Thoughtful Thursday: Haunt

This week, we’ll talk about haunting. No, not the fun spooky Halloween kind of haunting. We’ll talk about the horrible things you can’t get out of your head. Sorry.

Different people get affected by different things. Some people can stomach any human injustice but get their heart broken by cruelty to animals. Some people feel a protective urge toward children, or anxiety about illness, or a fear of accidents. Some people are touched by the personal, and some people are most affected by large-scale calamities.

Bloggy friend and Intelligentsia member Strong Blonde just posted about how she can’t stop thinking about the tragedy that happened this week in her family. Her husband’s cousin killed himself… after murdering his toddler.

Someone who went to graduate school with me had a daughter who was diagnosed with cancer as an infant. The whole department was very concerned, but one good friend of mine, with a daughter almost exactly the same age, was obsessed. She often woke her husband up in the middle of the night to talk about this sick baby she’d never even met (his sleepy automatic response: “Yes, it’s terrible, we are so lucky”). She’d check the baby’s health website for updates every few hours, and for a while she spent literally several hours a day reading back posts and learning about this particular kind of cancer. Her obsession got less intense over the period of this baby’s long illness, which took up almost all of her short life. When the little girl died, my friend became obsessed all over again.

After Hurricane Katrina, a co-worker spent every moment when she wasn’t at work watching news footage of people stranded on their roofs. She told me, “I can’t stop. It’s all so horrible. I can’t stop watching.”

I’ve been obsessed with various things over the years. Like the time during an IVF cycle that I looked up everyone who’d ever cycled on CycleSista to calculate statistics on their success rates, twin rates, type of intervention, total number of cycles before achieving success… It was quite the spreadsheet.

I don’t tend to think much about big disasters, in part because I stay away from news coverage in general. Individual hardship can make me momentarily sad for the people involved, but I tend to move on quickly. At times I’ve worked with issues that didn’t faze me at all but are too much for most people to even hear about; sometimes, when meeting new people, just the mention of what I do has been enough to send people in a beeline across the room with no explanation but, “Oh, uh, that’s great, uh, bye.” I’m notoriously hard to shock. A robot.

But, you know the one thing that really haunts me? The Holocaust. It didn’t resonate until I married a man with several grandparents-in-law and numerous other relatives who are/were survivors (and even more ancestors who were killed). His relatives almost always avoided talking about The War, so it’s not like I heard a lot of details from them. It’s just the idea that entire nations of people could stand by (or join in) while their neighbors and friends were persecuted, imprisoned, and killed. Letting horrible things happen not to enemy combatants but children, little old ladies, everyone, from their own country.

I usually don’t think about the Holocaust, but occasionally I’ve visited memorials or visited the graves of relatives whose headstones also honor the members of their immediate family who were killed in the Holocaust, or encountered other reminders. Then for a moment I mentally put my family in that situation, and it’s too horrible to think about anything bad happening to my husband and babies and I block it out of my mind.

Most recently, I was looking at the website of the Survivor Mitzvah Project to make a donation in memory of a relative who’d survived the Holocaust but recently died. Once again, I am haunted. The people on the website survived a genocide then have spent the subsequent 65 years still suffering. After the war, they went back to their little towns as one of the handful of remaining Jews and have lived in poverty ever since, often facing further persecution under new dictators or oppressive governments or soulless neighbors. Unlike the people whose stories I’ve heard before — relatives, friends of relatives, activists — these people didn’t start new lives in North America or Israel. Their letters tell heartbreaking stories not only about the cruelty of their neighbors and countrymen, not only about war or poverty, but about the ugliness that such situations can bring out in the people you love. Which brings us full circle, back to that baby who will never play with Strong Blonde’s twins at a family reunion, because his father did something that most of us can’t even bring ourselves to imagine.

Yes, it’s terrible, we are so lucky.

What haunts you?

