Wednesday, October 31, 2012

Scary thing

So over the weekend I broke a tooth.  I wasn't doing anything exciting to break it, just chewing gum and some of it wound up in the gum, then another hunk fell out Monday when I brushed my teeth.  Ick.

After hemming and hawing, I called around to find a dentist who could see me stat because it hurt now that it was out.  This morning I went in and was told they couldn't be sure if I needed a root canal or just a filling replaced without xrays.

So I considered, and considered that waiting to fill what might not be that big a thing could lead to a root canal, and then decided to take the risk and get the xray.

I had completely not considered that there might be no avoiding an xray, so I didn't research it at all.

My dentist (who was probably my age, go figure, this should not surprise me at all anymore and yet it does... like the 16 year old MD I had when I got admitted to get my gallbladder out who was probably just a brand new MD fresh from residency and not 16 at all) said the risk is unknown although it wasn't considered unsafe like xrays in the first trimester would be.  It was up to me, and with the spouse at work and unreachable, it was up to just me.

So I jumped and I'm nervous but mostly I'm excited that my tooth doesn't hurt any more.  Now the rest of my teeth hurt because I had them all cleaned!  And with no dental insurance for me, now we're broke too! A thrilling way to spend my Wednesday before the evil exam.

And now, back to fake-ovudine and other HIV drugs and immunomodification.  Ugh.

Auto refill fiasco!

I do promise to write about the fungal meningitis outbreak going on around the US at some point, but probably not until after the evil test of evilness on all the AIDS drugs and the immunopharmacology that goes with them (think an evil combo of complicated information combined with "-ovudine" and "-ivir" drug names that all sound like diseases themselves AND I'm behind on studying... shocker...).

This article from Consumerist is one of my favorites on the subject.  Apparently (and this is totally unsurprising if you've ever filled a prescription at a CVS more than once) pharmacists and pharmacy technicians have been bullied into signing people up for auto refill without asking them about it.  Speaking as a minion of a chain pharmacy, I can totally believe it.  My chain isn't nearly so heavy-handed about auto-refills on prescriptions.  The regional management just lectures the store manager about it and promises are made that "we'll try to get more people signed up" but when we didn't, there were no repercussions beyond another lecture in a few months.

I like auto-refill personally but not the way CVS does it.  We used to live very near a 24 hour CVS and so we got prescriptions filled there because we could just walk over any old time and fetch medicines if needed (or whatever, since the grocery store was across 6 lanes of insane traffic and then across a 2 block parking lot).  The week before I'd run out of something, CVS would call to remind me to pick up my prescription.  About every 12 hours (maybe only 10, but twice a day).  Starting before the thing was even ready with "your prescription will be refilled at your local CVS soon!" calls.

But I never actually signed up for auto refill.  I would have noticed that.  I'm kind of obsessive about reading things and so forth. It took about 4 months to get off of auto refill, and I had to ask twice. CVS kept calling me to invite me back as a valued customer for another 3 months after that.

So I hope this investigation changes the metrics that big chains use to determine success. Maybe customer satisfaction surveys might be better, for example. I hope CVS quits being so awful and remembers that a pharmacy exists to help patients stay healthy, not solely to make money. I really hope CVS quits filling dubious prescriptions just to make more money.

As an example of a CVS "helpful policy," here's my recent experience shopping there. I needed an antacid so I stopped in while out of town. I never shop at CVS because they made me so mad the last time I was a customer. When I went to pay for the antacid, the cashier asks if I have a rewards card and I say no, and no thanks, I don't want one. She rings me up, I pay, she hands me a receipt, AND a rewards card! Arg! What an awful policy!

I have two rules about getting a job after graduation: I will never work for CVS (or Wal-mart either for that matter) because corporations live and die by middle management's obsessions. Profit at the expense of patients is a pharmacy chain death sentence. It's only a matter of time.

Tuesday, October 30, 2012

Fun things to do while pregnant: a short list

1. Imitate a beached whale and demand the spouse rescue you with beverages and fish sandwiches. Chips optional.

2. Discover things that entertain the fetus, such as poking, show tunes, and the cat purring.

3. Enjoy Little Monster kicking in response to typing of laptop propped on top of hir.

4. Play "does this fit?" dress-up with the 4 year old.

5. Declare shopping is required because nothing fits other than the spouse's dress shirts and take 4 year old shopping.

6. Play "pick the most excitingly colorful outfit" with the Kid and then try to let her "win" and acquire some of her festive choices without looking like a clown or like the 80's threw up its rejected outfits.

