Monday, September 23, 2019

Fertility fights on a freelancer's budget

So, looking at my old posts, at one point I broke down the costs of buying a house. Well, let me tell you, being an adult comes with expenses a lot less fun than that, though at the time I didn't know it. Though a lot of things in my life are going really well, and I don't feel particularly elderly, in the last year I have truly been slapped in the face with the reality of aging.

Specifically, with how quickly fertility can decline with age. For anyone looking at egg freezing or IVF, let me break it down for you a little. Because I really had no idea when I got into this.

So first, a short back story. About a year ago I started feeling unexpectedly crappy. My normally regular period showed up, and then refused to leave. I bled for about 40 days straight. I felt crampy and nauseous, and actually had to leave work early a couple times. For me, this is not normal. I've shown up to work running fevers before, because as a freelancer, if I don't work I don't get paid.

I made a doctor's appointment and also started googling pretty intensely. After a visit and then an ultrasound, my suspicions were confirmed. I had some pretty big fibroids. These are non-cancerous tumors that grow in your uterus. Mine were big enough that they'd likely make getting pregnant hard. They were causing all the bleeding and symptoms I was feeling. Though they are very common, actually, most don't get big enough to cause the problems these were causing. I basically had a couple small oranges and a lime (kiwi?) growing out of my uterus.

So, okay. Now what? My OBGYN recommended I talk to a fertility doctor about the next step. Older women often just get hysterectomies when faced with bothersome fibroids, but I want kids. I really, really, really want kids. After talking to the specialist, he recommended a myomectomy (surgery to remove the fibroids from the uterus and then repair the uterus). But he recommended not doing it yet. Since fibroids tend to grow back, he wanted me to wait until I was ready to get pregnant, so that I didn't have to get operated on more than once.

Simple enough, right? Wrong. Because he also ran some additional tests. And those additional tests showed that not only was my uterus a hot mess, but I had really low AMH. And what THAT means, is that my ovaries were also not operating the way they should for someone my age. I basically had diminished ovarian reserve (DOR), meaning I was running out of eggs way sooner than most women do. My AMH was more similar to a woman in her mid-40s than someone in her mid-30s.

So my uterus is full of benign tumors and my ovaries are starting to run out of eggs. And I'm 34(then), and in a new-ish relationship, and a freelancer with uncertain and unsteady income (and health insurance!).  My doctor recommended freezing some eggs, stat, and putting the fibroid situation to the side for now. He wanted me to aim for 20 frozen eggs.

So, I went on continuous birth control to try to stop my constant bleeding. It took a couple months before all the breakthrough bleeding stopped, but it worked. And then I did two rounds of egg freezing, to fairly depressing results. I do not have 20 eggs. I have more than zero, but not 20. And it was all very expensive.

For those thinking about it, or interested, these are some of the costs I encountered:

- The initial ultrasound that diagnosed the fibroids, despite having insurance, cost me a couple hundred dollars. They accidentally billed me twice, though, and it took MONTHS and so many incorrect bills to get it fixed.

- Then I did a saline ultrasound (where they inflate your uterus with water first, to get a better look). I thought this would be covered under my insurance, but they rejected it since it was considered fertility-related (vs gynecological), and it cost me close to a thousand dollars, unexpectedly, out of pocket. It almost cost me 2k, but I argued and pleaded and kept calling the billing department until they took pity on me.

- The two rounds of egg freezing, including medication, cost about 20,000. The medication was about $3,000 per cycle, with the rest going to the doctors. The first round cost more than the second, because my clinic gives women a 1k discount for subsequent rounds, plus I had some medicine left over. Regardless, about 20k combined.

- Acupuncture was recommended. I spent over 1,000 on acupuncture, because the woman my clinic recommended cost about $100 per session. She was great, and I think it did help some, but again, all out of pocket.

- I also spent some money on better food. I tried to cut out alcohol and coffee, at least during the cycles, and upped my consumption of fish and leafy greens. Avocado, pomegranate, eggs, and other fancy, expensive foods.

- LOTS of supplements. The supplements were maybe a couple hundred all told, but were a drop in the bucket by this point. Prenatals, folic acid, DHEA, Vitamin D, and COQ10 were all recommended to me.

ALL OF THIS was out of pocket. Money I had painstakingly saved to hopefully one day buy an actual home (not an investment property) went to this instead.  My insurance covered a few of the blood tests, but basically nothing else.

Was it worth it? Yes. Maybe. I'll know in a couple years. The first round of egg freezing I got only 3 eggs. Most women my age get about 15. The second round I got 6.  So I'm at 9, out of the 20 my doctor initially recommended.  I'm not going to make it to 20, I think. I just don't have the money.

