The Power of a Single Clap

For quite some time before moving back to Iowa, I was not handling the stress of being a mom very well.  We didn't have a babysitter and didn't have anyone close enough that we trusted them to watch the kids. The only quality time together (without the kids) that DH and I had was when family came in from out of town - typically two times per year for my parents and 3-4 for DH's mom. 

It wasn't until we had already committed to moving back that a friend told me that most YMCA's offered free childwatch for people with family memberships.  While you can't utilize them as a babysitting service, they do watch your child while you are exercising.

We moved back Memorial weekend, May of 2006.  On June 8th, I decided to join the YMCA.  I was tired of being out of shape and felt like I should take a new approach to my health.  When I first started, I was doing the elliptical.  In August, I was talked into taking a cardio class (you can read about that story here.)  Every class is different.  Sometimes we do circuit training, sometimes kick-boxing, sometimes step.  It takes a few months before we see a repeat class.

The very first class that I took was a routine involving a row of steps lined up side by side - like a 40' wide/long step.  Half of the class (Group A) was on one side of the room, Group B was on the other side.  Group A would traverse the row of steps doing something like tap up/tap down to get to where Group B started.  At the same time, Group B would do something like lunges across the open floor to get to where Group A started.  We would do that about 4 times then do a different type of activity.  Over the top and back of the benches and moving squats on the way back.  The activities continue to rotate and one of the more challenging tasks is the inchworms.  Basically, it involves walking your hands into a push-up position (push-up optional) then walking your feet to your hands... continuing to the other end of the room.  Ugh.

I remember being dead tired and Leah even announcing to the class "If you need to take a break, walk the track."  She doesn't single people out unless they are doing something that could cause injury or if she knows they don't mind.  But since I was new, I didn't realize that she was indirectly directing her comment at me.  This time, she looked me straight in the eye, swung her finger in a circle in the air and said "If you need to take a break, walk the track."  Then she smiled.  Then I started to walk the track. 

Once I got comfortable with the class and the people, every time we did that workout I would say "This is the first workout I ever did."  Leah got to the point where she waited for me to say it when I arrived and saw the setup.

Well, this Wednesday was a little different.  Most of my regular friends were absent for the holiday so I didn't blurt it out.  Part way through the class, Leah announced "This is Nicole's class" (maybe she said workout or routine... I don't remember because I was already very tired.)  Anyway, it isn't my favorite routine in terms of activity, but emotionally, it is.  It is an absolute gauge of how far I have come in two years. 

As usual, I did my best - working at a high impact pace when I could and doing low impact on things like jumping jacks (because I have bad knees.)  I went strong on every pass across the row of benches and was able to smile as I remembered how difficult it was on that first day.  Lunges, squats and all that stuff are becoming easier but still are challenging in the midst of our exhaustion.  The inchworms were the true test.  While progressing through, Leah reminded us that the push-ups are optional.  When she saw that many of us were pushing ourselves to do them anyhow, she decided to jokingly add "Okay, you can add a clap in the middle if you like."  So on my next inchworm, I did just that.  I did a push-up with a clap in the middle... something I haven't done since my high school and college days of being in shape.  Leah acknowledged it as did a few classmates.  It made me feel great.

Granted, I have a lot of weight still to lose, but I feel so much better these days.  That one clap in the middle is a powerful reminder that with continued commitment, anything is achievable.

(The first photo was taken at Christmas 2006. The second one was just a few days ago when I tried on a fitted shirt that DH bought me.)

Is Early Intervention Worth the Trouble?

When Miss M was born, I was pretty much on my own while DH was at work.  Miss M and I would venture out to the store, sometimes go on walks and occasionally hang out with the neighbor who was only a few days older.  But we didn't participate in any kind of mommy and me groups, structured programs or hang out with other peers.  We didn't have any family living nearby either.

We had a lot of great one-on-one time and I loved it.  I took pictures of her, played with her, read to her, helped her learn her alphabet.  If I needed to microwave something, I would pick her up, point her finger and say the numbers as I helped her push the microwave buttons.  "3-zero-start"

What we recognized as she started to get older is that her rote skills were very strong.  I didn't realize it at the time, but the lack of interaction with other kids was having an impact on the development of Miss M's communication skills.  Before she turned two, we noticed that her ability to express herself verbally was below what "the books" said she should be.  During a visit to her pediatrician, I asked for his opinion.  He told me that it's like a light bulb for some kids - it just turns on and they start spitting out words left and right.  But he didn't have any guarantees so he explained that he could give me a referral to the Regional Center when she turned two or I could self refer.  In California, there are Regional Centers that are funded by the state to help kids that are behind their peers - physically, mentally, developmentally, whatever.  It was broad based and provided the testing needed to make sure Miss M was where she should be.

