Common sense and health care reform

Let me begin this post by saying I HATE it when my child wakes me up at 5:30 a.m., and I happen to have a blog post marinating in my head. My only option if I wish to attempt sleep again is to fricking write to get all my thoughts out of my head so unconsciousness might bless me once more.

Lately, I have been hearing a whole lot of naysayers tell these increasingly idiotic tales about health care reform in this country and what it means for us, the US population. I always do what I can to refute their tales with a simple thing I like to call "an ounce of common sense." Rarely does it work, but I feel compelled to share it anyway.

Yesterday, my MIL's neighbor began telling me about her "friend" who lives in England who, GOD FORBID, had a midwife and was in labor 36 hours and then had to have an emergency c-section anyway. Horror of horrors! Clearly this dear woman has no understanding of history because otherwise she would know that virtually everyone born prior to 1940 was birthed by midwives of some sort or another, and at home too. Ob/gyns are a modern phenomena. My father was born at home in 1942, and my mother was the first of her siblings to be born in a hospital in 1938.

Today I am sending an email to the Administration, my senators and representatives and anyone else in Congress who I think needs to hear someone say, "Keep working on this. It has to be done." And in my dear little blog, I'm gonna say why people who think health care reform is the worst possible course for our country are downright fools.

Mind you, I am not studying this in my "free time." My knowledge is limited to what I am able to read in the newspaper, online occasionally, and in the snippets of tv news I see. What I have is my experience and, more importantly, common sense.

1. CANADA and UK

If the health care system in Canada and the UK was so bad, then we would hear a LOT more complaining about it. As best I can tell, I don't know of many demonstrations by Canadians and the Britons denouncing their system. I do hear alot of Americans complaining though about our current system. I do read about more Americans filing bankruptcy as a result of their increasing medical bills.

What I do hear are "tall tales" that go like this: "So-and-so had to wait 3 months for hip surgery in Canada." I've never had hip surgery in the US, so I really don't know how long it takes to wait, but most people don't just wake up one morning with a bum hip. They spend months and years feeling their hip slowly decline and then after medication and batteries of tests, go in for surgery. So, honestly, if this is what a person in the US has been experiencing, what is another couple of months? Ah yes, I forget, we Americans are the Veruca Salts of the world: We want it now.

1a. If the health care system in Canada was so bad, then why are all these American working like dogs to get their medication from.....Canada? We like Canadian health care when it saves us a buck.

1b. A family member recently shared some insane notion with my mother that in the UK they just let people die who are on dialysis (this person's hubby is on dialysis after years and years of diabetes coupled with an utter refusal to eat properly and exercise). Again, countries with nationalized health care do not just let people die. With the media like it is, we would hear about this. Maybe if a person is in their 80s or 90s in terrible health, they might say, "No, you've got terminal cancer, I don't think knee replacement surgery is warranted." But this is COMMON SENSE!!!!!

2. SMARTER CONSUMERS?

D works for a relatively small company which went to a high deductible plan a few years ago. It took a long time to get used to it. One premise behind these plans is to help "consumers" make smarter health decision, and to some extent this has been successful for us. When one has a $4,000 deductible (and is responsible for 10% of costs up to $10,000), you tend to think a little smarter about how often you run to the doctor.

When my kids have a fever, I don't rush to the doctor after days 1 or 2. I usually let them go 4-5 days, treating as needed with fever reducers. Because common sense tells me that if they are running a fever and have a stuffy nose, they have what is called a virus. The doctor is going to charge me between $70-90 to tell me, "Let it run its course." And I let their fever go up to about 102 degrees before dosing them with ibuprofen. A fever is a good thing--nature's way of fighting illness naturally.

Now when G was an infant and began having tons of ear infections, I didn't just let them go. I saw the doctor sooner because of his age. And over time, I recognized the signs and symptoms better. For me, part of being a smarter health-care consumer has been learning better how my children react to illnesses.

(And I don't demand antibiotics. This could be listed as #1 health care pet peeve following closely by people who don't finish their antibiotics as directed.)

But here is one problem with this attempt to be a smarter consumer. There are TONS of health care plans with slight differences depending on which company you work for, which plan it is, and what benefits you have. So I can't just call my doctor's office or pharmacy and say, "How much does such-and-such cost?" in order to determine my cost or whether I really want to have the test or use the medication. The doctor or pharmacist can't just tell me. Believe me, I have tried this approach, and it simply doesn't work.

