Tests, Tests and More Tests.

21.5.08
Email from case officer (CO) in London received.
3rd set of medicals required.
Diabetologist report to comment on renal function prognosis.
Also extra documents from myself and hubby are required to prove our eligibility to sponsor them.
(Test 3)

Note: we are given until 21.7.08 to get this information to the Case Officer. That is 60 days – something that will become vitally important later on.

26.5.08
Email to CO with Extra Documents from myself and hubby.

25.6.08
Helen and Hubby granted Citizenship. We have a ceremony at Carterton Town hall. Unfortunately my family can’t be there to see it.

Mid August.
Dad phones the Case Officer to let him know that there will be a slight delay with the medicals, and we get a 2-week extension.

24.7.08
Results from Diabetologists.
Improved blood glucose levels
No history of Macrovascular complications
No evidence of Diabetic Retinopathy
No Microalbuminuria (an Albumin/ Creatinine ratio of over 2.5mg/mmol in males is considered Microalbuminuria. (ACR has reduced from 3.4 to under the 2.5 limit)
Microalbuminuria is a sign that the kidney is not functioning properly.
Dad’s levels are shown as having been <2mg/mmol in May 2008
BMI 29

There is a PPS with this letter recommending that Urea and Electrolytes be rechecked with EGFR, Calcium, Phosphate FBC, Plasma Viscosity and Abdominal Ultrasound.

These results go to the CO 65 days after they were first requested, and just 5 days later than the original timescale.

11.9.08
Email from CO.
Request for “fuller report” from GP regarding renal function.
” If detailed enough may be ok but may lead to request for specialist review”.
(Test 4)

Note: at this point we are now off the Diabetes, and on to Kidneys.

17.9.08
Letter from Diabetologist regarding request for clarification.
Seems very annoyed to have his work questioned.
States it is unlikely that Dad had Diabetic Kidney Problems
States once again that there is no protein in the Urine and no evidence of diabetic eye disease which would be the case if there were diabetic kidney problems.

19.9.08
Test results from UK GP
Urea & Electrolytes: Urea and Creatinine slightly elevated.
GFR low

22.9.08
Email sent to CO with letter from Diabetologist.

22.9.08
Email sent to CO from Helen.
Asking why some Migrants parents are getting through the process so much faster despite having similar or worse medical issues ( we know of at least 2 by this point).
Asks for clarification as to why the goalposts keep changing and why we are not getting definite goals and timescales.
Ask for a meeting to discuss in person (we will be in London during October for a friends wedding, so this isn’t quite as daft as it sounds!)

24.9.08
Email from CO dismissing concerns and refusing to comment with the usual cop-out of “Each person is dealt with on a case by case basis.”
Refuses a meeting with us.

25.9.08
Email to CO with Test results from 19.9.08
Includes a summary of the tests results in an easy to understand spreadsheet, outlining the test, the usual parameters and Dad’s results.
Will be sending a report from GP to follow on the 4th October
Asks for clarification on timescales for a decision (no answer is received – funny that!).

29.9.08
Report from UK GP is received.
States Mild Kidney problems at CKD stage 3.
Includes GFR’s for 2 years and states that deterioration is MINIMAL and that the problem is STABLE.
States HbA1c is on the whole satisfactory since 2001
States BP is reasonably controlled.

1.10.08
Email to CO enclosing summary and data sheets and report from UK GP.

6.10.08
Email from CO asking for all reports to be sent as attachments in one email and then he will send them in.

(This will cause a huge amount of frustration later on – for which we get the blame – funnily enough!)

7.10.08
Email sent to CO with Attached UK GP results (5 pages) and Extra Test from GP(1 page) along with reply from Diabetologist (1 page) as requested by CO.

25.10.08
Letter from CO asking for Renal Specialist Review with Diagnosis, Treatment and prognosis.

(Test 5)

29.10.08
Email to CO regarding a letter dated 25th October.
Expresses disappointment that GP report has been ignored.
States appointment made to see renal specialist on 5th November.

10.11.08
Report from Consultant Nephrologist.
States No overt complications
States No Diabetic Retinopathy
States Recent blood test showed Creatinine of 125 micromol showing renal impairments
States BP is 167/99, 140/84, 140/84
States that Renal function has been absolutely stable since 2002 and that there is NO proteinurea or microalbuminuria.
States it is highly unlikely that renal function is due to renal ischeamia (low blood flow) or Hypertension.
States he has no evidence of diabetic renal disease.
States that it is highly unlikely that kidney function will deteriorate in future
States that the absence of proteinurea is an excellent prognostic indicator of future renal function.

Note: Ok, so basically he’s still fine and in pretty damn good health.

Also, this clearly shows that there is very little likelyhood of future costs to the NZ health system – which is what NZIS are supposed to be looking for. At this point – not one iota of evidence or even a suggestion has come from the MA to say otherwise – which according to policy means that dad has an acceptable standard of health.

18.11.08
Email to CO enclosing Nephrologist reports.
Highlights that Dr Tapson has said, “I think it is highly unlikely that {Dad’s} kidney function will deteriorate in the future”.

18.11.08
Email from CO asking (again) for all the reports to be sent in on e email so the whole lot can be forwarded to the assessor.

(Don’t they have them all yet????)

18.11.08
Email to CO with a complete set of test results (again).
Diabetologist tests from 24.7.08
GP renal report from 29.9.08
Nephrologist report from 10.11.08

17.12.08
Email From CO asking for Ultrasound that is mentioned in the Diabetologist report back On 24th July!
(Test 6)

Coming next: we lose the plot.