The goal for most of the patients that I see is to keep them out of the hospital. I explain to them that we need to cooperate to accomplish this goal. As a pulmonary physician I can prescribe appropriate medications and treatments, but the patients must take responsibility to follow my instructions and take their medications and, even more importantly, patients need to protect themselves from getting infections. In today’s climate this means patients need to get vaccinations, wash their hands, keep away from anyone who is sick and call us or the family physicians at the first sign of a chest infection.

Unfortunately, despite everyone’s best efforts patients with severe lung disease will end up in the hospital. There are many good things that can be done for sick patients in the hospital but the nature of a hospitalization can cause unforeseen problems. One issue that creates some difficulties in the hospital is the timeliness of blood draws.

A study was actually done on the time at which most blood was drawn in a major US teaching hospital. Most blood was being drawn between 4 and 6 in the morning. This interrupted the sleep of elderly patients subjecting them to delirium and a possible post hospital syndrome. Early blood draws are needed so that the results are available for the decisions needed to be made on the morning rounds.

If you end up in the hospital, go to be early. You need adequate sleep to recover.