Hygiene and infection Prevention in Organ Transplants
Now that you have had your transplant, you need to take some simple measures to keep healthy. It is important to remember that our goal is for you to return to a normal way of life. In this section, you will find some guidelines to help you prevent infections and stay healthy.
Good hygiene is taking care of your body to keep it in the best of health. This is accomplished by knowing what to watch for in every part of your body.
Oral Hygiene
Some of the medications can cause a coating over your tongue or sores in your mouth called thrush or Candida. Report these to the doctor or clinic nurse if this occurs to you. If you need any medications for this infection, it can then be started. You should always use a soft toothbrush for best dental care, and visit the dentist twice a year.
If you need dental work done, your dentist needs to prescribe antibiotic coverage for you. The standard medication is ten (10) penicillin, 250 mg tablets. Take two the night before the procedure, one tablet four times the day of the procedure, and four tablets the next day. If you are allergic to penicillin, you will be prescribed another medication. It is best to call the clinic and get our advice regarding this issue.
Skin Hygiene
Your skin is your first line of defense against infection. If you get a cut, wash it well with soap and water. Observe the area for redness, swelling, a discharge, or if you develop a fever. If any of these occur, call the clinic. Also to protect your skin, we do not recommend sun bathing. If you are in the sun, though, you need to use a
sunscreen with a minimum SPF (sun protection factor) of at least 15. If you notice any moles that have changed shape or color, notify the clinic.
If you are a diabetic patient you need to care for yourself and your skin better than you did before your transplant. The immunosuppressive drugs make you more susceptible to infections. You will need a podiatrist to care for your feet. If you wish to see one at the hospital, we can recommend one for you. Check your feet daily for redness or open areas, and report them to the clinic. If you cannot see your feet well, have someone close to you check them. Never walk barefoot, avoid hot walkways or beaches that may cause blistering, and watch for sores carefully when you have new shoes.
Internal Health
After your transplant you will be on antibiotics to prevent urinary tract infections. Some people are asked to stop these six months after their transplant, while others stay on the antibiotic long-term. No matter which group you are in, be sure to recognize that the signs and symptoms of urinary tract infections include burning on urination, frequency, fever, or loss of control of your bladder. Make sure you report these immediately so you can be treated before it becomes a bigger problem.
It is important to have your eyes checked with an ophthalmologist -- a medical doctor who specializes in the eyes -- after you get on a stable dose of prednisone. In some patients the medications can cause changes in vision or cataracts. We recommend yearly visits to the ophthalmologist.
Some medications may interact with your immunosuppressive medications We cannot provide a complete list here, so always check with the clinic or your nurse.
Even though the world around us is filled with germs, we do not want you to go home and live in a "plastic bubble". A commonly asked question is, "Can I go out into crowds?" Generally, the answer is yes. However, using a little common sense can go a long way in preventing infections. It is best to avoid large crowds during the flu season. If you are interested in receiving a flu shot, consult with your transplant physician in the clinic.
After receiving your transplant, you will be susceptible to catching colds and the flu like anyone else. After a period of time -- when your body is used to the immunosuppression -- your recovery from these illnesses will be much like anyone else. Avoid contact with people who have respiratory infections. Your friends and family will understand that you must refrain from close contact if they are ill.
NEVER take over the counter cold remedies unless ordered by the transplant doctors. They may interfere with the immunosuppression medications. There are certain medications we can prescribe to help you recover from the flu or a cold. It is also very important for you to let the transplant team know when you develop a cold or the flu, because we need to follow your symptoms. Remember, proper rest, nutrition and hydration will help you feel better.
Vaccinations
Before your transplant, the doctors will have asked you about your history of childhood illnesses and vaccinations. It is important for them to know this information prior to your transplant so they can help protect you against certain illnesses. If you are exposed to chicken pox, you should report it immediately (within 24 hours) so appropriate measures can be taken to prevent development of the disease. This would mean a trip to a local physician or the transplant clinic for the administration of a medication. This information is not only important for children, but for adults who have also been exposed to chicken pox, if they have never had it.The chickenpox pox vaccine is now available and should be discussed with the clinic staff.
If you become injured and need a tetanus injection, please have your local physician call the transplant team. There is a special Tetanus Immune Globulin that you should receive. The traditional tetanus shot can trigger a rejection episode, so it should not be taken.
Its also prudent to be aware of the oral polio vaccination. Pediatric transplant recipients as well as children of adult transplant recipients should only receive the injection method of protection against polio. This will help the transplant patient from being exposed to the disease. This form can easily be obtained by a pediatrician or a transplant physician. If you have any questions, consult with the transplant team.
If you are asked to be tested for tuberculosis (TB) you may do so. This test will not interfere with your transplant.
To help prevent infection while you are immunosuppressed, it will generally be necessary for you to have antibiotic coverage for any kind of invasive procedure.
Avoiding Sexually Transmitted Diseases
In order to help prevent the transmission of certain viruses, such as cytomegalovirus (CMV), human immunodeficiency virus (HIV), and especially herpes simplex virus (HSV), transplant recipients are strongly encouraged to use condoms during sexual activity, using the same guidelines as for the general population. Oral sex is discouraged if there is a chance of acquiring HSV, especially if the non-transplant partner has had HSV previously. If you note any sores or ulcerations of the mouth, genital area or anus, you need to let your doctor know. This could be HSV. Transplant recipients are susceptible to this virus but it can be treated easily with proper medication.
Pets
Transplant recipients often ask about their pets at home. There is no need to give away a pet, although there are some guidelines. It is recommended that the transplant recipient avoid cleaning up after the pet. This includes, but is not limited to, hamster, gerbil, or bird cages, as well as fish tanks. If acquiring a new pet, puppies are generally safe, while kittens are discouraged. It is best to avoid a young pet who is prone to scratching you during play. Acquiring new birds are discouraged, although you may keep any birds that you may already have. Do not ever clean out a kitty litter box.
Travel
While planning long distance travel, you should discuss your plans with the transplant team. Traveling across the United States is not a problem. The concern is traveling to other countries where sanitation is not optimal. This may include, but is not limited to tropical vacation areas. Generally, travel is no problem when staying within North America, Europe, Japan, or Australia. If you have any questions regarding travel, please consult the transplant team.
Do's and Dont's
Learn to live healthy with your transplant. Remember, the emphasis is on preventing infections, not just treating them. Using common sense will allow you to return to a normal lifestyle and enjoy your good health.
Do Call If:
- Temperature > 100
- Cough or diarrhea for more than days
- Any rash
- Pain on urination
- Abdominal pain
- Chest pain
- Shortness of breath, not made better by resting
- Pain over the transplant site
It Is Best to Avoid
- Visiting with others who have the flu, colds, or contagious diseases
- Soft eggs -- the harder cooked the better
- Gardening without gloves
- Gardening with manure products
- Unwashed vegetables and fruits
- Self-prescribed medications, or other over-the-counter medications. When in doubt, ask a member of your Transplant Team.
- Cleaning fish tanks -- allow others to do that for you
- Cleaning out the kitty litter box
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