In the Hospital, Again
I'm bored and blogging in a broad hospital bed. It's a crummy place to be on a warm holiday weekend, but I couldn't breathe so it's necessary that I'm here. Plus it gave me an opportunity to use all that awesome “b” alliteration in the first sentence. Word nerdin', even while ill.
As I mentioned in my intro, my health really took a nose-dive in 2016 when I experienced a colon perforation from a colonoscopy. (Don't worry if you need to get one – they're fairly rare, and I was at high-risk due to my pre-existing ulcerative colitis.) The perforation was my first-ever hospitalization and it was quite an education. I find myself back in the hospital, this time for respiratory issues. As an adult I've been prone to upper- and lower- respiratory infections 2-3 times a year. I get snotty, I cough, and it gets really real when I develop what Joel calls “sick whiny voice.” That's apparently when he and the animals run for cover, because I have gotten ugly-sick. This time, though, the congestion and coughing progressed to severe wheezing and breathing restrictions over the past month, which landed me in the ER twice in the last week. This time, they admitted me and are investigating if I've developed asthma.
Let me pause momentarily to extoll the virtues of the Cleveland Clinic Foundation, at whose affiliated hospital I'm currently located. I am lucky enough to live within driving distance of two world-class health care facilities. Medical care, education, and research is a growth industry in northeast Ohio and the local population reaps the benefits of this. When my dad was diagnosed with diabetes in the '70s he went to the CCF and we've been a Cleveland Clinic family since then. I try to consolidate all my health care providers to affiliates of the CCF because they can all see my entire record and communicate with each other more efficiently. It really streamlines my complicated care. Since I'm juggling specialists for diabetes, thyroid, liver disease, gastrointestinal disease and now respiratory disease (but my heart's in good shape!!) and then my routine stuff like primary care and gynecology, it makes life so much simpler if I don't have to carry copies of my charts around. If you're local, they're worth the drive. If you have a complex case or need major surgery or something, it's worth the extra effort for the quality of care.
I love the Cleveland Clinic. No, they're not paying me, I'm just a fan.
Anyhow. When I was on the surgical ward it was for an indeterminate amount of time, and I couldn't find anything online about how to maintain good mental health as a patient in the hospital. Searching the internet and research literature, I found lots of research indicating that good mental health is crucial to physical healing in the hospital, but I couldn't find useful tips for patients on how to stay sane in that challenging situation. I decided then that if I ever got my oft-imagined blog off the ground, a post with tips for staying sane in the hospital would be a good thing. Now that the website is a reality and I find myself in a similar - albeit less life-threatening – hospital setting, now seems the opportune time.
How to Maintain Good Mental Health and Improve Your Outcomes When You're Hospitalized
You're going to feel a lot of things, and it's ok. Being hospitalized, for any reason, is going to cause you to experience a lot of feelings – some will seem reasonable and some will catch you unprepared. You'll experience a loss of control as nurses, doctors and aides take over your every movement. You will be poked, prodded, and stabbed. Your skin will be examined, and people want to know about every substance leaving your body: color, volume, consistency. They will be completely unfazed as they ask these questions. You will be surrounded by sick people in various levels of pain and distress. You are going to have all kinds of emotions and ALL OF THEM ARE OK. Feel it, then deal with it.
Personalize your space. Hospitals are pretty accommodating these days, but a few upgrades may make you feel more comfortable and relaxed. They will provide toiletries, but I find having some of my favorites like my own deodorant and preferred toothpaste make a big difference. Be aware that you should NOT bring scented perfumes, lotions, deodorants or essential oils unless ok'd by your doctor because of possible allergen triggers. Hospital socks tend to be too warm and bulky for me so I prefer to bring a couple pair of light cotton socks and a pair of slip-on shoes like Crocs. You can tuck the shoes under the edge of your bed and step into them when you have to go to the bathroom or to get testing done. Hospitals take their anti-slip policies very seriously, so make sure you are always wearing something non-slip on your feet when you're out of your bed! Your nurses and aides will bring you lovely warm cotton blankets if you tend toward the chilly, but there is something visually comforting about having a colorful prayer shawl, lap afghan or quilt. I wouldn't bother with the throw if you're only going to be a day or two, but if you're going to be hospitalized more than two or three days, that touch of the familiar makes a big difference for your mental state.
Advocate for yourself. Hospitals have installed dry-erase boards at your bedside that help you be aware of who your care staff is, because there will be a lot of people coming through your room. Check the board to make sure it's accurate. Practice using the names of all your staff. If you call them by their names, they are more likely to remember you and may be more receptive to you. Medical records are good these days, but you are ALWAYS in control of your healthcare. If your treatment isn't going the way you think it should and you don't feel your direct-care staff is working well with you, ask to speak to a supervisor, patient-care specialist, social worker, or ombudsmen. ASK QUESTIONS if you don't understand what is happening to you. Bonus points for using feeling words, “I am nervous about this medication you want me to take. Can we talk more about potential side-effects before you give it to me?” When I was being admitted this time, I wanted the staff here to touch base with my gastrointestinal specialist because he is my go-to guy. He checks on all the moving parts of my medical care, and he manages my scary but effective Humira, which can have some rare but serious side-effects. They didn't see any reason to call him since “this isn't a gastro issue.” Ha! No. I called and left a message for his nurse and asked him to call me before he left for the long weekend. He called me back after he reviewed my labs and x-rays that were done in the ER (benefit of keeping all services in one hospital system!) and we talked about possible complications, as well as changing my dosing for the Humira until the respiratory issue is completely healed. In a spirit of cooperation, I informed my nurse and Hospitalist about my conversation and they entered it in my notes. No one was offended, and I felt better that all my bases were covered. Also, if you take supplements or have a traditional health adviser like a certified community herbalist, make sure your Western medicine providers know exactly what you're taking (including essential oils). They may not like that you are using multiple healing systems, but it's important that they're aware of any potential drug interactions. Follow up with your community herbalist/healer with any new meds after discharge.
