My son accidentally ingested peanut butter yesterday.  He’s allergic.

He’s done this once before, which is when we found out about the allergy.  He had some really awful hives 3 hours after he ate that small bite of peanut butter sandwich but that was all.  His allergist told me that it would most likely never get worse than that.

He managed to eat some more yesterday.  I braced myself for the hives to come, and we dosed him with Benadryl.  An hour later he vomited.  The pediatrician’s advice nurse advised me to take him to the ER.  At the time I thought it was overkill.  He wasn’t having any breathing difficulties beyond the cough he already had (he has a cold).  He definitely wasn’t acting quite right, though, so off we went.

I barely made it down the street before he started having very long coughing fits.  He was breathing okay in between, but he just kept coughing so much.  He couldn’t go more than 10 seconds without coughing.  About a mile from the hospital (this is probably 1 1/2 hours after ingestion) he started putting his fingers in his mouth but wouldn’t tell me why.  Itchy tongue?

It was the longest ride of my life.  Traffic, red lights.  Imagine being the 13th car at a red light when you have an emergency!  Of course there was no parking when I got to our nearest ER.  I hastily parked in a “reserved” space (sorry, director of geriatric services) and ran in.  Although the waiting room appeared to be full, there was no line at registration.  When I put him on the counter, I noticed that his lips were bluish.  I told the lady at registration and he was in triage within about 30 seconds.

I was a little hesitant to come to this hospital.  About a year ago I had a panic attack, which I had never had before.   I had been hyperventilating for a couple of hours (due to a reason not related to the panic attack) and then it occurred to my CCU trained brain that hyperventilating for a few hours might be Very Bad for my serum pH level.  This made everything exponentially worse and I was immediately convinced that I was going to die.  Convinced. It didn’t occur to me that debating whether my pH was above or below 7.1 might be indicative of the fact that I was most likely just fine.  I think if one’s pH is really 7.1 they aren’t debating much at all!

So we went to the nearest ER late at night.  I was doubtful that I’d make it there alive, visions of ABG’s being drawn and intubations happening… I was really scared and really quite irrational.  But my CCU brain was still there, feeding into it all, convincing me of all the bad things that could happen.

When I got to triage, they could not have been less impressed with me.  A ho and a hum and a normal pulse ox later, I was thrown to the waiting room.  I’ll admit that the normal oxygen level calmed me a bit but I was still hyperventilating for some reason and could not stop.  Already long story short:  Panic attack caused by hyperventilating caused by a probable reaction between two commonly prescribed drugs that I’d taken earlier for The Worst Headache Ever.  Whatever it was wore off, I calmed down, we went home.

So I wasn’t sure, running into that same ER with my son, how responsive they’d be.  I had nothing to worry about.  The triage nurse exuded a level of calm that blanketed over everything.  It wasn’t an unconcerned or disinterested calm.  It was a “I’ve seen this before and know exactly what to do” calm. She handled my son (and me!) perfectly.  She wanted to put the pulse ox probe on his finger and told him that Elmo had been there the day before and had had the same sticker put on.  My son doesn’t know very many cartoon characters, but he knows Elmo very well.  If she’d said Dora or Mickey Mouse or Barney, he wouldn’t have had a clue what she was talking about.  But because Elmo had had it the day before, he finally reluctantly let me put his finger out.

His pulse ox was 90, which is not very good.  Normal is about 95-100 on room air for a reasonably healthy person.  I told them it was an allergic reaction to peanuts and they got us back to a room so fast our heads spun.  When his oxygen level dropped to 85, once again my CCU trained brain had visions of Horrible Things happening, but it never came to that.  After some oxygen, Benadryl and IV steroids, he was back to almost normal.  The hives did show up 3 hours after ingestion on the dot, and they were uncomfortable but not as severe due to the meds he’d received.

So being a highly trained RN is a bit of a double-edged sword when healthcare becomes personal.  On one hand I never needed to ask for clarification about what anyone was saying, and I had no trouble understanding the conversation between the doctor and nurse.  I knew the reason for and possible side effects of every medication they talked about giving him.  I knew what all the equipment was for and what the normal numbers were supposed to be.

On the other hand, I knew exactly what they were talking about, I knew what everything was for and what normal numbers were supposed to be.  When I realized they weren’t normal, I was pretty freaked out.

