(Music) (A headline saying "Notice from pharmacists" and still images of a medication notebook and a medication manual are shown)
(Narration): When you are admitted to the hospital or visit the hospital as an outpatient, bring documents that show which medication you are taking, such as your medication notebook and medication manual.

(A headline saying "Do not take multiple medications with the same effect," an illustration of Hospital A and Clinic B, and two kinds of tablets are shown)
(Narration): When your medications are prescribed by multiple medical institutions, it is necessary for us to check which ones you are taking, because the same medication may have been prescribed. Although the names of your medications may differ, the same ingredients might be present in them, especially when you are taking generic medications.

(A headline saying "Combination of medications" and still images of several medications are shown)
(Narration): When you are taking multiple medications, it is necessary for us to check them, because their combination can weaken or strengthen their effects and thus the desired effect may not be obtained.

(A headline saying "Drug suspension: suspending medicine-taking" is shown)
(Narration): You might be required to suspend taking medication depending on your symptoms or disease to prevent the medication from having negative effects on an operation.

(A headline saying "Look at a scene showing a patient and a pharmacist" is shown)
(Narration): Mr. INOHANA Taro is scheduled to undergo an operation after being hospitalized. After visiting the hospital as an outpatient, he was advised to visit a pharmacist to check the medication he is currently taking.

(Video of a pharmacist meeting Mr. Inohana at a consultation room at the hospital is shown)
(Pharmacist)：Hello. My name is Niibe, and I'm a pharmacist. Let's talk about your medication. Are you taking any?

(Inohana): Yes. Their names are written here (medication notebook).

(Pharmacist): You are taking medication for blood pressure and diabetes. Here you are. Thank you very much. Do you use any medication that you have bought at a pharmacy or a drug store?

(Inohana): No. I'm not using any.

(Pharmacist): Do you take any health foods or supplement?

(Inohana): No, I'm not taking any.

(Pharmacist): Have you ever had allergic symptoms or felt sick after taking certain food or medications?

(Inohana): Nothing in particular, I believe.

(Pharmacist): Do you have any concerns about taking medication?

(Inohana): At the consultation I just had, I was told to stop taking this medication. But I am worried if it is all right to stop taking it, because I am taking it every day.

(Pharmacist): You were told to stop taking this medication, right? I assume you are very anxious about stopping a medication you have been taking for a long time. The medication you are taking is a blood thinner. If you take this before the operation, it will make it difficult to stop bleeding. That's why we are suspending its use. As your attending doctor told you, please stop taking this medication from Wednesday next week.

(Inohana): Is that right? I understand. Do I have to stop using it permanently?

(Pharmacist): In many cases, patients start taking this medication again after an operation. So please pay attention to what your doctor has to say after the operation. Also, please keep taking other medications as usual, except the one the doctor told you to suspend using.

(Inohana): Sure. I am relieved to hear that, because I was bit worried.

(Pharmacist): If you have to undergo surgery in future, a doctor might not necessarily tell you to suspend using the medication. So please don't stop taking it at your own discretion. Is there anything else that concerns you?

(Inohana): No, nothing in particular.

(Pharmacist): So, please bring other medications that you are taking at the time of your hospitalization.

(Illustrated image of consultation between a pharmacist and a patient is shown)
(Narration): As we've seen, a pharmacist may ask you about medication that you are taking before you are hospitalized. Please be sure to bring your medication notebook and medication manuals when you visit the hospital as an outpatient.

(A headline saying "Supplementary information 1" and a still image of medication and illustrated image of medications are shown)
(Narration: It is difficult to take out the suspended medication if it is packaged together with other medication for you to take at a certain time.

(Narration: It is difficult to take out the suspended medication if it is packaged together with other medication for you to take at a certain time.
(Narration): If your suspended medication is packaged with other medication, please consult with your pharmacy. If it is difficult for the pharmacy to take out the suspended medication, please let our staff know, because the Pharmacy department at Chiba University Hospital can handle it.

(A headline saying "Supplementary information 2," a still image of medications and illustrated images of an outpatient consulting with a doctor and being hospitalized are shown)
(Narration): In case your medications change between the outpatient consultation and hospitalization, please be sure to let your attending doctor and family doctor know about the change.

(A headline saying "To close," a still image of prescribed medications and an illustrated image of over-the-counter medications are shown)
(Narration): Please declare all medications you are using, including medication prescribed by other medical institutions, external medicines, including ointments and eyedrops, and over-the-counter medication you usually use.

