Role Reversal

I fully expected to receive some push back on my declaration that this will be the one and only child J and I will be having. Surprisingly, there has been far less than I had anticipated, although that may very well change this weekend as we are attending a family picnic hosted by J's cousin, none of who are shy about expressing their opinion on how we should be conducting our life.

I did not expect J to receive as much push back as he seems to be getting right now, and it surprised me. J is irritated, he has had far too many conversations in the past several weeks with co-workers who absolutely refuse to accept that maybe the two of us have a pretty good grasp, after nine and a half years of marriage, of where our collective limitations end. To wit, they end with one child.

The pattern of the conversation is always the same. J mentions an alien is gestating, coworker responds with an exposition on the joys of parenthood. This is followed up by an interrogation on our current parental status, continued with statements on how eager the two of us will be to have another once the first is past the helpless alien stage. J responds that we intend to have one child. Coworker counters with the classic “you will change your mind”. J, unable to make himself walk away at this point, proceeds to explain all the logical reasons (time, money, resources, overpopulated planet, I don't want another child and hate being pregnant). Coworker dismisses explanations as the lunatic ravings of a nervous, first time father. The fact that I have no desire or intention to go through the experience again does not enter into the coworkers consciousness as a legitimate reason.. After all, once married, ownership of my reproductive organs passes onto my husband. I'm just the safe holding the goods. J gets to decide how the goods are used.

J shuts these conversations down by explaining that I have a history of depression, pregnancy has been far more difficult on me than he had anticipated and that he has no intention of putting me through such an experience again. Coworker shuts up.

Not wanting to be pregnant again? Not a reason. Not wanting your already crazy wife to become even crazier. Perfectly acceptable, after all there are children involved.

My parents were in the city over the weekend, to see Til Death Do Us Part: Late Nite Catechism 3. J and I met them at Six Penn Kitchen (home of a killer lobster macaroni and cheese dish that I have yet to try with the lobster) for brunch on Sunday morning.

Brunch began as the breezy and fun meal it is supposed to be late on a Sunday morning. Dad ordered an espresso and a green pepper stuffed with various meats, mom an iced tea and cheesecake stuffed french toast. J voted for coffee and an omelet stuffed with various meats while I opted for decaffeinated tea (served loose in a press pot), fresh orange juice, huevos rancheros and a side order of the macaroni and cheese*.

Remarks were made on my very gradual weight gain (I'm still in most of my regular clothing and only appear pregnant to those in the know), as gaining weight gradually is supposed to be less stressful on the body, lead to less weight gain overall, easier loss of weight post-pregnancy and, as told to me by my father-the-expert on such things, fewer and lighter stretch marks. Oohs and aahs were expressed over the twelve week ultrasound photos. An update on the Perkins restaurant that burned down several weeks ago was given.

This discomfort began once the details of the meal had been settled. J's mom wants to throw me a baby shower, an announcement that the majority of my female friends, knowing and sharing my deep aversion to showers bridal, baby and otherwise, greeted with much hilarity and the promise to present me with some highly inappropriate gifts to keep my spirits up during the execution of the event**.

As the alien I will be expelling is number six in a line of grandchildren on J's side and the first for my parents, it felt only appropriate and correct that my mom get first crack at torturing her daughter in the fashion of a baby shower. Except that, as carefully as I phrased the question, I could not find a way of explaining myself without sounding mercenary and made my mother very uncomfortable, as it had not occurred to her to think about hosting a baby shower.

As J and I have been trolling Craigslist in recent weeks for gently used infant clothing, a second hand crib made within the past three years, a second hand stroller and other baby related items, it was frustrating to come across as an individual who was begging for stuff. The only new items we intend to purchase are the breast pump, the infant car seat and the mattress for the crib. We are not assuming that anyone will providing us with anything.

After mom made it clear that she was more than willing to pass the shower honor on to J's mom, the conversation turned to our future plans.

J has a very bad habit of asking, in an audible undertone, if we should share information in front of the very people that I may want to withhold information from, at least in the short term. Over the years, I have gotten better at explicitly telling J to avoid certain topics of conversation, but once in a while an item will slip and he has never caught onto the concept

Such as the fact that I am seriously considering staying home.

My mom, who quit working when I was twelve to stay at home, did not approve. At all. And argued against it. My explanation, that out of the two choices, living with less money stressed me out less than the thought of the getting the alien bathed, fed and to/from daycare while holding down a full-time job, did little to appease her. J's explanation that I would be doing unpaid work for a friend part-time appeased her a little, but not much. All the contingencies J insists on putting into place to ensure that I get out of the house did little to appease her.

