Hitting the bottom

Yesterday, I clearly hit the bottom of my emotional barrel.  I spent nearly three years begging my ex to "pick me, pick me" and now I'm feeling it with my kids.  I don't mean that I want them to pick me over their dad.  They need us both.  But right now, my ego needs them to want me.


I am also my own worst critic.  Aren't we all?  Despite the fact that I rail against society for the "what do you DO all day?" nonsense against stay at home moms, I am the worst when it comes to that for myself.  I look around my house and wonder, what am I spending my time on?  I know that I waste time.  I know that I "should" be doing more (you know, like the laundry that is piling up again)...


But the piece that I frequently choose to ignore, is that I am chemically depressed.  There may or may not be physical/chemical components to this stemming from health concerns that haven't been addressed.  What I do know is that some days it is a miracle if I can do the bare minimum.  I'm talking kid to school, homework done, lunch packed, other kid fed.  If the best I can do from there is put on movies and snuggle my baby, that's the best I can do.  I know I do my best.  And sometimes that means I can pick myself up by my bootstraps and not fall on my face.  Other times I simply cannot.  Yesterday and today, I could not.  But where do I go from there?  And does that mean I'm best for my kids?


Today was better than yesterday.  By far.  I only got mad once and it was because my big kid hit my little kid.  Otherwise I stayed calm and steady, even in moments of frustration.  Because with two kids under five who have BIG personalities, there are many, MANY moments of frustration.


All I can think is I must truly be depressed if thinking my children would be better off with anyone other than me.  But that right there my friends is the crux of the problem.  Wouldn't anyone be better off with anyone other than me?

Other people's opinions

I try very hard to not let other people's opinions of me get me down.  I am terrible at it.  Today is a perfect example.


This morning I had an interview.  I also had a date for tomorrow night.  Both things I was excited about.  I left the interview feeling totally unsure about how it went.  It was short and I left with the impression that I didn't say what they wanted to hear.  Or I wasn't the person they wanted to find.  It shouldn't matter, but I want to be wanted.  I want the job because it sounds interesting, and challenging, and would allow me to be home with my children while paying the bills.  And the guy... Well he was younger.  But not crazy young.  And adorable.  And we had plenty in common that would have kept things fun and interesting.  But apparently when I stated that I wanted more than just sex, that meant I wanted something serious.  Despite the clear explanation of what that meant (and far from serious it was).... But instead of meeting me, and seeing if we clicked, or talking to me about it, he freaked out and cancelled.  Again...  Oh yes, this is the second go around I've had with this gentleman...


Between these two things, and my children not listening, (because they were tired and transitioning from being with their dad all weekend, and they were hot), I lost it.  I stopped being the mom I want to be.  I lost my temper and bedtime was no fun.  My energy was sapped and now I want to go to bed early instead of doing anything useful (though I did at least clean the kitchen)...


I am tired of feeling this way.  I'm tired of feeling undesirable.  Guys want to sleep with me, but not date me.  People want to see my house, but not buy it.  Companies want to interview me, but not hire me... Well I guess that last one is yet to be seen.  Still, none of it should actually reflect on my self worth.  And yet here I lie, with a splitting headache, feeling even worse than I did before I had the possibility of any of these things.  I know I am worth more than I am getting.  Yet I continue to allow the treatment of less.  So how do I change this?  Just like my house, how do I get people to see the value I see?


I feel a little beat down from this one... And lets be honest, we don't know what is happening with the job, so really, it is all over a guy that I just wanted to have some fun with... Go figure.

Falling in love

I want to fall in love.  I know, odd since I just posted yesterday about how I am not ready for a relationship.  But I look around, I see pictures on facebook, and everywhere I look, I see couples.  I know the reality under it all, so it isn't that I believe everything I see.  But I do know what it feels like to be in love.  And I miss that.  I miss feeling like my heart is pouring out of my eyes when I look at someone.  I miss being in someone's arms when I sleep at night.  I miss having that one person who wants to be with you above all else.


I know it will come when it is time, and I am super clear that it isn't time yet.  I also know that the distractions I've been trying to hold that space with simply don't work.  And as hard as the emptiness is, it is what I need to come to terms with.


So my next thought is that I need to fall in love with myself.  I've been trying in truth.  I've been dating myself for about a year now, and I think it is going well.  I enjoy my own company.  I think I'm funny and have excellent taste.  I like all the same things as me and am even discovering some new things that I didn't know I enjoyed.  The only trouble is I can't quite wrap my arms around myself at night.  There is no extra warmth when I share my bed with me.  And when I talk to myself, I frequently get funny looks from other people.


