Tuesday, November 15, 2022

The Cost Of: Prenatal Care, First Two Trimesters

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With any medical care-related expense in the US that's billed through health insurance, it's not necessarily that meaningful to hear about anyone else's experience. So much depends on the vagaries of one's own health plan, something I personally find nearly impossible to decipher or predict before my bills after insurance actually come in. (That's as someone who litigates multi-million dollar commercial contract disputes at my day job, no less!) 

Nonetheless, I always like to read about how much things cost, including American healthcare. I was originally hoping to do a post like this earlier in pregnancy, potentially one for each trimester. As it turns out, the billing department at my OB-GYN's office can be quite slow, so it was only recently that what I think(?) is the last bill from before the end of my second trimester - nearly 7 weeks ago - was finally processed with my insurer. 

This kind of timing isn't necessarily a huge shock in the American system, either. For instance, it was only this June that I finally saw a record pop up with my insurer for a PCR COVID test I took last December, during the start of NYC's Omicron surge. (That length of delayed billing is pretty unusual though, in my experience. There wasn't actually a bill to me involved either, because COVID testing in NYC was generally still free to the patient with government support back in December 2021.) 

For my prenatal care throughout the first two trimesters, through 26 weeks of pregnancy, the amounts I paid out of pocket for expenses that were - or could have been -  put through insurance was: $1,827.68

Unfortunately, I think this solidly establishes my health plan as being "not very good," in terms of the extent and quality of my coverage. Which is something I did already know beforehand. Many biglaw firms are known for offering associates extremely expensive health insurance plans, sometimes with poor coverage. My health insurance premiums aren't as bad, but the co-pays and other terms keep getting slightly worse by the year. For one random data point of comparison, a YouTube vlogger I follow who also lives in NYC only paid around $366.00 out of pocket on her insurance for prenatal care through roughly the same point in her pregnancy.

Saturday, November 12, 2022

Fully Recovered from COVID

via Unsplash

Thank you for all the well-wishes after I got COVID! By the time my last post went live on Tuesday (after the onset of mild symptoms on Saturday and first testing positive with my peak symptoms on Sunday), I was already feeling much better. I've since continued to recover fairly quickly: I'm now close to feeling 100%, though have continued to rest at home as much as possible. (K tested at home almost every day, but he never got a COVID positive and his symptoms stayed mild.) 

Because I hadn't taken advantage of early voting before I came down with COVID - and because a certain conservative-leaning news sources in New York insisted that the only particularly contested race on my ballot, for New York's governor, was going to be close - I needed to step out briefly on Tuesday to vote. (That race turned out the way I wanted.) I masked the entire time I was out of my apartment. It's barely a two-block walk to my poll site; I was in and out in slightly less than ten minutes; and my symptoms were down to a mild cold level, though with some icky-sounding congestion. Nonetheless, I still needed to lay down for an hour or two afterwards to recover my energy. 

While my case of COVID has been extremely mild and quick to pass - even compared to fully vaccinated and boosted friends who were not immunocompromised by pregnancy at the time they had COVID (though I'm the only one who got it after having one of the new bivalent boosters, since those came out so recently) - it definitely felt weird compared to various colds I've had previously, or the flu. I lost my sense of smell completely for two days, which felt out of proportion to the moderate congestion I still had by then. (That, in turn, significantly muted my sense of taste.) 

Hard to pinpoint exactly how, but the cough and congestion just felt really different from my usual bad colds in past years, it sounded much worse than it felt. I think the hit to my energy levels for a few days also felt worse than with typical colds, but I've bounced back now, very quickly. 

It's looking like my mild to moderate COVID case won't increase my schedule or intensity of prenatal care, but I might not be able to fully confirm this until my next appointment OB-GYN on Monday. I was already due to be seen at least weekly starting at 36 weeks next week no matter what, so I'm going to have plenty of medical supervision regardless. My blood sugar was fully back to normal by Monday afternoon, and it's continuing to look like I won't need to go on medication or insulin for gestational diabetes this pregnancy, which is a huge relief, as that would have opened up a lot of potential issues. 