Thoughtful Thursday: Pee

A silly one for you this week…

Tamale has a problem with peeing. She pees a lot. It’s very common for her to overflow her diaper overnight, during naps, and especially during car trips of any length. Last week I changed her the moment before we got in the car, and within 40 minutes I had to pull over because she’d soaked herself and wouldn’t stop screaming. I’ve tried to be prepared and bring an extra pair pants when we go out, but so many times she’s ended up wetting the original pair plus the backup pair. Now I try to bring two extras. She loves beverages, but even when she drinks the exact same amount as her brother, she leaks but he does not. It’s not the diapers; it’s her.

I have a different problem with peeing. My life is full of (usually, but not always successful) mad dashes to the bathroom. I get so engrossed in what I’m doing that I don’t get up, for anything. Yesterday when I was leaving work I realized that I was in danger of having an accident while walking to the car because I’d sat at the computer for 4.5 hours and forgot to go to the bathroom. It’s not like I was taking in liquid; I didn’t get up for that either. I was in the zone, and that zone does not involve taking any breaks.

I also had pee problems during each of my embryo transfers. The first time, I didn’t drink enough water and had to drink more and make them wait. The second time, I dutifully drank a lot of water — so much that the RE insisted on removing some of the urine via catheter before the transfer, and the rest via catheter after transfer because “it’s humanly impossible for you to hold it for 10 minutes after transfer with that much urine in your bladder, and we don’t need you to pee on the table.” The first time I was a not-good-enough patient; the second time I was too good a patient.

My husband has yet another peeing problem. When he worked in an office, he drank so much water that he’d need to go to the bathroom constantly. Like every half an hour. Many people in the office laughed at him, and many others gawked at the weirdo who appeared to have a bladder the size of a walnut. They also wondered how he could get any work done if he spent that much time walking to and from the bathroom and to and from the water cooler; he works just fine. A medical professional friend of ours once insisted that DH get bloodwork because no one should drink that much water and something must be gravely wrong with him. Nope, just well-hydrated.

My pee problem says that I get engrossed in what I’m doing. DH’s pee problem might seem to say something about his work ethic but in fact says that he just loves water. Tamale’s pee problem partly that she loves water like her father, and partly says that she just happens to make a lot of pee, and partly says that we should probably make more of an effort to change her diapers as often as possible.

Do you have a pee problem? What does your problem say about you?

Thoughtful Thursday: Drawing Lines

Still in limbo. It has gone from being delicious to excruciating to a chance to practice being patient and back again.

One of the things I’ve been doing while in limbo checking out alternate scenarios in case this job doesn’t happen — how would it play out if we stay here, where else might we move, etc. Mostly, though, I’ve been keeping tabs on our potential new city.

Any new housing listings being posted in the desired areas? An exciting new option might come along, or the owners of the house we’ve already settled on may decide that they can’t stand this limbo any longer and need to rent to someone else.

I already know which organic market I’d shop at. Which farmers markets operate on which days.

I’ve drawn up a short list of preschools — not for this year, and probably not for the next year, but the one after that.

I know what route I’d take to get to work every day.

I know which gym my husband should join, and I know where to find yoga classes for myself and for my little budding yoginis.

I have scoped out every playground within walking distance. I know which museums have reciprocity with my existing museum memberships. I know which pumpkin patch we’d visit for Halloween.

The one thing I don’t yet know, the one thing I haven’t allowed myself to search for? Where I’d do pottery.

For each of the other cities we’ve thought we might move to in the past year, I looked up all of the options and settled on a pottery studio. By drawing this boundary, I’ve simultaneously given myself something to look forward to and kept myself from getting too entrenched in one possible future (as if the farmers market and yoga schedules are not entrenched). The line is arbitrary and artificial and silly, but the existence of a line means that I stay (vaguely) grounded in reality instead of only What Ifs.

Sort of like when I was in infertility limbo. In each city where we lived during IF, I had selected an OB, a prenatal massage therapist, a studio for prenatal yoga, a doula… I’d picked out names, and strollers, and car seats… I literally read a dozen books on pregnancy the first year I was TTC… but I didn’t allow myself to buy a single baby item. In that case, it was already too late to keep myself from getting mired in What Ifs. The boundary was more about waiting for reality to catch up with fantasy. It’s a good thing that I established that particular boundary: if I’d actually bought a car seat when I started TTC, long before I ever got pregnant with Burrito and Tamale that car seat would have passed the expiration date.