So what comes next?  How do I make my life what I want it to be?  I know it can't be forced, but how do I find happiness and contentment in this space?  I know that my life is pretty darn good.  I have no real world problems, only first world problems.  I am educated and skilled and could likely go out and get any number of jobs quite easily tomorrow.  I have food in my refrigerator and a beautiful home.  I have two children who love me, and I them.  I have wonderful friends and family who have my back.  I have many comforts beyond this that the vast majority of the people in this world do not have.  And yet, with all of that, I still feel lonely.  I used to tell my ex that I didn't care what he did for a living.  If he was miserable (and he was) he should just quit his job.  The worst that would happen would be that we would lose our home and have to live in some crappy apartment together.  But we would be together.  I know he never believed me since he liked the trappings of our life as much as I did.  But I always meant it.  And to this day I mean it.  I know the value of having love in your life.  It is the people and the relationships that matter.  And it is something I miss deeply.


This is where the what ifs start to play in my head.  What if I don't meet anyone to share my life with?  What if it is just me and my kids now?  What if once they leave, it is just me?  Can I be happy?  Although I am certain I could be happy, and will find my way to enjoying my life as it is, I don't believe I will be satisfied being alone.  I used to imagine my adult life alone.  I never imagined a partner for myself until much later in life (of course that was because I was going to be too busy with my starring broadway career)...  My imagined successful life was a beautiful NYC apartment, with a performing career and a dog.  I lived alone in that dream.  But now that I have had enjoyed a taste of partnership, togetherness and true love, I feel incomplete without it.  Don't get me wrong, I am a whole person.  I have interests and friends and a life that is pretty full and great.  But having that person by your side, makes it all worth more.


So here I am, walking through the in between.  My life isn't what it was but not what it yet will be.  It is an uncomfortable place for me.  And my distractions have all abandoned me.  The question is- what is it I am supposed to be focusing on?  What is it that I am supposed to be working on?  I've been sitting in this awfully uncomfortable space for some time now and I'm losing my patience for it.  I need movement. 

Trying to trust, but really FREAKING OUT

So life is pretty overwhelming for me right now.  I'm still dealing with the emotional fallout of the end of my marriage.  He is with the woman he had an affair with and I am reminded every single day.  My kids talk about her and her daughter.  Old friends are spending time with them.  I have to remember that he isn't only thinking about himself and me and our kids, because he has a new partner that is in his ear about life decisions.  If I make a "bad" move or choice, it just adds fuel to the fire for why I shouldn't be taken care of.  I am on the edge of breaking every single day.  But somehow I find the strength to carry on, hold my head up, and start over each morning.  I'm not wishing to win him back, but I miss what I thought I had every day.  I have a moment of sadness for future lost every day.


Meanwhile I am in the process of trying to sell the house.  The house that was supposed to be our family home.  The house that we bought together to have and raise our children in.  To hold our family holidays in.  The house that was our home.  The house he left me in.  Once alone in this house, I actually have come to love it a great deal.  I see things I would do differently.  I envision a backyard to play in.  Lights strung up across the pool.  Family photos on the walls.  But instead I did what I could to clean it up and placed it for sale.  I am going insane keeping it "show" ready daily.  Trying to wrap my brain around holding it open for the third week in a row.  Meanwhile I'm getting the feedback that it needs too many updates, and has a bad layout.  Really?  Well okay, yes, it is "out of date" but it is livable, and has newer appliances and the bathrooms and kitchen have been remodeled- they aren't original or anything.  And we put quite a bit of work in too.  It isn't in "need" of anything.  It may not be pretty, but it isn't grotesque.  And there is more than enough room for anyone.  They just don't have the imagination for it.  I know, it only takes on buyer but seriously.  So frustrating.  And that our "competition" sold immediately, with two offers... Ugh... We shouldn't have been priced the same.  But there is nothing I can do about that now.  I just have to wait.  And trust.


And then there is kindergarten.  Had another reminder today.  Got a letter from the school she is registered at based on our current residence.  That we are selling.  And moving out of.  The school I don't really want her to go to.  But I'm not in contract anywhere else.  And the house I want won't even consider an offer from me because I'm not even in contract on my house.  And school starts in less than two weeks.  So what do I do??????????  Move in with my friends who are in the district that I believe we will end up in?  Register her based on that?  Move her later?  Why in the world is school starting so flipping early??????????????????


Then there is this business that I am starting.  And NEED to start because we really need the income.  I am so worried that I don't have what it takes.  It is taking so much to set it up that I am feeling totally inadequate.  What if I screw it up?  I really need this to work.  I fully admit that part of me is thinking I should just forget about it, start applying for jobs again, and accept whatever is out there... But I have passion behind my idea so I don't want to give up yet.  I want it to work out.  I want it to be amazing.  But I am so scared...


I have more balls in the air than I know what to do with.  And I'd really just like to be held and told it will all be okay.  And that I am loved and loveable.  And worth fighting for.  And not easy to leave.  I have spent the last year plus fighting so hard to love myself, and see myself, and really get the life I deserve.  But I fully admit that some days I still don't believe I deserve it.  And my insides still hurt so badly.  I choose to fight for myself because I am worth it.  Days like today though, I really really wish I had someone to fight for me every so often.

