question to Dr or anyone who knows

I was under a great amount of stress with my fathers sickness. Now before this I was doing great with my band and able to eat without any troubles. Doing the stress it seemed like my band closed up and I was vomiting all the time. Well the sad new is that my father did pass away from his illness and is at peach now . I have also relaxed a bit and I am starting to eat without discomfort. Why does stress do this to a banded person? I know I should have had an unfill but with everything going on there wasn't a time I could do that. So I just kept trying to eat. Anyone else had this happen?

Teresa, The only thing I could think of is that when you are under stress you might not be concentrating on eating slowly and chewing well. Dr. C

Agreed. Stress will change your eating habits dramatically without you realizing it. Calvin Selwyn, Jr., M.D. Assistant Professor of Surgery UC Center for Surgical Weight Loss University Hospital/Christ Hospital/University Pointe - West Chester [email protected] 513-475-7770

Hi Dr. Selwyn. Just wanted to let you know I saw you on t.v. last night and you are quite the star. I also wanted to ask you or Dr.Curry about the new findings they are finding about the deaths within a year. It was on the 11 o'clock news. What is causing this and what are the criterias ?Is it for the ones who are very sick or could it be with a post-op who are totally fine for a long time. I would love to hear you doctors clear this up for us. Is this a new study? I think they said 20 %. Thanks for your input. Sincerely ,Cindy

Cindy, My dad told me about this. I am trying to search the internet about this. He said it was on the news this morning. If you find out anything please post. This concerns me as well. Thanks Barb

Cindy, This is what I found..... http://www.whiotv.com/health/5118765/detail.html http://jama.ama-assn.org/ Take Care Barb

I am so sorry about you dad. I have now lost both of my parents and the stress is unbelievable. I think stress is the worst thing that could happen to any ones body. I wish I could help you but there are no words. Lots of luck,love and prayers, Cindy

Cindy: I didn't see the newscast. I must assume that they are talking about the articles that came out in the Journal of American Medical Association October 19, 2005 edition regarding the early mortality rates among medicare patients who undergo gastric bypass. Please realize that these patients are usually >65 years of age and the mortality quoted was for surgeons whose volume was less than 15 persons in medicare patients specifically. The mortality was at one year after surgery for this situation and yes, in that case the mortality was 21.0%, quite high. Also, realize that the mortality for someone over the age of 65 is still significant but for an experienced bariatric centers who do a large volume of medicare/older patients, such as the UC program the rates are much lower in the neighborhood of 1.1% at 90 days after surgery and 3.6% at one year postop, as quoted by the study. In summary, centers should carefully select the patients who would make good cadidates for the surgery and will be successful. Most studies in the past performed by surgeons have concentrated on 30 day mortality as the measure of success of the procedure. This article sheds new light on the longterm outcomes. The numbers you saw are concerning but they also speak to experience of the surgeon and program but also to the serious disease processes that person over the age of 65 have that make them higher risk patients to begin with. Sometimes the risk of surgery is greater than the risk of doing nothing and the article states that it is up to the surgeon to decide when this is the case in Medicare/older individuals. I have said no before to a few patients in this situation when their insurance company had the coverage because I believe it was good medicine and the safest route. P.S. I don't like being on TV, but I do like the education that results from it. I hear radio takes 10 pounds off your voice. If you would like a copy of the articles just email me, if your having a hard time sleeping this will definitely cure insomnia. It's pretty dry reading but good information. Sincerely, Calvin Selwyn, M.D. Assistant Professor of Surgery UC Center for Surgical Weight Loss [email protected] 513-475-7770

Thank you so much for your answer. I do feel better now. Anyway to me you looked like a young kid. You did a great job. Sincerely,Cindy