Yesterday, our new benefits packages from Blue Cross Blue Shield came in the mail. I anxiously opened the envelope, hoping they'd give us something to work with. As I pretty much expected, not much has changed. But, at least they've thrown us a bone.
The new insurance will include coverage for office visits -- a $25 co-pay for in-network visits, and 30% co-insurance for going out of network. The disclaimer at the bottom of the benefits outline states, in small letters, "Infertility services, including prescription drugs, are limited to the diagnosis of infertility only. No benefits are provided for the treatment of infertility." How gracious of them to bring someone to the point where they can find out why they're unable to get pregnant, but can't fix the problem to help them get a baby. Maybe I'm asking for too much, but what good is knowing the problem if they won't help solve it? Seems like a tease to me, and I already know what our problem is.
I'll have to start making phone calls to BCBS to find out exactly what they mean by "office visits." Sounds like that will at least cover a consultation, which is great considering that would run about $350 if we paid ourselves. Hopefully that will also cover some blood draws and ultrasounds, as well as any other diagnostic testing they might want to do to make sure there really is nothing wrong with me.
I still plan on writing a letter to our company's president and pleading our case (thanks for that tip, Tori!). Can't hurt.
Saturday, May 16, 2009
Thursday, May 14, 2009
Sick
I’m sick with a head cold. At least it’s not swine flu, but I don’t like being sick. After all my efforts and precautions to keep Mike away from sick people, I’m the one who gets sick. Mike seems to have a touch of it, but he’s fighting it off like a champ. His stem cell donor must have been Superman!
I'm stuffy as anything, have watery eyes and wish I could just veg out on my couch until it passes. On Monday and Tuesday nights, right around bedtime, I got the chills and ran a small fever (between 99 and 100), but last night there was no fever. I think I’m starting to get over the hump. I’m still very, very stuffy, but not as bad as yesterday. The worst of it is my nose – I look like Rudolph’s twin sister. What makes it even more lovely is that it’s so raw from me blowing it every 15 minutes (and that’s not an exaggeration), that it’s dry and beginning to peel. To be blunt, it looks like I have snot all over my nose. I feel like everyone here at work is looking at me and wanting to say, “Um, yeah…… you’ve got…… something…..right there……”
I'm stuffy as anything, have watery eyes and wish I could just veg out on my couch until it passes. On Monday and Tuesday nights, right around bedtime, I got the chills and ran a small fever (between 99 and 100), but last night there was no fever. I think I’m starting to get over the hump. I’m still very, very stuffy, but not as bad as yesterday. The worst of it is my nose – I look like Rudolph’s twin sister. What makes it even more lovely is that it’s so raw from me blowing it every 15 minutes (and that’s not an exaggeration), that it’s dry and beginning to peel. To be blunt, it looks like I have snot all over my nose. I feel like everyone here at work is looking at me and wanting to say, “Um, yeah…… you’ve got…… something…..right there……”
Wednesday, May 6, 2009
A Fresh Set of Eyes
It's been a week since I checked out that new fertility clinic. I've been wanting to post an update for days, but wanted to give it the time and attention it deserved. I didn't get any grand revelations or unexpected surprises, but I was so glad I went and I think having a new outlook had done me a lot of good.
First of all the place is closer than our current clinic -- not by a huge mark, but closer nonetheless. The staff (the office manager and the financial coordinator) who greeted us was very nice and friendly. Mike couldn't make it, so it was just me along with another couple and a single woman.
Dr. H, the founder of the clinic, came out and addressed us all in the lobby. He introduced himself and told us a bit about his background and what sets his clinic apart from others. Over the course of about an hour, he explained the basics of fertility treatments (IUIs, IVF, donor eggs/sperm/embies, etc.) and explained what a typical cycle consists of. It seemed to me the others in attendance that night were just starting out in their IF treatment journeys. From the questions they asked, I just assumed none of them had been through extensive treatments before. I, however, felt like I knew too much. I could relate to what he was saying. I knew the terms. I felt like I was an A student being forced to take summer school. In other words, been there, done that. I guess I was a little glad for that -- in some way my experience helps me to know some of what works and what doesn't (for me, anyway). I also know what I don't have to waste time trying.
Dr. H is obviously a wealth of knowledge. He seems very smart and experienced. He seems clinically minded, and I've heard from a few people that he doesn't have the best bedside manner, but that's something I can tolerate if he can get the job done.
