Breast Health Navigation Program Patient
Breast Health Navigation Program Patient
Liliana Gonzalez is a 49-year-old woman who came to New Haven from Venezuela with her husband in 2016. They moved to be closer to their daughter, who is a student at the University of New Haven, and to escape political turmoil in their home country (they have applied for political asylum). Her husband works at a local restaurant, often working long shifts into the early morning to make ends meet. She is a freelance writer who worked as a journalist in Venezuela, but has mostly had unpaid jobs since relocating to the U.S.
Ms. Gonzalez does not have health insurance, so when she noticed a lump in her breast, she was hesitant to go to the doctor. However, she learned about Fair Haven Community Health Center (FHCHC) and decided to make an appointment. On January 25th, 2018, she saw a midwife at FHCHC who noted the mass on physical exam and ordered a mammogram. She had a mammogram on February 5th that showed an abnormality and a biopsy on February 9th that confirmed a breast cancer diagnosis. She was referred to PA-NH and enrolled in our Breast Health Navigation Program. Within three weeks of her diagnosis, Ms. Gonzalez completed breast cancer staging studies (including CT scans of her chest, abdomen, and pelvis, and a bone scan), had initial consultations with medical and surgical oncology, received genetic counseling and testing, and began neoadjuvant chemotherapy (i.e., chemotherapy given prior to surgery to shrink a tumor). After completing chemotherapy, she had a partial mastectomy and is now undergoing radiation therapy. She has also had several appointments with the Smilow Cancer Hospital at Yale New Haven’s Cingari Family Boutique, which provides support services to cancer patients to help them feel comfortable with their appearance during and after cancer treatment.
To-date, PA-NH has navigated Ms. Gonzalez to more than 75 appointments with no “no-shows.” All of her care has been provided free of charge through our Volunteer Provider Network, primarily through our relationship with Yale New Haven Hospital and the Smilow Cancer Hospital at Yale New Haven. Ms. Gonzalez has complied with all of her oncology care to-date and is responding well to treatment. She agreed to share her story and provided the following testimonial via interview with the PA-NH Program Coordinator. The interview was conducted in Spanish, translated into English, and excerpted below:
“I learned of Project Access from the Fair Haven Clinic after being diagnosed with breast cancer. I was devastated with the diagnosis of my illness. I live with my husband and daughter and we did not have the slightest idea of where to go for help and support. We do not have the means to cover the medical costs and we did not know how to deal with everything required by my cancer treatment. Feeling that I could receive help and financial assistance from Project Access gave me hope to live.
The Project Access staff are always attentive and willing to provide help and information. When I receive their calls to remind me of my medical appointments, they are always very kind and willing to guide me. I appreciate all of their support. I was able to see a doctor quickly and I am currently being treated at Smilow. Since enrolling in Project Access, I have received medical attention from an oncologist, a breast surgeon, many nurses, and other medical personnel. Everyone has been very nice and my experience with Project Access and my doctors has been excellent.
Without Project Access, I would not be able to pay for my treatment. Before knowing about Project Access, I found myself in an unsustainable state of distress thinking about the possibility of dying with a cancer that does not stop, instead it continues to grow and reproduce. My mood got better and I felt more hopeful about the future thanks to Project Access. The difference is immense – I am very thankful for Project Access.
I am a writer and journalist. I write for various media outlets in Venezuela and Connecticut. Currently I find it hard to write because of my health, but I hope I can get back to work.
From heaven to earth, thank you Project Access. My family and I feel confident, protected, and supported in this difficult stage of our lives. I am very grateful for all the staff of Project Access, as well as all the people and institutions that collaborate with this program to provide help to people like me who need medical care.”
