A NEW MAN
Materiel Services employee benefits from UMHS disease management programs
Eric Marsh had a lot to celebrate when he turned 30 in December. Mostly, he was thankful for his life.
Marsh, a stockkeeper in Materiel Services, always had a weight problem, but in the spring of 2004, he tipped the scales at 530 pounds. Upon examination, his primary care physician, James Peggs, M.D., professor and associate chair, U-M Department of Family Medicine, discovered extreme water retention and started immediate treatment. Peggs also referred Marsh to U-M cardiologist Todd Koelling, M.D. and the Heart Failure Management Program, one of the Health System’s seven JCAHO-certified disease management programs that provide clinical intervention for patients to strengthen self-management chronic care skills.
“A lot of places would have just sent me home with new medication,” Marsh says. “Dr. Koelling took one look at me and said, ‘I’m admitting you today.’” In eight days, through IV diuretics and urination, he lost 100 pounds of fluid. “I felt like a completely different person,” Marsh says.
Testing and a complete review of his medications revealed that Marsh had a leaky aortic valve—and, surprisingly—a thyroid problem. “That was why I had no motivation to exercise,” he says.
Thea Picklesimer, B.S.N., R.N., lead nurse in the program, says, “After the fluid was off, Eric said to me, ‘You know, this is the first time in years I could tie my shoes. Someone else needed to tie them or I’d buy slip-ons.’ That thought stayed with me for days.
“His medications were reviewed. Additions were made. And exercise was encouraged,” says Picklesimer of his care. “We taught Eric to weigh himself daily, and explained the signs and symptoms of heart failure, along with dietary teaching, including fluid and sodium restrictions. The patient's adherence to the plan is vital, and Eric had the desire to become as healthy as possible."
The comprehensive services and planning that are part of this and all disease management programs enabled Marsh to get the bariatric surgery he needed, too. Marsh continued to receive care and guidance from his UMHS health care team, including education, medication reviews and contact with the Heart Failure Telemanagement Program, in which nurses manage patient care through frequent phone calls.
“There’s just a lot of caring at U-M, a lot of effort,” Marsh says. “Thea calls me monthly to find out how I’m doing, explain test results, determine whether or not I need more medication, and more.”
Today Marsh is down to three medications—from 13—and 270 pounds. He works out at a gym four times a week, and gets plenty of support from his wife, Tasha, an inventory control support associate in Hospital Transactional Purchasing.
Now that the stress is off his heart, Marsh’s heart problem isn’t a problem anymore. Soon, he will look into the mirror and see an even slimmer self. At the end of this month, he will have 30 pounds of excess skin removed through plastic surgery. In losing so much weight, Marsh gained his health. “I got a second chance,” he says.
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