Ego Bashing

Between divorce and dating my ego has taken a thorough bashing over the last couple of weeks.  I'm not sure what it is about me but for some reason online dating seems to only bring me men that want to sleep with me.  Not even take me on a date first, just sleep with me.  Although at first that wasn't an issue because I needed that sexual confidence again; to believe that I was desirable and had something interesting to offer.  Now though I just want more.  Not the next love of my life, but someone who wants to hang out with me.  Go to dinner or a show, or anything really.  The intimacy is a natural part of it, but apparently the other is hard to find.  I frankly don't understand it.  I'm not looking for love and marriage here- what's wrong with a little food or drink together?


Meanwhile I've had to spend all this time with the ex this week as we prepare the house for sale.  I was reminded what a great team we make.  How many memories we share.  We even had some really good conversations about things moving forward that needed to happen.  At one point we were talking about painting and what a pain it is.  He was making fun of himself (he is really not good at painting) and commented on how he did a bad job the first time he painted the family room and that's when he was trying to do a good job to impress me.  I laughed and said "you never tried to impress me"... He said he did.  That all his "little projects" around the house, there was always a piece that was trying to impress me.  When he said this it broke my heart.  Further proof of how terrible our communication and understanding of one another was.  I truly never felt that anything he did was about me.  I didn't feel like he was trying to impress me in any way.  He did what suited him and possibly factored me in, but that was the extent.  Don't get me wrong, occasionally there were things he did for me of course, but I definitely never felt as though he was trying to impress me.  If only he knew how much I loved him then.  The people we have become today definitely do not belong together.  But that love, in the past, was real and powerful... And then he called his girlfriend.  Yeah.  That hurt.


And this is where my stupid ego comes into play again.  I don't want a relationship and all it entails.  Not right now.  But I want someone calling me, wanting to see me and spend time with me.  And I don't have that.  Not like that.  I am blessed to have amazing friends and family that fill that hole currently, but it is different.  Having that one person who just wants to make you smile, and you feel the same.  That's special.


So I go back to the dating world.  The "friends" I have are all wrapped up in their own lives right now.  No one is seeking me out.  The only guys reaching out to me want sex and nothing more.  And the one guy I was connected to that I actually felt some chemistry with, ended up reacting to me almost identically to my ex, which sent me into those old habits and behaviors.  Suffice it to say, I will not be seeing him again.  Not that he was really trying to see me any way.  And that's what sucks.  New guys come around.  They are interested for a minute, and then disappear.  Some pursue me with great vigor and even make a date, and then just stop replying.  Others never make it to actually asking me out but suddenly a switch is flipped and they turn into horny sex monsters.  Who send inappropriate pictures of themselves.  Or they're in prison.  Or married.  Or out of the country... Yeah so my ego is a little messed up right now. 


Of course this isn't where my energy or attention needs to be.  It needs to be on preparing my house for sale, and moving, and starting my business.  But everyone needs a little pick me up, a little distraction from time to time.  Something to spur me on through what is easily the hardest thing I've done maybe ever.  I don't want to move.  I don't want to walk away from the life that I had.  I realize it was broken, but I would have fixed it.  It didn't belong in the trash.  But that is where I am finding myself.  Alone.  In a house far too big for me.  With kids that don't even seem to like me most days (why would they when dad's house is so much more fun)...  This too shall pass, right???

exhausted

I had great intentions of going to bed early tonight.  I didn't get nearly enough sleep last night and have a lot on my plate tomorrow.  I should already be asleep for that matter.  But the truth is, I am emotionally wounded.  I am beat down, ground to a pulp, exhausted.  I have been working incredibly hard to just keep myself afloat.  To slowly climb out of the emotional hell I have been in for the last 2-3 years... no strike that, the last 5 years.  Battling a natural inclination for depression and anxiety is hard enough, add on the challenging early years of children, cancer, betrayal by affair, and finally divorce, and I'm lucky I still have a smile on my face most days.  I have minor wounds attacking me daily.  My kids talking incessantly about their dad and his girlfriend.  Struggling to stay on top of the never ending housework with no one in the house to participate.  Quiet nights when my kids have gone to bed and all I want is someone to snuggle with and watch some mindless entertainment.  Hearing about friends date nights with their spouses.  It is all those little things that add up to a dull ache in my heart and an awful lot of loneliness.  But I push through because I know it isn't forever.  And my kids deserve a happy mommy, even if it is happy but alone.  So I push forward.  I am looking for a job, despite wanting to give my time to my kids.  I am selling my house despite knowing that keeping it would be a better financial decision to stay in the long term.  I trust that there is a light at the end of the tunnel of this process, because, well, there has to be.  And then I am dealt yet another blow.  A suspicious MRI that will result in a biopsy, either via ultrasound or MRI.  Best case, they see nothing on ultrasound or mammogram and I have to move on to an MRI guided biopsy which is apparently really uncomfortable for the patient.  Worst case, they see something on ultrasound and do the biopsy the "easy" way (which still hurts quite a bit) but pretty much would be indicative of cancer.  I'm doing my very best to not future trip about the possibility of cancer.  The fact is that whatever it will be, it already is.  I have no control over it, and worrying will only make this process more hellish.  But even without the possibility of this being a really big deal, just the process of making sure it isn't a really big deal is pretty awful.  One more thing on top of an already full plate, particularly when it comes to my emotional load.  A true partner would be such a huge benefit right now, because that is when sorrow shared is less.  But I am my own partner for now and will utilize the amazing friends and community I have in my life as I can.  I trust that no matter what, best case or worst case, I will survive and ultimately thrive in this crazy crazy life I'm living.