7. Take extra naps, possibly even in the mornings.

8. Take comical pictures of cat wearing recently discarded wardrobe items.  Kitty is not amused.

9. Try on every coat in the house to find one that fits now and might fit until Little Monster arrives.  Check all the pockets and discover hidden treasures!  Expired benadryl! $3.68 in change!  Ticket stubs from a play 5 years ago!

10. Demand extra snacks be delivered frequently, including special orders from the local convenience store's snack section and other normally forbidden items like Cheetos.

11. Play the "I'm so dehydrated!" card a bit more often than accurate to get drink delivery in addition to snacks.

12. Make ridiculous lists to entertain self while suffering through biostatistics lecture.

Monday, October 29, 2012

On "everything happens for a reason"

I was just minding my own business, reading a blog because I'm avoiding a homework assignment for a few minutes more, when there was this post about PCOS, infertility, and infant loss.  So I think to myself, "Well, self, let's read this and see if it resembles our experience."  And then I read the comments and it was a mistake.  TRIGGER!

Of course there was a comment about everything happening for a reason.  There always is one of those.  "Everything happens for a reason" la la la, here let me try to tell you your pain serves a purpose and that some divine intervention caused it.

I spent some time with the school chaplain (yes, yes... I go to one of those schools, where someone is talking about faith at least once a semester, and I personally think it's a good thing, but that's another post) about just this after the last miscarriage when I was struggling more than I am now with this "If there's a divine plan for my/anyone's life, how can it include such unpleasant stuff?  If EVERYTHING happens for a reason, what does that tell us about the nature of the divine and do I want anything to do with such a divine presence if it's sending such horrors on unsuspecting people?" quandry.  She pointed out something that I really appreciate.

First, if we trust in a loving, parental, divine figure, then not everything happens for a reason.  As parents we get to see that children just do stuff sometimes and they have no idea why.  While "everything" might be in our control as parents, sometimes what happens defies control or explanation.  It just happens.  You can trip and catch yourself a thousand times and then one day fall and break bones.  There's no reason for that instance over another to have a bad outcome, it just happened.

Second, even if we accept that the divine is the boss/parental figure and plans out every step of our lives, we still have free will and can do whatever we want.  This resonates for me since I dreamed of meeting the spouse in the weeks before we had a chance to meet at an event that I ended up not attending.  I had the same dream 2 years later in the weeks before we actually did meet.  To me, this tells me that the plan was there but I intervened and we didn't meet for a while, until we did.  Same goes for the bad stuff in life.  There is no plan for a car accident today, but if I'm texting while driving, I sure increase the chances that one will happen.

Additional to this is the "G-d must be saving them from something worse that would have happened."  Again, this really puts a mean-spirited tone to the divine.  If we understand our every action is planned out, why would the loving parental figure we thought up first plan out something awful?  It's nearly impossible to hold the idea of infinite loving divine figure and also plotting nasty stuff divine figure in your head at once, which suggests to me it's theologically bunk to make the effort. One of those ideas is wrong.

And third, it's short-sighted to ascribe meaning to what might just be chance and randomness.  Just because our brains like patterns and order and reasons doesn't mean there is a reason.

So keep your "everything happens for a reason" ideas about the bad things in life to yourself.  It hurts whether there was a reason or not and imagining all the bad things I could have done to cause whatever bad thing happened just ruin me.  Just because I learn and grow after something bad happens doesn't mean I had to go through all that pain to learn whatever it was.  I could have learned to value friends and to get them help the minute I saw a problem some way besides losing a friend to suicide.  That didn't happen to teach anyone a lesson.  It happened for all kinds of reasons but they aren't about punishing the living.  Those miscarriages, those might-have-been babies, they didn't die because I was a bad person or because I needed to learn something from it.  That's too horrible an idea for me to live with.

For me, faith in the divine has to come from that loving parent perspective.  I have faith that there is a plan for my life and that some things are destined to happen, but none of them involve sorrow and pain.  I believe in a plan for my life that includes good things and a path to being helpful to others.  That's the faith that I'm sharing with the kid, that the divine is like a loving parent, helping us figure out where we need to go and how we can live in harmony with each other.