Well, I decided to self refer since I didn't want to wait until she turned two.  As a result, she was tested and it was determined that while most of her skills were age appropriate, her cognitive and receptive communication skills were significantly below her age.  We had one person, I believe a psychologist, test her and unofficially (yet inaccurately) diagnose her as autistic.  Thankfully, the pathologist that tested her a week later reassured us that she wasn't anywhere near autistic on the scales; she just didn't know how to communicate well. 

So we got an IFSP (Individualized Family Service Plan) approved through the Regional Center that included a Mommy & Me program a few days a week supplemented by in-home speech pathologist visits.  When she turned three, her IFSP was changed to a school district based IEP (Individualized Education Plan) and she started a speech and language preschool program.  When we moved to Iowa, the IEP followed us and it required the local school district to continue the services that were determined necessary by the people in California.

I fought hard for all the services that I thought she needed.  I opened my mind to any suggestions they had to help improve her communication skills.  I didn't worry about the "special education" stigma that she might carry with her through school.  My priority was getting her to where she should be.  Period.

Well, during Miss M's parent-teacher conference last week, we were informed that they didn't see a need to continue IEP services.  The had evaluated her on several different abilities and said Miss M is caught up with her peers in communication abilities and exceeds many in other skills.  On one of the tests, she scored the highest in her class.  They recommended we not renew her IEP when it comes due in January.  To ensure that it's the right approach, they'll do a 45 day trial of no-services where they will discontinue any special education, speech therapy, etc.  If we don't see a lapse, then we know she's good.

So I know that all the proactive therapies, teachers, IFSPs, IEPs, tests, classes and whatnot - all the early intervention work - paid off.  It was all worth the effort knowing that by the time Miss M reached Kindergarten, she was caught up with her peers.  If I had to do it again, I would take every single step, every headache and every heartache.  And if anyone ever asks my opinion on whether they should be proactive with their child, even if they are unsure, I would strongly encourage it.  People may say that their child is delayed because of older siblings "talking for them" or isn't walking because they just think it's easier to crawl.  Whatever the delay or whatever the reason, just ask your school district or physician if there are services available to have your child tested.  You won't regret that you did.

Who Doesn't Love Free Drugs

If you're here for anything other than legal prescriptions, move along please. This is just for honest people looking for a way to save some money on their prescriptions. In this case, nothing tops getting them free.

I've talked before about how we don't have insurance. I'm constantly on the lookout for ways to save money on bloodwork or prescriptions. Although I haven't posted about it, several pharmacies have gotten on the $4 generic prescription bandwagon. Even better, $4 for a 30 day prescription or $10 if you get a 90 day prescription. When we lived in California, I surfed my prescriptions. In other words, I moved from pharmacy to pharmacy based on who had the best prescription transfer coupon floating around. My copay was $10 so I ended up either even or $10 up since most transfer coupons were either $10 or $20 (with an occasional $25).

But I stopped surfing my prescriptions when I found out that Sam's Club had awesome prices. They were one of the first to have discount pricing for non-insurance prescriptions. But now that there are so many companies doing that, the transfer coupons are back in play. Last month, I transferred my prescription to Target using a $10 transfer coupon. I received a 90 day supply for $10 then received a $10 gift card to use on a future purchase. I essentially walked out with 90 days of prescription for free.

But I didn't bother to mention it since the transfer coupon was expiring... Until now. In today's Target ad (at least our local one), there was another $10 prescription transfer coupon! If you have a regular prescription or even have a non-regular one that needs to be filled, it's worth finding out if it's on the $4/30 day or $10/90 day list. Take advantage of the coupon, transfer your prescription to Target and net yourself some free drugs. When you're ready for another refill, you can always transfer it back to wherever you had it before or somewhere else if another coupon shows up. Nothing better than getting something you need for free.

My Long Road to Motherhood

A few weeks ago, I read a blog post from one of my blogger friends - chronicling her sorrows about difficulties with conceiving a child. It's not the first blog I've read that has been filled with despair. Each time, I promise them - or myself - that I'll share my story. It's difficult. It's emotional. I could never bring myself to do it. Until now. If the road to becoming a mother is bumpy, it's best to have someone riding shotgun.

So I brought my notepad outside to write while surrounded by my ultimate inspiration. I laid on the ground and watched my girls playing with the sidewalk chalk. It made me smile and I realized how lucky I really am.

