Anderia323
04-07-2008, 07:01 PM
Hi to everyone,
This is my first time posting. I have been working on my HSL and so far this is what I have (still so much to go!), Please read over and let me know what I should do. I feel like it is so long already and I still have my two daughters to write about who have alot of medical issues like my son and I'm worried about the length. I have so much to write about and it seems like all of it is important and I don't know whether to try to summarize or what . Please help!:blush:
February 15, 2008
U.S. Citizen and Immigration Services
American Consulate General
Ciudad Juarez, Chih., Mexico
PO Box 9896
El Paso, Texas 79905-9896
Re: Case No. XXXXXXX
Applicant: XXXX XXXX
Application for Waiver of Grounds of Excludability (I-601)
Claim of Extreme Hardship on the U.S. Citizen Spouse/Children
Dear Sir or Madam:
I, Anderia Lucille Lopez, declare under the penalty of perjury, under the laws of the United States, that the following is true and correct:
I am a U.S. Citizen humbly asking that the Waiver of Grounds of Excludability (I-601) please be granted so that my husband, XXXX Lopez-Coclame may return home to his family that needs him.
I, along with our three children, XXXX XXXX, XXXX XXXX and XXXX XXXX , would suffer many extreme and severe hardships if my husband is not allowed to re enter the United States. Our many interacting hardships include: health, education, financial, family ties and special factors. These hardships keep us from living in Mexico with my husband, but however, due to strength of our family bond we would be compelled to do so.
Our Family Background:
In June 2002 after separating from my ex-husband XXXX XXXX I was a truly broken person. After two years of day after day physical and mental abuse I finally found the strength to leave. The relationship had left me with absolutely no self esteem and I was deeply depressed. The only reason that kept me alive was my two children. With the help of my beloved mother and grandmother I was able to escape the misery, and I moved back home to give my children a better future.
Through out this time in my life I was filled with uncertainties. I had so many hopes and dreams for us and so many unanswered questions. I began to take refuge in God and I prayed in earnest every night for Him to take our lives in His hands and give me strength to go on and for Him guide us in all aspects.
God indeed did have something very special planned for us. I believe will all my heart and soul that this is why XXXX appeared in our lives. We began dating in September of 2002 and we became an instant family. XXXX became the father my children never had and the partner in life that I had always wanted: someone to love us unconditionally and without reserve.
From the very beginning of our relationship XXXX made me feel special, a person that he saw as beautiful inside and out. He has always treated me with respect, compassion and understanding, something that I was unaccustomed to. But most of all he won my heart through the kids. Even though XXXX and XXXX aren’t biologically his you would never know the difference. He treats each child with warmth, patience and tenderness and loves them as if they were his own. He has done everything with them, from XXXX taking her first steps to teaching XXXX how to ride a bike and everything in between. XXXX has been in and out of their lives off and on since our divorce and although they know that XXXX is their biological father, they believe that XXXX their “Real Daddy”. They are both extremely emotionally attached to XXXX, being that he’s the only father that they have ever known.
XXXX tells us everyday how much we are loved, but he also proves his love and devotion to us daily. Whether it be a quiet word of reassurance, bandaging a scraped knee, fixing a faucet, or cooking dinner for us or just by asking how our day went, he has in my eyes been an answer to all my prayers. Actions to me speak louder than words and he has proved himself above and beyond as a father and as a husband many times over. He has returned my self esteem and inspired me to want be a better person both physically and mentally. He has also provided an excellent role model to our children, teaching them strength, compassion, patience and courage. XXXX has done so much for us as a family and I honestly don’t know what I would do without him at my side. Many things I have doubted in my life, but XXXX’s love and devotion to us will never be one of them.
Through out our time as a family we have suffered many tragic events that continue to affect us deeply, but despite this we have been able to survive and go on because of the enormous family bond that binds us together and gives us the strength to tackle whatever lies ahead. To deny XXXX the wavier would be taking away the other half of our family that makes us whole.
Please take into consideration the interacting hardships that our family would face if this waiver was to be denied. Listed below are our hardships.
Medical Hardships
Anderia
In 1998 I was diagnosed with Polycystic Ovarian Syndrome (PCOS). PCOS is an uncurable endocrine system disorder that affects a women’s reproductive system. The symptoms of PCOS are: infrequent or no menstrual periods (anovulation), irregular bleeding also known as dysfunctional uterine bleeding or DUB, infertility, increased hair growth (hirsutism), ovarian cysts, acne, weight gain/obesity, insulin resistance or type 2 diabetes, high cholesterol (lipid profiles), and high blood pressure, pelvic pain, and anxiety or depression due to appearance. (See Exhibit 1a and Exhibit 1b)
For many years I had various symptoms; Irregular menses, DUB and obesity. (See Exhibit 2) In 2005 my family went through two tragedies that affected us terribly. In March my beloved grandmother passed away from a long illness of congestive heart failure and diabetes complications, and just months later in September we found out that our daughter XXXX had been sexually abused. From these events I became deeply depressed and I began to gain an extreme amount of weight. From this weight gain I began to have serious complications of the disorder.
