With Support, Patient Becomes Self-Advocate
As an EMT, I have had my share of “frequent fliers” — patients who are high utilizers of the emergency department (ED) with non-emergency complaints. If these patients have chronic pain for non-specific reasons, they eventually earn the label of “drug-seeking.” At first glance, my first patient at the Coalition would have earned that label, with 15 ED visits in six months for chronic abdominal pain. But my time with her taught me to go beyond the labels that we in the health care field can be so prone to give easily.
Her abdominal pain was due to chronic pancreatitis, and she also had untreated diabetes. Yet in spite of her situation, she never felt sorry for herself and managed to remain thankful for what she had: her family.
She was also thankful for what our team did for her, but we always reminded her that she was the one who did all the hard work. When we first met the patient, she had been scheduled for surgery but was never medically stable enough to undergo the procedure. Her physicians were concerned that the surgery could actually cause the patient’s health to deteriorate more quickly. With that in mind, we set her up for a consult with palliative care, but ultimately she was determined to have the procedure.
We supported her determination by setting her up with pain control services, beginning with a transition to her primary care physician post-hospital discharge. She was also referred to Manna, a meal delivery program that provides nutritious food for at-risk individuals. In addition, she was referred to pain management to address her need for long-term pain medications.
With these simple interventions, the patient was able to stabilize to undergo the surgery. She reports marked pain reduction post-surgery. Other than the hospitalization post-procedure, it has been four months since her last ED and hospital use. I continue to be in awe of how, with the support of her family, this patient has taken ownership of her health and transformed her label to “proficient self-advocate.” But it is sobering to realize that she would not have become the empowered individual she is now had we simply discounted her with the “drug-seeking” label.
By Health Coach Shelly Lluz