FAQ

NWH Main Hospital

The Breast Institute

Cancer Treatment and Wellness Center

Maternal Child Health

Orthopedic and Spine Institute

Radiology

Surgical Weight Loss

Clinical Trials

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NWH Main Hospital

How are sleep disorders diagnosed and treated?

Diagnosing sleep disorders begins with recognition of the possibility of a sleep disorder by the patient, bed-partner, or doctor. For some disorders such as insomnia or restless leg syndrome, a medical history, sometimes supplemented by other testing or the maintenance of sleep diaries, reveals the problem.

For other disorders such as sleep apnea or narcolepsy, the disorder must be confirmed by a sleep study or polysomnogram. A polysomnogram or sleep study is a non-invasive test which records your sleep pattern, breathing, oxygen level, heart rate and rhythm, and muscle tone while you sleep overnight in a private hotel-like room at the Center. For narcolepsy and occasionally other conditions, this study is followed the next day by a similar test performed during brief naps (multiple sleep latency test).

Sleep apnea may be treated by one or a combination of these therapies: surgery, dental appliance, weight loss and/or a breathing device called nasal CPAP. Narcolepsy and restless leg syndrome are treated with medications. Insomnia is treated primarily by behavioral approaches including a relearning of sleep habits.

What are sleep disorders in children?

Pediatric sleep disorders are common. There are a variety of sleep disorders such as obstructive sleep apnea (the most common), infant apnea, restless leg syndrome, parasomnias (an umbrella term for night terrors), sleep talking and confused arousals, sleep walking and others. During a Pediatric sleep study, parents remain in the room with their child for the duration of the evaluation.

Who will perform the evaluation to see if I have a sleep disorder?

The Center for Sleep Medicine is under the medical direction of Nicholas Rummo, MD, who is Board Certified in Internal Medicine and Pulmonology and a Diplomat of the American Board of Sleep Medicine. Dr. Rummo works in cooperation with a team of technologists and consulting staff who are experts in diagnosing and treating sleep disorders.

Dr. Lewis Kass, a board-certified pediatric pulmonologist specializes in pediatric sleep disorders.

How do I get an evaluation?

Discuss your problem with your doctor who can refer you for a consultation or a sleep study. Or call The Center for Sleep Medicine directly to schedule an appointment with one of our specialists.

What happens next?

The sleep study is performed at The Center for Sleep Medicine at Northern Westchester Hospital. This state-of-the-art facility has four patient testing rooms on a dedicated unit of the hospital and offers the latest technology in diagnosing sleep disorders in a comfortable, contemporary setting.

On the evening of the study the patient arrives at the Center between 7:00 p.m. – 10:00 p.m.

Each private monitoring suite is equipped with a bathroom, shower and cable television for the comfort and convenience of our patients. Once the patient has settled in, the technologist connects the patient to the monitoring equipment via stick-on electrode patches without the use of any needles. The hookup procedure takes approximately one hour.

The study is conducted throughout the evening while the patient sleeps. In most cases, the patient is able to leave for his/her normal routine early the next morning.

What does all this cost?

Most insurance companies and managed care plans cover the cost of evaluating, testing, and treating sleep disorders. The Center’s staff will assist you and your doctor to obtain the necessary pre-authorizations from your health plan.

The Center for Sleep Medicine participates with most major insurance companies. Under special circumstances, individual payment plans can be arranged. Don’t let cost cause a delay in diagnosis and treatment. Call today for the care you need. Today, new technology is making it possible to rediscover the energy and well-being that are direct benefits of a good night’s sleep.

What is an Advance Directive?

An Advance Directive helps you express how you want to be treated if you are seriously ill and unable to speak for yourself. An Advance Directive gives clear direction to your loved ones and to the clinical care team taking care of you about the medical treatment you want or do not want to have. An Advance Directive is a gift to you and your family. It allows you to maintain control over how you are treated and to ensure that you experience the type of care and the type of death that you desire.