In August of 2006 I began a period that lasted continuously for months due to elevated estrogen levels from my weight. Unfortunately at this time I did not have insurance and my only option for care was through the emergency room. I was seen various times in the E.R. and I was diagnosed with acute exacerbation of chronic dysfunctional bleeding, type II diabetes and morbid obesity.(See Exhibit 3) Finally in the beginning of April of 2007 after being seen by yet another doctor, she suggested that I try a long term diet and exercise plan to alleviate my symptoms and hopefully this would regulate my weight and my body to begin to function normally.
At the end of April I began the Atkins diet, which is a low carb ketogenic diet that reduces insulin resistance associated with PCOS. Even though I had tried the diet before I never realized just how hard it would be just to get started and I had serious doubts that I could lose any weight, but with my husband’s unconditional love and support I began to exercise daily and follow the diet to a “t”. I don’t know what my starting weight actually was, but it had to be more than 350 pounds. Our scale would only go to 350, and for a solid month it would only show “E” for error. I thought I would never start to lose weight but slowly it started to come off. (See Exhibits 4a, 4b)
During the next month I lost weight steadily with XXXX’s help, but I continued to bleed continuously. During this time I was accepted for insurance through an excellent program for residents of Hillsborough County, The Hillsborough County HealthCare Plan of Florida, (See Exhibit 5-A Insurance card) Through my primary care doctor I was referred to a gynecologist in May of 2007 because of my on going problems. Because I had now been bleeding for 9 months I was sent for a endometrial cancer biopsy and put on progesterone to control the bleeding, and I was further counseled to try to lose more weight due to health risks associated with PCOS. (See Exhibit 5B)
I continued to lose weight through Atkins and and exercise but despite losing 91 pounds I continued to bleed. In October of 2007 it had been 14 months since the beginning of my ordeal. I was then diagnosed with Menorrhagia, or excessive menstrual bleeding, and I was then put on FemCon birth control pills (2 pills 1x a day) and Aldactone (2x a day) for hirsutism and told to continue with the metaformin 850mg 2 x a day. (See Exhibit 6)
Two months later in December I was seen again for a follow up due to still having bleeding despite taking twice the normal amount of hormones. It was decided that my birth control would be changed again to Yazmin and if the medicine didn’t work I would need a possible Dilation and Curettage (D and C), where the tissue from my uterus would be examined again with a biopsy or a hysteroscopy would be done to check my uterus for any structural abnormalities.(See Exhibit 6 -pg.3, and Exhibit 5- pgs. 3 & 4)
Two months later in February of 2008, I was seen yet again. Despite taking the prescribed Yazmin and contributing more than enough in weight loss (As of February 29th I am now down to 224, for a total of 126 pounds in 10 months) I continued to bleed. My doctor decided to change my birth control pill again to Lo-estrin which has stronger dose of hormones. It was decided that if this doesn’t work this time after the third change of medication that my only hope for cure is endometrial ablation. Endometrial ablation is where the complete lining of my uterus would be destroyed through freezing or heat techniques. Unfortunately although this would cure the DUB, I would still have my ovaries and uterus and therefore I would still be at risk for the serious health complications associated with PCOS.(See exhibit 6a pg 5 and 6b pg.1)
According to The Journal of Clinical Endocrinology & Metabolism “The syndrome is associated with significant morbidity in terms of reproductive and non reproductive events. Having the disorder may significantly impact the quality of life of women during the reproductive years, and it contributes to morbidity and mortality by the time of menopause” (See Exhibit 7) Recent studies also found that women with PCOS have greater chances of developing several serious, life threatening diseases including type II diabetes, cardiovascular disease and cancer( see Exhibit 1 Pg.5)
According to the OCED Heath Data of 2007 resources in the health sector (human, physical, technological) health care supply is low in Mexico by OCED standards. In virtually all dimensions for which data
are available, Mexico lies well below average. (See Exhibit 9) and also according to Nationmaster.com “Mexico is ranked #1 of 29 countries with 15.3 percent of female life lived in ill health.” (See Exhibit 8, pg. 8)
In Mexico I would also be unable to obtain insurance because we couldn’t afford it. Here in the U.S. The Hillsborough County HealthCare Plan covers all my doctors visits, including specialists, along with lab work and hospitalization with no cost and any prescription is only $1.00.(See Exhibit 5) To get this type of care in Mexico would be very costly. According to Nationmaster.com “The out of pocket private health expenditure in Mexico is 94.4 %” (See Exhibit 10) “Based on the high out of pocket expenditures and the prevalence of poverty, financial protection is another major challenge. Each year around 3 million people in Mexico face catastrophic expenses due to major illness or injuries.” (See exhibit 11) Just for me to get basic care for my complications would take every bit of money XXXX could earn and would leave us having to decide between food or a doctors visit. This is not a situation that I want to be placed in.
