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Army of One : Adventures of a Squeaky Wheel 

7/29/2014

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I've railed on in this blog against the unfairness of the fact that my life is still very much effected by both the financial and medical ramifications of the most heartbreaking experience of my life. On a daily basis credit card statements, hospital bills, follow up appointments, and insurance documents pull me back into the murky mire of a pain that I keep mistakenly thinking I've outrun (I never have been much of a runner). This post is less about the features of that particular beast though and more about the response I have had to have to the inevitability of its presence in my life. I have had to build an armor of information and health-care system knowledge even though it very much goes against my natural inclinations (I'm a lover, not a fighter, you know?). I have had to obtain this armor however, because it is very apparent that those who do not have said protective gear are pulled under and trampled over in this battlefield of reproductive disfunction and medical need. 

I am not a numbers person. I never have been. I got by in math class until I graduated high school and then let my math brain go into early retirement. When the bill comes at dinner I hand it to someone else to divvy up. I throw my pay stubs in an envelope and with little to no thought (until its time to panic at tax time). I forget to look at price tags and then have zero ability to quickly add up in my mind how much things are worth to determine if I'm being overcharged. So, when it comes to navigating deductibles and insurance coverage that same numbing of my synapsis always seems to occur. I can hear the insurance representative speaking in what seems to be a reasonable tone seemingly laying out a logical progression of thoughts, but her words are not translating into my language. It can feel belittling and I often feel the need to interrupt the representative and suggest that perhaps she ought to speak to a grown up about this rather than myself (then I remember I am one of those). So the first part of the armor has been wrapping my brain around deductibles, co-insurance, EOBs, COBRA, and all manner of other acronyms I never had reason to know before. I've had to demystify this process for myself and take ownership over it. I've had to remind myself that no one expects me to be an expert on everything (except myself apparently). It has been my new strategy to remind myself that informed deferment to the people that actually are experts on this stuff is okay.

The next part of the armor has everything to do with self-advocacy as it pertains to my medical plan. It's strange that this should be difficult for me as a big part of my job at the hospital was being a patient advocate and encouraging patients to advocate for themselves. However, when it comes to my own life it feels quite a bit more complicated. I get paranoid. I do not like to be a bother. I don't like the idea of being the patient about whom the medical secretary secretly rolls her eyes. However, I am finding that if I don't keep track of the intricacies of my own medical needs and follow up on them with the doctors myself, they will often go unaddressed. Sometimes this takes multiple calls, call backs, emails, and, hey, sometimes it takes tracking down a physicians vacation home and staking out in the backyard overnight (kidding. don't be frightened). 

I think self-advocacy is key in many medical specialties, but there is an added layer that I am beginning to uncover when it comes to reproductive endocrinology.  The more I am in this world and speak to other women who are as well, the more my theory is backed up. No physician or nurse or secretary would ever admit this, but there is a certain underlying attitude toward women who require reproductive support. I'm not suggesting this energy is created maliciously. It's indirect and never acted on, but it exists. It's palpable. It's a certain gentle implication of desperation, a nod toward the archetype of the neurotic woman with biological clock ticking , a hint of blaming deep-seated and justified emotions on simply being "hormonal". A certain degree of this exists, but you know what else exists and trumps all that? The questions that I need to get answered. If it takes persistence and fortitude to get those answers -- I've decided I am ready to go to battle.  

So what I am turning over in my mind today is how to be this empowered warrior in a strange land unapologetically. I am finding that the more of my genuine self I bring to the process, the more I am treated with humanity. I have had to rise above the paranoia about being "that patient" and reframe it for myself that I am the hero of my own healthcare plan. I've had to remind myself that when I was on the other side of this, I never thought patients with a lot of questions were a bother, I thought they were engaged. I felt for them. I wanted to help all the more. This is battle none of us signed up for, but we were drafted into it and now our best strategy is bravery, heart, knowledge, and hope.
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The Question

7/22/2014

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Over the weekend I was lucky enough to have a little escape with a dear girlfriend in her hometown by the sea. While there, I got to meet some of her family who were also in town. They were lovely and we had a great time getting to know each other. I felt instantly comfortable with them. As we chatted they asked how long I'd been married and about my job. Someone asked, "So are you guys planning on kids soon?" Dun dun dunnnnn. There was The Question. A question that has become unbelievably loaded for me this year. I've gone through phases with it. I'm in a relationship with it. It's my dearest hope and greatest enemy. It's nothing and everything. 