Project-Access New Haven Patient
Miguel Gomez is a 51-year-old man who was referred to Project Access-New Haven (PA-NH) from Fair Haven Community Health Center due to an infected mass on his left foot. He was referred on February 9, 2016, met with a PA-NH Patient Navigator for an intake visit the following morning, and had an MRI of his foot at Yale-New Haven Hospital’s (YNHH) Diagnostic Radiology facility at Temple Medical Center later that afternoon. He had an initial appointment with a podiatrist approximately one week later, at which time he was scheduled for pre-operative testing and surgery. Mr. Gomez was admitted to YNHH on March 11th for ambulatory surgery to remove and biopsy the mass. He was followed post-operatively by his podiatrist and also seen by an infectious disease specialist. One of the tests recommended by his infectious disease physician could only be conducted by a specialized laboratory outside of the YNHH system. PA-NH requested charity care coverage from the laboratory and helped Mr. Gomez complete the application paperwork (Mr. Gomez only speaks Spanish and the paperwork was only available in English). He has also been treated with antibiotics and pain medicine, which have helped him regain the ability to walk without pain or discomfort. He agreed to share his story and spoke with a PA-NH Patient Navigator about his experience in August 2016. The interview was conducted in Spanish, translated into English, and is excerpted below:
“I have been having problems with my foot since 1990. I was treated in Mexico for some blood that was inside my foot and was becoming like a mass on my foot and it was painful. I had two surgeries, but the doctors were not sure then what was causing my problems. When I migrated to New York in 1994, I started having the problem again. I went to see different doctors, but none were able to help me because they said I needed insurance to get more tests done. I was very frustrated because I knew that I needed help, but I wasn’t able to get it being uninsured and I didn’t have the money then or now to pay for the doctors visits or the tests.
I was also going through some difficult times with my marriage and decided to move my family to Connecticut to have a fresh start. Moving to Connecticut made the situation worse for me. My wife left and I had to take care of three children (now 21, 18, and 15 years old). My oldest daughter had always needed medical attention, as she was born premature and had 10 surgeries already. I felt devastated, but I kept on going because of my children. While taking care of my kids, my job, and trying to keep going with life, my foot just got worse and worse. I have cried so much out of pain that even customers at my car wash job tried to help me with pain killers. I missed a lot of days from work. Because my boss has seen me in so much pain, he understood and never gave me a hard time. The pain was so bad that I thought of cutting my foot off. I just couldn’t take it anymore. But I kept thinking of my children and how they needed me to work. My oldest daughters had to bring me to the emergency department several times. The pain was so bad that they had no choice but to bring me. I would cry to them in desperation.
I started going to Fair Haven Clinic to get help for my foot. The doctors weren’t sure what to do or how to help me since I had no insurance. I was losing hope and I prayed to God to give me strength to keep going for my kids. The same day that I left Fair Haven Clinic feeling hopeless was the day that I received a call from you guys at Project Access. I thank God for sending you to save me. I couldn’t do it anymore. I couldn’t walk and bear the pain. The infection on my foot was so advanced that the pus was coming out and burning me. My foot was so swollen that I went from a size 10 to a 12. And then you called me and you gave me hope. I am happy now, I can work. Every day I go home and have dinner with my kids and I am no longer in pain. The doctors are still trying to figure out what causes this, but I am ok now. They told me my foot might stay the same size as it is still swollen, but that’s ok. I have no pain. The medicine is working and I am ok. I have no words to thank you. You are saviors and I will always be grateful for your help. If there is anything I could do to pay you back I would. It has been very difficult for me and feeling better and having no more pain has saved my life.”
Breast Health Navigation Program Patient
In 2017, I started having sharp pain in my breast and my primary care doctor referred me to the free mammogram van. The mammogram showed some inflammation and I was referred to Project Access to help me have more tests. I was told that everything was ok and to have another mammogram in a year. In 2018, I repeated the mammogram and this time they found something. I had a biopsy and was told that I had cancer.