Do you ever draw lines for yourself? Do the lines represent real, meaningful boundaries, or are they arbitrary?

Thoughtful Thursday: Limbo

No, not limbo as in the dance with the stick. I’m talking about the in-between place, between something and something else, or something and nothing.

I am in limbo.

I have been in limbo, on and off, for the better part of a year.

Career limbo. House limbo. Geographic limbo. Previously, between the time my mom got sick and her death, sandwich generation limbo.

Right now, today, is about as limbo-y as it can get. I am waiting to hear back on a job. I thought I might hear yesterday or today, but I haven’t. Maybe tomorrow. Maybe next week. If I get this job, it will change the trajectory of my career, certainly for several years, likely forever. It would also require moving to a different city. If my house happens to sell before the move, great, but that seems unlikely. I would be out of career and geographic limbo, but I would remain in house limbo. It would either get rented or sit empty, leaking money.

I know limbo well. Isn’t that what infertility is? Maybe you’ll have a kid a year from now, but maybe you won’t, so are you sure you want to plan that trip, that life event, hey maybe you should anyway, oh but if you don’t have a kid by then you don’t want to mess with the timing of an IVF cycle so maybe… I did not care for that kind of limbo. Part of what made it extra awful is that I didn’t know how long that limbo would last.

I’ve also written about pregnancy as limbo: a time of fear but also infinite possibilities. For the most part, except for times like being in an ambulance or getting magnesium pumped into my veins, I liked it. Even during the months of blah, the months of bedrest, and the month of hospitalization, I liked that limbo — partly because it meant that the infertility limbo had (maybe) finally ended.

House limbo is pretty crappy, but there’s not much I can do about it: someone will buy my house, or they won’t. (Hey, wanna buy a house?)

Job limbo is a bit nerve-wracking but actually kind of delicious. Even moreso for geographic limbo. In the past few months, there has been a legitimate chance that we would move to any one of a half dozen cities. Right now, I still get to go through my normal life, but possibility looms. After I hear the job verdict, either I don’t get it and I’m sad and I’m once again stuck in my current job/city/house. Or, I get the job, and I have to spend the next couple of months frantically finishing my old job and packing the house and moving.

Right now, I get to float in a bubble bath of uncertainty. My fingers are about to turn into raisins, and the bubbles are starting to pop and reveal my naughty bits, but the water is still warm and I’m still floating.

How do you feel about limbo? What kind of uncertainty can you tolerate, and what kind can’t you stand?

Summer Camp Day 4

Day 4 of blog summer camp at Creating Motherhood!

Today’s prompt: What has most surprised you about being an adult?

When I was a kid, anything seemed possible if you worked hard enough and wanted hard enough.

When I became an adult, I learned that some things are close to impossible no matter how hard you try and how hard you want, like getting pregnant.

I also learned that you can’t count on very many people in this world, even in your own family.

I learned that intelligence, education, and hard work don’t get you nearly as far as connections, charm, and getting intelligent educated others to do the hard work for you.

Bonus: A reprieve of Summer Camp Day 1! Specifically, a photo of my temporary blogging spot, one weekend only. It looks an awful lot like camp, but it was actually a weekend getaway on a lake. Although it wasn’t camp, there were canoes, watermelons, and bug spray.

There are lots of other adults at this camp!

Mothers’ Day

From my birth until 2001, I only thought of Mothers’ Day from the perspective of a daughter.

From 2002-2008, Mothers’ Day primarily called attention to my status as a non-mother.

In 2009, I was a hopeful almost-mother, toward the end of my first trimester with Burrito and Tamale.

Last year, I celebrated the day with my babies, and I sent the appropriate greetings to my mother, grandmother, MILs, grand-MILs, et al.

This year, I celebrated the day with my toddlers, and only almost burst out crying once when I thought of my own mother being gone.

At the time, I had no idea that 2010 would be the only Mothers’ Day of my life that I’d both be a mother and have a mother.

At least it happened once.