There was a time that question made me want to burst into tears. There was a time it made me extremely anxious. There was a time it made me angry. Now it does none of those things, but it still makes me squirm slightly only because I struggle with the right way to answer at this point in my journey.  How do I answer honestly, while not making the asker uncomfortable? How do share without over-sharing? How do I keep the conversation casual, without glazing over and disrespecting the deep hurt I'm still lugging around? So I said : "Yes, we definitely want to, but we've had a bit of a bumpy road in that area". I figured, that gives enough that they could inquire more if they wanted to, but if they were uncomfortable we could just leave it at that. One of the moms present offered a tip she used when she was having trouble conceiving. I could tell the miscarriage drift hadn't quite been caught and that was totally fine. Then there were some questions about how long we'd been trying and it started to feel weirdly disingenuous not to clarify. I figure, it is part of my mission to be open about this stuff anyway, so I shared (in as breezy a tone as possible where this topic is concerned) that the problem hadn't been getting pregnant as much as staying pregnant. This time it was met with understanding and was responded to in as kind a way as I could have possibly hoped for. As has been shown to me over and over during this experience, warm openness is 99.9% of the time met with warm openness in return no matter how potentially uncomfortable the subject matter. Despite any slight awkwardness, I am so completely grateful for every person that shows interest in an open dialogue about something that is so easily and often brushed under the rug.

This experience got me thinking about The Question. It got me thinking about how we talk about this stuff and the self-imposed timelines and restrictions we put on it. 

One of the first follow up questions that is often asked when I share about my miscarriage is : "Oh, was this recent?"  When I say it was six months ago I wonder what that means to the asker. What does it mean to me? Does that mean I should be over it by now? Is the time to talk about it drawing to a close? Do I get some sort of extension because I still have so many unresolved reproductive medical issues? Of course anyone would say, there is no "right answer" to how long to mourn or how long to talk about it, but sometimes there is a certain undeniable internal pressure to "be okay" and to make it feel okay for others too. I guess the best we can hope to do is answer The Question in a manner that is consistent with where we are in our journey and not to judge that place. Maybe the answer is as simple as the truth. I can't control if I make someone else a little uncomfortable with the truth of what is going on with me and if I shy away from the topic I miss an opportunity to normalize the larger conversation about miscarriage. I think if we find ways to share from an honest and comfortable place, then others will pick up on that energy and everybody will benefit. I mean, I'm not saying you shouldn't also read a room before launching into a charming miscarriage anecdote (thats not a thing), but if the asker seems interested, then there is no reason to be embarrassed to share the reality of the situation.  Answering the questions that get thrown our way after miscarriage without that pesky added layer of shame seems like an important step in the quest Ever Forward. It sends the message to others, and more importantly to ourselves, that life can move forward and feel normal despite experiencing something traumatic.

What ways have you found to answer potentially tricky questions about miscarriage, infertility, or otherwise? 
Leave your suggestions in the comment section if you have ideas--i'm sure they'd benefit everyone who reads!! 

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Brave new (bizarre) world...

7/15/2014

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In the world of infertility and pregnancy loss there are many strange and unexpected circumstances in which I never dreamed I would find myself. In fact, I was blissfully ignorant to an entire world that so many women inhabit. Now I am oh so initiated and let me tell you : it's weird. It's so very, very weird, friends.

The other day I had to go for an HSG--in case you don't know, it's this test where they shoot you up with dye under an X-Ray and see what's cooking in your uterus and fallopian tubes. I was told it was incredibly uncomfortable by several trustworthy sources (no, not just google) and so I was nervous. The details of the procedure were fairly uneventful--first take a pregnancy test (because they just like to rub it in, I guess), change into another hideous sacky hospital gown, assume a compromising position in an exam room, and have something decidedly not fun done to your insides. The physical discomfort was reduced by taking a bit more than the recommended dose of Advil beforehand (disclaimer : I'm not a doctor, I'm not a drug pusher, and I am in no way recommending going against whatever medical advice your doc gives you, but when my "sources" suggested I go to town on the ibuprofen, I did, and for me, it seemed to help). The good news was that my fallopian tubes are in great shape (in case you were losing sleep over that) with no sign of the blockage that the MRI had originally suggested. Which brings me back to this bizarre world in which I live where I utter sentences like "At least now I only have to have surgery on my uterus". But hey, one less surgical intervention? I'll take it.

The takeaway from this experience had very little to do with the actual medical details, however, and more to do with taking new steps on my continuing quest to find ways to decrease the emotional discomfort. The thing I was left turning over in my mind was the idea of how to merge this odd world (a world of tests, discovering "egg reserves" are a thing, cryptic acronyms, ovulation, surgical interventions, and the depressing purgatory vibe of old waiting-room magazines) with the world I have (for the most part) comfortably been navigating up until this point.  How do I integrate this bizarre new world that has been thrust upon me with my pre-miscarriage life? How does it become just part of business-as-usual without feeling like it is stealing a little bit of my soul? 