Faith, Trust and Pixie Dust

Well our lives have gotten a little messier in the last week and slightly less beautiful. I'm not going to share details here, at least not yet. However, it is going to affect what I share here so I felt like acknowledging it. I don't know what my point to this post is. Maybe to say it is good to trust your gut and your instincts. They're usually accurate. Also, that we all have our battles, seen and unseen. I truly and completely experienced first hand how true it is that we all live in glass houses, and most of us can't see our own house. So if you can remember to hold your rocks, because things break easily whether you're inside the house, or outside. I am broken wide open at the moment. I know that I will heal back stronger than I was before. I'm sad and angry that I had to be broken again, but it seems that is what it will take for me in my life. This time, it at least feels like I will rise like a phoenix from the ashes I've been buried in. Oh and just in case you are concerned- I do not have cancer again. At least not to my knowledge. =)

Until then, I will survive on Faith, Trust and a little bit of Pixie Dust.

Enough

I had an interesting conversation with my dad the other day.  He watched my kids for a couple of hours so that I could go and meet a girlfriend for a grown up lunch.  When I returned we were talking about the reason behind the lunch and I shared that I have really been struggling lately.  He wanted me to elaborate so I did.  I mentioned that some of my insecurities have been coming up lately.  He sort of laughed made a comment (forgive me I can't remember) but I asked if he was being facetious because he was indicating that he didn't seem to think I had any real insecurities.  I elaborated for him though it struck me that this person who has spent a fair amount of time with me over the last three years (clearly my whole life, but I would say that our relationship has become more consistent and open since I had Bella) was completely unaware of how dark and twisty my internal processors are.

I consider myself fairly open.  I don't always share everything in person.  To be fair, in person I don't share much.  If asked a question, I will usually answer honestly, but I tend to keep to myself.  This is not out of pride (usually) or even a desire for privacy, but actually further proof of how totally insecure I am.  As I explained to my dad what exactly my insecurities are, I tried to explain how the theme is essentially that I don't feel like I am enough.  Let me elaborate for you.

I don't feel that I am a good enough friend.  I am mostly terrible at keeping secrets mostly because I don't deem most things worth secrecy.  I have exceptionally high expectations and standards and am easily disappointed.  Once my trust is broken, it takes a great deal to earn it back.  I don't consider myself terribly fun, often a nay-sayer and frequently negative (ahem, realistic). 

I don't think I am a good enough wife.  I'm insecure about my body.  I don't keep the house clean.  I often fall prey to "fixing" problems when an ear is the only thing desired (see, good enough friend as this applies there too).  I don't work very hard to look good (clothes, make-up, etc).  I tend to be lazy and overwhelmed leaving me prey to ordering take-out, having a messy house, and looking for the path of least resistance.

I don't think I am a good enough mom.  I get frustrated easily.  I don't have a lot of energy to run around and play.  I get overwhelmed easily (see wife) and fall prey to yelling, and avoiding activities that have the potential for messiness or complications.  I lean towards attachment parenting but not fully leaving me somewhere in the middle and not entirely anything.

I realize that many of these statements could be argued.  This is merely an insight to my thought process.  The list goes on and on.  Not enough feminist, not enough daughter, not enough sister, not enough performer, not enough cancer survivor, yada yada yada...

And then, while I'm trying to be enough I get spread so thin that then I am even less to everyone.  It has been an interesting process trying to explain my issues to someone who I thought knew how damaged I actually am.  If only we all could be clear about who we are and also what we think about each other.  Maybe some of those dark corners would have some light shed on them.

Body love

I just came across this article about a large woman doing a 30 day love yourself challenge. http://m.huffpost.com/us/entry/3943938/

This is a topic I've been pondering quite a bit lately. As a large woman myself, I experience a great deal of body shame. I avoid mirrors and hate clothes shopping. I fully admit that I let motherhood be my excuse to care little about my appearance. Who has the time when some grimy little person is just going to cover you in something in five minutes anyhow?

The truth is though that it is just an excuse. I haven't loved my body ever. And since becoming an actually large woman (unlike simply thinking I was which was the case when I was younger) I have increasingly bought into the societal belief that my body makes me bad.

It makes me bad in many ways. The first and most obvious being that I am not sexy or attractive. (Having the affection of a partner doesn't dispel this since he fell in love with me when I was skinny.) I am less of a desirable friend because I can't (don't enjoy) partake in the long held tradition of shopping together. First because I don't enjoy trying on clothes, but even if I get over that, I can't shop in the same departments or stores as my more petite friends. I am less of a desirable performer because most roles for large women require a) ethnicity b) age or c) a large belty voice. I have none of those and no one wants an ingénue in a fat girls body. Apparently its not believable that a fat girl would be the object of affection.

