Defy reviews - not happy so far

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HoustonTX

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I joined defy because of all the great reviews I came across on here. I've been very displeased by their staff so far. I'd be happy to go into more detail, but I'll give one of many examples.

My biggest issue like many others on Trt was estradiol management. When my estradiol is in the right zone, my sex drive is through the roof and crazy super erections are good, when it's not, erections are sloppy or if it's super high like in the 40s on a sensitive test they are non existent.

I tried to talk to a staff member about this, and their reply was well Trt comes along with ed. We'll have someone talk to you. WTf?! They've given me no direction on my medication compared to the doctor can I had that knew nothing about trt. Maybe the docs at defy have some valuable knowlege, but I've been a patient for almost a year and wouldn't know. Things have not gotten better with the staff, and I'm feeling like I'm wasting my money. My last doc gave me no direction either, but at least wasn't paying much for it. I'm willing to pay for expertise, but I haven't gotten any at Defy.

I feel like i am paying for a Cadillac (not a sports car) and getting Walmart service
 
Defy Medical TRT clinic doctor
Honestly, with the knowledge base just floating around now, I am not sure why you would even hesitate a moment to not just find a good PCP that will RX what you want when you want. That does happen. It may not be easily done, but it beats being disappointed and enriching a system you do not believe in.
 
I am happy with Defy and the medical staff. There is a tremendous amount of info just on this site about estrogen management, libido etc. But, for all that info and knowledge gained, getting the estrogen balance takes time, and I am still not there yet. Certainly, I understand how frustrating it can be to be in and out of a narrow range that makes or breaks your erections and sex life. I have the same experiences, but I seem to be less sensitive to the fluctuations as it seems the test in general has increased my libido regardless of estradiol levels. In my case, I experience some lessening of libido when the estradiol level is too low. When it's high it's not an issue for me.

We have to be patient because this is not always as simple as just finding "the sweet spot" with estrogen and test. Many other factors come into play. When I compare my care from Defy versus other experiences and I have had in HRT, I feel blessed to be under the care of Dr. Saya and Defy medical.

Before I started with Defy my estradiol was on the low side. I used no estrogen blockers when I started the test regimen with them since it was already low. Eight weeks or so later, my estradiol was over 100 ! Time for adjustments: Test dosage was lowered and Arimidex was added. Will see what the next labs show. I am patient.
 
HoustonTX said:
I joined defy because of all the great reviews I came across on here. I've been very displeased by their staff so far. I'd be happy to go into more detail, but I'll give one of many examples.

My biggest issue like many others on Trt was estradiol management. When my estradiol is in the right zone, my sex drive is through the roof and crazy super erections are good, when it's not, erections are sloppy or if it's super high like in the 40s on a sensitive test they are non existent.

I tried to talk to a staff member about this, and their reply was well Trt comes along with ed. We'll have someone talk to you. WTf?! They've given me no direction on my medication compared to the doctor can I had that knew nothing about trt. Maybe the docs at defy have some valuable knowlege, but I've been a patient for almost a year and wouldn't know. Things have not gotten better with the staff, and I'm feeling like I'm wasting my money. My last doc gave me no direction either, but at least wasn't paying much for it. I'm willing to pay for expertise, but I haven't gotten any at Defy.

I feel like i am paying for a Cadillac (not a sports car) and getting Walmart service
Click to expand...

Houston - have you talked to me or one of the other MEDICAL (vs support) staff recently? If so, what changes were made and what were the follow-up lab results? Everyone is so unique that for most patients a few to several adjustments are needed especially if you are particularly prone to negative results with fluctuations in E (perfect example is that E in the 40's is not "super high" for most guys, but may in fact be for you). What is your DOB so I can look up your chart? Not enough detail here to offer any useful answers/suggestions.
 
HoustonTX said:
I joined defy because of all the great reviews I came across on here. I've been very displeased by their staff so far. I'd be happy to go into more detail, but I'll give one of many examples.

They've given me no direction on my medication compared to the doctor can I had that knew nothing about trt.
Click to expand...

You've been with Defy for almost a year, and they've given you no direction on your medication?? All of your consults over the past year with Dr. Saya or Dr. Crisler (when he was affiliated with Defy) resulted in them giving you no direction...that's what you're saying here? Sorry, but I've got to wave the BS flag.