I intuitively knew why we had to put an IV in, but couldn’t help thinking about possible infection of the site and infiltration.  I wasn’t worried about giving the Benadryl as he’s had that several times in his life for various reasons, but the Solumedrol he needed?  That’s a drug I’ve probably given a thousand times, and never have I seen a reaction from it.  But this was my son, and how was it going to affect him?  Did they know how to calcuate the dosage based on his weight?  Would there be a miscalculation while drawing it up?

Everything turned out fine.  Everyone was professional and competent and knew just how to deal with a sick kid and his anxious mother.  Kiddo is completely back to normal today and is no worse for the wear from the whole experience.

But now my complacency about peanut butter is gone.  The hives were certainly awful but not life threatening, so I hadn’t really been overly concerned.  I’ve been careful, of course, as have those who watch him, but 3 year olds are 3 year olds and they are amazingly fast.  Now that I know it can affect his airway, I’m even more concerned about the times that he won’t be in my direct control, especially when he starts to go to school.  I feel like I’m going to need to tattoo it on his forehead.  I think the public in general (and schools in particular) are more aware of allergies, which is a tiny bit comforting.

He’s also allergic to eggs, which I used to think was the bigger pain in the butt.  There’s a lot more that he can’t eat due to eggs than peanut butter, but his reaction to eggs is very minor comparatively.  I used to even think that if I had a choice, I’d rather he not be allergic to eggs.

I’ve changed my mind.

When Beth found out that her husband had cancer, a friend suggested that she look into creating a page on CaringBridge.org.  As she puts it, “CaringBridge became a tool to help us communicate with others.”

I spoke with Sona Mehring last week, who is the owner of CaringBridge.  The site started as a simple webpage for a friend of Sona’s who was going through a difficult pregnancy.  Sona and her friends used the site to keep friends and family informed of updates, keeping everyone in the loop without having to make several phone calls each day.

Thus, CaringBridge was born.  Anyone with an illness or those who are taking care of someone with an illness can create their own webpage through the site to keep friends and family informed of the patient’s progress.   It’s free, there are no ads, and Beth states, “I appreciate its ease of use. It is an intuitive interface, so it didn’t take much time at all to set up and use. I’ve never been frustrated using it!”

Sona pointed out that using the site is beneficial to 3 different groups of people.  The patient stays connected to family and friends through updates.  Those who get updates can then sign a guestbook with questions or words of encouragement.

The patient’s main caregiver can also benefit from messages of support.  Being a primary caregiver can become very isolating as they become more and more involved with the patient’s day to day care – traveling to appointments, trying to procure test results or helping out in the hospital.  The caregiver might also find comfort in being able to journal their feelings on the site.

And the site can aid the community’s ability to rally around the patient and caregiver.  Sona mentioned a study showing that contact with family and friends can decrease significantly when someone is diagnosed with a major illness.  One of the biggest reasons was that the patient’s community did not want to “bother” the patient or caregiver.  This concept was not lost on Beth, who said, “I sense that some are eager to keep in the know, but do not want to feel like they are bothering me.”

CaringBridge not only connects patients with community; it also connects patients with other patients.  Sona explained that patients and families often meet others going through the same thing in waiting rooms or treatment rooms and swap CaringBridge websites, thereby forming a support group of sorts amongst themselves.

Sona says that people come to use the site mainly through word of mouth from current and previous users.  Hospital employees also refer patients and families, and CaringBridge is active in trade conferences as well.

Personally, as a nurse, I think this site is a fantastic idea.  I certainly have days at work when I’m getting call after call inquiring about the status of a patient from different family members.   We always encourage families to designate one person to call the unit for an update and then disseminate that information to everyone else.  Rather than making numerous phone calls, that designee can update the website.  People visiting the site can enter an email address to be updated automatically every time an entry is made.

Beth did say that it’s sometimes difficult to know how to say things: “One of the challenges has been knowing what to share and how to share it, as the information is broadcasted.”  She went to on explain that when both caregiver and patient are contributing to the site, the needs of both need to be taken into account.  One person may have the desire to share a lot of information when the other person might want to show a little more restraint.

The last feature about the site I want to mention is the ability to easily turn a journal/pictures/guestbook into a real book.  Sona mentioned that some of these books are even used at memorial services.

If you’ve been reading codeblog for awhile, you know that I don’t regularly endorse websites.  I find CaringBridge.org to be exceedingly useful to patients and families and wanted to help spread the word.

