Dr. Boyce and aftercare

[SJB41976]

So, I'm not really good at smiling and nodding, and that is what I keep reading for most aftercare for DS, including Dr. Boyce.

So, do they do correct labs? Are they open when you say I want "such and such" lab done? Are they supportive when you say you are following a different vitamin regimen. What exactly is that process like? Do they freak out if something is too high or low or question why you are taking such a high dosage of whatever. Just wanting to know what that is like.

When I have had aftercare before I had to write out a food diary...if I'm eating like a DSer and they think I need to eat like an RNY what comes from that meeting? I don't need anymore guilt. At my old doctor (with the band) they wanted us to eat 400-600 calories a day because that's why RNY are supposed to eat in the losing phase. I thought that was ridiculous, especially since I had all of my stomach and felt HUNGER. lol.

The other stuff I think I could handle, follow-up wise, if it's like most after-care. I won't be going to many meetings because I live out of town.

Any other things you find useful about what you have experienced in aftercare (Boyce or not) I would love to hear it.

Thanks!
Susan

 

[southernlady]

So, do they do correct labs? Are they open when you say I want "such and such" lab done? Are they supportive when you say you are following a different vitamin regimen. What exactly is that process like? Do they freak out if something is too high or low or question why you are taking such a high dosage of whatever. Just wanting to know what that is like.

The labs they pull NOW are a pretty comprehensive list EXCEPT they don't do an a1c or a lipid panel as "your PCP handles that".
They WILL push the vitamins sold by his office but as long as your labs are in good shape, they will accept that you are taking other brands. It's just other brands don't line his pocket.
After you get out of the hospital, do not EVER expect to see Boyce again. Only reason I did was due to my gallbladder going south 6 months later. In fact his staff will say if you want to see him post-op, you have to request an appt with HIM. Otherwise it is just his staff.
Try to get follow ups with Krystal not Clara. Krystal still pushes the "party" line but doesn't get weirded out when you don't.
IF your labs are DS normal, how can a dose of vitamins be too high or too low? That's like a PCP I was trying when we first moved here told me I didn't need cytomel (a thyroid medication) cause my values were normal...hell, they were normal BECAUSE I was taking the medication. I fired him.
Since you are out of town, get your PCP on board as fast as you can to pull needed labs. Once healed, you really do not need a surgeon for follow up care.

 

[SJB41976]

I don't care about seeing the surgeon, but if I am paying them what-- 3,000 fee for 1 year of aftercare-- is that what that fee is for? I can't remember. I know I get 1 year of follow-up, that may be included in the self-pay bundle? Not sure.

I wouldn't care to ever go back after immediate follow-ups after surgery to make sure I am healing, but if my labs are going to paid for I will use them.

Thanks @southernlady for the info.

 

[southernlady]

I don't care about seeing the surgeon, but if I am paying them what-- 3,000 fee for 1 year of aftercare-- is that what that fee is for? I can't remember. I know I get 1 year of follow-up, that may be included in the self-pay bundle? Not sure.

I wouldn't care to ever go back after immediate follow-ups after surgery to make sure I am healing, but if my labs are going to paid for I will use them.

Thanks @southernlady for the info.

You need to balance the cost of going to get labs done by them (even with a few missing) or staying local and having a copay thru your PCP.

I don't think labs were covered but I would have to dig thru my bills from that time frame to find out. If they were, I think they charged the insurance and the copay was covered not the entire amount.

 

[Charris]

@southernlady Can she just get them to email her the required lab script and she has them drawn locally. That's what Dr. K does a week before my visit. Then I have no copays

 

[southernlady]

@southernlady Can she just get them to email her the required lab script and she has them drawn locally. That's what Dr. K does a week before my visit. Then I have no copays

They USE to do that but not sure if they are allowing that now. But @SJB41976 that is a question worth asking.

 

[Charris]

@SJB41976 I like to get it in advance so the results can be actually discussed when I'm right there with the doctor. I hate having to listen to a message about my test results.

 

[SJB41976]

Thanks, ladies!

 

[duh_Mom]

Hey @SJB, I have been traveling for business so coming late to the discussion. I am currently active in the after care of Dr. B's office. My experience is just a bit different and likely your experience will be different than mine. The aftercare cost is 1800 and as far as I know is not negotiable, I guess I did not realize that it includes the cost of the labs - I had my 4 month labs drawn about 3 weeks ago at the hospital and have not received a bill.
I have seen the nutritionist 2 or 3 times and the exercise physiologist once - The EP it was her first week and was a waste - the nut I saw first was Ciara but the next 2 times I ended up with Krystal quite by accident - my NP visit took longer than expected so Ciara was busy.

