Monday, August 31, 2009

Well, Holy Damn!

Well, the new medicine from the doctor cleared up my bleeding problems. And we got our bill for the first labs today. Boy, howdy, is this going to be fun. Still no word from Medicaid. We were supposed to know a WEEK ago.

M and I have been putting food away in preparation for being gone to my parents' for the better part of a week. We've spent the weekend and today harvesting from the garden and drying, canning, shredding, and freezing. So far in the past three days, we've put away:
A couple of pints of dried herbs
3 pints of zucchini
2 pints of summer squash
7.5 quarts of pickles (dill and freezer)
9 sunflower heads
3 pints of spicy tomato juice
4 pints of salsa verde
a 5-gallon bucket full of dill stalks
10 pounds of onions
3 pounds of potatoes
2 pints of green beans

This is in addition to the things we've already canned or cooked, which include:
5 pints of Southern-style pickles
8 pints of spaghetti sauce
4 pints of salsa
4 pints of hot salsa
6 pounds of green beans
countless zucchini and summer squash
5 pounds of potatoes
5 pounds of onions
20 ears of flour corn
30 ears of sweet corn

All in all, we've had a decent year from the garden (though we've learned how to make it better) and a very busy few days.

Our laundry-room leak has returned. Tonight, after laundry and canning are done, we are shutting the water off again, and tomorrow we go in search of a part that will NOT leak. Everything we've done so far should have fixed the problem, but we have problems with our lines maintaining steady pressure, so we think that may be part of the problem. The hot-water line in the laundry room is just fine and isn't leaking a bit, and it's M's hypothesis that the water heater helps a bit with the pressure equalization there, so tomorrow we go a-huntin' for something that might help...we may have to go to one of the stores up in Lafayette to find the part we're thinking of.

Oh, and things have been slowing down a little on the work front for me, so if you know anyone who needs some proofreading or editing done (for a modest time is valuable), send 'em my way! After all, we have a pregnancy to pay for (monetarily...I'll pay for it in other ways later). ;)

So all in all, kind of a frustrating past few days between the money and time for the extra prescriptions and tests ordered by the doc, the water leak, the exhaustion, and the slow work. But as M told his mom today, we don't have any problems a million dollars wouldn't fix. That helps keep things in perspective. We're healthy, we have no relationship problems, our house is 99.99% sound and problem-free, our time is ours to do with largely as we please, we don't have to sleep in a subway bathroom or on a subway train, and we have the love and support of our family and friends.

* Stringham high:
* Stringham low:
* Stringham super-high:

Friday, August 28, 2009

We're Havin' a Party

As usual, my parents are having the Turtle Soup party on the Sunday before Labor Day (September 6). If you will be in or near Perry County (or feel up to a weekend trip), come on by. Soup will be ready between 11 and 12 Central time. BYOB. Of course, there will be other foods there aside from turtle soup, so if you just want to come for the experience and other delicious food, you're all good. You are welcome to bring a side dish, dessert, or main dish for the pitch-in if you like, but it is not required.

If you need directions, please let me know, and I'll be happy to provide them.

Thursday, August 27, 2009

Pregnancy Update and Still Waiting

Spoke with the nurse at the OB's office today and learned that I have an infection, so they gave me a prescription to clean that up, and they ordered a couple more tests because they're changing my blood pressure medicine. No idea what the cost for these tests is going to be. Ridiculous, most likely.

Still no word from the case worker about the (Hoosier Healthwise) pregnancy Medicaid. Thursday of last week, she had told me that she should know on Monday or Tuesday of this week. I called on Monday, I called on Tuesday, left voicemails. I called yesterday and spoke with a very irritated-sounding caseworker who emphasized that she would call me when she hears anything. In just one week, it will have been a month since I submitted my original application. Sheesh. But I'm crossing my fingers that the extra time is because we are just above the monthly income cutoff and that they're trying to figure out a way to finagle coverage for us. But maybe I'm hoping too much out of government employees...

* Stringham high: Yay for treating infections!
* Stringham low: Slow state employees.
* Stringham super-high: My parents are going to make a crib for the baby!

Oh, hey, and the title links to something I would love to have--size 3.
Or there's always this (2X)...

Saturday, August 22, 2009

We Are Gathered Here Today to Join in Eternal, Perpetual (if we're lucky) Wedlock PVC and CPVC...