You can also find them on Twitter and Facebook.

I took care of an elderly man recently.  He’d been dealing with multiple medical problems for almost 30 years.  Despite being in some very significant pain, he still made eye contact, still said “please” and “thank you.”

He wasn’t faking the pain.  He was very stoic, but I could tell he was hurting.  That tight-lipped grimace, the tachycardia, not moving a muscle unless it was absolutely necessary.  Still, manners prevailed.

My colleagues and I went above and beyond for him and his family.  There’s just something about being polite to others that makes those others want to help you and help you and help you some more.

I’m not saying that we don’t want to help those that aren’t overly polite.  It was just nice to be treated, well, so nicely.  I wouldn’t expect everyone in severe pain to maintain such decorum.  Every once in awhile you just click with a patient and it makes being a nurse so enjoyable.

So!  News #1.  Another of my posts has made it into a book.  It’s called “Lives in the Balance” and was edited by Tilda Shalof, who has written quite a number of books about ICU nursing.  I have read some of those books, so when she personally asked for one of my posts to be included I was quite flattered!

I’ve read the whole book, which is full of very compelling stories written by nurses who work in ICU.  I highly recommend giving it a read, and not just because one of my little posts made it in!

News #2 will only be news if you don’t follow me on Twitter or Facebook.  I am just over 10 weeks pregnant!  We are over the moon about this and can’t wait to meet him or her in late July.

And I guess the bonus news is that this blog is 7 years old this month :-)

First of all, hightail it over to Reality Rounds for the latest edition of Change of Shift!  She did a splendid job of making it very spooky by renaming our blogs.  (I am Corpseblog!)

And tune in tonight at 6pm PST to the Dr. Anonymous show, where he will be interviewing me.  Talk about scary :-)  I am excited to finally be asked (I’ve waited years!) but also nervous because I am not exactly well-practiced in live interviews!

Welcome to Grand Rounds!  This is volume 6, number 6…. and the 6th time I am hosting… during the week of Halloween.  Does anyone else find that creepy coincidentally satanic fascinating?!

(Incidentally, if you are reading this through RSS, I am aware that the formatting is less than optimal.  Very sorry about that and we are trying to fix it!)

For this edition, I thought we could go out Trick or Treating on Medblogger Lane.  I’m sure we will find some colorful stories along the way…

The first house we come to seems amiable enough.  The porch light is on and when the door is answered, some good old fashioned chocolate is put into my Trick or Treat bag!  Even though she is diabetic, apparently Amy at Diabetes Mine prefers to give out the real stuff instead of the sugar-free kind.  The reason may surprise you.

The next house also has the porch light on, but no one answers the door when I ring the bell.  Finally I notice a note that says I should just take some candy from the bowl.  Not Nurse Ratched is horribly sick with H1N1 and doesn’t want to spread any germs.  Read her first-hand account of what it’s like to be knocked out by this flu.

Dr. Bates from Suture for a Living is at the next house.  She has some great candy but it was kind of a pain to get.  She said that the candy was password-protected and that I had to prove that I had a professional responsibility to eat the candy, and would not eat it out of mere curiosity.  Take a gander at what happens when HIPAA is peering over your shoulder when you go looking around where you shouldn’t.

If I thought that was hard, I was not prepared at all for what I’d have to do to get the sweets from Barbara at Florence dot com.  First, I had to document that we did a time-out so that the correct candy would be given.  After that I had to document that the candy was received.  She actually made me eat some in her presence so I could document that the candy had no adverse effects on me.  Then she had me stick around to report off to the next trick-or-treater about everything that had just transpired.  You might be tempted to skip this house, but you can’t.  She shares her perspective about a recent study that claims nurses spend 35% of their time documenting documenting documenting.

The next house was just crazy.  When I arrived, they would only open the gate to let me in if I was wearing a face mask.  Laika from MedLibLog wasn’t taking any chances after watching this very descriptive video that shows how the flu virus is transmitted and starts taking over the cells in your body.  When I finally got past the gate, Dr. Val from Better Health informed me that she would love to give me some candy, but unfortunately the Big Candy Store down the block ordered it all up and now there wasn’t any left.  So I wouldn’t feel as though I wasted a trip (and a mask!), Dr. Anonymous sat me down and told me all about the candy H1N1 flu, including busting some myths about the vaccine and informing me of when it might be available.