I'm going for round #3 this year, though, after saving some more, because 9 just doesn't seem like enough.  The initial ultrasound I did today ($320, out of pocket) showed even fewer follicles than last year. About half, in fact. So my crappy, crappy ovaries are getting even crappier.  Oh, and the fibroids seem to have grown. And now there are more than the initial 3 - he saw little lumps all over my uterus. No wonder I've been feeling so bloated.

Even scarier: I'm freezing eggs, rather than embryos. So I don't know if my eggs are even good enough quality to successfully become embryos.  But, as wonderful as things are with my boyfriend, unless we know we're getting married, I don't want to make embryos I might have to throw away if we break up. They are too hard for my body to make. But I'm also really hesitant to use donor sperm when I'm in a very nice, committed relationship. That feels wrong. So, egg freezing it is. Over 90% should survive thawing, per my doctor, so out of my 9 eggs, I'm hoping all survive, or at least 8.

So, hopefully this information is somewhat useful to someone out there thinking about freezing. And I so, so hope women approaching their mid-30s think about getting their hormones and fertility checked. I had no idea things were so bad, since I don't smoke or drink excessively and I was always fairly healthy. But my reproductive system sucks. And so might yours! So just get checked, for peace of mind if nothing else.

In the next year, I'll have to decide what the next step is for me. So will my boyfriend. That's scary, too. It doesn't look like I'll be one of those mythical women who fall pregnant easily in their late 30s/early 40s.  But until then, I'm going to do what I can, which amounts to setting money on fire, and I'm going to hope it's enough.

Tuesday, September 10, 2019

The More Things Change...

Time for my annual update (just kidding...kind of)! It's funny, I feel like I've come such a long way the past couple of years - geographically, financially, with my personal life - and yet, some things haven't changed at all.

Though I'm able to charge more than I did, and work has become more steady, I still freelance, and therefore still deal with periods of unemployment and constant job hunting.  I now have more in savings, but also much higher expenses and obligations. These include happy expenses, like a nicer rental home and improvements on my investment property, as well as slightly less enjoyable expenses that include egg freezing and ultrasounds after some out-of-the-blue negative news about my fertility. Though, duh, I'm not as young as I once was, so maybe I shouldn't be so surprised.

And of course, I'm now an LA resident with a lovely LA boyfriend. Creeping up on three years together, and I still like his stupid cute face and his hugs and his goofy jokes.

So overall, I know I'm very lucky. I do feel it. I do appreciate it. There's still a lot of restlessness, though, as well. A lot of uncertainty about the future, and what comes next.  I'm creeping up on middle age, somehow, insanely. I'm 35. I don't feel it. I still feel 25. At least I finally don't feel 15.

Is it just me? I know that I used to think 35 was ANCIENT. I was just going into middle school when my parents were that age, and I thought they were definitely old. And yet, I do not feel old at all. I'm still figuring so much out. I don't have kids yet. I don't live in a house I own yet. Never been married. Doing better work-wise, but still so much I want to accomplish.

So is it perception or reality? DID my parents have it so much more figured out at my age? Or was I a dumb kid with no idea of how young and confused my parents still were? Maybe still are now? Or am I just some sort of immature avocado-toast-eating millennial who is refusing to grow up? I don't even know. I look at my friends and I don't think I'm doing so much worse than they are, so if it's me then maybe it's all of us. Maybe we have it harder. Maybe we're just softer.  Maybe every generation is actually the same, and I'm just too far into it to be able to notice yet. I guess if I live long enough, I'll figure it out.

Saturday, September 22, 2018

Camping

I'm awake and restless and in a fairly foul mood, so rather than focus on the myriad of things that are currently stressing me out, I'm going to focus on things that are cheering me up. Such as my upcoming first camping trip. For most of the world, camping is a beloved childhood activity but I was a city child and my family didn't really do things like that. Which is why I am going to be completely impossible to deal with this weekend. Like a kid at Disney, except with all the unstoppable freedom of a slightly-deranged adult.

I WILL make S'mores. I WILL attempt an overly complicated campfire meal. I WILL attempt to pick a wildflower bouquet, thereby annoying environmentalists and hungry bees alike. I WILL be a total baby about peeing in the woods (as in, omg, I'm not sure I'm going to be able to). I WILL MAY get eaten by a bear (See? There's that optimism!). And lastly but not leastly, I WILL cuddle romantically under the stars with my lovely bf.

I WON'T focus on job/money stress. I WON'T focus on my stupid broken ovaries and uterus. I'm just going to go have fun with my beau in a beautiful natural setting.

So there.

Sunday, September 9, 2018

Living in Lala Land

So...I'm now an LA resident. And I have been, on and off, for a little while now. It seems crazy, since I was always mildly antagonistic towards Los Angeles based on nothing more than a high school trip. A perfectly pleasant trip, too, but LA just seemed so bland that it turned me off to the idea of living here for well over a decade.