In Mexico it is also doubtful that I would receive the quality of care that I have received here. Mexico has a serious problem of inequity in their health care system. “Equity is one of the 3 main challenges faced in the Mexican health care system. In Mexico, 40 million people have incomes below the poverty line, and in contrast only 2% of the population is rich so the gap is enormous.” (See Exhibit 11) ”In large cities, excellent specialty trained physicians and high technology tertiary care medical centers compete with similar U.S. centers to provide care for Mexico’s wealthy. At the other end of the spectrum, large numbers of unregulated and unsupervised private physicians, often without residency training work out of individual “clinics” to deliver health care mostly to the uninsured, who can afford to not use the under equipped and understaffed Ministry of Health facilities”. (See exhibit 12)
As you can see from my documentation, the quality of my life has already been affected greatly through out this ordeal. I already have Type II diabetes which is one of the high risk diseases associated with PCOS, and now I am also at high risk for endometrial cancer because of my complications. It is of utmost importance that I continue to receive the care that I need to prevent any further problems that may arise. I am completely confident that through my doctor’s expertise and the advanced technological services available here in the U.S. that I can overcome my health obstacles. Considering the complications that I have had at this time I cannot afford to place such risks on my health by relocating to Mexico. It has taken a great deal of time and effort with my weight loss and the appropriate medical attention to get me to this point of being somewhat stable. As you can see with the state of my current health a forced move to Mexico would place an extreme hardship in my life, leaving me unable to continue to get the care I need.
XXXX’s Medical
Our son XXXX has many serious health issues. He has been diagnosed with Type II diabetes, attention deficit/hyperactivity disorder (ADHD), central auditory processing disorder (CAPD), asthma and severe allergies.
A. Diabetes
According to the National Diabetes Education Program “Diabetes is a chronic disease in which the body does not make or properly use insulin, a hormone that is needed to convert glucose and other food into energy. People with diabetes have increased blood glucose levels due to an absence of insulin, or failure to respond to insulin’s effects (insulin resistance). Inadequate insulin results in high concentrations of glucose that build up in the blood and spill into the urine, causing an obligate urinary excretion of glucose. As a result the body loses its main source of fuel. ” (See exhibit 13 pg. 2)
XXXX was diagnosed with obesity in October of 2006 at the age of 6. His doctor recommended testing his blood sugar as a precaution because of the known risks of obesity and diabetes. After checking XXXX’s blood sugar we found that it was in the 200’s. We called the doctor right away to report the results and XXXX was then referred to a pediatric endocrinologist who diagnosed him with glucose intolerance. Unfortunately despite our efforts to control his diet and weight this has now turned into full blown diabetes. (See exhibits 14a pg.5, Exhibit 14b, and Exhibit 14c pg.3)
XXXX suffers from hyperglycemia, or high amounts of glucose in the blood. “Over time hyperglycemia can cause damage to the eyes, kidneys, nerves, blood vessels, gums and teeth.” (See Exhibit 13 pg.5)
“Diabetes care for children should be provided by a team that can deal with these special medical, educational, nutritional, and behavioral issues. The team usually consists of a physician, diabetes educator, dietitian, social worker or psychologist, along with patient and family. Children should be seen by the team at diagnosis and in follow up, as agreed upon by the primary care provider and the diabetes team” (See exhibit 13 pg. 6)
To take proper care of XXXX it will be necessary to manage his diabetes through blood glucose testing, nutrition, and increased physical activity. It is also important to monitor any complications and reduce his cardiovascular disease risk.
As you can see taking the best care of our son will take more than just adequate medical attention, which is something that he will not receive in Mexico. To properly manage his condition it will take the time and effort of many dedicated medical professionals with knowledge of the disease, many doctor’s visits, and possible specialized treatments to prevent and control any complications and a strict following of diet and exercise.
The American Diabetes Association also states: “In Mexico, diabetes is the first cause of adult nonobstetric hospital admissions and hospital mortality and the third cause of mortality nationwide.’’ “Obesity, which is a high risk factor for type II diabetes, is also increasing rapidly in Mexico. In fact, between 1993 and 2000 the prevalence of overweight and obesity increased from 55 to 62 % in adults.” “These conditions that predispose Mexicans to type II are compounded by an inadequate preventive health care system.” “The public health care system in Mexico provides services for insured and uninsured population, and those that are uninsured might receive care from the “oportunidades” (OP) and the “seguro popular” (SP) programs. The OP program covers 10-15 % of the population, i.e., the extremely poor, and provides some primary care services including drugs for diabetes and hypertension. The SP was expected to cover 500,000 families by the end of 2003, but by 2010 it will be expected to cover 45 million Mexicans. Therefore, by the end of 2003, 43 million people would have to pay for drugs and for most of their health care services. Furthermore, monitoring supplies and syringes are not provided by the public health care system. The cost of drugs in the Mexico-US border city of Tijuana in 2003 was $60.00 U.S. a month for treatment and control of diabetes, $60.00 U.S. for treatment of high cholesterol, and 60.00 U.S. for the treatment of hypertension. In 2002 at least 65% of the family income in Mexico was approximately $250.00 U.S. a month. That income will hardly meet the need for treatment of diabetes and hypertension for one member of the family. In fact, at The National Health Survey it has shown that more than 50% of adult population has at least one chronic disease and that more than 50% of them have no drug treatment. The above data suggest that neither the public health care system nor the uninsured population can afford to control the “diabesity” epidemic.” (See Exhibit 15)
Diabetes and heart problems have run in our family for generations, and we want our son to have every possibility to be able control this disease. If we were forced to move to Mexico it would be impossible to have the ability to care for my son and I due to our both having diabetes. We wouldn’t make enough money to cover treatment or supplies for one of us let alone both, and this would force me to make a terrible choice between my child and I. Making that choice would put an extreme hardship on me and is something I am not capable or willing to do. My son’s health comes first and is the most important thing in the world to me, and of course I would rather be the one to go without care, and therefore would my health would seriously be affected.
