Thursday, May 27, 2010

Wrist Update and Good News!!!!

The doc removed my stitches on Monday. I have to say that I was really surprised at how neat my incision looks. It is a very thin one, not raised at all. I guess it was surprising because of the other scars I have from when I had a pin put in my leg (broke that when I was 14). One on my buttocks is huge and raised, and then I have one on my hip, and one above my knee where the screws were to hold the pin in place, and those are actually a little sunken, but wider looking incisions. It was just not what I expected.

I have a green hard cast until June 7th at which point I will go into a removable fracture brace and start physical therapy. They had a physical therapist come in and do a little mini eval at my appointment the other day and I am losing range of motion in my hand which I suppose is to be expected when you've had limited use for 9 weeks. I am under orders to lift nothing heavier than a coffee cup. That's proving to be difficult.

In other news, our insurance's fertility coverage is going to change effective July 1st. Our coverage right now is that you are allowed 4 IUI cycles with $100 copays, and up to 3 IVF cycles or a maximum cap (for IVF only) of $30,000. We have a seperate med cap of $10,500. Basically as it was, we had done two IVF/ICSI cycles which we had used just under $25,000 of our IVF cap and just over $3,000 of our med cap. We had never done any IUI's as our sperm motility and count were not sufficient, and would have been a waste of time and money.

As you know if you've read some of the previous posts, I questioned our fertility doctor about whether our semen analysis last time would have been good enough for IUI and the thought was that it would have possibly worked, so we were going to explore that once we paid off half of our credit cards. Well, upon reviewing our upcoming changes in our coverage, we've come to new conclusions.

With our new coverage, any reproductive medical procedures including IUI's, IVF, meds, etc will be covered under a $40,000 cap. We will still have a $1,000 copay per IVF cycle, or $100 per IUI. Where previously our office visits, labwork, and diagnostic radiology were included in our cap, they now will be billed seperately which is good. They will not be reclassifying things that have been done previously, so they will not be going back and changing how much we've used so far. So, as of July, we will have used $28,174 of our $40,000 cap. That means we have enough for another IVF!!!!!!!!!!

So, when will we do this? I'm not sure. I've been out of work for 10 weeks already, and probably by the time I go back, I will have been out 15-16 weeks. Our short term disability works like this-you use your own time (vacation, sick, personal time) for the first month that you are out. Then your short term disability kicks in. It's different for maternity than it is for an injury. So at this point I am getting paid 60% of my base pay (no differential) by the short term disability, and I am using 12 hours of my own time to supplement my paychecks. I had something like 260 vacation hours, 70 sick hours, and 20 personal leave hours saved before I broke my wrist. By the time I go back to work, I might have 60 hours left.

For maternity leave, you use your own time for the first month, then if you had a vagina delivery short term disability pays you 60% for two weeks, and if you had a c-section, they pay you 60% for four weeks. I have no reason at this point to believe I would need a c-section as Jack wasn't a c-section delivery. So if I calculate how many hours I need to take a full 12 week maternity leave based on a vaginal delivery, I would need 384 hours. It would take me a year to save up 182 hours. So if I wanted to be sure I had that much time saved up, I wouldn't attempt to do another cycle for year and a half. I could do what many women have to do and just take 8 weeks. That would mean I'd need 240 hours which I could conceivably have in another year. So I could do another cycle 3 months after I return to work! We will probably shoot for the end of the year if I had to guess.

I've been asked if we will still try for an IUI first. My answer to that is that I'm not sure. It would really depend on what our labwork and semen analysis showed. I only have one patent tube which makes me think that maybe it wouldn't be as good of a chance, and I don't want to waste what money we do have available through our insurance on a shot in the dark. I am also nervous and scared to try IVF again given how horribly I dealt with our last cycle being a huge flop. I tried so hard to not get emotionally invested, let my guard down when our fertilization report came back ok, and then got smacked with the bad news. I felt like I was insane afterwards. I guess if we do that I will have to psych myself up that it will work (we will be going back to our protocol we did on our first cycle that was successful!), and I will not let my guard down. I have alot of questions for my doctor before we make any decisions, and we would have to have some more routine pre-cycle testing done before we could make a decision between the IUI and IVF anyway. The office told us to call a month before we want to do another cycle, so maybe in September we will get started.

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