Lifestyle Adaptations for Transplant Patients

After the transplant, I was like a new person altogether. Post-transplant is a great lifestyle change. Because you feel so good now, it’s
amazing how well the body reacts, or how your mind reacts to pain and memory – you forget all that
stuff. It’s an inner change to accept what
you’ve gone through. I wanted to live! And I was given this
opportunity. It has been the most wonderful experience. Narrator: Being a
transplant patient presents many lifestyle adaptations after surgery. If you’re like Mark, a kidney transplant
recipient, you’re ready for solutions that will
facilitate your recovery and help you get back to enjoying life.
You know the temperature Miami yesterday? 32 degrees. Ah, perfect! I can’t wait. I really need this
holiday. You and me both! Hey, we’ve been doing
everything right. We’re going to do this right too. This video will help you identify the activities and events in your life that now require
special attention and show you how to handle them. Things
such as exercise and returning to work; getting an updated
medical alert bracelet; rules you must follow concerning
prescribed and non-prescription medication; proper sun protection; the importance of
good nutrition; seeing your dentist and doctor; sexual
activities; birth control; precautions concerning
household pets; and even planning a vacation. There are
some things you’ve never had to think twice about before, like driving, and remembering to keep the
seat belt from irritating your incision. A person can expect to return to activity driving a motor vehicle once
they feel capable and have cleared this with their
individual transplant coordinator or physician. There are some restrictions, however, if
all persons experiencing headaches, dizzy spells, or visual disturbances, the
spine should be reported to the coordinator and of course they should
not be driving a motor vehicle at that time. Also, if the patient is using pain
control medication that contains narcotics, such as Demoral, Codeine or Percocets, again they should
not be driving motor vehicle. No matter what type of transplant you
had, always wear a seatbelt. Just remember to
protect your incision. keep a towel or small pillow in the car
and use it for extra padding until the area heals. For example, if you have had a lung or heart transplant place the towel here. Liver transplant
recipients need protection in this area, and kidney patients, here. Exercise it’s good for you; just take it easy for
the first month or so. Don’t lift anything over 10 pounds. Go
easy on the abdominal exercises. Avoid push-ups and pull-ups, and don’t
push or pull heavy objects. Kidney transplant patients should avoid
these activities for at least two months. Lung, liver, heart, and pancreas transplant
patients – three months. For patients following
transplant, we do have individual programs for them, specifically the lung transplant patients.
They come to exercise with us for the first three months,
three times a week and they do a gradual increase in
exercise. The heart transplant patients, we give them an individual program as well,
and we provide education for them, in that they have a denervated heart and they don’t have a normal response to
exercise, so we make sure they follow their signs and
symptoms and comfort levels for exercise. For the liver patients, again, we get them up, mobilizing them, making sure they
independent in walking and stairs and they are given a gradual exercise
program in preparation for home. When I went into the hospital, I obviously wasn’t feeling well, and I was in a bed for three weeks, and i got up
and I look at my legs, my legs were really thin, and they had never been that
thin before. So, I knew that I had a lot of work to do! Two to three months may seem like a long
time not to be able to do something as simple as lifting a ten pound weight, but it is six weeks for other types of
surgery. The reason it’s more for transplant
recipients is your medication delays the healing process. So, think about what you’re doing at all times. A bag of groceries, or a small child, may be
more than you can handle. This may require some problem solving
for mothers home all day with youngsters. Every day, things that you once took for
granted like grocery shopping, lifting appliances,
or moving furniture, now require special consideration. And
remember, it’s not forever. I started exercising I was swimming – I took up swimming because that was one of my choices. I did do stationary bike also, and I wasn’t working, so I did a lot of mall walking, which really helps for those who don’t have those facilities available to them. Walking is
probably one of the best ways to get back in shape. Hey mom! Dad’s going to want to take these to Florida! He’s going to want to, but I think this is the only club that is going to see any action. As soon as you feel ready to do more
strenuous exercise, and the proper time has elapsed, discuss
it with your transplant clinic physician. Talking things over with your
physiotherapist is always a good idea too. You may not be able to do things exactly
the way you did before your surgery. Your physiotherapist can offer
alternatives that will allow you to continue to do the things you enjoy. They suggested that I go back to my
bicycle, and I’m back to 10 kilometers, and I try to do it three
times a week. Once you receive permission from your
transplant team you can return to work. We see
returning to work in post-operative period as as a normal aspect, and part of the post-transplant phase. Our patients do many different
occupations, and I’m whether it’s a job at home, where
you’re lifting laundry or vacuuming, or doing a job in a factory, where it’s
welding, there is absolutely no restriction.
