Road to a healthy recovery after transplantation

Jan 13, 2021 | Olivia White | @oliviawhite | Comments (1)

Patient-Stories-2 Having a recovery plan set in place after transplantation includes several key steps like a caregiver, living close to the transplant center for a few months, new medications and getting used to a ‘new’ normal. Including appropriate exercise and diet as you recover is also important. Exercise will vary as you continue to heal post transplantation and you work with physical therapy or your care team to slowly increase your activity level but this is an essential part to recovery as well.

On average, a transplant patient can gain between 10-20 pounds after transplantation. The exact amount varies based on several different factors including which organ was transplanted and other factors such as:

Reduced activity level during recovery: After a major surgery like transplantation, it can take a while before you are back to normal activity levels.
Medication side effects: fluid retention or decreased metabolic weight.
Increased appetite post-surgery due to overall feeling better.
Eating comfort foods as you are healing.
Not needing as many calories with a healthier body that works more efficiently post-transplant.

While weight gain after transplantation is common, it is important to establish healthy eating and exercise plans into your everyday life so the extra weight doesn’t become a lasting side effect. Excess weight is unhealthy for post-transplant patients. It can hinder your recovery by slowing down healing, and it could put you at higher risk for disease and/or complications like diabetes, heart disease, hypertension, non-alcoholic fatty liver disease or even cancers. Some ways to help set yourself and your care team up for success in this part of your recovery plan are:

Working with your transplant dietician.
- A part of your transplant care team is a dietitian. You and your caregiver can talk with them about foods you like/dislike and healthy options of your favorite foods. They can also help you develop a list of meals that would be good to jump start your plan.
Be aware of portion sizes.
Snacking on fruits, vegetables, nuts and other healthy options instead of the desired bag of chips.
Drinking enough non-caloric fluids.
- Your body has been through a life changing surgery so take it slow as you recover, but once you are cleared by your doctors and on your way to being at full speed, get active! It is recommended to start with 20-30 minutes of exercise 3-4 times a week.
- Weight training is another great option. This can help boost your muscle mass. Make sure to be cleared by your surgeon first!

We would love to hear how you have tackled this part of transplant recovery, please share below!

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scottij | @scottij | Jan 14, 2021

I was a taut 160 lbs, exercised everyday, did not drink nor smoke and per friends boringly never did drugs. A surprise diagnosis of congestive heart failure in March of 2019 resulted in valve surgery in April 2019 that did not work. My slow decline resulted in a heart transplant on December 30, 2019.

During the decline I suffered from cachexia, or a wasting away of muscle mass. I was down to 138 pounds just before the transplant. (I do proudly note that I walked 14,000 steps the day before my transplant under a 9% ejection fraction,) I was released from Mayo Phoenix on January 13, 2020 at a weight of 145 lbs. We took residence in a small condo near the clinic. I began to walk daily with a goal of 15,000 steps. Of course my caregiver; a.k.a. She-Who-Must-Be-Obeyed, my wife, slave-driver, over-seer, my wife, Vicki, was advised that she would have to try and limit my desire to move as the body was not quite ready. After living with 9% ejection fraction a "new heart" pumping out at around 60% plus made me want to slay dragons. I did suffer from shin splints due to muscle loss in my legs after so much walking but they went away with a combination of ignoring the pain and perseverance, I joined the Mayo Clinic Cardiac Rehab program in February of 2020 and was there three days a week first thing in the morning. I highly recommend this as you are monitored and tracked and the staff can ease you back into various exercises to rebuild muscle mass. Covid-19 interrupted my last few sessions at rehab and then we returned home to Marana, AZ in April of 2020. There I began my daily routine
1. Exercise first thing in the morning with 60 minutes of crunches (Six 10 minute sessions) with each session interspersed with six sessions of 100 full sit-ups on an exercise ball, eight different exercises for my shoulders and seven different exercises for my hips, and finally weights. This takes up to two hours.
2. A 7000 to 10,000 step walk with She-Who-Must-Be-Obeyed and our dog, Greta just after sunrise.
3. 45 to 50 minutes on our elliptical trainer five days a week.
4. An evening walk from 3000 to 5000 steps

My diet is pretty consistent. Oatmeal with flax in the morning sweetened with just a touch of honey or fresh fruit. A larger meal at noon (yesterday was grilled pork loin with mashed potatoes and corn) and a very light dinner. I weighed in this morning at 144.2 lbs. so no weight gain in a year though my body fat percentage has inched up from the low 13s to low 14s. I really don't have any comfort food per se though if you put some high quality pastries in front of me I may try to distract you while I snarf down a few (Mmmmmm...bearclaws!)..

I did have some dehydration problems early on which created bad headaches. Drinking too much plain water made me nauseous so I found drinking Gatorade really helped. I now use powdered Gatorade Zero and have had few headaches and my BUN and Creatinine numbers are way down.

So with respect to 20 - 30 minutes three to four times a week? Please, I knock that out by 4:30 AM every day. With Covid and nothing much to do I am exercising about 4 hours a day. I figure since my new heart is doing such a good job of taking care of me, the least I can do is take of "him".

In all seriousness, I just completed my first annual to rave reviews by my team at Mayo. Yes I was given a good heart, yes I had an existing exercise mentality, yes exercise hurt a lot early on and mostly mentally, yes I have the best doctors in the world caring for me. Still I would be a fool to ignore all of that good fortune and sit on my keester. Again, the least I could do to honor all of those gifts is to not waste them and exercise.

Best always,
s!
Scott Jensen