After my diagnosis, I went into a state of shock. It felt like I had the weight of the world on my shoulders and my life was over; I wanted to give up. All my family is back home in Peru and I am separated from my daughter’s father. All I could think about was my young daughter growing up without her mom. I did not leave my house for days. I was in a dark place. My daughter could tell something was wrong with me, but she did not know what and I had no idea how to tell her.
I have a friend who became a sister when I told her about my diagnosis. She has been there for me and my daughter – she has taken me to appointments, cooked for us, watched my daughter so I could rest after treatments, and been a shoulder to cry on. She encouraged me to leave my house and face this challenge God put in front of me.
The staff from Project Access always has made me feel like they genuinely care about me and love me. They helped me get appointments scheduled right away after my diagnosis. When they call to remind me of appointments, they ask how I’m feeling or if I need anything else. I really appreciate those calls. I work part-time at McDonalds and sometimes with treatment, work, and my daughter, I would forget about my appointments. I feel like I have a personal alarm clock that will not let me forget. When they call me after my appointments, they care and take the time to listen to me. I do not know how I would have ever gotten treatment without Project Access supporting me.
The staff at Smilow has also been wonderful and so kind to me; everyone makes me feel so loved. In the last six months, I have had surgery and radiation therapy and I am scheduled to see my doctor in May to start Tamoxifen.
I have a new view on life. I feel loved by many people and want to enjoy every day and live it to the fullest. To anyone who is going through cancer, I would tell them don’t be afraid or try to hide. Talk to people and ask for help. Love yourself and your family, be happy and enjoy the moment, those memories will always be with you. God has gifted us another day to live we have to live it to the max.
– Elizabeth Chalco, Project Access-New Haven Breast Health Navigation Program Patient
Urgent Specialty Care Patient
Sergio is a 35-year-old man who suffered from nasal congestion for many years. His primary care doctor at Fair Haven Community Health Care treated him with medications with little improvement. By the fall of 2019, he was having significant difficulty breathing, frequent headaches, and chest tightness. He could not sleep because of his breathing issues and had to reduce his hours at work because he was often tired and out of breath. His doctor referred him to PA-NH for an otolaryngology (ENT) consultation. He met with a PN to enroll in PA-NH on October 9 th and had an appointment at Southern New England ENT on October 18 th . His ENT ordered a CT scan that confirmed the need for surgery and performed nasal surgery at Yale New Haven Hospital in early January. After surgery, Sergio’s breathing and quality of life improved considerably – he has been able to sleep, increase his hours at work, and participate in activities with his family. He agreed to share his story and provided the following testimonial via interview with the PA-NH Program Coordinator. The interview was conducted in Spanish, translated into English, and excerpted below:
“I have been suffering from sinus congestion on an off for over ten years. I would take over-the-counter medication and that would help the symptoms for a few days. About a year ago, I felt the medication was no longer helping. I went to Fair Haven [Community Health Care] and my doctor started treating me with Flonase and antibiotics again. The symptoms got better for a few days, but then I was stuffy again. I was unable to sleep because I could not breathe. I had to cut my hours at work because I was so tired and could not breathe.” “I was shocked to get a call from Project Access telling me that you may be able to help me. I was happy to learn
that my doctor had referred me and I would finally be able to see a specialist.
Everything has been perfect – I am so happy to have found Project Access. I am grateful for the calls reminding me of appointments and checking in with me after the appointments. You do an excellent job helping people. Project Access got me an appointment quickly with an ENT (at Southern New England ENT). The staff there have treated me good and have been very helpful. At my first appointment, the doctor told me I would need surgery and he sent me for a CT-scan to confirm. After the scan, he confirmed I needed surgery and prescribed medicine to help my symptoms while I waited for the surgery.”
“Before the surgery my nights were very long – I could not sleep. After surgery, my life changed. I am able to work more and I have a better quality of life, thanks to God. I have less stress because I can breathe. It is easier to do my daily activities and to spend time with my son and do things with him. God sent you to help me. I will always be grateful and thankful for Project Access and the doctors who have helped me.”