My grandmother suffered for many years with poor health and eventually passed away from congestive heart failure and diabetes complications, and I don’t want my children to see me suffer the same consequences that she did. We as a family have worked extremely hard to fight our obesity problems and so far we have done well. XXXX has made it a priority to add exercise to our families’ daily routine and we go to the park to walk and play outside everyday. XXXX also takes the time to make sure that we eat properly by preparing healthy meals for us and because of this we have had great results, not only have I lost a tremendous amount weight but XXXX has slimmed down some as well and both of our sugars are better controlled. XXXX helps us in so many ways and without him I don’t know what we would do. I need XXXX here to help my son and I deal with this disease.
B. Attention Deficit/Hyperactivity Disorder (ADHD)
“ADHD is a condition of the brain that makes it hard for children to control their behavior. It is one of the most common chronic conditions of childhood. All children have behavior problems at times. Children with ADHD have frequent, severe problems that interfere with their ability to live normal lives.” (See Exhibit 16 a)
XXXX was diagnosed when he was six with ADHD in March of 2007 after many years of symptoms of the disorder. Since XXXX was very little we noticed that he had trouble sitting still and he would always seem to be in motion, and that he had a very hard time paying attention. In preschool he was seen for speech therapy and occupational therapy, where they also noticed that he seemed to have trouble with his behavior.(See Exhibit 16 a, b and c) As he grew older the symptoms seemed to worsen; he began having trouble with his behavior and grades later in regular school.
Since his diagnoses he has begun to take Adderall 20 mg a day, and it has helped him to greatly improve his focus, but “unfortunately when people see such immediate improvement, they often think medication is all that’s needed. But medications don’t cure ADHD; they only control the symptoms the day they are taken. Although the medications help the child pay better attention and complete school work, they can’t increase knowledge or improve academic skills. The medications help the child to use those skills he or she already possesses.” (See exhibit 16 e pg. 14)
“Many children with ADHD approximately 20-30 percent also have a specific learning disability (LD). In preschool years these disabilities include difficulty understanding certain sounds or words and/or difficulty in expressing oneself in words. In school age children reading or spelling disabilities, writing disorders, and arithmetic disorders may appear. Reading disabilities affect up to 8 percent of elementary school children” (See Exhibit 16 d pg.9)
XXXX also has suffered since beginning school with reading difficulties. He has been below level compared to others of the same age since kindergarten and he is just now beginning to catch up.(See exhibit 16-?) His school and his teacher has been our greatest source of help in this. His teacher, Mrs. Lackey is trained in dealing with this type of disorder and from her specialized training he is doing much better in school than ever before. (See Exhibit 16 e letter from XXXX’s teacher) XXXX has also been in an after school tutoring program through the A+ C.A.T. Tutoring Services for the last two years free of cost through Hillsborough County School System which has also helped him enormously to improve his reading skills. (See Exhibit 16 f)
“As with other chronic conditions, families must manage the treatment of ADHD as an ongoing basis.” “It may take some time to tailor your child’s treatment plan to meet his needs. Treatment may not fully eliminate the ADHD-type behaviors.”(See exhibit 16 a)
“Medication can help the ADHD child in everyday life. He or she may be better able to control some of the behavior problems that have led to trouble with parents and siblings. But it takes time to undo the frustration, blame, and anger that may have gone on for so long. Both parents and children may need special help to develop techniques for managing the patterns of behavior”(See Exhibit 16 d pg.15)
XXXX and I have worked very diligently with his doctor and his teacher and it has taken a tremendous amount of time and effort from all of us to get XXXX to this point where he has more self esteem and does better in school and at home. XXXX has been my rock working through out our son’s difficulties; he has helped me provide structure and stability in XXXX’s life which is something I couldn’t do on my own. I know that it will take all of us working together with XXXX to help him overcome his obstacles in life and without XXXX here to help me it will definitely affect XXXX’s future. Relocating to Mexico would place an extreme hardship on my son and I by causing huge setbacks in XXXX’s success. If we were to move to Mexico we would have to find another doctor who could follow XXXX through out his childhood because “About 80 percent of children who need medication for ADHD still need it as teenagers, and over 50 percent need it as adults.”(See exhibit 16 d pg. 14) We would also need to be able to pay for the on going doctor’s visits and XXXX’s medicine, and we would also need to find a suitable school where the teachers would have comparable training in dealing with students with ADHD so that he could continue to excel in school. Because of this it is very important that we remain here with my husband in the U.S. so that XXXX has every opportunity available to continue to do well in school and overcome his problems.
