Going Back Home – Do’s & Don’ts

After your transplant, you will want to return to your normal life as quickly as possible. While the transition from hospital to home is normally a happy time, there are many adjustments to make. At first it may be difficult to return to a normal life as so much may have changed.

A common reaction to going home is to feel stressed. One important way of lowering stress is to make sure you feel confident looking after yourself and monitoring your own health.

Do’s After Going Home

Monitoring Your Health – As a transplant recipient, it is extremely important that you monitor yourself for any signs or symptoms of rejection or infection. You will need to check your weight, blood pressure, pulse, and temperature every day for the first 3 months. Thereafter it should be checked when necessary.

Routine Health Care- Even though you will be making regular visits to the Transplant Clinic, you should continue to have yearly medical check­ups.

Eat healthy foods – Choose vegetables and fruits, whole grain products, low fat dairy products, fish, beans and legumes, skinless poultry, and lean meats. Try to reduce your intake of fat and cholesterol in order to protect your coronary arteries from fatty build­up. It is especially important to limit saturated fats such as butter, cheese, cream, processed meats and chocolate.

Try spices and herbs instead of salt to add flavor to foods. It is important to reduce the amount of sodium in your diet so you will not retain water. Limit salty sauces and canned pickled, processed or cured foods.

Eat plenty of calcium rich foods. Some of the medications you will be taking after transplantation lower your body’s calcium stores, which could cause bone thinning or osteoporosis. Try to eat three servings of low fat dairy products per day. Milk also contains vitamin D, which is equally important for healthy bones.

Use Sunscreens – Skin cancers are a major problem after transplantation. It is essential to use a sunscreen whenever you are outside. Also try to avoid spending time in direct sun. You should have your skin checked regularly by a specialist. The anti­rejection drugs can make you more prone to cancers, especially skin cancers. It is extremely important that you protect your skin from the sun and always wear SPF 30 sun block or cover exposed skin when outside. You need to make sure your skin is checked at least once a year by a dermatologist.

Hygiene – Have good personal hygiene to avoid infections. Bathe regularly, take care of your teeth and gums, and visit the dentist regularly. Keep your house and living area clean. Avoid people with colds or infections. Avoid dusts and molds, wet down substances like soils or potting mix to lower the risk of inhaling dust. Damp dust your house. Go see the doctor immediately if you develop signs of an infection.

Reduce the salt and fluid in your diet. Immediately after your heart transplant your body may hold extra water. You will be able to drink more fluids once your body stops retaining water, however it is recommended to continue to follow a low salt diet as high blood pressure is very common for heart transplant patients. Talk to the doctor about it.

Be careful to maintain blood sugar control. You may have high blood sugars after your heart transplant because of the high dose prednisone medication. To achieve/maintain good blood sugar control, eat regular meals and snacks, limit foods that contain simple sugars like sweetened beverages, regular pop, ice cream, and exercise regularly. Talk to your doctor and dietitian about good blood sugar control.

Eat a high protein diet for about 4 ­ 6 weeks after your heart transplant. Talk to your Dietitian about your long-term protein needs. You need high protein foods to, heal from surgery, prevent infections, prevent breakdown of your muscles due to high doses of prednisone.

Keep the wound area clean and dry. Your doctor will give you specific bathing instructions. The sutures or surgical staples will be removed during a follow-up office visit, if they were not removed before leaving the hospital.

Don’t After Going Home

Do not smoke – Smoking is bad for anyone’s health, and especially bad for your health. Because you are taking anti-­ rejection drugs, you have a higher risk of getting lung infections or cancer. Second­hand smoke is also harmful, so stay out of smoky areas. Smoking is particularly bad for your new heart because it constricts blood vessels, which contributes to coronary artery disease.

Do not drink -We recommend not to drink alcohol after your transplant

Do not indulge in any activities that may cause stress on your sternum (breastbone). Heavy lifting anything over 3.5kg is a no-no. Driving a car, vacuuming, scrubbing, sanding, hammering is also not allowed. You may feel some pain when you go home, so remember to ask your doctor and take pain­killers when needed. After 6 ­ 8 weeks you will be ready to resume most activities.

Avoid grapefruit and grapefruit juice. Grapefruit and grapefruit juice can make your blood levels of your transplant medications too high.
Avoid raw seafood – There is a risk of infection from bacteria that may be present in raw seafood. If you eat raw seafood that is contaminated, you may experience one or more of the following symptoms: nausea, vomiting, diarrhea, abdominal cramping, fever, skin rash and low blood pressure.

Avoid eating foods that will lead to excessive weight gain and high cholesterol. After the transplant, it is often quite easy to gain unwanted weight (fat). There are several reasons why. The medication prednisone can increase your appetite. It changes the way your body uses fat and sugar. Excess weight gain may cause high blood pressure, contribute to hardening of the arteries and worsen blood sugar control for people with diabetes.

Try to keep your weight within your ideal weight range by cutting down on fatty foods and sweets which provide a high amount of calories. Eat 3 meals a day so you do not become very hungry and overeat at meals. Choose low-calorie snacks, such as fresh fruit and vegetables, diet soda, sugar free jelly, sugar free beverages to satisfy your appetite or sweet tooth. Add flavors instead of adding fat to food. Try onion or garlic powder, other herbs and spices, and fat free dressings that are on the market. Eat more high fiber foods (Fruits, vegetables, whole grains, beans). They are naturally low in fat and can help to prevent feeling hungry.

Related Links
Going Back Home – Do’s & Don’ts
Things You Need to Know Post Transplant
Lungs
Intestines
Pancreas

References:
Fortis Memorial Research Institute
www.medanta.org
http://www.bhf.org.uk/