2 down, one to go.

We have now met with our wonderful social worker from Children's Home Society for the second time last night.  After our first meeting, I really thought she was going to stamp our file with a big red 'X' and the word 'CRAZY!' written under it.  She was very clinical with us in the first meeting, going through a questionaire we had filled out.  Both meetings lasted a little over 2 hours.

If you couldn't tell, I was nervous going into our sessions with our social worker.  First of all, it's a social worker.  Social workers get involved with families generally when there is a problem with the family dynamic.  At least, that's the stigma.  In reality, social workers help families get back on course, and are not the enemy.  Still, admitting that you need professional help is difficult.  Lord knows, I've probably needed professional help for years.

Secondly, it's hard to be questioned about your life, your choices, your decisions.  The 'kid in me' screams about how unfair it is that we get grilled about our life, while other families, even other infertile couples, get to have families without the Spanish Inquisition.  The adult in me realizes, that it really isn't the Spanish Inquisition.  In fact, our social worker's primary weapon is the comfy cushion. She just wants to make sure we aren't worthy of the CRAZY! stamp.  She was really sweet in walking us through our background, offering her own experience in adoption to help us make difficult decisons about what child we want. 

Yeah, it's kind of like, 'Build-a-Bear'.  We went through a list of diseases we were willing to accept, what level of disability, or 'abnormality' was okay.  What gender.  How old.  Things like that.  She was sweet, as I mentioned.  But firm.  Realistic.  Ugh.  The optimist in me says I can handle anything, overcome any obstacle.  The practical side of me was glad for her making us think about where the rubber hits the road.

The easiest example is our thought about the age of a child.  We told her we would be open to any age group of children under 24 months.  We just wanted to make sure we weren't so choosey that it would take five years for the proper child to be found.  She suggested we should do some research on toddler adoption before we commit to an older child.

Turns out, it's pretty hard to adopt a toddler.  Life has pretty much taught them you can't trust anyone, that every caregiver will leave you sooner or later.  You take control by trying to shop for your own new mommy, even though there maybe someone trying to be your actual mommy.  Mommy's come an go, so treat them how you want.

It's called attachment and bonding disorder, and it's common amongst all kids who have had multiple caregivers.  Most children can get over it, if they are given the proper support and care by their adoptive parents.  Kids under one years old tend to be a bit more resilient, and have probably lost fewer caregivers, so the process for helping these kiddos, while difficult and intense, is possible.  Older children, who have the capacity to deal with their disorder through language can also work through the grief caused by attachment and bonding disorder.  Toddlers are in a unique stage that makes it more difficult.  Optimistically, a toddler will work through the disorder with the help of their adoptive parents in a matter of 1-3 years.  Most people who choose to adopt toddlers know exactly what they are getting into, and understand the work required to adopt toddler.  According to one study we read, Parents who specifically choose to adopt toddlers will feel the happiest about the outcomes of their adoption process.  Parents who choose toddler adoption as a second or third choose, do not.

Since we fall into the second category, we decided an infant is more up the alley.  There was a fleeting sense of sadness when we came to this conclusion, but logically, it wouldn't be right for the child.  They deserve better.

Our second meeting with our social worker was fun.  We laughed.  We talked more about our backgrounds, our families, our losses, and times we felt like the minority.  We nailed down that adopting from Ethiopia was a good choice, BUT there was an inkling that adopting from Colombia may be an option for us, too.  It may take a little extra work so that we can get the paperwork done before Angie turns 39, but still possible.  And it will probably take less time to wait for a child than with Ethiopia.

Choices, choices, so many choices....

Tune in next time when she actually visits our home!

Dear God,

If you would be nice enough to allow us to have a child, we promise not to stuff them in a crate under our bed, or put them in a balloon shaped like a Jiffy-Pop popper.

Thanks,

Charlie and Angie

Tip #1 for interacting with infertile couples

At a recent meeting, one of my supervisors got up in front of a group of our supervisors and nurses, and asked that anyone who was currently pregnant, or had given birth within the last 6 months to stand.  About 75% of the room stood up.  We really are having quite the baby-boom in our company.

I can't imagine how hard that was for the infertile supervisors in the room to see the multitude of people standing up.  This is why it is hard for infertile - these situations make it seem like the world is made for fertile people only.

And so it goes.

We finally got our packet of our paperwork in to Children's Family Home Society - the group that will help us with our adoption choices. Right now, we are leaning towards adopting from Ethiopia first, and doing an embryo adoption down the road. It's exciting and nerve racking at the same time. It's really hard to be patient for the next step, but impatience has been the mood for 3 years; I don't know why it should be any different now.