(Illustrated images of health foods and supplements as well as an illustrated image concerning allergies and side effects are shown)
(Narration): Let us know if you take any health foods or supplements. Also, it is essential that you tell us if you have any allergy to certain foods and drugs and/or any side effect after taking certain medications.

(Illustrated images of medications are shown)
(Narration): Patients' cooperation is essential in order for them to receive good medical care.

(Contact)
Pharmacy department, Chiba University Hospital
Tel: 043-222-7171

(Music)
(A headline saying "Confirming medication before an operation" is shown)
(Still images of medicine notebooks and a medicine manual are shown)
(Narration): Please bring your medication notebook, medication manuals and other materials that can identify medications you are taking.

(A headline saying "Do not take the same medication" and an illustrated image of medical institutions are shown)
(Narration): Caution is required not to take the same medication when multiple medical institutions prescribe your medication.
Many medications have the same ingredients, even though their appearances and names are different - a problem compounded by an increase in the number of generic medications. That's why we confirm the medication you are taking.

(A headline saying "Be cautious about medications combination" and illustrations of capsule and tablet medications are shown)
(Narration): It is necessary also to pay attention to combinations of medications.
When you are taking several kinds of medications, their combination can weaken or strengthen the effect and this cannot achieve the desired effect. So, we check which medications you are taking.

(A headline saying "Drug suspension," illustrations of packaged tablets, a pharmacy and a still image of the Pharmacy Window of Chiba University Hospital are shown)
(Narration): We may ask you to suspend taking a medication depending on your symptoms and disease.
If your suspended medication is packaged with other medications, please consult with your pharmacy.
If it is difficult for the pharmacy to take out the suspended medication, please consult with the Pharmacy department at Chiba University Hospital.

(Illustrated images of an outpatient consulting a doctor, a hospitalized patient and an attending doctor are shown)
(Narration): In case your medications are changed between the outpatient consultation and hospitalization, please be sure to let your attending doctor and family doctor about the change.

(Illustrated images of internal medications, eyedrops and ointments, health foods, supplements and over-the-counter medications are shown)
(Narration): Do you take medications prescribed by other hospitals? Please let us know about all such medications, such as internal medication, ointments, eyedrops, medical patches, health foods, supplements and over-the-counter drugs.

(Illustrated images showing allergies and side effects are shown)
(Narration): Be sure to notify us if you are allergic to any drugs or foods and if you have had side effects after taking a certain medication.

(A still image of a meeting between a pharmacist and a patient is shown)
Patients' cooperation is essential in order for them to receive good medical care.

(Music)
(A headline saying "The purpose of rehabilitation in perioperative period" is shown)
(Video featuring Chairman MURATA Atsushi of the Rehabilitation Medicine Department is shown)
(Murata): Even if your operation treated your ailment successfully, you may experience post-operation suffering due to a delayed recovery, which could lead to a delayed release from the hospital. There are two possible causes.
One is pulmonary complications. If your lungs do not inflate well or phlegm is not spit out entirely, there could be pulmonary complications.
Second is disuse syndrome. Several days of rest can lead to weakened muscles, lower cardiac function, and/or decreased mental functions such as memory and judgment capability.
The purpose of perioperative rehabilitation is to prevent such complications.
Surgeons operate on patients, while rehabilitation staff can assist you in functional training.
But patients themselves hold the key to overcoming disease.
I would be happy if you can prepare thoroughly for your operation by using this video as a reference.

(Video of medical staffers assisting patients after an operation is shown)
(Narration): Patients who are normally active in their daily life may find it difficult to get up by themselves, due to becoming tired easily or staggering after undergoing an operation involving the use of full anesthesia.
You might find it difficult to spit out phlegm as a result of weakened coughing strength due to pain stemming from surgical incisions.
After your operation, it is important to spit out phlegm and start walking together with a rehabilitation staffer or ward nurse soon after the operation.

(Video of patients undergoing a walking practice or other kinds of rehabilitation is shown)
(Narration): To get over difficulties following your operation, it is recommended that you build up your physical strength before the operation and learn how to spit out phlegm well beforehand.

(Examples of explainer videos for rehabilitation and a video of a person walking are shown)
Please prepare for your operation by practicing these steps every day by looking at a pamphlet or videos, and by building up your physical strength through walking and other forms of exercise.