My experience with Defy over the last year has been the exact opposite of yours. From the front office staff to the medical professionals treating me, I've received top notch service all the way around. I've never had any doctors in my past that went into the detail that Dr. Saya does during one of his consults. There's never been any lack of direction concerning my protocol (where it's been, and where it's going), or any of the meds I'm taking.

Sorry Houston, but we have a problem here. Your claims of "no direction" from the medical staff at Defy simply doesn't hold water, and couldn't be more different from my experience with them.
 
HoustonTX said:
I joined defy because of all the great reviews I came across on here. I've been very displeased by their staff so far. I'd be happy to go into more detail, but I'll give one of many examples.

My biggest issue like many others on Trt was estradiol management. When my estradiol is in the right zone, my sex drive is through the roof and crazy super erections are good, when it's not, erections are sloppy or if it's super high like in the 40s on a sensitive test they are non existent.

I tried to talk to a staff member about this, and their reply was well Trt comes along with ed. We'll have someone talk to you. WTf?! They've given me no direction on my medication compared to the doctor can I had that knew nothing about trt. Maybe the docs at defy have some valuable knowlege, but I've been a patient for almost a year and wouldn't know. Things have not gotten better with the staff, and I'm feeling like I'm wasting my money. My last doc gave me no direction either, but at least wasn't paying much for it. I'm willing to pay for expertise, but I haven't gotten any at Defy.

I feel like i am paying for a Cadillac (not a sports car) and getting Walmart service
Click to expand...

Reading in to this I will offer this, you seem to be at apoint that you can take more control over your protocol, you seem to have a grasp on E and E management, just inferring because I think your post is rather vague, but you can indeed manipulate any AI dosing and frequency on your own direction. I've experienced a very comfortable thing from Dr Saya and the medical staff to allow me to get my own testing and adjust doses as I see fit, they've been 100% supportive that way.
 
I'm going to agree with jackie treehorn here.

I am a patient of Defy and I've had nothing but a good experience with them and none of what you describe. Dr saya spent more time talking with me about how I feel, my goals, my labs and details about medications and hell even random theoretical questions I had that were just for pure curiosity than any other doctor I've ever seen before.

I find it hard to believe one of their doctors didn't give you directions and instructions on the medications prescribed. I've called in to ask questions in retrospect were "dumb" and got nothing but helpful advice, and when the front staff doesn't know something or can't answer it, they ask someone more experienced like a nurse or one of the doctors, and get back to me. It's also the first medical office I've dealt with, that after 1 week of being on new medications called ME to ask me how everything is going, it honestly caught me off guard lol I thought something was wrong it was so out of the blue for what I expected.

Can you go into more detail with exactly what you experienced issues with?
 
I get top notch care from Dr. Saya. He is incredibly committed to listening to my concerns and working toward resolution. I would not expect to or want to discuss my care with support staff.

Highly sophisticated records management software is required to give patients on-line access such as we get from large institutions. I'd like to be able to review my after-visit summary on line, progress notes and prescriptions. I'd love to see Defy implement this however the cost must be prohibitive.

While I do find the majority of the staff extremely helpful I have been frustrated with one person when it came to getting lab results. He did not know that it is illegal for Labcorp to deny Dr. Saya access to labs ordered by another doctor. I do not appreciate time wasting argumentative people who require multiple transmission and requests.

Finally, I was under the impression that all injectables require an Rx. Not according to staff. As a result of the way my "Rx"s were described as "recommended not ordered" I have been unable to fill those since last year. There was and continues to be an unacceptable lack of follow up from the staff, the result being that the medicine ordered has not been available to me. I've given up all hope of receiving them.

edit: I needed to have a third party pay for the meds. In fairness Defy isn't set up to accept 3rd party payment. They gave it a shot though and it failed. I just wish they had let me know so that I wasn't looking for them daily for three weeks.
 
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i've been at defy for a couple of years now. Dr saya is great which is why I havent left yet so I have a hard time thinking that OP's reason for his dislike of the practice is medical related.

But that said I've noticed a change in the last 10-12 months that I don't particularly care for. Nothing super major but a few minor things and price increases that annoy the hell out of me that have had me considering making a change.
 
HoustonTX said:
I joined defy because of all the great reviews I came across on here. I've been very displeased by their staff so far. I'd be happy to go into more detail, but I'll give one of many examples.

