The American Health System aka The Insurance/Health System

It's the day after the operation and we've spent the morning being batted between my OB's office, the insurance company and the lab, where the testing on my POC (product of conception or rather my baby) will take place. It's standard procedure for them to test whether there was a chromosome defect with the foetus, but an additional test is whether it died of genetic defects; the Boy and I could find out if we're destined for X illness or have Y wrong with us.

Coming from the UK, how much medical procedures cost has never been an issue for me. I find myself now checking how much everything could potentially cost before agreeing to any kind of treatment or testing. Should any of the procedures or providers not be covered by our insurance, the testing of my dead baby will cost around $1,200. Well, this is what I've found anecdotally online, anyway.

The trouble is, the insurance people just wouldn't give us a definitive answer. It depends on whether it's medically necessary and as long as it's not a 'cosmetic' procedure, it should be covered. We just can't understand but are hopeful it's covered and have given the doctors a green light to go for full testing. I am crossing my fingers.

In other news, I spoke to reception at the OB's to make an appointment to follow-up on my surgery. I start the call with, 'I had a D&C yesterday and would like to make a follow-up appointment.' We go through dates and times and then the receptionist asks, 'So you have a baby now?' I have to ask her to repeat the question three times. Well played, Receptionist. Super tactful question.

D&C

Today was operation day. Again, we were delayed, this time by a new computer system at the hospital. We were an hour late in registering my details, though it was chaos across all departments.

I sat in my paper gown for about 2.5 hours waiting for my operation, as I kept getting bumped for emergency cases. I was tired, thirsty and hungry, as I wasn't allowed to eat or drink after midnight the night before.

Surgery in the States is strange for many reasons:
1) I have nothing to compare it to, as I've never had surgery until now;
2) I walked myself to the operating theatre and hopped on the operating table myself;
3) I had a conversation with the doctor - who I had hugged in the pre-op waiting area, as she is my OB - about whether the genetic testing of the 'tissue' i.e. my baby would be covered by insurance; and
4) I had been interviewed by three of the four people present in the theatre prior to the operation.

I had an interesting conversation with the anaesthetist. He put in the IV and then told me he had just administered a small dose of the medicine that would put me to sleep. 'Oh yes, I can smell it. It smells sweet.'

'Really?' He asked. 'You must be like me. I see things in colour and taste things. You must smell things.'

Everyone is so kind when they hear you are having a D&C. The anaesthetist gently rubbed my face when I started to cry on the operating table and encouraged me to feel sad. I could feel my OB and the operating nurse rubbing my legs as I was drifting off... All in all, we were in the hospital from 8.30am-5.30pm. Not bad considering we were supposed to be able to leave at 1pm.

Tonight the Boy and I had a sad moment. I no longer feel distraught, but just deep-seated sadness. My tears roll slowly down my face. I can feel them staining my cheeks. Unlike two weeks ago, it's not that intense pain I felt and the floods of tears I knew. I feel relieved that I'm pragmatic and practical, but also a little heartless; unfair, as I had been protecting myself during my first trimester for bad news.

Tomorrow I will cry some more, but then Wednesday we start afresh.

Nas Vegas and Flying Home

If you ever go to Nashville, you must, must, must go to Modell's. They serve breakfast, brunch, dinner and lunch family-style i.e. your part sits at a table of 10, which invariably means you join a table full of randoms and eat whatever they give to you. 

We got there at the end of the brunch service and were ushered to join a small table of seven people. Slowly, people realised that they were sitting at a brunch service rather than a lunch service, so our numbers dwindled down to four. This meant that the four of us had to eat the following (which would have fed 15 people, I think):

- fried chicken

- southern biscuits (UK scones)

- cinnamon rolls

- creamed corn

- scrambled eggs

- country style ham

- sausage patties

- bacon

- cheese grits

- fried potatoes

- gravy

- stewed apples

- pancakes

We hardly made a dent, but I am proud to say I had four pieces of fried chicken, which is why after two weeks away, I have put on four pounds. 