If they have a job which requires a lot of physical
activity, this may make their return to work a little bit longer than somebody
that has a desk job. I made a decision to return on a part-time basis, just to ease myself
into to the workforce and my work didn’t have
any problems with that. So we made an arrangement, and then gradually, over time, increased
my hours until I eventually returned to full-time. I was back fairly early because it wasn’t that strenuous. I’d go to a desk, and I worked the phone, and I’d get in my car and I’d drive and I meet people, so wasn’t that tough
to do. Probably about a month and a half to two months after
the transplant I was back. Any patients with individual concerns
about returning to work should discuss it with
their transplant coordinator or the transplant physician, and appropriate considerations will
be taken in at that time. I need a few things for this trip. Wow! For the first time I list is longer than
yours. I’ll just be a minute I’m heading for
the cosmetic counter. Ok – I’ll see you over by the sunglasses. If you have a medical alert bracelet, it needs to be updated and replaced. The
form is available from your transplant center. Fill it out before you leave the
hospital. Your transplant coordinator will be happy to assist you. Once you receive your new bracelet,
put it on and don’t ever take it off. In the event
that the transplant individual is unable to
speak, it is important that they have their medical alert bracelet or necklace on, so
that they can be identified as the
transplant individual who is immunosuppressed. There is a simple rule to follow when it
comes to taking any medication. All medication, whether over-the-counter or prescribed by your family position or
general practitioner, must be cleared by your transplant
coordinator, or transplant physician. This includes all cold, flu, and allergy
relief products. And, never take pain relief tablets
containing aspirin or ASA unless specifically
prescribed by your transplant physician. The problem with taking a medication
that hasn’t been prescribed by your transplant physician or surgeon is that it might interfere with your
transplant medications. Tylenol plain is usually recommended for
incision pain or headache. if your head ache or pain persists,
notify your transplant team. These days, everyone should wear sunscreen, and
transplant recipients are at an even greater risk of
developing skin cancer because if the immunosuppressant medications they take. Remember to examine your skin regularly
and look for any abnormalities. Make a note of any change and report it
to your transplant coordinator. It’s important for patients to worst
sunscreen everyday, especially whether it’s cloudy or
whether it’s sunny. On cloudy days. though, we are often forgetting to wear them. And the reason being is that people
don’t think the sun is getting through. But the Sun can get through, seventy to
eighty percent. And also, if you’re near water, sand, concrete or
even snow, the sun will bounce off and can affect you.
It is very important to apply sunscreen a half hour before going out into
the Sun. Also, in order to apply it, should be
applied liberally on all exposed areas except
around the eyes. Choose products with the highest Sun
Protection Factor or SPF. Experts recommend 20 to 30, and an opaque sun block for the most exposed areas like your nose, ears, and shoulders. Use a hand and facial
cream, also with a high SPF. Your clothing needs
to be lightweight, and long-sleeved, and wear a hat. It’s
best to avoid going outside when the Sun is at its strongest. This is usually between 11 a.m. and 3
p.m. And, don’t forget, your eyes also need
protection from ultraviolet or UV light. Make sure you
buy sunglasses that filter out UV rays. Hey, take a look at these. What do you think? Not bad, I don’t think your son will be
seen with you though. Why not? Yeah. Before you received your new organ, you
were most likely following a special diet. Now that you’re on the
road to recovery, you were progressing back to a regular
diet. Good nutrition is extremely important to maintaining
your good health, We want people to eat a well-balanced diet. They are normal now, a normal healthy
lifestyle is eating a well-balanced diet. And our
transplant dietitian is always available for people who are having problems or need some guidance in this area. Be sure
to use the tips your dietitian gives you on how to control salt, calories, fat, and cholesterol. The
medication you’re still taking could cause your blood fat and
cholesterol levels to rise. Drink six to eight glasses of water
every day but avoid drinking mineral water because it may contain high levels
of salt. Spring water, on the other hand, is just
fine. Because of the medication, my appetite increased. And I thought, how marvelous! I was eating everything and that’s really enjoying my food,
and then suddenly, I noticed, and well, I could feel it too, I put on 15 pounds.
