WWYD? Remicade issue

[centralperk]

Quick background:
I'm American but I'm currently living in Sweden (my DH is Swedish). I've been on Remicade (and 6MP) since I got sick, over 3 years now. I have been doing great, no flares (knock on wood). I've sometimes gone a little over 8 weeks between treatments, but never more than 9 weeks.

Here's the situation:
I get Remicade every 8 weeks. I am due for my next infusion around Oct 31. I am going to be in the US from early/mid November until about mid January. I don't have the exact dates yet, but hopefully I will soon. Since I'll only have minimal insurance while in the US, it doesn't seem like I'll be able to get my infusion while I'm there. I haven't exhausted all my options yet, but it's not looking good.


My options are:

1. Get my next infusion immediately before I leave, and then get one immediately after I come back. The interval would be about 11 weeks, depending on the exact dates. To minimize the interval, I would have to push my next infusion up a little bit, and it would be about 9 weeks. This in itself is not concerning to me, but I figured I should mention it.

2. Fly back to Sweden at some point and get an infusion close to the 8 week mark. That would be around Christmas, so I could fly back, but that will mean missing time with my family, as well as a shitload of $$$$ and a PITA.


I've spoken with my doctor and she says it's up to me. She does think that the 11 weeks would be fine, and that she's not concerned. Especially since I don't usually feel worse right before my infusions (some people do, and that would indicate that the effect is starting to wear off. That's never happened to me though. yet.)

I'm terrified of getting sick again, but at the same time, I want to live my life.

WWYD? Any input would be really appreciated.

[OrangePixyStix]

I am on Remicade 8-week infusions, but I have only been on since last December.
If I were in your situation, I would do option 1 and get the infusion right before the trip and right after. It sounds like you have been fairly steady between doses so I wouldn't think 11 weeks would be too long of a time frame between treatments.

Is your insurance through an American company, or is it Swedish insurance? I'm not sure if it would be an option for you, but I am finally approved to do at-home treatments which are considerably cheaper than being admitted into the hospitals for them, so maybe if you really need to have it done in the US, you can see about doing that option rather than the full-fledged hospital session. I really have no idea how it would work with your insurance though (if you need to call them to see first, or get approval prior to contacting a mobile physician, etc).


Good luck, I hope if you have to extend the time between treatments that everything is fine and you can enjoy your trip!

[caramia]

I agree, option 1 sounds the best since you're pretty stable. 

If I were you, I would call my insurance first & see if they have any affiliation with providers in the US - you might be able to get the infusion here at a reduced rate.  (I really know nothing about international insurance, but it seems like they would be able to do something, you know?)  Or maybe you could purchase some kind of US health insurance on your own for a month so you could get the infusion? 

Good luck!  I know how scary it is to risk getting sick again...

[bcv513]

I would go with option 1 if those are the only choices. Can you call your insurance company and explain the situation? They might be willing to help you out.

[centralperk]

Thanks everyone for your input, I really appreciate it.

I don't really have insurance right now. Where I live, everything is covered by the government. There are private insurance companies if you want to get something above and beyond, but I don't have that. So there's no company to call. I have called the company (well, I guess it's more like a government agency) that is paying for my insurance while I'm in the US, and explained the situation. They said it's definitely not covered. There's no way I can get any help from Sweden for this.

I am also going to try to call the medical school I'll be at and see if they can help. But I don't think they'll be able to.