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Post by kennyk on Oct 5, 2013 3:36:42 GMT -5
I was refered to an Endocrinologist by dr. kini's Pa Dana.
They are out of network and it will be a thousand dollars before labs. On a positive note, no appointment till nov. 20th so I have time to look in to an in network Dr.
I am half thinking of evn a new pcp ( love my Dr but I need some DS understanding, I think) any ideas, suggestions, or thoughts?
Kenny
Btw long island preferable but that may just be wishfully thinking.
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Post by newyorkbitch on Oct 5, 2013 6:44:27 GMT -5
I don't know anyone on LI but I can recommend NYC doctors. What type of insurance do you have?
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Post by louteg on Oct 6, 2013 17:23:11 GMT -5
I am also looking for a NYC PCP with some DS understanding, anywhere in 5 boroughs, my preference is Westchester or the Bronx. I know I am asking for a lot so I am more than willing to travel. My Insurance is Blue Cross Blue Shield PPO; at my next appointment with my surgeon I was planning on asking for a referral. I am thinking waiting until December to get that referral is to far off. Thanks
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Post by newyorkbitch on Oct 6, 2013 17:30:23 GMT -5
It is not likely anybody is going to find an internist with meaningful expereience/knowledge of the DS specifically. What you want is someone who understands your malabsorption. You simply need to say that you do not absorb fat soluble vitamins (A, D, E, K), calcium, iron. So you need to pay attention to iron levels, PTH, albumin and pre-albumin, serum calcium....I do not depend on any doctor to guide my nutrition or supplementation. That being said, I like my internist very much. Because she's really smart, interested, and listens to me. But it is my job to be educated and informed about the DS - not hers.
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Post by newyorkbitch on Oct 6, 2013 17:41:25 GMT -5
Kenny what insurance do you have for in-network providers? And why do you need an endocrinologist now?
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Post by newanatomy on Oct 6, 2013 18:06:46 GMT -5
Kenny,
I bet that you insurance has a website that you can look up in-network providers. Look on there then you can ask about them on here.
Steph
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Post by louteg on Oct 6, 2013 18:55:49 GMT -5
It is not likely anybody is going to find an internist with meaningful expereience/knowledge of the DS specifically. What you want is someone who understands your malabsorption. You simply need to say that you do not absorb fat soluble vitamins (A, D, E, K), calcium, iron. So you need to pay attention to iron levels, PTH, albumin and pre-albumin, serum calcium....I do not depend on any doctor to guide my nutrition or supplementation. That being said, I like my internist very much. Because she's really smart, interested, and listens to me. But it is my job to be educated and informed about the DS - not hers. I told that to my current PCP he seemed to understand. However, when I went to get my labs two weeks ago it's like I never had this talk with him. he only order what my surgeon requested on the lab slip, and he did not want to order anything that was not listed on the paper nor discuss it. I need someone who is willing to listen to me as the patient, not a piece of paper. |
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Post by newyorkbitch on Oct 6, 2013 19:01:07 GMT -5
I bring my list to my internist, or to my hematologist, and they run whatever I want, in addition to whatever they want.
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Post by kennyk on Oct 6, 2013 20:54:48 GMT -5
I recently sorry hematologist and got an iron infusion. When I mentioned to my PCP that my D was low and asked about it, He said I can either take over-the-counter 2000 mg Or go see an endocrinologist for an infusion. I left and told him that I probably need 50 200,000 mg a day And maybe an endocrinologist was a good idea just to let you learn a little bit more about my own labs.
Yes my insurance has a lot of providers but it would be great to have somebody that I'm not the only DS person They have ever met. This endocrinologist works with several DS people but I am not thrilled to pay $1000 out of network as opposed to a $20 co-pay! Also my PCP is a great guy but he's really burnt out lately having nothing to do with me with or a DS but just getting harder to deal with because he's on such a short string, So I figured while I was looking for an endocrinologist referral maybe I should even take a look at it PCP that knows a little bit about the DS.