I shrugged her objections off, only to have them come back to haunt me at 4:30 in the morning. By the time J got up I was in tears and anxious.

And J was he gentle blunt self. “When have you honestly felt like you mom really supported you?” he asked me in the kitchen, after my bout of histrionics.

“Rarely” I replied.

“There's your answer. Do what makes you happy”.

*The ability to order an enormous amount of food without commentary is one of the few remaining prerogatives a pregnant woman has these days, after being denied lunch meat (including roast beef), sushi, rare steak, various cheeses, most seafood, chocolate, beer/wine and caffeinated beverages. And it is a prerogative that is slipping away as the media becomes increasingly enamored in shaming pregnant women for completely natural weight gain.

I also feel compelled to go on record and state that I did not finish all that food and took the rest home. The rest of the huevos made an excellent Sunday evening dinner and the macaroni and cheese is tonight's meal.

**A flask was mentioned. A full one. With wine. As for why I am opting to go through this particular torture, I may not be mercenary, but I'm also not a fool.

Options

J has been searching for a job for several months. Because of the gradually tightening economy, his success has been non-existent. Messages from recruiters have dropped to zero and his calls to them go either unanswered or offer no progress.

He received an email last week informing him that a product manager position has opened up at a company J left five years ago. The email came from an ex-coworker (and good friend) still employed at the company. He proposed J's name to management and received an enthusiastic response to the idea.

The job is ideal for J. Highly technical, with opportunities to interact with clients on a regular basis and attend major developer conferences, for a decent salary, working with individuals that J knows well and still maintains a good relationship with these many years later.

It is also highly stressful, with travel ranging from two to seven days every month and an average burn-out rate of a year. At a company that made J so miserable that I nearly moved out of our home near the end of his tenure there, rather than put up with one more day of his bad attitude. When he finally found new employment I threatened to leave him if ever went back *.

The interview went well, but he is only the first person interviewed and we think the company is balking at J's salary requirements.

J and I have both tried to live by the general rule of not stopping the other from doing something we really want to do, as long as it does not violate the boundaries of our very bourgeois marriage values. Ninety percent of the time it works out well. J is free to buy the Porsche, I am free to fly off to Paris for a week by myself.

But the thought of the amount of travel he will have to do every month, no matter how minimal, leaves me stressed, as it is becoming painfully clear, in spite of our best intentions, that if I continue working I will be overwhelmingly responsible, at least for the first year, for the care of our child. Feeding, watching over, getting to and from day care and doctors appointments. Even if he does not take this job, I feel an incredible amount of the burden falling on my shoulders. And I'm a little bit angry that the dictates of biology and culture make it this way.

So, I quit. Or am quitting. Maybe. Possibly. When I sit quietly and weigh the two options in my mind, being home makes more sense. J had put out feelers among his network of developer friends and one is interested in hiring me to test on a part time basis. I could work on the sketches for the children's story I wrote seven years ago. I could spend some time writing. And J insists that I keep my gym membership and figure out a budget for hiring a sitter, to get me out of the house alone a 2-3 days a week.

Then my common sense weighs in and tells me that I'm crazy to quit in this economy and need to tough it out. That we can get by on one income, but I need to be employed in case J becomes unemployed. That it is worth giving up 1/3 of my paycheck to childcare and my temporary sanity to ensure that we stay afloat in the long term.

This sucks.

*Obviously an empty threat.

Handmade Cutting Board Blues*

J and I manged to escape our house over the weekend and spend a day in State College, at the Central Pennsylvania Festival of the Arts. It has not been easy to escape, as of late. J has been working long hours and too many weekends, a situation that is causing both of us frustration and some anxiety, as attempts to plan some sort of last hurrah as a childless couple getaway-ish type weekend have been thwarted by his work responsibilities.

After an early lunch at the Deli, we spent a happy afternoon wandering the streets of State College and portions of Penn State University's campus, peering into booths filled with prints, painting, pottery, jewelry and woodwork.

Midway through our tour of the tents we stopped to admire the blockcut prints made by an artist named Thomas Bucci. As we were studying the prints, the thunder we had been hearing for the past twenty minutes became louder, the wind kicked up and it began to rain. Thomas invited us to shelter inside his tent during the storm, assuring us that it would be strong, but very brief.