As you check in you fill out papers - papers papers papers - there is always papers - but I digress - the papers ask if you record your food and then is asks for the average intake of carbs, fats, and protein. I am honest when filling that out - then it asks if you record your food and how often a week. the last time I went in I was honest and said was not doing it - was in a bad place - but that is another discussion. Krystal did not mention it - I did - I explained how I switched up my food here and there to make sure I was getting a big hit of protein in the early am - bacon alone was causing me to be hungry later in the day. She suggested I look at something other than bacon as it did not have much protein - I told her exactly how much it had and that was the end of that conversation.

As for the lab - if you refer to my post on Barilife and labs you can see on the spreadsheet exactly what they order. They pulled a lipid profile, but not an A1c. I am not diabetic, but it was elevated pre-op and I want to know what it is. I will ask her to order it next time. The papers to ask you to record exactly what you are taking for supplementation. Next time, I will take my print out - I am so not writing all that down. they do 'manage' the labs if done at Tennovva or I think it is Lab Corp. Otherwise they won't. They give you yet another piece of paper initially that tells you that. They emailed on the portal an told me to increase my Vit K. The email gave all kind of warnings about not having adequate intake.

They have been very receptive to order what I have requested - from CT scans to additional meds, so I honestly don't expect there to any push back on requesting specific labs. It will be interesting to see if your experience is different, so for sure keep us posted. I bet they would give you an order for the labs you want to get close to home but of course you would have to pay for them.

At my first Nut appointment I did see Boyce - they went and got him to discuss some challenges I was having totally unrelated to nutrition. I had some serious complications.

The one challenge I have had is with billing - my insurance paid for the lap band removal so I got a bill for my portion of that procedure - it was 1100 dollars and I was quite surprised! I thought the upfront amount paid for 100% of everything. I spoke with the office and they ended up speaking with Boyce who told them to write it off. I also got bills from cardiologist for visiting in the hospital and reading EKGs. I got bills from radiologist for reading scans and X-rays. Again, I called the office and they had me send them my insurance info - I did fully expecting it to be declined but they paid it. I was pleasantly surprised. Just last week the office called asking about some additional radiologist bills that they were called about. They keep referring to my second surgery that I had as a hernia operation - well it was a hernia in that my bowel was herniated thru one of the trocar sites from the original surgery otherwise called and incarcerated bowel. (sigh) So far i have not had to take that on because Dr. B remembers and when they ask him about the $$ he tells them to write it off.

well now that I have written a novel . . . I wish you great luck and will of course be following your journey. I don't think you will have to fight and bicker with the Nuts but we sure do want to hear about it however it goes.

 

[southernlady]

As for the lab - if you refer to my post on Barilife and labs you can see on the spreadsheet exactly what they order. They pulled a lipid profile, but not an A1c. I am not diabetic, but it was elevated pre-op and I want to know what it is. I will ask her to order it next time. The papers to ask you to record exactly what you are taking for supplementation. Next time, I will take my print out - I am so not writing all that down.

Glad to see them pulling the lipid profile now. Be interested to see if they add the a1c for you. Let us know.

Back when I had my last set of labs pulled there, I was told that my PCP could pull the lipid profile and a1c (and I was/am diabetic as WAS on an insulin pump pre-op). Since I was having my a1c checked every 3 months back then as per the American Diabetes Association recommendation) I saw that as unnecessary. Why have TWO lab pulls when ONE could cover all of it. I fought them on getting them to send the lab slip too my PCP who was in a different hospital system (not Tennova). I'm glad we moved away as now I can just get my current PCP to pull all of it.

A Williams patient (he's Boyce's partner) is about 2 years out and they will not give her a lab slip unless she sees a nut. She is a 2 hour drive away from that office and her insurance does not cover the cost of a nut and she is over two years out now, she is beyond frustrated as a nut visit isn't needed to get her labs. She is capable of reading them for herself.

 

[Moonbeam]

I searched and found this post. I know it's old, but I thought I would follow up to see how it is going now for you. I am in North Georgia and thinking of using Dr. Boyce since I can't find any doctor that will take an in-state patient here in Georgia. It will be 3 hours away from me. Let me know how you are doing, thanks!

 

[writegirl]

I searched and found this post. I know it's old, but I thought I would follow up to see how it is going now for you. I am in North Georgia and thinking of using Dr. Boyce since I can't find any doctor that will take an in-state patient here in Georgia. It will be 3 hours away from me. Let me know how you are doing, thanks!

@Moonbeam I think I referred you to this group (Hi, I'm Tori anyway, I am a recent Dr. Boyce post op. I had my DS with him on June 19th. You'll get excellent advice from the vets here--glad you found your way to the BF community.

 

[Moonbeam]

@Moonbeam I think I referred you to this group (Hi, I'm Tori anyway, I am a recent Dr. Boyce post op. I had my DS with him on June 19th. You'll get excellent advice from the vets here--glad you found your way to the BF community.

Hi! And thanks!