Tuesday, November 8, 2022

After Nearly Three Years...

via Unsplash

... COVID has finally gotten me for the first time, as far as I know! I felt a tiny bit off this past Saturday, but tested negative on a home COVID test. Then, by Sunday morning, my symptoms suddenly intensified to nasty cold level (sore throat, headache, general feeling of malaise) and I tested positive. 

Luckily, my COVID symptoms never got too intense, though my congestion and cough still sound really gnarly and worse than I actually feel. I never got a fever, and my symptoms already feel like they're improving, so fingers crossed I continue to avoid getting a fever or anything worse! Because third trimester already involved a moderate amount of shortness of breath, at least for me, that's gotten a bit worse while I have COVID symptoms. (I had my second COVID booster, with one of the new bivalent vaccines, around five weeks ago. K had his around four weeks ago.)

K started getting cold symptoms the day before I did, which he totally thought was a side effect from getting his annual flu shot the day before that. He's actually still testing negative on home COVID tests though, which hasn't been unusual for my colleagues and friends whose significant others tested positive for COVID in recent months. 

This turn of events hardly feels fair because I continue to be quite religious about masking in public indoor settings except when actively eating or drinking. That's even while at work in a very small office where I generally have only minimal or fleeting direct contact with my colleagues most weeks, including last week (legal practice can be a surprisingly solitary affair, even when done in-person at the office). At this point though - now that masking is essentially no longer required almost anywhere in NYC except in some health care settings, including my OB-GYN's office - the masking rate most places, including on crowded buses and the subway, is probably generally only around 20-30% here. 

K and I did eat out once last Tuesday, but that restaurant was nearly empty, We also ate out once somewhere busier the weekend before that, which I guess might be the more plausible source if I first got COVID symptoms roughly a full week after? But I don't think most people in NYC who need to go to the office and use public transit like me can ever know for sure when and how exactly they caught COVID these days, since there's generally always a fair amount of it going around. 

Like some other gestational diabetes ("GD") patients, I found that COVID caused some chaos with my blood glucose numbers. My blood sugar spikes weren't as extreme as some I've heard about, but on my first day of testing positive for COVID, my after-meal numbers were significantly over what they'd normally be for meals I've had often since I started testing daily. Thankfully, it seems like that particular effect of COVID is also subsiding quickly for me. That's despite losing my sense of smell, which also mutes my sense of taste somewhat, which does make it harder to fully keep up with my recommended eating and snacking schedule with GD. But my glucose numbers haven't been too badly affected by that. 

Having COVID during my third trimester isn't the most fun. The occasional pregnancy insomnia has made it difficult for me to really sleep in and get as much rest as I'd like. I'm also still trying to run down whether having COVID while fully vaccinated and boosted will require me to have more follow-up appointments with my main OB-GYN or the specialist team I was referred to for  my GD. (But at 36 weeks next week, I was already due to start having weekly appointments with my OB-GYN regardless.) 

Monday, October 31, 2022

October 2022 Shopping Reflections

Well my third trimester bump is so large and unwieldy now, and my pregnancy-related physical discomfort so substantial, that I'm definitely no longer able to expend any mental energy on trying to wear cute clothes! Almost all my fashion-related purchases this month are maternity wear, to get ready for fall and early winter temperatures in NYC. 

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I was originally thinking I might be able to wear my usual fall/winter uniform of dresses and tights (and sweaters, particularly the J.Crew Juliette sweater blazers) once the weather cooled down during my third trimester. But after ordering a single pair of maternity tights (from Spanx) to try on, I quickly realized that just wasn't going to work. It takes so much effort to get into a pair of tights now - even putting on socks can leave me winded these days, and significantly more contortions are required to get a pair of tights on fully - that I could only ever manage it for special occasions. It's simply not happening for everyday wear. Thus, I'll be in maternity pants or leggings for the remaining six to seven weeks of my pregnancy. 

