The Good, The Bad and The Ugly of Telehealth For Tulita
A year has passed since Telemedicine went viral. Does it still matter? This is Tulita Ordeñana’s story.
By Roberto Bolaños
“My Facebook, Instagram, and my WhatsApp’s status are going to explode when they see my photo in Paris.” Those were the words of Tulita Ordeñana after taking photos on her first visit to Paris in August 2019 thanks to monetary compensation for injuries. Her first visit to Europe was a dream she had from a very young age, she said with a smile from ear to ear and her curly hair that sparkled as she remembered how delicious it was to “eat real pizza in Italy”, her next stop. What he never imagined was that after a couple of months, France, Italy and Spain were going to close their borders due to the high levels of Covid-19 and his life would take a 180 degree turn as she could not continue with her visits to the doctor and have their physical therapies in person.
Before closing, Ordeñana attended physical therapy 3 times a week since 2018 and consisted of a main doctor assigned by the compensation insurance, a nurse and a nutritionist. During her therapies, Ordeñana performed knee mobilization, stretching, and relaxation exercises using an electric machine placed on her right shoulder and knees. The nurses were in charge of following up on the prescribed medicines and constantly checking her blood and sugar levels since due to her overweight, osteoporosis, and hypertension, she was left in a vulnerable state.
After the closure due to the high contagion of the coronavirus in New York City, Ordeñana lost direct access to her main doctor assigned by her compensation insurance, nurses and nutritionist until a second notice. During the first month of confinement, she was unable to perform stretching and relaxation exercises as her house is very small and she does not have enough space for her routines. Also, due to the confinement, added to the stress of listening to the ambulances go by and seeing the negative news, she gained weight rapidly.
The in-person sessions went virtual in July 2020, after New York City began its partial reopening. For Ordeñana, the experience with Telehealth was not pleasant at all. Her internet connection was not the best when it came to attending her online Zoom appointment. Interaction with her doctor, nurses and nutritionist worsened, first because of the language barrier, as Ordeñana does not speak English and there was hardly ever an interpreter available.
In addition, she did not have someone to correct any errors when doing the exercises, and did not have the electronic devices to relax her knee and shoulder. Ordeñana says that this led to her deterioration and her not being motivated to eat healthy foods. Diseases such as high blood pressure and cholesterol reappeared. For Ordeñana, Telemedicine was more of a headache than a solution.
Ordeñana emigrated to the United States in February 2007, after waiting almost 15 years for a family petition made by her American citizen father, with whom they had basically had no contact since the beginning of the petition. “I daresay it was the only good thing he did at the end of his life. During my childhood I suffered his mistreatment and insults, but in the end, I think it was all worth it, ”said Ordeñana.
For newcomers to this country, adaptation is not an option, or a mandate, the only thing that exists is to work and leave celebrations, birthdays, parties, Christmas aside. “I came to this country and started working on whatever , you know, the one who doesn’t work with eats.” said Ordeñana.
In 2009, Ordeñana got a job as a caregiver for the elderly at the Partners & Care company. Her salary was $35,000 a year, she was finally able to decorate her apartment with items from Macy’s, Target or any other store where she could buy flowers, plates, and other utensils of different colors and shapes.
Within a few months, Partners & Care began assigning Ordeñana to remote locations in Brooklyn, Manhattan, and Upstate New York. Not only did she miss family celebrations because she had to work every day, but she stopped sleeping so she could catch the first train at 5 in the morning to reach her destination. “I started getting up at 4 A.M. to enlist, then at 3:00 A.M. Imagine getting up at that time in winter and eating all that cold,” said Ordeñana.
The job of caring for the elderly includes carrying them, moving their furniture and bathing them, “Mijo, can you imagine carrying people 300 lbs or more? Or take care of people who are the same age? I take care of them, but who is going to take care of me?”
By 2011, Ordeñana began to have pain in her hands, knees, and shoulders. Also due to high levels of stress, and the great physical demands of her job, she began to eat uncontrollably and gained weight. By 2015, she weighed 210 pounds and was walking slower due to knee pain. Her physical, nutritional and mental condition continued to deteriorate until 2016 she had to resign because her body simply gave up. Ordeñana was rushed to the Elmhurst Hospital in Queens for doctors to remove some water from her right knee due to the deterioration of her bones and muscles.
By 2017, after her daughter practically convinced her to speak to a lawyer, her life took a turn. María Odeñana, Ordeñana’s daughter, works as a school teacher in upper Manhattan, teaching natural sciences to elementary school students. After seeing her mother cry out in pain while the water was taken from her knee, Maria decided to seek legal help: “No more, I was tired, irritated, frustrated, I would not allow that to happen to my mother. “
After many consultations and appointments with different attorneys and paralegals from the Ginarte practice, they decided to legally represent her. Within 3 months, Ordeñana’s lawyers referred her to different doctors and all said that she had developed severe arthritis, tear problems in her right shoulder and had no cartilage in her right knee. He needed to get into physical therapy as soon as possible. “I was very ashamed to be honest, I felt guilty about the exploitation that I received in my old job, I said yes to everything!”
Ordeñana immediately began receiving a pension of $ 3,000 a month, plus physical therapy with all expenses paid, and at the end of the case, a large settlement. Everything continued as normal for the next few years, money here, therapy here, shopping every weekend. “I think I’m living the American dream,” said Ordeñana with a laugh.
When she returned from her trip, everything continued as normal. What Ordeñana never thought was that all this would change a couple of months after arriving. “My daughter followed the news a lot and told me that something strong would come, so my quarantine began on March 7, 2020.”
Not only did the drastic change occur with the virus, but also with his compensation case. The Partners & Care lawyer fought hard and managed to lower the pension because she was not attending the therapies, the courts were canceled and she could not have contact with the lawyer who was representing her. “The law is rare in this country, they lowered my pension and I couldn’t believe it, my therapies are over, my purchases are over, and my bank account is bad,” said Ordeñana.
Ordeñana was forced to have her sessions and therapies online. The telehealth sessions were very different and inefficient for the care of Ordeñana’s knees since she did not have her specialist in person to continue with the ligament reconstruction treatment in her knees.
At the beginning of the pandemic, and thanks to the fact that the classes continued on the Internet, María was able to help Ordeñana financially and became her translator when it came to having the hearings by telephone or telemedicine sessions by video call: “Imagine that my mother had passed this pandemic by herself? how would he have fed? who helps her with access to the courts and virtual doctor appointments, ” said Maria.
When the court decided to hold the phone call hearings, Ordeñana lost a lot. The judges could not see their condition and the use of an interpreter was more difficult since the connection was sometimes not very good. “The judge told me that I had to follow my therapies with a doctor through a video call … the judge said something like Telehealth, the first time I’ve heard that in my life,” said Ordeñana.
Due to the lack of direct medical attention, Ordeñana’s knee gave up completely. When the hospitals were able to agree to operate on Ordeñana, after the partial opening, they had to do an urgent transplant of her right knee. While she was mentally preparing for the operation that would take place in February 2021 in New Jersey, Ordeñana said that all this was thanks to the bad decisions she made. “If only I had listened to my other son tell me to eat better, to exercise, to quit that job, maybe we would not have reached this point.”
