Telemedicine and Horizon’s interpreter services have played a pivotal role in the treatment of Tin Aung Thein.
Thein moved to North Carolina from Burma in February 2022. He learned he had chronic kidney disease in 2003. He saw a doctor in North Carolina but not a kidney specialist. Due to his health, he stopped work and stayed home to take care of his children. A family member told him about Horizon.
As a federally qualified health care center, Horizon providers see all patients, regardless of their ability to pay or insurance status. Once Thein was referred to the James Valley Community Health Center in Huron, he began regularly seeing provider Len Wonnenberg, PA-C.
Wonnenberg was able to connect him with a specialist at Sanford Health in Sioux Falls and Dr. Tina Melanson, a nephrologist at Prairie Lakes Hospital in Watertown. Thein speaks with the specialist via an interpreter at the James Valley clinic. Karen interpreter Aye Aye helps Thein interact with his specialists and Wonnenberg.
Because Thein has no way to get to out-of-town appointments, telemedicine, also provided by Horizon, has been an invaluable tool in his care. Since he can ride the bus to his appointments, he has seen a specialist two or three times, Thein said. Wonnenberg meets with the specialists at the same time to better coordinate his care. This is a rare privilege for the general practitioner and specialist to be able to confer in person.
“It makes for awesome care,” Wonnenberg said.
Horizon has a contract with People Transit in Huron to help bring patients like Thein, who lack transportation, back and forth to their appointments, making it easier to stay on track with their treatment plan.
Thein hasn’t had formal care with a nephrologist, or kidney specialist, since moving to the United States. He is facing a future of dialysis treatments for his late-stage kidney disease. Wonnenberg said Thein is aware of this. His next step is visiting with a vein specialist to prepare to receive the treatments.
Thein’s access to care in Burma was different to the relatively convenient access he has now. He said in Burma, if he could pay for the treatment he could go to the doctor. He would see different doctors who would prescribe him different medications based on his test results. Often their efforts revolved around increasing his potassium levels, which Thein said had always been low.
“If you can afford it, you get the care, if not you do not receive the care you needed,” Thein said. “Sometimes it’s hard.”
Thein speaks a little English, Wonnenberg said and is very educated. The interpreter service offered at the James Valley clinic is instrumental in providing quality care, he said. Aye Aye not only helps patients communicate, but she is a great patient advocate for the Karen-speaking people.
“They know resources for the Karen I don’t know,” Wonnenberg said. “They (the patients) feel very comfortable coming to her, to work with the interpreters, because they get to know them on a one-on-one basis.”
Wonnenberg said through working with the interpreter to speak to Thein, he is learning things as well.
“He teaches me about the people from Burma, about his life experience and I’m able to share a little with him and then carry that over to other people who might be in a similar situation,” Wonnenberg said.
Right now, the clinic staff and his specialists are trying to provide treatments that will buy him a little time before dialysis is necessary, or he finds financial assistance to pay for it. Dialysis has to be done at a hospital and is expensive, Wonnenberg said. If the kidneys cannot work correctly to rid the body of toxins, that can cause kidney and heart failure, Wonnenberg said.
“By working closely with Dr. (Tina) Mellenson and having resources in-clinic, we are able to avoid having those bad things happen,” Wonnenberg said.