Once Dr. H finished giving his presentation, he took questions. One of other women asked him something about transferring over previous records of her medical history at a nearby hospital. Dr. H said she should, that sometimes they catch things on records that other doctors at other places didn't see. In fact, he said it happens all the time. He said, "We had a patient here who was trying to get pregnant for years. She did IVF three times at another clinic and failed. Then she came here and we found she had several large fibroids. We took them out and now she's successfully pregnant." As he told this story I got shivers. He didn't name names, but I knew from the story that he was talking about my cyber/message board friend "T" -- the one whose success story prompted me to check out this place! I couldn't believe it.
Once questions were over, the office manager showed me and one of the girls around the clinic. She showed us the offices and two of the four different "pods" each doctor/nurse team has. She also showed us the lab areas upstairs. The place is a little smaller and more "no frills" looking than my current place, but again -- who cares? It's what patients take away that matters.
After the little tour, I was able to take a few one-on-one minutes with Dr. H. Below are some of the basics of our conversation, paraphrased and in no particular sequence:
Me: My husband is a cancer survivor, and he banked his sperm before his treatments.
Dr. H: Very good.
Me: So, there's really nothing "wrong" with me; we're doing IVF because of my husband's health history.
Dr. H: How many vials of sperm do you have?
Me: We started with 13 and now we have 12 left. I've done one fresh and one frozen cycle over the past two years.
Dr. H: Where did you go?
Me: [Told him our clinic's name]
Dr. H: [Nodded]
Me: In fact, I think earlier you mentioned a friend I met on message board. She used the same clinic as me. It's because of her success story that I came here tonight.
Dr. H: It's unconscionable what they did. Unconscionable.... How old are you?
Me: I just turned 34.
Dr. H: Oh, you're young.
Me: [with a laugh] That's what everyone keeps telling me but I'm not feeling so young anymore!
Dr. H: How many eggs did you make with your fresh cycle?
Me: 17
Dr. H: [Surprised] Wow. And how many fertilized?
Me: 15, using ICSI.
Dr. H: Wow, I thought you were going to say only a few fertilized. That's great.
Me: Yeah, so that's what's so frustrating and confusing for us. They didn't really give us any reasons why it didn't work. I know after the fresh cycle they said my estrogen levels were pretty high and that could've worked against me.
Dr. H: And after the second failure, did they do an [some term he used for doing a biopsy of the uterus, and I think an HSG] or were they just for going right on ahead with another cycle?
Me: They didn't mention doing any other tests.
Dr. H: Well, I'd want to check to make sure there aren't fibroids or something else going on in there. Also, you don't need to make so many eggs. We just need a few high quality embryos. Were your transfers on day three?
Me: Yes, day three for the fresh cycle.
Dr. H: Did they mention anything about doing a day-two transfer?
Me: Day two? I didn't know there was such a thing.
Dr. H: Yes, we sometimes do day-two transfers. Your body might be a better incubator than a lab.
Around this time, the financial lady came around and we all started talking about our other issue -- insurance. We have nothing in terms of infertility coverage. At one point, before I was employed there, our company had IF coverage, but later dropped it. We live in a "mandated" state, meaning companies based in this state and which have at least 100 (or so) employees must offer IF coverage to their workers. However, the company Mike and I work for is "self-insured" which basically means they don't have to comply with the mandate. It's a loophole which has thrown us for a loop. We all discussed the insurance issue for a few minutes, and both Dr. H and the financial lady think I can contest this exclusion and maybe even win coverage. They said they thought this lack of compliance was illegal (though I'm sure our company's lawyers knew how to get around it legally) and I should push for the insurance. I said I'd give it a try.
So, after spending a couple hours at the place, I thanked them all for their time and headed home. I immediately called Mike and then my mom, and told them all about the place and my chat with Dr. H. I really left there feeling hopeful again, like maybe this is the place we're supposed to use. And who knows, maybe I can challenge the insurance issue. I never really pushed either our H.R. department or the insurance company. I got the "self-insured" explanation and then dropped it. Maybe that was a mistake.
