breakdowns and grief

It's been a really rough month, hell- it's been a really rough winter/spring. My husband has been super supportive, but I really don't think he quite understands what I'm going through and why I'm so emotional. I *think* I may finally be coming out of depression. I realized I was actually depressed earlier this month, or late April. Straight up clinical depression if I were to diagnose myself.

I also came out on Facebook with this blog and my friends have been unbelievably supportive. It's also nice to know I'm not the only one going through this. I've tried really hard to get through all of this with a few supportive friends and family. And they've been great, but no one understands what this is like unless you've been through it. It also super hurts when people say "yeah, this happened to my friend and she now has 5000 kids." Sigh. I know you don't know what to say, but this process is different for everyone. And I'm 40. Yeah, maybe I could have some random litter of children, but let's be honest. I'm likely not. Yes, I still can hold out hope that my body will decide to produce one viable egg one month and miraculously I carry that child full-term. That hope will always be there, probably until menopause. But I also needed to grieve. And I don't think people get that.

On mother's day I confirmed my suspicions that my neighbor, who I encountered at the end of my last IVF cycle at the fertility clinic, is pregnant. I haven't been able to look towards their house since I found out. It hurts. It triggers me so much. Why them and not us?

I was talking to someone about IVF, my infertility, and my thoughts. They were like "stop talking about this." I'm like "this is my life, I can't stop talking about this." Again, someone who hasn't been through this does not get it. I didn't understand until I went through it. Sure, I had friends who were going through IVF and I was supportive, but was I supportive enough? I'll never know. I hope I was as supportive as they needed.

I've also lost a friend through this whole process. My understanding is this friend may be going through the same thing. She hasn't spoken to me since October. I reached out for months, but had to give up when I started the IVF process in February. I needed to focus on me. I don't know why I lost her and why she ghosted me, but I tried to be a friend. Losing this friendship is also adding to my grief and depression.

I've cried so many times in the past few months I think I'm running out of tears. I've had so many unexplained breakdowns it feels like darkness inside of me that won't release. I want it to release so badly. I want to feel happy without faking it. I want to be able to live my life without this darkness dragging me. I also really, really don't care anymore. I want to give up, not like suicidal, but just give up. I feel no joy. I don't have a whole ton of hope. My coworkers have noticed over the last few months how I've been. Some of them know what's going on, others don't. One person surprised me by saying she's concerned about me because I'm not my usual joyful self and I haven't been for months. Another coworker simply calls me out and is like "I really thought vacation would be helpful, you're worse than you were." I know.

I also know myself well enough to know that eventually this darkness will dissipate and if it doesn't I'll need to do something. I know talk therapy wouldn't be helpful because I've done all the analyzing I need to do. I have the insight. I don't have behaviors I need to change. I have accepted my infertility and at this point am grieving. And this grief will take months. I hope no longer than months. But there might always be a small part of me grieving that child that never was. I probably will never stop wondering, what would our child be like. What I probably need is an energy cleanse or something similar to that. Or just time. We'll see what happens. Now that my job is a bit lighter stress will be a bit lighter and I can also focus on me more. I've also started practicing yoga more often. Grief takes time. If you know someone going through this, recognizing their grief and allowing them to grieve is what they need from you, if it means they talk about it ad nauseam, allow it.

The one thing I truly hope is this darkness dissipates and I can be joyful again. I just really need that now. I wish no one would have to go through this process, ever.

IVF again?

Last week I emailed the nurse from the fertility clinic because I have leftover medication and I very much want to be rid of everything from IVF. She wants me to hold onto it until I've fully decided I don't want IVF. So now I'm rethinking these things. There is literally only one thing that makes me want to try IVF again and that's the ability to control the situation more. We would know how many eggs would be developed, we would know if there's an embryo placed. When it's just life, you never know and who likes that?

So, I've been rethinking this whole thing again. But there's so many more cons. The emotions. OMG, I cannot go through that again. I was so anxious. If I did try IVF I would have to try other things to eliminate the anxiety and stress. I would have to do so much differently.

The scheduling everything around shots. Or dragging them with me. And the bruising.

We think we'll be getting our money back from the medications, and I've nearly spent all of my out of pocket maximum on insurance so it wouldn't cost a whole lot to go through another cycle. But, and this is the biggest but... the quality of my eggs decrease with IVF. My egg quality already sucks, which is why my chances are so low. And the doctor really did agree that the chances of IVF and naturally conceiving are basically the same.

