Thursday, October 25, 2007

Musings of my inner luddite

Ok, so we’re at the point here where I think I can safely say…

I’m not getting a baby anytime soon.

We’ve been trying to get pregnant for fourteen months with absolutely no success. Yes, ok, we didn’t give it our BEST try every single month. We were stressed and busy and tired some of those months. In December and August we didn’t try at all. (Neither moving boxes nor my parents’ house at the holidays gets us in the mood.)

But most of those months… we did everything right. I read the books. I charted my temperature. I got real up close and personal with all my… well suffice it to say that I learned A LOT about my reproductive cycle.

And now, in addition to my baby-less state, I’m noticing some… unpleasant changes. At least five times since we’ve been trying, my period’s been a WEEK early. Not a few days early – a full, freaking WEEK. And when this happens, it lasts days longer than usual.

So this week, I went to see my new gynecologist. Seems like a nice lady. Wasn’t horrified by my psychiatric history.

She says I have “unexplained infertility.” Fantastic. Just what I wanted. Another diagnosis for my collection.

She referred me to the University Fertility Clinic. As if my weeks weren’t busy enough doctor’s visits.

You wanna know what I think?! (WARNING: No, honestly, you don’t and should probably stop reading RIGHT NOW.)

I think this is natural selection at work. I’m the weak zebra in the herd. I’ve known it for a while now.
  • My eyesight’s crap.
  • My GI system’s temperamental.
  • My psyche’s all broken and held together with scotch tape.
  • There’s massive gobs of heart disease in my family.
  • I’m a good 30 pounds overweight.
  • I have ingrown toenails and a urinary tract that gets infected if you look at it wrong.
  • I can’t even hold a freakin’ soda can for pete’s sake!
If I were left to fend for myself in the wild I’d be eaten by a cheetah in about 30 seconds. (Ok, I’m smart - maybe I could outfox it for a few minutes but that’s probably about it.)

So why, given all of the above, do I have the arrogance, the gall to think that I have the RIGHT to reproduce? I’d just be weakening the species. Sometimes, I wonder if the responsible thing would be to leave well enough alone, listen to nature and forget medical science. Maybe it’s better to let the bad DNA end with me.

Except for my husband. He's got some pretty nice DNA. It'd be a shame to let that go to waste.

Wednesday, October 24, 2007

How I got my (new) therapist II

Step 4: Call my insurer. My new therapist’s clinic didn’t take my husband’s insurance, despite the fact that he works for the biggest employer in town… But really, who can blame them for not wanting to negotiate their rates down and submit to scrutiny from case managers. So, nervously, I called my insurance company.

Um… I said, I just moved here from California. I was seeing a therapist there. I want to see someone here. I have a history and diagnosis of major depression. (I didn’t say Borderline because – hey, insurance doesn’t cover personality disorders! Subterfuge - what fun.) Oh, no problem, they said. “You have unlimited visits and we don’t require pre-authorization for visits.” That sounds… good, I thought.

Um… what if I find a therapist I like but they’re not in your network? That’s fine, they said. “Just download the claim from our website, submit it and we’ll pay 70%.” Also, not terrible news.

Step 5: Paperwork. I asked my therapist if they’d help me with the claims. No, she said, “we’re not really set up for that.” Uh… I’m not really ‘set up’ for it either! I’m just the patient. But I don’t have a choice! Good point, she conceded.

So I did the forms. They were incredibly complicated. But I’d filled out similar forms in CA so I worked it out. I called the insurance company one last time, just to double-check some details. Oh yeah, I said, “as long as I’m calling, I wanted to ask. You guys pay 70% of ‘reasonable and customary’ for out-of-network providers. What do you consider reasonable and customary?” I was put on hold. For a long time.

Turns out, they consider $130 per hour a reasonable rate. My therapist charges $150. That meant that each week I’d be paying 30% of $130 PLUS that extra, unreasonable, uncustomary $20. Add to that the $15 per week for group. So my therapy was going to cost us about $75 a week. I don’t know about you, but I think that’s a LOT of money.

Step 6: Negotiate. I went to my therapist and oulined the situation. I asked if the clinic would be willing to offer me a reduced rate. Would they lower their hourly rate just $20 or even $10 to make up for the difference in the insurance? It’s not my fault they don’t take my insurance. It’s not my fault the insurance sets their rates absurdly low… I picked THEM instead of some in-network bozo that knows nothing about personality disorders*.