What was a tiny leak a couple of weeks ago and a very, very small leak this morning had turned into a leak (still small, but much more damaging) the size of the original this evening. It messed up our linoleum even more and left quite a bit of mold on the wooden plank that the pipe is secured to.

M has once again tried to fix it, with the last connector we have (from the bunch of 4 that I bought a few weeks ago) and one of the last o-rings (from a box of them we bought a few weeks ago). Interestingly, in the piece he sawed off tonight,we could actually see the disconnect between the cement and the piping. Needless to say, that didn't make us happy. But we tried a few more tricks (an extra layer or two of cement combined with the 90-degree twist, for one) and we're going to let it sit overnight to dry instead of just 5 hours like last time. *sigh*

This plumbing thing is for the birds. And we can't figure out why the hell this joint (technically, a new joint each time) is leaking, when none of the others we've done in our year here have leaked. We can only guess that it's because we're trying to connect PVC with CPVC. Hence why we're leaving it to set longer this time, in case the two materials need longer to bond together with the cement (the cement is for both CPVC and PVC). The problem is that we just can't find a PVC fitting that we need to match up to the PVC piping. Grr.

If all goes well, you, our friends and family, won't have to hear more bitching about this topic ever again. This last joint lasted a month or so. Maybe the next one will last to put off the formation of New Grand Canyon (see earlier post) until after our lifetimes...if we're lucky.(By the way, on, clicking on the title of this post takes you to a video that shows some linoleum that ours is aspiring to be's already peeling away from the floor and wall.) [I know, you're thinking all I can do is bitch, bitch, bitch. And I'm okay with you thinking that. Sometimes the two of us get a little isolated here and we need others to bitch to. :D ]

* Stringham high: Our kitchen table is loaded down with produce from our garden, both fresh and preserved.
* Stringham low: Water.
* Stringham super-high: What's there to be super-high about when it's 11:36 PM and you're fixing plumbing issues and will be without water for 12-24 hours? Oh, our health, I suppose. And the baby...sorry, fetus.

Boring Ol' Updates...

Met with the CNM on Wednesday... Lisa. I’m going to like her. She really wants us to have 2 ultrasounds, and she pushes it, but she also understands that we have no extra money. So she suggested I call the case worker every day to see if I have passed for Medicaid coverage. And she believes that we will likely qualify for it..she’s had one patient who had two kids and paid for it all out of pocket because they didn’t think they’d qualify, but on the third, she urged them to apply, anyway, and they did qualify. So we’re holding off on ordering the US until we find out about Medicaid. If we get approved, she’s ordering it right away, and if we don’t get approved, she’ll order it at the hospital because the hospital is, apparently, good about helping with payments, and there is a fund in the county—a medical trust—that helps people with their bills from the hospital.

So we didn’t find out much today. She really is pushing for the first US because I don’t have regular periods and because we haven’t been able to conceive for 3 years, so she wants to make sure everything is okay and to confirm timing of the baby, for various reasons. We couldn’t hear the baby’s heartbeat with the doppler machine, but she had told us that we might not hear it, because 12 weeks is usually about the earliest they can hear it, and sometimes not even then if the baby is turned.

When I mentioned some slight bleeding, I've been having over the past couple of days, she said she thinks it’s probably because of a mild infection I've got, but she can’t be sure without having more data, like the US and a heartbeat…so, yeah. *sigh.* And she warned me there might be some more because of the exam.

Now, I’m just praying for Medicaid to come through for us. (When I called the caseworker on Thursday, she said she had turned all the paperwork over to "a state worker" and expects to have an answer on Monday or Tuesday.)

By the way, a note on the weather—it’s like fall. Today’s high is something like 72 degrees. In the middle of August. It’s cloudy and cool, and the breeze coming through our screen door actually makes me want to shiver. It’s beautiful weather. And I hope this will be another nice year for Turtle Soup. It’s been unusually cool most of the summer, and it’s been fabulous. There were a few uncomfortable (normal summer) days, but they have been few and far between. I’m hoping one of those few and far between ones won’t pop up for Turtle Soup. Of course, I hope it’s not quite THIS cool for Soup, either, because it might keep people away just as effectively as the extreme heat sometimes does.

