Thankful for HealthLink

Liam and his family have a holiday story that is probably more interesting than yours. Thanks to HealthLink, it has a happy ending.

Thankful for HealthLink click to enlarge Liam restored to full health.

Liam is an inquisitive, cheerful, and healthy nine-year-old boy from Durham.  When he’s outside he likes playing soccer. When he’s inside, he enjoys reading, writing, and playing games and the piano. A few months ago, Liam was looking forward to a fun-filled and memorable Thanksgiving holiday with his family.

It was definitely memorable.

Liam’s parents decided to kick off Thanksgiving weekend a bit early with a trip to the zoo on Wednesday, and take-out for dinner on the way home.  Thanksgiving dinner was to be at his grandmother's house in Sanford.

Liam ate different take-out food from his parents.  An hour or so after eating, Liam’s stomach began to hurt.  After about another hour, Liam was writhing in pain.  A heating pad didn’t help nor did walking around, lying down or changing position.

By 10:00 p.m. on Wednesday Liam felt nauseated.  He started throwing up around 10:30 and by 11 felt a little better, just enough to sleep a bit.

Liam developed a high fever overnight.  Still, Liam managed to sleep until about 6 a.m.  When he woke up, the pain had spread across his entire lower abdomen.

On any other day, Liam’s parents would take him to the doctor.  Of course, on this day his doctor’s office was closed, so at 9 a.m. on Thursday, after telling Liam’s grandmother, “Don’t put the turkey in the oven,” Liam’s parents called a resource they had trusted since Liam's infancy: UNC HealthLink, the after-hours advice line for his doctor's office.

UNC HealthLink is a service of UNC Health Care that has provided after-hours nurse triage to contracted practices across North Carolina for greater than 20 years.  Experienced HealthLink registered nurses provide nurse triage and care advice to patients and families providing access to the appropriate level of care at the right time and the right place when the doctor’s office is closed 365 days a year.

Liam’s parents spoke with Nancy Shaw, one of the nurses at HealthLink. She listened carefully, and asked a series of questions.  Nancy and Liam’s parents agreed – there wasn’t an immediate need to visit a doctor, but that might change. This could be a simple case of food poisoning or a bad stomach bug that would resolve itself, or it could be something more serious.  So Nancy gave Liam’s parents a list of things to look for, and Liam’s parents agreed to call back if things didn’t feel right.

“I clearly remember spending a longer time than usual triaging this child,” says Nancy. “I’m glad these parents had the information and tools they needed.”

By 2:30 in the afternoon, Liam was still in significant pain and still had no appetite.  Liam’s parents called back and spoke with Louise Minnich, another nurse at HealthLink.

“As a triage nurse it is important to listen to parents' concern because they know their child's normal behavior and know when something is different,” says Louise. “I was impressed with the detailed description of physical symptoms and tracking of time related to symptoms the parents were able to provide.  They expressed concern the symptoms were not improving.”

The conversation led everyone to agree that it was time to act.  Louise told Liam’s parents she would be checking in with the doctor on call and would call them back soon.  She left the following bit of advice: “You might want to pack a bag while you are waiting.” 

The HealthLink team reviewed the symptoms with the doctor on call. The description of symptoms and the parents’ observations that something wasn’t right made this an easy decision. While it wasn't completely clear what was wrong, it was possible he had appendicitis – an infected appendix – which could require surgery.

 Liam’s parents got a call back from the doctor and agreed it was time to visit the Pediatric Emergency Department. The coordination among the HealthLink team, the doctor on call, and the pediatric emergency medicine staff had everyone prepared and ready to go as soon as the family arrived.

A resident physician met with the family, ordered tests and examined Liam, confirming the growing suspicion that Liam would need surgery to remove his appendix. The Chief of Pediatric Emergency Medicine also spoke with Liam’s parents, assuring them that they made all the right decisions.

Everyone Liam met spoke with him, not at him or down to him.  The nurse explained and demonstrated the I.V. kit, and offered to let Liam work with a sample of one to better understand it.  The ultrasound technician explained how the equipment worked. The surgeon and anesthesiologist described everything they planned to do and encouraged him to ask questions. Even the patient transport team made sure Liam knew where he was going and made sure he knew the entire staff was there to help him.  Liam's parents said, “We experienced a comprehensive and caring system to address Liam’s medical need.”

Liam had successful surgery on Friday.  Surgeons later revealed that had Liam’s family waited another day, his appendix would likely have ruptured.  That would have meant at least a week’s stay in the hospital and any number of complications.

Thanks to a strong partnership among Liam’s parents, doctors, and the staff at HealthLink, Liam left the hospital on Saturday and was well on his way to a full recovery.

On Sunday, Liam’s family got another phone call from HealthLink – making sure Liam was doing well, that follow-up appointments were scheduled, he had any medication he needed, and if the family had any questions.

Liam’s parents wants to make sure people know about HealthLink and its great team.  “We already knew about HealthLink because our pediatrician’s office already uses it,” they said.  “But people might not know what resources are there if they’re not able to get in touch with their doctor.   When we shared Liam's story with our friends, moms and dads all wanted to know how we knew it was appendicitis since they worry about failing to recognize a serious condition. We said we didn't know what it was initially, but we were able to figure that out by working with HealthLink and the doctors at UNC.”

Liam’s dad sees HealthLink as an important process to get a medical team and a family important information so they can make the best possible decisions.  “Medicine works best when doctors and patients are on the same page,” he says. “That live, back-and-forth discussion was critical.”

HealthLink nurse triage services are available to medical practices that contract with UNC HealthLink across North Carolina. To learn if your child’s practice works with HealthLink, ask your child’s primary care provider. 


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