One of the most difficult tasks a person may face is asking for help. A person’s heritage and values may have honed the ideal we take care of family, the problems we face and we do so without help. A person finally asking for help does it in a mode of desperation by taking their pride and setting it aside. One day, I received a voicemail from the wife of one of my patients. The message stated, “I need help, Mr. B has lost 50 pounds and I do not know what to do.” Mr. B never revealed to myself, his case manager, he was no longer able to eat by mouth and he could not afford the cost of over-the-counter supplements. His radiation treatments for nasopharyngeal cancer have caused burns to his throat. Mr. B suffered in silence from rapid weight loss.
Mrs. B advised she had been administering pureed food through his peg tube such as cans of soup and thinned mashed potatoes, as the nurse at the doctor’s office instructed. I asked Mrs. B to keep a food journal for three days to see how many calories Mr. B was receiving. That same day, I was able to secure ten cases of ensure from a local food bank. Mr. B had an immediate food source. The food journal was able to show Mr. B was only receiving 600 to 900 calories from pureed food source and these calories lacked the nutrients needed to help repair and maintain his body. A resource for free enteral feedings for people who lack the resources to afford this feeding was located through Nestle’ Nutrition Financial Assistance program. I shared the food diary with the physician and requested for him to order Nestle’ Nutren with 1.5 calorie density and assisted physician and Mrs. B on necessary paperwork so Mr. B could qualify for this needed program. Within two weeks, Mr. B was receiving his enteral feeding through this program.
Mr. B is now cancer free and is eating by mouth with occasional use of a supplement to help supply his body with necessary nutrients. Mr. B has regained most of his 50 pounds and he enjoys many activities in his community. Unfortunately, I am in the process of closing this member to case management since he is no longer covered under his policy due to not being able to afford the cost of his premiums. Mr. and Mrs. B were set up with insurance through Mrs. B’s employment and were educated on basics of insurance and how to make sure new insurance will cover the cost of treatments and follow-up care on his cancer diagnosis. I am keeping Mr. B opened to make sure his new insurance is covering medical bills for his cancer diagnosis, or perhaps, I may be keeping him opened longer since I have developed a source of kinship. We take care of family, the problems we face together as a family and we do so by asking for help.