And that stupid pipe that was leaking a few weeks ago is still leaking. It’s a minor leak, but it’s still bad enough that it’s making the wood that the pipe is mounted to wet and moldy. We just don’t understand why it keeps leaking. It’s not the threads on the pieces that are leaking but the join between PVC and CPVC. That’s where the past two or three leaks have been in our fixes. We really don’t understand. None of the other stuff we’ve fixed in the house with PVC and CPVC and glue have leaked, but this one just seems determined to keep leaking and eventually cause rotting after the mold issues its already started. At least the leak’s small, but that’s the amazing power of water—it wears things down slowly, gradually, when you’re not paying attention. Maybe our little leak will start another Grand Canyon, right here in our basement. A few thousand years from now, you never know what this place might look like…. :)

* Stringham high: The midwife is cool.
* Stringham low: Stupid water leak *grumble*
* Stringham super-high: 72-degree high in August!

Monday, August 17, 2009

Garden Update (Ain't Life Grand?)

We’ve done really well with tomatoes and squash and green beans from the garden. Everything else, we’ve done OK on. We have a big learning curve, which we knew. We’ll probably plant all the same things next year, but we’re going to try using more organic matter in the soil to loosen up the soil. (Our root crops were all stunted this year because of the clay…it’s like they were all able to grow to about the size of the holes we dug to plant, maybe a little larger and that’s it.

But the tomatoes have more than paid for themselves. With me working and trying so hard to catch up and make a little extra money, M’s been doing the canning. We’ve managed to can 4 or 5 pints of pickles, 4 pints of spaghetti sauce, 4 pints of salsa (2 of which we’ve already eaten), and 4 pints of hot salsa. M’s going to harvest our third bunch of green beans today. Our first two batches each yielded about 2 pounds, so we just cooked them in the crock pot. But it looks like there are so many on the plants now that we may actually have enough to can green beans. I sure hope so. And we should have some more tomatoes so we can make another 4 pints of something in 3 or 4 days. All the tomatoes are just ripening—and we’ve got more buds started. We’ve gotten several peppers (Wenk’s yellow hots, jalapenos—though they don’t get very large and aren’t very prolific, cayennes, garden salsa hybrid). By far, the Wenk’s and the Volcanoes are the most prolific.

Potatoes gave a decent yield, but not a good return on investment. We basically ended up with “new” size potatoes. And the peas just didn’t do well. Cucumbers are still producing, and we can make a few more jars of pickles. One of our biggest fights this year has been the weeds. It’s been so temperate and wet this summer (very unusual) that the weeds have thrived. We just couldn’t keep up. We even did companion planting that’s meant to keep the weeds down, and it didn’t help much. So we “lost” most of our greens and our root crops (we hope to possibly reclaim the root crops—aside from potatoes and onions—after the first frost, because most of them taste better after the first frost) in the weeds. And M just tramps through the weeds around the beans (which don’t seem to care about the weeds) and the herbs (which also don’t seem to care about the weeds). We are still trying to figure out a plan of attack for the sunflowers, as we know that the snakes liked to curl up in the weeds in that patch earlier this summer…

Like I said, everything else fared decently (the corn cross-pollinated, as did our squash, so, yeah…we have a lot, but it’s all non-standard). The sunflower patch has all opened now, I think, though there is a wide variety in size. One plant is easily 8 or 10 feet tall with a huge head, and some are only about 3 feet tall with heads that have just opened. But the bees and butterflies have taken off on them. One day, not long after that first (now gigantic) head opened, it had at least 1 butterfly and 3 bumblebees on it. And all the other heads that were open at the time had at least 2 bumblebees each.

So all in all, not a bad harvest we’ve been raking in. Much better harvest than last year, and we’ve been learning a lot about what we can do, what is going to be problematic (cross-pollination of tomatoes, corn, and squash; raccoons; cabbage worms and caterpillars; bean beetles), so we should be able to do a lot better next year. We won’t be building raised beds as we had intended because we’re going to have to put up a fence around our overall intended garden area to help keep out the freaking raccoons. Although with all the fields around us being planted corn next year, we shouldn’t have a problem; it should be like last year, unless the coons have figured out that we have sweet corn and the fields don’t. After all, when they got into our corn this year, the ears that weren’t sweet just had a bite or two taken out of them and then were tossed aside, but the ones that were sweet got stripped—the husks strewn away from the garden and the cobs gone completely.

* Stringham high: Tomatoes and squash and beans, oh my!
* Stringham low: Weeds
* Stringham super-high: 16 pints canned!