Thoughtful Thursday: Sunk Costs

Jumping off from the Dollars and $ense of Family Building (and by the way, if you haven’t checked out the blog hop yet, please do — and if you want to contribute your own post, even better!)…

One theme I’ve seen come up over and over again in the Dollars and $ense posts is money spent on failed cycles and other efforts that didn’t pan out. Some people seem to accept it as a necessary part of the process. Other people seem to lament the waste. I’ve referred to it in my own post and in a blog post years ago as water-under-the-bridge money, and for the most part that’s how I’ve approached it.

Some people are prudent in their approach to sunk costs, cutting their losses and moving on. Others keep going because of the resources already invested, even when it doesn’t make any sense to keep going.

Eating something that tastes horrible?
Halfway through watching a terrible movie?
Paid thousands of dollars in repairs for your crappy car?
Invested a couple of years in a bad relationship?
Spent tens of thousands of dollars and years of your life trying to have a baby?

With the little things, eating something yucky or watching a bad movie, I’m likely to just finish, even though it would be wiser not to. When it really counts — relationships, big ticket items — I think I’ve been good about cutting my losses. With infertility, though, I was in between: I accepted the losses as water under the bridge, but I couldn’t ever bear to cut my losses and move on. The hard part is that during infertility, you don’t know whether you’re showing perseverance necessary for achieving your goal, or whether you’re succumbing to the sunk cost fallacy and throwing good money after bad. Of all of the awful things about infertility, that part — not knowing if you will ultimately succeed if you just keep going or if everything you put in will ultimately be wasted — is, to me, the very worst.

When there are sunk costs, do you move on or try to stick it out? How does your typical sunk cost approach relate to your family building efforts?

Dollars and $ense of Family Building

Welcome to my contribution to the Dollars and $ense of Family Building blog extravaganza!

I am one of the organizers, along with Lori Lavender Luz of WriteMindOpenHeart. At Lori’s blog you can get the background and overview of the project, as well as add a link to your own post if you’d like to join the fun.

Lori and I wanted to get a variety of bloggers’ perspectives on the role of finances in family building, and you can find a dozen others at the main Dollars and $ense page. There are infertility and adoption bloggers with just about every perspective you can imagine. The perspective I’m bringing is that of a longtime infertile who pursued treatments with no regard to the cost.

I didn’t set out to break the bank. I got into treatments, both financially and medically, little bit by little bit. I started TTC at age 26, and after more than a year of patience I decided that my charts just didn’t look right and I needed some help with my luteal phase. I was a graduate student at the time, so I went to the student health center. The pediatrician who saw me obviously didn’t know how to handle infertility, nor did the gynecologists who spent most of their time preventing girls from getting pregnant. They immediately referred me to a specialist affiliated with the medical school, who just so happens to be a world-famous reproductive endocrinologist (Dr. Fancy Pants, as I’ve called him before on my blog). It doesn’t really make sense to send someone just starting out to a doctor at the very top of his field, but that’s where I was sent.

I expected Dr. Fancy Pants to start slowly with a month or two of assessment, but he preferred to jump right in with Clomid and do the assessment along the way. It was just a little pill, it didn’t seem like a big deal. Then the next cycle we added progesterone. Then the next an HCG trigger. Meanwhile I was paying out of pocket for each ultrasound (performed by the doctors themselves rather than a tech, ooh la la), each blood draw, and everything else. A hundred bucks here, a couple hundred there. Before I knew it we’d spent over $10,000, which was all of the money we had saved in the 6 years we’d been married. We stopped treatments, in part because a miscarriage took the wind out of my sails but also in part because we were out of money.

I needed to stay away from treatments for a couple of years but decided to try acupuncture (which was covered by my student health plan). When I finished my graduate program, acupuncture stopped being covered, but by that point I felt like it was benefitting my cycles enough to be worth the expense. Through two long-distance moves I pursued Eastern rather than Western medicine. Casually at first only every few weeks, then I added herbs, then I started going weekly. All of those treatments added up too. Eventually my (3rd) acupuncturist and I simultaneously came to the realization that I’d given Eastern medicine a full try and it was time to go back to Western medicine. He referred me to Dr. Full Steam Ahead.