And even if you try to be a smarter consumer, there are just some costs you simply cannot avoid. With this new baby coming, we are gonna be out $10,000. It is a given. The baby has to come out some way.

My practice doesn't do VBAC, and I opted to stay with the practice rather than search for another doctor. So my c-section will cost an extra $500 for the doctor (it is $2500 for vaginal birth, $3000 for c-section), extra for the anesthesia (although women who do have vaginal births with epidurals pay this amount too so don't poo-poo the c-section's "must use an epidural" thing"), and extra for day 3 in the hospital to monitor me.

If there was a true birthing center in our city with midwives and nurses, with immediate easy-access to the hospital for emergency situations, I would do it no problem. But there is not. Every birthing center is IN a hospital. Every option is an ob/gyn. And when these are the options, there is no option. A woman is going to be over-monitored and over-intervened because that is just the way hospitals and obs are. In order to find something like this, I have to cross the bridge into Indiana (which for me equals more time costs, more gas costs, and potentially another c-section anyway depending on how the birthing process would go.)

When G was breech, my doula knew of 1 doctor who delivers breech babies. ONE DOCTOR in my city. And he is considered a "high risk" doctor because no one else wants to chance delivering breech babies and all the "potential" complications. I wasn't about to switch doctors at 37 weeks of pregnancy and incur the "costs" of seeing a new doctor and the stress.

So the point I'm trying to make here, although I feel certain I've gone off on a tangent, is that even if you try to be a really savvy health care consumer, there are limitations to what you can realistically do (or feel comfortable with) because of the current mess called US healthcare and insurance.

3. PAYING FOR IT ANYWAY

People worry about taxes to cover reform. But what they forget is that they are already paying for the uninsured. Health practitioners, facilities, etc, charge extra to help manage the load of the uninsured or underinsured. It is already worked into your cost in the same way that the cost of the sweater or tv you buy covers all the little tiny, unseen expenses associated with making it. The cost of a sweater is not just the cost of materials----it is the materials, labor, benefits for labor, insurance for the company that makes the sweater, machinery used to make the sweater, advertising to sell the sweater, and so on.

So as more and more people are uninsured, so too does your cost keep rising. As the cost for physicians to get liability coverage goes higher, so too does your cost keep rising. Anyone besides me notice how this has been happening?

To CONCLUDE (although I doubt I can go back to sleep now)......

I know there are inaccuracies in my "mental picture" of health care. But I simply get tired of hearing people lament as if our current system is the best in the world. It is NOT!!!! This has been researched. There is proof that despite all the money we collectively spend, it is not working in its current state because so many people are uninsured, because so many other people are underinsured, because so many people are spending increasingly large chunks of their pay for health care.

There used to be a time not too long ago, when the majority of people spent most if not all their money on meeting their basic needs: food, shelter, clothing, In many countries, this is still the case. The US is slowly moving towards that time again, which just drives us mad because we want to ooze money and spend money on our toys and entertainment. That time, I believe, will come sooner rather than later, if we continue on our current health care path.

Preparing for baby and other odds & ends

1. Journal

I took the kids to Borders today and purchased a pregnancy journal so that Baby #3 will know just how much of a surprise he/she was and how long it took me to adjust.

I have never really thought of this baby as an "accident." A surprise--Fuck Yes--but not an accident. I guess I have watched Kung-Fu Panda too many times, but I always think about what Master Oogway says, "There are no accidents."

It helped my mindset tremendously seeing the ultrasound pictures from last week, particularly the 3D ones. Seeing his/her face makes it "real," which I know is a stupid thing to say given the size of my abdomen and the kick fest that occurs multiple times a day.

Here is an update on dr. visits and other sundry details since this post.

June 26th -- 24 weeks, 1 hour glucose test, 150 lb.

July 9th -- 26 weeks, u/s scan with maternal/fetal specialist.

July 13th -- 27 weeks, 3-hour glucose test.

July 15th -- passed glucose test. Am amazed, astounded and thrilled.

2. Class

I am halfway finished with my class and am breezing right along. I am reading lots of really good children's books, which is fun in and of itself. But it is also nice that N can "help me" with my homework. She feels like a big deal sitting on the couch so mommy can read her homework.

