Coordination of Care Saves Life of Lake View Patient

When what he thought was food poisoning didn’t get better, Charlie Bohm turned to trusted medical experts at Stewart Memorial Community Hospital who removed his gallbladder and set him on the road to recovery.

When what he thought was food poisoning didn’t get better, Charlie Bohm turned to trusted medical experts at Stewart Memorial Community Hospital who removed his gallbladder and set him on the road to recovery.

At 12:30 AM on July 4th, 2016, Charlie Bohm’s eyes snapped open. He felt awful. His stomach hurt, and he needed to get to the bathroom quickly.

Recalling a bout of food poisoning he’d had the year before, Charlie thought his symptoms were the same. The Lake View native, who works as a drag line operator at a gravel pit operation, decided to tough it out for a couple of days before making an appointment at McCrary Rost Clinic in Lake View on July 8.

Rochelle Guess, certified family nurse practitioner, saw Charlie in the clinic. A blood test revealed a high white blood count indicating infection. Suspecting a gallbladder issue, she sent Charlie to Stewart Memorial Community Hospital in Lake City for an MRI.

Magnetic resonance imaging (MRI) is a radiologic test that uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body. In many cases, MRI gives different information about structures in the body than can be seen with an X-ray, ultrasound, or computed tomography (CT) scan.

When the MRI confirmed Charlie was suffering from acute calculous cholecystitis, or inflammation of the gallbladder, Dr. Susan Hornback admitted him to inpatient care at the hospital.

The gallbladder is part of the gastrointestinal system in the body. It functions as a resevoir for bile which helps digest fatty foods. Bile can also form stones. Gallstones can become stuck in the bile duct causing bile to build up which then inflames the walls of the gallbladder.

The first method of treatment in Charlie’s case was to administer IV antibiotics and pain medicine in an effort to reduce the infection and make Charlie more comfortable. He recalls sleeping a lot for the first two days of his hospital stay. Dr. Hornback explains, “Surgery works best for a patient’s recovery when he is stable and the acute inflammation has subsided. We always take the conservative route – see if the body will heal itself with the least invasion.”

When the antibiotics didn’t affect the white blood count as much as desired, it was determined that removal of the gallbladder was the best option in Charlie’s case.

Dr. Marc Miller, general surgeon, scheduled the surgery on Monday, July 11. Charlie recalls, “Dr. Miller had a surgery to do in Manning on Monday morning. Then he got called in to perform an emergency surgery in Carroll. While I was waiting, the surgery staff kept me well informed about what was going on, and that helped to ease my anxiety about the delay.”

When Charlie awoke, he was told Dr. Miller had performed the surgery laparascopically. During laparascopic surgery, otherwise known as minimally invasive surgery, small incisions are made through which plastic tubes, or ports, are passed. A small camera is sent through the port and the surgeon views the area on a video screen. He then passes the instruments through the ports and removes the gallbladder. The small incisions made in laparascopic surgeries lead to less discomfort for the patient, quicker recovery and less scarring.

Although Charlie never felt sick prior to the onset on July 4th, his gallbladder was in bad shape. “Dr. Miller told me it was one of the worst ones he’d ever seen. It had gangrene!”

Charlie was impressed with the level of communication by the staff. He says, “Everything went really smoothly. Each phase along the way, everybody knew what was going on and made the transition very easy.”

“We have a good system at SMCH,” says Dr. Hornback. “Rochelle, Dr. Miller and I worked together closely to ensure Charlie’s outcome would be the best for him. Three heads are better than one, ensuring all the bases are covered. There is continuous dialogue among everyone involved in the patient’s care. It’s a good partnership.”

After surgery, Charlie spent several days in the hospital recuperating. His children, Stuart, Scott and Staci, found it convenient to stop and check in with their dad. Having family close by made the ten day stay a little easier. “I had excellent care,” he says, “I can’t say enough about the nurses, aides and everyone involved in my care. It makes the mending period a lot easier when you have people who care.”

He was visited by the transition coaches during his stay. The transition coach program at SMCH consists of specially trained registered nurses who help manage the care of patients. Their role includes patient education, communication with all involved in the patient’s care, and coordinating follow up care. “They talked to me about my diet after surgery and gave me a packet of information about what to avoid, letting me know it would be some trial and error.”

The Mayo Clinic recommends patients who’ve had their gallbladders removed avoid high-fat foods, fried and greasy foods, and fatty sauces and gravies. “Increase the fiber in your diet. This can help normalize bowel movements. Add soluble fiber, such as oats and barley, to your diet. But be sure to increase the amount of fiber slowly, such as over several weeks, because too much fiber at first can make gas and cramping worse. Eat smaller, more-frequent meals. This may ensure a better mix with available bile. A healthy meal should include small amounts of lean protein, such as poultry, fish or fat-free dairy, along with vegetables, fruits and whole grains.”

While Charlie also utilizes medical services at the VA for scheduled procedures, he chose SMCH during his time of need. He feels confident that the care he received during his illness and after surgery was top-notch. “I’ve doctored here all my life,” he says. “When you get good care, that’s where you’re going to go.”