Archive for November 15th, 2006

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Game Over

Waffling continues. Or Continued. Decision made.

Yesterday I was 99% certain I would not do the clinical trial. My reasoning was simple: I knew that the likelihood was that in 6 months I'd probably get to the point where I couldn't take it anymore and I would drop out of the study. That's my right to do and they can't stop me. But it would be unethical of me to enter into the clinical trial KNOWING that the likelihood was that I wouldn't uphold my promise not to try to get pregnant for 12 months. To me, that would be like stealing. It's a $20,000 device that they're planning to implant in my heart at no charge to me. If I knew I'd end up voiding my ability to count in their data, I'd be stealing. So I was completely certain that I would get to the end of the headache diary month and tell them "sorry, but no."

And then I got a call from the study coordinator wanting to tentatively schedule a surgery date so that if/when I qualify it's already on the books. And what did I do? I scheduled a tentative surgery date. And I felt good about it. I knew I wanted to do the study. Maybe this was my sign that I should just do it and deal with the consequences later. After all, how often will an opportunity like this come about? And I really do want to do the study. It's a dream come true! I've been waiting for this study for years!

So I was right back to where I started. Not sure what to do. Continuing to waffle. I figured I'd just have to flip a coin at some point. But the proverbial coin has been flipped for me. Insurance coverage is rearing its ugly head.

I started a new job in May and when I changed jobs, I changed to a company based in Virginia. Virginia, unlike Maryland, has no mandated fertility coverage for insurance plans. And I had extremely good coverage under my old plan (and, in fact, if I hadn't gotten a 40% raise to change jobs, I might have just stayed at my old job for that very reason… I loved my old job!). Anyway, for that reason, I've been paying out of pocket for COBRA so that I can keep my old coverage. Problem is, of course, that COBRA is: 1) extremely expensive; and 2) limited time availability. A year from now, I will have to switch to my husband's insurance coverage. I asked him to look into fertility benefits and so I could figure out how that affected my outlook in a year if I choose to do the study. The results are in.

My husband's coverage, while not quite as robust as my current coverage, is quite good. He works for a major hospital in a major city, so this isn't shocking. However, I would have to go to the hospital system's fertility center in Baltimore, which isn't feasible. It isn't practically feasible, and it isn't financially feasible. And I'd probably have to change jobs to be able to be close enough to make it happen. More importantly, they haven't been around very long and their stats are terrible. Well, not so terrible, considering how few procedures they've done, but the point is, they're not as good as Shady Hell.

And that, my friends, is game, set, match. I am inflexible on this point. Since I won't have what I consider to be optimal insurance coverage for fertility treatment a year from now, the migraine study is no longer feasible. I don't love it, but I'm happy that the decision has been made on logical/practical grounds instead of the emotional grounds I was wrestling with.

Therefore, tomorrow I will stop being such a chicken and I will have my blood drawn to see if my hCG level has bottomed out. If it has, the clock starts ticking and in four weeks, I'll start Provera, and then I will start my next IUI cycle. If it doesn't work, I'm telling my doctor that we will switch to IVF. If she doesn't agree, I will change clinics. I'm tired of waiting. I now need to be agressive. And I feel really good not having these conflicting goals anymore. Now that I know which goal I'm aiming for, I'm good. And so, I am relieved.

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