Hi!

[Jennie1980]

Best place to start for keeping labs in good order is stay AWAY from his bariatric vitamins and follow the Vitalady list found here
I get heartburn with his office pushing HIS vitamins. He should not be making money that way. And they aren't adjustable. IF I had used his, I would be toxic on A, E, and all the B's or severely deficient on D and K. Plus they are expensive. Just find a way to avoid lining his pocket.

And I suspect that with your starting BMI, you will avoid his pre-op diet. Made the staff nuts but he told me not to lose any weight pre-surgery as I was too close to the cutoff. Normally he says 2 weeks of pre-op diet for those under a 50 BMI and 4 weeks with those over a 50. BUT at a 35.2, he was afraid, I would slip too much under the 35 and then be too small according to insurance.

As far as the diet and education classes...they are focused on RNY NOT the DS. So just learn to smile and nod...and then listen to the people who actually LIVE with the DS.

I'm learning. I don't like the idea that he thinks once size fits all when it comes to vitamins. Don't get me wrong, I really like and respect Dr. Boyce. I feel like I have to find a balance between medical advice and real life experience advice. Another thing about making money. Is it typical to pay a surgeon even when your insurance covers at 100 percent? A thousand bucks isn't much to some but I'm not swimming in cash or I wouldn't have government insurance.

And speaking of insurance, because of that he told me not to lose a pound and he wouldn't be upset if I gained 10 or 15lbs. No problem there as I just quit smoking...

 

[newanatomy]

I'm learning. I don't like the idea that he thinks once size fits all when it comes to vitamins. Don't get me wrong, I really like and respect Dr. Boyce. I feel like I have to find a balance between medical advice and real life experience advice. Another thing about making money. Is it typical to pay a surgeon even when your insurance covers at 100 percent? A thousand bucks isn't much to some but I'm not swimming in cash or I wouldn't have government insurance.

And speaking of insurance, because of that he told me not to lose a pound and he wouldn't be upset if I gained 10 or 15lbs. No problem there as I just quit smoking...

Hello and welcome! Good job on the quitting smoking! I quit smoking about 7 months prior to my surgery and have never started again, yay me! One of the best decisions ever!!

Unfortunately, It is becoming the norm for surgeons to demand extra payment from the patient because the fee they have agreed to accept from insurance is so low. It is aggravating but, what are ya gonna do? Lots of surgeons are selling vitamins too. It's disgusting and unethical in my opinion. Ignore that and follow your labs.

 

[Jennie1980]

I have a question about insurance. I've been reading and searching and so far no luck. I'm looking for someone with experience with TennCare, Tennessee's medicaid. I have Bluecare but change to United Healthcare during open enrollment in July. Dr. Boyce only began taking BlueCare in January 2016. He has been taking United Health Care for some time and prefers them because they pay more. I have no problem switching as my PC and specialists take both.
My concern is this that I can not, for the life of me, get BlueCare to send me any type of information what so ever as to their coverage of bariatric surgery. My worry is my letter if recommendation from my PC. I mentioned a language barrier before but getting her to understand what needs to be in the letter is complicated. Especially considering the only thing I can offer her in writing is my hand written scribbles done while on the phone with the insurance company as they read the requirements to me... I asked for a link and got TN dot gov, which offers me a definition of bariatric surgery (sarcastic face). I'm sure her letter is very important. I've considered typing my own and taking it to her to put on letterhead and sign. But that's difficult as I can't quote the language in the policy...

 

[southernlady]

I feel like I have to find a balance between medical advice and real life experience advice. Another thing about making money. Is it typical to pay a surgeon even when your insurance covers at 100 percent? A thousand bucks isn't much to some but I'm not swimming in cash or I wouldn't have government insurance.

IF his medical advice was DS based then I might listen to him. But it isn't, it's based on the RNY. I asked one of his nuts why they preach low fat when we malabsorb fat...got the RCA dog look in return. Medical professionals have been preaching low fat for so long, they don't know any other way. And it's not fat that makes us fat but carbs (especially combined with fat) and processed foods/drinks.

With vitamins and eating, real life is far above medical advice. We have a combined hundreds of years of real life experience on here. http://bariatricfacts.org/threads/dear-family-and-friends.3627/

As far as the program fee...it technically covers all follow up visits and labs for one year. (make sure your 1 year follow up is before the surgiversary of your DS or it's not covered). And like NA said...they aren't getting much from the insurance company. BUT, on the other hand, his fee was much higher 5 years ago.

 

[southernlady]

I have a question about insurance. I've been reading and searching and so far no luck. I'm looking for someone with experience with TennCare, Tennessee's medicaid. I have Bluecare but change to United Healthcare during open enrollment in July. Dr. Boyce only began taking BlueCare in January 2016. He has been taking United Health Care for some time and prefers them because they pay more. I have no problem switching as my PC and specialists take both.
My concern is this that I can not, for the life of me, get BlueCare to send me any type of information what so ever as to their coverage of bariatric surgery. My worry is my letter if recommendation from my PC. I mentioned a language barrier before but getting her to understand what needs to be in the letter is complicated. Especially considering the only thing I can offer her in writing is my hand written scribbles done while on the phone with the insurance company as they read the requirements to me... I asked for a link and got TN dot gov, which offers me a definition of bariatric surgery (sarcastic face). I'm sure her letter is very important. I've considered typing my own and taking it to her to put on letterhead and sign. But that's difficult as I can't quote the language in the policy...