Why should I complete an Advance Directive?

By completing an Advance Directive you empower your loved one to act on your behalf and ensure that they will make decisions about continuing or discontinuing treatment that upholds and respects your specific wishes for treatment.

What are the types of Advance Directives?
1. A Health Care Proxy: A Health Care Proxy is a document that lets you name someone to make decisions about your medical care, including decisions about life support. By completing a Health Care Proxy Form you are appointing someone to speak for you anytime you are unable to make your own medical decisions, not only at the end of life.
2. Living Will: Is a document that lets you state your wishes about medical care in the event that you develop an irreversible condition that prevents you from making your own medical decisions. The Living Will becomes effective if you become terminally ill, permanently unconscious or minimally conscious due to brain damage and will never regain the ability to make decisions. In a living will, you identify clearly the healthcare treatment you want or do not want.
Do I need to complete both of these documents?

Completing both documents helps to ensure that you receive the medical care you desire. However, you should continue to have ongoing discussions with your spokesperson to assure that person knows your values and wishes and can speak on your behalf regardless of what your circumstances may be.

In addition, it is beneficial to have completed both documents in case you suffer an injury or acute medical episode while traveling and are unable to make decisions for yourself.

Whom should I name as my Health Care Proxy?

It is important that you name a person as your proxy who knows your goals and values and whom you trust to carry out your wishes. Be sure to talk with your agent about your wishes in detail and confirm that he or she agrees to act on your behalf. You can always change or revoke your proxy. If you do make a change, make sure your proxy is aware of the change you make.

*When does the Health Care Proxy decision making take effect? *

So long as you can make decisions, you are in charge. Therefore, your healthcare proxy can only make decisions on your behalf when you are no longer able to communicate your decisions.

Do I need an attorney to complete a Health Care Proxy?

An attorney is not needed and the documents do not have to notarized. However, the documents do require witnesses.

How can I obtain a Health Care Proxy Form?

The Hospital can provide you with a Health Care Proxy form and help you complete it. Please call the Department of Patient Advocacy for assistance 914-666-1951.

Download the 2009 Advance Care Planning Booklet by the New York Bar Association for a complete listing of forms and guidance on completing an advance directive.

What if I have more questions?

Call the Warm Line at NWH if you have questions about yourself or your baby. our Maternity & Nursery Nurses are available 24 hours a day after discharge to answer any questions:

Maternity 914.666.1030
Nursery 914.666.1068
Breast Feeding 914.666.1370

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The Breast Institute

What can I do to reduce my risk of getting breast cancer?

It’s important to know your risk, and even if you’re not at high risk, you still need to be vigilant. Studies have shown that women who do three or more hours of aerobic activity a week can reduce their risk. It has also been shown that being obese can increase your risk. Increasingly, fat is being viewed by the medical profession as a separate, endocrinologic organ that can have important health implications.

Why did I get breast cancer?

Unfortunately, there is no good answer to this question. Many breast cancer patients are women who exercise every day, eat low-fat diets, have low cholesterol and do yoga. While a gene mutation can point to a hereditary link, many other women who do not have this gene mutation also get breast cancer.

Will I need chemotherapy?

Whether you will need chemotherapy is determined after surgery. After surgery the type of tumor is analyzed, along with its size, and whether there has been a spread to lymph nodes. It’s not possible to know before surgery whether chemotherapy will be necessary. What can be known before surgery is whether or not you can have breast conserving surgery, or whether mastectomy is the best option. Through various tests and diagnostic biopsies, a surgeon can have a clear plan of the surgical procedure that is necessary and the treatment that will follow.

Do I really need to have a mammogram?

Yes. Despite the recent controversy about the benefits of mammography, it still is very important to have a mammogram every year, starting at age 40 and continuing for as long as a woman is in good health.

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Cancer Treatment and Wellness Center

Why should I choose to have my radiation treatments at NWH?