I like the clinic. Like I said, it doesn't have all the bells and whistles, fancy lobby or huge facilities of our current place, but is that all necessary to make a baby? Might it just take one doctor or lab tech who looks a little deeper and doesn't take a situation that appears to be a "gimme" for granted? I'm not calling anyone out or saying our current place messed up or missed the mark. But our RE told us from the beginning, with a good amount of confidence, "I can't see this taking more than one or two tries for you." For two years I've held onto those words for comfort as if they were gospel. Well, here we are two years and two tries later with no child. Even if our situation looks like a slam dunk on paper, I'm no longer willing to just forge on ahead time after time because the odds should eventually favor us. There's a reason we've had two failures, and Dr. H at least gave me the feeling that he wants to explore those failures.
In my heart, I have my own theory as to why we had two failures. As painful as those failures were, I believe God had His hand on them. Within a couple months of each failure, Mike was diagnosed with another cancer recurrence. Had I been pregnant during either of those times, how would we have enjoyed it? The entire pregnancy would have been filled more with dread and worry, not knowing what the future held for Mike. Even worse, would the stress have hurt the baby and could I have even lost the pregnancy? Looking back, neither time would have been right for a baby. All I can hope and pray for is that when we make our next attempt, we are ready and our other health woes are behind us.
Side note: Today at work, our company president sent an e-mail telling us that effective June 1, we're changing insurance carriers. He said we'll be pleased with the changes, such as lower co-pays and higher lifetime benefit maximums (which is an answer to our prayers for Mike, whose benefit payout is now probably up to half a million dollars). Over the next couple weeks, employees will be receiving the details of our new coverage. I hope and pray there is some infertility coverage on this new plan. If there is, our financial barrier will be lifted. Please pray that this new insurance gives us what we need to give IVF another try!
First of all the place is closer than our current clinic -- not by a huge mark, but closer nonetheless. The staff (the office manager and the financial coordinator) who greeted us was very nice and friendly. Mike couldn't make it, so it was just me along with another couple and a single woman.
Dr. H, the founder of the clinic, came out and addressed us all in the lobby. He introduced himself and told us a bit about his background and what sets his clinic apart from others. Over the course of about an hour, he explained the basics of fertility treatments (IUIs, IVF, donor eggs/sperm/embies, etc.) and explained what a typical cycle consists of. It seemed to me the others in attendance that night were just starting out in their IF treatment journeys. From the questions they asked, I just assumed none of them had been through extensive treatments before. I, however, felt like I knew too much. I could relate to what he was saying. I knew the terms. I felt like I was an A student being forced to take summer school. In other words, been there, done that. I guess I was a little glad for that -- in some way my experience helps me to know some of what works and what doesn't (for me, anyway). I also know what I don't have to waste time trying.
Dr. H is obviously a wealth of knowledge. He seems very smart and experienced. He seems clinically minded, and I've heard from a few people that he doesn't have the best bedside manner, but that's something I can tolerate if he can get the job done.
Once Dr. H finished giving his presentation, he took questions. One of other women asked him something about transferring over previous records of her medical history at a nearby hospital. Dr. H said she should, that sometimes they catch things on records that other doctors at other places didn't see. In fact, he said it happens all the time. He said, "We had a patient here who was trying to get pregnant for years. She did IVF three times at another clinic and failed. Then she came here and we found she had several large fibroids. We took them out and now she's successfully pregnant." As he told this story I got shivers. He didn't name names, but I knew from the story that he was talking about my cyber/message board friend "T" -- the one whose success story prompted me to check out this place! I couldn't believe it.
Once questions were over, the office manager showed me and one of the girls around the clinic. She showed us the offices and two of the four different "pods" each doctor/nurse team has. She also showed us the lab areas upstairs. The place is a little smaller and more "no frills" looking than my current place, but again -- who cares? It's what patients take away that matters.
After the little tour, I was able to take a few one-on-one minutes with Dr. H. Below are some of the basics of our conversation, paraphrased and in no particular sequence:
Me: My husband is a cancer survivor, and he banked his sperm before his treatments.
Dr. H: Very good.
Me: So, there's really nothing "wrong" with me; we're doing IVF because of my husband's health history.
Dr. H: How many vials of sperm do you have?
Me: We started with 13 and now we have 12 left. I've done one fresh and one frozen cycle over the past two years.
Dr. H: Where did you go?
Me: [Told him our clinic's name]
Dr. H: [Nodded]
Me: In fact, I think earlier you mentioned a friend I met on message board. She used the same clinic as me. It's because of her success story that I came here tonight.