Insurance is @DianaCox and @Larra's baliwick. I know others have gotten thru with TennCare but since mine was a Medicare Advantage policy thru BCBSTN and not TennCare, I am of no help.

Maybe call the insurance company back and ask them to email you the info in writing? Tell them the link doesn't give the actual requirements.

 

[Jennie1980]

I'll call them tomorrow. I speak to them more than I do my family lol.

I think Dr. Boyce is making progress with DS needs though. He asked me about meat... I must have a look about me that says "bring me bloody steak now or I shall throat punch you because I'm a hangry person!" Any ways, meat and smoking are how ended up with a recommendation for DS. Maybe now they realize fat isn't the enemy?

 

[southernlady]

I'll call them tomorrow. I speak to them more than I do my family lol.

I think Dr. Boyce is making progress with DS needs though. He asked me about meat... I must have a look about me that says "bring me bloody steak now or I shall throat punch you because I'm a hangry person!" Any ways, meat and smoking are how ended up with a recommendation for DS. Maybe now they realize fat isn't the enemy?

Maybe HE does but it hasn't filtered to the office/NUTS yet. I see what they post in his group on FB. Have to sit on my hands a LOT!!

 

[Jennie1980]

Today was not a good day. Add a diagnosis of hypertension to my list.... Lisinopril

Also, finally got the results of several scans I had done over a month ago and I have polyps in my gallbladder... jeez

 

[Jennie1980]

Today was not a good day. Add a diagnosis of hypertension to my list.... Lisinopril

Also, finally got the results of several scans I had done over a month ago and I have polyps in my gallbladder... jeez

 

[BrianChesteen]

I would also add as a Boyce DS patient who is 2 years and 4 months out, please ensure you discuss with him exactly what he plans to do regarding your sleeve size and common channel length. When I had my DS I was uninformed and just assumed I would get an industry standard DS but when I got home and read my OP report it stated that he only did a 50% sleeve reduction and left me with a 125cm common channel. This is not what was advertised on his website.

While I have been successful and lost a bunch of weight and have been able to keep most of it off, I have never met my original goal and my sleeve has never been as restrictive as I would have hoped. I also imagine that a shorter common channel would also have helped me reach my goal.

 

[Jennie1980]

I would also add as a Boyce DS patient who is 2 years and 4 months out, please ensure you discuss with him exactly what he plans to do regarding your sleeve size and common channel length. When I had my DS I was uninformed and just assumed I would get an industry standard DS but when I got home and read my OP report it stated that he only did a 50% sleeve reduction and left me with a 125cm common channel. This is not what was advertised on his website.

While I have been successful and lost a bunch of weight and have been able to keep most of it off, I have never met my original goal and my sleeve has never been as restrictive as I would have hoped. I also imagine that a shorter common channel would also have helped me reach my goal.

Knowing Dr. Boyce and his (ahem) personality, how would you approach him on the topic,@BrianChesteen

 

[BrianChesteen]

Knowing Dr. Boyce and his (ahem) personality, how would you approach him on the topic,@BrianChesteen

I would just ask him. Your the patient and it is your body and your the one paying him.

I am sure he would rather talk it out now vs after the fact. I just did not know to do that before hand.

 

[Larra]

You should be able to get your EOC (evidence of coverage) from the insurer, either online on paper. If your insurance is through your employer, or spouse's employer, you should be able to get it through HR, but be prepared to encounter a whole lot of ignorance. You will need to specify that what you need is NOT a summary of benefits, but the whole, long document. This should contain all the details of your coverage for bariatric surgery, as well as appeals rights, if any.

Re: hypertension, given that it is recent onset and hopefully easily controlled, it should resolve after your DS. Not instantly, but gradually, and you and your pcp will work together to adjust your dosage and eventually discontinue your medication.
Re: gall bladder polyps, not alarming, gall bladder cancer is very rare. But it is an abnormality and discuss with Dr. Boyce removal of gall bladder at the time of DS. You can just throw that in with the cheery conversation about sleeve size and limb lengths. @BrianChesteen is right, you as the patient have every right to know ahead of time what you are having done and why, and better to ask before than to be surprised/unhappy/angry after.

 

[Jennie1980]

Thank you @Larra unfortunately our insurance through my husband's insurance, excludes WLS. I have a secondary. It's BlueCare throughTennCare, which is Tennessee's medicaid. I will ask for the EOC. I will ask again that is. I think I'm going to be ok. I just hope I can get a good recommendation/clearance letter from my doctor. I'm giving thought to writing it myself and asking her to put on letterhead and then sign it.

I realized yesterday that she doesn't understand the concept of DS at all. I hope she is as willing to learn as I first thought she was. If not, I'll find another after the surgery is done. I really do like her though, and her husband, my rheumatologist.

 

[Larra]

I think preparing a letter for your pcp is a good idea. You wouldn't be the first, believe me. Docs are so busy anymore that most welcome the help. I would also recommend giving her an article from the medical literature about the DS - just one, overwhelming her with literature will result in her not reading any of it. If you send me a pm with your email address, I can provide a great article for you to pass on to her, and good reading for yourself as well. And if all this doesn't get her on board, at some point you will need a new pcp, but since you already know and like her it would be great if you can educate her and make a supporter of her. You never know, you may be helping future patients of hers as well.