My husband says whatever I want to do, and I know he'll be supportive, but I also know that he wouldn't do this if he were in my shoes. It's nuts to even think about it. And I know that. So literally the only reason I'd go through IVF would be to be in control of this situation that I have no control over anyway. Which is dumb.

other options

So with infertility comes looking at other options. I met with a lady from DSS today to discuss foster care and adoption. Ideally, we would be able to adopt a child who's ready for permanent placement. Ideally, the child would be younger. Ideally, that child would have little trauma history. Ideally, ideally, ideally. I'm also aware that ideal is not likely. What will come will come. However, this lady was so negative I walked out of there crying.

I'm a social worker, I know how and why children come into care in DSS. I know that the system is not perfect. I know that it's a challenging calling. I also know that if I didn't have fertility issues I likely would still have considered foster care/adoption. So, when she's sitting there telling me all about how it's unlikely we'll be able to adopt from foster care in the county, that even adopting an older child may not happen and that all the children have a ton of trauma history it's opening up healing wounds. I know it's going to be a process. I know that it's not going to be all positive and rainbows and roses. I do know that DSS worker also says that we don't have enough foster care parents in the county and that they send kids out of county. I also know that there are kids who need permanent placements, and forever families. It's good to be reminded, but I really don't think this should've been her focus. It was painful. And she was so burnt out from her job it showed. I never wanted to work at DSS as a social worker, and my life never led me in that direction, so I can only imagine what her work-life is like.

I did speak with a colleague after this and she had a lot of helpful comments and suggestions. We begin our training in July. It's a week long training that begins the process, which includes home visits, medical sign-offs, financial inspections, etc. Once we're approved for the county we're approved for the state, and also any child out of state who is approved to move.

I'm excited about this prospect, but also a bit overwhelmed. One step at a time...

last insurance hurdle?

I truly hope this is the last insurance hurdles anyway. Last night I received a promising phone call from Ashley, the supervisor from my pharmacy insurance assigned to my case. Here's the thing... Ashley can't see anything that I've sent to claims because the claims department is their own entity in which no one can speak to, email, contact, etc. even apparently inside the company. So, Ashley has been working "blindly" on my case with the faxes I originally sent that were processed and denied.

So last night the conversation goes something along the lines of:
First, the usual conversation about what dates and drugs I want reimbursed. This is literally the exact same conversation I have with everyone from insurance company and it's kind of getting super old.

Ashley: well, it seems they're requesting the National Drug Codes and Menopur was recently denied because... huh, well, um... because... (trying to figure it out)

Me: I've sent them the NDC numbers at least 3 times now. I'm not sure what more they want. First they wanted the NDC number with day supply. I sent that. Then they want the NDC number with strength and name. Now, they're saying they need the NDC number again. I'm super confused.

Ashley: Okay, so the NDC number needs to come directly from the insurance company, on the original invoice.

Me: Well, someone could've told me that 3 faxes ago.

Ashley:  Yeah, I think this is why I was put on your case, I specialize in this and the rules just changed.

Me: Thanking her profusely. I also was denied because I used an out of network pharmacy, but I sent an appeal letter for that....

Ashley: I can push that through

So yay! This was the second most promising phone call I've had with the insurance company. She immediately contacted the pharmacy (who needs a release of information from me) and then requested me to send her directly all the faxes I've previously sent (okay, she actually didn't say all, I just faxed her 3 which was still more than she asked, but I'm so, so tired of dealing with this I'd rather her have more information than not enough). So this morning, I scanned everything in and emailed to the pharmacy and the insurance company. Hoping and praying that this is my last hoop, my last hurdle and reimbursement will be sent.

My next step is getting rid of all the medications that I have leftover. I need to dispose properly of some of them. Dispose properly of all the needles, the pen, etc. (how?) And then donate one of the medications that I didn't get to use since I didn't implant. That one is kind of hard to do. I want to hold out hope that I will still need that medicine, maybe there will be a miracle and I'll need the extra progesterone and estrogen to help my body keep the embryo. But I think I need to let go. I need to let go of this hope completely. I need to accept this so I can move on.

Dreading Mother's Day

I really dreadMother's Day. I'm perfectly fine giving my mom a card and gift in appreciation for what she has done for me. And I enjoy doing that. And I'm also happy for all the moms that get appreciated that day. I just really dread this day so much. I fear this year is going to be more painful than ever.