As we stood inside his zipped up tent, he explained how he created the prints. He pulled out his Blackberry and showed us some of the sketches he created on his phone, done with a piece of software and a stylus.

I was amazed. I loved the mingling of art and technology. As the rain stopped, J and I purchased two prints to add to our collection, most likely to decorate the walls of the alien's room.

We saw the artisan who made the jewelry box J purchased at the Three Rivers Festival as a birthday gift for me two years ago. J was thrilled to find him, as we owed him money. When we originally purchased the box, we asked if he could change out one of the sections. Since it could not be done at the festival, we put a 50% down payment and he agreed to make the change and call us before sending the box so we could pay him the rest.

Except that he never called. He packed the box up and shipped to us, without asking for the rest of the money. By the time we received the box we had lost his business card and had no way of contacting him to pay up.

It took a while for J to convince him that we still owed him money and J was only able to pay him back half of what we actually owed. But it was something.

I also experienced something like homesickness while talking to a weaver from Greensboro, N.C, my home during graduate school. She was sunny and bouncy and fun and caught me up on some of my favorite places in the city. I walked away with a matching mohair hat, scarf and shaw, which I plan to use while cuddling the alien next winter. She walked away delighted at the thought that the shawl would be used to keep warm a new life.

* Title inspired by the antics of a customer at one booth who wanted to make sure that she was shipped a cutting board without any knots in it. She did not like any of the boards he had available because they were "knotty".

Things I'm Thinking of Rather Than Working

Because I'm writing this on a sunny Friday afternoon when I should be working...

It is my general philosophy to not attribute to malice what can be explained by stupidity, but I suspect Robert Hanlon never had to deal with health insurance company.

Conversations with all involved parties have allowed me to piece together the factors that precipitated Coventry's determination that the Midwife Center is an out-of-network provider. A brief time line:

1. The Midwife Center faxes a standard letter to Coventry notifying the insurance company that the center will be providing my prenatal and birth care. The letter contains my name, group number and insurance number. The letter does not contain the Midwife Center's provider number, as the center is not billing Coventry for any services at this time.
2. Coventry sends me a letter stating that the Midwife Center is an out-of-network provider.
3. I call the Midwife Center and inform them of the letter. They call Coventry, verify that they are in-network and tell me that I need to call the insurance company and try to determine where the mistake happened.
4. I call Coventry and speak with a very nice CSR. She explains to me that the Midwife Center has two provider numbers, probably due to a change in the name of the center sometime in the past. One number is out-of-network and essentially defunct. The second is in-network. It appears that an employee assigned the fax to the out-of-network number. In order to change it, I need to get the Midwife Center to refax the information to Coventry, with the correct provider number. Once they receive the corrected information, they will send me confirmation.
5. I call the center back and explain the situation. The woman who handles the billing is completely bewildered as the center has never put the provider number on this type of notification. She also does not seem to understand why it is necessary to refax the information with the provider number included. She says the situation will resolve itself when the Midwife Center bills Coventry at the end of the pregnancy. She seems to have missed the simple fact that this company has pre-emptively refused to pay in-network for a service and will stick to that decision until told otherwise.
6. After hanging up, I remind myself that I paid a considerable sum of money for my older, but still highly functional CDMA/GSM hybrid phone, and breaking the phone by throwing it across the conference room is a bad idea.
7. I decide, instead, to spend my Sunday composing and filing an appeal with Coventry, using the information that the very nice CSR gave to me. Copies of this appeal will be sent to Coventry, the Midwife Center, the PA Department of Insurance and the PA Attorney General. Coventry will also be receiving a copy of the formal complaints I will be filing with the PA Department of Insurance and the PA Attorney General.

My week was rounded out, on Thursday, by my first official "pregancy scold" lecture from a co-worker who felt that I should not have indulged in a sushi dinner earlier in the week. She felt it was "too risky" as "you never know, with all the physical changes to your body, what might make you sick".* While I have experienced a significant aversions to some foods, such as the smell of peanut better and well done (overcooked) meat, I have not become suddenly and mysteriously allergic to raw fish.

The sushi was magnificent.

* The dinner consisted of spider rolls (cooked, soft-shell crab), sweet shrimp sushi (also cooked) and crazy tuna rolls (raw, ahi tuna mixed with wasabi served on warm, lightly fried rice rolls). The combined amount of seafood in the meal maybe reached 8oz total, most of the food was cooked and wasabi is used with sushi because of its anti-microbial qualities.