This is my first time posting. I have been working on my HSL and so far this is what I have (still so much to go!), Please read over and let me know what I should do. I feel like it is so long already and I still have my two daughters to write about who have alot of medical issues like my son and I'm worried about the length. I have so much to write about and it seems like all of it is important and I don't know whether to try to summarize or what . Please help!:blush:
February 15, 2008
U.S. Citizen and Immigration Services
American Consulate General
Ciudad Juarez, Chih., Mexico
PO Box 9896
El Paso, Texas 79905-9896
Re: Case No. XXXXXXX
Applicant: XXXX XXXX
Application for Waiver of Grounds of Excludability (I-601)
Claim of Extreme Hardship on the U.S. Citizen Spouse/Children
Dear Sir or Madam:
I, Anderia Lucille Lopez, declare under the penalty of perjury, under the laws of the United States, that the following is true and correct:
I am a U.S. Citizen humbly asking that the Waiver of Grounds of Excludability (I-601) please be granted so that my husband, XXXX Lopez-Coclame may return home to his family that needs him.
I, along with our three children, XXXX XXXX, XXXX XXXX and XXXX XXXX , would suffer many extreme and severe hardships if my husband is not allowed to re enter the United States. Our many interacting hardships include: health, education, financial, family ties and special factors. These hardships keep us from living in Mexico with my husband, but however, due to strength of our family bond we would be compelled to do so.
Our Family Background:
In June 2002 after separating from my ex-husband XXXX XXXX I was a truly broken person. After two years of day after day physical and mental abuse I finally found the strength to leave. The relationship had left me with absolutely no self esteem and I was deeply depressed. The only reason that kept me alive was my two children. With the help of my beloved mother and grandmother I was able to escape the misery, and I moved back home to give my children a better future.
Through out this time in my life I was filled with uncertainties. I had so many hopes and dreams for us and so many unanswered questions. I began to take refuge in God and I prayed in earnest every night for Him to take our lives in His hands and give me strength to go on and for Him guide us in all aspects.
God indeed did have something very special planned for us. I believe will all my heart and soul that this is why XXXX appeared in our lives. We began dating in September of 2002 and we became an instant family. XXXX became the father my children never had and the partner in life that I had always wanted: someone to love us unconditionally and without reserve.
From the very beginning of our relationship XXXX made me feel special, a person that he saw as beautiful inside and out. He has always treated me with respect, compassion and understanding, something that I was unaccustomed to. But most of all he won my heart through the kids. Even though XXXX and XXXX aren’t biologically his you would never know the difference. He treats each child with warmth, patience and tenderness and loves them as if they were his own. He has done everything with them, from XXXX taking her first steps to teaching XXXX how to ride a bike and everything in between. XXXX has been in and out of their lives off and on since our divorce and although they know that XXXX is their biological father, they believe that XXXX their “Real Daddy”. They are both extremely emotionally attached to XXXX, being that he’s the only father that they have ever known.
XXXX tells us everyday how much we are loved, but he also proves his love and devotion to us daily. Whether it be a quiet word of reassurance, bandaging a scraped knee, fixing a faucet, or cooking dinner for us or just by asking how our day went, he has in my eyes been an answer to all my prayers. Actions to me speak louder than words and he has proved himself above and beyond as a father and as a husband many times over. He has returned my self esteem and inspired me to want be a better person both physically and mentally. He has also provided an excellent role model to our children, teaching them strength, compassion, patience and courage. XXXX has done so much for us as a family and I honestly don’t know what I would do without him at my side. Many things I have doubted in my life, but XXXX’s love and devotion to us will never be one of them.
Through out our time as a family we have suffered many tragic events that continue to affect us deeply, but despite this we have been able to survive and go on because of the enormous family bond that binds us together and gives us the strength to tackle whatever lies ahead. To deny XXXX the wavier would be taking away the other half of our family that makes us whole.
Please take into consideration the interacting hardships that our family would face if this waiver was to be denied. Listed below are our hardships.
Medical Hardships
Anderia
In 1998 I was diagnosed with Polycystic Ovarian Syndrome (PCOS). PCOS is an uncurable endocrine system disorder that affects a women’s reproductive system. The symptoms of PCOS are: infrequent or no menstrual periods (anovulation), irregular bleeding also known as dysfunctional uterine bleeding or DUB, infertility, increased hair growth (hirsutism), ovarian cysts, acne, weight gain/obesity, insulin resistance or type 2 diabetes, high cholesterol (lipid profiles), and high blood pressure, pelvic pain, and anxiety or depression due to appearance. (See Exhibit 1a and Exhibit 1b)
For many years I had various symptoms; Irregular menses, DUB and obesity. (See Exhibit 2) In 2005 my family went through two tragedies that affected us terribly. In March my beloved grandmother passed away from a long illness of congestive heart failure and diabetes complications, and just months later in September we found out that our daughter XXXX had been sexually abused. From these events I became deeply depressed and I began to gain an extreme amount of weight. From this weight gain I began to have serious complications of the disorder.