When we planned this cancer center we wanted it to serve the needs of everyone in our community. We didn’t believe it was fair to have people travel far for expert coordinated comfortable care. We have succeeded in providing this for all of the common cancer syndromes, and many patients choose to have their care here rather than travel elsewhere including New York City. While we never will say we are better than anyone or any other center, we will proudly say that we are not worse than anyone either. It’s our compassionate expert staff, our healing environment, and our outcomes that speak for us.

How do I know I will get treated correctly?

The reports in the New York Times that highlighted the inherent dangers of radiation therapy and all of the possible errors that could result was an important contribution to the public’s knowledge. We were, in fact, pleased that such information became public because we have always managed radiation treatment and its process vigilantly and seriously. The articles supported our existence as a quality center. Our Quality Assurance Policies and Procedures were not modified at all after their publication because our procedures already go beyond what was highlighted as pitfalls in the articles. We have always been extremely cautious in our double and triple check procedures and in our pursuit of ensuring perfect treatment accuracy. Each staff member understands their role in being alert to any possible error at every step of the process. We use time outs, daily image guidance, entrance radiation measurements, exit radiation dosimetry (gamma function analysis), and constant vigilance to detect and avoid and or minimize any errors we know might possibly exist. It pleases us to know that we have not had any misadministration’s or reportable events since the cancer center opened 5 years ago at Northern Westchester Hospital. We must and will remain vigilant, however.

With regard to gamma knife procedures...

Will it hurt?

No it does not hurt.

How long will it take:

It depends on the volume of area being treated.

Who will be there?

A team of doctors and clinical staff; Radiation Oncologist, Neuro Surgeon, Anesthesiologist, Physicist and Nurses.

What are the possible side effects?

It depends on the area being treated and what symptoms you have.

Will I lose my hair?

No you will not lose your hair.

Laurie Bass Sklaver Infusion Center questions regarding chemotherapy infusions:

Will I lose my hair, what am I to expect?

All our patients receive continuous individualized patient education. Once we receive and review your physician’s written order for chemotherapy we will begin by giving you printed information about the drug(s) that you will receive and the side effects that you can expect. Our staff of Registered Nurses, who are certified in Chemotherapy and Biotherapy Administration, will thoroughly review with you and your care partner the drug information which includes potential side effects. We also have a dedicated pharmacist in the infusion center who assists in our patient education. Your education will continue during all visits to the infusion center.

Will I be nauseous and vomit from the chemotherapy?

Because of the new antinausea medication available today, your physician will order pre chemotherapy and post chemotherapy medication to prevent and or reduce any nausea or vomiting. We will also make a referral for you to our Department of Integrative Medicine. The Integrative Medicine nurses will assess your symptoms and offer Integrative Medicine modalities to aid you. These sessions are complimentary to the patients of the Cancer Treatment and Wellness Center.

What is the Health and Wellness Program at the Cancer Treatment & Wellness Center?

The Health and Wellness Program is designed to support our patients in parallel to their medical treatment plan after they receive a diagnosis of cancer. In addition to traditional medical treatment, (i.e., radiation therapy, chemotherapy, etc.), a dedicated Nurse Practitioner Care Coordinator works with each patient and his or her caregiver to include four additional disciplines in the care plan: nutritional assessment and planning, integrative medicine strategies, fitness and exercise programs and emotional support.

Here is the link to the Health & Wellness program:

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Maternal Child Health

What if I have trouble breastfeeding?

At Mt. Kisco, New York’s NWH, we encourage breastfeeding. For those new mothers who are encountering difficulty breastfeeding, we have 18 lactation consultants on staff who have a high degree of expertise in helping new mothers. All of our nurses also receive extensive lactation training.

What if I don’t bond with my child?

We encourage rooming-in for optimal mother-child bonding. For mothers that are feeling emotionally fragile and/or have concerns about bonding with their child, we have access to social services and other psychological services that can help to ease the very dramatic transition to motherhood.

Can other family members be in the room during delivery?

