Features January 2007 Issue

3 Strategies to Ease Hospital Stays

Prepare now to protect yourself and speed recovery from a future procedure.

Three steps you take before you enter a hospital for treatment can determine how quickly you get home and get better, according to Cleveland Clinic cardiologist Richard Krasuski, M.D.

His prescription for preparation requires thinking ahead actually starting now even if you donít anticipate needing procedures like bypass surgery or angioplasty to restore circulation to heart muscles.

And his advice takes into account new research on the use of statin medications before treatment, and how pre-procedure exercise can help speed your recovery (see related story, right).

1. Today, make sure your doctors have all your medical records, including any images of your cardiovascular system.

Maintaining an illustrated medical history can save time and prevent errors if you need emergency treatment in the future. "One X-ray picture revealing blood flow through your heart arteries may be worth a thousand words in your records," Dr. Krasuski says.

Pictures help reveal your treatment opportunities.

"Iíve seen plenty of patients who were labeled eight to 10 years ago as Ďinoperableí or not eligible for treatment," he says. "Then when we look at the old images of vessels in their hearts we discover that thanks to advances over the past few years, we can offer them something likely to help." Itís true that your doctors would view new cardiac X-rays before performing a procedure. But your medical "photo album" can help physicians learn your heartís history and determine whatís changed.

Words protect against error.

Your written medical history including reports on past procedures, allergies and medications you take, including herbal supplements is essential information to ensure routine good care. It becomes even more important if you need hospitalization.

Example: Your record should show whether youíre allergic to latex, since some surgeons still wear gloves made of it. And if youíve ever suffered an allergic reaction to anesthesia like shortness of breath, hives or facial swelling your medical history should say so.

If you smoke, stop as long as possible before you enter a hospital.

2. Review your physicianís instructions about prescriptions you should stop, and ask what medications you should start, including statins if you donít already take them.

Cleveland Clinic almost always requires patients to discontinue aspirin and clopidogrel or any other medications that prevent clotting before open-heart surgery.

Statins, normally prescribed to fight abnormal cholesterol, are another matter. Taken within two weeks of hospitalization, statins reduce mortality and "acute coronary syndrome," a catch-all term for cardiac-related chest pain and heart attacks, according to recent research (September 25 2006†Archives of Internal Medicine). "We start patients with statins almost the minute they arrive at the hospital and report symptoms suggesting heart damage," Dr. Krasuski says. These drugs appear to carry other protective benefits even before they significantly lower LDL ("bad") cholesterol.

3. Exercise now for future procedures and you may not need them.

Typically, Dr. Krasuski asks his heart patients whether they can climb a flight of stairs without running out of breath. "If you can, youíll do better in surgery, recover faster and require less intensive care following a procedure," he says, compared with those who donít exercise. Starting now to build your cardiac muscles, for example with daily walking, might even help keep you out of the hospital.