Complex, choreographed care

complex care

At first Sherry Smith thought she was gaining weight, a little potbelly distending her lower abdomen.


Caring for the elderly

Caring for the elderly and medically fragile

When the problem can't be fixed

By the time she developed pain, she was also having trouble breathing and had pretty much stopped urinating. She knew it must be serious when her doctor insisted that she go to Emory University Hospital, where a CT scan showed large blood clots blocking the vessels leading to her spleen and kidneys. Over the next two weeks, she had four operations. Surgeons removed the clots and her spleen and cut out portions of her bowel that had been destroyed by lack of oxygenated blood. She required a feeding tube and a tracheotomy to help with breathing as she recovered.

When patients require bowel surgery of this magnitude, they often end up at Emory for two reasons: the surgical expertise at Emory University Hospital and the long-term acute care provided at Emory’s Wesley Woods Hospital. 

Patients can move seamlessly between the two Emory Healthcare facilities, for surgery, treatment of the raging infections that can accompany bowel disruption, and total parenteral nutrition (TPN) in which nutrients are given intravenously. 

Smith got it all, moving back and forth between Emory and Wesley Woods as her surgery sites healed and she graduated from TPN to a clear liquid diet, from a bed hooked to wires and tubes to a wheelchair.

She also got some unexpected help in paying for her care. When she got sick, Smith lost her job. During the six months she spent moving between the two hospitals, her bill at Wesley Woods was more than $120,000, and that at Emory University Hospital, almost $130,000. 

To her relief, Emory offered to pay her hefty COBRA fees to help her maintain her insurance for the time allowed. It was a cost-effective move for Emory, even if the payments would cover only part of the actual cost of care, and it was an emotionally gratifying one for Smith. Wesley Woods social workers also helped her apply for Medicaid to cover health care costs when her COBRA coverage ends while she continues her recovery in a rehab facility closer to her home.

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