Discharge: Going Home From the Hospital

Hospital Guide, Part 8: Were you briefed about possible drug side effects and surgical complications?

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The day you get your walking papers is one to celebrate after three to four days in step-down, but you're not home free. There will be follow-ups with the surgeon to check your progress. You may need to start physical therapy, join a smoking cessation program, and get more blood tests.

And again, it is your medications, which very likely have changed, that could trip you up. Drug interactions, side effects, and other medication complications account for nearly two thirds of all problems during the weeks after discharge, according to a 2005 study in the Journal of General Internal Medicine. The more medications, the higher the incidence of adverse drug events.

Before leaving the hospital, you should have all the information you will need at home—not just a printout, but detailed notes. While 90 percent of the patients in the study above said they got written information about their medications, only 62 percent recalled discussing side effects. Patients who knew about side effects were half as likely to have any.

Got questions? A good hospital anticipates this. Patients of Sentara Heart Hospital in Norfolk, Va., receive detailed instructions, including when to stop which drugs. Prescheduled appointments are listed, with phone numbers for the surgeon, cardiologist, and the cardiac surgery nurse practitioner clinic, where nurses take questions from patients or family members during the day.

You need guidelines for reclaiming your real life, too. Sentara tells patients who have had open-heart surgery not to drive for 30 days while the breastbone reknits, unless cleared by the surgeon or a nurse practitioner. The wires securing the bone could break if the steering wheel or air bag slams into your chest. Resuming sex is usually fine, if pressure on the chest and incision is avoided. Because of concerns about low blood pressure, men on certain medications, such as beta blockers, cannot safely restart Viagra until their cardiologist gives the word. Showering is off limits until the fifth postoperative day to protect the raw incision. Bide your time. Think about the coming bliss, the most-appreciated shower of your entire life.

Return to the beginning: A Painless Guide to Navigating Your Hospital Stay

This story was originally reported on 7/15/07.