Oh, and another mouse fatality yesterday. M saw one running across the living room floor and couldn't get the cats' attention on it, so he killed it. So far, our cats really aren't such good hunters (but really, why would they need to be?). This mouse was fairly small, so we think we've got a fairly new litter around here somewhere...

Tuesday, August 11, 2009

I'm Coming Out (Warning: You will be here a while.)

Of the closet. The pregnancy closet. I am in my 11th week (according to "last menstrual period" calculations). Yes, we are happy. Extremely happy. In my first three weeks, I took test after test to confirm that the previous one was correct. And that the baby was still hanging in there. Yes, thrilled.

But I think it only fair that people know what's been going on. We "let the cat out of the bag" early and let a lot of people--probably you, fair reader--in on the secret earlier than we wanted to because we needed help. As I have learned over the past few weeks, Indiana has a poor history of maternal health and prenatal care. So some programs have been created to help pregnant women get the proper care needed for themselves and their unborn and newborn babies. "That sounds wonderful!" you might be thinking. But let me tell you that I now understand WHY Indiana has a poor history of women getting the proper prenatal care they need. Much of it has to do with location, location, location.

M and I have been "trying" to get pregnant since about the time we got married. We had insurance until M lost his job in February of this year. We decided to take our chances. Honestly, I figured I hadn't been able to get pregnant this far, so what were the odds. I should have known. I may be a Stringham now, but I am still a Seifert, and subject to what my dad likes to call Seifert's Law. We managed to get M enrolled in a very affordable health insurance made available for farmers and self-employed people in May, effective June 1. But I was not eligible because of my BMI. I have to lose about 60 pounds to be covered by them. But the agents were very helpful and told me about this wonderful program that Indiana has to make sure that all residents have health insurance available--regardless of preexisting conditions. Yep, I looked into it. I'm generally healthy, but I appreciate the need for health insurance. Because I am a woman of childbearing age, my premium would have been somewhere between $400 and $600 a month. (Yup, for a woman from 18 to about 60 years, it's the same cost. Not so for men.) Now, I'm making fairly decent money on my own, but I'm supporting both of us, and a large portion of the money has to be set back for taxes and Social Security--you know, all those things that employers help you pay?

And we're trying to be responsible, here, and pay off our debts. They are considerable, and they are mostly mine. I have student loans to pay for, and I have substantial credit card debt because we almost lived off my credit cards for certain periods while we were both in grad school and when M was done with grad school and was looking for a job. Now, things are tight, but we've been paying our bills, and even making some headway on the debt. But $400 to $600 a month, we didn't have. But of course, I was practicing good eating habits and exercising in an attempt to lose weight TO GET HEALTH INSURANCE, so that most likely contributed to us actually conceiving this time (early June).

So, you might be thinking that if I had been lighter, I could have been on the same insurance as M and therefore had my pregnancy covered. Not so fast, boss. Most private insurances like this (M's included) require that a woman be enrolled for a year BEFORE pregnancy is covered. So, obviously, there must be some insurance out there that would take me despite my weight? Sure, maybe, for a very high premium. But still, pregnancy not covered unless you've been enrolled for a year. Hmmm... And even if they HAD decided to cover me despite my weight? Pregnancy is a preexisting condition, and private insurance...well, they tend to frown upon preexisting conditions.

"So, what next?" you may ask. Well, ever the resourceful, talented, and brilliant woman I am, I extended my request for help and information to all the talented, resourceful, brilliant people I know. I was given lots of helpful advice. Well, much of it would have been helpful for someone. Here's what I've found, folks:

Cinergy is not health insurance. They make it sound like it is in the commercials, but it's not. It's a health discount plan. This means they have a network of providers who have agreed to automatically discount for people bearing a membership card. Many such programs guarantee that they will save you x% over what you would have been able to negotiate. On doing further research, I have found that this is often not the case, if you know how to negotiate and use the correct words: "cash patient," "self-pay," and "pre-pay." Oh, and, in the case of the hospital, "pre-register." (More on this later.)

Midwives are wonderful. I'd love to have one. In Indiana, however, a midwife must be a Certified Nurse Midwife (CNM) and must be working with/under the supervision of a doctor. All well and good, but it is relatively difficult to find a CNM in Indiana unless you're in a city, as I have found. (But not impossible, as I have also found...but more on this later.)

