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In re Turrell

November 12, 2002


Appeal from the Circuit Court of Du Page County. No. 94-D-1441 Honorable John T. Elsner, Judge, Presiding.

The opinion of the court was delivered by: Justice Bowman


The marriage of petitioner, Virginia Turrell, and respondent, Graham Turrell, was dissolved in 1995. Virginia subsequently filed petitions against Graham, seeking payment of extraordinary medical expenses for the parties' son, Sam, and an increase in child support. Graham filed a petition to modify the marriage settlement agreement, seeking to reduce his child support obligation and terminate his maintenance obligation. Graham filed an additional petition in which he asked the court to order Virginia to provide him with notice prior to incurring new or ongoing extraordinary medical expenses for Sam. Following a hearing, the trial court directed a finding in Graham's favor on the issue of the payment of certain medical expenses. The court denied Virginia's request for increased child support, decreased Virginia's maintenance by 60%, and ordered that her maintenance would end after two years. Additionally, the trial court ruled that Virginia had to notify Graham before incurring any extraordinary medical expense for Sam and that Graham had the right to investigate and object to any such expense. Virginia appeals, arguing that (1) the directed finding in Graham's favor on the issue of the payment of certain medical expenses was improper; (2) the trial court abused its discretion when it denied her request for more child support; (3) the trial court abused its discretion when it reduced her maintenance and limited it to two years; and (4) the trial court erred in allowing Graham the opportunity to investigate and object to Sam's extraordinary medical expenses.


Under the marital settlement agreement (agreement), Virginia is Sam's sole custodian. The agreement acknowledges that both Virginia and Sam are afflicted with Lyme disease. With respect to Sam's medical expenses, the agreement provides that Virginia is responsible for Sam's "ordinary medical expenses" not covered by insurance, which are defined as those less than $25 per occurrence. Graham bears responsibility for all "extraordinary medical expenses" not covered by insurance. The agreement does not define "extraordinary medical expenses."

The agreement required Graham to pay child support of $850 per month. It was later modified to require Graham to pay $894 per month. In 1997, the parties entered an agreed order increasing child support to $620 biweekly.

The agreement further provided that Graham was to pay Virginia $1,250 per month in maintenance for a period of five years. At the end of five years, the issue of maintenance was reviewable. The agreement noted that Virginia received Social Security disability payments and provided that whether Virginia would be entitled to additional maintenance at the end of the five-year period "shall be dependent upon [her] employability, health, and needs at that time." In 1999 Virginia filed a rule to show cause, alleging that Graham owed $5,197.68 in back child support and $18,395.81 for Sam's extraordinary medical expenses. Graham filed petitions to modify the judgment of dissolution in which he sought, inter alia, to decrease his child support obligation, terminate his maintenance obligation, and require Virginia to notify him before incurring extraordinary medical expenses for Sam.

At the hearings on the parties' petitions, Virginia related Sam's medical history. He was diagnosed with Lyme disease soon after his birth in 1991. From 1991 to 1997, he was a patient of Dr. Dorothy Petruca. Dr. Petruca's office was in New Jersey, and Sam saw her there every six months. As a result of the Lyme disease, Sam had cognitive deficits, attention problems, and pain in his joints. Dr. Petruca treated Sam with oral antibiotics. In 1997, Dr. Petruca referred Sam to Dr. Cancillieri. Dr. Cancillieri practices in New York and will treat only patients who reside in New York. Consequently, Sam and Virginia moved to New York from May 1996 through September 1998. Dr. Cancillieri treated Sam with oral antibiotics and sleeping medications until Sam began having hallucinations and his condition deteriorated significantly. Dr. Cancillieri then placed Sam on daily intravenous antibiotics. In August 1999, Sam was doing poorly and Dr. Cancillieri told Virginia there was nothing more he could do for Sam. Consequently, Dr. Cancillieri referred Sam to Dr. Charles Jones, a physician in Connecticut. Dr. Jones treats patients with Lyme disease who reside out of state. Virginia paid for the travel and relocation expenses associated with their trips to the East Coast to visit Sam's physicians as well as a trip to California where she and Sam received hyperbaric oxygen treatment.

