by Elizabeth Huber (Catholic Charities AIDS Services Intensive Case Manager)

It is 8:30 in the morning when I arrive at my office. I check my voice mail messages and discover I have 8 new messages since I left the office yesterday.

The first message is from Sarah, who recently relapsed and lost her housing. She states she is in a local detoxification unit and has nowhere to go when she is discharged, which may be today. I am concerned that she has been off of her HIV medications, which happens when she resumes drug use, rendering them less effective in the future.

The next two messages are from other service providers requesting my presence at an impromptu meeting today at 2:30. The meeting is to address Marie’s recent suicide attempt and subsequent hospitalization. Marie recently lost her fiancé to AIDS and is struggling with her grief. I had scheduled time to attend to paperwork this afternoon, but that will now have to wait for sure.

A message from Albany Medical Center’s Oncology Department follows, stating Kyle’s appointment for tomorrow was moved up by two hours and they are unable to reach him as his phone was disconnected. Since Kyle lives only a few miles from our Albany Office, I place a call to see if a co-worker can stop by Kyle’s house and let him know of the change. He has already missed several appointments and cannot afford to miss another.

In the midst of listening to my messages, Deanna has called to say she is having chest pains and difficulty breathing and doesn’t know what to do. I tell her she need to go to the emergency room and get checked out. She requests that I take her and I explain that I do not want her to delay treatment by waiting for me to arrive. However, I indicate that I will call 911 for her. After several minutes of resistance Deanna agrees to go. I make a quick call to 911 and it’s on to message #6.

This one is from George who needs help paying his $30 co-pay to his mental health provider. I schedule time to meet with him to complete a financial aid request to assist with the co-pays.

The messages are nearly through when I hear the call from Sierra, saying she has to cancel our home visit this morning. She is very nauseous due to new HIV medications. She requests that I ask her doctor to call in a refill of her anti-nausea medication. I make a call to the nurse at the clinic who agrees to call in the refill. I then make a second call to Sierra’s pharmacy to request that they deliver it to her as soon as possible.

My final message is from Janelle. She has good news at last! She has finally been able to access her food stamps benefits. It seems that her DSS worker forgot to place the stamps on her benefit card this month.
Due to my 9:30 home visit cancellation I am able to catch up on some paperwork, but first I call the mental health unit where Marie is and let them know I will be in attendance at this afternoon’s meeting. I then call Sarah at detox and arrange a meeting with her clinician for tomorrow; luckily Sarah will not be discharged today.

It is now 10:15 and I am out the door to do an intake on a new referral. I meet Mark at his doctor’s office as he lives with his parents; he has not yet told them of his HIV diagnosis when he found out himself last week. I spend over an hour with Mark but make little headway on the intake paperwork. Instead I spend most of the time reassuring Mark and answering his many questions. Before leaving I schedule another appointment for later this week. We walk to the parking lot together.

I now hurry to make it to a lunchtime training on HIV and Hepatitis C co-infections. Luckily for me, both the training and lunch are great.

Next on my schedule is my meeting at with the mental health clinicians but first I stop to check my messages. There are several from Deanna saying she is being admitted to the hospital for pneumonia and needs me to call her at the ER with a list of her medications as she cannot remember them. I quickly call the clinic and let them know of Deanna’s admission and request that they fax a list of medications over to the ER.

When I enter the mental health unit, Marie is waiting for me. The meeting is productive and before I leave Marie asks me if I can take care of her cat while she is hospitalized. I tell her about a program called PAWS that will do that for her, and promise to start the process to take care of this.

My last appointment of the day is back at my office with Rina. As I exit my car in the parking lot Rina is waiting. She pulls me across the parking lot to a car and proudly states, “Look… it’s mine!.” As I stare at the car I remember meeting Rina almost two years ago. At that time she was not taking her medications, was unemployed and was living on $724 a month in social security payments. Her health was poor and she was depressed. Since then Rina has completed a medication adherence program, as well as a CNA training program. Her health has improved tremendously and she has a job for the first time in years. After Rina landed her job I referred her to a program that helps qualified individuals obtain a car. Seeing Rina with her car and realizing what a difference a little help can make, I head home ready to begin again tomorrow.