My biggest issue like many others on Trt was estradiol management. When my estradiol is in the right zone, my sex drive is through the roof and crazy super erections are good, when it's not, erections are sloppy or if it's super high like in the 40s on a sensitive test they are non existent.

I tried to talk to a staff member about this, and their reply was well Trt comes along with ed. We'll have someone talk to you. WTf?! They've given me no direction on my medication compared to the doctor can I had that knew nothing about trt. Maybe the docs at defy have some valuable knowlege, but I've been a patient for almost a year and wouldn't know. Things have not gotten better with the staff, and I'm feeling like I'm wasting my money. My last doc gave me no direction either, but at least wasn't paying much for it. I'm willing to pay for expertise, but I haven't gotten any at Defy.

I feel like i am paying for a Cadillac (not a sports car) and getting Walmart service
Click to expand...

Hey HoustonTX

I am trying to understand your frustration:

1- Estradiol- Are they not giving you enough to have your estradiol where you think you have best erections?
2- Have they not offer Cialis trouches or Trimix as options if item 1 above does not work?
3- When you said they have not given you directions on your medication, what do you mean? Dr Saya spends considerable time with patients.
4- How long have you been using Defy?
 
In almost a year since I've been a patient of defy, I've only had one interaction with. Dr. which was Dr. Crisler. I gave him all my previous labs which was about 15 over 2-3 years. He was a bit confused with all of the information and pinpointing where to start. I didn't put the blame on him, so I took it upon myself to catalogue all of my labs and out them on a spreadsheet along with how I was feeling and performing physically. I'm almost certain it went into my file, and no one ever looked at it. I have been directed toward the staff to try and calibrate my arimidex and test dosage So, I don't feel like I got the "dialing in" that they discussed with me. I realize that I can insist and probably should have insisted that I at least speak to a nurse or doctor. I expected a follow up to be scheduled with a doc after about 3 monthsif not sooner, because they kept telling me they'd let me know when it's time for a follow up. 6 months flew by, and I finally meet with a nurse. That meeting was positive. We agreed that we should increase my test dosage to 175mg. She asked me to keep her informed as to whether I had any ed as a sign of low or high estradiol. But, yet again, I'm directed toward the staff. This time I've insisted that I talk with the nurse I spoke to last time. This is getting pretty lengthy, but I've had at least 3 negative experiences with the staff. And as Vince suggested, I'm going to deal with them as little as possible in the future.

Keep in mind that I was on 200mg of test and .25mg twice a week of anastrozole before I came to defy. I had estradiol management issues on that. I was on that amount under a doc that gave me no advice, and I told the doc what I needed from my own research about what was typical on trt and how to manage my own estradiol. I had decided to drop it to about 120mg of test and then raised it to about 150 with no anastrozole and going with eod injections which is what Dr. Crisler kept me on. My estradiol felt like it was shooting up. I requested a lab through defy, and it was very high. They said I needed to take .25mg of arimidex.

Im not refuting or saying that Saya and Crisler aren't the highest standard when it comes to trt docs. I still think they are. I had 40 minutes or so with Crisler, and I haven't experienced the personalized approach or expertise I expected.

Regarding the cialis, I take it, but I'm also seeing new people and not in a long term relationship. I have absolutely no problem with erections or erection quality, except when my estradiol is off which is roughly 10% of the time. So, I'm great 90% of the time, but the 10 is awful and stressful. And, I'm not going to take even a 10% risk the first time I have sex with someone or even the first 10 times.
 
I should have been clearer when I said no direction on medication. They give me the basic take 2 of these type of direction. I'm referring to getting dialed in on my estradiol with medication
 
HoustonTX said:
In almost a year since I've been a patient of defy, I've only had one interaction with. Dr. which was Dr. Crisler. I gave him all my previous labs which was about 15 over 2-3 years. He was a bit confused with all of the information and pinpointing where to start. I didn't put the blame on him, so I took it upon myself to catalogue all of my labs and out them on a spreadsheet along with how I was feeling and performing physically. I'm almost certain it went into my file, and no one ever looked at it. I have been directed toward the staff to try and calibrate my arimidex and test dosage So, I don't feel like I got the "dialing in" that they discussed with me. I realize that I can insist and probably should have insisted that I at least speak to a nurse or doctor. I expected a follow up to be scheduled with a doc after about 3 monthsif not sooner, because they kept telling me they'd let me know when it's time for a follow up. 6 months flew by, and I finally meet with a nurse. That meeting was positive. We agreed that we should increase my test dosage to 175mg. She asked me to keep her informed as to whether I had any ed as a sign of low or high estradiol. But, yet again, I'm directed toward the staff. This time I've insisted that I talk with the nurse I spoke to last time. This is getting pretty lengthy, but I've had at least 3 negative experiences with the staff. And as Vince suggested, I'm going to deal with them as little as possible in the future.