Medicaid. Well, yes, Medicaid does provide help to people who make very little money. For a family of three (that's counting the unborn child), that's a monthly income of about $300. Well, M brings in more than that from his unemployment insurance. But Medicaid in IN has a plan for pregnant women--premium-free healthcare coverage. And the minimum monthly income is greatly increased--largely, I believe, because of the abominally damned difficult time pregnant women in this state have getting care. But still, we make in this household just a bit more than that monthly allowance. Ah, but in the fine print, I see a note saying that for self-employed people, 40% of their income is automatically removed in calculating eligible income. This means that only 60% of our monthly income is calculated in determining my eligibility. I do the calculations and find that we're still awfully close, and depending on just how they figure, we may still make just a SMIDGE too much for us to be covered. But it's worth applying. So I print out an application from online and prepare to submit it. But what's that I see? Proof is needed. Proof of income. A little difficult because of my self-employment, but I keep detailed records, and that shouldn't be a problem. A letter from a healthcare provider stating when the pregnancy began. Of course. They don't want to provide pregnancy coverage for a woman who's not actually pregnant.

So I begin calling around to see who can administer a pregnancy test (I'm fairly certain that taking in my own pee stick to the social services office doesn't count as a letter from a healthcare provider). What am I told? "Congratulations on your pregnancy! We'll be happy to take you in as a new patient. What insurance do you have? None? I'm sorry, but I can't schedule an appointment with you if you don't have insurance." Well, this complicates things...I can't get insurance without a letter verifying the pregnancy from a HEALTHCARE PROFESSIONAL, and I can't see a professional without insurance. [At this point, I'm already frustrated and want to stop. I have work to be doing to earn money, after all. But if I am this frustrated and discouraged and I have a Master's degree in health communication (focusing largely on the issues had by people who can't get insurance or can't get decent insurance) and a neonatal intensive care nurse for a mother-in-law, how the hell do most women in my area (who probably have a high school diploma, if that) feel when they are without health insurance?] So I ask the woman on the other end of the line if she knows WHERE I might be able to get such a pregnancy test and a letter confirming my pregnancy so I might be able to get some public assistance. [After all, I've been paying taxes since I was 15, and I've never used a dime of Federal or state money. Except for the educational LOANS, which I am currently repaying to a private company.]

Well, the Women's Resource Center might be able to help me. Hooray, a lead! Yes, they can certainly give me a test and provide me a letter. Free of charge. They are volunteers and provide counseling and abortion-alternative services to women. Yes, I went in. They administered a pee test. Yup, just like the ones I took over and over, but this one was administered by a nurse who volunteers at the center, so I was able to get a letter. Along with some questions about my religious history and my church-attendance and my relationship with God. *sigh* Although I don't really profess to be a Christian, I was raised a Christian, and I am still on good terms (as far as I am aware) with the Big Enchilada, and I speak with it nearly every day if not every day. Especially since becoming pregnant. So I am vague enough in my answers to maybe just sound like 80% of people who have been raised Christian but no longer attend my life well, talk to God, depend on God, yadda yadda yadda. M was a bit uncomfortable when the nurse asked to pray with us for the health of the baby, but I was perfectly content. Prayer is a good thing, and the more people asking for the health and well-being of our child, the better.

Okay, so, with my letter in hand on a Monday morning, I call the social services office to ask what I need for proof of income now that I am self-employed and my husband unemployed. I gather these things together and go down to the office to apply in person. I am handed a form, fill it out, give it back, and am asked if I would be available at 10 AM the following Thursday for a phone interview with a case worker. No, I didn't need my proof of income or proof of pregnancy at that time. Well, folks, had I known that ahead of time, I could have applied two or three weeks earlier and gathered all my information in the meantime. But that's okay, it's all gathered.

Now for all the hard work. Oh, yes, there's more. So much more.

You may not need to read this if you've been through a pregnancy before, but chances are, you had insurance. Here's what it's like. Here's all the research I had to do on my own.

I called my OB/GYN in Carmel and asked to get an appointment set up. Self-pay. I don't want to keep my care in Carmel, considering I'll have to make treks there for appointments in the middle of winter, and that's not fun when I'm not nervous and pregnant. But I can at least get some initial care while I continue looking for providers in our area. Sure, they can do that, and they'll transfer me to the business office to tell me everything I need to know about paying cash. Here's what I found out: I had to have $700 to step through the door the morning of my appointment. Let's stop there and consider that a moment, folks.

