Once more, with feeling.

I really hate that I can't write about what's going on right now. But as a friend recently told me, there's sometimes such a thing as sharing too much.

And now, a word from the grammar police.

This has nothing to do with any of my so-called themes, but I don't care. While there are many things that annoy me (like insurance companies), almost nothing irritates me as much as the misuse of the apostrophe.

Thanks to my friend Mark for sending me this cartoon.

Why I hate insurance companies.

So this infertility thing is stressful enough without having to deal with insurance companies. Today was a perfect example.

I happen to have pretty darn good coverage for infertility through my husband's employer. But when one of my many doctors prescribes infertility-related medication, United Healthcare makes us go through a mail-order outfit called Pharmacare. Usually, this works pretty well. At least it did this summer. My IVF clinic faxed in my prescription, and Pharmacare shipped me a huge box of meds. Once they even shipped them overnight mail to the Tahoe area (long story). This coverage isn't trivial: the meds for an IVF cycle can total thousands of dollars, and I have the credit card balance to prove it.

But when the process goes wrong, it goes very, very wrong. Take what happened today.

It all started Monday, as we headed into what I think is going to be our last ride on the infertility merry-go-round. (I was hoping for a miracle "natural" pregnancy after last month's miscarriage, but that was not to be.) I saw Dr. R, and he prescribed letrozole to start Tuesday, and Menopur to start Friday, with a possible Ganirelex chaser.

I knew that there was no way Pharmacare could get me the letrozole by Tuesday, so I went to my local pharmacy. But I had Dr. R's office fax the Rx for the Menopur to Pharmacare.

Tuesday, I got a call from Pharmacare saying that they couldn't fill my order because I still had a balance from this summer that United Healthcare had denied. You heard that right: the insurance company makes me use Pharmacare, and then won't pay them. Only in this case, Pharmacare had it wrong: I logged onto the UHC Web site, and sure enough, United Healthcare had paid Pharmacare. They'd paid late, but they'd paid. I called Pharmacare, talked to two different people, and got everything straightened out, with assurances that I'd receive the Menopur on Friday.

On Thursday, I called Pharmacare to confirm that my meds were on their way. Yes, they'd shipped, the kind gentleman on the phone told me. That day, I did receive a delivery of needles and syringes (to work no less), but I just assumed that the actual meds would follow the next day, because the Kind Gentlemen had confirmed that they had shipped.

Well, Friday (today) arrives, and there was no shipment for me. I called Pharmacare, and after being on hold for an eternity, the representative tells me that my prescription hadn't shipped because of a miscommunication between the billing department and the orders department.

"But I have to take this medication starting today," I pointed out, somewhat sternly.

"I'm so sorry," said the woman, and told me that they could ship it so I could get it on Saturday.

"But my doctor wants me to take it starting today," I repeated. (Those of you familiar with the joys of infertility will understand the importance of timing. My husband and I have had to excuse ourselves from dinner parties to administer shots.)

What could she do? In the end, she arranged to ship it overnight, and I had Dr. R's office call the Menopur prescription into my local pharmacy for pickup today, even though it meant I was going to have to pay more than $1,200 for the meds out of my own pocket. I mean, I did extract a promise from the Pharmacare rep that Pharmacare would reimburse me, but I'm not holding my breath.

At least I get some 1,200 frequent flyer miles. Yeah. That helps.

Insulin and its discontents.

This is going to be a serious post.

Today I found out that our friends' baby son has hyperinsulinism. The mom has been keeping a blog about it since January, but I just found out about it today through a Plaxo update. I feel badly that I didn't know until now (lost as we've been in little infertility drama, which pales in comparison), but I feel much more badly for them.

Because I don't know what else I can do to help other than offer support and lots of prayers, here are some links for more information on the disease:

Diagnostic tests
Athena Diagnostics
Children's Hospital of Philadelphia
Stories about kids with HI
Resources for families
Treatment of congenital HI

I don't understand why bad things happen to good people, especially to babies who haven't done anything to hurt anybody. In every picture of this little boy, he's wearing a huge smile, even when he has a tube in his nose. I need to have a little talk with God. Not that He owes me an answer, but what's He thinking?

Speaking of insulin, Dr. R thinks I have a "little" insulin resistance, based on the number of follicles I'm producing (I don't have the other risk factors, like obesity). He prescribed Metformin. I'm also supposed to cut down on carbs like pasta, which I don't eat that much, and sugar, which I do. I'd better get serious about cleaning up my act as we go into this last and final round.

Still...blah blah blah. So I have to cut down on the M&Ms (and probably my nightly glass of wine) and hit the gym a little more often. It's a far cry from what my friends and their little boy are going through.

So, here's a note to self: Self, be grateful for what you have. In abundance. And when you start moping about what you don't have, it's time to think about what you can do for someone else.

A man's point of view.

One of the unfortunate things about infertility (as if there weren't enough) is that you seldom get to hear from the guys. This blog post from AceOfSpuds captures the male point of view. Captures it exactly, according to my husband, who says that AceOfSpuds put into words precisely what he has often felt, but could not express.

But AceOfSpuds doesn't just get what the men are going through. He also manages to portray the no-(wo)man's-land of secondary infertility:

I'll let you in on something that very few people really understand. Having a baby is every infertile couple's dream come true, no question. But the baby doesn't make the infertility go away. Infertility and childlessness are not the same thing, and it's really the infertility--not the childlessness--which causes most of the grieving. Which is one reason that "You could just adopt..." is a really insensitive response.

Here's the passage that really got to me:

And even if that one child is exactly the right number for your family, you still will never forget the pain of the struggle. Even when you gaze every night at that angelic, sleeping face, you are still an infertile couple. Even when you're awakened every morning by that little bouncy creature snuggling up in your bed and telling you he loves you, you are still an infertile couple. Even when you are unequivocally welcomed into the fraternity of parenthood by playgroups, schools and other rites of passage, you are still an infertile couple. All of the joys of parenthood cannot completely make the years of infertility recede into blessed forgetfulness.

Of course, as AceOfSpuds rightly points out, that's not always such a bad thing. Sometimes the memory of what you've gone through is a "wise counselor." Like when your toddler is having the Mother of all Tantrums.

I "met" AceOfSpuds by chance. Sort of. It turns out we work at the same large company, and belong to the same childcare email list. I've always been impressed by his eloquent, even-keeled responses to some of the more "interesting" messages on this list, and have had some very nice email conversations with him. So when he wanted to add me as a friend on Facebook, I glad accepted (usually I don't add anyone I haven't met in person).

Well, of all the things to have in common, AceofSpuds and I have this. He's been much more open with the world about his struggles, as he describes here. "We need to do something about the shame that surrounds infertility," he says. Yes. We do. Again: he gets it. I think most men going through this do, but they don't know how to say it.

Last night, my husband and I watched the episode of HBO's uncomfortably accurate "Tell Me You Love Me" where Palek tells a roomful of friends (two of whom have just announced that they're pregnant with their third child) that he and Carolyn are trying to have a baby as well, and have been for a year. Awkward silence all around, followed by an argument between Carolyn and Palek on the drive home, followed by a fight that ends in graphic and aggressive make-up sex. All generated by two very different points of view about whether infertility is a source of shame, or a fact of life, a medical condition, that should be shared with friends.

If you have cancer, it's generally OK to tell people. But if you have infertility--and studies show that infertility patients suffer depression on the same level as cancer or HIV patients--you keep quiet. Why?