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The difference you can make when you're all for health.

Coordination of life-saving care helps young family heal

Katie and Matthew were preparing to welcome their second child into the world when Katie began to feel ill. When it became clear Katie had a rare, life-threatening disease, their world turned upside down.

Katie ended up in the care of doctors at Lehigh Valley Hospital who coordinated with Highmark on her treatment. Together, they worked tirelessly to ensure she was able to get all the complex tests and procedures she needed. And that they would be covered.

This family of 4 is Living Proof that when your care and coverage work together, you can focus on healing.

Mysterious symptoms

Katie thought her chills, sweats, and headaches were from the flu. Or perhaps they were hormonal. She was 26 weeks pregnant with her second child, but otherwise healthy.

When her symptoms began to worsen, her family convinced her to go to the local emergency room. The doctors ran some tests, but didn't find anything unusual. Matthew asked Katie's OB-GYN, Hussain Ali, MD, to take a look. He suspected something was seriously wrong. He arranged for an ambulance to take Katie to Lehigh Valley Hospital, which was better equipped to handle this situation.

Once she was admitted, her condition quickly declined. She started to have trouble breathing and began to lose consciousness. Doctors needed to stabilize Katie's condition and reverse the inflammatory response her body was experiencing. So they put her in a medically induced coma. Katie's organs then began to shut down.

Matthew, couldn't believe what was happening. A school teacher, he was due to start school that week, but this wasn't a normal week. "Every step of the way, it was the worst-case scenario," he said.

Care and coverage working together

But the collaboration between Katie's health care team and her health insurance couldn't have gone better.

"This was an example of perfect coordination between Highmark and the hospital," said Highmark Manager of Care Management in Utilization Review, Matthew Taylor. "Everything went extremely smoothly because we worked so closely together. And because Highmark was so proactive, it enabled Matt to focus on his family, rather than his insurance coverage."

And Matthew was able to concentrate on the quality of care his wife was getting. "Everyone we were involved with at Lehigh Valley went above and beyond. They are a special kind of people over there," said Matthew.

A proud moment

In order to save both mother and baby, doctors needed to attend to them separately. They decided to deliver baby Jacob, even though he was 12 weeks premature. It took doctors 3 minutes to perform a cesarean section.

"It was a made-for-TV moment. It was the first time I got to see my son," said Matthew. "Everyone was optimistic about his condition."

Within hours of Jacob's birth, doctors connected Katie to an extracorporeal membrane oxygenation (ECMO) machine to help keep her heart and lungs functioning. All the hospital staff members in the wing were pulling for Katie and Jacob, according to Matthew. They were relieved to hear that both patients' conditions were stable after both procedures.

A diagnosis

The teams of doctors tending to Katie continued to run tests so they could understand what was causing her body to fail. High levels of ferritin in her blood tipped them off to a diagnosis. Ferritin is a protein in the blood that stores iron.

Infectious disease specialist, Aylin Colpan, MD, realized Katie had hemophagocytic lymphohistiocytosis (HLH), a rare condition where your immune system doesn't work properly. Some of your white blood cells start attacking other blood cells. It is more common among infants and children, and not often seen in adults. HLH can be genetic, but it can also be triggered by an infection, cancer, or a rheumatoid condition.

The next step

The next step was figuring out how to help Katie. Hematologist-oncologist Brian Patson, MD, took over Katie's treatment. He was determined to find out what caused the HLH. But he didn't overpromise.

"I met with the doctor and we were talking percentages of survival," said Matthew. "It was the worst day of my life."

Katie's body then began to bleed internally. "She had to go into the emergency room three times that day," said Matthew. "Each time, I wasn't sure if she would come out alive."

Katie was given chemotherapy and heavy doses of steroids to bring down the inflammation. This would help her organs regain function.

Three weeks later, Matthew got the call he had been hoping for. Katie woke up from the coma. "A month after she was hospitalized, she walked out of there," he said. And one month after that, they picked up baby Jacob from the neonatal intensive care unit.

Easing into recovery

While doctors were treating Katie, hospital bills and health insurance were furthest from Matthew's mind.

"Once she started getting better, it became the reality," he said. Luckily, Katie, who is also a teacher, has excellent coverage from her school district. "You don't think you'll need to access those services in your 30s."

So when Matthew called Highmark customer service representatives to go over what was covered, "They took the pressure and anxiety out of the process. The hospital and Highmark meshed well together," said Matthew. “

And with the level of follow-up care Katie required and a new baby at home, Matthew appreciated the simplicity. "It was amazing. There was such a level of attention to detail. Everything was coordinated so well," he said.

Lehigh Valley Health Network and Highmark recently began working together to improve the overall health care experience for members. For Highmark members with the Lehigh Valley Flex Blue plan, it's now easier to access high-quality care and preventive services that are affordable. They generally have lower out-of-pocket costs when they choose doctors and hospitals that participate at the Enhanced Value level of benefits.

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