How member Michelle Williams listened to her gut—backed by a Regence care manager—and changed her life

Regence member Michelle Williams (above) had been feeling off for weeks. She couldn’t explain the dull discomfort in her abdomen below her right rib. Then one night, the pain hit.

“It was like I wanted to throw up and pass out at the same time,” she recalls. “I started seeing white circles. The pain was so acute that I couldn’t tell my husband what was happening. I didn’t know what to do.”

Her husband rushed her to the emergency room (ER), where doctors ordered a CT scan but found no clear answers. Her pain subsided. The doctors asked her to return to the ER within 24 hours, but that examination didn’t result in a diagnosis either.

“The ER doctor literally said, ‘I’ve got nothing for you,’” says the Washington resident. She was sent home and told to follow up with her primary care doctor. Williams suspected a gallbladder attack, where gallstones block the organ’s normal functioning. She felt a “stretched balloon” sensation in her upper abdomen. But the earliest appointment she could get was three weeks away. 

Professional, compassionate advocacy

That’s when Kadi J. called.

Kadi J., RN, CCM, is a nurse care manager with Regence. She contacted Williams after being alerted to claims from the member’s two ER visits.

Kadi shared Williams’ suspicions and gave her information about the dangers of untreated gallstone blockage and the serious, life-threatening risk of abdominal inflammation and sepsis. She pointed out that an ultrasound—not a CT scan—is the appropriate diagnostic tool to identify gallstones, and encouraged Williams to call her doctor’s office and advocate for an earlier appointment.

“She never said, ‘Why didn’t you speak up?’” Williams says. “She just said, ‘I think you should listen to what your gut is telling you. And if you’re uncomfortable advocating for yourself, I’m happy to do it for you.’”

That affirmation and offer of assistance made all the difference. Williams called her doctor’s office, mentioned she was symptomatic and working with a case nurse, and was seen within days. An ultrasound confirmed what they suspected: a severely inflamed gallbladder full of stones. Surgery was scheduled for six weeks out. At Kadi’s urging, Williams called the surgery scheduler back; after explaining her active symptoms, the scheduler booked her surgery for the following week.

On May 1, Williams had her gallbladder removed. The recovery was smooth, she says, and she hasn’t looked back.

“I felt super empowered”

“I honestly would have just accepted whatever the doctors and the schedulers told me,” Williams says, reflecting on the experience. “I grew up not questioning doctors or anybody in positions of authority. I wouldn’t have advocated for myself. Kadi gave me the confidence and the knowledge to push back. I felt super empowered because I had a medical professional—a registered nurse—backing me.”

Another advantage, Williams explains, was having a consistent, reliable person to help her navigate her care journey. “I had two ER doctors, my primary care doctor, the radiology technician, the surgeon, the surgical nurses, and the schedulers,” she says. “It was really comforting to have one person, Kadi, help me navigate it all because it was overwhelming. Who do I call about this? Do I call the number or do I send a message through the patient portal? Kadi helped me with all that and made the process way smoother.”

With support from Regence, Williams avoided hospitalization for a life-threatening condition and saved $47,580 in inpatient healthcare costs.

Healthier than ever

At the same time, conversations with Kadi sparked a broader health transformation for Williams. Kadi shared information about resources available through her plan benefits such as Vida, a personalized weight management app, and Hinge Health, a virtual physical therapy solution, which Williams decided to explore. She’s since lost eight pounds, started taking daily walks on her work breaks, and completely changed what she eats throughout the day.

Williams, who turned 60 this year, says she feels better than she has in years, and she’s become something of an unofficial ambassador for Regence Care Management at work.

“I keep telling people, ‘This is free,’” she says. “’You don’t have to wait for them to call you. You can call them.’”

She adds, “It was professional and compassionate advocacy that I didn’t even know was available to me. It changed my life.”