Pre -Transplant Diet and Exercise Ideas

@rosemarya @colleenyoung
Thanks ladies for helping us discuss how important it is to be in shape for the changing moment of our lives. We will need all of our energy just to get thru the operation!
For me, that was a big wake up call. I somehow...managed to put on 20 lbs in 1 yr after diagnosis of Stage 4 Cirrhosis. I was and still am dead tired...not even able to get out of bed some days. No appetite...didnt even want to see the kitchen let alone go to the food store. As a young woman I was always athletic and active..cheerleader..aerobic dancing instructor...didnt know what a diet was! Suddenly I find myself in strange territory. Some of the answers are there..water retention...portal hypertension and throw in a little HE for fun! So after my evaluation at Mayo Jax...things are changing...
Because each of us has our own special set of complications... ie diabetes, etc. each of us has a different plan of attack.
I am now on the Medditeranean Diet. It's not too hard on me because I always ate pretty healthy food. The water weight was killing me so Im now reading labels and eliminating sugar and salt...best I can. I spent a whole day researching before I even attempted the grocery store. Remember nothing in a box, bag, or can is your friend. Read the labels. Fluids are very difficult for me. I never drank coffee, gave up
beer and soda years ago...not a big fan of water as I don't think it's a good idea to switch around especially when traveling. Thought fruit juice would work ... still too much sugar...switched to lemonade watered down...didnt work. So.....I found bottled water that I add fresh berries or fruit and a pinch of Stevia ...seems to be working. Diuretics were increased and now Im losing weight and have a little more spunk. Exercise is a whole other subject that I will talk about next time I get the motivation to get on here again.
That's part of what I am doing. I cant tell you how important finding motivation is. We each find it differently. We just have to be receptive to desiring to make the effort....
It is worth it...you WILL, of course, make yourself ready for receiving that gift of life. The former owner of my new liver deserves it....
Carry on.....

My husband had his liver transplant 17 days ago. He is doing fantastic and he attributes it to the fact that he was able to go out and jog / walk a couple times a week while waiting. He also ate healthy. It has made a world of difference for him!
Blessings,
JoDee

Great topic, Rosemary! Last year we interviewed Heather Bamlet, RDN, LD, transplant clinical dietitian at Mayo Clinic’s campus in Rochester on the topic of weight gain AFTER transplant. She had lots of good tips for getting the scale to go down, and I assume many of these are relevant to patients looking to get healthy before their transplant too.

Cooking and Meal Planning:
-Plan meals ahead of time.
-When designing a meal, follow the MyPlate method.
-Use cooking methods that will keep the foods out of reach for snacking, such as a slow cooker.

Eating:
-Be aware of your portion sizes.
-Eat more fruits and vegetables.
-Choose whole grains, lean meats and low-fat dairy products most often.
-Keep treats like cake, candy, cookies, chips or soda to a minimum.
-If still hungry after meals using the MyPlate method, reach for more fruits and vegetables.
-Make sure you are drinking enough noncaloric fluids.

Exercise:
-Get active. Aim for at least 150 minutes of exercise weekly. It is better to split this up and do at least 20 minutes most days of the week.
-Do weight training. Add this in to boost your muscle mass after your surgeon clears you to do so, since muscle burns more calories at rest than fat does.

Here's the link to the full post: https://connect.mayoclinic.org/newsfeed-post/weight-gain-after-transplant-where-does-it-come-from-and-how-to-get-rid-of-it-2/.

Great topic, thanks for bringing it up. I struggled with calories right after transplant because everything started tasting so good. YUM! Before my kidney transplant I was pretty toxic and I was nauseous a lot and food smelled gross to me. Everything changed with that new beautiful kidney I received and it was so hard to stop myself from chowing down on everything in sight. I started drinking herbal tea, I kept sugar free popsicles in the freezer and started making lots of vegie soup so I could enjoy snacks with no negative impact on my health. 🙂

I do not like the word sugar-free. Just what does it mean; no added natural sugar (cane, beet, honey or maple sugar), no added artificial sugars (chemically made), or things like corn syrup - it's not sugar because sugar isn't in its name. Just what is a sugar free Popsicle? I don't eat them so I don't know if you mean frozen fruit juices or flavored ice cubes with no added sweeteners? I need some help here. Once you got that new kidney it was too easy eating foods that you couldn't eat before and "chow down" on unhealthy foods now. I sat by a man, when I was no dialysis, who received a kidney when he was 19, and like all teenagers, he "chowed down" on everything in sight and ended up over 400 lbs. then lost his kidney. When I met him he was down to 300 lbs. and had to loose another 100 before he could be evaluated for another kidney.

