Sabbatical year in foreign country w/ cancer diagnosis

[Treehugger]

I'm not sure this is the right sub-forum, but here goes.

My husband has been looking forward to his upcoming sabbatical year (2021-2022) for a long time now. He would really, really like to go to New Zealand and is currently contacting a colleague about working together. (The plan is to arrive in Sept. 2021, after NZ will have hopefully reopened its borders. Of course, he really wants me to go with him too (I am retired, so no conflicts).

I would absolutely love to go. Also, I would absolutely hate to be left behind in the US for a year while he has the time of his life in New Zealand.

However, I am really concerned about the health care situation. I was diagnosed with and treated for stage 3 lung cancer last year. Currently, I'm in remission with about a 30% chance of recurrence in the next 18 months. If I do have a recurrence, I will have to go on immunotherapy (one injection every two weeks for two years). Unfortunately, immunotherapy is extremely expensive ($10,000 - $15,000 for every injection). It is completely covered by our current health insurance (thankfully), but it would not be covered by our insurance if I were abroad. It would also not be covered under any kind of long-term travelers insurance nor will I be able to be covered under New Zealand's socialized medicine plan (I would be covered for accidents and routine infections, but not for extremely expensive long term care).

Long story short, if I had a recurrence, I would have to come home to be treated. I would also have to come home for scans and check-ups since they won't be covered either. And, if I had to come back to the US to be treated, I would even be able to stay in our own home because we are planning on renting it out. And I wouldn't have a car either probably. Sigh. Just sigh.

What to do?

Just go along and hope and pray I am in the 60% that doesn't have a recurrence and just travel back to the US for scans? Then just deal with the stress, chaos and deep disappointment of having to leave my husband in the middle of the year, if it comes to that?

Or should I just say: "Ok, go have fun in New Zealand for a year and I'll stay here." Of course, I will be thinking "...for what may be the last year or last healthy year of my life which I might have to pass in pain alone while you have a great time hiking, traveling and squeezing in some research..." But of course this last part is difficult to say ...

[Puget]

Only you can decide, but to me it is clear from what you wrote that you would regret not going.

Depending on the cost, perhaps it would be possible to have the scans there and only return if you need treatment?

And it seems like you could do some advanced planning now for how to make things work if you do need to return, such as identifying month-to-month rentals or extended stay hotels near the hospital where you would be treated (some may even have discounts for patients). Having a contingency plan could help you relax and enjoy the experience in NZ.

[Treehugger]

Thanks. I just spoke with a real life friend who pointed out that I was being very doom and gloom about things and only imagining the worst possible scenario (I.e. I got the recurrence very soon after we arrive in NZ and have to go home immediately so I will miss out on everything). If I got the recurrence before we left, we could change our plans. Or if I got the recurrence 4 to 5 months in, it wouldn't be so awful. It would suck going home and potentially leaving Mr. Treehugger there, but it's not like I will have missed everything.

Besides, we still have a long way to go from here to Sept. 2021. Who knows what can happen (but not liking an extra level of uncertainly in my life right now).

Also, yes, I could potentially get the scans there. They would certainly be a lot more afford than the immunotherapy.

[Parasaurolophus]

Only you can decide, but to me it is clear from what you wrote that you would regret not going.

Depending on the cost, perhaps it would be possible to have the scans there and only return if you need treatment?

And it seems like you could do some advanced planning now for how to make things work if you do need to return, such as identifying month-to-month rentals or extended stay hotels near the hospital where you would be treated (some may even have discounts for patients). Having a contingency plan could help you relax and enjoy the experience in NZ.

I agree. From what you say, it seems worth trying, to me. As long as finances allow, you guys can always get a short-term rental (and even rent a car) if necessary. And while that road involves extra costs, it sounds to me like they'd be worthwhile extra costs.

(Also, I can't imagine a worse compromise than you staying home for the better part of a year and Mr. Treehugger going--especially if it turns out that you do have a recurrence, because then you'll have spent a chunk of time apart and won't have had a chance to enjoy yourselves together before the next round.)

[Kron3007]

I'm sure it is different when actually faced with the situation, but I would definitely go.  As you say, this could be your last truly healthy year, and what better way to spend it than travelling to what sounds like a dream location with your partner?  Also, to flip it on you, if you were to stay and it remains in remission, how would that feel? 

I also agree that it probably makes more sense to get the scans/tests done there and come back if you need treatment.  Unless the tests are exceptionally expensive, travelling home dosnt seem practical.