This is my story...
In 1994, a year after we got married, my father-in-law suffered a heart attack. On the long drive from Iowa to Alabama (where he was hospitalized), DH and I discussed starting a family. It was a casual thing at first, figuring it would happen when it was meant to. We didn't get pregnant, but at the time, it was a good thing. We had the opportunity for DH to accept a job in Los Angeles and I doubt we would have taken such a risk if we had another mouth to feed. So we accepted the job and moved.

We were trying but it just wasn't happening. In 1996, my brother emailed us a trivia question and said we needed to call to get the answer. The email simply said "A N U S". I quickly deciphered it to mean "Aunt N Uncle soon". (Turns out it meant Aunt Nicole Uncle S.) It was a difficult call to make, that's for certain. I doubt they had any idea to what extent I was torn between excitement for them and total hopelessness for me. Although my family knew we were TTC (trying to conceive), I had never shared the full extent of my situation. Between family and friends, I had heard all the comments "You're too young to have kids." "Just relax." "Get drunk, that always works." My heart was broken every time I received another birth announcement in the mail. It just was easier to keep to myself.

By 1997, I finally decided it was time to consult a physician - during my next annual exam. He prescribed clomid...like every other OB/GYN on the planet. Like any good patient, I followed my doctor's instructions. He was the doctor so I had no reason to question his treatment plan. I had no idea that my OB/GYN was wasting my time, money and emotional well-being. Answer this. What types of sites were you surfing back in 1997 or even 98 or 99? I would venture to guess not blogs or even advice columns. The only 'support group' I found was at ParentsPlace - a division of iVillage. There were so few of us that we even had a gift exchange at Christmas one year. Information was scarce and details (about treatment options) were very limited.

After a year and a half of clomid - which included various types and levels of progesterone support, I was encouraged by my ParentsPlace friends to get a referral to a reproductive endocrinologist (RE). I stopped the clomid and waited. My doctor was offended and not very helpful but eventually submitted the paperwork. If I had known then what I know now, I wouldn't have spent more than three or six months on clomid. That's one of the basic things that people learn now - Clomid has diminishing effects as each month passes. I'll spare the medical details behind the ineffectiveness of it. But I wasted over a year not realizing that I had no chance of getting pregnant. Each month I would be crushed, broken and hurt when my period would start and I would grieve for another failed cycle.

When I finally got a referral, the RE performed tests and informed us that we were pregnant. That brief break from Clomid was enough for my body to recover back to normal. Unfortunately, in December 1999 I miscarried. Believed to be primarily due to undiagnosed and untreated hypothyroidism. All the weight I had gained was because of my thyroid. I blamed it on stress and clomid. My RE insisted I take some time off for my body to heal; when it was time to start again, I was told he was retiring.

This time, I was referred to Dr. Tina Koopersmith. She started us easy but moved into Gonal-F. I never realized how difficult it would be to measure and prep for an injection at exactly the same time every evening. That meant any destination at that time of day would be my mobile lab. Airport, mall, restaurant to list a few. I looked like an addict getting ready to shoot up, but I didn't care... I had my priorities.

All the Gonal-F shots were subcutaneous in the thigh, while the HCG shot was intramuscular in a small area on the backside of my hip. The Sub-Q shots were doable and I figured out a system that worked well for me. As painful physically as the HCG shot was, it was far worse emotionally for DH since he was saddled with the responsibility of administering it to me.

In May 2002, we were on what we figured would be our final cycle because it was just too difficult and was causing me a great deal of mental anguish. I was bitter. I was angry. And I was taking it out on the person who mattered most to me in the world, my husband. If this cycle, which included Gonal-F and an Intrauterine insemination(IUI) didn't work, then we would not have children.

On June 4, 2002 - After approximately 8 years of trying, countless dollars, daily temperature charting, ovulation predictor kits, a year and a half of clomid, enough arm pricks for bloodwork to turn me into a fountain, a very painful Hysterosalpingogram, a difficult uterine biopsy, months of daily thigh injections and related HSG shots, progesterone suppositories and creams, home pregnancy kits, blood sweat and lots of tears, Dr. Koopersmith called to inform us we were expecting. My father-in-law's birthday is June 3rd and his anniversary June 5th so we felt it was a gift that we get this call on the 4th. Unfortunately, my FIL had passed away the prior December.

I had a high-risk pregnancy but after some problems during labor, delivered a healthy, happy Miss M. When my doctors recommended I start birth control, I proudly explained "I paid for this one. I'm not going to pay NOT to have another. If it happens, I'll be happy."