What I dislike about Mother's Day:

• How it seems like women are failures if they aren't a mother. Too many articles, memes, videos, etc. state "today is a day for women." See meme. Nope. Not true. It's a day for mothers, not all ladies. Not at all. And not all mother's are ladies/female/women.

• 
• I  dislike the whole "every woman is a mom in some sort of way." No, being an aunt is completely different than being a mom. Being a nanny is completely different than being a mom. Struggling with infertility, I want to be a mom so much that I spent nearly half a year's pay to try to have a kid with only 12% chance of success. I don't want a consolation prize that I'm an auntie. No. It doesn't work that way. Appreciate me for being an aunt or for being a good friend to your kids on another day.

• And Mother's Day sympathy "we are with you as you struggle." Fantastic. I truly appreciate your support and those who have been supporting me throughout the entire process have been AMAZING! Those who learned of the struggle recently, so appreciated. I mean that from the bottom of my heart. But again, I'm not a mother and I want Mother's Day to be about mothers and appreciating mothers. I may be the only person who feels this way, but this is how I feel. I want your support when you can provide it. If that's Mother's Day, fine, but most likely it's more of an afterthought of Happy Mother's Day and to those who can't be or don't want to be mother's oh right it's kinda your day too I guess... we've got you.

• When memes, sayings, etc. differentiate the different types of moms. Foster moms are moms pure and simple. Adopted moms are moms pure and simple, there needs to be no differentiation between what type of mom you are. 

• Church on Mother's Day. Oh, I just don't go. Haven't been for years. I just can't swallow that day in church. It's painful. It's dreadful. It's hurtful. Pastors try to include all women, but again, for me it just makes everything worse. Even before I knew I was infertile, even before I was trying to have kids, even before I knew I wanted kids- it's just not the place for me on this day.

• Finally, the sexist reason I dislike Mother's Day. Men are not treated this way on Father's Day. They are unbelievably praised for saying "hi"to their kids which is ridiculous. They may exist, but I do not see the ridiculous amount of memes about how Father's Day is for all men. However, Father's Day has it's own issues with memes primarily racist and transphobic memes. 

So, Happy Mother's Day. I mean that. But recognize that this day is incredibly painful for many people, for many reasons in ways not to diminish the appropriate recongnition. I understand people don’t know what to say or are uncomfortable so do what you need to do. I didn't discuss losing a mother, or losing children, because that's not my story. I also didn't get into the cis and heteronormism of differentiated days...

weekly appeals

Not a lie. This is my appeal paperwork. Every week I'm contacting insurance to appeal their denials. Every week my slowly healing wounds have to be reopened because I have to look back at the paperwork, I have to remember why I was taking this medication, I have to talk with people who have absolutely no empathy. No that's a lie... 2 weeks ago I finally reached someone who had sense, a supervisor who finally provided me with a case number and said that my case will now be monitored by supervisors. Last week I received a phone call from a nice lady updating me (with absolutely no new information, but it was still nice). This week I received yet another piece of paper stating that what I've provided in the past wasn't enough. Come on now... this is getting ridiculous:

 

Let me start from the beginning, if you don't recall, my medications were denied by insurance. Due to the medication being time sensitive, my husband and I figured out a way to pay for the medication. Then, I became angry. Angry at so much, but decided to take it out on insurance. Thanks to HR assistance, I was informed that indeed my medication should've been covered. Hence the appeals.

Appeal 1: fill out form with medication and dates. Done. Denied.

Appeal 2: Provide NDC numbers. Done. Denied.

Appeal 3: Why didn't you use an in-network pharmacy? Letter written. Not sure exactly what happened with that because...

Appeal 2.5: We didn't receive the fax with the NDC numbers. Refaxed. Denied.

Appeal 4: NDC numbers needed again with name of medication and dosage. Completed today. 

6 weeks of jumping through ridiculous hoops. 6 weeks of wounds being reopened. I should be completing my first trimester. Instead I'm fighting insurance for an unsuccessful IVF round.

They now inform me how I can avoid this... but of course I'm not going through IVF again
(see previous blog). The kicker of all this is that there's not a number in claims. I have to go through people who don't have access to claims and they only find out the outcome. So frustrating.

Overall, my mental health is pretty good. I'm accepting and working through this. There are moments of days I'm down, but most days are just normal. This insurance stuff sucks. 

I am grateful that the guy I talked to a couple weeks ago pushed everything through.