I'm sure I could come up with many other reasons why my body makes me a lesser citizen of planet earth. I'll leave you with these three examples though.

On the flip side my body is AMAZING. It has grown and birthed two healthy beautiful children. It provided some milk for one and complete sustenance for the other. It sustained me with little ill effect through a barrage of cancer treatments ultimately ending cancer free. True it allowed the cancer to take hold in the first place but I digress. If these things don't make my body good, I don't know what does.

I continue to work towards loving my body and "being beautiful". Until then I will remind myself of the strength of my body's miracles.

The more things change...

Well it has been quite an eventful few weeks. I still owe you a Disneyland post (its coming I promise!) but have some other things on my mind at the moment. I've become nakedly aware that my biggest set of insecurity buttons relate to feeling included, loved, valued and worthwhile. The place that these issues most frequently arise for me are around friendship.

I've always struggled making friends. I'm painfully shy and deal with extreme social anxiety. Once I'm confortable in a friendship I tend to be overly honest and have high expectations. As you can imagine that can often cause me issues in keeping those friendships. To top all of that off with this crazy phase of life I'm living in, I'm not great at staying active with my friends, leaving yet another gap.

Well some of these buttons have been pushed over the last few days and I'm sitting here feeling like I've been kicked out of another club. (Side story I was actually kicked out of a club my friends formed in the 5th or 6th grade, followed a few months later with an "I hate Karey" club... Yeah, you can say I have issues.)

So what do you do when you feel like you've been discarded or forgotten? And when those who are still active in your life, you're struggling to be a good friend to them?

I don't have any answers, just a whole lot of questions.

I know something in my life has to shift. I just don't know what or how. I also know I need to find my way back to my best friend - my husband. Having two littles has definitely done a number on our ability to be present for and with one another. The love is there, I'm hoping the time will avail itself soon. :)

I'm also hoping that at least some of the lost friendships prove to be figments of my imagination. It has been known to happen.

In my head

I'm currently writing a post in my head.  I started to type it out today and quickly realized that it wasn't going to turn out the way I wanted.  So I will save it for another day.  Two kids are keeping me on my toes.  I am worn out.  Poor Gio is really suffering with his acid reflux.  We put him on meds a couple of weeks ago and it helped at first.  Then I don't know, maybe he outgrew the dose or something, but this past week has gotten so bad again.  He cries so much.  And I know he is in pain.  It breaks my heart.  But it wears me down too.  I'm definitely struggling.  Meanwhile I'm trying to make sure Bella is still getting what she needs but when you have a screaming baby, your attention is clearly going to go to that.  I'm so lucky and grateful to not be doing this alone all day every day, between my mom and Nick at home, and other friends and family when they're around too.  Even with my amazing support system, this is just hard.  I am so determined to breastfeed at the very least until six months, but hopefully until the one year marker when they recommend breast milk or formula until.  I don't want to give him formula if I can avoid it.  However, if I don't figure out how to make things easier, and soon, I don't know that I will be able to make it that far.  This is hard.  It isn't the actual nursing that is a challenge, but the constant desperate neediness going on.  If he isn't eating or sleeping, he is crying.  Okay we do get some happy times, but they feel few and far between right now.  I was handling the sleep deprivation okay, but combined with the fussy baby and strong willed toddler, I see my positive attitude slipping.  What helped fortify me during these tough times with Bella was my mommy group.  I could go there and cry or laugh or vent and know that I was in the company of people who understood and empathized.  But there is no mommy group for babies and toddlers (not like you could talk much with toddlers running around!)... Actually the mommy group I used to go to has been disbanded, which is particularly sad for me.  I could have at the very least arranged babysitting for Bella and taken Gio to get some mental support.  I'm working on some ideas to get that support again.  I need my mommies again!

Well I didn't expect this to be so long or so full of vents but I guess that is just where I'm at.  The truth is ugly sometimes.  I love my babies.  They are amazing and there is at least one moment each day with each child that makes my heart grow a little bigger, but the minutiae of day to day is tough.  And I guess right now, I'm feeling the weight of it all.

Sometimes the universe has other plans...

I woke up this morning feeling rather frustrated as I get closer and closer to having to schedule my induction.  So to take charge I decided to call my doctors office and head down to have my membranes stripped between my weekly appointments.  I thought if it didn't get things going on its own, that coupled with doing it again on Friday, surely I'd been in labor by the end of the weekend.

I got to my doctors office, checked in and settled in to wait for my appointment.  As I sat there I started to smell gas.  Natural gas, the type you'd smell from your gas stovetop if it didn't light properly.  I stood up to ask the ladies at the front if they smelled it too and heard them talking about it.  All of us smelled it and it had come on quite suddenly.  We all started to go outside (maybe it would be better?) while the office manager called the fire department.  She came out and indicated we all needed to evacuate fully.  And so, I was not seen.  No taking charge, no forging ahead.  Just more sitting and waiting.