But I'm here and, dare I say it, I actually am growing to like it quite a bit. It sneaks up on you. At first it's all strip malls and road construction. And then you find a couple cute little hiking trails and maybe wander through a farmer's market. And then you stake a claim on a couple of little brunch spots, and find a favorite taco truck. And all of a sudden the garbage-y streets of NYC aren't quite as appealing as they were before (though, don't get me wrong, part of my heart will always be in NY).

So, new adventures here. Big adventures. Job stuff, boy stuff, health stuff. It's all happening here, after a couple of years of just rebuilding and shoring up in New York. And I'm liking it, even as I hold my breath through some of the change and cross my fingers on some of the other stuff.

I don't know how often I'll update here, but I thought maybe it was time. Not that anyone is still reading, if anyone ever was. But here's a record anyway, maybe just for future me one day.

Sunday, March 20, 2016

New Chapter

After almost 2 years of trying, I finally closed on a house. It was a longer process than I thought, and more expensive, but also exciting.  I'm also starting a new job, after a longer-than-usual stretch between freelance projects (SO fun to be out of work when buying a house). On top of that, I am going to be an aunt for the first time, which seems CRAZY. It feels like a lot is happening right now. I haven't been writing as much, because it seems like there is too much to do in real life to sit down and write about it.

I'm going to try to get back into a rhythm, but I'm also not going to kick myself too hard about falling behind my writing goals. Life is kicking into a higher gear, and I'd rather be doing interesting things than writing about the interesting things I want to do.

Anyway, just wanted to put a little update out there to show I'm still alive. I'll be back.

Friday, February 26, 2016

The Unexpected Costs of Buying a Home

I'm a first time home buyer. Well, almost. And I thought I was pretty prepared for the process. But let me tell you, it costs SO much. Even more than expected.  Here are some costs that I didn't know about (and that you, possibly, also don't know about):

- You have to prepay an entire year of insurance at closing. Thousands of dollars. You also then have to put a couple additional months into an escrow account in order to start socking away money for the following year's pre-payment. So in total, you are paying for 14-15 months of insurance all at once.

- You also have to prepay a couple months of property taxes for the same reason.  I think it's so you don't get a big bill all at once the following year.  You start paying it in advance instead and the mortgage company holds it for you in an escrow account.  But that means you really get kicked in the teeth at closing.

- All the inspections cost more than you think they will. Everything is so expensive. Expect, even on a cheap house, to spend $6-8K in inspection/title/misc fees for closing.  And if everything isn't perfect, you may need to have them come back for a re-inspection.

- Since you wait, wait, wait and then need to send checks ASAP to arrive the next day, or you need to wire money to arrive immediately, you end up paying money in wire transfer and overnight mail fees. I've spent probably a couple hundred dollars just on fed-ex and wire fees.

- If, like in my case, it's an investment property, everything costs more. Inspections and insurance included, in addition to a higher interest rate.

All this means I'm probably out almost 5K more than I thought I would be. Thank god I had a healthy savings account, but I'm feeling poorer right now than I have in years. I want to get someone in there renting ASAP and start building my reserves back up as quickly as possible. I just keep reminding myself it's a long term investment, not anything that will yield fruit in the next year or two.  I think buying is a great investment, but one that has a steep cost of entry, even steeper than many first time buyers expect.

Sunday, February 14, 2016

Indecisiveness

Has anyone else ever noticed how much easier it is to run other people's lives that to run your own? When friends or family ask for advice, I generally have pretty strong feelings on what the right path is. And yet, when it's time for me to make a decision about anything, I'm completely wracked with doubt. 

For instance, restaurant menus. I will sit there and go back and forth over what to order for 10 minutes, before generally getting the same thing I always get. Or I'll pick at the wording of an email until it bleeds. My latest indecision is house based. I am thisclose to finally closing on a house, god willing and the creek don't rise, but it is really bringing my decision making skills (or lack thereof) to the forefront. I have to buy appliances. Hard. I have to buy a cart for the kitchen. Surprisingly hard, though after polling about 10 people I think I finally settled on one.  Now I have to pick the paint color for the outside of the house and, oh boy, that is not easy. 

I mocked up a bunch of options (did everyone know that you can fake paint a house at the Sherman-Williams site? Because I didn't) and sent them out to be voted on, but everyone likes a different one. There are two I'm kind of leaning towards, but they have gotten the fewest votes. So I am in a fog of indecision, as per usual. 

I think I need to find someone to run my life for me, while I'm busy running other people's. That should work well.

Until I manage that, what do people think? Blue, green, dark blue, white, or yellow?