On my way to the next place, I passed someone dressed up as a shark.  That reminded me of Dr. Auerbach’s post at Healthline.com about shark attacks – why they attack and steps we can take to avoid being attacked.  I was especially amused at reading this: “…it is important to note that any shark, including the seemingly docile nurse shark, will bite a human if sufficiently provoked.”  I’m sure there are a few doctors out there who learned that the hard way.

I finally arrived at the Medblogger Lane Haunted House.  It was with much trepidation that I walked through the front door…

…and had to stifle a scream as I entered the room!  A mad scientist was performing various experiments on poor unsuspecting subjects.  You would think that a little playful squirt of lime would result in no harm, but Dr. Charles explains how it could end up badly.  The adjacent hallway was dark and a little spongy.  It seemed strangely reminiscent of a certain screening exam.  The Clinical Cases & Images Blog gives us the quick and easy Cliff Notes version of colorectal screening guidelines.  Allergy Notes describes the scary effects of sulfite hypersensitivity.  In another room Sharp Brains had specimens in jars and was performing tests to find out if caffeine had a sustained lifetime benefit or harm.

The last room had people who have had very scary things happen to them.  Trauma Junkie described a typical day in the life for a patient with Cystic Fibrosis and shares his newfound wisdom about how sometimes the patient teaches the practitioner.  Chris at Life in the Fast Lane relates a story with a very important lesson: sometimes we need to dig a little deeper and ask a few more questions before the medical mystery can be solved.  And Robin at Survive the Journey describes what it’s like to parent a child who has Cushing’s Disease, from diagnosis and management to terrifying flare-ups and hospitalizations.

After all that, I was ready to get back to some more trick or treating!  The next house I came upon was giving out gift certificates to iTunes!  I thought that was perfect because I could use it to check out some of the Anatomy software apps on Dr. Penna’s list.  As I was leaving, I overheard a conversation about a laptop being stolen from Blue Cross Blue Shield and the potential damage that could result.  Dr. Joseph Kim from Non-Clinical Jobs lets us know what to do in case we find ourselves in this predicament.

I finally arrived at a huge scary house… you know, the kind that is decked to the nines in Halloween decorations… the one that makes your heart go just a little faster as you’re walking up to the porch.  I rang the bell, said “Trick or Treat!” and waited.  And waited some more.  Surely a house as big and fancy as this would have great candy, right?!  Finally a piece of paper was slipped under the door.  It asked if I had any conditions that would be exacerbated by procuring and ingesting sweet edibles.  It further stipulated that I needed to meet a minimum threshold of candy before they would provide me with any more!  What was this?  Some kind of confectionery deductible?  I concluded that I had unwittingly arrived at the House of Insurance.

Instead of filling out the forms that had piled up outside, I decided to sneak in the back door to see if I could find out anything interesting, and boy did I ever…

Insure Blog was trying to figure out how Washington would handle 14 million new patients finding themselves on Medicaid if the Baucus health care bill is enacted.  Louise at the Colorado Health Insurance Insider was pondering the composition of hospital boards of directors – are they comprised of objective participants, or is there some significant conflict of interest going on?  And in the corner was a group led by Leslie at Getting Closer to Myself discussing the merits of marrying for love… or insurance coverage.

By this time it was getting late and I decided to head home.  I spotted a big bonfire along the way and decided to stop by to see what was going on.  Several people were gathered around the fire sharing experiences and information.  Jolie Bookspan at the Fitness Fixer described several ways to treat knee pain that do not involve scalpels. Jenni at ChronicBabe informed us about fibromyalgia and contributed a list of resources that provided education on how to live and even thrive with the disease.  Jeffrey at Nuts for Healthcare explained that fibromyalgia remains controversial in the medical community; however, while drug companies have been accused of fear-mongering to a desperate population for a handsome profit, recent neurological research has begun to unravel the biological manifestations of the disease in the hope to pinpoint a cause.

Novel Patient proudly described how she painstakingly stood up against her chronic illness and disappointing new diagnosis.  Rachel at talesofmy30’s divulged her secret for learning to love her body after enduring disordered eating patterns and a type 2 diabetes diagnosis.  Stacey at ACP Internist spoke about a possible reason as to why medical students are not going into primary care.  David Harlow at HealthBlawg gave a detailed account of his experience at the Connected Health Symposium 2009 conference held last week in Boston.  To finish the evening, Barbara at In Sickness and In Health shared with us a story she told her father while he was ill in the hospital.