I am still scheduled for Friday but will also be scheduling my induction date on Friday.  I was really really hoping to avoid even scheduling induction, let alone having one.  I'm not sure at what point during the week we will schedule the induction, and clearly we still have some time but I'm feeling the pressure and a bit disappointed that I'm even at this point.  Today was just one more blow.

So send me baby having juju!  If he was born any time tomorrow his birthday would be 10-11-12.  How cute would that be?!?!  Come on baby boy- it is time!!!

Deep breath

I'm going to blame hormones, well, because I can.  But it seems that my emotional state is getting worse not better.  I'm doing the right things, going to counseling, talking to the people around me, seeking support, but I'm finding that I'm in a constant state of low-level anxiety with limited coping skills as a result.  I'm trying, and hopefully once this whole non-stress test insurance situation has fully shaken out (nearly there!) it will improve, but some of it I am just trying to take in stride.

Okay, so what is going on?  Well the first realization that I had is that I'm feeling very much as though this is the beginning of the cancer saga.  Don't get me wrong, I don't believe that I am going to get cancer again, but my emotional and medical journey began at the end of my pregnancy with Bella.  I have an emotional through line from the end of my pregnancy, into delivery, through breastfeeding, and straight into cancer.  It isn't rational exactly, but understandable.  After explaining that to Nick, he agreed and said that he actually felt the same way.  So we both feel a little bit like we are holding our breath to be sure it isn't going to happen again.  I at least enjoyed a little validation in Nick feeling the same way, and that it wasn't just me being crazy. =)

On top of that, I've been dealing with this nonsense with testing and my insurance blahdy blah blah blah.  I've found an OB's office in the next town north (different county, but same drive as the hospital I'm currently being referred to), that does non-stress tests in their office.  This means I will have no co-pay, or a standard office visit ($20).  I can handle that. =)  They have said I can go there, it is in network for my insurance, and doesn't require anything additional on my part (from what I can tell).  Sadly, after a horrible phone call from one of the doctors in my OB's office that I have yet to deal with, I received another phone call from them after I called with this news.  Their only response to me was that if the doctor saw anything wrong that they would send me to a different hospital to have my baby (the one closer to them), and if I was okay with that then I could go there.  I do understand that if there was an emergency situation I would need to go to the nearest hospital and in theory that means my OBs office would not be able to be there for delivery.  However, most likely anything they see on a NST would not be "emergency" and I would have time to drive down to my hospital.  The only reason I mention this is that it feels like my OBs office is not in my corner.  I do not feel supported by them at all because I'm not just doing what they tell me to do in full compliance without questioning.  It worries me about how my delivery will go.  I'm going to have to deal with this face to face in my OBs office I think to make sure we are all still on the same page.

Finally I had a growth ultrasound today and it left me a little freaked out.  Baby boy is measuring quite large, which isn't in itself surprising, though he jumped percentiles and that scares me a little.  According to today's measurements he is trending towards 10 pounds at full term.  Yikes.  I know how hard it was to push out 8.5 pounds, so another pound and a half is quite intimidating.  What left me more anxious however, is that the ratio of his head to his abdomen is trending the wrong way.  It is still fine, but closer than it was at the last ultrasound and close in general.  The radiology doctor said my OB might want me to go back for another scan.  I hope she does.  Essentially if the abdomen is larger than the head, you run the risk of shoulder dystocia or the baby getting stuck after the head is out.  Not good for mommy or baby.  Just don't want to even come close to that being an issue because I just don't trust that the doctors won't push for c-section.

And all of this is tied up in to crazy low lying stuff about guilt around my gestational diabetes, and not being able to do much anymore because I am tired and mentally/emotionally at capacity.  I seriously don't know how people have had babies over and over throughout history.  I admit, I feel a little bit like a failure because this is so dang hard.

Life is not all bad.  We had an AMAZING time at my sprinkle this past weekend.  I want to do it justice with its own post when I'm not grumpy and upset over unrelated things.  I am so blessed to have such an amazing community of women in my life.  I was not only sprinkled but spoiled this weekend.  And little man has already got a wardrobe that rivals his sisters.  =)  So I will leave you on that note of positivity with a whole post to come on it.  Five and a half weeks or less and little man will be here.  Count down!

Navigating Bureaucracy... Again...

If you've been following me since cancer, you know that I've come up against the bureaucracy of the medical industry many, many times.  I've won some, I've lost some.  I'm at it again.

In a middle of the night panic attack, I realized that the non-stress tests I've started are being done at the hospital.  The reason this matters is that for all outpatient "procedures" done at a hospital, I have a copayment of 20%.  If these were done at a stand alone office, they would be covered at 100%.  On Tuesday, I began making my calls to confirm that yes in fact these would be billed as outpatient, and asked what the actual cost will be.  With the potential of up to 16 of these appointments, it is more than possible that I could actually meet my annual out of pocket maximum.