Every birth is unique and we at NWH respect your personal preferences. Family members are welcome at the birth. We will help you prepare a Personal Birthing Plan before you come to Northern Westchester Hospital so you can make your wishes known prior to giving birth.

Can my husband or partner stay with me overnight?

Our birthing suites provide a home-like surrounding where moms, dads, and babies can all stay together. Rooming-in is available. We have sleeper chairs for partners to spend the night in the room.

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Orthopedic and Spine Institute

FAQs about Spine Surgery

Spine Surgery Questions and Answers

When should I schedule my first post-operative follow-up office visit after surgery?

Please call to make your first post-operative follow-up appointment as soon as you arrive home. The visit should be scheduled for approximately 1 to 2 weeks from the date of your surgery.  Call 914.666.1499.

If present, when will my staples be removed?

You should plan to have your staples removed approximately 7 to 10 days after your surgery date. Please ask your surgeon whether this will be performed at your rehabilitation facility, surgeon’s office, or at another location.

What exercises should I perform at home?

You will be given a series of exercises in your surgery booklet, but please consult with your surgeon or physical therapist about which exercises are most appropriate for your specific condition.

How long will my activities be restricted?

Restrictions to physical activity vary based upon each patient’s specific condition. We recommend speaking with your orthopedist and your physical therapist about specific restrictions relating to your surgery.

May I go outdoors prior to my first follow-up appointment?

Yes, we encourage you to do so; but please keep in mind that you will need to take things slowly at first.

May I drive myself to my first follow-up appointment?

There is a significant difference in driving restrictions depending on your surgery. It is recommended that you consult with your orthopedist and physical therapist about when you will be physically able to drive.

Must I sleep on my back after spine surgery?

No. Depending on which area of your back your surgery was performed, you may lie on your side, your back, or on your stomach – whichever is most comfortable for you. Avoid flexion or extension of your neck or back and try to remain in a neutral (flat) position.

FAQs about Total Hip Replacement

Hip Replacement Surgery Questions and Answers

When should I schedule my first post-operative follow-up office visit after surgery?

Please call your surgeon’s office to schedule your first post-operative follow-up office visit for approximately 2 to 3 weeks from the date of your surgery.

When will my staples be removed?

You should plan to have your staples removed approximately 2 weeks after your surgery date. Depending on your hospital and rehabilitation facility length of stay, or whether you go home after your surgery, your staples may be removed at either the rehabilitation facility, the surgeon’s office, or at another location.

Is swelling of my hip, leg, foot, and ankle normal?

Yes, it is normal for your leg to be swollen for several months. To decrease swelling, elevate your leg above heart level as often as possible (three to five times per day) and apply ice for 20 minutes each time.

What exercises should I perform at home?

You will be given a series of exercises in your surgery booklet, but please consult with your physical therapist about which exercises are most appropriate.

How long will my activities be restricted?

Restrictions to physical activity vary based upon each patient’s specific conditions. We recommend speaking with your orthopedist and your physical therapist about specific restrictions relating to your surgery.

How long will I need to use assistive devices, such as crutches, a walker, or a cane?

You may need some type of assistive device for several months after your surgery. You may need crutches or a walker initially and then advance to a cane as quickly as your strength and balance allow (usually 2 to 4 weeks). Your physical therapist will provide you with specific instructions based upon the pace at which you recover.

May I go outdoors prior to my first follow-up appointment?

Yes, we encourage you to do so; but please keep in mind that you will need to take things slowly at first.

May I drive myself to my first follow-up appointment?

There is a significant difference in driving restrictions depending upon if your surgery was on the right or the left hip... right total hip replacement will require a longer period of time before you can return to driving. You should not drive if you are taking prescription pain medications. It is recommended that you consult with your surgeon and physical therapist about when you will be physically able to drive.

Must I sleep on my back after surgery?

No, but for those patients who are instructed to follow hip precautions, it is necessary that you sleep with a pillow between your legs for the first month or so. This will help prevent your hip from dislocating while your muscles are healing. You may lie on your side, your back, or on your stomach – whichever is most comfortable for you.