In the fall of 2003, we asked the doctors to start our referral paperwork so we could start the process all over again. My physician would not process it until they confirmed Miss M didn't have health issues. One day in January 2004, a few weeks shy of Miss M's first birthday, I informed DH that Miss M was going to be a big sister. We were in shock - no fertility treatments. An awesome and easy pregnancy, about 30 minutes of labor and a healthy Miss K was in my arms.

It was a long and painful road but well worth the journey.

Day 1 of the 100 Day Challenge

Today is the first day of the 100 Day Challenge, part of "Live Healthy America." Although I go to the gym regularly, I'm seriously overweight so I felt compelled to sign up for the program. As part of a 5 person team, I'm hoping that I'll be motivated to attend more classes and develop a better fitness routine. I signed up for the gym's (free) wellness program and will begin that on Monday. Ultimately, I want to lose some weight. For the 100 day challenge, I think it's reasonable to drop about 15 pounds, but I'm certainly not going to put that on paper anywhere. Umm, anywhere else, I mean.

I have no self-control when it comes to sweets; I just love them. To further complicate matters, food is my outlet for when I'm bored, frustrated or whatever. That's one of the reasons I so adamantly attend classes at the Y… to compensate. Maybe this challenge and some supportive teammates (and one very supportive and loving DH) will help me get focused on planning better meals and eating right.

Today, I did an hour of Leah's cardio/strength challenge class followed by 45 minutes of Pilates. I've been a little under the weather, but I still survived both classes. It's only the third time I've done Pilates so I totally get my butt kicked in what I previously thought was a laid-back exercise class. At least by doing the cardio class first, I can tell myself that I'm just tired because of that.

I'm actually very excited about the whole program and simply wanted to share my commitment. Good luck and best wishes to anyone else participating in the "Live Healthy America 100 Day Challenge" program. Please be sure to post a comment if you're participating so I know who to cheer along!

How Much are Your Prescriptions?

That sounds so much like a commercial, or spam, that I should probably rethink the title. Nah, it's better than my first title "Are you paying too much for your prescriptions" because that definitely sounded like the beginning of an advertisement. I assure you, it's not an ad or even a lead-in to a product commentary… it's just another trick-of-the-trade for saving a little cash.

Last night, while having dinner with my parents, my mom mentioned that she's paying $14 per month for a prescription (through Medicare, I think) and was disappointed that she couldn't fill it for more than one month at a time. I mentioned that if she disregarded her insurance, she could get a 90 prescription and probably save some money. Then I started having flashbacks to my quest to pinch pennies while living in Los Angeles.

Before moving back to Iowa, my insurance plan stated that I would pay a $10 copay for each 30 day prescription. Since I take thyroid medicine daily, I was locked into a monthly expense that frustrated me. Being thrifty, I would find the latest "Transfer your prescription" coupon offer available and take advantage of it. Typically, Albertsons, Ralphs, Vons and Target were my go-to places with an occasional CVS, Rite Aid or Walgreens thrown in. Each month, I would transfer my prescription to the next store and get the advertised bonus of anywhere from a $10 gift card to a $25 gift card. The little extra work in planning, coordinating and driving, was justified in that I was getting a free gift card to spend on groceries or whatever each month. On months where DH or the kids had prescriptions, the total on the gift card was very nice. Unfortunately, they started putting restrictions (such as couldn't have ever had that type of prescription at that location before) on the coupons so I wasn't able to take advantage of it every month unless I wanted to increase the distance I was willing to drive. At least I was saving every once in a while now and it was good while it lasted.

Then again... there's nothing quite as ego-deflating as figuring out that you're not getting the best deal out there. Before we moved back from Los Angeles, I wanted to get our prescriptions refilled so it would be one less thing to worry about during the packing-and-moving-cross-country-trek-and-unpacking-settling- in-chaos that was about to ensue. Our insurance was no longer active, so I was looking for the best rate on prescriptions – online or B&M – to save a little money. I was absolutely sick when I realized that I could have gotten the prescriptions much cheaper all along by not using my insurance. My $10/month copay (and related cheapskate song and dance) could have been traded for what's behind door #1… just buying my prescriptions outright. For one specialized prescription that was costing more than $10/month even with insurance, I was able to get a 90 day prescription for $24 through the pharmacy at Sam's Club. Hmmm…One trip every 3 months to a store I would typically shop at anyhow and save money. Although I had done okay with the transfer coupons, in hindsight, I felt like an inside joke between the folks at the insurance company and the pharmacies. "Ha ha, look how much she's paying for her prescriptions and she thinks she so smart transferring from store to store. What a sucker!" Sucker indeed. My regular thyroid prescription would be $12.95 for a bottle of 100. When we kept researching, we talked to the pharmacist and found out that if the doctor rewrote the script for one of our medications (changing it from 1 pill per day to 2 pills per day of a smaller dosage), we would save significantly. As I mentioned in my blog about saving on bloodwork, it really helps to learn about your medications and treatments so you be an informed patient and save money, as well.