I'm not interested in talking about money here, it is more what I am dealing with from a bureaucratic standpoint.  I have an HMO plan.  The benefit of a plan like this is that you can generally plan for and expect your out of pocket expenses, and they are relatively minimal.  I have no annual deductible, or crazy copayment percentages.  The downside is that you are limited with which doctors you choose, and facilities are limited.  It has served me well, even providing me with excellent doctors through out my cancer journey and now pregnancy.  I've felt lucky and rarely missed my Kaiser team, despite the ease with which I could navigate that system.

Today, that has changed.

I am continuing to battle this latest in a crack in my coverage.  The reality is that when you look at my coverage, the intention of the plan, including the copayment percentage, is to limit out of pocket expenses.  I didn't even meet my out of pocket maximum in my year of cancer treatment (as a point of reference).  All my doctors visits, crazy tests, chemotherapy, surgery and radiation, still did not add up to that amount.  So to think that one simple, and relatively standard test for pregnancy would have me hit that, clearly strikes me (and everyone I've spoken to) as crazy.  And also not the intention of the structure of the plan.  Even outpatient surgery would cost the same as one of these appointments. 

Why do I have to go to the hospital?  It is apparently the only place in Marin County that handles this service.  In my last pregnancy my OBs office handled it.  You literally sit in a chair (or on a bed in the hospital), strapped to the fetal heart rate monitor, and contraction monitor, and wait for about 20 minutes.  As long as baby moves, and has heart rate accelerations in accordance, you pass.  That's all there is to it.  They do also do an ultrasound to verify that the baby is still head down and to check your amniotic fluid levels.  Not rocket science by medical terms.  And yet, apparently no one else does it in their office.

On top of all of this, the primary doctor at my OBs office called me today in response to my inquiry regarding options to deal with this.  I had offered a suggestion that actually would have been sufficient for their needs as well as my own, and was open to discussing other ideas.  Her message was short, almost rude, and essentially punitive.  The message was clear "no alternatives, you must do these, and by the way you need to deal with the blood sugar issues once your pregnancy is over".  In other words, not only do you need to spend potentially thousands of dollars on tests because no one else can be bothered to offer them in office and we are unwilling to consider any other options for you, but this is all your fault anyhow so suck it up and get healthy.

Yeah- suffice it to say I am not in love with the medical world today.  I'm not done with my fight yet.  I plan to call everyone involved (insurance company, medical group, and hospital billing) to get someone to find the exception and how to make it happen since clearly this is not the intention of my insurance policy.  I also intend to let the doctor know that the way she handled me was unacceptable.  I was never saying I wouldn't do the right thing for the health of my baby, I was simply saying "work with me".  She shouldn't speak to any patient that way, ever, but in light of my recent medical history, I feel that if anyone deserves some kid gloves, it is me.

I keep reminding myself that I have six weeks or less, and then this beautiful baby boy will be here and I can stop seeing all of these freaking doctors.  All I know is that something has to change with this industry.  I think the doctors and patients ultimately all want the same thing, but being caught in this crazy system no one is getting what they want and lots of people are getting lost in the process.  Shameful really.

Follies

This week has confronted me with some of my personal follies.  We all have them.  Some we are more aware of than others.  Some cause real issues in our lives, other slight inconvenience or discomfort.  Often they are those "issues" that come up time and time again in our lives.  One of the ones that came up for me today is my increasing need to ask for help.  Try as I may, I just can't do it all.  In fact, every day, I can't even do most.  As everything gets more and more difficult for me, I look back to my pregnancy with Bella.  Of course, every pregnancy is different, but the clear difference here is having a child that I have to keep up with.  I realized today though that by this point in my last pregnancy, the nursery was done and I had enjoyed both of my baby showers.  I was sent to labor and delivery approximately three weeks from now for the first time.  This is also when I had to slow down at work (or be forced off early by my doctors).  I am five weeks away from going on maternity full time.  I had to stop my exercise classes and was doing little other than relaxing and mentally preparing.

The question keeps going through my mind- how do people have multiple children and just keep going?  This is a normal part of most people's lives so I just can't help but wonder- how do they do it?  I will have Bella on my own from waking to sleep tomorrow and am seriously considering how to manage that.  This shouldn't be a big deal, but I'm tired just thinking about it!

So this leads me to my folly.  I struggled asking for help when I was going through treatment.  I worked on it and I think came to an acceptable place.  Now that I'm in "need" again, I just don't want to do it.  Not unless there is a reason.  I don't even want to talk to Nick about where I'm at and what that means in having him step up.  Somehow I feel like it is unreasonable.  He is going out to dinner tomorrow with the owner of his company and a new hire.  This is a reasonable and important thing for him to do.  I understand it.  But it feels hard to me.  That is an unreasonable response I know, but then the underlying feelings are not unreasonable.  So how do I deal?  How do I say "I'm so sorry but I need you home when you're not working your normal hours."  Is that even fair?  We will get through it of course.  And just as I figured out how to care for a newborn the first time, I will figure out how to care for both my children as it comes.  Not much I can do now other than stress about it, so I won't.  Two more months!