Here's a piece that I am adding to the puzzle of the particular predicament of integrating the two worlds : it has to do with the way the day of my HSG appointment rolled out. Chris just started a new job so he couldn't leave to accompany me to the appointment as he usually would. Mom offered to fly in, but it's really not that big of a deal and so that felt unnecessary, so everyone's favorite series regular, my best friend and platonic life partner, Jeremy, was up to the plate (that dear man has a special place in Heaven where they erase all the knowledge of my uterus that has been forced upon him over the last 6 months à la Eternal Sunshine of the Spotless Mind). The day turned out to be not nearly as miserable as I had anticipated. I had visions of the collective sadness and sense memory of returning to the building where I had my D&C crashing down on me hard, but it didn't really go that way. I am just now putting together why that might have been so I can recreate it in the future. Here's what I can deduce... 

One of the keys to bringing these conflicting worlds together is to actually just go ahead and physically mash them together even if it feels unnatural at first. I didn't set aside a day just for the energy of appointment. I could have. If I had left a little more room to wallow, believe me, I would have. Instead I met Jer for coffee in the morning as we do eight billion times a week, we grabbed a bite, we laughed at the serious-looking nurse who I feared would not be able to tolerate my sass-mouth in the exam room (she turned out to be excessively lovely), we marveled at the inexplicably and heart-wrenchingly beautiful United Colors of Benetton ad that were the secretaries at the hospital Radiology Department (clearly sourced from Central Casting), I told the doctor a funny story while she sent my uterus into unpleasant contractions, and we followed it all up with strawberry frozen yogurt with rainbow sprinkles. Afterwards, Jeremy put my drowsy butt into a cab back home and instead of the slow-motion cry I expected to have while feeling like a zombie ransacked of all my sparkle, I just felt like a slightly more tired, achy version of me.  

In short, I was just myself in a weird situation instead of letting the situation shift me off my usual trajectory into weird energy. Trust me, I know it is SO not easy to find laughter and normalcy in these decidedly abnormal circumstances. I know that being in medical environments such as these can start to feel disconcertingly similar to an Invasion of the Body Snactchers scenario. There have been plenty of times I've sat in a waiting room desperately wanting to separate myself from the other downtrodden uteri present. I've wanted desperately to scream, "Just so everyone knows--I'm not like all these other women! This isn't my life! I just took a wrong turn!" However, I think a key to unlocking this whole thing may be working toward a certain acceptance that these experiences are more an innocuous part of my world and less an interloper determined to wreck my entire existence as I know it. I'm not suggesting I should brush over honoring the magnitude of the physical and emotional trauma, but I also don't have to give it all the power. I do not have to be a pod person version of myself in this storyline. I am not "That Reproductively Challenged girl". I am messy, ridiculous, optimistic, silly, emotional, sarcastic, mush-ball Becca who happens to be making a special guest appearance in the Valley of the Infertile. It is a landscape I hope to not walk forever, but as long as I am here I will continue to look for ways to claim ownership of my stay. 

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There's No Place Like it...

7/8/2014

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You know that saying, "You Can't Go Home Again?" I was wrestling with that saying a lot during a recent visit home to see opening night of a play my dad directed. I wanted to prove it wrong. Initially, all signs pointed to this saying being full of bologna. For example, the second I got home I was cradled by the smell of the air, the comfort of my childhood home, the familiar faces, and the easy unpretentiousness of a place that I know like the back of my hand.  I found myself smoothly slipping into the parallel universe version of myself that still inhabits that world. Can't go home again?! I thought. Ha! Watch me! 

However as the trip went on, I couldn't ignore a nagging conflict inside me. The last time I was home for an extended amount of time I was there to be in a play. It was a moment in my life where I had just left years of working 9-5 as a therapist in a hospital environment. I felt liberated in many ways. I was happy and on fire. It was a summer of late balmy nights, local bars, memorizing lines by the water, doing what I love, listening to the same much loved albums on repeat as I drove around town, and quality time with friends and family. I felt young and wild and free and bursting with possibilities and life. During my recent visit home there were times it felt like slipping on an old article of clothing that you expect to fit a certain way, but after wearing it around a bit you notice the seams are pulling slightly in a way you didn't remember. Had it always fit like this or had time shaped me into something new? I started to wonder if maybe it wouldn't be quite so easy to go back home in the way I always knew it (ugh I hate being wrong). 