(Music)
(A headline saying "Visit the Oral-Maxillofacial Surgery department for outpatients " is shown)
(Illustrated image of a person's oral cavity is shown)
(Narration): The oral cavity is inside the mouth.
It has important functions such as breathing, vocalizing, biting, tasting and swallowing.
But there are many germs -- reportedly 500 to 800 kinds - inside the mouth.

(Animated depiction of germs from the mouth entering the lungs is shown)
(Narration): Germs in the mouth can enter the lungs when a tracheal tube with germs is inserted into the trachea, triggering complications such as pneumonia.

（A headline saying "Be careful: the power of resistance decreases after an operation" and an illustration of a patient lying in bed are shown）
(Narration): Patients who have just undergone surgery must be especially careful, because of their decreased power of resistance.

(Animated illustration showing how the entire body is affected by oral germs and the likelihood of developing complications when compared with when oral care is performed: Cerebral infarction, a factor of 2; aspiration pneumonia, a factor of 2 to 5; premature delivery of a baby with low birth weight, a factor of 4 to 7; diabetes, a factor of 2 to 4.)
(Narration): Failure to perform oral care will affect the entire body; increasing the likelihood of developing cerebral infarction, for example.
This is why oral care is needed.

(A headline saying "Oral care is needed!" is shown .)
(Narration): There are three purposes.
Prevention of infectious diseases.
Improvement in speaking, tasting, swallowing and other oral functions.
Improvement of digestion and absorption, remedying bad breath.

(Bar graphs showing the differences in the length of hospitalization at four clinical departments between patients who have or have not undergone oral care: When oral care was provided, the hospitalization period in the Dentistry and Oral-Maxillofacial Surgery department decreased to 78 days, compared with 102 days without oral care; to 29 days (42 days) in the Gastroenterology department; to 29 days (39 days) in the Cardiovascular Surgery Department; and to 69 days (108 days) in the Hematology department.
(Narration): According to a study done by the hospital, many clinical departments reported that patients who received oral care recovered early with shorter hospitalization periods.

(Still image showing oral care given to a patient)
(Narration): This shows a specialized staff member removing tooth tartar from a patient before an operation.

(Still image showing special instruments used for oral care)
(Narration): Tooth tartar, etc., is removed by using special instruments.

(Illustrations showing tooth decay treatment and testing for periodontal disease)
(Narration): Treatment of tooth decay and testing for periodontal disease are also conducted.

(Still images showing before and after oral care)
(Narration): As a result of oral care, the teeth became clean like this.

(Slides showing the procedure to receive oral care)
(Narration): It is necessary for you to make an appointment for specialized oral care at the outpatient section of your clinical department.
After conducting examinations and making a diagnosis, we will plan and conduct oral care.

(Slides showing specialized care and self-care)
(Narration): Oral care requires specialized care and self-care.

(Video showing a staffer massaging her parotid gland)
(Narration): For example, putting the ends of fingers on your cheek around the back teeth of the upper jaw and gently massaging around the cheek with all your fingers.

(Video showing a staffer massaging her submandibular gland)
(Narration): Put your fingers under the jaw bone and massage gently from under your ears to the tip of your jaw.

(Video showing a staffer messaging her sublingual gland)
(Subtitle) Repeat this five to 10 times.
(Narration): Use your thumbs to push the lower jaw upward.
You are encouraged to do these steps by yourself from today.

(Music)
(A headline saying "Receiving anesthesia safely with a peace of mind" is shown)
(Video featuring Professor ISONO Shiroh, Chair of Anesthesiology, Pain and Palliative Care Medicine department, is shown)
(Isono): Hello. As anesthesiologists, we manage anesthetics administered to patients, as well as their entire body, during operations by keeping a constant watch over them so that they can be operated on safely without feeling pain.
There are roughly three kinds of anesthetics.
Local anesthetics keep patients conscious, while, undergoing full anesthesia allows patients to sleep during an operation. The other type of anesthesia is a combination of the two.
This video explains how a patient will receive anesthetics and be operated on in an operation room.
First, please look at this actual example.

(Video of a patient entering an operation room is shown)
(Music)
(Subtitle) Only patients can enter the operating room.
Family members are not permitted to enter.
We ask the patient for their name, blood type, etc. for identification.

(Video of the patient lying on the bed is shown)
(Subtitle): A patient lies down on the bed and takes off his surgical gown.