Why is my leg bruised?

It is normal to have blood accumulate in the form of a bruise after surgery, but as with all procedure sites, it’s important to monitor regularly. If the bruise worsens or becomes painful, please contact your surgeon and inform him or her of the situation immediately.

My leg feels long – is this normal?

Yes. Muscle tightness and post-surgical swelling may cause this sensation.

How long will I remain on the blood thinner?

You should continue taking a post operative blood-thinning medication for as long as your surgeon suggests.

FAQs about Total Knee Replacement

Total Knee Replacement Surgery Questions and Answers

When should I schedule my first post-operative follow-up office visit after surgery?

Please call your surgeon’s office to schedule your first post-operative office visit for approximately 2 to 3 weeks after the date of your surgery.

When will my staples be removed?

You should plan to have your staples removed approximately 2 weeks after your surgery date. Depending on your hospital and rehabilitation facility length of stay, or whether you go home after your surgery, your staples may be removed at either the rehabilitation facility, the surgeon’s office, or at another location.

Is swelling of my knee, leg, foot and ankle normal?

Yes, it is normal for your leg to be swollen for several months. To decrease swelling, elevate your leg above heart level as often as possible (3 to 5 times per day) and apply ice for 20 minutes each time.

What exercises should I perform at home?

You will be given a series of exercises in your surgery booklet, but please consult with your physical therapist about which exercises are most appropriate.

How long will my activities be restricted?

Restrictions to physical activity vary based upon each patient’s specific conditions. We recommend speaking with your surgeon and your physical therapist about specific restrictions relating to your surgery.

How long will I need to use assistive devices, such as crutches, a walker, or a cane?

You may need some type of assistive device for several months after your surgery. You may need crutches or a walker initially and then advance to a cane when your strength and balance allow (usually 2 to 4 weeks). Your physical therapist will provide you with specific instructions based upon the pace at which you recover.

May I go outdoors prior to my first follow-up appointment?

Yes, we encourage you to do so; but please keep in mind that you will need to take things slowly at first.

May I drive myself to my first follow-up appointment?

There is a significant difference in driving restrictions depending on if your surgery was on the right or the left knee... right total knee replacement will require a longer period of time before you can return to driving. You should not drive if you are taking prescription pain medications. It is recommended that you consult with your surgeon and physical therapist about when you will be physically able to drive.

Must I sleep on my back after surgery?

No, but you may find it more comfortable to sleep with a pillow between your legs for the first month or so. This will provide cushion for your operative-side knee. You may lie on your side, your back, or on your stomach – whichever is most comfortable for you.

Why is my leg bruised?

It is normal to have blood accumulate in the form of a bruise after surgery; but as with all procedure sites, it’s important to monitor regularly. If the bruise worsens or becomes painful, please contact your surgeon and inform him or her of the situation immediately.

My leg feels long – is this normal? Yes. Muscle tightness and post-surgical swelling may cause this sensation.
How long will I remain on the blood thinner?

You should continue taking a post operative blood thinning medication for as long as your surgeon suggests.

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Radiology

Do I really need to have a mammogram?

Yes. Despite the recent controversy about the benefits of mammography, it still is very important to have a mammogram every year, starting at age 40 and continuing for as long as a woman is in good health.

Should I be concerned about radiation exposure?

At NWH Radiology in Mt. Kisco, New York, we are committed to administering the lowest radiation doses possible, while still producing the highest quality images.

Our practices and techniques are regularly monitored by Radiologists and Medical Physicists, in conjunction with the American College of Radiology’s Image Gently™ guidelines.