Fashion - (TOTAL: $372.95) 

  • Kizik Vegas Sneaker, white - $140.45* - I got these solely because of Kizik's primary gimmick, that their sneakers are "hands-free", and slip right on. I'm happy to report these shoes work as promised: I do need to angle my foot in a little since I keep them fully tied and the opening for my foot isn't that large, but it's easy enough to do, even in my heavily pregnant state. These took a little time to break in the toe box and ankle, my feet got a bit sore after several hours out and about on the first day of wear. But that's typical enough and I didn't have any blisters or anything. I've been wearing my Kiziks almost every day since receiving them in early October, and they seem to be holding up reasonably well so far. 
  • Pact Maternity Airy Long-Sleeve Tee, storm - $40.00 - I bought four maternity tees from Pact once I knew I'd be in pants and leggings for most of my third trimester, and I'm quite satisfied with the quality. (All my non-maternity tees are too short to accommodate my third trimester bump.) The cotton fabric feels nice, though is slightly on the thin side (but the white tee is not sheer, so there's no real problem there). I don't layer sweaters over these for now because it's still somewhat warm. As with many other maternity wear lines, Pact recommends taking your size from before pregnancy - for me, a M - though I found these tees ran a noticeable amount larger than that. This is probably the first maternity wear brand I've tried that I'd describe that way because I grew so much in the bust and bump early on that I'd have done better sizing up in many brands by the middle of my second trimester. One additional issue is that my pre-pregnancy bust measurement puts me solidly in a M on Pact's sizing chart, while my waist and hip measurement belong in a S. 
  • Pact Maternity Airy Long-Sleeve Tee, mink gray - $40.00 - While all these Pact maternity tees are good quality, I don't love many of the color choices in their maternity line. This "mink grey" seems awkwardly in between olive green and light grey, so it's not my favorite as far as neutral shades go. Though I needed a lot of tees, so I still ordered this, and it was at least more neutral than some of the other remaining shades. 
  • Pact Maternity Slub Slouchy Tee, white - $40.00 - The neckline on these is a bit wide, so the effect can be a bit pajama-like. But I personally still prefer a slouchy, loose maternity tee over a ruched one. Just my nitpicky style preference... 
  • Pact Maternity Slub Slouchy Tee, ore - $40.00 - This is another somewhat odd neutral from Pact. The storm color the long-sleeve tee comes in is truer dark gray. Meanwhile, this ore shade is somewhere between slate blue and dark gray, though that works for my wardrobe a bit better than the more olive green mink gray. 
  • J.Crew Factory Maternity Jamie Pant, black - $44.50 - These have a comfortable soft stretch, though the fabric is fairly thin. I ordered two sizes - 6 and 8 -  to try on. From that, I don't think it makes the biggest difference with these pants to size up from your pre-pregnancy size or not, as the two sizes felt very similar. I ultimately kept the larger one because I figured it'd leave more room for the continued growth of my third trimester bump. 
  • Spanx Maternity Tights, black - $28.00 - (also here) I can't really give much of a review for these because I tried them on just once at home and quickly realized I just wasn't going to be able to regularly put on tights in my third trimester. My belly is just too in the way! As suggested, I ordered my pre-pregnancy size on their size chart and that seemed correct for my early third trimester bump. (Though as with many other brands that suggest taking your pre-pregnancy size in the maternity line, I think that by the end of pregnancy I'll be close to or actually in need of sizing up from that recommendation.)  
*Indicates that price includes sales tax

Nothing too exciting this month on the shopping front, and that will probably continue to be true for the rest of my pregnancy. There isn't even that much time left now, most likely around six or seven weeks, and that's such a daunting thought! Though I'm also feeling so big and unwieldy already that I'm totally kind of looking forward to it being over. (I was my mom's first baby and was born almost two weeks early with no complications or issues, so part of me is wondering if I might also deliver a bit early.)