Marcus was admitted to the hospital and diagnosed with peripheral vascular disease with a blood clot. An angiogram was conducted three times but unfortunately, it didn’t resolve the issue and he had to have his leg amputated above the knee.
Amputations have a high rate of complications like muscle atrophy, reopening of the surgical wound, infections, and additional wounds from wearing a prosthetic. Marcus needed complex postoperative care to avoid complications and heal properly. In addition, he needed someone who would advocate for him to get a prosthetic leg that would meet the strenuous demands of his job. And finally, he needed emotional support to adapt to his new way of life.
Many members don’t have the knowledge or resources to navigate a complex medical procedure. In this case, a nurse advocate certified in case management engaged with Marcus immediately after discharge.
First, she evaluated his postoperative needs and conducted research to determine the highest quality providers with the best outcomes. Then, she coordinated care between the providers, overseeing the entire process to avoid complications and help him recover as quickly as possible. She also provided education on phantom pain symptoms and treatments, nutrition, wound healing, signs, and symptoms of infection.
The nurse advocate stressed the importance of adhering to follow-up care and offered emotional support, helping Marcus overcome negative thoughts and motivating him every step of the way.
As Marcus progressed, the nurse advocate worked directly with the prosthesis provider and third-party administrator to get him a prosthetic leg that would meet the strenuous demands of his job. She also made certain that he was fully healed for proper fitting of the prosthetic.
The nurse advocate made certain that Marcus had the very best outcome for his condition, avoiding severe complications, helping him get the right prosthesis, and supporting him emotionally as he adapted.
Marcus averted unnecessary costs by avoiding complications and receiving a more durable prosthesis upfront. A standard prosthetic leg costs $70,000, but isn’t designed to meet the harsh working conditions for his profession. He required a second, more appropriate prosthesis at a cost of $75,000. We were able to avoid the unnecessary $70,000 expense.
Without the correct prosthesis, Marcus’ job performance would have been affected or he would have been forced to change professions. In fact, many amputees receive poorly fitted or improper prosthetic legs and revert back to using a wheelchair. By getting him the right prosthesis upfront, he was able to return to work quickly.