Event 8: Outcomes

After a few weeks of coordinated care with his treatment team, Peter James meets with his nurse case manager to review his progress. Aside from the treatment goals he outlined in the beginning of the case, Peter James also filled a prescription for Naloxone in case of opioid overdose while he still takes oxycodone.

Medication Reduction

In the beginning of this case, Peter James said he wanted to increase his overall function as part of his treatment. He felt one of the ways to achieve this goal centered on reducing his medication. After meeting with the different members of his care team, Peter James now sits in a chair opposite to the nurse care manager in an examining room to discuss his progress so far to increase his function.

The nurse care manager says, “It’s been a couple weeks and I just wanted to review how things are going. I know you’ve seen a number of people, right?”

“A lot,” Peter James laughs. “Don’t ask me to name names.”

The nurse care manager smiles and says, “I understand, but hopefully as you’re working with a team it’ll get a little bit easier and you’re seeing people a little regularly.”

She continues, “Dr. Kent and I spoke a couple of times. I understand he talked with the pharmacist and made a plan with you about making some adjustments in your medicines.”

“Yeah,” Peter James says. “We’re decreasing dosages and looking to see which ones we can eliminate completely.”

This conversation is in keeping with Peter James’ desire to decrease and eliminate some of his medication that prevented him from functioning in his day-to-day life.

Reduce Insomnia

Peter James sits in a chair opposite to the nurse care manager in an examining room to discuss his progress so far to increase his function. He expressed a desired to reduce insomnia as part of his treatment goals.

In response to whether his insomnia has improved, Peter James says, “I guess it’s getting a little better. I find it easier to fall asleep. I mean, I might not always stay asleep for more than two hours, you know, before the nightmares start, or phantom pain wakes me up or something like that.”

The nurse care manager replies, “I think it’s going to take some time. You know, you’ve been on the medicines a long time and we’re trying to do things a little bit at a time so that you can adjust to changes. And then also have that coordinated with the psychologist.”

Increase Function

Peter James sits in a chair opposite to the nurse care manager in an examining room to discuss his progress so far to increase his function.

In response to whether he’s noticed a difference in his phantom limb pain that benefits his overall function, Peter James says, “The phantom pains aren’t as frequent. I haven’t noticed a big difference in intensity yet. But just the frequency is good. It’s decreasing.”

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