Overcoming Extreme Adversity - A Patient's Story

Francisco came in for his first appointment on a day when most businesses were closed for the holidays. However, luckily for him, the Order of Malta Clinic was open and caring for patients.

Francisco arrived to the United States several months prior to his visit as a refugee from one of the poorest countries in Central America. After spending time at an immigration center with no resources, Francisco went to live at his brother’s house. At the time, it seemed like a great opportunity to be able to live with his family, however, it was very contentious, especially between Francisco and his sister-in-law. And even though he found work at a factory in the Oakland area, pay was poor and working conditions were dismal and stressful. Things came to a head on Christmas Eve when Francisco left his brother’s house and slept outside in a park.

Over the course of a few short months, Francisco lost more than 100 lbs. after weighing in at robust 260 lbs. when he arrived to the US. Since living with his brother, he had been getting by on one meal a day, eating late at night, and feeling increasingly weak and unwell. Francisco also suffered from blurry vision and lost his taste and smell. In addition, Francisco developed thrush, a fungal oral infection that produced painful cracks on both sides of his mouth as well as numerous esophageal lesions. Thrush and yeast infections are sometimes a complication of an uncontrolled medical condition.

His first examination included getting a standard panel of bloodwork and a urinalysis. Results were alarming. He had ketosis in his urine, a fasting blood glucose level of 364, and an A1c greater than 14. He also had a total cholesterol of 316 and a handful of other out of range, very concerning results. 

Our Diabetic Nurse Educator (DNE) came in immediately the next day, a day of the week she normally does not volunteer, to help Francisco. He was put on life saving Tresiba insulin, given a Clinic provided glucometer and test strips, and educated on how to test blood sugars and properly manage diet and food.

We learned at this time that Francisco was fired because he missed work when he came to the Clinic the day prior. It devastated him and he broke down as he told us his story and the anxieties he experienced because of his lack of financial resources. Because he had no income, we provided him with information on local food programs and food banks. In addition, we could sense his despair and gave him a few $50 community program grocery gift cards that the Clinic had left over from public vaccination efforts. And all of this was done with the help of Clinic translators, as Francisco speaks almost no English. 

When Francisco came back 10 days later, for primary care and DNE follow-up, he had gained 5 lbs. and was back at his brother’s house. Francisco’s wife Maria had also just arrived to the US a couple weeks prior, and now accompanied him to his appointments. Sadly, we learned that Francisco had not picked-up his anti-fungal medication to combat the thrush, since he didn’t have the $17 to purchase the prescription. This was taken care of immediately, so he could go get the medication from the local Safeway pharmacy. Luckily however, because he had been managing his diabetes, the fungal infection subsided a bit as a result.

During his second visit with our dedicated DNE, Francisco received a Freestyle Libre 2 Monitor and sensors, the latest in technology for real time glucose data and monitoring with no finger sticks. This was all made possible by the funding and support from the John Muir Health Community Partner Benefit program.

The Clinic provided Francisco and his wife with additional grocery gift cards to help supplement their diet while they waited to join local support programs in the community.

Francisco’s fate could have been very different had the Clinic not intervened and provided him with much needed care. At this point in Francisco’s road to recovery, the Clinic will continue provide care for both him and his wife, until they can access health care coverage of their own. Francisco and Maria’s story is complex and requires more time and Clinic resources, however, it is one of the many stories that hear at the Clinic.

Brewing a cup of hot tea for Francisco and Maria while they waited for their appointments and shaking their hands as they tried to express thanks, more said with their eyes than with words, was truly an honor and an encounter to be remembered.

‘For I was hungry and you gave me something to eat…I was sick and you looked after me.’  – Matthew 25:35-36

Names and some details have been changed.

By Anne Brussok, DM