That’s all for this edition of Grand Rounds.  Next week, Grand Rounds will be held at nonclinicaljobs.com.

Have a safe and happy Halloween everyone!

Last week I attended the Blog World Expo conference in Las Vegas.  This is the first year that medbloggers had a track all to ourselves!  The sessions I attended were interesting, and as part of the audience I was delighted to watch my fellow medbloggers on the panels.  There were lots of thoughtful questions & answers, and many silly antics (how many times DID Doctor Rob get onto the big live Twitter feed anyway?? blogworld blogworld blogworld!)

Unfortunately, due to a splitting headache, I was not able to attend the last session, but I had plenty of chances to meet and spend some time with medical bloggers that I have been reading for years.  It was truly great meeting each and every one of you and I’m looking forward to seeing everyone again!

Meeting Terri from Nurse Ratched’s Place was a real treat, as was meeting Kim at Emergiblog.  Kim posted quite a bit about the conference – you can read her post here, which contains LOTS of pictures!  Kim and I shared a lovely (albeit sugary!) lunch together AND managed also to do a joint interview, which can be seen here. (The MJ Propofol anecdote?  True story.)

Here are some other thoughts from the bloggers that attended, namely Doctor Rob (one of these days I will earn a golden llama for my blog.  It is a blog goal of mine), Dr. Wes, Dr. V, Kerri (congratulations!), Kevin MD, Doctor Anonymous,  Nick MD, and Dr. Ramona Bates.  Ramona made a beautiful quilt that we all signed.  It was given away as a door prize to one very lucky person, who did not happen to be me.  I was really thrilled to meet one of my favorite bloggers who is also the medical blogger I’ve known for the longest time (7 years in December!) GruntDoc.

A big thanks goes to Dr. Val (also fantastic meeting her finally!) who helped arrange the whole darn thing, and Johnson & Johnson and Medpage Today, who sponsored us.

2010, anyone??  :)

Grand Rounds is up at Sharp Brains today!

Next week, Grand Rounds will be held here at codeblog for the 6th time (Yes, GruntDoc, I counted!)  Use the submit your story/contact form at the top of the page, or email to codeblogrn gmail.  There is no theme, but it will be very close to Halloween, so if you want to submit something super-scary, I’m all for it!

He knew she was angry with him.

“Whenever I come to see her, I reach out and take her hand, but she looks away.”

Husband and wife for well over 50 years, they had been through a lot.  They met in another country in another time, and to hear him tell it, it almost seemed fated that they’d end up together.  Since then, they’d moved many times, raised a family, supported each other through myriad illnesses.  They were growing old together.

Unfortunately, “growing old together” doesn’t always work out like we hope it will.  Diseases and illnesses ravage our bodies; dementia ravages our brains.  She’d long ago given up on their little garden in the backyard.  It was her favorite hobby, but she couldn’t manage it anymore.

She had dementia, and she weighed less than 100 pounds.  Though not a result of her dementia, she was unable to eat properly and had slowly grown smaller and smaller.

She had done all the right things.  She was a nurse and she knew how these things could go.  She had an advanced directive filled out; not only signed and dated, but specific treatments and procedures were addressed – feeding tubes, antibiotics, tests, organ donation, resuscitation – really almost everything you can think of.

Many people designate a DPOA – Durable Power of Attorney – along with filling out an Advanced Directive form.  When in a condition where making one’s own decisions is impossible, a DPOA is a person chosen by the patient (in advance of illnesses and while the patient is considered competent) to make decisions for them.  The hope (for us, as healthcare workers) is that the patient has had a long, frank discussion with their chosen DPOA as to what their wishes are.

In her case, although they may have had this talk, her wishes were also explained in great detail in a written document.  A document that we had a copy of in her chart.  A document that her family readily provided to us.

In the condition she was admitted in, she would need IV fluids, antibiotics, x-rays and tests.  She wasn’t completely unconscious, but she wasn’t very coherent either.  Add in her element of dementia, and it was clear that she wasn’t able to make decisions.

Her family waited quite awhile to bring her in.  They were managing her pneumonia at home until she started having trouble breathing.  That is when they brought her to us.

