Recovering in the Hospital After surgery: 10 things to be aware of

20Oct09

Many things do go wrong in the hospital and I usually applaud the patient and family members who stand up for themselves and question the medical establishment. Here is a list of 10 items to agree to and insist upon id they are not offered in the first 24 hours after a surgical procedure.

1) Keep the leg squeezing boots (sequential compression device) on during the night. Even if they disturb your sleep try to ignore them. They are used to prevent you from getting blood clots (which can kill you and are common after surgery). This non-invasive inconvenience that should be tolerated, and if they forget to apply or turn them on ask about it.

2) Use your call light and ask for help especially if you are getting out of bed for the first or second time. Also, make your request specific (help going to the bathroom, pain medicine, drink, etc.). Do not just ask for the nurse for every request. Most hospitals have nurses aides to help with simple tasks. The RN is caring for several other patients. The aide can fill the water pitcher, boost you up in bed, help you to the bathroom, get you another blanket etc. Make sure whenever someone leaves your bedside the call bell is in your reach.

3) Request pain medication when you have the start of pain. Do not wait for it to become unbearable because it may take an hour to get the pill to you (although it shouldn’t it might). Take the medication as prescribed unless you have a prior personal experience with a negative experience. Remember it must be your own and not a friend or a relative or something you read about.

4) Don’t repeatedly ask if you can eat after or before surgery. The answer is NO for a reason. Before surgery it is because your stomach needs to be empty so that you don’t vomit during the anesthesia induction which could easily be missed. If you do vomit you could breath it into your lungs and really have complications. After surgery you still cannot eat until you pass gas. If you eat too soon you can have major complications that may require you to go back to surgery. The hospital staff and your doctor do have vested interest in you getting well.

5) Bring your essential medications with you to the hospital in the original clearly labeled bottle. Hospitals have formularies. Your particular medication may not be on it. Your doctor is probably not completely aware of what exactly is on the formulary. Medical providers people do not think of drugs in the same way you do. They think in terms of drug classes not brand names. Also, all the supplements that you take (vitamins, herbs, aroma therapy, rubs etc.) leave them all at home. They are considered non essential in the immediate post-operative phase (24-72 hours). Also keep in mind the more pills you request be given the more chance for errors.

6) Do Not refuse vital signs. I know you want to sleep, but the whole reason you are in the hospital is to be monitored overnight. That means vital signs every four hours at least, and your drains emptied and measured. You should also know that if admitted to a certain level of care and vital signs are not updated in a timely manner your insurance company may deny payment because the hospital cannot charge for care that was not rendered. Many claims have been denied for insufficient charting and data that is consistent with the unit or level of care being claimed as medically necessary. This is especially true if you are ready for discharge but you feel you need another night you could be liable for the extra nights charge. It may be cheaper to hire a private RN for care at home combined with medical house call.

7) Get out of bed when they tell you to walk. It will help you heal faster, and it may even help relieve your pain, and it will prevent other complications. It would be much easier for the staff to leave you in bed, but because they care and have your health in mind–take the pain medication and walk.

8) Do not ask what is going on with the patient in the next bed, next room etc. Also, do not ask if their is a certain celebrity on the floor. All of this is confidential. You put the staff in an awkward situation. They are going to say they can’t tell you and you are going to pout. Also, do not take pictures of other patients or visitors or staff.

9) Do I have to have the IV? Probably Yes, otherwise they would not have ordered it. Do I have to have my blood drawn? Again, Yes. That is how they can tell what is going on inside you without cutting you open. Do I have to have this tube in me? Yes, it’s there to help measure, track, drain.

10) The middle of the night is not the time to bring up routine concerns. Overnight you are being monitored by a covering physician, nurse practitioner or physician assistant. That means the person really doesn’t know the specific things that you and your doctor discussed. This covering person knows just enough about your type of case and general recovery and emergency protocols to get you through the night. Any specific questions about your care that are not emergent should be saved for the primary surgeon and their team during the day. Or call their office directly.

Observing these suggestions will make for a more pleasant hospital stay, and get you out as quickly and unscathed as possible. This is just some friendly insider advice based on the requests and behaviors that I have observed in many patients over the years.

If you are in the Manhattan area and would like to schedule a medical house call for after hospital care please visit Metro Medical Direct.



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