Confession time: It's been very hard for Angie and me to go to church during this trial. I mentioned in another post that my brother died 6 years ago. During my grief of losing him, it was very easy to slip into the thought pattern of 'Why would a loving God do this? Can God really exist?' Coming through that process strengthened my own faith, as I felt healed by His love through others - family, friends, co-workers, strangers, etc.

But now we're back to square one. Again, why would a loving God do this?

I know enough now that there is a randomness to life that God doesn't control.

*1 Kings 19:11-12 "And he said, Go forth, and stand upon the mount before the LORD. And, behold, the LORD passed by, and a great and strong wind rent the mountains, and brake in pieces the rocks before the LORD; but the LORD was not in the wind: and after the wind an earthquake: but the LORD was not in the earthquake: And after the earthquake a fire; but the LORD was not in the fire; and after the fire a still small voice."

To me, this says there are things that God doesn't control. Even the most ardent believer in the dominion of God will state that humans have our own freewill. But this passage has always spoken further to me that random geological and meteorological events are outside of God's doing. Perhaps biological events fit inside this verse as well.

But, and there is always a but, there are people who have prayed and prayed, and have had their prayers of biological parenthood answered. Why not us?

I came to the conclusion that I don't believe that God doesn't exist. Rather, I am very angry at God.

Seems kind of insolent, doesn't it? I first heard the phrase, 'I am angry at God' from my pastor as he gave a eulogy at my brother's funeral. It shocked me when I heard it, but I ended up finding solace in the statement during the healing process of my brother's death. We don't waste time being angry at things that don't exist. That wasn't all that was said in the eulogy. There was a lot about finding comfort in each other, and that we would find healing in God's arms when we are ready to accept it.

So, I'm about ready to accept it. We attended a service at our church a few weeks ago. The main catalyst for us attending was that the Episcopal Church is starting to focus on ministry for people who are experiencing the loss of miscarriage or infertility. Right up our alley.

I was surprised when we went to see familiar faces at the group. One person I knew by acquaintance had just been given a diagnosis by her doctor that she wouldn't be able to have children. Another friend who I've known for 15 years+ shared that she had had a miscarriage. I was blown away by both. It's surprising how wrapped up we've been in our own infertility that we've missed the pain of friends around us.

It seems like possibility has been sneaking up on us.   The possibility of helping others through their journey as we go through ours.  Without a doubt, I'm sure they can help us too.

No,
Actually, the doctors would cut me off as soon as I said "heavy periods" and made me feel like a hypochondriac. They cut me off and didn't even listen to the litany of other symptoms, including extreme pain and migraines, etc
Angie
p.s. The following tells me I'm not a hypochondriac and deserved to be diagnosed on time, not after 25/26 years of having the disease!

http://www.pbs.org/moyers/journal/07312009/watch.html

Embryo Adoption

I heard about the idea of Embryo Adoption as a potential path to pregnancy the same day I heard that embryo storage was akin to abortion.  I was listening to a speech by Dr. John Kilner, a noted bio-ethicist from Trinity International University.  I was lucky enough to spend some time with Dr. Kilner while he was in town giving the keynote speech for a conference my company was putting on.  Dr. Kilner made it abundantly clear that IVF was not unethical; it is simply a way to connect an egg and a sperm.  To him, infertility is just a disability that medical technology could cure.  Dr. Kilner's problem with IVF was that some clinics, in an attempt to raise their success rates, would attempt to create a surplus of embryos (I'm looking at you Nadya Suleman's doctor!), and dispose of or store any extra.  It doesn't take a rocket scientist to realize that destroying an embryo at any stage is a problem to many Americans; it is, for some, the same thing as an abortion of a viable embryo.

Dr. Kilner said that the use for surplus embryos would be for a future implantation.  You can put them in frozen storage, he said, but at a cost.  1/3 of embryos do not survive cold storage.  Imagine you have three children, and you hand them off to a babysitter.  When you come home only two of the children had survived.   Needless to say, you wouldn't use that babysitter again.

Is freezing an embryo the same thing as an abortion?  It's not for me to say.  What I can say is that this is a difficult thing for infertile couples to hear.  Not only do you have to worry about the cost of funding IVFs as well as the stress inherent in the process, but now, if you have extra embryos, someone can call you a baby-killer if you don't use them all.  This is quite the dilemma for someone who has already experienced the tragedy of infertility. 

