The road to recovery

Many people who have to be admitted to hospital for an illness or an operation think that once the doctor has told the ward staff they are well enough to go home, that's it.

But, in fact, both patient and their partner or family should be aware that this is only the start; a large part of the recovery begins at home.

"Remember if you have been admitted to hospital you have gone through quite an experience," warns Dr Catti Moss, from the Patient Partnership Group of the Royal College of GPs. "You may have lost blood, you may have had an anaesthetic or been given drugs you are not used too, you may have lost weight and your body may be adjusting after an operation.

"You will have been kept in bed and in a very much slower environment than the world outside hospital. So don't be surprised at how much you are affected when you return home."

She advises: "Physical activity is very important on the road to recovery, but take it steady. For the hospital to release you to go home, you only need to be able to get out of bed yourself and walk up and down the ward. So when you get home you may find you are unable to be as active as you might like, at first.

"However you can build this up very easily with a steady plan of gentle mobilisation, doing what is comfortable and gradually increasing it.

"Go for a walk, daily, and don't worry if at first you can only make the garden gate. Just go until you begin to feel tired, take a rest and then walk back - taking little rests on the way if you feel you need to. Listen to what your body is telling you. Try and make sure that if there's an uphill part of your walk, you do that bit on the way back.

"A daily walk is an important part of recovery, whether you have had a knee operation or a gall bladder removed, and is a way of exercising safely."

Dr Moss says patients are often shocked and worried by how weakened they have become when they first start trying to pick up their lives at home again but she says this is perfectly normal and should not be a cause for concern, as long as there is a steady improvement in fitness.

She adds: "Before the hospital admission you may have been very fit and active and be shocked by how weak you feel. Most people will find they get breathless - even if their condition has not involved their heart or lungs.

"But if you have had an anaesthetic, this will have an effect, if you have lost blood this will also have weakened you and that's before you consider the time you have spent in bed. If you have been operated on, your body has taken an extra knocking and will be trying to adjust.

"So take things gently, don't push yourself too hard but do a little more every day and slowly and steadily you will see your strength return."

She says it is both the fittest and the laziest people who find recovery the hardest - the former by pushing themselves too far too fast, and the latter by allowing themselves the excuse of staying a couch potato too long.

Most patients will have been given some form of drugs while in hospital and many are surprised that they find it hard to sleep when they return home. This may be because they have had sleeping pills while on a ward, says Dr Moss. After a few nights the body should readjust and the natural sleeping pattern resume.

Other patients may be having to adjust to a different medication or a new combination of pills which may make them feel strange - especially if they turn out to be not quite the right combination.

Dr Moss says patients shouldn't always rely on the hospital to relay relevant information to their GP; he or she may not be aware of any changes in medication that need to be monitored. "Always get an appointment with your GP to discuss what's happened, as soon as you feel well enough," she says.

Hospital food is a running joke, so it's no surprise that although ward patients are pretty inactive many of them find they have lost weight. "Food portions are small and often people don't feel like eating, or don't feel like eating what is on offer," says Dr Moss.

"When you get home make sure you have good nutrition and eat more fruit and vegetables. It is more important to do this than to take vitamin pills, and if you are eating a proper diet you shouldn't need them. You may possibly be anaemic and in need of iron if you have lost blood, but that is something to ask your GP about rather than self-medicate."

One benefit of a hospital stay is that smokers may have got out of the habit, she says, so why not use it as a good way to kick start a new smoke-free life?

Although the hospital will usually tell you how much recovery time you should allow yourself before returning to work, Dr Moss says each person is different and if you really don't feel well or fit enough you should talk to your GP before forcing yourself back into the workplace.

In addition, says Dr Moss, some people can suffer depression as a result of what they have gone through, and this also needs a GP's attention. "Emotionally, reactions to going into hospital can be quite complex. If you don't feel you are improving, have concerns or are not enjoying life again as you think you should, go and see your doctor."

And watch out if you have ever been called a perfectionist in the past. Dr Moss says it is those who set themselves high standards who will struggle with relaxing into a recovery period, and who run the risk of over-doing it and setting themselves back.

So take it steady, and allow your body to set the pace.