The rest of the day was spent at Belle Meade Plantation House, at the Union Hotel (stealing their wi-fi), a former train station, eating at Moto, one of the Mstreet restaurants in the Gulch, and drinking at a honky tonk bar. A fine end to a fine stay in a fine city. 

This morning, the captain of our plane had announced that we were two minutes ahead of schedule and first in line for the queue when there was another announcement to say one of the cables on the doors had broken. We sat there for an hour whilst they decided whether it needed to be fixed and whether we would be turfed off the plane. I had another little cry, as again I was worried I wouldn't be able to make it home before miscarrying. 

Fortunately, we were home in time and we had our last confirmation ultrasound. No changes with the foetus so I await surgery tomorrow morning... 

Nashville

Nashville is such an incredible city. The vibe is amazing, the city is lush and green, creativity just permeates the air, peeps are friendly and everyone seems to know everyone. Plus we've apparently come the one week of nice weather a year, so we've been blessed with perfect temperatures, much sunshine and a passing storm as we were driving back last night.

I got an insight in the music industry here in Nashville last night, as we attended a recording session for the Country Music Channel complete with free cocktails and canapes. We then hot-footed it over to the Bluebird for a gig by Gary Burr, who has been inducted into the Nashville Hall of Fame.

The Boy's offices here in Nashville are incredible. Based in Music Row, there are dozens of famous publishing houses and record labels all located in converted houses. It's so strange and cool to see his colleagues working out of bedrooms and to use a bathroom as office loo.

Apparently, they regularly have writers come in to compose songs and write music in the offices. A commonplace occurrence in Nashville and all seem to have access to a liquor cabinet (though theirs is under lock and key because some of the writers can't drink).

Today I got whizzed off to lunch with a fascinating lady who has transitioned from the music industry to the not-for-profit sector, fundraising for a local organisation that supports families to stay together. The Head Honcho of the Nashville office seemed to know everyone and was meeting and greeting folk at the restaurant we were in left, right and centre. 'Splitting time between Barbados, Nashville and London', 'Elle McPherson', 'Madonna' are all words that came up in conversation today - and not in a far off star-gazing way, but in a 'her best friend's dad married...' and 'managed Madonna's...' kind of way.

I wasn't going to write about miscarrying, as I haven't cried in 24 hours, but I just received a call from my OB-GYN's office about the operation on Monday. The operation is scheduled for 10.30am in the morning so there isn't time to get to the office for one last ultrasound. Our flight lands at 2pm on Sunday and I have an appointment at 4.45pm for a final ultrasound otherwise I'm going to have to go ahead with the surgery the next morning or push it back a couple of days. That would be an ultimatum in the truest sense of the word. Hopefully there will be no delays. I must be due some good luck.

A Nightmare Journey

I was upbeat about taking the bus after all yesterday. My body was at peace and I was sure that we would make it safely to Nashville on the Greyhound.

We got there nearly hours before our bus was due to leave with the vain hope of getting onto the earlier bus. As predicted, on $15 tickets there's not much flexibility. We had the option of buying a brand new ticket for $150 each, but that wasn't an option. The Boy ran off to get us some food and I manned the bags.

They started to board the bus and within minutes the waiting area was completely empty. I was absolutely freaking out, as I kept texting and calling him but had no response. He emerged 15 minutes before our bus was due to leave and we rushed through the gate only to find two lines of people queuing to get on buses.

'Are you going to Nashville?' We kept asking people.

'Uh, no, we're going to Chicago/Pennsylvania/New York...'

All the while, I was getting more and more upset, as I had visions of missing this bus, which would trigger immediate miscarriage. (I wasn't thinking very logically by this point.)

Finally, I made the Boy clamber over the barriers to run and find our bus. He left me there, a wailing mess, convinced that I'd start to miscarry because I'd have to take the later bus. Thankfully, the Boy reappeared having found the right bus amongst the half dozen all standing, higgledy piggledy together. As I was running and wheeling my suitcase, my backpack, my handbag and my overflow bag, I had convinced myself that I would start the process off because of stress and exertion.