(Video of a nurse putting a monitoring instrument on a patients' fingertip is shown)
(Subtitle): A monitor to measure electrocardiogram and other vital signs is put on the patient.

(Video of a nurse placing an oxygen mask on the patient is shown)
(Subtitle): Before putting the patient under full anesthesia, an oxygen mask is placed on the patient.

(Video of a nurse injecting a drug through an intravenous drip is shown)
(Subtitle): A drug that will put the patient to sleep is injected through an intravenous drip.

(Subtitle): After that, the patient will be under full anesthesia and will sleep without feeling pain until the operation is completed.

(Video of a surgeon, a nurse and an anesthesiologist during an operation is shown)
(Isono): As you can see in the video, in the operating room, not only a surgeon, but also an operation nurse and an anesthesiologist work as a team to conduct the operation.

(Video featuring Professor Isono is shown)
(Isono): The safety of anesthesia has improved in recent years, so I hope patients will undergo operations with peace of mind. But no medical procedure is 100 percent safe. We thoroughly study the nature of the operation and the condition of the patient's entire body, and then propose an optimal anesthesia method for the patient. We use it only with the patients' consent.
I assume many patients are worried about pain after their operation. But please feel at ease, because we administer a painkiller during the operation.
It is not good to endure pain. If your pain worsens, please consult with a ward nurse without hesitation.

(Subtitles are shown)
(Subtitles): It is extremely important to prepare appropriately to conduct anesthesia procedures as planned in an operation such as the one shown in this video.
Before an operation, anesthesiologists and operating room nurses check the conditions of the patient's entire body, as well as the state of preparations. Additional laboratory tests and preparations are conducted if necessary.
In doing so, the anesthesia questionnaires on the last page of the pamphlet will provide vital information.
Please fill out the questionnaires after watching this video.

(Music)
(A headline saying "Breathing exercise" is shown)
(After the headline "1. Deep breath (stretching the neck, shoulders and around the chest)," a video of staffers taking deep breaths is shown)
(Narration): First, let's do a breathing exercise.
Stretch your neck, shoulders and the area around your chest by moving your body in sync with your breath.
Inhale from the nose on the counts of one and two, and exhale from the mouth on the counts of three, four, five and six.

(After the headline "2. Neck stretching," a video of the staffers moving their head up while inhaling from the nose and returning the position of their head to the original state while exhaling from the mouth is shown)
(Narration): Move your head up to stretch the neck muscles while inhaling and then return the position of your head to the original state while exhaling.
Inhale on the counts of one and two, and exhale on the counts of three, four, five and six.
Stretch your neck muscles well.

(After the headline of "3. Frank stretching," a video of the staffers tilting their body sideway while inhaling and returning to the original position while exhaling is shown)
(Narration): Tilt your body sideway while inhaling and exhaling while returning your body to the original state.
Take a deep breath through your nose and exhale a long thin breath from your mouth.
Be mindful to stretch your flank well.

(After the headline of "4. Arm raising exercise," a video of the staffers raising both arms while inhaling and returning their arms to the original positions while exhaling is shown)
(Narration): Inhale while raising your arms and exhale while lowering your arms to the original position.
Stretch your chest well.
Do each stretching exercise five to 10 times.

(Music)
(A headline saying "Abdominal breathing" is shown)
(Video of a staffer lying on his back on a bed with knees bent, his right hand on his chest and his left hand on his abdomen is shown)
(Narration): Put one hand on your chest and the other on your abdomen.
Gently bend your knees.
Slowly inhale through your nose, and exhale a long thin breath from your mouth.
When inhaling, feel your abdomen is inflating with your hand on your abdomen.
Thoroughly practice this before your operation so that you will be able to do this five to 10 times every hour afterward.

(Music)
(A headline saying "Practicing to spit out phlegm (huffing and coughing) is shown)
(A headline saying "1. Huffing" is shown)
(After the subtitle "In cases of abdominal surgery," a video of a seated staffer taking a big breath and exhaling by making sounds is shown)
(Narration): Inhale deeply and exhale with the sound of a long "huh" as if you are trying to fog up a pane of glass.
Next, inhale deeply and then exhale vigorously while making the sound "huh, huh, huh."
This will allow phlegm to come up to the throat entrance.
When the phlegm comes up, cough to spit it out.