Really??!?!

To add insult to injury, my phone has stopped working.  I cannot get it to take a charge and it is dead.  Why is this happening?  Oh, well when Bella threw up after her nap on Friday, in my bed, she was holding my phone.  Vomit managed to get into every crack and crevice of my phone.  At first it seemed ok.  Clearly not anymore.  I am praying that I can just get it to charge enough so that I can download the few things I haven't recently, and back the darn thing up.  Ugh.  This is so frustrating.

You know, because having the stomach flu wreck my house wasn't enough, now it is leaving me without a phone and costing me money...  So.  Frustrated.

Navigating the System

I posted yesterday about my frustrations with insurance.  Well I spent today on the phone getting the runaround from each and every office I spoke with (though the individuals all meant well).  At the end of a very frustrating experience I came to the conclusion that I am getting worked by the system despite my best efforts and just have to suck it up and write a check.  Gratefully I have an out of pocket maximum for the year and will meet it (actually exceed it) with one bill (plus all the payments I have made to date).  So I will pay that singular bill and send the rest back to my insurance company.

What kills me is how this business is set up.  For example, as a part of my initial diagnostics I was sent for a Pet scan.  They sent me to Novato Community Hospital for this scan, with no discussion of other places I might be able to go.  I was clear that I had a flat copayment for this service.  What I didn't know was that by virtue of the fact that I went to NCH for this test, I was treated as an outpatient for a procedure, which has a 20% copayment.  In this case, that copayment turns out to be 5 times the cost of the expected flat copay.  Although again it isn't about the money because I am going to hit that maximum regardless, I was flabbergasted that no one bothered to notice this for me, or warn me or give me any sort of a choice.  I know there are standalone radiology units where this wouldn't have been the case.  I don't so much blame my doctors office who referred me for being malicious, simply not aware of the difference or too overwhelmed to even think about it.

But this experience takes me back to what I said yesterday- who is looking out for the patients?  Here we are facing life-threatening illnesses.  Doing whatever it takes to save our lives, and getting screwed from every angle in the medical billing world.  How can we be expected to know our own policies well enough to be able to advocate for ourselves that we will not go to a local hospital for a scan because it will be billed differently than if we went somewhere else?  It would never have even occurred to me.  I did take the time to review my policy and familiarize myself with what the costs would be associated with each and every treatment and exam I expected to have.  But I absolutely could have had no way to know that things would be billed differently than one would logically figure they would be billed.  Between the location of my Pet Scan and the coding of my post-chemo shots, there was absolutely no way that I could have planned for or avoided these costs.

Maybe this will be my calling, putting together a non-profit that offers financial and billing advocacy.  At the time of diagnosis (assuming patients are referred to us as soon as possible) we would familiarize ourselves with their policies, and work to protect them from what feels like a predatory industry.  Too bad I really dislike this stuff personally.  Anyone love numbers and accounting and policies and want to help me get this service started?

The sad thing is that I think I am one of the lucky ones with decently good insurance coverage and the capacity to pay attention and advocate on my own behalf.  I just keep thinking about those who are worse off and still fighting for their lives.  It just breaks my heart.

Insurance woes...

I've been dealing with some insurance nonsense for a couple of months.  I think it is a running joke in the world of breast cancer (and frankly all serious injuries or illnesses) that insurance and billing issues are just par for the course.  It genuinely blows my mind however at how insidious this problem really is.  Generally speaking, I think my treatments, appointments and tests have all been standard of care.  I haven't had anything truly out of the ordinary.  Yet, somehow, my doctors office, medical group and insurance company can't seem to figure it out.

The current issue that I am dealing with truly amazes me.  After each chemotherapy treatment I was given one to three shots to boost my white blood cell count.  I had to go into the doctors office for each of these treatments.  My medical group approved these treatments, and authorized my doctors office to treat.  For some reason they are billing these shots as "self-injectable".  So what difference does that make to me?  Well if it is a straightforward "injectable" (i.e. the doctor gives you a shot, like I experienced) it is covered 100% by insurance.  If however it is a "self-injectable" I have a 30% copay.

I've notified my doctors office of this clear mistake (which by the way I had my insurance company confirm for me) and yet they and my medical group are continuing to argue that it was billed correctly.  This in spite of the fact that my insurance has been denying half of the claims, and payment is delayed as a result.

So tomorrow I will spend another day on the phone trying to get this business sorted out.  Gratefully I know how to read my insurance policy and reasonably understand what I'm reading.  I also have the ability, energy and wherewithal to pay attention and speak up when something is wrong.  I can't help but think about how many people just can't or don't deal with these issues.  I'm willing to bet at least half (if not more) of patients with serious illnesses just accept what is put in front of them and never think to question it.  Makes me want to create a service to help people with this exact issue.  I know I would appreciate someone else keeping track and advocating on my behalf so that I can spend my energy healing, getting healthy and loving my family with whatever is leftover.