There was a strange dissonance between effortlessly clicking back into the girl I was last summer and feeling about a thousand years older after the physical and emotional torment of the last six months. It made me think of that trauma theory that one re-experiences the trauma in a new way with each stage of development. I feel like that might also apply to being placed into various environments. The sense memories of home lit up my recent struggles in a new and unfamiliar light. As part of the theatre community of my hometown I saw many, many friends and acquaintances at the play. There was an instant comfort with everyone, but also this odd feeling that I wasn't sure if the person I was speaking to was aware of my deepest, darkest personal reflections (cuz, ya know, crazy me went and put them on the INTERNET). It felt like I was re-experiencing my trauma through the eyes of all these familiar faces and they were re-experiencing me through the eyes of the trauma. Part of me desired to be recognized for the trail of tears that I have walked and another part desperately wanted to keep that from everyones' minds so I could be carefree, fun Becca again. Doing fine. Doing just great. The city is wonderful. No complaints. Thanks for asking. 

No matter how much traveling home made me long to morph back into the woman I was a year ago (who had no idea what was about to hit her), being home also shone light on the ways this experience has helped me grow. I feel more deeply than ever (I hear my closest confidents collectively groaning and saying, please! enough with the feelings! she feels deeply enough! no more! we surrender!!) and I take nothing for granted. I absolutely see the world in a very different way than I did just one short year ago. Yes, there has been more pain, but I have to imagine that with that comes the increased potential for joy. Maybe I was initially hoping that going home would magically transform me into the same old hometown Becca who isn't scarred by miscarriage, or infertility, or surgery, but by the end of the trip, I realized I wouldn't want to go backwards anyway.

So no, I guess you can't go home again and expect to be the same version of yourself, but you can allow home to be a touchstone, a magnifying glass, and most importantly, you can let home evolve right along with you. 
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A Call to Action...

7/1/2014

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Be a part of The Ever Forward Movement! 
TheEverForward@gmail.com

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I started this blog because after my miscarriage I wasn't finding what I personally needed on the Internet. I was craving access to the story of someone who could relate to what I was going through and who was approaching it with real-talk, self-reflection, and even a dark sense of humor every now and again.  Okay, basically I just wanted to know I wasn't crazy (or at least that I was that I was in great company if I was). Since I began this blog I have been overwhelmed with the amount of women who have come forth to say they completely relate and who have relayed their own unique viewpoints. It has sparked a sense of community that has been extremely validating. For me, the very act of sharing my truth in this forum has been empowering and clarifying. Now I would like to offer that same opportunity to anyone out there who is interested. I want to share the sense of camaraderie and support that I have been so grateful to have found through this blog.  SO..... I have decided to expand my Guest Blogger section to invite some of you to share publicly the powerful observations and reflections that I have been honored to have you share with me privately. I want to offer this site as a space where women can put their experiences out in the world boldly and in turn receive the kind of supportive feedback and understanding that we all crave. 

I know how maddening it is to feel bogged down by the emotions that follow miscarriage/infertility. Chances are, a lot of women who read this blog know about those things too. All too well. The comforting things is : no matter what you are experiencing, chances are, someone else out there has been through it, can relate, and has maybe even figured out a way to cope with it that you haven't thought of yet. I think as a group we have the potential to support each other and move (ever)forward in a really profound way. As a drama therapist I especially believe in the benefit of collaboration and shared stories in the therapeutic process and I would love to bring that spirit onto the blog for the mutual benefit of all reading and sharing. 

So here is your chance to share and play an active role in this little (but mighty) community we are building! Send your stories and thoughts to TheEverForward@gmail.com (keep them short-ish, maybe 500 words or less)! They can be absolutely anything that you want to get off your chest regarding the experience of miscarriage, infertility, etc. Also, if you have already sent me your story or thoughts in the past and want to give me permission to post them here drop me a line again and let me know. You can request to keep your story anonymous or not, just specify what you would prefer. Keep in mind! --you don't have to be someone who has personally experienced miscarriage or infertility to submit a story-- it would be equally appreciated and important and interesting to have the points of view of partners, best friends, siblings, parents, grandparents, aunts/uncles, dog walkers, physicians, reiki practitioners, shamans, spirit animals, and acquaintances.

Lets shake things up a little with some new energy, new voices, and new perspectives! I can't wait to hear from you! 
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    lover of life. celebrator of everything. drama therapist. wife. friend. picking up the pieces. finding creative ways to put them back together.

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    © Rebecca Elkin-Young  and theEverForward.com, 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Rebecca Elkin-Young and TheEverForward.com with appropriate and specific direction to the original content.

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