In August of 2006 I began a period that lasted continuously for months due to elevated estrogen levels from my weight. Unfortunately at this time I did not have insurance and my only option for care was through the emergency room. I was seen various times in the E.R. and I was diagnosed with acute exacerbation of chronic dysfunctional bleeding, type II diabetes and morbid obesity.(See Exhibit 3) Finally in the beginning of April of 2007 after being seen by yet another doctor, she suggested that I try a long term diet and exercise plan to alleviate my symptoms and hopefully this would regulate my weight and my body to begin to function normally.
At the end of April I began the Atkins diet, which is a low carb ketogenic diet that reduces insulin resistance associated with PCOS. Even though I had tried the diet before I never realized just how hard it would be just to get started and I had serious doubts that I could lose any weight, but with my husband’s unconditional love and support I began to exercise daily and follow the diet to a “t”. I don’t know what my starting weight actually was, but it had to be more than 350 pounds. Our scale would only go to 350, and for a solid month it would only show “E” for error. I thought I would never start to lose weight but slowly it started to come off. (See Exhibits 4a, 4b)
During the next month I lost weight steadily with XXXX’s help, but I continued to bleed continuously. During this time I was accepted for insurance through an excellent program for residents of Hillsborough County, The Hillsborough County HealthCare Plan of Florida, (See Exhibit 5-A Insurance card) Through my primary care doctor I was referred to a gynecologist in May of 2007 because of my on going problems. Because I had now been bleeding for 9 months I was sent for a endometrial cancer biopsy and put on progesterone to control the bleeding, and I was further counseled to try to lose more weight due to health risks associated with PCOS. (See Exhibit 5B)
I continued to lose weight through Atkins and and exercise but despite losing 91 pounds I continued to bleed. In October of 2007 it had been 14 months since the beginning of my ordeal. I was then diagnosed with Menorrhagia, or excessive menstrual bleeding, and I was then put on FemCon birth control pills (2 pills 1x a day) and Aldactone (2x a day) for hirsutism and told to continue with the metaformin 850mg 2 x a day. (See Exhibit 6)
Two months later in December I was seen again for a follow up due to still having bleeding despite taking twice the normal amount of hormones. It was decided that my birth control would be changed again to Yazmin and if the medicine didn’t work I would need a possible Dilation and Curettage (D and C), where the tissue from my uterus would be examined again with a biopsy or a hysteroscopy would be done to check my uterus for any structural abnormalities.(See Exhibit 6 -pg.3, and Exhibit 5- pgs. 3 & 4)
Two months later in February of 2008, I was seen yet again. Despite taking the prescribed Yazmin and contributing more than enough in weight loss (As of February 29th I am now down to 224, for a total of 126 pounds in 10 months) I continued to bleed. My doctor decided to change my birth control pill again to Lo-estrin which has stronger dose of hormones. It was decided that if this doesn’t work this time after the third change of medication that my only hope for cure is endometrial ablation. Endometrial ablation is where the complete lining of my uterus would be destroyed through freezing or heat techniques. Unfortunately although this would cure the DUB, I would still have my ovaries and uterus and therefore I would still be at risk for the serious health complications associated with PCOS.(See exhibit 6a pg 5 and 6b pg.1)
According to The Journal of Clinical Endocrinology & Metabolism “The syndrome is associated with significant morbidity in terms of reproductive and non reproductive events. Having the disorder may significantly impact the quality of life of women during the reproductive years, and it contributes to morbidity and mortality by the time of menopause” (See Exhibit 7) Recent studies also found that women with PCOS have greater chances of developing several serious, life threatening diseases including type II diabetes, cardiovascular disease and cancer( see Exhibit 1 Pg.5)
According to the OCED Heath Data of 2007 resources in the health sector (human, physical, technological) health care supply is low in Mexico by OCED standards. In virtually all dimensions for which data
are available, Mexico lies well below average. (See Exhibit 9) and also according to Nationmaster.com “Mexico is ranked #1 of 29 countries with 15.3 percent of female life lived in ill health.” (See Exhibit 8, pg. 8)
In Mexico I would also be unable to obtain insurance because we couldn’t afford it. Here in the U.S. The Hillsborough County HealthCare Plan covers all my doctors visits, including specialists, along with lab work and hospitalization with no cost and any prescription is only $1.00.(See Exhibit 5) To get this type of care in Mexico would be very costly. According to Nationmaster.com “The out of pocket private health expenditure in Mexico is 94.4 %” (See Exhibit 10) “Based on the high out of pocket expenditures and the prevalence of poverty, financial protection is another major challenge. Each year around 3 million people in Mexico face catastrophic expenses due to major illness or injuries.” (See exhibit 11) Just for me to get basic care for my complications would take every bit of money XXXX could earn and would leave us having to decide between food or a doctors visit. This is not a situation that I want to be placed in.