What is an MRI?
MRI stands for Magnetic Resonance Imaging. MRI is an advanced, state-of-the-art imaging method that produces very clear pictures, or images, of the human body without the use of X-Rays.
The human body is made up of millions of atoms which are magnetic. When placed in a magnetic field, these atoms line up with the field, much like a compass points to the North Pole. Radio waves, tuned to a specific frequency, tip these tiny magnets away from the magnetic field. As they tip, they gain energy. When the radio waves are turned off, the atoms try to realign with the magnetic field, releasing the energy they gained as very weak radio signals. A powerful antenna picks up these signals and sends them to a computer, which performs millions of calculations to produce a black and white image for diagnosis.
MRI has much greater soft tissue contrast than Computed Tomography (CT or CAT scan), making it useful in neurological, musculoskeletal, cardiovascular and gynecological imaging.
NWH offers a high-definition MRI that uses magnetic and radio waves to visualize the structure and function of the body and provide detailed images in any plane. MRI services offered:
• Breast MRI
• LAVA — Specialized Liver Imaging
• MR Angiography
What is Yttrium-90 treatment for liver cancer?

Tumors need a blood supply, which they actively generate, to feed themselves and grow. Interventional radiologists are uniquely skilled in using the vascular system to deliver targeted treatments via catheter throughout the body. In treating cancer patients, Interventional Radiologists can attack the tumor from inside the body without medicating or affecting other parts of the body.

Combining the radioactive isotope Yttrium-90 (also known as Y-90) into microspheres to deliver radiation directly to a tumor allows for a higher, local dose of radiation to be used-without subjecting healthy tissue in the body to the radiation. Each microsphere is about the size of five red blood cells in width. These beads are injected through a catheter from the groin into the liver artery supplying the tumor. The beads become lodged within the tumor vessels where they exert their local radiation that causes cell death. Y-90 radiates from within and is administered via the hepatic artery. Y-90 treatment is approved by the Food and Drug Administration for the treatment of unresectable (inoperable) liver cancer.

NWH is one of only 5 Hospitals in New York State to offer Yttrium-90 therapy for the treatment of liver cancer.

What should I know about radiation safety?

Before your imaging procedure be sure to ask your physician the following questions:
     Why is the test needed?
     How will having the test improve my care?
     Are there alternatives that do not use radiation and deliver similar results?
     Is the facility accredited by the American College of Radiology (ACR)?
     Are pediatric and adult tests delivered using the appropriate radiation doses?

Why should I have my imaging exam done at an accredited facility?

When you see the gold seals of accreditation prominently displayed in our imaging facility, you can be sure that you are in a facility that meets standards for imaging quality and safety. Look for the ACR Gold Seals of Accreditation.

To achieve the ACR Gold Standard of Accreditation, our facility’s personnel qualifications, equipment requirements, quality assurance, and quality control procedures have gone through a rigorous review process and have met specific qualifications. It’s important for patients to know that every aspect of the ACR accreditation process is overseen by board-certified, expert radiologists and medical physicists in advanced diagnostic imaging.

What does ACR accreditation mean?

Our facility has voluntarily gone through a vigorous review process to ensure that we meet nationally-accepted standards of care.
Our personnel are well qualified, through education and certification, to perform medical imaging, interpret your images, and administer your radiation therapy treatments.
Our equipment is appropriate for the test or treatment you will receive, and our facility meets or exceeds quality assurance and safety guidelines.

What does the gold seal mean?

When you see the ACR gold seal, you can rest assured that your prescribed imaging test will be done at a facility that has met the highest level of imaging quality and radiation safety. The facility and its personnel have gone through a comprehensive review to earn accreditation status by the ACR, the largest and oldest imaging accrediting body in the U.S. and a professional organization of 34,000 physicians.

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Surgical Weight Loss

When is surgery a good option for treating obesity?

A person should consider surgery if he or she:

• is morbidly obese
• has tried other non-surgical weight loss options and has not had successful results
• has been obese for several years
• has a condition that is so severe that it requires rapid, urgent treatment
• does not have any active drug or alchohol addictions
• does not have any significant psychiatric disorders

Moreover, a person should consider surgery if the health risks and emotional cost of being obese exceed the risk of having surgery.