Practice patience and use your manners. Like most employees these days, healthcare workers tend to be overworked and understaffed. Plus, they're human, and as humans, we're all fallible. We have good days and bad days, and sometimes work or home screws with our heads and life gets messy. If you can be patient, keep your cool, and use your manners, it will help your helpers get into a better head-space and make their jobs easier, which in turn means you'll get better care.
Get organized. You'll be getting a lot of paperwork and information while you're in the hospital. Get yourself a notebook and a folder and start a medical journal. My favorite is the spiral-bound notebooks that have built-in pockets. Keep some pens or markers handy so that you can write down questions you want to follow up on, directions that you'll need to follow later, and names and numbers of healthcare providers and referrals. You will get all this info in written format when you're discharged, but it is a lot of paperwork and it is sometimes jargony and difficult to comprehend. If you take your own notes in your own words, you have a back-up.
Entertain yourself. Hospitals know we live in a digital age and most of them now offer TVs for every bed and free wi-fi. You are going to have A LOT of time to sit in a bed by yourself and think. If you are a worrier like me, this is bad, bad, bad. Plan to be busy. You will have staff coming and going literally 24 hours a day, but they are focused on attending to all their patients, and while they will chit chat as they have time, they can't stand around and pull you out of your head. Just remember that you want to be careful about what you bring and how you store it because sadly, theft can sometimes happen. For me, my cell phone and either a tablet or laptop is crucial. If I have access to my music, social media, news, and digital reading material I can keep myself happily occupied for a long time. I actually buy a multi-sectioned spiral-bound notebook so I can use one section as my medical journal from #5 and use the other sections for writing, journaling, doodling, writing notes, etc. I like to have a couple magazines, a coloring book & pencils, and a deck of cards. For the longer stay Joel brought me my yarn bag with my current crochet project. I already had lots of family pictures on my phone so I didn't bring any of those. The hospital will often provide complimentary newspapers, and one time there was a candy-striper coming around with seasonal coloring pages and activity books. Since it's Memorial Day weekend, this hospital is passing out carnations to all the patients. These places are full of surprises!
Be efficient. You will likely only have 2-4 square feet for your personal belongings, even for a long-term stay. (Unless you're really rich and can rent the personal concierge medical suites. I can't even imagine. If this is you, congratulations, enjoy, and I'm not too proud to accept gifts if this is useful to you. Ha!) Plan to only bring essential items that would fit into a dufflebag and/or book bag. Leave your really valuable stuff with a family member or put them into the hospital safe, and minimize what jewelry you wear. The hospital won't likely want you wearing a lot of jewelry which could interfere with your treatment, and you don't want to tempt anyone's humanity. If you can, bring a charger that is compatible with all your electronics because you may only have one outlet at your disposal. Choose items to bring that are well-organized, multi-functional, and essential to your well-being.
Use your mental health tools. Plan a schedule for your day. You'll soon learn when you're busy and when it quiets down. Plan on at least a washcloth bath every day. Scrub your stinky bits. Wash your face, brush your teeth and hair, change your undies. Do some meditation – if you're at a loss get a guided meditation from Insight Timer. #link You may even be able to do some gentle chair yoga if your doctor clears it using a video from YouTube. Communicate with your support system by phone or social media. It is beautiful how many people will be genuinely interested in your getting better. Accept visitors in moderation if possible, but make sure that you are getting as much sleep and rest as you can, too. The body does an amazing amount of healing while you're sleeping. If you're able to do a little work from your hospital bed, that's ok, but give yourself permission to not touch your work at all if that is better for your healing! Journal, read, write, draw, daydream. Breathe slowly and deeply. Often. Speak kindly to yourself. Accept that at this time, you have to practice trust and patience and you will be better for it in the long run. Be peaceful. Pray if that feels right. Practice being realistically hopeful about your health and your future. Research and contact local therapists for some brief therapy after discharge if you think you may need help adjusting to post-hospitalization life. If you are faced with a terminal situation, that will require some further guidance and I encourage to ask for spiritual and social advice from your own resources or through help provided by the hospital. However, it's more likely that this is a blip on the radar, or a slight adjustment to a new normal, but either way it's unlikely that this hospital stay is the end of your road.
At the end of this post is a check-list for packing for your hospital stay that you should be able to either download or cut-and-paste into a new document. I hope you find this helpful.
Also, check back soon for my series on transgender issues in culture and counseling. I've actually been working for weeks on a transgender issues post that I'm really excited about, but I've postponed it a couple times. First, because I was creating some mental health seminars for elementary school kids, and then because I got this respiratory goo. But I don't have my notes with me, and this hospitalization has become pressing, so I'll have to put the transgender posts off again. Stay tuned for that, though, and an exciting update about getting back in the office. Yay!
Please leave me some feedback if you find this post helpful, or if you have anything that you would add from your experience to help others maintain good mental health during a hospital stay. Grow Well, friends!