As I drove Dr. Kilner to the airport, I told him about my wife's and my journey through infertility.  After hearing a bit about our story, he suggested that embryo adoption would be a less expensive and 'easier' path to pregnancy.   It would be an adoption, but wouldn't require travel, and my wife would be able to experience pregnancy.  There was the ethical side to him too:  We would be saving embryos that had been put in cold storage by other couples.  Embryos would not be destroyed nor used for research.

So now I'm in an ethical dilemma:  Cold storage=bad, but using embryos from cold storage=good?  It's a double standard that could be self-defeating.  If you keep everyone from using cold storage, then there would be no embryos for people to adopt who desperately need to get pregnant.

The change that occurs in a endometriosis patient is miraculous.  Women can receive a new lease on life.  She can get a few years endo-free.  I don't want to envision a McEmbryo world, and there should be some sanctity involved with embryos.  But it seems to me that mothers should be able to help other potential mothers if they want.

When I checked with the best embryo adoption center, they said we needed to be married 3 years in order to adopt.  At that time, we hadn't been married 2.  We are getting close to our third anniversary, and it is starting to look like one of the best options.

Health care stinks.

While I can be political amongst my friends, I try not to do so on the internets. I have my personal views on a lot of issues, but they require process to explain and some nuance. American politics are not fond of nuance. So I'll skip them over. If you are ever interested in having a beer with me, I'll go into detail of where I think our two main parties fail. I'm wrong most of the time, and know it, so I look forward to hearing your views as well, provided they aren't screechy. My main rule of thumb is you will not find salvation in your political party, so don't even try.

But since this blog is about our experiences with infertility, it's difficult to not talk about the problems we've had with our insurance coverage. It's easy to throw out a phrase like 'Death Panel', but when you've actually waited for your insurance company to decide if they will pay for something, you get the notion that all may not be right with our insurance system.

I'd like to talk about one personal experience with our health care system. My brother was diagnosed with cancer 7 years ago in October, and he died the following February. He was a seminary student, about halfway through with his studies. He went through a large surgery to remove a good portion of his cancer, had a lengthy hospital stay, followed by several rounds of expensive chemotherapy. When it was determined that the cancer would ultimately take his life, he was given wonderful hospice care and was able to die under his terms.

He actually passed away a half an hour after I arrived at my parents house on his final day on Earth. I am humbled.

I mention this story for several reasons. One, he was severely underinsured. Many young folk think they can swing staying healthy and skip insurance payments. If you're in school, you can't afford insurance, and you're 30 years old, it seems like a great idea until something catastrophic happens.

My brother racked up $200-300,000 dollars in medical debt during the four months he spent fighting his disease. What young person could payback that much money? He wouldn't have been able to. He died, and none of his bill was paid back to the hospital. The hospital makes up that payment by charging extra to people who can pay, or who have insurance that will pay. The next time you get treatment at a hospital, and are charged in exorbitant amount for a cheap-o medication, know that you are paying for someone else's treatment.

If my brother had survived, he would have been bankrupt. He would end up like many in our country: one catastrophic illness, and kiss-your-American-dream-goodbye. The hospital still wouldn't have received the entire payment, and you would still be paying out the nose for aspirin. Moral of the story - you get sick; you never make it out of debt. And everyone in America pays your debt through higher hospital bills.

In my job, if a system is causing everyone to fail, you realize that the problem isn't all the people who can't handle the system, it's that the system is broken, and you fix the system. Right now, in America, if you or a loved one gets terribly sick, you will go bankrupt. There is no way to survive a catastrophic illness without becoming a debtor for the rest of your life. The health care system is and has been broken for quite some time, and needs to be fixed.

Angie can talk at length about how she knew something was wrong with her, and her doctors couldn't figure out that she had endometriosis. If she had been given the diagnosis sooner, she could have gotten it removed, and remediated and given therapy sooner. She could have chosen her own path to fertility. This is obviously not health insurance problem, but a lousy doctor problem, but if we did have a system of best practices, she may have gotten the information she needed sooner.

As I've mentioned in passing before, the best therapy for endo is pregnancy. An endo patient's body figures out what's up, and can give her anywhere from 5 years to indefinite balance of estrogen. Getting an endo patient pregnant is the hard part. It's difficult to say what the actual problem will be, since each patient is different, but it can affect quality of the eggs, the shape of the ovaries, it can create blockages of the fallopian tubes, and it can prevent embryo implantation. How can you solve all of these problems? IVF! Yes, evil IVF, which most insurances won't cover, which can cost $30,000 per cycle, and oh, yes, you might need to go through a few cycles before you get it right. I'll talk about our experiences in IVF another time.