Insurance Battle Number 1

I received a letter from Coventry Health Assurance today.

Coventry Health Assurance has decided, in spite of my diligent checking three months ago*, that the Midwife Center is an out-of-network provider and that I will be responsible for a $2,000.00 out-of-network deductible plus any overages above what Coventry Health Assurance feels like paying as reasonable cost to the Midwife Center.**

Oh, and I have a right to appeal, but it will not be considered an urgent appeal, so Coventry Health Assurance could, in theory, tie up the appeal past the point where I would be able and permitted to switch to an in-network OB.

The next person who tells me that nationalized health care will send the United States down the road to rationed care is getting punched in the nose.

* A phone call to the Midwife Center to confirm they were in-network and several hours digging through a provider search interface designed to create the maximum amount of aggravation with a minimum number of results. The search options are Find a Doctor, Find a Hospital, Find an Ancillary Service Provider, Find an Urgent Care Center or Find an Allied Health Professional. You can not search by clinic or practice name. You can not search by individual name if the provider is anything other than an MD, unless you try Ancillary Service Provider or Allied Health Professional and your guess about which category a CNM falls into is as good as mine. You can search by specialty, but the only names that come up are, once again, MD's.

** My interpretation.

Don't Panic - Episode I

One of the more pleasant aspects of visiting the midwives is that I am handed my chart as I walk through the door for an appointment. Rather then endure the borderline humiliation of being weighed by a nurse, I go into the bathroom, weigh myself on the old fashioned scale and note it in the chart.

Task done, I took a few moments while waiting for the midwife to read through my chart, including the results from a very unpleasant procedure I had several years ago and the more recent reports from the ultrasound done earlier this month.

Noted in the ultrasound report - Placenta: previa (complete).

Oh. No.

I digress to openly admit that I read way to much sometimes. Once I accepted that this pregnancy was real I became acquainted with the Mayo Clinic's website and have become obsessive at learning about all the things that could possibly go wrong during a pregnancy. But in all my worries about birth defects, gestational diabetes (because I hate the idea of having to stick myself with needles multiple times a day) and pre-eclempsea (because I hate the idea of forced bed rest and possible stroke), that I might have the condition known as placenta previa never occurred to me.

In this, I have potentially hit, at once, all of things I fear with frightening pathology - forced bed rest, repeated ultrasounds, steroids, needles, knives, surgery and death.

Dana the midwife* calls me back to the office and we sit down to chat. She asks me if I have any questions. I ask her about the "previa (complete)" notation on the ultrasound report.

Dana explains to me that this condition is very common into the second trimester of pregnancy and that the placenta usually moves upwards as the uterus expands. If I had not had the ultrasound, I would not have known. They will check again at the 18-20 week ultrasound and take necessary action if the placenta has not moved by then.

This should have been enough to calm me down, at least until I have the next ultrasound. In the short term, defined as the sixteen hours between the end of my appointment and this morning, it was.

Then I had to look up the complications. I knew that previa meant c-section. It did not register in my first round of reading that it might also mean enforced hospital bed rest, steroids to speed up fetal lung development, premature delivery, excessive bleeding, hysterectomy and possibly death. Finding out the resolve rate for partial previa is 95%, complete previa 90%, did not help much, because there is that 10% to worry about. And 10% is a lot when you are not quite ready to shuffle off the mortal coil.

J is calm in contrast of my controlled panic. Calm, but irate, the way men become when they will not allow themselves to panic. He wanted to know why the doctor, who told us "everything was normal", failed to mention the previa.

I'm not as curious. He's a doctor. He sees a previa, note that I am just finishing the first trimester, assumes that it will resolve and moves on. Does not want to deal with giving an already stressed out woman potentially bad news about a life-threatening condition that usually resolves itself.

The bills from the first ultrasound and blood tests are starting to roll in. Almost $600.00 towards my $1000.00 deductible already reached. The insurance breakdown came first, followed by a bill from National Chain Lab who has not sent the results of my blood work two weeks ago to the midwives. They sit on the dining room table waiting for me to match up the statements, to ensure that I am not being overcharged for any service. The next ultrasound should eat up the rest of the deductible. Then the fun of explaining to multiple parties that I have fulfilled my deductible and that they need to take it up with the insurance company begins.

*There are five midwives in this practice. Patients are rotated through all five over the course of a pregnancy and receive labor and delivery care from whomever is on call at the time labor begins, whether at the center or in the hospital. Even if I go to the hospital, the midwife will be there for support.