ECM Service Story: When a Simple Pain Isn’t Simple at All

Last Updated April 19, 2024

Grace was having a difficult year. Things in her life had been improving, but then, at twenty-eight-years-old, she began periodically experiencing intense stomach pains, nausea, and vomiting. The events were turning her world upside down and were so frequent she had begun to take the pain for granted.

Grace’s health plan had initially referred her to the Partners’ Enhanced Care Management (ECM) program. Her health challenges at the time included diabetes and hypertension. Her first conversations with a Partners’ Care Coordinator helped her focus on chronic disease self-management as a means of dealing with those conditions.

Being part of the state’s ECM program is highly beneficial. It provided Grace with a free glucose monitor to keep track of her blood sugar level and made available educational resources on diet and nutrition for diabetes. “Those resources really helped me stay healthy,” she explained. “They also prevented any complications from the disease.”

Grace’s Care Coordinator also discussed with her the importance of annual eye exams for adults with diabetes and arranged a referral for her to see an optometrist. That visit checked for signs of retinopathy and diabetic macular edema, which is common for people with diabetes.

Things changed and started going downhill during June of 2022, when Grace began experiencing stomach pains that regularly landed her in the emergency room. A round of diagnostic imaging at the local hospital showed that a gallstone was present, and it was causing Grace’s gallbladder to expand in size. It was that expansion causing Grace’s bouts of pain, nausea, and vomiting.

What she had all along thought was “just stomach pain” turned out to be gallbladder inflammation and close to rupture.

Grace had been unsure about having the imaging done, being unsure about the cost. Her Partners Care Coordinator talked it through with her, and strongly encouraged her to have it done so she could find out what was behind the pain. According to Grace “Without that extra push,” she said, “I might not have taken the next step and ended up in a very different circumstance. The Partners team really looked after me.”

When her doctor saw what was visible in the diagnostic images, he immediately determined that Grace needed to go into surgery as soon as possible because she was close to a ruptured gallbladder.

Grace was nervous and fearful about the surgery, but she knew it was the best decision for her health. The surgery was a success, and Grace has been recovering well. Only once in the past three months has she returned to the hospital, and that was to retrieve new medication. This has significantly reduced Grace’s medical costs while improving her health.

According to Grace, “I was fortunate to have the Partners in Care Foundation helping me through these issues, and a Care Coordinator helped me advocate so strongly on my behalf. My doctor told us that if the complication had been overlooked any longer, it would have been life threatening.”

These days Grace is feeling healthier than ever with an effective nutrition plan for her diabetes, and no more stomach pain or nausea since the successful gallbladder removal surgery.

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