3. The Kids

I try to jot down cute things the kids say and do in their journals, but that is hard between the tiredness of pregnancy and my class. And not having 2 seconds in the day to do anything even remotely "fun" or relaxing.

G is simply at a stage of adorableness. He is totally into his board books. In the morning when I get him out of his crib, he wants to sit on the floor and look through every one of them. When he gets to Brown Bear, Brown Bear, What Do You See? he says, "I see," over and over as he flips the pages. We have obviously read it enough that he remembers the story.

I've been trying to keep N busy with summer camp and the pool and playdates, but I know she is bored. Staying home with mommy just doesn't stimulate her the way being at school or with her little friends does. I think we are both a little nervous for school to begin but more than a little ready nonetheless.

For the past few nights I have been staying up until 11:30 and later doing schoolwork, so tonight I am signing off to head to bed early. Unless I wind up wasting time on FB after I type this word.

Days with the insane clown posse

If you think I'm talking about the rock band, you are wrong, so putter along to a website that actually knows anything about music.

I'm talking about my family.

I love them, but jesus, days like today just about do me the fuck in.

Now I could just rant and bitch about my kids and hubby, but I am gonna try to write something nice or funny or wonderful they've done after I bitch about them. To prevent myself from getting in my car right now and driving to Arkansas.

The GIRL--

I love her, but she so reminds me of what a needy little turd I probably was as a kid. She cannot entertain herself to save her life, just like her dear ole momma. This afternoon I read a couple books to her on the couch and then we snuggled and watched a movie while G slept. Quality mommy-daughter time, to my way of thinking.

But when G woke up, he wanted to help me fold clothes. (He tumps over the basket and then hands me undies and socks, saying "Tank you" each time he hands me something.) N decides to launch herself into the clothes pile, which wouldn't have been a problem, except them she decides to splay them all over the floor and makes it virtually impossible for G to hand me any clothes or for me to grab any clothes without having to haul her ass up to get them.

I got frustrated and asked her repeatedly to stop, and then she got mad at me for fussing at her and starts running her sassy mouth, which makes me even more angry, resulting in her getting a time out in her bedroom.

And when she pisses me off, that pissed off feeling lasts far longer than I'd like it to. But I just have such trouble shrugging it off because I get tired of being treated like a piece of dog shit. Mommas, are ya feelin me????

The MAN----

And all the while this is going on, the man is in the basement having his "downtime" playing Xbox games.

The BOY-----

He is suddenly hitting his tantrum twos. When he is unhappy about something, he throws things and cries and hits and is generally very unpleasant to be around. And this is happening more and more. Fortunately, I have lived through this before so I know it ends at some point. With the 5-year-old, I haven't been down this road...all new territory to me, and I know it only gets more frustrating the older and more mouthy they get.

Ok, so I've vented, now I'm gonna share something positive.

The GIRL--

She has become a little reader, which is so totally cool. She reads books to G in the morning while I'm getting dressed. She points out words in her books as I'm reading to ask what it is and what it means. She tries to read small parts of some of her books and is so proud to call me over and read it to me.

The MAN--

Is gainfully employed and still comes home every night after work even though it is a madhouse.

The BOY--

Is talking like gangbusters. He finally says "tar"for car instead of "nananana." He says "pish" for "fish." He points out diggers and stop signs. He sings along to No More Monkeys Jumping On the Bed, but his version with finger wagging and all is, "Noooo Mooooo Mommies..." and then it trails off. He points out his boo-boos or where his most recent boo-boos have healed up every chance he gets. He tells me after he's pooped, which is tremendously helpful since I ignore both of my children more than I ever thought possible.

Ahhhh, I love 'em again.

Tying things up???

I keep thinking I don't want to get my tubes tied when I have this baby in October. Last night I tried to explain my feelings to D, and he said I wasn't making any sense. Of course it was late, but I have to admit my sentence, "I know I don't want anymore kids, but what if something happens to #3?" isn't particularly well thought out.

So let me see if I can clarify my feelings for myself (and for him since he reads my blog). Isn't it sad how much of what I think my hubby learns from my postings?

