Finding a way, with so much at stake
For a young patient facing kidney failure and systemic roadblocks in every direction, the odds were stacked against her.
By all appearances, she was a healthy teenager when she came to OneWorld for a health care appointment. But lab work revealed an urgent medical condition – one that would become complicated to treat because of systemic barriers standing between the patient and the care she needed.
The patient, not named here, received orders for blood work after a OneWorld clinician grew concerned over her high blood pressure during the initial visit. The blood work showed that the patient’s kidneys were functioning at less than 10%, with the chance that her kidneys would completely fail within the next year. Her best option was a transplant, but the odds were not in her favor.
“One of the big problems we face with organ failure is that the road to transplant is very long and it basically doesn’t exist if you don’t have status in this country,” said OneWorld Family Medicine Physician Melanie Menning, MD, MPH. “And so, knowing the initial reason the patient presented, we were aware of very large barriers that were going to be in place – but also knowing her kidneys were likely to fail completely within the next year or two.”
Knowing the average wait time for a nephrology visit is 9-12 months, Dr. Menning reached out to a colleague who’s a nephrologist at University of Nebraska Medical Center, Ryan Mullane, DO. According to Dr. Menning, Dr. Mullane “moved mountains” to help the patient, even knowing she had no insurance, financial assistance or other important supports.
Meanwhile, at OneWorld, Dr. Menning and the social services team sat down to discuss barriers the patient was likely to encounter and identify solutions to address them. First up was identifying strategies that would keep her in school and able to graduate on time, despite the need for hours of medical treatment. They also needed to provide education about her health care needs to her and her mom, along with interpreters, to make sure everyone was involved in and understood the plan.
Community partnerships were another piece of the puzzle. The Center for Immigrant and Refugee Advancement (CIRA) provided legal support to help the patient get her temporary green card; other community contacts helped her secure a job with insurance. Dr. Mullane pushed for her to get on the transplant list.
There were other hurdles on the patient’s journey toward getting the care she needed, but a dedicated team of advocates made sure she could continue on the path. The patient’s life went on outside of doctor’s appointments too. An excellent student, she enrolled in college and continued her education with the hopes of pursuing a career in health care. Then she hit another roadblock: she was forced to put her studies on pause when her kidneys failed and she had to be placed on dialysis.
Fortunately, an answer finally arrived. Today, several years after her first visit to OneWorld, the patient has successfully navigated financial, legal and other hurdles to get the life-saving care she needed.
She received her kidney transplant this fall.
“You know, one of the best parts of caring for people at OneWorld is we’re really good at finding a way, and even though we encounter initial roadblocks, we’re very good at asking why it’s a no and then trying to be creative in our solutions to make that no a yes,” Dr. Menning said.
As the patient continues to heal, OneWorld will continue to have her back – and will keep helping her and other patients find their “yes.”