(A headline saying "2. Coughing practice" is shown)
(The subtitle "In cases of abdominal surgery" and a video of a seated staffer coughing with a pillow pressed against surgical incisions on his abdomen is shown)
(Narration): When the abdomen has been operated on, place a pillow on the surgical incision before coughing.

(The subtitle "In case of chest (side) surgery" and a video of a seated staffer coughing with his opposite hand under the arm on the operated side are shown)
(Narration): When the side of your chest has been operated on, place the opposite hand on the surgical incisions firmly under the arm before coughing.

(The headline of "In case of chest (center) surgery" and a video of a seated staffer placing a towel on the chest with both hands before coughing are shown)
(Narration): When the center of your chest has been operated on, place a bath towel or other soft objects on the surgical incisions before coughing.
While protecting your wounds, take a deep breath and cough vigorously.

(Music)
(A headline saying "Stretching" is shown)
(After the headline "1. Calf stretching," a video of a staffer putting his hands on the backrest of a chair and pulling a leg backward to stretch the calf is shown)
(Narration): Place both hands on a stable place, and pull one leg backward and put your weight on it.
Maintain this position for 30 seconds and slowly return your leg to the original position.
Do the same with the other leg. Repeat this for both legs twice.

(After the headline "2. Stretching the entire body," a video of a staffer lying on his back on the bed with knees bent and then placing both knees to one side while turning his head to the opposite direction is shown)
(Narration): Lie on your back with knees bent.
Place your knees to right side and turn your head to the left.
Be careful not to lift your shoulders from the floor.
Keep the posture for 30 seconds before returning your body to the original position.
Do this for the opposite side. Repeat this twice without holding your breath.

(Music)
(A headline saying "Muscle training" is shown)
(After the headline "1. Lifting buttocks," a video of a staffer lying on his back on the bed with knees bent and then lifting his buttocks up and returning to the original position is shown)
(Narration): Lie on your back with your knees bent.
Lift your buttocks from the floor and after taking a breath, slowly return them to the floor.
Keep a distance of 30 centimeters between your buttocks and heels. Do not arch your back or bend your knees too much.

(After the headline "2. Abdominal muscles," a video of a staffer lying on his back on the bed with his both hands on his knees as he raises his upper body is shown)
(Narration): Lie on your back with knees bent.
As both hands reach your knees, raise your upper body while exhaling.
Bend your neck as if you're looking at your navel.
Lift your upper body enough to raise your shoulder blades.
After taking a breath, return your upper body to the original position.

(After the headline "3. Leg raises," a video of a staffer lying on his back with one leg stretched and the other bent and then lifting the stretched leg to a 45-degree angle is shown)
(Narration): Lie on your back with your right leg stretched and the left leg bent.
Lift your right leg to a 45-degree angle and slowly return it to the original position.
Points to remember are not to bend the knee of the leg you are lifting, and to keep your toes pointing upward.
Do the same with the other leg.

(After the headline "4. Heel raising exercise," a video of a staffer placing his hands on the backrest of a chair and lifting and lowering his heels is shown)
(Narration): Stand up while putting your hands on a stable place.
Lift both heels from the floor to stand on tiptoe and then slowly return them to the original position.
Be careful not to bend your knees or arch your back.

(After the headline "5. Half squat," a video of a staffer placing his hands on the backrest of a chair and then bending and slowly unbending his knees while keeping his heels on the floor is shown)
(Narration): Stand up while placing your hands gently on a stable place.
Bend your knees and slowly return them to the original position.
Be careful to bend your knees at a 45-degree angle.
If possible, try to bend your knees further as close as possible to a 90-degree angle.
Points to remember are not to lift your heels or arch your back.
Each exercise should be repeated 15 times.

(After the headline "6. Calf pumping," a video of a staffer lying on his back on the bed and lifting and lowering his toes is shown)
(Narration): Lie on your back and move your ankles upward and downward vigorously. Moving your calves will improve the blood circulation.
After undergoing an operation, it is recommended that you do this as frequently as possible.

(A headline saying "To close" is shown)
(A video showing a person walking outside)
(Subtitle): Exercise before an operation.
(Narration): To gain physical strength before hospitalization, take a walk that results in mild shortness of breath, or the exercises we have introduced.

(Video of a person walking in the hospital after an operation) is shown
(Subtitle): Rehabilitation after your operation
(Narration): After your operation, you are encouraged to spit out phlegm, start walking frequently soon, and spend the day without lying in bed as much as possible.