Dr. H: It's unconscionable what they did. Unconscionable.... How old are you?
Me: I just turned 34.
Dr. H: Oh, you're young.
Me: [with a laugh] That's what everyone keeps telling me but I'm not feeling so young anymore!
Dr. H: How many eggs did you make with your fresh cycle?
Me: 17
Dr. H: [Surprised] Wow. And how many fertilized?
Me: 15, using ICSI.
Dr. H: Wow, I thought you were going to say only a few fertilized. That's great.
Me: Yeah, so that's what's so frustrating and confusing for us. They didn't really give us any reasons why it didn't work. I know after the fresh cycle they said my estrogen levels were pretty high and that could've worked against me.
Dr. H: And after the second failure, did they do an [some term he used for doing a biopsy of the uterus, and I think an HSG] or were they just for going right on ahead with another cycle?
Me: They didn't mention doing any other tests.
Dr. H: Well, I'd want to check to make sure there aren't fibroids or something else going on in there. Also, you don't need to make so many eggs. We just need a few high quality embryos. Were your transfers on day three?
Me: Yes, day three for the fresh cycle.
Dr. H: Did they mention anything about doing a day-two transfer?
Me: Day two? I didn't know there was such a thing.
Dr. H: Yes, we sometimes do day-two transfers. Your body might be a better incubator than a lab.
Around this time, the financial lady came around and we all started talking about our other issue -- insurance. We have nothing in terms of infertility coverage. At one point, before I was employed there, our company had IF coverage, but later dropped it. We live in a "mandated" state, meaning companies based in this state and which have at least 100 (or so) employees must offer IF coverage to their workers. However, the company Mike and I work for is "self-insured" which basically means they don't have to comply with the mandate. It's a loophole which has thrown us for a loop. We all discussed the insurance issue for a few minutes, and both Dr. H and the financial lady think I can contest this exclusion and maybe even win coverage. They said they thought this lack of compliance was illegal (though I'm sure our company's lawyers knew how to get around it legally) and I should push for the insurance. I said I'd give it a try.
So, after spending a couple hours at the place, I thanked them all for their time and headed home. I immediately called Mike and then my mom, and told them all about the place and my chat with Dr. H. I really left there feeling hopeful again, like maybe this is the place we're supposed to use. And who knows, maybe I can challenge the insurance issue. I never really pushed either our H.R. department or the insurance company. I got the "self-insured" explanation and then dropped it. Maybe that was a mistake.
I like the clinic. Like I said, it doesn't have all the bells and whistles, fancy lobby or huge facilities of our current place, but is that all necessary to make a baby? Might it just take one doctor or lab tech who looks a little deeper and doesn't take a situation that appears to be a "gimme" for granted? I'm not calling anyone out or saying our current place messed up or missed the mark. But our RE told us from the beginning, with a good amount of confidence, "I can't see this taking more than one or two tries for you." For two years I've held onto those words for comfort as if they were gospel. Well, here we are two years and two tries later with no child. Even if our situation looks like a slam dunk on paper, I'm no longer willing to just forge on ahead time after time because the odds should eventually favor us. There's a reason we've had two failures, and Dr. H at least gave me the feeling that he wants to explore those failures.
In my heart, I have my own theory as to why we had two failures. As painful as those failures were, I believe God had His hand on them. Within a couple months of each failure, Mike was diagnosed with another cancer recurrence. Had I been pregnant during either of those times, how would we have enjoyed it? The entire pregnancy would have been filled more with dread and worry, not knowing what the future held for Mike. Even worse, would the stress have hurt the baby and could I have even lost the pregnancy? Looking back, neither time would have been right for a baby. All I can hope and pray for is that when we make our next attempt, we are ready and our other health woes are behind us.
Side note: Today at work, our company president sent an e-mail telling us that effective June 1, we're changing insurance carriers. He said we'll be pleased with the changes, such as lower co-pays and higher lifetime benefit maximums (which is an answer to our prayers for Mike, whose benefit payout is now probably up to half a million dollars). Over the next couple weeks, employees will be receiving the details of our new coverage. I hope and pray there is some infertility coverage on this new plan. If there is, our financial barrier will be lifted. Please pray that this new insurance gives us what we need to give IVF another try!
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