Bariatric surgery is the only remedy that has proven to be effective in treating obesity in most patients. Of course, it is possible for an obese person to lose weight without surgery.  However, most obese people lose weight only to relapse and regain weight. Surgery does not replace the need to exercise and make better food choices, but rather, it makes these goals realistic and provides a long-term control mechanism to assist in managing this chronic problem.

What are other options for my weight problem besides surgery?

Bariatric surgery can be an excellent option for treating obesity, but it should not be the first option. If you can lose weight without an operation, that is preferable.  If you cannot and obesity is affecting your health or quality of life, then surgery should be considered. Nutritional counseling, exercise and group programs should all be considered prior to surgery.

How much weight can I expect to lose from surgery?

The amount of weight you will likely lose depends on a wide range of variables, such as:

• your genetic makeup
• what operation you select
• your dietary habits before surgery
• your diet after surgery
• how well you adopt a healthy lifestyle including exercise and proper eating
• your metabolic rate

On average, people lose approximately 70% of their excess weight one year following a gastric bypass. Our results show that after 10 years, most will maintain 60% of the initial weight loss. With a LAP-BAND® Adjustable Gastric Band, weight loss is about 55% to 60% of excess weight.

Those who only rely on surgery and do not change their behavior—by becoming more active and eating healthy—will not have as favorable results.

There are a number of different bariatric procedures…which type of surgery is best for me?

As you know, in medicine, there are no absolutes…each operation has advantages and disadvantages. Some may be done with minimally invasive surgical techniques. You should have a consultation with your doctor to discuss your major health problems, concerns and expectations. At NWH Surgical Weight Loss Program, our surgeon will discuss your surgical options with you in detail and outline a strategy that works best for you.

What are advantages of minimally invasive surgery?

Some bariatric procedures can be done with minimally invasive surgical techniques. With minimally invasive surgery, it is not necessary to cut through the muscle; instead, the surgery is done through small incisions. The surgeon is able to see the operative field using a television monitor. Advantages include a reduction in potential wound complications and hernias, as well as a faster return to full activity. It is important to understand that even when surgery is done through small incisions, it is still a major operation.

What are the risks of surgery?

As we emphasize to our patients at NWH, all bariatric procedures are major operations—even minimally invasive surgery—and pose serious risks. The national average death rate for bariatic surgery is 0.5%. The following list outlines some risks, and is not an exhaustive list. 

Risks and Possible Complications of LapBand


Operative	Short-Term	Long Term
Death	Death	Weight Gain
Anesthesia	Slippage/Prolapse	Slippage/Prolapse
Injury to Other Organs	Vomiting	Vomiting
Cardiac Arrest	Frothing	Frothing
Bleeding	Tube Leakage	Tube Leakage
Respiratory	Erosion	Erosion
Abcess	Port-Dislodgement	Port-Dislodgement
Pneumonia		Mechanical Failture
Infection		Esophogeal Dysfunction
Blood Clots (DVT/PE)		Infection
		Re-operation

Risks and Possible Complications of Gastric Bypass

Operative	Short-Term	Long Term
Death	Death	Weight Gain
Anesthesia	Stricture	Malnutrition
Injury to Other Organs	Vomiting	Calcium Deficiency
Cardiac Arrest	Frothing	Anemia
Bleeding	Ulcer	Hernia
Respiratory	Dumping	Bowel Obstruction
Leak	Obstruction	Chronic Abdominal Pain
Abcess	Re-operation	Fistula
Pneumonia		Ulcer
Infection		Leak
Blood Clots (DVT/PE)		Re-operation

 

While most of these issues rarely arise, it is important to recognize that these procedures should only be done when necessary and by surgeons who have experience in this specialty. Additionally, having the surgery in a hospital provides you complete medical care and resources should they become necessary.

 

When can I return to work?

