Breaking in a new PCP

[BebeZed]

Well I saw a new healthcare provider today... I was assigned a nurse-practitioner by the clinic my health insurance assigned me to and well, she's just a regular fount of wisdom. Some of the stuff she said to me:

1. Half of what you eat needs to be vegetables. Try steamed broccoli.
2. You must severely limit fats.
3. Supplementation needs for the DS are exactly the same as for RNY.
4. Are you dumping much?

and my particular favorite:

5. You don't really need regular labs - you should judge how you're doing by how you feel.

This one is going to be a tough nut to crack but I am well armed and I know how to smile and nod at her advice. She did end up ordering labs but said some of them were "unnecessary" ... but I insisted. Complication though - looks like I will have to pay out-of-pocket for some of the labs because the state health insurance doesn't cover them. I'll know more about that tomorrow hopefully...

I also discovered that the insurance won't cover the twice-daily omeprazole 20mg, so they gave me a 40mg daily version instead. If that doesn't work well enough I'll just go back to buying the OTC stuff myself and taking it twice a day.

Fun stuff.
Can't wait until the day I get back to work and have *real* health insurance. And a PCP who is at least teachable.

 

[newanatomy]

I have to self pay for most of my labs, too. It sucks but, there ya go.

Good job on the bob and weave with the nut. It is too bad that she is too ignorant to bother to learn about her ignorance.

 

[southernlady]

For the labs that are self pay: http://bariatricfacts.org/threads/did-you-know-you-can-order-your-own-labs.2068/ I read on FB that she was switching from LabCorp to Quest so the prices may change but she beats the insurance prices hands down.

 

[Clematis]

Advice like this is so dangerous for DSers and in turn ends up making the DS look like a risky surgery. The surgery is excellent, it's the follow up advice that's harming patients.

We need to prepare a hand out for our physicians with Dr. K's graphic of post surgery anatomy, nutritional needs, vitamin needs, and lab needs... and how this differs from RNY.

I take once a day 40mg prescription Prilosec which is omeprazole sodium. OTC Prilosec 20mg is omeprazole magnesium. My doc swears prescription is better and that once a day is how it should be taken. (OTC is very expensive. My insurance covers prescription.)

 

[southernlady]

Advice like this is so dangerous for DSers and in turn ends up making the DS look like a risky surgery. The surgery is excellent, it's the follow up advice that's harming patients.

We need to prepare a hand out for our physicians with Dr. K's graphic of post surgery anatomy, nutritional needs, vitamin needs, and lab needs... and how this differs from RNY.

I take once a day 40mg prescription Prilosec which is omeprazole sodium. OTC Prilosec 20mg is omeprazole magnesium. My doc swears prescription is better and that once a day is how it should be taken. (OTC is very expensive. My insurance covers prescription.)

I TRIED with MY surgeon's office...After beating my head against the brick wall, I just did the smile and nod...and work BEHIND the scenes to educate those willing to listen that use his office.

 

[BebeZed]

For the labs that are self pay: http://bariatricfacts.org/threads/did-you-know-you-can-order-your-own-labs.2068/ I read on FB that she was switching from LabCorp to Quest so the prices may change but she beats the insurance prices hands down.

Thank you for that info!! I will definitely go this route for my 6 month labs since I know this NP gal isn't going to want to order them (assuming I don't want to fake feeling sick so she'll feel justified). Depending on how much they want to charge me, I might go that route this time too. I *really* appreciate you bringing this to my attention. I know I'd read it before, but I forgot it was available.

 

[Clematis]

I TRIED with MY surgeon's office

I am going to create something which I will share here. I will ask my physician to read it (hopefully) but never the less to keep it in my file. Physicians giving incorrect medical advice to patients is MALPRACTICE.

 

[BebeZed]

Advice like this is so dangerous for DSers and in turn ends up making the DS look like a risky surgery. The surgery is excellent, it's the follow up advice that's harming patients.

We need to prepare a hand out for our physicians with Dr. K's graphic of post surgery anatomy, nutritional needs, vitamin needs, and lab needs... and how this differs from RNY.

I take once a day 40mg prescription Prilosec which is omeprazole sodium. OTC Prilosec 20mg is omeprazole magnesium. My doc swears prescription is better and that once a day is how it should be taken. (OTC is very expensive. My insurance covers prescription.)

I had printed out tons of info, including the generic lab order. She didn't look at any of it except the lab order and then it was the third degree on where it came from and why all the tests are necessary, etc etc. She still thinks the DS is a gastric bypass with a sleeve instead of a pouch, even though I explained about the pylorus etc. I will just have to be VERY informed and do the work myself. That's cool - I figured I would have to do that.

I'm glad to hear the 40mg works for you. I know that OTC gets expensive - I've been buying it thus far - so it's nice that my insurance will at least pay for that.

BTW, the odd thing about all of this is that they DO pay for bariatric surgery and follow-ups but their surgery of choice is the RNY. Of course. LOL

 

[Settledownnow]

This is really scary. I hope you can get back to work and have "real" insurance and find more knowledge PCP very soon.

 

[BebeZed]

This is really scary. I hope you can get back to work and have "real" insurance and find more knowledge PCP very soon.

Thanks. I'm actually hoping to be able to return to school next month (if I don't get a job) to get a certificates in both medical coding/billing and phlebotomy. There are LOTS jobs available here and the biggest employer has outstanding health insurance so eventually things will fall into place. I'll just take it as it comes, keep myself educated and on top of things, and things will work out. As for finding a PCP who has any real knowledge, well... I can dream

 

[Larra]

I guess you don't have the option of firing this person?? That's a shame, and her conduct is shameful as well. There are excellent NP's out there but apparently this isn't one of them.
Do keep in mind that a NP is required to work under the supervision of an MD, so if you run into an insurmountable problem with her you can request to get the MD involved. At least in my state that's a requirement.

 

[BebeZed]

I guess you don't have the option of firing this person?? That's a shame, and her conduct is shameful as well. There are excellent NP's out there but apparently this isn't one of them.
Do keep in mind that a NP is required to work under the supervision of an MD, so if you run into an insurmountable problem with her you can request to get the MD involved. At least in my state that's a requirement.

Well, I could switch but there's absolutely no guarantee that I'll get someone better and there are only a few options in the practice to begin with. I think I can work with this one so we'll let it ride for now. And yes, it's the same here too - there is a supervising MD. If I have to, I'll get him involved.

 

[Elizabeth N.]

Large bummer :-(.

I do not understand how someone who earned an advanced degree can be so closed-minded. Education is supposed to make you curious and excited about learning new stuff FOREVER.

 

[Munchkin]

Too many people have been taught to blindly accept everything that comes out of a healthcare providers mouth as the gospel truth. This is why so many DSers wind up in big trouble. And they should be ashamed.

 

[BebeZed]

Too many people have been taught to blindly accept everything that comes out of a healthcare providers mouth as the gospel truth. This is why so many DSers wind up in big trouble. And they should be ashamed.

I agree 100%! I am just really glad I have the support of this community. I truly don't know what I would have done had I not found you (thank you @Larra !!)