Thursday, December 30, 2010

Why Does it Always Have to Be So Hard?

Where to start?

Tuesday was the one year anniversary of my losing Trey. I can remember almost everything about that day in vivid detail - what I wore, what time I called the doctor's office asking for an ultrasound, the list I made of things to ask which I then never needed, playing a game on my iPhone in the waiting room, joking with the ultrasound tech, answering her questions as she turned the screen away from me as if somehow that would save me from having to find out my baby had died..............

The day actually went okay. I was and still am sad and if I think about it too long I start to cry but I think that's normal. I think being pregnant again helps because I have hope that this will be our live, healthy baby.

It was back to Dr. Coulam's yesterday and the ultrasound went really well. The baby had a bit of a growth spurt and is now measuring a few days ahead. The heart rate was 171 so that is right on track as well. What wasn't so great was my blood work which once again came back showing elevated natural killer cell activity. The doctor doesn't understand why it keeps going up instead of going down since I have had the intralipid treatment.

She suggested I come back Monday for another intralipid IV and I asked if it has a better chance of working the second time around of if it would be worthwhile to try IVIg. She said that the IVIg is super expensive and I, like a total naive idiot, said that my insurance had agreed to cover it. She said in that case it was definitely worth trying that over the intralipids to see if I had a better response.

Back in July I had gotten prior approval for Gammagard as a treatment for recurrent pregnancy loss and so with that in hand I figured piece of cake. WRONG! The pharmacy called Blue Cross and they said that they would deny the claim. The pharmacy relayed that to me and so I called Blue Cross. Over and hour later I was told to call CareMark who administers my pharmacy benefits (despite me only having a Blue Cross insurance card which makes zero mention of someone else handling the pharmacy benefits). Anyway, a call to them and half an hour later I have confirmed my pre-approval for the IVIg and yet somehow now there's extra conditions such as it has to be ordered through a retail pharmacy and billed through my pharmacy benefits, not my medical benefits and on and on with a whole bunch of stuff that makes zero sense to me. A call back to the pharmacy yields the statement that they don't believe they will get reimbursed. At this point I give up for the night. It's exhausting and stressful (no wonder my natural killer cells are elevated) and something doesn't seem right about having to fight so hard for something that could potentially save my baby's life.

I spoke with the pharmacy again this morning, this time with a reimbursement specialist who agreed to all CareMark and check on if my pharmacy benefits really will cover the medicine like they said they would. Of course, it's now been hours since I spoke with her and I haven't heard back so that's probably bad news right? Or, was it good news and now she's just trying to find a nurse to come to my house to administer the IV?

I wish things didn't have to be this hard.

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