Wednesday, October 24, 2012

Monthly theme post: Baby obsession

It's time for a PAIL monthly theme post!  This month's theme is baby obsession...

Here's some questions that were posed, and I figured I'd start with answering them and we'll see how this goes.
  • Since traveling the ALI journey have you found yourself “obsessing” over all things babies?
 YES.  I was a bit obsessed beforehand, but not all that much.  I would really say that I was interested a great deal before the loss and then infertility part of family-building.  After, obsessed. It's ridiculous.  It could probably trend toward an addiction, really.  I am that overly involved in all things baby.  It started with a carseat, then a stroller, and now we've moved along to prenatal development and a name.  Maybe we've picked a name so who knows what is next?
  • Do you find yourself researching all things child-related, from toys, to food choices, to child-raising methodologies?
YES.  I wish I could stop. I am continuing to generally avoid child-raising methodologies because I really don't like the "by the book" approach to children.  Historically I've felt that "by the book" was irritating as all get-out and that it disabled parents because they were all book, no attention to the child in front of them.  BUT I really liked NurtureShock and I'm badgering the spouse to read it too, so... whatever that means.
  • What choices have you made, or not made, as a result of your ALI journey?
I have to battle my nerves more to let the kid go and be a kid.  I have this urge to control as much as I possibly can, so I struggle with that much more now than I did before.  Choices not made, yeah, more of those.  Like: I want 4 kids, the spouse is dead set on no more than three (and thinks three is pushing things a bit far).  After the almost 3 years to get to child 2, this discussion has died completely.  We are living in the now and forget additional children, we just really want the second one!  Housing: we are not at all thinking about buying a house right now or any time soon because we know we'll have medical bills to pay off and any savings we manage will disappear there.  We are no longer really even discussing a house and if we ought to buy, we're just focused totally on family building.  I suppose that if we get to plan no-more-bio-kids (this is post-6 medicated cycles, that we have figured out and it's our limit, no fancy IUI or IVF we decided - so far at least), we'd need a house then .  Considering that is too much though. We'll wait.
  • Do you obsess over your child’s health, development, socialization, etc?
No. I mean, I try to make sure she meets a variety of people and spends time in a variety of settings, but I've let this one go (victory! yay!).  I know she's meeting milestones (since she sees her doctor and that's been the report so far) and that's enough for me. I figure this is the result of growing up with so many adults so deeply involved in my development being textbook-perfect, that the only way to rebel is to totally ignore any such development trajectory for the kid.
  • Do you obsess over adding to your family?
Only all the time.  I wonder if this will change/go away when Little Monster gets here or if it will ramp up.  I wonder if I/we will care about spacing child 2 and 3 or if we'll wait a bare minimum of time after child 2 to try for 3 because we have no idea how long that will take/if it will happen via adoption. I worry that (aside from having exclusively iPod photos take of hir) Little Monster will feel extremely middle child if we are in a hurry for kid 3 and somehow magically successful, or that the kid will be unhappy that there's yet another baby taking away from her awesomeness.  Growing up I knew a family that had 3 children, with an 8 year gap between 1 and 2, and between 2 and 3.  How weird would that be, to have 16 years between first and last child but only one in the middle?  AND WHAT IF THAT'S ME AS THE PARENT?  What if we wind up with a 10 year old, 5 year old, and baby?  Or what if we have a 6 year old, 1 year old, and baby?  Eeeeep!  Or what if we do a medicated cycle and wind up with multiples?  How would we fit more than 5 people in this house?  I hate moving! Yipes!

See? Obsessing.

On the bloggy front, I started reading pregnancy/baby blogs when we decided we were ready for kid 2, then I stopped for a few months after loss 1, then got even more obsessed after that break, then stopped reading again when we got to loss 2 (I was SO MAD), and then after loss 3, I shifted what blogs I read but I didn't stop for any length of time at all.  I hadn't expected this at all, but I felt supported in the blogosphere in a way that I wasn't IRL (because I was hiding and being anti-social and spent hours crying in my car, hiding even from myself sometimes just how much I hurt).  Between 2 and 3 (so...2011) I started reading various infertility blogs and it was largely like coming home.  It was a good break from strictly baby obsessing to venture into obsessing about baby-making instead...

