded like he knew, so my mom or sisters must have filled him in. 

I still don’t feel like I want to try to call him. My Lover thinks that I should keep trying, that since he called me last it is my turn to call him. 

I love my dad, and I know that he loves me. I really do. But I can’t compete with his addiction. I can’t. and I don’t want to try. maybe because I know what he will choose. maybe because i don’t think I should have to. 

But as I contemplate what makes a dad a dad. andd my fears (which will remain a word-less blob of emotion). and my feelings of wanting to protect My Lover from the pain of this journey. I wonder how my feelings about my dad overlay on top of all this. 

Today is my grandpa's birthday. He passed few years ago. I miss him all the time,and can't help but think that things would be different if he were still with us. 

Wow - that got a little heavy. But Ohhh does it feel good to write! and this day is so gorgeous, so I’m heading home to get my puppy and head down to the beach.