As you might've guessed I read every single post that comes on this board and try and follow as much as I can but I'm always very anxious about screwing it up And would like to get a real reading of my labs to see what is going on and how my trending looks.
Kenny
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Post by newyorkbitch on Oct 6, 2013 21:18:37 GMT -5
You need dry D. Your PCP doesn't understand your malabsorption issues. Are you following Vitalady's regimen ??
Post your labs here.
What insurance do you have ?
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Post by kennyk on Oct 7, 2013 0:09:35 GMT -5
OTC dri D is 400 unless from mail order(50k)
I take 5-8 400's at a time 2-3 x a day.
NUT thinks that is good, I have serious doubts.
I have been trying to contact vitalady for months,
Here public, PM, face book and phone.
Most I ever got was a PDF from someone at company but can not seem to make contact with michelle.
Insurance is empire for govt employees.
And sure I will post la s in the Am thanks for all the help
Kenny
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Post by newyorkbitch on Oct 7, 2013 3:11:21 GMT -5
Why do you need to contact her? It's all on the Vitalady website.
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Post by kennyk on Oct 7, 2013 4:42:17 GMT -5
I was hoping to get my labs looked at rather than jumping to all of these bits at once.
Just seemed like it made the most sense as well as what most people seemed to have done.
K
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Post by newyorkbitch on Oct 7, 2013 5:56:12 GMT -5
But why do you need to contact Vitalady? You can order things without talking to her...I've never talked to her in all these years...
Why not post your labs here?
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Post by kennyk on Oct 7, 2013 5:58:54 GMT -5
Addendum....
I guess I should also say I am half following the advice of my NUT and surgeon/PA.
I am taking 3 barbaric Advantage ADEK a day.
2000 mg calc citrate a day (at least 1/2 being in liquid form mith magnesium citrate and D3 (solgen brand, I stir it into all ckinds of stuff)
Was doing 2-3 BA iron pills after my trends were down I stopped taking them and had an infusion of hemefeme? Can't recall the name but it is a non I've iron infusion. I take labs to check it this week..
In the interim no more oral till hematologist sees results.
I also take zinc OTC and sublingual B12
The PA also commented my K is Low was supposed to change from BA ADEK to calibrate (way more K) but I just got in a new 60 day ADEK and figured I will just supplement my K in the interim to a real plan, but I don't know the type to get and I am like a perfectionist who does nothing rather than does it wrong. Sort of like a deer in the headlights sometimes.
K
(Feeling really fucked up and out of my element)
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Post by newyorkbitch on Oct 7, 2013 6:42:52 GMT -5
You need much more A, D, E, and K than ADEKs provides. Get them from Vitalady - all separate.
Sounds like maybe you got feraheme? That's the iron infusion get too.
You need dry D - get it from Vitalady.
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Post by kennyk on Oct 7, 2013 6:55:40 GMT -5
Lol yup that is the one I got too.
Just remember if life keeps handing you melons you may be dyslexic!
I was thinking of staying with the ADEK and adding the K etc. to it.
But not sure K, K1 blah blah blah
(it is all starting to to roll and rattle in my head)
I will try and figure out posting labs today , in fact I think I may have somewhat once a bit ago
K
Btw thank you all for listening and putting up with my nonsense here, ESP you NYB!
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Post by newyorkbitch on Oct 7, 2013 7:11:32 GMT -5
Kenny, if there's one thing you have to know by now is that you MUST NOT TRUST THE NUT. Please, for chrissakes, please just get on Vitalady's regimen.
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Post by kennyk on Oct 7, 2013 8:00:45 GMT -5
I just can't wrap my head around such a drastic move without comparing my labs.
I am so on last thread at this point I can't even begin....
K
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Post by michellemj on Oct 7, 2013 8:36:38 GMT -5
Kenny: Please please please DO NOT TRUST KINI'S NUT. She is not educated in much besides RNY. Listen to NYB and get on Vitalady's regimen.