And this is where she and I met.  They only thing she would say to me is, “I want….” but would never finish the sentence.  She seemed to really want whatever it was and I hope I was able to provide it with everything I tried.

Her husband came in to see her, and this is when we had our conversation.  He told me that he knew she didn’t want any of this.  Definitely did not want a feeding tube, but that’s the direction we were going to have to go in in order to treat her.  He said that he knew she didn’t want it, but that he was her Power of Attorney, and it didn’t matter to him – he was going to ask us to give her one anyway.

It was obvious he was grieving and in denial.  There was no malice, only a very matter of fact manner.  And a deep underlying sadness.  It appeared to me that he was simply unable to carry out that which she had painstakingly directed.

He assumed that this was the reason for her anger; the reason that she wouldn’t look at him anymore.  She had trusted him not to put her through this.

I sometimes take care of patients that are clearly terminal.  They often don’t have their wishes written out in a detailed manner; many people don’t even understand what we as medical professionals are capable of doing to them to keep them alive.

My patient knew.

But she chose a person who was unable to follow her wishes when the time came to actually make the heart-wrenching decisions.  We assume it’s our spouse or closest family members who would be our best advocates, but sometimes that isn’t the best way to go.  Of course, then you are stuck choosing someone that will have to go against your family at a most critical and emotional time.  Do you know anyone strong enough to advocate for you?  To make sure your wishes concerning end of life care are honored?

I very gingerly tried to get him to tell me why he would go against her wishes, but he wasn’t able to give me a straight answer.  I could tell that he already missed her so much.  I hope she can forgive him.

When University of Louisville nursing student Nina Yoder blogged about her experience watching a patient give birth in a post entitled “How I Witnessed the Miracle of Life,” she may have thought she was just blowing off some steam. Well her school saw things very differently.

When school officials read Yoder’s post, which included a description of the baby as a “creep” and “a wrinkly, bluish creature, all Picasso-like and weird, ugly as hell, covered in god knows what, screeching and waving its tentacles in the air,” they moved to expel her from school by calling her into an office, searching her for weapons (apparently because Yoder had separately blogged about her support for the Second Amendment), and informing her she was no longer enrolled at the school.

That’s right. No hearing, no notice. Expelled from nursing school for blogging.

Not surprisingly, Yoder sued the nursing school in federal court for reinstatement–and won. U.S. District Court Judge Charles R. Simpson III ordered that Louisville reinstate Yoder because her blog didn’t violate the school’s honor code, confidentiality provisions, or principles of professionalism; the judge concluded that although the post was “crass and uncouth” and that Yoder’s attempts at humor were an “abject failure,” it wasn’t written in a professional capacity or from the view of a representative of the nursing school.

The school had argued that Yoder broke confidentiality principles and the school’s honor code by disclosing “the following identifying information about the birth mother: the number of her children; the date that she was in labor; her behaviors; the treatment that she underwent (an epidural); her reaction to labor (vomiting); and the reactions of her family.”

The court rejected that argument, though, finding that such information was non-identifying; types that would be considered identifying, according to the judge, include “the birth mother’s name, address, social security number, or the like….age, race, or ethnicity….‘financial’ or ‘employment related information’ [and] where she was in labor.”

Yoder maintains that her blog post (and others, such as those in which she mocks a suicide patient and calls alcohol abuse “a choice”) “is a mixture of fiction and satire, aimed to be an emotional relief from daily stress.”

Well Yoder won this round in court, but what do you think? What should students in RN programs be allowed to blog about? Did Yoder cross the line?

Guest post by Michelle Fabio, About.com Guide to Law School and frequent contributor at LegalZoom.com.

My particular take on this is that she crossed the line.  I’m not sure that she crossed it enough to be expelled without due process, though.  She was technically within the lines of HIPAA and thus did not break any laws.  But there are more appropriate ways of letting off steam.  Others will probably disagree with me, which is fine.  I personally found her comments very unprofessional.  -ed.

I meant to link to this awhile ago but didn’t think about it again until today.  Get Better Health posted an article outlining some tips for patients describing ways to stay safe while in the hospital.

They are very good ideas, and I’d take the very last tip one step further.  When you are being discharged and your nurse is going over your discharge instructions, ask for a printout giving information about new medications you’ll be taking.   This should be available at most hospitals… and if it isn’t, it should be.  That way you’ll have a detailed reference you can look at later when you’re at home.

Here is the post. Enjoy!