Keep in mind that I was on 200mg of test and .25mg twice a week of anastrozole before I came to defy. I had estradiol management issues on that. I was on that amount under a doc that gave me no advice, and I told the doc what I needed from my own research about what was typical on trt and how to manage my own estradiol. I had decided to drop it to about 120mg of test and then raised it to about 150 with no anastrozole and going with eod injections which is what Dr. Crisler kept me on. My estradiol felt like it was shooting up. I requested a lab through defy, and it was very high. They said I needed to take .25mg of arimidex.

Im not refuting or saying that Saya and Crisler aren't the highest standard when it comes to trt docs. I still think they are. I had 40 minutes or so with Crisler, and I haven't experienced the personalized approach or expertise I expected.

Regarding the cialis, I take it, but I'm also seeing new people and not in a long term relationship. I have absolutely no problem with erections or erection quality, except when my estradiol is off which is roughly 10% of the time. So, I'm great 90% of the time, but the 10 is awful and stressful. And, I'm not going to take even a 10% risk the first time I have sex with someone or even the first 10 times.
Click to expand...

Houston - the staff should always give the OPTION of speaking with nurse, PA, or physician...the choice is then usually made by the patient whom to follow up with based on the complexity of their case/questions and then also based on the cost of the consult itself. If this didn't happen then it is certainly an error.

Also, the staff is NEVER allowed to make suggestions or recommendations for changes to medications (even anastrozole). They may forward issues to the medical team for their recommendations, but have never up to this point unilaterally changed a patients dosage or even suggested a change in dosage as this would be grounds for immediate termination. If this has indeed occurred, please forward the name of the staff member along with any supporting info and it will be addressed swiftly and permanently.

Lastly, why not set up an appt to review with me? I've seen just about every possible variation of difficult to manage estradiol cases and, while there's never any guarantee, it would certainly be a good next step. Also, as mentioned, if you provide your DOB I should be able to pull up your chart and can offer some insight even prior to an official consult.
 
I've been a defy patient for the last 2years and also have high E2 levels 55,59,57 but I'm very Happy with DR SAYA and his staff (GREAT CUSTOMER SERVICE especially Amanda Brooks ,Charles, Missy and MIRANDA). I'm overweight and that might raise e2 levels and my diet isn't the best but I'm making changes . After Suffering with LOW T for 6 years and having NY doctors that treat numbers and not the symptoms or the patient, DEFY has been a BLESSING! My E2 levels Fluctuate but are being aggressively treated by DR SAYA 1mg of Anastrozole 2x a week. Hopefully they'll level out or I know DR SAYA will adjust my dose of Anastrozole.
 
At this point, this is a matter between the member, HoustonTx, and the staff at Defy. Dr. Saya has offered his comments and suggested a way to proceed. We all wish them well.
 
I don't want to start another thread but curious If Dr. Saya or Jasen could assist me. I have had a couple issues on communication and not getting a response. When it comes to making adjustments to the protocol, reviewing supplemental labs who should we email or call? Do these situations require a consult?
 
Loki said:
I don't want to start another thread but curious If Dr. Saya or Jasen could assist me. I have had a couple issues on communication and not getting a response. When it comes to making adjustments to the protocol, reviewing supplemental labs who should we email or call? Do these situations require a consult?
Click to expand...

Hi Loki -

Generally any adjustments to protocol (dosage, frequency, etc) are best suited for a consult (with nurse, PA, or myself) to assure all bases are covered and all questions answered. Also, lab reviews are required for "required labs", any "supplemental labs" should be reviewed with a medical team member before, as noted above, any protocol changes are made. It is generally not wise, both medically and legally, to make protocol changes outside of the context of a valid medical consult (which is one reason I *try* my best to not make changes via email, online forums, etc)...my malpractice carrier would get very upset with me :-(
 
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