Friday, July 15, 2011

Who's on first? What's on second?

There's an old Abbott and Costello routine in which Abbott is talking about players on his baseball team, and Costello is having a hard time understanding him:

Costello: Look Abbott, if you’re the coach, you must know all the players.
Abbott: Right, certainly do.
Costello: Well, I never met the guys, so you’ll have to tell me their names, and
then I’ll know who’s playing on the team.
Abbott: Oh, I’ll tell you their names, but you know strange as it may seem, they
give these ball players now a days, very peculiar names.
Abbott: Well let’s see, we have on the bags, we have Who’s on first, What’s on
second, and I Don’t Know is on third.
Costello: That’s what I want to find out.

This goes on for quite some time, because the joke is that the name of the guy on first is "Who," the name of the guy on second is "What," and the name of the guy on third is "I don't know."

Much funnier to see/hear than read:
Here's a link on YouTube

I'm often reminded of this when we go to doctor's appointments with our surrogate. (As a tangent, those rooms are designed for 2-3 people, pregnant person, partner, and midwife or doctor. Imagine cramming our motley crew of 5 in one of them!) Our midwifery service has 9 midwives, so thus far we often have a new midwife. Imagine being the midwife walking into a situation with 2 women, 1 of whom is pregnant, and 2 men in the room. You can see the gears turning in their heads before they read the chart notes. They're trying to be polite, not ask outright, but I can see it cross their faces: Who's the mother? Which is the father? I don't know...oh, she's in the womb!

This got very tricky with something they call the "quad screen," which asks for all sorts of genetic information about the mother and father. But of course, in our case, this isn't the woman who is pregnant's genetic information, but our information. It's a good thing I was sitting next to the surrogate to help her out as she was filling out the paperwork as it is asking things like, "Is there a history of neural tube defects on the mother's side of the family? On the father's side?" and "Are their any genetic conditions on the mother's side of the family? On the father's side?" Naturally the paperwork assumes that the person who is pregnant is the mother. At one point I was glad I asked a question, "How is the risk factor for Down Syndrome and neural tube defects calculated from the information you collect?" Our midwife explained that it was based on the level of various proteins in the mother's blood (ummmm, hold on, no one took my blood, they took "Lisa's" blood), the results of the ultrasound, and the mother's age. Ok, time to do some sorting out. Is it the protein's the the person who's pregnant's blood, or the genetic mother? Turns out it's the person who is pregnant. OK then, is it the age of the person who is pregnant, or the age of the egg. Turns out it's the age of the egg. But there's no way in their computer system to explain that the age of the egg is different than the age of the person who is pregnant since it is assumed that the egg is the same age as the person who is pregnant. So calls were made to the lab and numbers recalculated. It didn't change much, but it reminds me that we can't take for granted that people who work with us in the hospital know our situation, and have taken that into account for every test. We have to think through every step to see if there's something that needs to be clarified.

Pretty soon we need to meet with our attorney to file a "judgement pro tem" explaining to the hospital and everyone who would possibly care that when the baby is born is is our child, not "Lisa's". Of course, from day 1, we've known this, and Lisa and "Linus" have known this, but the powers that be at the hospital don't legally know this, although by now our midwifery team does. We've got to have that piece of paper for when the child is born because otherwise the hospital assumes that the woman who gives birth to the child is the child's "mother," will make all decisions for the child, and will have the child go home with her. In our case, that's not true, but that's what the hospital will legally assume. And we all know what happens when you "ASSUME" something! ;)

This also changes rooming arrangements. Lisa can leave the hospital perhaps as early as 6 hours after the delivery, but particularly because we're going to be traveling to Seattle after the baby is born, the baby will stay a day or two. Which means that we'll have a postpartum room for the baby, even though I'm not postpartum. They usually keep the woman who has given birth and the baby in the labor and delivery room for about 2 hours and then go to the postpartum floor. In our case we may get 2 postpartum rooms, or they may keep Lisa in L&D a little bit longer and she can be discharged from there.

And, of course, the wonderful bureaucracy known as insurance is sure to be utterly stumped since they can't even seem to bill a standard primary care physician's visit correctly. Up until now, Lisa's insurance has covered the pregnancy, and will cover the delivery expenses and her care after delivery. But when the baby is born everything that she needs will be transferred to our insurance. Usually not a problem because the insurance company has seen all of the pregnancy bills and the delivery bills and it sorts itself out a week or so later when the baby gets her own insurance card. But what happens when we aren't even in the hospital's database system with our insurance information???

No matter how much prior preparation and planning we do, I'm pretty sure there's a bunch of things I haven't even thought of yet. And I'm the mother...but I'm not the pregnant person...but the egg is the same age as me...but the blood proteins are found in Lisa's blood....and now I'm totally confused. Oh yes:

Who's the mother. Which is the father. I don't know, she's in the womb.

1 comment:

  1. I will be waiting with bated breath to see how it turns out and hopefully following in your footsteps very soon! Glad you updated!!