It's considered evil by some for a few reasons. Some say it's playing God. It's actually only helping the process along by uniting a sperm and an egg, so I don't have time for people who use this argument. The other argument that is used is that it creates extra embryos which are frozen and stored. Since there is some risk to freezing embryos, this is considered on par to abortion.

Look, I can't solve your fears on this one, but speaking for an infertile couple, you need a back up plan. If you can create extra embryos, you can use them down the road for another try, or another child, or you can choose to put them up for adoption. Seriously. I'll talk about embryo adoption more another time.

Anyway, the point is, none of the costs of IVF, from treatment to the medications, are covered by my wife's insurer. Nor are they covered by many insurers. I don't expect to get it all covered, but since the very same drugs are covered in smaller doses if a person decides to pursue an artificial insemination, why can't part of it be covered? And since this pregnancy through IVF would also be a therapy for her endo, why not cover it if it could remediate my wife's disease for up to five years (or potentially longer)?

So, now what happens to my wife? She can't get therapy through her insurance, and she can't get different insurance since she has a 'pre-existing condition' - what options do we have? THIS.IS.THE.INSURANCE.COMPANY.COMING.BETWEEN.YOU.AND. YOUR.DOCTOR. You can't blame a government bureaucrat for this one.

I won't go into the idiocy of the surgery I had last summer, that my insurance did pay for, but there was no rationale for why it was done, and while it did improve things, they actually didn't need to be improved. I guess I did go into it, but I'll try to talk about it more another time.

Post #2 - 6 months later

Well, 6 months have brought many changes to our thoughts about our process to become parents. We got the news around the time of my last post that we would not be able to have biological children. I won't lie, it was hard to hear, but part of me knew that was going to be the answer after not being able to conceive for so long. While being very sad, I think it was the kick in the pants to start down another road.

As kicks in the pants go, it didn't take long to get another hiccup. My wife had been diagnosed with 4th stage endometriosis last summer. We had played around the endo for a long time, hoping Angie could conceive to 'reset' her system. This seems to be the proscribed method - if you can't conceive because you have Endo, you need to try to conceive. Huh? The cure actually is the impossibility. After going through the heartbreak (not strong enough of a word) of two failed IVFs, Angie heard of Dr. Charles Haislett. Dr. Haislett specialty was excising endo, and he recommended we get it done right away.

The surgery was set for 1 month following our pre-adoption classes at Children's Family Home Society. The way the doc had described it was that it would be a quick surgery, and she would go home that day. Both of us had had outpatient surgeries last summer to clear up infertility issues- Angie was supposed to be 'lasered' (one way of removing endo) and I had a varicocelectomy. Look it up. Obviously, none of this worked at the time.

The big day arrived - late April. Angie got sent to pre-op, and I was allowed to follow in about a half an hour later. As we sat and joked, the doctor finally arrived. He was hurried, because the anesthetist was late. He mentioned as we talked that Angie would be staying for three, maybe four days. Huh? Hadn't planned on that. It ended up that she needed it. She still has the 6 inch scar along her mid-section. Ouch. Sitting up was very hard for her for about a month after the surgery.

In the end, the doc removed almost all of the endo in Angie. To get it all, he would have most likely needed to remove her womb. He did take one ovary and fallopian tube, and about 30% of the other ovary. The hope is, that someday, with treatment, she still could conceive. The short-term solution is to get her pregnant through a donated embryo, which should 'reset' her system. For now, she is one hormone suppressants.

All of this put a damper on adoption for a few months as we reconnected and vacationed over the summer. We're getting into high gear again, getting paperwork ready for our homestudy. Fun. Lots of intrusive questions that biological parents don't have to answer about childhood, and how you were raised, and stressful situations you've gone through. The unexamined life is not worth living? Socrates was a jerk.

First. Post.

I'm not completely sure of the catharsis of writing a blog, but I hope that someday my wife and I can look back at our time spent in our journey through infertility. Here's the recap: we got married in 10/06. We started trying to have children a few months later. We have had several IUI's, a couple of surgeries, and 2 cancelled IVF cycles. We have started the process to adopt, but we are very early on. Currently, the best option for adoption looks to be Ethiopia, but there are a few other ideas we are checking out. It has been a difficult way to start our marriage, but I suppose nothing is ever easy.