*My insurance company did provide me with a list of hundreds of in-network providers. How would I use this, I wonder? How would I know if any of these people know how to treat my VERY controversial, VERY divisive, VERY tricky diagnosis? Should I call all of them and see who’s taking new clients? The good ones are likely booked up. Should I interview the ones who ARE available? That would take lots of visits and co-pays! And ultimately, I’d still be paying $30-40 a week for an in-network provider.

My therapist said that she thought it was a reasonable request. She’d talk to her partners and get back to me. She got back to me today. She said that neither she nor practice could afford to reduce their rates right now. She suggested we talk about it again in January and see if things have changed. I was disappointed, but I felt… responsible.

Step 7: Pray.
I’m sure there’s a yearly maximum or some other catch hidden somewhere.

Tuesday, October 23, 2007

How I got my (new) therapist I

Step 1: Research. I asked all my therapists in CA if they knew anyone in New England that specialized in Borderline Personality Disorder or DBT. (I figured if they do DBT, then they know all about Borderline) Then, I searched online for “DBT therapists in my state.” When I was done, I had a list of about a dozen people. I could eliminate a couple of people just based on their titles: One sounded too intensive. One ran a partial hospitalization program. One worked at a mental health center for low-income and low-functioning clients. One specialized in depression. Two were researchers, not practitioners.

Step 2: Phone interviews. I emailed or called the rest of the list. Most, but not all, got back to me and said that they’d be interested in working with me. Then I had a phone interview with the remaining few. By which I mean that I interviewed THEM. I eliminated one person because she was only available one day a week. I eliminated another because I didn’t need couples therapy.

Step 3: In person interviews. By now, there were only two left from my original list*. I made appointments to meet with them as soon as I arrived on the east coast.

*Along the way, the people I had contacted had given me more names of providers. I discovered, to my delight, that I had actually, on my own, already found and contacted almost ALL of the practitioners within 10 miles of my home! I decided to hang onto the other names in case the first couple didn’t work out.

When we finally met, I interviewed them, politely, in depth. I told them about what I wanted and needed. I asked them about their perspectives on Borderline. And I tried to listen to my initial, gut impressions. I liked one a lot. I didn’t like the other one. A lot.

But I’d found someone I liked. Now I just had to pay for her.

Sunday, October 21, 2007

I can live without the bon-bons. But daytime TV... that's a different story.

So I got myself some employment… and instantly became BUSY. (hence the lack of blogging in recent days).

I kinda had to get some part-time work – unemployment was eating holes in my self-esteem. I don’t wanna work full time but it turns out, I gotta do SOMETHING or else my head starts to feel all bored and slosh-y.

Getting the jobs was easy to the point of being embarrassing. Basically, I sent my resume to six Craigslist ads for tutoring positions. A DAY later, five of them wanted to hire me. It took the 6th a couple of weeks to read their email and then they wanted me too. This of course, made me feel completely proud and guilty and conflicted all at the same time. (Ah black and white thinking, my dear old pal… what would I do without you.) It’s nice to be wanted but getting a job shouldn’t be that easy! I’m left assuming that all those Ivy League words on my resume are doing the heavy lifting – and not me. (Cue the impostor syndrome.)

But could I just take one job and be satisfied? Oh no, I had to pick two. It’s like I’m “controlled by [a] Puritan Lady, some witch of industry who lived inside us, kicking us with her buckled shoes, making maniacal demands: every minute had to be accounted for, an arrow aimed at a target.” Also, It turns out that I’m a sucker who can’t say no. Must. Please. Everyone.

So, on Monday & Wednesday afternoons I’m tutoring at a non-profit charter school in the “inner-city." On Tuesday, Thursday & Friday afternoons I’m teaching at a for-profit, boutique tutoring center in a fancy suburb that provides tutoring from a psychological perspective.

The Monday/Wednesday job has been good for the soul. It's only a two hour commitment each day and I get to feel like I'm doing good - helping kids who really need it. On the other hand, it's a bit depressing. These inner-city kids are SO behind and I feel like my little interventions can only make a tiny dent. At least the student I’m paired with is finally starting to look at me like a human - not a very pale, alien, life form.