I am totally good with 3 kids. I know I don't want 4, or 5 or anything beyond 3. BUT tying tubes 10 seconds after birth is scary because so much can (or could) happen to a newborn. Yes, the list I'm about to provide is worst case scenarios, but they live in my brain so they get a voice on this particular post:

1. What if the baby gets swine flu (which may or may not have a resurge in the fall) and succumbs?

2. What if baby dies of SIDS at 3 months old?

3. What if baby has some weird endocrine disorder and doesn't thrive beyond 4 months?

4. What if any of these aforementioned scenarios occur, and then D dies unexpectedly, and I meet someone else when I'm 39 and want to have another child?

Realistically I know that nothing can replace a child who dies. But I also suspect that if something happened to my child, especially an infant, I might want the option of trying for another child at some point before I go through menopause. Not that I would choose the option, but I'd want the option nonetheless.

The idea of tying things off permanently minutes after birth when I'm weepy and emotional does not sound like a good idea to me. I don't think I want to experience the joy of new motherhood with the potential worry (and potential regret) of being sterile. I know how my brain works, and I know which would would seep into my conscious mind more often. I do a poor job of handling mixed emotions at the same time, so walking headlong into it seems dumb on my part.

So my thinking is that when baby is 3 months old, hubby consults with urologist for the snipping, and then gets it done when baby is 6-7 months old. Because by then, I will be less emotional, be headlong into caring for 3 children (and therefore really mentally prepared to be OVER IT), and feel more comfortable that baby will probably survive its first year and beyond. Plus, in my experience, nursing a baby constantly the first 6 months does NOTHING for my libido.

And I will be that much closer to 37 years old. And given how much extra checking I've had to go through with this "geriatric pregnancy" I feel certain I don't want to do it again (unless said worst scenarios occur).

D didn't want 3 kids (although he is excited now about our surprise baby), and under no circumstances wants anymore....with me or anyone else (although I have a sneaking suspicion if I dropped dead and he married Miss 24-inch Waist and Big Tits who really wanted to have a baby he would comply immediately). So since he is TOTALLY certain, I think he should take the permanent precautions.

Because I am sick of being pregnant and feel 99.8% certain I don't want to do this again, but that .02% will bother me forever if I take permanent measures while I'm on the table watching the nurses clean up my baby.

What you forget

When I first started this blog, I named it "Mood-Disordered Mama" because I was knee-deep in adjustment issues. I had dealt with a breakdown when N was 9 months old--the constant crying, the anxiety that kept me from eating, the panic attacks that woke me all hours of the night, the intrusive thoughts that haunted me throughout my waking. I felt like I would never, ever feel "normal" again, although normal for me had been none too happy, really.

I felt like I would never feel like life wasn't a struggle.

But over time, as with any change, I did adjust. I got used to being on medication and the idea of being on medication. My symptoms eased. I learned a great deal about myself and my negative thinking through therapy. I think I became a better person...or at least a more knowledgeable person.

Life gets busy, and you do feel "normal" again, even if it is a new kind of normal. You forget how badly you felt. But then you have moments or episodes when you remember again, when you feel maybe just twinges of the sadness, the anxiety, the panic. It doesn't do you in; it doesn't take control of your entire life as it had.

But it does make you feel that maybe you don't have as great a handle on yourself as you like to think you do. It makes you remember that your issues are ingrained, set in stone, that your medication eases them, masks them, makes them bearable but under no circumstances does it make them go away forever. You are in remission; you are not cured.

I have a terrible memory, and I have read that folks with OCD do have memory issues, which is why they obsess and are compulsive. Their brains don't remember that they already locked their car and therefore don't need to relock it over and over or worry about whether they locked it. They don't remember that they did turn off the oven and therefore don't need to turn the car around 3 times to recheck it.

For me, my memory problems also make me forget that I struggle with my moods and have my entire life. Being down, being the pessimist, being the curmudgeon are what feels "normal," even though I know that this is unhealthy and really, truly abnormal thinking and feeling. But when I feel it again, after forgetting, it almost feels like falling into a soft, warm bed, the bed I grew up in, the bed that enveloped me my entire life.

Even the most dysfunctional of us feel like what we know, have known our entire lives, feels safe and secure, even if it is the worst thing for us.

