Post-Transplant Wellness
Preventive care
after transplant
It's very important to stay healthy after a transplant
and to prevent infections. All transplant patients
need to follow these guidelines:
- See your primary care physician at least once
a year
- Have a yearly flu shot
- Have a pneumococcal pneumonia vaccine every
five years
- Avoid contact with anyone who has had a live
virus vaccine
- Wash your hands frequently especially before
eating
- Have your teeth cleaned every six months
- Keep your skin as clean as possible
- Avoid people with colds and communicable diseases,
such as chickenpox, measles or herpes
- Avoid exposure to the sun. Wear sunblock and
a hat.
- Women should have a yearly Pap smear and mammogram
- Men should have a yearly prostate specific
antigen (PSA) test
Exercise
after your transplant
If you've just received an organ transplant, you're
most likely weak from the illness that caused
the need for the transplant. In addition, you're
recovering from major surgery. As a result, you’ll
need to resume exercise gradually. Regular exercise
with gradual increase of intensity is essential
to achieve and maintain your best level of fitness
and health. You should not lift anything that
weighs more than 15 pounds for at least 2 months.
You'll need to exercise regularly to regain your
strength. Because you may feel tired at first,
you should take rest breaks during exercise. Walking
is an excellent form of exercise when you first
get home. Gradually, increase the amount and type
of physical activity you enjoy. Ask your transplant
physician or nurse before taking on a new sport.
Remember to avoid any activity that could cause
a direct blow to your transplanted organ.
Avoid
weight gain after transplant
The average weight gain after organ transplantation
is between 15 and 35 pounds. Some people need
to regain weight if they were underweight before
transplantation. However, excessive weight gain
often occurs as a result of eating habit changes
after transplantation. In addition, many individuals
experience an increased appetite as a result of
steroid medication.
Excessive weight gain can be harmful to your
health because it increases the risk of heart
disease, vascular disease, diabetes
and hypertension.
To avoid excessive weight gain:
- Be smart when food shopping. Choose low-fat
dairy products made from 1% or skim milk, and
lean meats, such as canned tuna packed in water,
chicken breast, turkey breast or extra lean
ground beef. Buy more fresh vegetables and include
them with meals at least twice a day. Also try
selecting healthier condiments, such as mustard,
"lite" mayonnaise, "lite"
salad dressing or tub margarine.
- Choose healthy cooking methods. Bake, grill,
broil or boil foods. Avoid frying. Use nonstick,
fat-free spray, fat-free sauces or unsaturated
oil (substitute 1 tablespoon of olive or canola
oil for butter).
- Avoid overeating. Curb your appetite by drinking
more water. Try to eat high-fiber foods, such
as raw vegetables and fruits, which make you
feel full.
- Be cautious when dining out. Most restaurants
serve large portions, so save half for later.
Avoid high-fat entrees, such as prime rib, chicken
wings or fried fish. Choose grilled chicken
breast, grilled and baked fish, or veggie burgers
instead. Stay away from entrees cooked in high-fat
cream sauces, and instead choose marinara sauces.
Also, limit high-calorie condiments by asking
for salad dressing or mayonnaise on the side.
- The transplant dietitian is available to you
if you need additional support.
Diet
after transplant
After your lung transplant, you will be feeling
better and looking forward to returning to your
normal lifestyle. A major part of that normal
lifestyle is the ability to enjoy eating again.
However, Prednisone, a steroid that decreases
your body's natural tendency to reject your new
organ, affects the way in which your body processes
food.
Everyone who receives a transplanted organ will
take Prednisone. You'll notice that your appetite
may increase quite a bit while you take Prednisone,
and you'll be likely to gain weight, putting on
both pounds and inches.
Prior to your discharge from the hospital, a
dietitian will talk to you about your dietary
goals and requirements. You may gain less facial
and body fat if you follow a low-fat, low-calorie
diet. However, each person is different, and the
dietitian will recommend meal plans that might
work for you.
Prednisone tends to decrease calcium absorption
and increase the risk of osteoporosis. Therefore,
you should add more calcium to your diet, in the
form of calcium-rich foods, such as low-fat dairy
products and green, leafy vegetables or calcium
supplements.
Generally, people who have received an organ
transplant should eat a balanced diet with plenty
of fruits and vegetables and a minimum amount
of salt, processed foods and snacks. The recommended
daily allowances include:
- 2 to 3 servings of milk, yogurt or cheese
- 2 to 3 servings of meat, poultry, fish, dry
beans, eggs or nuts
- 3 to 5 servings of vegetables
- 2 to 4 servings of fruit
- 6 to 11 servings of bread, cereal, rice and
pasta
Serving sizes are listed on food package nutrition
labels. Eat as little fats, oils and sweets as
possible. Try to watch your food intake and develop
good habits that will help control any weight
you may gain.
You should strive to stay within a normal weight
range and add exercise to your routine.
Don't drink alcohol or use any drugs that aren't
prescribed by your physician, as these may harm
your new organ. If you have a problem with drugs
or alcohol, talk with your social worker for help
in arranging for counseling and other support
services.
If you have any problems with your diet, or with
weight gain or weight loss after transplant, tell
your transplant coordinator and ask to see a nutritionist
who could recommend changes in your meal plan.
Sex
and reproduction after transplant
Many transplant recipients are curious to
know how their sex lives will change after their
transplant. Most transplant recipients return
to normal sexual activity after their sutures
are removed and their incisions have healed.
Practicing safe sex after your transplant is
more important than ever. A woman's menstrual
period usually returns within 6 months of transplant,
though ovulation often starts sooner, so you need
to use birth control immediately. A condom and
diaphragm, when used properly, are the most recommended
form of birth control. If your period is irregular
after your transplant, you should discuss this
with your gynecologist.
Female transplant patients of childbearing age
who want to have children should consult with
their doctor before becoming pregnant. Though
childbirth is often possible, there are serious
health considerations for you and your baby.
Male transplant patients of childbearing age
usually remain fertile. In fact, male transplant
recipients who were infertile often become fertile.
Any infection following a transplant is serious.
If your partner has open sores on his or her genitals
or in the mouth, abstain from sex. If you develop
unusual sores or vaginal or penile discharge,
see your doctor.
Some medications may impair sexual function.
If you think this may be true in your case, talk
to your doctor or specialist.
Reviewed by Robert
Kotloff, MD
Last updated September 2004
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