The time required to accomplish the goals stated can be extremely variable, but in uncomplicated cases, our patients remain in hospital for approx 4 d. Earlier discharge times are quoted by some authors (9). An important factor is the need to rule out endocrine complications before discharge, especially if, as in our unit, the patient population is not drawn entirely from the immediate locality.
The dosage of discharge medications, especially steroids, and their purpose, should be clearly explained to the patient. It is especially important to advise patients who are discharged on hydrocortisone replacement of the need to double the daily dose of steroid in case of an accident or severe illness. A steroid card is issued with written instructions. The drug regimen and the plans for continuation of therapy or retesting are communicated to the patient's family practitioner.
At discharge plans can be made for the timing of formal endocrine assessment as an outpatient and for postoperative imaging, which is usually undertaken at 3 mo.
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