If you believe eating "vegie soups" so you can have all the "snacks" you want will leave you with "no negative impact on your health" you could be so wrong. Once you were given a new lease on life, with the transplant, you need to care for your new kidney so it will care for you. Once you loose that kidney, for whatever reason, you may never get a chance to receive another one again. In order to keep our new kidneys we all have to have a new "life style", not a diet, which can change from day to day, but a "life style" which becomes our way of life for ever and ever.

mlmcg

mlmcg, You have brought up some good points for our awareness. We do need to read the food labels carefully. And we need to rethink snacks. This is true both after and before transplant.
The weight battle that you mentioned is similar to what many patients experience prior to being eligible for transplant. I would be interested in learning how these particular patients achieve their weight challenges along with failing diseases that can result in inactivity and poor eating habits. Do you have any hints, or recipe ideas that might be encouraging to them? In advance - Thanks.

@jeanne5009, You mentioned that you changed things after your JAX visit and that you have started the Mediterranean diet. After years with no restrictions, how difficult as it for you to begin to become conscious of/and adhere to a healthy eating program?

I enjoy homemade soup, and I have learned avoid the cream based ones. I especially enjoyed eating soup after my transplant because I imagined that I was pampering my new kidney.

@rosemarya Hi Rosemary:

I love the imagery you used, "pampering my new kidney." Word pictures like that are so helpful, they help make habit changes much easier.
Teresa

I have had two liver transplants at Mayo Rochester. I am also a Physical Therapist with a specialty certification in Aquatic Physical Therapy. I have found from professional and work experience, that gentle aquatic aerobic exercise in therapy pools (warmer than lap pools) is very comfortable for patients and there are very few health risks. Something to consider before seeking this out is if you have an open wounds, ostomy sites or issues with fecal/urinary incontinence. Don’t worry about not being able to get into and out off the pool because most Therapy pools have a lift or a walk in/out ramp to make it easier. Often times for patients with extreme muscle wasting, this is a great way to ease back into exercise without stressing the joints too much and is often very relaxing. Plus, I may be biased here, Aquatic PTs are super friendly and fun! The goal with this is to refer you to a community based exercise program. Many hospitals have this integrated into their Rehabilitarion program in some way, shape or form.

I could not swim after either transplant because I had a rather large wound to heal, but what I did in the hospital was request a PT consult and started walking right away. It comfortable at the first, but the more you walk the better you will feel. I learned that the hard way after my first transplant where I refused to get out of bed and sat and pushed my PCA button whenever I had increased pain.The second time around I was walking a mile post op day 1 and had the PT bring in a little bedside bike pedal to use whenever I was sitting up and watching tv or reading. And depending on your platelets post op, you can begin gentle upper extremity stretching in a variety of positions which helps with healing, swelling, and mobility. I always tried to adhere to what is common referred to as “Sternal precautions.” This is a basic set of guidelines given to patients who have had open heart surgery but came somewhat apply to lost liver transplant patient with some modifications. Briefly, they are:

1. Protect your sternum. Hug a pillow to your chest or cross your arms over your chest when you laugh, sneeze, or cough.

2. Be careful when you get into or out of a chair or bed. Hug a pillow or cross your arms when you stand or sit. Do not twist as you move. Use only your legs to sit and stand. You may need to use a raised toilet seat if you have trouble standing up without using your arms. Your healthcare provider may teach you to use your elbow for support as you move from lying to sitting.

3. Ask when you may take a bath or shower. You may need to use a bath chair if you have trouble getting into or out of the tub. Do not use a grab bar. Depending on where you are transplanted at, they may have different protocols for when you can shower after surgery.

4.Do not lift or carry anything heavier than 5 pounds. For example, a gallon of milk weighs 8 lbs.

5. Try to use both arms and hands for any reaching or grabbing of objects around you. Do not let anyone pull your arms to help you move or dress.

6. Do not push or pull anything. Examples include a car door or a vacuum cleaner.

7. Do not drive while you are healing. Your surgeon will tell you when it is safe for you to start driving again.

Depending on how you heal, you age and previous strength and flexibility prior to transplant, the PT can modify these to fit your particular needs.

After two liver transplants I have learned that physical fitness and diet are keys to living a long healthy life after transplant. Whenever I don’t want to go swim my 2 miles in the pool or eat my greens, I always remember that I am not just doing this for me, but for the person and the family who gave a part of their life so that I might live a little long!

Be well,

Teresa H.