How to Survive a Surgical Hospitalization

So far, I have given you some survival strategies for a psychiatric and medical hospitalization. A lot of the same information will overlap in some areas. To begin, I will go over key points quickly. 

Make sure you need to have the procedure done. Get a second opinion on your condition and possible surgical procedure. Make sure the surgeon explains exactly what will be done and what to expect after the surgery. The surgeons do a good job of instructing people about their particular surgery but they tend to be less forth coming with information regarding your post surgical side effects and care. Post surgical information is extremely important to know because chances are you will be home before they put the last staple on your wound! Your condition has to be near critical to spend any time in the hospital these days.   Ask your surgeon how many times he or she has preformed your procedure; if the answer is less than 25 in a year, ask why.  It is always a good idea to appoint a health care advocate especially if you are going to be placed under general anesthesia. Someone needs to be familiar with your condition and your health care wishes so that they can become your voice if you are unable to communicate. 

Have lab work, x-rays, and scans done on an out-patient basis before your surgery. You really don’t have to be inside the hospital for these tests to be done. Many times a test will show that the surgery may need to be postponed and thus, the reason you don’t want to be in-patient for pre-op testing; you will save tons of money. 

Remember to pack lightly! Please leave jewelry at home. If you do not want to take off your wedding ring, many times this is okay and during pre-op process the tech will place tape around your ring. If your surgery involves your head, neck, arm, or hand, do not wear your ring. The swelling from the surgery can be so severe that the ring will act as a tourniquet and cut the blood supply off to your finger. At that point the ring will be cut off your finger.

If you bring your purse, wallet, dentures, hearing aides, or anything of value, send the items home with a trusted family member. Remember people in hospitals steal things and hospital staff will lose things. Keep this in mind while packing.  

Meet with all of your doctors especially the anesthesiologist. He or she will have your life in his or her hands. Make sure you feel comfortable with the person who has so much power over you in a vulnerable situation. 

HMO’s have made Americans consumers of health care which means you are the boss. You have the right to refuse anything you may not see as necessary. Be informed and participate in your own health care. You are the one who knows your body the best.

If you are able, it pays to shop for a doctor and hospital that has a good track record. If you are in a situation where you could not shop for your health care workers, even if you are midway in your treatment; you can and have the right to change doctors. Remember YOU are the consumer. 

Read your name band before hospital staff places it around your wrist. Check for the correct spelling of your name, correct birthday, correct doctor, and so on. If you are allergic to anything such as medications, foods, or environment make sure this information is on an allergy band. Again, check your allergy band for mistakes before the hospital staff places that band on your wrist. 

If a health care worker comes in your room and has not washed their hands before they touch your body, stop them in their tracks and insist that they wash their hands and for good measure throw on some gloves too. You can stop the sloppiness, mediocrity, and the carelessness of hospital staff. Also, this information must be reported to a supervisor. The supervisor will then alert the infection control department. The infection control nurse will offer the person who did not wash their hands some more teaching and place the person on notice. The two biggest problems in large and small hospitals is that they both share considerable numbers of medication errors and copious numbers of hospital born infections which is called a nosocomial infection. I think until the hospital has to pay for each nosocomial infection, the infections will continue to occur. These instructions place a lot of defensive moves on your part, but you will make it out of the hospital alive, uninfected, and in the process of healing without preventable complications. 

Before surgery you will be asked to abstain from putting ANYTHING in your mouth after midnight. The principal behind this is that if you put anything in your mouth such as chewing gum this will increase the secretions in your stomach. If you should become ill on the operating table and throw-up, you may aspirate (breathe in) your stomach contents. This is very, very, very bad. Many people die because of this scenario. So, remember even if you are not eating or drinking, placing anything in your mouth before surgery can be very dangerous. This includes tobacco products too. Some doctors will allow you to take important medications for blood pressure, diabetes, and heart problems before surgery with a sip of water. This has to be written in your chart as a doctor’s order. Nurses can not independently give anything by mouth before a surgery. Ask if you can brush your teeth before surgery. Some surgeons say no to this question.Also, before surgery mark the place where the surgeon should cut. If your surgery involves your left foot write “DO NOT CUT” on your right foot and write “cut” on your left foot! Use a sharpie so the information will not run off. 

Take off finger and toe nail polish. The reason behind this is the nail beds are an indicator of whether you are getting enough oxygen. Cyanotic discoloration (blue nails) is a bad sign. If you are turning blue you definitely want your surgeon and anesthesiologist to know immediately.   No make up is preferable. The anesthesiologist will place ointment on both eyes while you are under general anesthesia. They tape your eye lids down as well for added eye protection.  Make up will run and irritate the eyes.  St. Johns Wart, vitamin E, Coumadin, Aspirin, heparin, and Plavix are medications that can cause blood thinning, decreased clotting time, and increased chance for bleeding out. (Hemorrhage) Ask your doctor when to stop any blood thinner medication prior to surgery. 

