Kathy Metcalfe, RN, CCM, CDMS, PSPM, has been a Paradigm Network Manager since 2011. In this four-part series, Kathy talks about her work with Butch Coffman.

Butch Coffman’s story began when he slipped on the ice going to work one winter morning. Over the next 12 years, his condition worsened and he developed chronic pain.

Butch was in severe pain when you met him, but what made his case especially complex and his recovery so remarkable?

Butch was 61 years old at the time I met him, and his injury had occurred many years prior. He didn’t want to talk to me, but his wife answered all my questions and told me he spent most of each day lying in bed. She said he couldn’t even walk within their home without a walker. When Butch did speak, he said he wouldn’t be able to live without his pain medication and spinal cord stimulator.

In addition to this initial resistance, Butch lives in a somewhat rural part of Michigan where healthcare options are limited. His treating provider was an interventional anesthesiologist whom we had to work with as there were no conservative pain management providers in the area, and Butch liked him. This provider simply refilled pain medications every month. When I asked for orders to create a multi-disciplinary team, the physician said it couldn’t be done. Butch had also been seeing a psychiatrist for several years. She prescribed multiple medications for depression and anxiety and enabled Butch to continue the sick role.

To learn more about Paradigm Outcomes and how our Network Managers assist in pain management for our injured workers, visit our website or join the conversation on LinkedIn, Facebook, Twitter, or YouTube.

About the Network Manager

I went to nursing school when I was in my 30s. After six years working in the emergency room, I began a career in case management. When I lived in Florida, back in 2004, I worked for Betty Reid and was dedicated to Paradigm cases. I returned to Michigan in 2007 and Paradigm hired me to join the pain team in 2011.

I have lived in El Paso, Texas, Carmel, Indiana and St. Petersburg, Florida. Two years ago, I bought a house on a lake, and my first boat, in mid-Michigan. The best part about living on a lake is watching my four granddaughters grow up playing here. I volunteer at our community theater as assistant to the prop master, making and managing props for the shows. I am an avid reader. Although I will reach retirement age next year, working for Paradigm Outcomes is too enriching to leave.