After transplant, what I looked forward to was having a
bit of salt in my diet, and it made things taste so much better. It’s important to strictly limit your
alcohol consumption because, while alcohol doesn’t interfere
with your immunosuppressive medication, it could interfere with other
medications you’re taking. As well, there are problems that could result by
overindulging, like errors in judgment, or missed medications. We monitor blood
levels really closely. Alcohol intake and alter those levels, so
we may misread the data, and we don’t want to do that and put the patients at risk as well. We ask the patients treat alcohol as
something they have only on special occasions, such as weddings and birthdays, or special family celebrations, that they can have a drink. My body
now tells me that I have to drink in in moderation. Whereas before, when I was sick, I didn’t
feel caffeine, I didn’t feel alcohol, it was all just part of the poison I was in my blood. And now it has all cleared out so quickly that is goes to my head immediately. I’m a cheap date! You know, improve your putting, and you improve your entire game. You’re
right! Putting separates the pros from the
amateurs. Oh, I agree. Hey, maybe you can become the putting
king of North America, go on Letterman even! Okay, you’ve convinced me. Sexual activity is one of the topics that
we like to talk to our patients about. Many people are reluctant to bring up
the topic because it’s very personal and many people get embarrassed about it. But
we believe that sexual activity or sexual beings is really a very important part of us and who were are, and it’s important to think about it,
just as much as it is about blood pressure any of the other health things
that we think about. We find that many people, prior to the
transplant, have not been sexually active because
they’ve simply been too sick. But after the transplant, as they get
better physically, most of them will resume sexual activity
and will become a sexual being again. I felt good about myself, I had a lot of
vibrant feeling. I wasn’t tired, so had to do extra activities, and enjoyed sex a lot better after transplant. The problem isn’t so
much interest at this point in time, it’s
performance, especially for males. Males have a problem with performance. They are impotent or partially impotent,
and the reason for this is that the drugs that are used to protect the
transplanted organ have side effects. They affect the sex hormones, and in men, this causes a a lack of normal
sexual performance. This is a common problem, it has got to be addressed openly and frankly.
There are solutions to the problem but it is a concern to a lot of patients,
particularly men. If you’re involved with sexual activity
with a partner that you’ve not been involved with before,
it’s very important that you protect yourself by either wearing a condom or having
your partner a wear condom, because you are
much much more susceptible to infectious diseases, not just HIV,
but herpes, and many other diseases that you can catch sexually. I think I was pretty much
back to normal pretty quickly. I think the almost the
adoption period, or adaptive period was not for me, was more for my wife I think, because she was more curious then I was, even hesitant. There’s a lot of pressure for the spouse involved as well in all this, and I think that she had more of a
difficult coming back to it than I did. Many patients ask us about the
possibility of becoming pregnant or in fact to fathering a child after a
transplant, and this is an area that that is very
individualized in which we encourage you to talk with us about. Many of the medications that you need for the transplant are reported to potentially cause birth
defects. In the doses that we use we don’t find a
great deal of difficulty in that area, but pregnancy for a woman who is a
transplant patient is a very big undertaking and we really
stress that every pregnancy be a planned pregnancy. It’s very
important that a patient not become pregnant in the first year
following transplantation during the time in which rejection is
the highest, and thereafter there’s probably some risk, but on
balance, most transplant physicians and surgeons believe that risk is low. Not wishing to have children now, we’ve decided to go with condoms and foam rather than taking a
chance of pregnancy. If you’re considering pregnancy, it is very
important discuss this with your transplant physician or surgeon before you
get pregnant. Along with taking care of your new organ, it’s important to take care of your
whole body. Have a yearly checkup with your doctor and ophthalmologist. The medications you are taking do put
you in a higher risk category for certain types of cancer. We think it’s particularly important in
our female patients see their gynecologist on an annual basis for pap smear and for a breast examination similarly
our male patients are advised to see
their physicians on a yearly basis for a testicular examination and a prostate exam, because again ever
increased risk of malignancy in those areas. Your rejection medication also makes you
an easier target for some of the common flu bugs, so you’ll also need a flu shot in the
