When Jamie Doss first met his Arkansas Blue Cross and Blue Shield case manager, he was drained- physically and emotionally. Doctors had few answers as to the origin of the pain and creeping paralysis that was gradually robbing him of his mobility. And now, he was being told it was all in his head.
“It upset me,” Doss recalled. “It made me think maybe I was crazy. But deep down, I knew that there had to be something wrong with my back and my legs.”
Doss, 52, worked as a concrete foreman for the city of Fayetteville. He and his wife of 32 years, Priscilla, a home health worker, live in the tight-kit community of West Fork (10 miles south of Fayetteville). They met in West Fork schools and raised three children there. Doss worked outside most of his life and enjoyed playing outside, too.
A confusing diagnosis
But in 2018, after 10 years of worsening back pain, he began a pattern of frequent visits to the doctor, ER and hospital. “It seemed like the more they did, the less it helped,” Doss said. “By 2022, it got to the point where I was crawling around on the floor and couldn’t stand up.”
Doctors, though, could not pinpoint a cause and concluded it must be “conversion disorder” (a label for unexplained blindness, paralysis, etc.). Scans had found a few small nodules on Doss’ spine, and he had diabetes and high blood pressure, but nothing explained the pain and paralysis.
That’s about the time Melanie Dunman, B.S.N., R.N., CDP, a nurse case manager for Arkansas Blue Cross, entered the picture. “I had never seen anyone with that diagnosis,” Dunman said. “But it didn’t take me long to see that this was not in his mind.”
After one particularly frustrating ER trip, Doss’ doctor (also a conversion disorder doubter) urged him to go back and insist that the hospital staff try harder to find answers. This time, an MRI scan found them- large nodules in the cauda equina (Latin for “horsetail”) nerve bundle at the bottom of the spinal column.
A successful spine surgery followed to remove three nodules. But it was not a magic cure. The Dosses face a future that includes lasting effects of disability. Jamie is unable to work. He has limited use of his legs, but he has lost feeling in them, and they can buckle unexpectedly.
Managing care through hard times
While Dunman was glad that the Dosses finally had an accurate diagnosis, her focus turned to helping them regain some of the quality of life they had lost. “Jamie is a very hard worker,” Dunman said. “He is someone who has always been active and took great pride in his work. He also took great pleasure from helping his friends and neighbors and doing the things he loved. I wanted to help him to be able to do as much as possible.” Doss had a standard walker and a second-hand wheelchair, but the walker was inadequate, and the wheelchair was very heavy and difficult to maneuver. For in-home mobility, Dunman secured forearm crutches for more independent movement from room to room. She also helped them get a new, lightweight wheelchair that would be easier for Priscilla to load into and out of their car. She also saved the couple money by procuring the wheelchair before a new annual deductible kicked in. In addition, she helped Doss apply for long-term disability.
Looking to the future
Dunman, who is based in Jonesboro, connected Doss with resources available through the Arkansas Spinal Cord Commission and put him in touch with Disabled Sportsmen of Arkansas. The nonprofit group helps disabled people continue their pursuit of outdoor life. “I think he’s regained a lot of that sense of independence,” Dunman said. “He is seeing now that there is a world out there for someone who has a disability.” “This case reaffirms why I do what I do,” Dunman added. “I have been in healthcare for 33 years, and I still have a strong desire to help people and make their lives better wherever I can.”
Doss said that aside from his wife, who he describes as his “rock”, and support from his community, Dunman’s help and encouragement has been one of the most positive parts of the experience. “You would not believe how big a help she has been,” he said. “She calls and checks on me all the time and helps me communicate with the doctors, and she’s always there to lift my spirits. And Arkansas Blue Cross has been amazing. I don’t know where I would be if I didn’t have them for my health insurance.”