By that point I had turned 32 and “you have plenty of time” was starting to become “you’re not getting younger.” Along the way we had sold a house at a large profit (thanks, housing bubble!) and had replenished our savings substantially. We decided to go full steam ahead with Dr. Full Steam Ahead, who within 6 months had put me through a full assessment, two IUI cycles, and my first IVF. DH and I had committed to finally getting pregnant successfully, no matter the physical or financial cost. Adding a second IVF that year, we ended up spending so much money on medical expenses in one year that it recently resulted in an IRS audit.

At that point our ample savings had ceased to be ample, and we wondered how much longer we could keep going. As with Dr. Fancy Pants years earlier, each new cycle brought an additional tweak such that each time it seemed like this must finally be it. Add this drug. Try IVF. Try ICSI. After the second IVF failed, though, we’d been through 10 treatment cycles and the excitement had worn off. We also looked at our finances and realized that our large savings had now become rather small. Along the way I’d taken a new job largely motivated by the need to secure (any) health insurance. The new insurance happened to cover IF – but only assessment and IUI, which we’d already moved beyond. Then I learned about a way that I could get health insurance that would cover IVF. (I was sure I’d blogged all about the trick long ago, but I can’t seem to find the post… hmm. Briefly, it requires starting your own company, and it only works in certain states, but if you can pull it off it’s a fantastic loophole.) In preparation for that, I did one last IUI to satisfy the future insurance company’s requirements for IVF, and from that perfunctory IUI came my twins.

In an alternate universe, if it hadn’t worked, we would have secured the IVF-covering insurance and exhausted the 3 IVFs it would have given us, bringing us to a total of 5 fresh IVFs. If that still hadn’t worked, I just don’t know what we would have done. Presumably by that point some doors would have started to close themselves – maybe the doctor would have declared that egg quality or my body’s response was inadequate, or something about the sperm-egg combo, or who knows. We very well might have gone back to paying out of pocket, and if we’d had to pursue something like donor eggs we definitely would have paid out of pocket. Thankfully we didn’t have to find out, and I was able to end my infertility tally at only $70,000.

Now, answers to specific questions that the participants raised.
1. Consider your now or future children as adults, and consider the fact that you had to spend money to either conceive them or make them part of your family. What effect do you think the latter will have on the former one day? What, do you think, your grown children might feel about the funds it took to create your family?
Honestly I think it’s a huge compliment to them, and a testament to how very much we wanted to bring them into our lives. While they’re slinging burgers to pay for college they might lament the “wasted “ money, but without all of that water-under-the-bridge money spent, they wouldn’t have come into existence.

2. How did/would you handle it if your child asks you, “Mom, how much did I cost?” How would you answer at age 7? At age 18?
At 7: We wanted you so much that we did everything we could to bring you into our lives. It did cost a lot of money, and we had to experience a lot of medical procedures, and it was very hard, but it was all worth it. We love you so much, and we loved you so much even before you ever existed.

At 18: Bringing you into the world cost a lot less than we’re about to spend on your college education.

3. When calculating the costs of your family building, what do you include? The direct costs are easy (such as RE fees for a cycle or homestudy fees), but what about fees that didn’t directly lead to your child’s existence in your life, such as cycles that didn’t work, adoption outreach avenues that didn’t work, failed adoptions, avenues that were explored (and that cost something) but not pursued, etc.?
I count everything. Each cycle that didn’t work was a necessary step in bringing us to our children, and each dollar spent was a dollar that we spent.

4. If two children in a family “cost” different amounts, should that have any significance?
My two children happen to cost exactly the same amount because they are twins who were conceived in the same cycle. If we’d had two singletons who came from cycles with different fees, I don’t think that would matter to us. But, if we had one child from treatments and one child naturally (did you know that people have babies without doctors? or maybe it’s just a fairy tale), it would seem significant – though less because of the financial cost and more because one conception was so much “easier” than the other.