fall unless you have an allergy to eggs. The reasons that someone who is allergic to eggs would not get the flu shot is the fact that the vaccine is made up the protein which is similar
to the protein found in an egg. Dental
hygiene is also very important to maintaining your health. Along with brushing and flossing twice a
day and bi-annual checkups, there are a couple f important
things to remember: you absolutely must inform your dentist that
you’ve had a transplant and what medications you are taking,
including cyclosporine. You may need to take additional antibiotics to prevent
the chance of infection before you have any dental work done. Any, and that includes a routine cleaning. We
should be notified at least two weeks prior to your dental checkup in order that we
may give you some antibiotic coverage if it is
necessary. It’s very important that if infection is
there that it be treated immediately, because when you’re on immunosuppressive therapy the infection can go through the body
very quickly and we want to prevent this. If you have
a pet, or are considering bringing a new
companion in your home, talk it over with your transplant coordinator or physician. Everybody loves their pet,
and we would just ask if you have a pet that you take certain precautions. We’re concerned about the dander that
pets can have, for example if you have a dog or cat and you’ve had the habit of fluffing up their face and talking
to them really closely, then we would have concern about that
dander causing a particular type pneumonia. It’s infection that we’re
worried about. The droppings from a bird – we’d would be concerned about. It would besomething that we would need to discuss if that’s a very important part that you have.
Litter is a problem for cats. We’re worried about
that dust in the litter box, and the feces in the litter box and would prefer that
someone else look after it. But, if you have to, gloves and masks are a good idea to
prevent inhaling that and touching that. We’re going to be away for two full weeks. Yeah, he’s a little nervous. No, relax!
We’ve got everything totally organized, we’re completely prepared! Yeah we’re even prepared to stay out a
few extra days we’re having fun and that idea is
sounding better and better to me all the time. We want transplant patients to return to
normal, so we want them to have as normal a life pattern as possible, and traveling is certainly an important aspect to living a full life. We do caution
patients, however, to not to travel in the first three months after transplant. The
reason for this is that during this three month period that most the problems can occur, especially with rejection. The incidences of rejection is highest
during the first three months. Patients have to be monitored carefully
and they really should be quite close to their transplant center. Of course, you want your holidays to be as
worry free as possible. A few do’s and don’t’s will help ensure
everything goes right. Always discuss your travel plans with
your transplant team in advance. Get a few extra days supply
of medication in case you’re delayed returning home. Buy airline cancellation and out of
country medical insurance. We would ask that our transplant patients carry with them a letter of information. That letter contains information regarding their drugs, their
latest blood work, and emergency contact numbers, with the physician’s and coordinator’s names
from this hospital in case they would require
any medical attention while out of the country. Some countries require you to have
certain vaccinations well before you leave. This can be arranged through a travel
clinic, and remember to carry your medication and your medical papers with
you on the plane. The stable temperature in
the cabin is better for your medications and you will not risk losing them if
your luggage is lost. Traveling is a big step for all transplant
patients. Knowing you have done everything to make it a successful event
includes being prepared to return home should you become ill while you’re away. If anything were to go really, really wrong, I would come home. I was on this travel
agent trip in Turkey, and I kept up with everyone. In fact, I
was very pleased myself, because no one knew I had had a transplant. I didn’t
want to feel sorry for me, I didn’t want to say, “Oh we’ll have to wait for Phyllis.” We went through the ruins and I did all the walking that everyone else did. We did it. Boy it’s a miracle! It sure is. Beach, pool, t-shirts, sand! Dad, you look kind of funny in those sunglasses. I do? Uh huh. Knowing what you can do, and when you can begin
doing it, is the key to a successful recovery.
The hotel was great, our balcony looked right over the pool.
And always remember, your transplant team is there to help
you every step of the way. Since the transplant, life has been more than 100 percent better. I’m active, and three years ago I had my daughter, Sarah-Lynn. I can take walks, I can do things for myself. I can prepare meals for myself, and I don’t have to rely on anybody. I
feel wonderfully well, I really must say I feel better that I felt years prior to the transplant. It just felt great. It was a small miracle from the way I’d felt from progressively getting worse to
absolutely feeling wonderful. It’s a life-giving thing.