$700 before I can sit down with anyone in the business office and work out a payment plan. And that's with the 20% cash discount. But really, it's explained to me, only $200 of that goes toward the care for me and the baby. $500 is for lab fees because so many tests are done on that first visit. And at any visit when a lab will be done, I have to pay for the test before I get to see the doctor. For example, around 28 weeks, their standard 1 ultrasound will be done, and that will cost about $330. That I'll have to pay before I can even have my visit. The very nice, helpful, informative lady in the business office (I am completely serious here--she was very polite and did not seem in a hurry to rush me off the phone throughout all my questions and note-taking) informed me that I could expect to spend about $900-$1200 on labs throughout the pregnancy.

Then there's the $2400 charged by the doctor for the delivery fee. This covers all my visits and a normal vaginal delivery, but not hospital costs. The doctor offers a cash discount, so the cost would only be $1920 if I'm paying cash. What a bargain. But it's due in full at 24 weeks. Well, at that point, I was already 10 weeks along. Hmm...that's not sounding promising. And they can set up a payment plan, but if they do that, well, there's no discount. Hm. So we're back to $2400 because I can't just come up with $1920 in the next 14 weeks. It may seem simple, but I can't remember the last time we had expendable income adding up to $137 a week. Oh, and if I would happen to get the Medicaid insurance (Hoosier Healthwise), they would not accept that. And then there would be the hospital fees. I would be able to choose one of two hospitals in the Indianapolis area to deliver at. Either one accepts Hoosier Healthwise. For either, fees for a normal vaginal birth for a 2-day stay would be $6000-$8000 paid up front or $10,000-$12,000 not up front. Not including anesthesia if I would so choose to partake. Not including any extra fees if something would go wrong or a C-section were needed. All for the privilege of delivering in their hospital.

All that, on top of both the doc and the hospitals being a good hour's drive from where we live. Not feasible. So I begin researching in our area again. I call various departments in our local hospital, various doctors, the Women's Resource Center, Planned Parenthood in Lafayette, and the neighborhood clinic provided free or for simply $12 for the people of the area. We have a serious lack of OBs in the area. And few general practitioners who will do OB. The Women's Resource Center does not provide prenatal care. Planned Parenthood does not provide prenatal care. The neighborhood clinic does not provide prenatal care. (Basically, the neighborhood clinic cares for any of a person's needs except prenatal care.) Well now. I've read that some hospitals will provide prenatal care for cash to women without insurance. When I speak to someone at the hospital, they say they do not provide prenatal care, but they tell me to speak with the OBs who practice at the hospital. The number they give me is the number of the practice I called when I was informed they couldn't even schedule an appointment if I didn't have insurance.

Oh, the joy.

Finally, I send an email to the hospital seeking further information. Anything, I say, will be helpful, but I need information. How can I get care if I don't have insurance? A few hours later, I was informed that I needed to call that practice again and speak with the business manager. They do, indeed, provide care to people without insurance, but there are special requirements. Here we go again.

Yes, the business manager is very nice and very helpful, if a bit in a hurry and wanting to get me off the phone (or maybe she doesn't like being on the phone). But I am stubborn, and I have come prepared with a list of questions so I cannot be rushed and forget my questions. And this is for our baby. I need information, and I intend to get it. $2400 for vaginal delivery and all prenatal care. With a 20% discount, it comes out to $1920. Well, this all sounds familiar. I am not heartened. But only $420 is due at the first visit, and then there are 6 monthly payments of $250. Okay, I feel a little better. Relieved, even. This works out to everything being paid in full around the time of delivery. Much better than at 24 weeks. Ah, but there's more. (Isn't there always?) That doesn't include any labs, ultrasounds, or hospital fees. Ah, there's the kicker. She can't really tell me the cost of these things because they are billed directly from the lab to us. But she gives me the telephone number and billing extension for the lab so I can ask about the cost.
Oh, and yes, they do accept Medicaid, but until that coverage goes through, I would be treated and have to pay as a cash patient. Then, if the Medicaid goes through, I will be refunded all the money I have paid. Well, it's promising, and I understand completely. Oh, and they operate their practice such that I alternate between the three practitioners--an MD, an OB, and a CNM. They will all be familiar with my care, and whoever is on duty when it is time for me to deliver will deliver. Excellent. In the mix is a doctor I was told doesn't set much stock in how valuable your time is (but she's only in the office about once a week), a doctor who was praised highly to me, and a midwife. Two out of three ain't bad. I mean, really, if it weren't for my mom's history of preeclampsia and my weight, I'd prefer having only a midwife and consider having a home birth...