I slumped into a seat and bawled for a good 10 minutes.

Nashville lifted my spirits. It's a great city with a really laid-back vibe. There seem to be interesting neighbourhoods and the folk are friendly.

Dinner was a treat as we sat in a gorgeous outdoor area next to the fire, feasting on house-cured meats, double cut pork chops, mac & cheese with housemade pasta, shrimp & grits, cheeses, house-baked popovers and southern biscuits. The Boy posted on Facebook about the amazing music, so you can see where our priorities are. I somehow chipped a tooth - it must have been the squidgy pasta - but that seems to be par for the course luck-wise these days; you win some, you lose some.

Atlanta to Nashville

Atlanta has been fine. We managed to get out to see area where Martin Luther King lived and the house where he was born. The Olympic Park was quite cool with families running the gauntlet in the fountain display. Overall, Atlanta is an OK city. Not much to report.

Over the last few days, we've gone backwards and forwards on whether I'll be OK to take the bus to Nashville. I know it was a tight-arse thing for us to do in the first place, but for under $30 for the both of us compared to $180 plus fuel and parking, it seemed like a no-brainer when it only took an extra hour.

This was until I found out I was miscarrying. The Boy has spent the morning trying to get the DVLA/DMV in the UK to fax us a copy of his driving licence, which he has left back at the apartment. Unfortunately, we were thrown a red herring when we called up AVIS last night. They wouldn't have accepted it even if the DVLA had faxed it to us, so we face a five-hour bus journey after all.

I've felt fine so far today. I had slight cramping yesterday and the day before, but nothing more, so hopefully we'll be able to make it safely to Nashville. I am scared though.

One of the Worst Days of My Life

The Boy and I have had a quiet month because I was lying low until we could share our news. I went in for a routine scan on Tuesday to find out that my 8-week old baby had passed away and that I had had a missed miscarriage despite having seen a heartbeat the week before. I was, and am, devastated.

We were due to fly to meet the Boy's family that night in South Carolina.The Boy was due to meet his new 5-month-old niece for the first time. The doctor suggested I amend our plans, as I was and am still yet to miscarry. It could happen any day, but if not, I am booked in for an operation on Monday.

The waiting and knowing that I am going to miscarry is awful. Will it hurt? Will there be a lot of blood? Also, our plans have gone out the window. We might not have our little American baby. There might never be a little baby.

I write this because no-one likes talking about miscarriages. I have felt quite alone even with the support of the Boy, who has been great; I do feel truly loved. But, the sense of loss is huge and it has felt like I have not been able to openly acknowledge my sadness. No-one has made me feel like this, just me. I have felt that I shouldn't upset people by talking about it or by being open about my grief. I am writing this because I want miscarriage to not be this horrible thing that we're not allowed to talk about. It is horrible, but we're allowed to mourn death and break-ups, so let's make it acceptable to admit that miscarriages are awful and painful. My guilt has been heightened by how much sadness I have brought to my family. I know how much they wanted to be aunts and grandparents and great uncles and aunts.

As the days have passed, it has been easier for me to deal with. I'm still in denial and will be until it happens either naturally or surgically. Until then, I can't think about starting the process again. It feels like I got to mile 8 of a marathon and have had to restart because of a false start.

If you read this and want to get in touch, please don't post on my Facebook wall but send me a direct message or email me. If I don't respond, please don't be offended. I am lucky to have friends that care about me. I will get back to you once I feel more in control.

So Little to Report

Very little to talk about these last few weeks.

The highlights from this weekend were:
- Reaching series five of Mad Men. Seriously, why are all the characters so despicable?
- Watching the Team defeat the Spartan race. They done good.
- Eating my body weight in noodles and dumplings in Flushing.
- Eating my body weight in fancy grilled cheese (aka cheese toasties for my British chums) at the annual Big Cheesy Competition.
- Drinking my first New York Egg Cream. These things are damn tasty.

I promise the next post will be more interesting.