Hospitals Are Bad For You. Really. Bad.
(August 13, 2019)
I feel safe in saying that everyone hates going to the hospital. No one ever says, “oh, good, I’m going to be hospitalized for a while” unless they have three or more teenagers at home. But most of us don't admit that we hate the hospital as such. We tell ourselves that what we really dread is the illness that puts us there, or the costs of the institutionalization, or the implication that we’re so sick we can’t live our ordinary lives anymore. Not the hospital experience itself, because we think that that would be childish, to dislike a place where Everyone Is Only Trying To Help You.
Well, it just so happens that hospitals ARE bad for you. So you are right after all to anticipate the experience with horror. They are so rough on the average person that there is actually something called “post-hospitalization syndrome”. It is a real thing, and it is no joke at all. And all the little tortures and indignities that you are subjected to in the hospital (the ones that you feel ungrateful for complaining about) are the cause of it.
It has been known for some time that there is a period of about thirty days after having been hospitalized during which former patients have a markedly increased likelihood of returning to the hospital. In fact, one-fifth of Medicare patients return to the hospital within 30 days of their original release. So ok, not everyone gets all better right away.
But! Here's an interesting thing. Far more often than not, the reason for a patient's return to the hospital is completely UNRELATED to the original problem. Moreover, the seriousness of the original problem isn’t a predictor of who is most likely to return; just because you were really sick does NOT mean that you are more likely to return soon. Those two facts are what originally suggested to a couple of people who were actually paying attention that something else besides ordinary illness and recovery was going on. Those very smart people soon realized that that “something else” was the multiple stressors that patients are routinely subjected to while in the hospital.
Hospitalized patients are not only enduring illness plus treatments and tests which are no picnic in themselves, but as a matter of routine are subjected to multiple circumstances that even alone are known to cause problems in healthy people. Like:
-- Sleep deprivation;
-- Having normal day/night cycles disrupted;
-- Inadequate and insufficient nutrition;
-- Pain that is not well controlled;
-- Medications that produce not only side effects but also
cognitive and physical impairments and discomforts of all kinds;
-- An ongoing deluge of confusing and distressing situations at a time when one is uniquely vulnerable and helpless; and
-- Deconditioning from bed rest and inactivity.
The result is that after a patient is released, they are so weakened from dealing with multiple stressors that for a while they are far more prone to develop problems of every type. Someone newly home from the hospital isn’t just recovering from whatever put them there in the first place. They are in “a transient period of generalized risk for a wide range of adverse health events”.
Because after all, even in healthy people sleep deprivation adversely affects metabolism, cognitive performance, physical functioning and coordination, immune function, blood clotting, and cardiac risk. Disrupting sleep-wake cycles causes problems similar to ongoing jet lag (disturbed mood, physical and cognitive impairment, and digestive disturbances). Regarding nutrition, one study found that 20% of hospitalized patients 65 years and older were consuming less than 50% of their nutritional requirements. That's STARVATION. And the list goes on.
The elderly are particularly prone to this problem of course (one fifth of Medicare patients discharged from a hospital develop an acute medical problem within the subsequent 30 days that necessitates another hospitalization), but it can -- and does -- happen to anyone.
So aside from not running to your doctor for every single problem you develop, and keeping yourself in generally good health so those occasions are limited to begin with, I would recommend this. Anyone who knows they're going to be in the hospital for a bit (or who wakes up and finds themselves there) should call in every favor, make any necessary bribes, promises or threats, and generally pull out all the stops to have someone informed and sympathetic with them at every possible moment. It might spare them, and anyone who cares for them, a great deal of misery.
--dr. diane holmes
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