Next, I call the lab and ask what they charge for standard prenatal tests. Well, they can't tell me for sure without the specific names of the tests because every doctor orders different tests, and there are just too many, apparently, for them to list all to me with prices. I will have to have specific names in mind. I hastily thank the lady and hang up. Damn! I have forgotten to ask about payment plans. I call back and receive a friendlier assistant this time. Yes, they do offer payment plans (could we really get so lucky?). There are no set payment plans in order, I am told. They LIKE to have everything paid off within 4 to 5 months. But, by the lady's tone, I can tell, this is not a requirement. I am really taking heart. Further, they offer a cash discount if the fees for the labs are paid within 10 days and they don't have to bill insurance (in other words, if they don't have to deal with insurance and you pay quickly, you're saving them money). I am substantially relieved, but I still don't know how much they charge for all their labs. I'm guessing it's in the range of $900 to $1200 quoted me by the earlier doctor. But being able to work out payments rather than pay for labs before I even have the labs done? Well, that's a load off my mind.

Still, we're planning to ask the doctor (whenever we finally get one) about every single test and its necessity. We're going to have the baby even if it has some small problem, and I'm not at risk for any of the big genetic problems, etc.

Now, to call the hospital. Again, a perfectly lovely person in billing was happy to patiently answer all of my questions. The cost for a 2-day stay for a normal vaginal delivery is $9500. Am I insured? No. Oh, well, then I can pay $4750 one month before the delivery, and then the hospital will write off the cost of the baby's stay and care. I waited for further details. To hear what was due after the birth. There were no more details forthcoming. "Okay," I say, "I want to make sure I understand this correctly. If I have paid $4750 a month before the baby is due, I don't have to pay a single dollar more, if the delivery goes well and I don't need anesthesia or anything like that?" That's correct, this angel on the other end of the line tells me. And all I have to do is contact the hospital ahead of time and tell them I'm a prepay. I can even set up payments. All I have to do is call and pre-register and get an account number, and then I can send in payments whenever I like. All up to $4750, so long as I've paid it all a month before the baby is due. "Is that something you'd be interested in?" she asks. "Of course it is!" I want to shout in joy. A 50% discount. But I slowly say, "I think so, but I have to discuss things with my husband. I'll call back to pre-register later."

So, what have I (and M, to a lesser extent) learned from this journey?
1. I have not made the money I need to earn in these past two weeks because I have been too busy calling what feels like every agency set up to help the poor and/or pregnant in a 50-mile radius just to find care for my unborn child.

2. Obama's healthcare plan won't go into effect soon enough to help me. (Think what you want about his plan--and I agree that many people who have the power to make these decisions are suggesting all the wrong things, never having dealt with these situations before--but I sure would be happy to have it right now. Especially considering that I (1) have paid in for social programs since I was 15, (2) have been covered by health insurance all my life until February 2009, (3) STILL pay for social benefits such as Medicare and Medicaid, and (4) cannot get healthcare now when I need it most, because I am too fat, am pregnant, am self-employed, and make so much money that I "should" be able to pay for care on my own. [See a rather brief but beautifully concise discussion of the pros and cons of such "government-run healthcare" at my friend Peachy's blog for 13 July 2009.]

3. We are far less worried about the costs of providing a good life for our baby than the costs of bringing our baby into the world.

4. If the social services caseworker I speak with this week does not feel I qualify for Medicaid for prenatal care, I will fall into the so-called "donut hole" that is swallowing more and more middle-class people these days in healthcare. And we have to come up with about $8200 to have a baby through the traditional means, with nothing going at all wrong. It's a good thing I already planned to have as natural a childbirth as possible. And, by all that is holy, now more than ever, I hope for as easy a birth as my mother was blessed with.

5. M and I would never ask for monetary help. (And I am not asking for it now.) But we are in no position to deny such help if it comes our way. And if, for some reason, you would want to contribute to a gift for a baby shower, might I suggest, instead, money so we can make sure our child has a healthy start in this world? We already have the means to feed and cloth and shelter the child.

Oh, and I'm still holding out hope for Hoosier Healthwise. And I pray for the help and a sympathetic caseworker every day.

And if you have already given us assistance by way of information or money or emotional support, thank you, thank you, thank you many times over.