In Mexico it is also doubtful that I would receive the quality of care that I have received here. Mexico has a serious problem of inequity in their health care system. “Equity is one of the 3 main challenges faced in the Mexican health care system. In Mexico, 40 million people have incomes below the poverty line, and in contrast only 2% of the population is rich so the gap is enormous.” (See Exhibit 11) ”In large cities, excellent specialty trained physicians and high technology tertiary care medical centers compete with similar U.S. centers to provide care for Mexico’s wealthy. At the other end of the spectrum, large numbers of unregulated and unsupervised private physicians, often without residency training work out of individual “clinics” to deliver health care mostly to the uninsured, who can afford to not use the under equipped and understaffed Ministry of Health facilities”. (See exhibit 12)
As you can see from my documentation, the quality of my life has already been affected greatly through out this ordeal. I already have Type II diabetes which is one of the high risk diseases associated with PCOS, and now I am also at high risk for endometrial cancer because of my complications. It is of utmost importance that I continue to receive the care that I need to prevent any further problems that may arise. I am completely confident that through my doctor’s expertise and the advanced technological services available here in the U.S. that I can overcome my health obstacles. Considering the complications that I have had at this time I cannot afford to place such risks on my health by relocating to Mexico. It has taken a great deal of time and effort with my weight loss and the appropriate medical attention to get me to this point of being somewhat stable. As you can see with the state of my current health a forced move to Mexico would place an extreme hardship in my life, leaving me unable to continue to get the care I need.
XXXX’s Medical
Our son XXXX has many serious health issues. He has been diagnosed with Type II diabetes, attention deficit/hyperactivity disorder (ADHD), central auditory processing disorder (CAPD), asthma and severe allergies.
A. Diabetes
According to the National Diabetes Education Program “Diabetes is a chronic disease in which the body does not make or properly use insulin, a hormone that is needed to convert glucose and other food into energy. People with diabetes have increased blood glucose levels due to an absence of insulin, or failure to respond to insulin’s effects (insulin resistance). Inadequate insulin results in high concentrations of glucose that build up in the blood and spill into the urine, causing an obligate urinary excretion of glucose. As a result the body loses its main source of fuel. ” (See exhibit 13 pg. 2)
XXXX was diagnosed with obesity in October of 2006 at the age of 6. His doctor recommended testing his blood sugar as a precaution because of the known risks of obesity and diabetes. After checking XXXX’s blood sugar we found that it was in the 200’s. We called the doctor right away to report the results and XXXX was then referred to a pediatric endocrinologist who diagnosed him with glucose intolerance. Unfortunately despite our efforts to control his diet and weight this has now turned into full blown diabetes. (See exhibits 14a pg.5, Exhibit 14b, and Exhibit 14c pg.3)
XXXX suffers from hyperglycemia, or high amounts of glucose in the blood. “Over time hyperglycemia can cause damage to the eyes, kidneys, nerves, blood vessels, gums and teeth.” (See Exhibit 13 pg.5)
“Diabetes care for children should be provided by a team that can deal with these special medical, educational, nutritional, and behavioral issues. The team usually consists of a physician, diabetes educator, dietitian, social worker or psychologist, along with patient and family. Children should be seen by the team at diagnosis and in follow up, as agreed upon by the primary care provider and the diabetes team” (See exhibit 13 pg. 6)
To take proper care of XXXX it will be necessary to manage his diabetes through blood glucose testing, nutrition, and increased physical activity. It is also important to monitor any complications and reduce his cardiovascular disease risk.
As you can see taking the best care of our son will take more than just adequate medical attention, which is something that he will not receive in Mexico. To properly manage his condition it will take the time and effort of many dedicated medical professionals with knowledge of the disease, many doctor’s visits, and possible specialized treatments to prevent and control any complications and a strict following of diet and exercise.
The American Diabetes Association also states: “In Mexico, diabetes is the first cause of adult nonobstetric hospital admissions and hospital mortality and the third cause of mortality nationwide.’’ “Obesity, which is a high risk factor for type II diabetes, is also increasing rapidly in Mexico. In fact, between 1993 and 2000 the prevalence of overweight and obesity increased from 55 to 62 % in adults.” “These conditions that predispose Mexicans to type II are compounded by an inadequate preventive health care system.” “The public health care system in Mexico provides services for insured and uninsured population, and those that are uninsured might receive care from the “oportunidades” (OP) and the “seguro popular” (SP) programs. The OP program covers 10-15 % of the population, i.e., the extremely poor, and provides some primary care services including drugs for diabetes and hypertension. The SP was expected to cover 500,000 families by the end of 2003, but by 2010 it will be expected to cover 45 million Mexicans. Therefore, by the end of 2003, 43 million people would have to pay for drugs and for most of their health care services. Furthermore, monitoring supplies and syringes are not provided by the public health care system. The cost of drugs in the Mexico-US border city of Tijuana in 2003 was $60.00 U.S. a month for treatment and control of diabetes, $60.00 U.S. for treatment of high cholesterol, and 60.00 U.S. for the treatment of hypertension. In 2002 at least 65% of the family income in Mexico was approximately $250.00 U.S. a month. That income will hardly meet the need for treatment of diabetes and hypertension for one member of the family. In fact, at The National Health Survey it has shown that more than 50% of adult population has at least one chronic disease and that more than 50% of them have no drug treatment. The above data suggest that neither the public health care system nor the uninsured population can afford to control the “diabesity” epidemic.” (See Exhibit 15)
Diabetes and heart problems have run in our family for generations, and we want our son to have every possibility to be able control this disease. If we were forced to move to Mexico it would be impossible to have the ability to care for my son and I due to our both having diabetes. We wouldn’t make enough money to cover treatment or supplies for one of us let alone both, and this would force me to make a terrible choice between my child and I. Making that choice would put an extreme hardship on me and is something I am not capable or willing to do. My son’s health comes first and is the most important thing in the world to me, and of course I would rather be the one to go without care, and therefore would my health would seriously be affected.