Friday, October 19, 2012

Half baked

We've now arrived at right about 20 weeks gestation, so Little Monster is half baked (unless hir decides to follow suit after the Kid and wait around until well done at 41 weeks).  New trick this week includes kicking me in the ribs and being enthused about green beans or the terrible music playing here in the student union.  Who likes this music anyway? Bad hip hop with lots of cigars in the music video? Blech I'll pass.

I survived the 24 hour stomach flu and the horrid cold at the same time, and I'm still trying to get caught up on water intake after that dehydration.  I was pretty impressed actually that I could throw up that often for 15 hours straight, and now my ribs hurt a great deal because I got to cough AND vomit. Yowser.

At the halfway mark, I'm intrigued that SRB over at Little Chicken Nuggets has been having the exact opposite experience as me on the blogging front re: child 2.  She expresses very eloquently what I am feeling, that's for sure.  It's a weird deal, awaiting a surprise baby after much anxious waiting and worrying and weirdness of wandering in the ALI community online while having a (not going to say that adjective, but it starts with an n and rhymes with blormal) pregnancy.  The other piece that is SO HARD is accepting the loss of control.  Treatments give you some sense of control that you lose when you first realize it's not as easy to get/stay pregnant as chucking the birth control.  It's totally an illusion, but "knowing" that you can't get pregnant until you make an effort is sort of comforting, until it turns out to be a total lie...

I'd say that there's less, in my view, to post here about the Kid because of three factors:

1. She's 4 and a chatterbox and bound to start reading any minute now.  Also with the anonymity, it's hard to describe the Kid without getting into personal detail since she's quite the character.

2. She's been exceedingly frustrating lately following the trauma of moving and now being usurped as sole child, so I have been avoiding discussing this because it would be a short walk off a plank into a deep pool of me grouching that my slow-to-transition kid is, well, being herself... hmm... who's got the real problem? ME...

3. I am talking pretty close to zero about being pregnant in real life.  I'm not a thin person, so it's probable that I'll get to the hospital to check into L&D and have to explain what I'm doing there.  Aside from the obvious general dislike I have of being overweight, there is a great benefit to plus-sized pregnancy, which is that NOBODY TOUCHES MY BELLY!  I despise being touched so it's great to be able to be stealth-pregnant.

In the realm of stealth-pregnancy, I sort of enjoyed the "so when are you due?" chat with the lab tech when I had my glucose test.  I just loathed the ultrasound though, and then the doctor visit, because both involved the dreaded "Which pregnancy is this?" question.  Ugh.  Yes, fifth pregnancy, yes 2nd child, yes, I know.  The frown and "ohhhh" are really gratuitous and make me uncomfortable.  More uncomfortable.  This whole thing makes me uncomfortable, thanks.  I'm hopeful that I'll get to stick with a doctor in the practice soon, although I have been trying to see the bunch just to discover if there are any I loathe, because that will mean no more introductory conversations where we rake over my history of not so successful pregnancies.

On the professional front, ooooooooh lifestyle modification in drug therapy...  Sweet!  It's a really exciting new direction and possible job opportunity.  This has been a lovely conference and I am really excited about this prospect.  There will be more!

Thursday, October 11, 2012


Yep, I was nervous for nothing at all, it was all totally fine.  Little Monster is apparently going to be tall like hir big sister, also hates staying still while being scanned so it took a long stinking time, and refuses to be identified as a she or a he (that's what that "hir" pronoun is for, for gender neutral individuals rather than gender-neutral things that get an "it").

My glucose test was also totally fine, as was my fasting glucose, and let me tell you that was no fun at all.  No food or drinks after midnight until a blood draw and then glucose sludge swig at 8am.  Arg.  Then I studied for some test or other for an hour, got another blood draw, and then went to get coffee (a decaf with a shot of vanilla, cream, AND more sugar thank you very much).  Bad news is that I have to repeat the test at the normal end of 2nd/start of 3rd trimester mark (blech).  At least they had clear, very cold, lemon-lime slime to drink rather than the horrid orange stuff (that was WARM the last time I took this test. eeeeeew).

What else is there to say, except fall break is the greatest invention EVER?