The Tuesday/Thursday/Friday job has been almost the polar opposite. Most of the kids I’m working with have limitless resources. AND they’d love to fill up all my free time. I'm supposed to work for four hours on Tuesdays & Thursdays and attend a staff meetings and professional development lectures for a couple hours on Fridays - only about a 10-hour commitment… right? But, add a couple of extra hours of training a day and last week I was working almost 20 hours. I mentioned that the Monday/Wednesday job ends in December and they’re already planning to fill up those days too.

It’s flattering that they want to spend all that time developing my skills and selling my services to clients but…

Do I let on that I have a mental health disability and can’t do everything? If I tell them I have a disability, I open myself up to possible discrimination and judgments. If I don't tell them I have a disability, I worry that I'll come across as this slacker dilettante who only works part time because her husband keeps her in bon-bons and daytime TV. (ok granted, I DO watch a lot of daytime TV...) I know I shouldn't disclose my diagnosis in some settings but sometimes I feel like people just won't SEE the real me unless I do. I know that this is probably the reverse of how people with other disabilities see the issue but then again, with mental illness, people can't see your broken bits.

Monday, October 08, 2007

I don't bite (anymore)

So last Friday, I finally worked up my courage and wrote Paul & Denise a note. I tried to make it as non-crazy sounding as possible.

(although, I decided at the last minute to leave the note on their door instead of putting it in the mail which in retrospect may be construed as a bit stalker-ish...)

I said that we had just moved to the area because of my husband's new job (which I mentioned so they could Google him and see how nice and cute and respectable he looks on his website). I said that I heard they lived nearby and was amazed to discover (through the alumni directory) that they lived in the same apartment complex. I said that if they wanted to get together we'd love to see them but if they didn't that I wished them all the best. (I wanted to respect their sense of privacy. If I am/have become a horrible memory, I don't want them to feel... invaded. I mean, they lived here first.)

But I never heard from them. Now I'm thinking I probably never will. Oh well. Nothing ventured, nothing gained.

I emailed a friend from college to tell her about the note. She congratulated me on being brave. She pointed out that it's good to say things that are lingering in our brains and won't let us move on. At least I won't have to worry about awkwardly running into them in the parking lot. They know where I am now. If they don't want to see me, they can take preventative measures. They can avoid me like the plague.

Still, the whole thing has left me feeling a bit... like a menace to society.

I keep trying to tell myself that lots of people (even people without Borderline!) get into feuds. Lots of people have an ex or a nemesis they worry about running into. But if that's true, why do I feel like this conflict (and it's associated anxiety) is yet another tax I have to pay because of this disorder? Why do I feel like there are scores of people out there who remember me as difficult, pathetic or just plain nuts? How do I explain to them that I've changed, that I've earned a second chance? That it wasn't really my fault that I acted that way but I AM sorry for my behavior.

I wish I could get all those damaged relationships out of the friendship freezer. I'd warm them up and tell them how much I've missed them for all these years.

Wednesday, October 03, 2007

All I want for christmas is a forklift

So I’m back. Sorry for the hiatus.

To say I’ve been busy would be the understatement of the year. There were THINGS to take care of.

You see, every single THING we owned (including our car, our bodies and our cat) had to be carefully packed and hauled across the burning August wastelands of all those red states. Man is it hot and dusty and scary in those states. (They don’t clean their gas station restrooms very well either.)

Then all those THINGS had to be unpacked, cleaned and obsessively put away somewhere in an aesthetically pleasing pattern.

All the THINGS we couldn’t move had to be replaced – so in came new ink cartridges, food, toilet paper, spray cleaners, cat litter, and light bulbs.

Finally, every little THING needed to be re-registered and re-approved to exist in our new state.
  • Gotta organize the money – new checkbooks, grocery discount cards, jobs and IDs to park at the jobs. And 4 million change of address forms so everyone knows where to find us and our money.
  • Gotta organize the bodies – new health, dental & eye insurance, a new veterinarian, gym memberships, optometrists, and gynecologists.
  • Gotta organize the car – new oil, license plates, registration, and insurance policies.
  • Gotta organize the ass – new couches, scratching posts and security systems to protect the precious couches. Oh, and new gas, power, phone, and cable TV subscriptions to make sitting on the couch worthwhile.
  • And don’t forget the brain – new therapists to organize the brain, of course. More on that later.

So now that everyTHING is all clean and legal… now we just have to live.

Oh yeah. And buy a house. So we can do all this all over again in a few months.