As you might imagine, the amount of recovery time needed before returning to work varies from patient to patient, and depends on the type of work. Typically, most patients who are healthy return to work in several days following a band, and often less than one to two weeks with other procedures. Of course, your health and fitness prior to surgery is an important determinant of recovery time, and certain patients have a more prolonged recovery. Besides needing to build back strength after major surgery, it is also difficult to make the adjustment to a different way of eating. Additionally, a medical complication can cause a delay. We suggest that you plan to be away from your job for three to four weeks. If you have a strenuous, physical job, four to six weeks is necessary to allow for adequate healing. If arrangements can be made, you may be able to return to light duty sooner.

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Clinical Trials

What should I consider before participating in a clinical trial?
Each clinical trial is unique and has its own benefits and risks.
Some possible benefits of participation:
• You may have more treatment options.
• If the new drug or treatment works, you may be among the first to benefit.
• You may be able to help future cancer patients.
• The trial sponsor may pay for some of your medical care or tests. (Ask how much the sponsor will pay and how much you will be required to pay before you agree to participate.)
   
Some possible risks include:
• Side effects may be worse than standard treatment.
• Side effects may occur that the doctor does not expect.
• New treatments do not always turn out to be better than, or as good as, standard treatment.
• As with standard treatment, the new treatment may not work for you even if it works for other patients.
What questions should I ask about participating in a clinical trial?

As the patient, it is your decision whether to participate in a clinical trial. Since it is your choice, ask as many questions as you need until the answers are clear to you.

How will I know if I am eligible to participate in a clinical trial?

Each clinical trial has eligibility criteria, which are requirements that patients must meet before they can participate. Eligibility criteria might include information about:

• age and gender
• type of cancer
• stage (extent) of the cancer
• previous treatments that you must, or must not, have had
• length of time since you last received treatment
• results of certain laboratory tests
• medicines that you are taking
• other medical conditions
• previous history of any other cancer
• other conditions that are specific to each clinical trial.
   

If you have found a clinical trial you might qualify for, talk to your doctor, or contact the clinical trial’s principal investigator or research nurse.

Do cancer patients ever receive placebos (inactive medicines) in a clinical trial?

Cancer patients in a clinical trial always receive the best standard treatment available or a new treatment that researchers believe is as good or better.

A placebo is a substance that looks like medicine, but is not. Cancer patients are given placebos in a randomized trial only under unusual circumstances. If a placebo is used, researchers may give patients in the control group a placebo in combination with standard treatment to compare standard treatment alone to standard treatment with a new drug.

Who sponsors Northern Westchester Hospital clinical trials?

The U.S. National Cancer Institute (NCI) sponsors many of Northern Westchester Hospital clinical trials. Drug companies may also sponsor clinical trials. This is because these companies must show that their drugs and medical devices are safe and effective in order to receive FDA approval and become available to the public.

How do Northern Westchester Hospital patients pay for clinical trials?

The clinical trial sponsor (whether it is the government or a company) may pay for the experimental treatment, special testing, extra doctor visits, travel time and travel expenses.

Some health insurance companies will cover the costs of procedures that patients would have even if they were not in a clinical trial (routine costs). For Medicare patients, routine costs are covered in all Medicare-qualified clinical trials.

You will be responsible for any costs not covered by the clinical trial sponsor or your health insurance company. Therefore, be sure to ask the principal investigator or research nurse specifically about what costs will be your responsibility if you decide to participate in a clinical trial.

After the clinical trial ends, what happens to the information and results?

Researchers give patients a number or code to protect their identities. When the clinical trial results are published, patients’ names are not used. The research team may access clinical trial information to help the study sponsor submit data to the FDA for approval.

If you want to read what has been published about a clinical trial that you participated in, contact your doctor.

How do patients find a clinical trial at Northern Westchester Hospital?

You can learn more about clinical trials conducted at Northern Westchester Hospital by searching the Northern Westchester Hospital Cancer Center site or asking your doctor.

Where can I find additional information?

National Cancer Institute’s Cancer Information Service: (800) 4-CANCER or (800) 422-6237. Trained information specialists can help callers determine whether they are eligible for various protocols.

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