Talking to Your PCP About the DS

[southernlady]

When I went to my new PCP (who I love and drive over an hour to get to his office), I told him I took a lot of vitamins and I needed to have blood levels to know I'm on track. I told him he didn't really want to know how much I take and I couldn't remember off the top of my head. (This was before my vitamin rebellion). My levels all came back in normal range, then at the next appt, I had him sign the medical necessity form so I could buy my vites out of my health care spending account. I told him, this is what I take and you have seen my blood results based on those vites. He happily signed the form. Only test he wouldn't run because I'm no longer diabetic was an A1C.

me

I did tell my new PCP. But I also took him a copy of my previous lab work as well as other documents about the DS. I was his first DS but his nurse is a RNY'er out about 9 years so he is somewhat familiar with WLS. Since I found him, he's added two more DS'er's...my husband and a friend.

I don't bother with a HSA as we don't have one, on Medicare...it's just easier to budget for vitamins.

I use the Kirkland Daily multi...it's what was in Vitalady's package and while we didn't have a Costco near us when we started but we do now so we just buy it ourselves. About $15 for a bottle of 500. At three a day, it works out to a dime a day for my multi's.

 

[hilary1617]

Fantastic! Thank you so much!!!

 

[Angela Morgan]

Open this document, personalize it to YOUR situation, print it out and take it to your PCP. Tell her it is REALLY important that s/he is willing to learn about the care and maintenance of a DSer, and that s/he will at the very least (1) be willing to order your labs, and (2) not assume everything that is wrong with you will be DS-related.

The lab list in this document is old - compare it to the one here - in fact, bring your PCP a copy of this lab order:
http://www.paclap.com/downloads/annualdslaborders.pdf

Thanks for the info! Was informational for me as well.

 

[Razbry]

I have a PCP appointment in a month, and I was doing my usual thing of "communicating" with him before hand. I thought maybe this style might be helpful to some of you. So here is the letter I took in today to give to his nurse.

2/10/15

It Looks like I can’t get in to see you until the 2nd week of March, which is OK because I’m feeling great. However, I thought I should tell you about a couple changes I made before then.

· Calcitrol: It is based in coconut oil. Since I don’t absorb any oil it will not help me. I’ve discontinued it.

· Vit. K: After my Vit K lab came back with a low value I got a call from your nurse informing me that you wanted me to discontinue my pill form of Vit. K, and try to get
all I need through food sources. As I absorb between 0 – 50% of natural Vit K sources, there is no way for me to eat myself to a healthy Vit K level. I I continue to take Vit K1, and have added Vit K2. I’ve attached some interesting reading for you.

· Labs: I’ve attached what I think should be ordered (at least) annually. Just so you know, my insurance will pay for anything you order. I’ve highlighted the tests I
would like to see done every six months. It’s all your choice. I would, however, like it very much if I could get these labs done before I come in in March. It
would mean one less appointment that would take up your time to discuss the labs, or at the very least, avoid having to talk to your nurse about the labs. I
feel disconnected from you when I have to do that. If you chose to pre-order my labs, have someone call me so I can make an appointment to come in and
get them done.

Thanks!

I know my PCP reads everything I give him, but I don't like to overwhelm him with info. It's been a long learning curve for both of us, but we are getting there! My point is the encourage communication with you PCP anyway you can.

 

[GirlFriday]

I realize that I am late to the game in this thread, but I am in shock. My PCP recommended my surgeon, got copied in on all my test results, found me my counselor, and met with me last week for a check up and to make sure I am ready for surgery. We dicussed supplements, labs, and the B12 shots that I have to have.

I just assumed that all PCPs were interested in their patient's health.

 

[DianaCox]

"I just assumed that all PCPs were interested in their patient's health."

Ahahahahahaha ... that was funny.
Oh wait, you didn't mean that to be funny?
Most of us have to fight to get our doctors to understand the DS and cooperate with our post-op (and post-surgeon) needs.

 

[GirlFriday]

Again, I am shocked. If you are in the Indianapolis/Carmel, IN area and are in search of a PCP, I highly recommend Dr. Daniel Crabb, MD. He has been there for me every step of the way with this decision. When I mentioned it to him that I was thinking of having the surgery, he got me all of the information and his office made my initial consultation appointment for me. When my insurance wouldn't pay for the psychologist at the Bariatric Center, his office helped me find another counselor that was in my network.
Like I said before, I am a week away now but, at two weeks away, he scheduled an appointment for me for a general check up and he wanted to see if I had any unanswered questions or if there was anything that I needed from his office before I had the surgery.

I believe that I am very lucky. I guess I just didn't know it before.

 

[star0210]

Yeah I'd say you a VERY lucky!!

 

[Will2014]

Again, I am shocked. If you are in the Indianapolis/Carmel, IN area and are in search of a PCP, I highly recommend Dr. Daniel Crabb, MD. He has been there for me every step of the way with this decision. When I mentioned it to him that I was thinking of having the surgery, he got me all of the information and his office made my initial consultation appointment for me. When my insurance wouldn't pay for the psychologist at the Bariatric Center, his office helped me find another counselor that was in my network.
Like I said before, I am a week away now but, at two weeks away, he scheduled an appointment for me for a general check up and he wanted to see if I had any unanswered questions or if there was anything that I needed from his office before I had the surgery.

I believe that I am very lucky. I guess I just didn't know it before.

If this doctor turns out to be as good as he seems, you need to sing his praises loud and clear for all to hear. I'm sure some have looked at postings here about this Dr. or that, and might come away thinking folks here are being too critical or mean. Nothing could be farther from the truth! We are all DESPERATE to find excellent doctors who actually listen to their patients, perform the surgery they promised, are knowledgeable and skilled in performing said surgery, and are capable at managing the post DS procedure pt.'s unique challenges. When we find such a one, we quickly add him/her to an approved list and recommend them highly. They are a rare breed and well deserve to be promoted for their excellence.

 

[Marie H.]

Thank you for the list, I'm going to use this when I do my next set of vits, which will probably be in 3-6 months since I'm very low in my Vit D and A, I don't want to go another year in between, since they are deficient right now.

 

[danadear]

Open this document, personalize it to YOUR situation, print it out and take it to your PCP. Tell her it is REALLY important that s/he is willing to learn about the care and maintenance of a DSer, and that s/he will at the very least (1) be willing to order your labs, and (2) not assume everything that is wrong with you will be DS-related.

The lab list in this document is old - compare it to the one here - in fact, bring your PCP a copy of this lab order:

Hi Diana,
This is the very paper I took to my PCP and they said they couldn't do all the tests because they were not in their system. Ugh! frustrating! I am in the process of seeing if my hematologist will order the test for me. It's too bad we need a doc to order these for us. I am wondering however, why Vitamin E & K are not on the list.

 

[DianaCox]

Almost NOBODY is ever low on E, even DSers, so Rabkin removed the test from his yearly labs. I get K1 tested, but it is all over the place and seems very inaccurate, and apparently there's no commercial blood test for K2. I just supplement twice a week with Vitalady's dry K1and K2 and figure that's better than nothing.