Updated: Mar 7
Emily Everhart accepted a Tobacco Cessation Referral and before reaching out to the member, looked to see if she had a prescription on file. She noticed the member had been enrolled in the program last year around March, which made her ineligible until March of 2022. Everhart explained she would not be eligible until March 16th and the member's voice became anxious after hearing that information. The member explained she needed to have a procedure done, but no doctor would touch her because she is a smoker. Everhart told the member to use needing surgery as an advantage to quit smoking. While discussing the program, the member mentioned she was a worrier and stressed constantly. She needed a cigarette when she woke up and before she went to sleep, and for everything in between. Everhart advised the member that she could send out helpful information for quitting tobacco, stressors, triggers, etc. The member agreed and said that would be good. The member had tried patches and ended up being allergic, so she resulted to the inhaler. The member said it did work and was successful, but picked up a cigarette one day when she was stressing and never turned back. Everhart suggested setting a goal for herself. Since she is not able to start the program until March, Everhart told her that she could get her prepared so when she does start, she would have an easier time transitioning. Everhart could hear the change in the member's voice starting to become calm, and told the member that with her smoking 1-2 plus packs a day, it would be much easier to ween herself down before using a replacement. The goal was to get to 1.5 packs per day or less over the next month. The member thought it was a reasonable goal and knows that she needs to do this. Everhart told the member that she would send out helpful articles and would call her in one month for a follow up. Everhart gave her direct line to the member and told her that if she felt the need for a cigarette and knew she did not need it, she could call her and walk her through it, distracting her from smoking. The member thanked Everhart, and was so appreciative of suggesting the idea. By the end of the call, the member's voice was calm and happy. Helping the member understand that people like Everhart are here for her, gave her piece of mind that she is not doing this alone.
Sheri Meyer received a call from a member that really warmed my heart. Meyer called her initially on 12/22/21 to enroll her in the Disease Management program for diabetes. She was struggling with her diabetes, but mostly was having issues with stress due to having autistic 10 year old twins. Her husband and 27 year old son are very supportive in their care but the member was becoming increasingly isolated from the household ultimately sharing with Meyer she was bipolar and had chosen not to take medication. She was trying to manage it with therapy only. She suspected she was going through menopause as well. Meyer spent time listening to her, offering stress management techniques such as breathing exercises and encouraged her to discuss her feelings and symptoms with her doctor. It was a very productive conversation. Meyer noted on a routine review that she had been seen in the ER on 1/4/22 for worsening symptoms of bipolar and started on lamotrigine and began trying to reach out to her for follow up. The member called Meyer back and told her that after their conversation she had begun thinking about her history of bipolar and finally realized she had to do something about it. She did go to her doctor who then sent her to the ED to get the prescription she needed. She has been taking lamotrigine and increased the dose as directed and seems to notice a little improvement in her symptoms. She feels encouraged now that life in general will improve. The member was touched that Meyer called to follow up on her. Meyer offered more encouragement for her to continue on the path that she has chosen and congratulated her on making the brave decision to seek help. Meyer will follow up with her again after her routine PCP appointment for diabetes follow up and is looking forward to more good news from her.
Michelle Tracy has followed two brothers with muscular dystrophy for multiple years. Both are adults and both are total care. The one son that is worse was on a non-invasive vent at night. Tracy had supplied much education and assistance that could be provided at home and mom did not want help, she had family to help. Tracy had helped with an air mattress for the hospital bed when one broke. While on vacation in South Carolina this past August the older brother (the one that did not use non-invasive vent) got sick and ended up in Duke University Medical Center. Tracy got a call from the father, frantic, thinking they would have to pay. Tracy assured him this was an emergent admission and it would be paid for. Dad gave Duke’s discharge planner Tracy's information and she was in contact with Duke throughout the member’s 32 day stay. The member ended up with a trach, on a vent, and gtube for enterals. Tracy assisted Duke with par DME companies for the vent, trach, suction, enteral supplies and formula. All was set up with Appalachian Medical (who has already supplied the brother’s non-invasive vent) and with Bioscrips. Tracy also assisted them with par ambulance services to transport home. While still in-patient, Tracy emailed PCA and Waiver applications to start on. The father filled these out, Duke’s doctors signed and everything was faxed. Tracy had Dawn, the social worker, assist dad with questions on the applications, and Tracy assisted with home health agencies in member’s area. The Duke discharge planners were great to work with. Whenever Tracy thought of something they might need she would call them. Once home the father called and asked about enteral formula, he was told it was not covered. Duke happen to call on a day Tracy was off and they were told this. Tracy again assured the father the formula was covered, the member had failed multiple swallow tests and enterals were his sole source of nutrition. Tracy called Bioscrips and had them email the formula information and built PA for the formula -everything was in place. Tracy called the mother and found out the member did get PCA and Waiver, on a waiting list, and trying to find workers for member. The mother stated they had just called and asked what hours they wanted someone to work. Right now the member has home health, the mother's sister, sister in law, and friend who are helping. Tracy closed both cases. The mother was very grateful for all the assistance.