Donate your own blood if you and your doctor think you may need a blood transfusion before, during, or after surgery. Even if the doctor does not think you will need a blood transfusion, donate your own blood for your use only in case of an emergency. I don’t want to get on my high horse about this issue, but in short, blood in America is not safe. Use your own.  

Once your surgery is done you will be transferred to the recovery room. Nurses and doctors monitor your progress. You will get pain and anti-nausea medications. Comfort measures are taken like a warm blanket and ice chips if you can tolerate it. Total body tremors are not uncommon after a major surgery. The tremors go away usually before you get back to your hospital room. The tremors are very disconcerting if you are not expecting them. 

Depending on what kind of surgery you have you may wake up with tubes and drains hanging from your body. They look scary, but they really are not so bad. The drains remove extra fluid from the surgical site. Usually, the fluid collected in these drains is light red in color.

If the fluid changes to slightly thick bright or dark red blood you need to visit your ER immediately. This may indicate you are bleeding internally. Typically, the drains will stay in your wound for about a week. It just depends when the drainage stops.

Make sure before you leave the hospital you are able and feel comfortable emptying the collection container. Have the discharge nurse write down step by step how to handle your drains. Make sure the nurse gives you a phone number for help if you run into trouble with the tubes. 

You will be released from the recovery room after your vital signs stabilize. Once in your hospital room your nurse will assess your needs and provide individualized care. The nurse will show you how to get in and out of bed while splinting your surgical wound. Do not get out of bed without help the first time. Feeling faint is common.  

You will get TED hose placed on your legs to prevent blood clots. TED hose fit tight around you lower and sometimes upper legs. Sometimes the doctor will order sequential TED hose. This type of TED hose wraps around your lower legs and is held in place by Velcro. They fill with air and deflate several times an hour. This type of TED hose will make your lower legs sweat and can be uncomfortable because the outer portion is plastic. Have the nurse smooth baby powder over both legs before wrapping the TED hose on your legs. This goes for both types of TED hose.  You may receive heparin two times a day if your recovery is expected to be a long one. This medication will help prevent blood clots too.  Your vital signs, IV, pain level, intake and output, lungs sounds, cardiac status, bowel and bladder status, neurological checks, and wound checks will all be assessed several times a day and if anything is askew the nurse and doctor will fix try to the problem in a timely manner.  

The day after surgery the nurse will come in and ask you to get out of bed. If you have had a major surgery, you won’t want to get out of bed. Everything hurts! If you refuse to get out of bed and walk the halls, you will run the risk of contracting pneumonia and as mentioned before blood clots. You must get out of bed and walk several times a day to get better. This becomes easier after you have done it for a few times. 

During your recovery, incorporate your loved ones in the healing process. Lean on them for help. Eat nutritious foods and fluids. Ask if you can have a vitamin. You need protein vitamin C for tissue repair.

Listen to soothing music. Keep your stress to a minimum as it becomes difficult to heal physically when you are stressed emotionally. Schedule a massage if you think you can tolerate it.

Get your hair and nails done in the hospital if that kind of thing makes you feel better. Once you are released from the hospital do what you doctor suggests but also try to stay in a steady state.

Listen to your body. My rule of thumb is ‘if it hurts; don’t do it.’ Your body will tell you when it is time to increase your activity.

Observe your surgical wound for infection. Signs and symptoms of infection are: an increase or decrease in temperature. A decreased temperature can be serious because that can indicate sepsis. (This is a blood infection in your circulatory system.) Other symptoms of infection include redness, swelling, and tenderness at the surgical site. Sometime you may see oozing of puss. If any of these symptoms appear seek medical attention right away. You want to avoid sepsis at all costs. 

If you wound opens consider this an emergency. Put a moist sterile covering over the site and go to the ER. Typically, if your wound opens the doctors will not re-close your wound because of the chance of infection. The ER doctors will irrigate the wound and pack it. They will order wet to dry dressings twice a day. A nurse will come to your home to dress your wound. This is painful. Make sure you have enough pain medication for these dressing changes. A wound healing from inside out takes a long time, sometimes several months. Also, you will have a large scar.  

In summary, do your homework on the hospital, anesthesiologist, and your surgeon. Educate yourself on your procedure so that you will know what to expect. Keep the hospital staff on their good behavior. Secure your own patient advocate in case you are not able to speak for yourself. Place instructions on your body to tell the surgeon where to cut or what NOT to cut. Get out of bed and move as soon as possible to prevent secondary illnesses. Nurture yourself and remember ask for help when you need it. Good luck! Happy healing! 

If you find value in this article please consider making a donation to keep the information coming.