My grandmother suffered for many years with poor health and eventually passed away from congestive heart failure and diabetes complications, and I don’t want my children to see me suffer the same consequences that she did. We as a family have worked extremely hard to fight our obesity problems and so far we have done well. XXXX has made it a priority to add exercise to our families’ daily routine and we go to the park to walk and play outside everyday. XXXX also takes the time to make sure that we eat properly by preparing healthy meals for us and because of this we have had great results, not only have I lost a tremendous amount weight but XXXX has slimmed down some as well and both of our sugars are better controlled. XXXX helps us in so many ways and without him I don’t know what we would do. I need XXXX here to help my son and I deal with this disease.
B. Attention Deficit/Hyperactivity Disorder (ADHD)
“ADHD is a condition of the brain that makes it hard for children to control their behavior. It is one of the most common chronic conditions of childhood. All children have behavior problems at times. Children with ADHD have frequent, severe problems that interfere with their ability to live normal lives.” (See Exhibit 16 a)
XXXX was diagnosed when he was six with ADHD in March of 2007 after many years of symptoms of the disorder. Since XXXX was very little we noticed that he had trouble sitting still and he would always seem to be in motion, and that he had a very hard time paying attention. In preschool he was seen for speech therapy and occupational therapy, where they also noticed that he seemed to have trouble with his behavior.(See Exhibit 16 a, b and c) As he grew older the symptoms seemed to worsen; he began having trouble with his behavior and grades later in regular school.
Since his diagnoses he has begun to take Adderall 20 mg a day, and it has helped him to greatly improve his focus, but “unfortunately when people see such immediate improvement, they often think medication is all that’s needed. But medications don’t cure ADHD; they only control the symptoms the day they are taken. Although the medications help the child pay better attention and complete school work, they can’t increase knowledge or improve academic skills. The medications help the child to use those skills he or she already possesses.” (See exhibit 16 e pg. 14)
“Many children with ADHD approximately 20-30 percent also have a specific learning disability (LD). In preschool years these disabilities include difficulty understanding certain sounds or words and/or difficulty in expressing oneself in words. In school age children reading or spelling disabilities, writing disorders, and arithmetic disorders may appear. Reading disabilities affect up to 8 percent of elementary school children” (See Exhibit 16 d pg.9)
XXXX also has suffered since beginning school with reading difficulties. He has been below level compared to others of the same age since kindergarten and he is just now beginning to catch up.(See exhibit 16-?) His school and his teacher has been our greatest source of help in this. His teacher, Mrs. Lackey is trained in dealing with this type of disorder and from her specialized training he is doing much better in school than ever before. (See Exhibit 16 e letter from XXXX’s teacher) XXXX has also been in an after school tutoring program through the A+ C.A.T. Tutoring Services for the last two years free of cost through Hillsborough County School System which has also helped him enormously to improve his reading skills. (See Exhibit 16 f)
“As with other chronic conditions, families must manage the treatment of ADHD as an ongoing basis.” “It may take some time to tailor your child’s treatment plan to meet his needs. Treatment may not fully eliminate the ADHD-type behaviors.”(See exhibit 16 a)
“Medication can help the ADHD child in everyday life. He or she may be better able to control some of the behavior problems that have led to trouble with parents and siblings. But it takes time to undo the frustration, blame, and anger that may have gone on for so long. Both parents and children may need special help to develop techniques for managing the patterns of behavior”(See Exhibit 16 d pg.15)
XXXX and I have worked very diligently with his doctor and his teacher and it has taken a tremendous amount of time and effort from all of us to get XXXX to this point where he has more self esteem and does better in school and at home. XXXX has been my rock working through out our son’s difficulties; he has helped me provide structure and stability in XXXX’s life which is something I couldn’t do on my own. I know that it will take all of us working together with XXXX to help him overcome his obstacles in life and without XXXX here to help me it will definitely affect XXXX’s future. Relocating to Mexico would place an extreme hardship on my son and I by causing huge setbacks in XXXX’s success. If we were to move to Mexico we would have to find another doctor who could follow XXXX through out his childhood because “About 80 percent of children who need medication for ADHD still need it as teenagers, and over 50 percent need it as adults.”(See exhibit 16 d pg. 14) We would also need to be able to pay for the on going doctor’s visits and XXXX’s medicine, and we would also need to find a suitable school where the teachers would have comparable training in dealing with students with ADHD so that he could continue to excel in school. Because of this it is very important that we remain here with my husband in the U.S. so that XXXX has every opportunity available to continue to do well in school and overcome his problems.