Goddamn g.d. and my dark pregnancy mood

Well, I failed, and I hate to fail even when it is completely out of my control. Blood sugar is high, therefore I have to take the 3-hour glucose test. Utter waste of time as far as I'm concerned because I feel quite certain I will have to diet and monitor sugars for the duration of the pregnancy. Did it with N. This must be a girl.

It occurred to me last night that this pregnancy, in some respects, makes me feel like I did while carrying N---anxious, uncertain, lost. Fortunately I'm medicated because I think otherwise I'd be really, truly clinically depressed.

The surprise of the pregnancy factors in. The fact that I was sickly during the class I took from Jan-March. The fact that I had to push my second class up to the summer when I had planned to take it leisurely when N was in kindergarten this fall. The fact that G is a mere babe in arms and yet I will have another babe in arms as well to look after. And now the gestational diabetes. I, of course, knew it was a possibility, but since I didn't have it with G, I just thought maybe it was a fluke with N.

And then there's just being a mom to 2 kids and being with them constantly. I can't stand being with myself constantly, and I've had almost 36 years to get used to it. And the summer--no routine, no structure.

I guess what made me really notice that my mood is down is last week when N had a little virus. She ran a low-grade fever for a couple days and just felt run-down. No biggie, but I started ruminating on whether she had leukemia and was imagining all kinds of worst-case scenarios. Now this was common-place thinking before I was on meds. My brain only operated on intrusive, horrible thoughts and catastrophic thinking.

I am seriously thinking when I go in Thursday for the fetal echocardiogram, I am going to ask to find out the sex of the baby. On some level, I think the not-knowing is keeping me from coping as well as I think I could. Right now, I cannot plan, I cannot do anything except plod. And I feel out of control of everything. So, for me, I think grasping a little nugget of control might be a good thing (even though I know there is really no control; just delusions of control).

My down mood, the stress of the kids and class, the summer's lack of structure, the nebulousness of what life will be like with 3 kids, the unknowns of N's adjustment to kindergarten---all of these are weighing on my mind. And I feel unable to bond with this baby....like it is another unknown burden with which I have to contend. I don't like feeling this way.

I know this too shall pass. I know that these are mere inconveniences, and I am fortunate beyond words to have the life I have. People like to say, "God never gives you more than you can handle." I think god knows I cannot handle much.

Why I REFUSE to watch other people's children

I love my children with all my heart. I carried them for 9 months, nursed them each for at least a year, and would do virtually anything for them.

But I also feel the urge, especially now that I am nearly 26 weeks pregnant and in the middle of the summer "we have no routine so let's act like fucking apes" stage, to 1. smack them into the nearest universe or 2. get the hell away from them for as long as possible.

And it is for this reason that I refuse to babysit other people's children in my home. I have friends who do this, and it blows my mind because I love my own children more than life itself, and yet I want to kill them most of the time. What in god's name would I actually be capable of doing if I didn't love the kids that much? Hard to say, so I don't take chances.

Today was a crapper of a day. N woke up in a shitty mood...she was either sassy or trying to aggravate me or G (and she succeeded with me all day long on every front imaginable). I was LIVING for my trip to the grocery tonight, which is just sad.

G spent most of the morning crying because I was trying to transfer money and pay some bills online. Heaven forbid I give any attention to anything computer or telephone related. He screamed and was just a basket case. Of course when I try to sit him in my lap so he'll settle down, he bangs on the computer keys, making it truly impossible to get anything accomplished.

Things improved slightly when we ran some errands. Though this completely wears me out, it gets us out of the house.

This afternoon while G napped, N wanted me to play barbies with her. I wanted to lay on the couch and doze. But I attempted to be the "good mom" and play. Of course, we first had to get all the barbies dressed, so I was the lady-in-waiting, helping Pocahontas and Belle change into wedding appropriate attire. Then I got out my sewing needle and thread to repair the wedding dress and tuxedo of the loving couple. We were chatting about the planned wedding and the barbies' hair and other highly important things.

We also read some new library books after she momentarily tired of the barbie wedding preparations.

Of course, after we had done this for an hour or so, and I tried to lay down, she complained that I hadn't played with her. Apparently, getting the barbies dressed and discussing the nuptials does not count as playing. It sure the fuck does to me.

As I watch my two, I keep thinking, "What the fuck am I gonna do with another one?" And I really don't know. My standards are quite low, though. If I can keep my sanity and not murder them, I'll consider myself doing quite well.