Virginia testified that her daily food and clothing expenses for Sam have increased since the time of the dissolution. Her grocery expenses increased from $350 to $600 per month because Sam's appetite greatly increased. She stated that she has to buy Sam new jeans and shoes every three months because of his growth. In addition, Sam participates in soccer, basketball, baseball, and golf. These activities require Virginia to buy uniforms, equipment, and shoes.

Virginia testified that she is a registered nurse. She last worked full time in 1990. She worked part time until 1991. She resigned from her nursing job because her short-term memory loss caused by the Lyme disease interfered with her ability to perform her job duties. At the time of her divorce from Graham, her Lyme disease-related symptoms included fatigue, chronic joint and neck pain, and cognitive difficulties. As of 2000, she still had difficulty performing daily activities because of fatigue, arthritis, and pain in her hips and knees. She also continued to experience short-term memory loss.

Virginia further testified that she provides home schooling to Sam because he did not function well in public school. Because of Sam's learning disabilities, Virginia must assist him with reading, writing, and math. Virginia stated that she teaches Sam from zero to three hours per day, depending on how Sam is feeling.

Dr. Jones testified by videotaped deposition. He specializes in pediatric adolescent medicine. His practice primarily consists of treating children and adolescents with Lyme disease. Dr. Jones explained that the symptoms of Lyme disease usually are fatigue, headache, muscle soreness, joint pain and swelling, and occasionally a rash. Lyme disease affects the brain and peripheral nervous system, causing various cognitive deficits.

Dr. Jones first saw Sam in December 1999. He noted that Sam was very fatigued, extremely sensitive to light, and had impaired balance, double vision and intermittent blurred vision, and skin sensitivity. He also had a sinus and throat infection and generalized arthritis. In Dr. Jones's opinion, Sam suffered from both gestational and acquired Lyme disease, meaning that he had contracted Lyme disease from Virginia while in utero and that he had also been bitten by Lyme disease-infested ticks. Dr. Jones testified that Sam has severe disabilities, including learning disabilities, as a result of Lyme disease.

Dr. Jones prescribed oral antibiotics for Sam, and his condition improved. However, based on conversations with Virginia and an evaluation of Sam on March 1, 2000, Dr. Jones determined that Sam was not responding adequately to the oral antibiotics alone. Dr. Jones then placed Sam on intravenous antibiotics while continuing the oral antibiotics. Sam had to have a port for the intravenous antibiotics surgically placed in his chest. Dr. Jones also recommended hyperbaric oxygen treatments in conjunction with the antibiotics. The antibiotics Sam takes can cause gallbladder problems. Consequently, he must have monthly ultrasounds to make sure he does not develop gallbladder damage.

Dr. Jones testified that Sam's condition is improving. He did not have any arthritis as of his last office visit. However, since his hyperbaric oxygen therapy he has experienced increased joint pain and swelling. His balance is normal, and he has no double vision. His light sensitivity has improved. His ability to concentrate and his short-term memory are still impaired. In Dr. Jones' opinion, if Sam were to stop receiving continuous antibiotics he would relapse and his Lyme disease would not be cured. Dr. Jones anticipates that Sam will have to receive two to three years of continuous antibiotic therapy.

On cross-examination, Dr. Jones acknowledged that most physicians treat Lyme disease with a two- to six-week course of antibiotics. That is the treatment taught in medical school. The New York licensing board believes that four to six weeks of antibiotic therapy is proper. Dr. Jones stated that he is the only doctor in the United States who treats children with Lyme disease with prolonged antibiotics. Such treatment can cause liver and gallbladder damage and can cause the patient to develop an allergic reaction to the antibiotics. Dr. Jones testified that most hyperbaric treatment facilities will not treat patients with Lyme disease. Dr. Jones is not aware of such a facility in Illinois that will treat Lyme disease patients.

Dr. Jones also testified that he reviewed Virginia's medical records and, based on those records and his conversations with Virginia, she suffers from persisting Lyme disease and, as a result, cannot work. He never treated Virginia. In Dr. ...

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