[mamselle]

Having arranged things like this for people in reverse (bringing scholars from abroad to the US for similar sabbatical-related visits)--but quite a long time ago--it may be possible to see about his getting on some form of local health care there, if the people he'll be working with have a way to help you figure that out.

Their healthcare might even be better than US care, and/or less expensive, if you can qualify under some aspect of their national health plan.

If you've already checked this out and it's not possible, then please ignore, but I'd still double-check even if you have.

Of course, if it's a school-related healthcaregiver setup, we've been discussing those elsewhere...but the issue there is usually what is provided students, not what faculty, staff, and others get.

Short version: Go, have a couple of good backup plans in mind, enjoy as much as you are able, and figure out the eventualities if and when they arrive.

It sounds like that's what you really want to do anyway, right?

Say "hi!" to Kiri Te Kanawa if you get to meet her, for me, too...(more interthreaduality).

M. 

[no1capybara]

Hi,

I'm so sorry you have to deal with these kind of decisions.  As far as I'm concerned, you absolutely MUST go to NZ, it's the best place in the world! I hope you can see a way to make it work.  I lived in Wellington for 5 years so if your husband is going to be at Vic, PM me if you want any details on where to live or the best place for a flat white or anything.

[Treehugger]

Hi,

I'm so sorry you have to deal with these kind of decisions.  As far as I'm concerned, you absolutely MUST go to NZ, it's the best place in the world! I hope you can see a way to make it work.  I lived in Wellington for 5 years so if your husband is going to be at Vic, PM me if you want any details on where to live or the best place for a flat white or anything.

Actually, it would be Wellington!  I don't know the name of the University off hand. But there aren't that many in NZ I think so it's probably the same one.

Also, if I had to come back home for treatment, I could still travel back to NZ to visit (as long as the trips were less than two weeks). From what I have heard, it is possible that, at least in the beginning, I could have very few side effects. And if I did have a lot of side effects, I probably wouldn't enjoy being in NZ that much anyway. My oncologist also said that if I get a recurrence in a different spot, I could just get chemo/radiation again (oh joy!) which would only be a six week treatment (instead of two years of immunotherapy. Beginning to see more options/hope here....

[Hegemony]

I wonder if there's an available health plan that would cover you abroad?  Under Blue Cross and Providence we've had plans that did cover treatment abroad (albeit at "out-of-network" rates). Of course you would want to make sure that you can get in to see the right people without delay for the right tests and everything. That sounds complicated but doable.

Sadly, I think the most likely scenario is that New Zealand will not be open to foreigners yet. You might want to have a good Plan B at the ready for that eventuality.

Wishing you continuing remission and many years of good health, Treehugger.

[bopper]

How would he be covered for health care while abroad?  Why wouldn't you be the same?

[Treehugger]

How would he be covered for health care while abroad?  Why wouldn't you be the same?

There are different levels of coverage. It is fairly easy to be covered for emergencies for example, but extremely difficult to be covered for long-term very expensive, non-emergency treatment.

[Treehugger]

We've decided to keep our current health insurance and just buy supplemental traveler's health insurance.

We have a three-pronged plan:

1. If my scans continue being clear, I will just go NZ with Mr. Treehugger. I will either pay for the follow-up CT scans out of pocket, or take a trip home to get them — whichever is cheaper. I should only have to do this twice in 9 months. We have decided not to rent out our house, so I will be able to sleep in my own bed & check up on things to make sure everything is OK.

2. If the cancer returns either before I leave or when I am there, I will seek treatment at home, while Mr. Treehugger remains abroad if I am doing well with the treatment (not many side effects/ cancer regressing). Then, I will take multiple trips to NZ to visit in between treatments.

3. If the cancer returns and I am not doing well with the treatment, Mr. Treehugger will come back from NZ to be with me. He will come back temporarily if the setback seems temporary and he will come back for good if everything is going to sh!t.

I am feeling really happy about this solution.

This way we don't have switch our insurance around (and worry about coverage, shifting back to the old one, etc., etc.). We also don't have to worry about renting out our house, which is also a big relief.

Fortunately, we have built up a huge stash of cash so either one of these three solutions would be affordable.

[AvidReader]

It's wonderful that you will be able to go and have such clear plans. Yay!

AR.

[mamselle]

It's wonderful that you will be able to go and have such clear plans. Yay!

AR.

+1

Very well-thought-through.

Peace and a pleasant trip!

M.

[Treehugger]

Thanks! Now, I'm actually looking forward to it!