What can't I do after I get one?


OK, I had to add this question as I just recently did something myself that you can't do after you get a transplant.  I got my first real cold since my transplant (which for me, is extremely unusual in itself, much less because I'm immune suppressed), and I self-medicated myself, using an antibiotic that I even used to know was in conflict with Cyclosporin.  In fact, my sister reminded me that I was very insistent during my stay in ICU that they know that it was in conflict, as I was on it full time up to that point.  The drug is Biaxin, and it was a Friday night--I got a sudden cold, decided to try a three-year old stash in the Fridge, and get better.  Who would be the wiser?

Well, my smarter side prevailed and I called the transplant coordinators on Monday and learned the bitter truth, and it should be emphasized here to both patients and practicing transplant centers alike:

There are certain substances that are not simpatico with the drugs you must take post-transplant, and you need to know them.  For example:

1.  Grapefruit--That's right, do not take grapefruit two hours either side of your Cyclosporin dose, as it multiplies its effect, to the possible detriment of your kidneys.

2.  Biaxin--This and certain other antibiotics are not compatible, so always check first.  Amoxycillin is an approved antibiotic, by the way, and is most commonly used when you visit your Dentist, either to have work done or your teeth cleaned.  You take four 500 mg. caps one hour before your appointment, per the A.M.A. guidelines for heart valve replacement patients (go figure).

3.  Alcohol--Well, this isn't strictly verboten, but as was quoted to me one hazy afternoon after a bronchoscopy, you are permitted one glass of wine per week.  I have a workaround, but let's not get into that.

4.  Salt--Cyclosporin causes the body to retain sodium, which can drive up your blood pressure dramatically, so table salt is out, potato chips are out--beer and chips, whew, you've got to wonder if it's all worth it--and Mrs. Dash is in.

There are probably many others, but these are the ones that immediately come to mind.  And this is the message to practicing transplant centers--give out a chart, a wallet-sized laminate, or anything semi-permanent that lists this stuff, OK?

As far as what restrictions there may be on actual physical activity after a transplant, I'd list them as:

1.  Don't patronize populous situations with poor ventilation, such as airplanes, movie theaters, computer shows, guitar shows, gun shows, and the like.  This is how you get a cold or worse.

2.  Avoid anything that strains the chest area, such as driving, lifting anything over 5 pounds, etc., mostly during the first few months of recovery.

3.  Don't overeat, now that you can.  This is apparently so common that I constantly heard horror stories about it from all the transplant people, almost as a scare tactic--"This can happen to you!".  However, they see you at your sickest, not realizing that you were all of 200 pounds before you lost 60 pounds to IPF, so their expectations are a little skewed, but the fact remains--fat is not king.

There are no doubt others, but those are the high points.  I will add others as I recall them, or worse, actually do them and get spanked for it.