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Guidelines for Activities

No Smoking

Use your transplant hospitalization as an opportunity to quit smoking if you are a smoker. Our behavioral health team offers a smoking cessation program to help you quit. It is important that you do not smoke, and do not expose yourself to second-hand smoke. Not only does smoking increase your risk for high blood pressure, heart disease and cancer, it can directly damage your new organ transplant.

Exercise Do's and Don'ts

It will take time to regain your strength and endurance after your transplant, but eventually your activity level should get back to normal. Follow these guidelines when you get home:

  • Do the muscle toning exercises that you began in the hospital two times every day.
  • Do not lift anything that weighs more than 10 to 15 pounds until you have been home from the hospital for two months. This includes babies, children and groceries.
  • After two months, you may gradually begin to lift heavier items if it does not cause discomfort around your incision.
  • Walking and stair climbing are excellent exercises for maintaining muscle tone and strength. Consider walking five to ten minutes a day when you first get home, and slowly increasing the time you walk each week.
  • Do not do any strenuous exercise such as contact sports, jogging, tennis, sexual activity, or body conditioning (weight-lifting, push-ups, sit-ups, etc.) for at least two months after you go home. Talk to your transplant doctor or nurse before you resume these types of activities.
  • It is normal to tire easily. Pace yourself, and rest when you are tired.

Driving

You should not drive after leaving the hospital. Some of the medicines you are taking can have side effects that affect your ability to drive safely. You and your doctors must be sure these side effects, such as sleepiness, tremors, muscle weakness, and blurry vision, are under control before you get behind the wheel.

You must also be sure your attention is focused on the road and not on your incision. You should be sure that you could quickly turn the wheel and step on the gas or brakes without being held back by discomfort in your incision. Any pain medication you are taking may interfere with your concentration or ability to stay awake while driving.

When you are feeling stronger, talk with your transplant team about when you can start to drive again. Wait until your doctor or nurse says it is okay. This precaution is an issue of safety for you and others on the road.

Returning to Work

An important goal after organ transplantation is to return to the work force. It may take anywhere between two weeks to six months for you to regain enough strength to go back to work. We strongly encourage you to take at least six weeks off work to ensure you have the time to attend to the frequent clinic appointments and testing you will need after transplantation. Talk to your transplant team about the best time to go back to work. We are happy to provide you with a letter to verify that you have needed time off from work for medical reasons.

If possible, ask if you can work fewer hours for the first week or so that you return to work, until you have more energy. But depending on how you are feeling and recovering from your transplant, you may need to take a longer leave from your job. Your social worker can talk more with you about your different options and may direct you to other resources in the community such as:

  • Talking with your human resources department through your employer.
  • Contacting the Massachusetts Rehabilitation Commission (MRC), which provides comprehensive services to people with disabilities to maximize their quality of life and economic self-sufficiency in the community. Multiple programs in the MRC work together to help individuals with disabilities:
    • The Vocational Rehabilitation Services Program
    • The Community Services Program
    • The Disability Determination Services Program
  • Applying for social security disability (SSDI) or Supplemental Security Income (SSI) through your local Social Security Administration (SSA) office. Contact the SSA for specific eligibility requirements at 800-772-1213 or www.ssa.gov.
  • If you already receive disability benefits, you may be surprised to learn that you can work a limited number of hours without jeopardizing your benefits. Read more about this on the SSA web site: http://www.socialsecurity.gov/pubs/10095.html

Traveling

Always talk to your transplant team before you plan a trip. We can share tips and strategies for taking good care of yourself while you are away, so you can enjoy your travel to the fullest. Here are some guidelines about traveling, especially out of the country.

  • Take enough medication to last for the duration of your trip. Taking enough for an extra two days is a good idea in case of emergencies. Some of your medication may be difficult to get in some locations. Ask your pharmacist how to pack the medications so they will not lose their potency.
  • Do not pack medication in checked baggage. Always keep your medications with you in carry-on luggage.
  • Bring prescriptions for your medications with you and a list of all your medications, allergies and contact numbers for the Transplant Center (617-632-9700).
  • Avoid exposure to the sun and be sure to wear sunscreen with a protection factor of 30 or higher.
  • If you become ill, go to the nearest health facility that is equipped to care for transplant recipients. Ask the physicians to contact your transplant team.
  • If you are going to a foreign country that requires certain immunizations, please ask experts for advice. The travel clinic at Beth Israel Deaconess offers great advice about traveling and immunizations.
  • Always avoid uncooked or undercooked foods, especially meat, fish and seafood/shellfish.
  • Avoid unpasteurized dairy products.
  • Do not drink or use ice made from unpurified water. Use bottled water for drinking, ice cubes, and brushing your teeth.
  • In some countries, the Customs Department may require a letter from the transplant team noting the specific medications you are taking.

Sexual Activity

Sexual intercourse can be a vigorous activity that uses abdominal musculature, which can increase the risk of hernia. Refrain from intercourse, and all strenuous exercise, for at least two months after you go home. Other sexual activity, such as kissing, is fine. Feel free to discuss guidelines with your physicians.

Because you have been through a difficult surgery and are still recovering, it may take several months for sexual desire to return to what you and your partner consider acceptable. Some of your medicines might interfere with sexual functioning. Talk to your transplant team or primary care physician about problems or concerns.

If you are sexually active and do not have a regular partner, you should practice safe sex by using condoms to reduce your risk of sexually transmitted diseases such as Chlamydia, syphilis, herpes, hepatitis, gonorrhea and AIDS.

Carefully Weigh Becoming a Parent

Some transplant recipients have children after transplant surgery. But women should wait at least one year after they receive a transplant before becoming pregnant. And men should wait until they are fully recovered from transplant surgery before fathering a child.

There are increased risks for mothers (high blood pressure, rejection and transplant organ loss) and babies (premature births and low birth-weight). Also, some anti-rejection medications, particularly CellCept and Rapamune, may be harmful to a fetus. Talk with your transplant team about your plans. We may be able to change your medications before conception; however, altering medications can increase the chance for organ rejection.

We also recommend that you have preconception counseling with an obstetrician who specializes in high-risk pregnancies. We strongly suggest that you make the decision to have a child only after thoroughly understanding all of the risks that are involved. Refer to the website of AST patient brochure on parenting after transplantation.

Sun Protection

Anti-rejection medicines weaken your resistance to skin cancers. As someone who received a transplant, you are now at higher risk for developing skin cancer. Here are some guidelines:

  • See a dermatologist once a year so he or she can evaluate your skin.
  • Always apply a sunscreen with a protection factor of 30 or higher when you are in the sun. Reapply frequently especially after you go in the water or if you have been perspiring.
  • Avoid spending long periods of time in the sun without the protection of sunscreen, a hat, long sleeves, long pants and sunglasses.
  • Because the sun is strongest between 10 a.m. and 4 p.m., try to avoid being in the sun as much as possible during these times.
  • Do not try to get a tan.
  • Call your transplant team or primary care doctor if you notice skin discoloration or moles that change in size, shape or color. For more information about skin cancer, visit the American Cancer Society or the AT-RISC Alliance, which is an organization that uses education and awareness to help reduce the incidence and severity of skin cancer in patients who have transplants.

Contact Information

Transplant Institute
Beth Israel Deaconess Medical Center
Lowry Medical Office Building, 7th Floor
110 Francis Street
Boston, MA 02215
617-632-9700