As it turns out, you don't even have to be a member of Costco or Sam's Club to utilize their pharmacies. I called Sam's this morning to find out how much my mom's prescription would be without insurance and was told $4.90 for a 30 day supply or $14.70 for a 90 day supply (compared to $14/month with insurance.) So I ask again - how much are your prescriptions? Try calling your local Sam's Club or Costco pharmacy and ask for a quote and see if you would be saving money by NOT using your insurance card next time.

Ah... maybe I should retitle the post "Does your insurance company laugh at you too?"

Back on Track at the Gym

When we signed up at the gym a year and a half ago, I never expected it to last. I signed up because I was tired of being overweight and out of shape. As I mentioned in a previous post, the weight gained as a result of having undiagnosed hypothyroidism, umpteen years of varying levels of infertility treatments, pregnancy (thankfully) and related chaos, had just become too much for me. I was unhappy and I figured the gym was a good starting point. Even if I only stuck with it a short time, I had decided that every minute I was at the gym was better than an equivalent minute sitting on my tail side watching TV or vegging at the computer. It was also a better alternative than snacking on something in hopes of feeling better. What I discovered is that exercising actually makes me feel better and my time at the gym has become exactly that, my time.

But with the holidays, things got hectic (preaching to the choir, I'm sure). I helped in the classroom or shuttled kids for a field trip. I needed to get Christmas stuff done or stayed up too late watching a movie. Oh yeah, there was also a spell of really crappy Iowa weather that made me want to stay in bed all day. What resulted was a two week hiatus that, surprisingly, frustrated me. Absence makes the heart grow fonder, but who would have ever expected that to hold true for something like working out at the gym?

Today was my first day back since a week before Christmas and I couldn't be happier. It was a difficult workout, as usual, but that's the way I like it. Leah, the instructor, encourages us to work at our own pace… whatever that may be. I worked as hard as I could without overdoing it.

Even after a year and a half, I'm still out of shape but at least I have some muscle-tone now. I feel better about myself and have realized that the scale doesn't tell the whole story. I also am stronger and more confident than before and must be emitting that vibe. For the first time in I don't know how long, (maybe ever) my brother didn't make any attempt to steal my garlic bread at this year's Christmas dinner.

How to Save Money on Bloodwork

With the upcoming election, the issue of health care is constantly making headlines. It is a problem, there is no doubt about that. Corporations are starting to charge employees more if they are overweight, smoke or have other health issues. It is a topic that has been buzzing around for a while now and was finally explained well in a recent Tribune Article. For those with limited or no insurance coverage, a little creativity is in order...

For several years, I have needed to monitor what is covered (or should I say not covered) by my health insurance. It has forced me to ask more questions about what kinds of tests, bloodwork, screenings are done and why. The result has been positive in that I've become a lot more educated about my own health, as well as that of the rest of my family.

About a year ago, my husband mentioned an article about how the Internet has opened the door to direct access to laboratories. When I had an upcoming exam, I researched whether this was an option for me but unfortunately, there weren't any local labs participating. When it came time for DH to have some bloodwork done, I checked again and was thrilled to see that there was now a lab to do this at. From what I understand, by providing a payment up-front, the labs are willing to offer a deeply discounted price. When we lived in Los Angeles, doctor's offices often offered a deep discount, as well. I guess labs and doctor's offices don't like dealing with insurance companies any more than the rest of us do!

So how does it work? Log on to any number of the direct access websites such as Direct Laboratory Services (my personal favorite), HealthCheckUSA or LabSafe. Browse the different tests available to find the one appropriate for your needs, then purchase the labwork online. Like I said, you become more aware of your own health situation because it creates a dialogue with the doctor to determine what test(s) you'll need. Since every lab names their panels differently, you actually have to ask WHAT you'll need, specifically. As an example, it's not just a test for thyroid, it's one or any combination of the following: T-3 Uptake, T4, T7, TSH, Free T3, T4-Free and Reverse T3. Eventually, you learn why the doctor is checking one and not another and what the purpose of each is.

After you order you labwork online, you go to their designated laboratory like you normally would. When you're done, the test results are sent directly to the doctor of your choice, just as would happen if you went through the normal route for bloodwork.

In the end, not only do you pay less, but you become a more informed patient!