5. To what extent have finances determined the family-building decisions you have made? How have you able to balance financial considerations against other factors such as medical, ethical, emotional…?
Finances have determined our decisions far less than they probably should have. As I mentioned above, we stopped treatments for a few years to replenish our savings, and we did opt for our 11th cycle to be an IUI rather than IVF specifically because of insurance requirements. We also opted to start IVF when we did rather than continue with another IUI or two because the IUIs were so expensive with such a low success rate that IVF just made more sense. Otherwise we didn’t pay much attention to money and just kept writing the checks until the account was empty. I don’t know that I recommend that approach, even for those who have the means, but it’s the approach we took.

6. Has institutional and governmental support for certain family-building paths impacted your choices? For example, ART being covered by insurance, tax deductions for adoption expenses, etc.
The fact that ART was not covered by insurance for most of our journey certainly had a huge financial impact. Once we secured insurance that covered treatments, you’d think that it would have been liberating. In fact, in our interactions with the insurance process, I realized how much leeway we had when we were paying out of pocket. For example, in our one covered cycle, the FSH wasn’t approved until it was too late to start the cycle, and I was only able to proceed as scheduled because I had leftover (and presumably spoiled) FSH from a previous cycle. If we’d ended up doing IVFs covered by insurance, I’m sure there would have been a lot of bureaucracy, to the point that it would have interfered with the cycles in terms of timing or even what procedures/drugs could be used. At $15K per cycle saved, though, it would still have been worth the hassle.

7. Have you considered having ART treatments abroad, either due to lower cost or due to certain methods being unavailable or illegal in your own country? In your decision-making, how did you balance the financial savings against issues like the unknowns of the country, perhaps not speaking the language, and medical practices that may differ from those of your home country? If you did travel abroad for treatments, what was your experience? Would you do it again?
The “IVF cycle as extended vacation” idea crossed my mind only because I’d seen others do it, but doing it locally was more practical and there wasn’t anything we could do abroad that we couldn’t do at home. There are other participants who can answer this question differently, though… Speaking of which, it’s time for you to visit the rest of the Dollars and $ense posts! Thanks for stopping by!

Visit Write Mind Open Heart for more perspectives on the Dollars and $ense of Family Building and to add your own link to the blog hop by May 1, should you want to contribute your thoughts.

Audit, Part 7

We left off in the office of our surprisingly human auditor…

I continued in sleep-deprived blabbermouth mode about how I understood how spending over $40,000 in medical bills despite having health insurance and not even counting the health insurance premiums must seem like a lot and it’s reasonable that it would raise their red flags but yes we really did spend all of that, on infertility treatments, the IUIs and the IVFs and the acupuncture and all of it, and they all failed and we were at it for many years before that and it was another $30,000 in the other years put together and it doesn’t look like we have enough extra income to spend that much money on medical bills but we did and we spent everything we’d saved and now we’re broke but it’s okay because now we finally have babies and they are so beautiful do you want to see a picture but yes we really did spend over $40,000 in one year on treatments that didn’t work.

Auditor: “How much do the cycles run?”

Well it depends on what kind of cycle and which drugs they use and what extra stuff they do but the IUIs are the cheaper ones and they each cost us around $5000 though some people spend less if they go to their gynecologist instead of a fancy reproductive endocrinologist or something but each IVF cycle cost about $15,000.

Auditor: “Oh shit!”

That’s really what happened, I swear.

Come back tomorrow, as all of this has been leading up to a very special bloggy extravaganza! Eventually we’ll get back to the audit story but it’s still in progress so you’ll have to wait.

Audit, Part 5

Continuing with the audit…

As the date for our appointment with the auditor approached, I still hadn’t gathered most of the paperwork nor organized everything into spreadsheets that someone else could understand. I figured that since I’d already organized and tallied everything when I did the taxes originally, it wouldn’t take long.

I was wrong.

The night before the appointment, I stayed up almost all night putting everything together. It’s not like the government knocks a couple thousand dollars off your taxes for superb organization, but I can’t help it. It’s who I am. My spreadsheets were magnificent.

Or rather, most of the spreadsheets were magnificent. The last one was slapped together — not even good enough to be called half-assed. Quarter-assed? Eighth-assed? I’d become too bleary-eyed to make any sense, so I decided to get a couple of hours of sleep.

Stay tuned to hear what happened when we met the auditor.