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Game Over - Karen's Musings
Random Rambling
Game Over
I've been spending a lot of time waffling about what to do about the whole migraine clinical trial vs. fertility treatment thing lately. I haven't been writing so much about it here, but it's been a constant battle.

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 Seth'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.

Seth'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. I work in Gaithersburg. 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.

Tags: , ,
Current Location: work
Current Mood: relieved relieved
Current Music: whatever my office mate is listening to

17 comments or Leave a comment
debsters1101 From: debsters1101 Date: November 15th, 2006 09:57 pm (UTC) (Link)
ok I definitely lost something somewhere there, but if you're not going to have good fertility coverage, isn't that a reason TO do the migraine study? I mean, because at least insurance will cover that, if you wont be able to get your fertility treatments?
also, why would you drop out in six months?
estherchaya From: estherchaya Date: November 15th, 2006 10:53 pm (UTC) (Link)
1. I currently have excellent fertility coverage. A year from now, I won't.
2. Insurance doesn't cover the migraine study. The sponsors of the study cover those costs.
3. I am not saying I would drop out in six months, but I think there's a high probability that after another six months of not trying to have a baby, I'll be climbing the walls and miserable. I don't think I can honestly commit to taking another 12 months off of trying to have a baby. In order to participate in the study, I would have to agree to 12 months of birth control. My Rav gave me a heter to do so, but I don't think I can agree to it personally.

Does the logic make more sense now? If not, please let me know. I wrote the post in a hurry.
debsters1101 From: debsters1101 Date: November 15th, 2006 11:15 pm (UTC) (Link)
yeah, gotcha. sorry.
im so sorry you have to go through this. you're in my thoughts... may G-D bless you with all u desire (and deserve) in life, without having to go through any more hell.
mrn613 From: mrn613 Date: November 15th, 2006 10:21 pm (UTC) (Link)
aha I didn't realize all of the insurance details. how many ivf cycles does the maryland mandate cover? I would definitely limit the number of IUI cycles if that means forgoing IVF cycles later when cobra is about to expire.
estherchaya From: estherchaya Date: November 15th, 2006 10:58 pm (UTC) (Link)
Maryland actually doesn't have a very specific mandate. The law says that if the employer sponsoring the insurance coverage has at least 50 employees AND they request that the insurance carrier provide infertility coverage, then the insurance carrier may not refuse to do so. That's all.

However, my insurance coverage was/is extremely good. It has a 3 IVF cycle limit (I THINK) and a $100,000 cap. There is no limit on IUI cycles, but they do, of course, count against the $100K cap. My husband's insurance covers 3 IVFs and 4 IUIs with a $30K cap, but must be done in Baltimore.

I didn't realize all the insurance ramifications either... I've been trying to work through the insurance ramifications for about 2 weeks now. I was hoping it wouldn't turn out to be so annoying, because I really DO want to do the study, even if I don't really want a 12 month waiting period. But I'm not going to forfeit my fantastically amazing insurance coverage either, and I'll use it while I've got it.

I'll do this one IUI cycle, but I'm not doing 3 as recommended. I just don't have that kind of time.
From: cecerose Date: November 15th, 2006 10:38 pm (UTC) (Link)
Sometimes decisions are easiest when circumstances take them out of our hands...

Given your options, it sounds like you're making the right call.
estherchaya From: estherchaya Date: November 15th, 2006 10:59 pm (UTC) (Link)
Yep. I feel good about it. I knew all along that I could more easily live with giving up the study opportunity than with giving up the next 12 months of TTC, even though I really DO want to do the study.
From: cecerose Date: November 15th, 2006 11:29 pm (UTC) (Link)
It makes perfect sense. Plus, as they say, you have a biological clock -- the migraines can definitely wait. I'm sure you're relieved that this is settled!
cellio From: cellio Date: November 16th, 2006 04:15 am (UTC) (Link)
What she said. I'm sorry you won't get to participate in the study, but some things are more important.
From: have_inner_lady Date: November 15th, 2006 10:50 pm (UTC) (Link)
Practical grounds are very good. And, in some years if you decide you want this (possibly) migraine-preventing device, it really is only money.

Best luck and wishes.
estherchaya From: estherchaya Date: November 15th, 2006 11:00 pm (UTC) (Link)
It's all good. I've lived with migraines for thirty years. I'm okay with another few decades. I'd much rather be pregnant than migraine-free anyway.
magid From: magid Date: November 15th, 2006 11:45 pm (UTC) (Link)
And by then, maybe the migraine treatment will be covered by insurance :-).
rlitterst From: rlitterst Date: November 15th, 2006 11:40 pm (UTC) (Link)
Yay for decisions being made! Blessings to you m'dear.
ichur72 From: ichur72 Date: November 15th, 2006 11:48 pm (UTC) (Link)
I'm glad the issue has resolved itself and that you don't feel like you had to make a decision purely on emotional grounds. Meanwhile, I'm davening for you!
yeishlitikvah From: yeishlitikvah Date: November 16th, 2006 02:20 am (UTC) (Link)
HUgs what a hard decision to have to make.. I hope it works out for the best.
kmelion From: kmelion Date: November 16th, 2006 05:43 am (UTC) (Link)
Best of luck with everything, hon.

About 2 months ago, Jerusalem Post ran an add from Hadassah Hospital, looking for IBS sufferers for clinical trials on some new drug. I told Zach that it would figure... I finally get pregnant and this comes up, something that might actually help some of my other problems.

As others have said, all for the best...
mabfan From: mabfan Date: November 16th, 2006 01:19 pm (UTC) (Link)
Good luck with your decision.
17 comments or Leave a comment