July 2009

A good night's sleep

After many sleepless nights, Jane* decided in January to enroll in TVA’s Informed Care Management program, administered by ActiveHealth. She soon began scheduled discussions with her nurse health coach, Caryn Ronzio. Now Jane looks forward to a good night’s sleep.


Registered nurse Caryn Ronzio: “What a pleasure to work with a member who follows through on suggestions that improve her life and have a positive impact on the rest of her family.”

Jane is the 60-year-old wife of a TVA retiree. She lives with several health conditions, including peripheral neuropathy, hypertension, osteoarthritis and chronic low-back pain; and she was recently diagnosed with type II diabetes.

With help from Ronzio, a registered nurse, Jane learned about a low-sodium diet, how to read and understand food labels and use a glucometer to check her blood glucose levels. Working together, they set goals for Jane to change her lifestyle by adding 30 minutes of activity three times a week, counting carbohydrates and limiting food portions at meal times.

Also, based on her conditions, Ronzio talked with Jane about the warning signs of stroke and myocardial infarction and the symptoms of hypoglycemia and hyperglycemia.

“After learning Jane’s symptoms, such as shortness of breath and lack of energy, and her continued high blood-pressure readings in relation to her poor sleep pattern, I talked to her about the need to discuss sleep apnea testing with her doctor,” Ronzio says.

Encouraged by Ronzio, Jane talked with her doctor, who ordered sleep-apnea tests that showed she had severely compromised oxygen levels — 64 percent — at night. Target levels should be 90 percent and above. The tests revealed that an overwhelming majority of the night, Jane was awake or not sleeping adequately due to low oxygen levels. She is now being fitted with oxygen-therapy support, and she followed her doctor’s recommendations to complete comprehensive lab tests and adjust her medication.

Now 10 pounds lighter, Jane says, “I want to be an example for other TVA members so they can see what working with a nurse health coach can do for someone. It was very helpful to take a letter with details of what Caryn and I discussed to my doctor so he would have important information I may have forgotten.”

Ronzio says it is easy to work with a nurse health coach. “We are here to support the conversation between you and your doctor, not replace it. We work with members to identify practical steps they can take to improve their health.”

*Jane is a pseudonym for a spouse of a TVA retiree who wants to remain anonymous.



The Informed Care Management program is voluntary and available as part of TVA’s medical-benefits program for employees and non-Medicare retirees.

You can participate in ICM if you or a dependent have any of these conditions:

• Asthma (adult and pediatric)
• Chronic low-back pain
• Congestive heart failure
• Chronic obstructive pulmonary disease (COPD)
• Coronary artery disease
• Diabetes (adult and pediatric).

You can reach ActiveHealth at 1-888-227-6859. ICM nurses are available 8:30 a.m. – 11 p.m. Eastern Time, Monday-Friday and 9 a.m. – 2 p.m. ET, Saturday.

All information is confidential and is not shared with TVA.