If you do not have copies of your labs, ask for them. and then post the results here.
I love my PCP. She will run whatever labs I want, no questions asked. But she's also in the Upper West Side.
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Post by kennyk on Oct 7, 2013 9:26:42 GMT -5
Have them just have a hell of a time posting via the iPad w/ pro boards.
I will try and get them up on here today though.
Thanks again
K
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Post by bb212 on Oct 12, 2013 16:03:59 GMT -5
Kenny, I'm sorry that I don't have any recommendations for PCPs on Long Island. But in case there are people in the NY reading this looking for docs, I wanted to recommend my old PCP.
Yafee Ruden on the Upper East Side (Manhattan) is a very good practice, although they tend to run late for their appointments. Dr. Ruden is a great PCP, but he's always booked 2-3 months in advance, luckily he has a large team of doctors and PAs for minor things and I have wonderful things to say about Dr. Ruden and Dr. Julie Bikhman. I get the impression I was one of their first patients to get the DS, but they were incredibly supportive, not judgmental at all, extremely willing to learn about DS post-op care & nutrition, and they had NO problem taking blood for my labs. Dr. Yaffe is an Gastroenterologist and he performed my pre-DS scope before I shipped off to TX for surgery, even though I'd only seen him once he was also extremely supportive of my decision. I wouldn't be surprised if the have a NUT at Yafee Ruden but I never used their practice for post op nutrition, just general health issues and for drawing labs. They're no longer my doctors because I moved out of state.
I don't know what the policy is linking to doctor websites, but anyone can google "yaffe ruden" and the website for their practice should be at the top of the search results.
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mistercy
Full Member
Posts: 228
Surgery Type: DS
Surgery Date: 03/26/2013
Surgeon: Mitchell Roslin
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Post by mistercy on Oct 12, 2013 16:15:41 GMT -5
For a NYC PCP, I've been pleased with mine, Dr. Benjamin Metzger. Like bb's recommendation, he has been willing to learn about post DS care & nutrition, and his office will do whatever blood work is needed for my labs. I haven't used a NUT in his practice, but I've found him willing to listen, and do what I've needed, which is really, all I ask out of a PCP.
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Post by newanatomy on Oct 12, 2013 16:38:41 GMT -5
Kenny,
Have you posted your labs? I want NYB to be able to see them.
Steph
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Post by newyorkbitch on Oct 12, 2013 19:06:49 GMT -5
My internist is Nina Priven, the practice is Westside Internal Medicine. Her partner, Iris Sherman is also terrific. She listens, she does what I ask, she talks things through with me. I also have a wonderful hematologist - Dr. Robert Klafter. Both Priven and Klafter are Mt.
Sinai affiliated.
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Post by newyorkbitch on Oct 12, 2013 19:09:39 GMT -5
I would never go to a doctor who is in practice alone. Nor would I go to someone not affiliated with a good teaching hospital.
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Post by newyorkbitch on Oct 12, 2013 19:13:30 GMT -5
I just looked at the website for Yaffe Ruden....you couldn't pay me to go there.
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Post by bb212 on Oct 12, 2013 19:23:57 GMT -5
I just looked at the website for Yaffe Ruden....you couldn't pay me to go there. I found the quality of the care from their staff to be excellent. Unless you've gone to them and can personally vouch for them, you don't have an opinion. |
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Post by newyorkbitch on Oct 12, 2013 19:28:23 GMT -5
They don't list the training for most of them - and most of them were trained overseas. Most of them are DOs and not MDs. There is no indication of board certification, or hospital affiliation, for most of them. Their personal descriptions are ridiculous.
And it is absurd to say that someone can't have an opinion without going....we choose (and judge) physicians all the time based on credentials, reputation, training, experience, affiliation, etc.
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Post by newyorkbitch on Oct 12, 2013 19:34:21 GMT -5
And you know - I"m not interested in the care of their "staff" - I'm interested in excellent, intelligent, attentive, experienced, board certified, physicians.
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