I have an awful cold or something and it's hard to function, so I took yesterday off from school (#noclassesWednesday) and watched romantic comedies and read a book.  It was lovely.  Next week is a short trip for a conference with classmates and I'm excited AND we're staying by a frozen yogurt bar restaurant (is that what those are called, where there's 6 kinds of frozen yogurt and about 30 toppings and you mix and match to your heart's content?), so I know what's for dessert all three days we're there...

I also have been thinking a lot about sex and gender and marriage and stuff, so that post will arrive soon.  I've also been thinking about the weird "clinical" versus "community" divide in pharmacy, so we'll get there too.

In the meantime, I really adored this discussion of keeping moms in the picture with their kids.  Although as part of this anonymity deal, there won't be any face pictures of me and the kid, maybe we could work in some no-face, we're both wearing clothes from Target shots (hint: this would be most of the time since we are incredibly boring and shop at Target out of convenience and being broke).  Because it's important to be visible parts of our kids' lives as moms and it's easy to step out and hide and pretend like we don't need to be in the pictorial record of our families.  There's even a great discussion and other folks' posts over here at the PAIL bloggers website!

Sunday, October 7, 2012


Tomorrow is the anatomy scan deal, and we get the glucose test results.  The horrid test itself was Friday because I refuse to try to not eat AND drink 3 glasses of water for an ultrasound on the same day.  I'm super nervous and have spent all day today not properly studying for my midterms (although Spanish is open book/open notes and pass/fail, I still need to study lots more than I have).  On the upside the spouse is coming with so it's less scary.  On the downside, it doesn't make me less scared...

Today the spouse and kid made me a lemon cake for my approximate birthday (off by who knows how many days... it's Sunday today, right?) so just in case I fail I got my cake.  It was quite good.  I think I need to have a few more lemon related things in the next few days, probably including lemon cheesecake.

A couple of the blogs about pregnant people I follow have good news today.  One delivered a healthy if very early little guy and the other made it to viability at 24 weeks!  I'm also making an effort to read more blogs about unexciting pregnancies too so it doesn't all seem like drama and scariness. 

And now, time for either studying or vegetating until tomorrow.  Also deciding whether to find out which variety of baby Little Monster might be.  We are terribly indecisive around here, aren't we?

Wednesday, October 3, 2012


It dawned on me this morning that I'm not actually following any "normal" pregnancies as written about by "normal" bloggers, aside from one (which is about 10% or less of my blog following).  I've been keeping an eye on a high risk pregnancy, and one formerly routine-ish pregnancy that's now moved to a hospital and possible pre-term labor.  I've been anxiously awaiting hearing about IVF cycles and clomid cycles and all that jazz.

So this realization that the only normal pregnancy I'm hearing anything about is one on facebook from a fertile friend who I haven't kept very close ties to over the years.  I'd say about 90% of the time I just scoff and ignore her posts the first time around, then later read them obsessively because something is wrong with me.

AND I know what it is!  I'm just a nervous person about pregnancy now, and that will probably never ever go away.

Example: All year I've been planning to go to the ASHP Midyear meeting in Las Vegas this December.  It's a big deal national conference, and yes, I don't actually need to go for school, it's just for my personal entertainment and education and networking and... ya know.  All that jazz.  I'm not totally sold that I'd be happy working in a hospital but I figured I'd go to this conference and see what I thought.  I went to the AMCP national conference previously and was shocked by how much I enjoyed it.  Never in a million years would I have thought I was interested in anything managed care, but it turns out I am.

So now, when it's time to sign up and actually make real plans to go, I'm hesitant.  I've been pretending it's because I'd be enormous (true) and uncomfortable the whole time (also true) and it's too expensive, but really, it's because I'm scared.  I'm not sure I want to travel at all while pregnant, not even into the city to visit my sibling for Thanksgiving, and that's not more than an hour and a half in the car.  Let's be honest.  I will never ever find childcare for a baby and the kid for 3-5 days so we can go to a conference somewhere warm in the winter.  This is really the last shot at that level of freedom for several years.

I'd like to imagine that the anatomy scan scheduled for Monday will make me feel all warm and fuzzy and confident about this, but it totally won't.  I'll still be nervous.  I'll still wonder every other minute if this is even going to work out at all, and what it does to the kid if it doesn't (as if moving wasn't trying enough, poor thing), what the worst would do to me.  I'll just try to remember that living in fear does me no good at all, and there's lots of hope that things will be totally fine.