Stage 5: Transplantation & Immediate Post Transplant Surgical Recovery
Stage 5 includes the transplant and the acute phase of recovery which generally spans 3 months. When the call comes in the candidate does not know whether s/he will have a transplant or a “dry run”. A dry run occurs when the individual either is notified to come in a a back-up to another patient or they get to the hospital and may even be on his/her way to the operating room when news arrives the organ is not viable. When this occurs the individual returns to Stage 4.
The actual surgical transplant is the most acutely stressful part of the process. The patient is unaware of the surgery, becoming increasingly aware of the pain and impact of high doses of drugs during the immediate post-surgical period. Fear and helplessness are mixed with hope. The individual is self-absorbed and influenced by high levels of anti-rejection medications which may cause altered mental states. As individuals stabilize medically, attention transitions to discharge, and the subsequent challenges of self-management at home. Ideally after 5-7 days of healing, stabilizing, and educational period the individual leaves the hospital, although it is not unusual for complications such as rejection to extend the stay to weeks or months of unpredictable and uncertain outcome.
Transplant teams medically monitor recipients for the remainder of their lives. The first three months is when the highest risk of acute rejection and re-hospitalization occur. Stage 5 generally continues through this three month period. Three months is the first post-surgical benchmark for survival, and 9 of 10 people transplanted will make it past this point. The recipient needs to stay close by the transplant center during the initial weeks following surgery. Highly immunosuppressed, the recipient is under close physical and laboratory monitoring with frequent visits to the transplant clinic. Recipients follow specific precautions to assist with physical healing and avoid infections. The focus of the team is on the body’s physiological responses to the transplanted organ, with support and reassurance to recipients and their families. Patients are central and all activities revolve around them. Everything is new, frightening, and exciting as the possibility of health returns. Stage 5, time is needed for healing. The body will need to adapt to the foreign organ. During this time the patient starts to feel healthy as the residual toxins left by the dysfunctional liver clear. The individual’s role of a transplant patient is central and there is a certain notoriety having received a transplant.
Return to independence in Activities of Daily Living (ADL)
Part of the work done by Scott has been to collect data on a series of patients recovering from transplantation is the area of ADL recovery. This is in response to questions such as “when will I be able to” (fill in the blank———-)?.Patients individually or through their transplant coordinators are able to track their progress on a questionnaire called the Occupational Self-Assessment-Daily Living Skills. For more information on the OSA-DLS please contact us here.
Scott has been developing, testing and revising as needed, a transplant recovery program. This program will be available to transplant centers and individuals as of the Beginning of 2021.The program will help transplant recipients and the people who support you, to work your way through the remainder of Stage 5- and through Stages 6 and Stage 7. Stage 7 is Return of Health. If you are interested inbeing notified when the program is ready, please contact us here. (link to a notify us.)
Within this program you will be able to share you progress as compared to others. If you, within the program, share data you will be able to see your progress as compared to others.
Opportunity to collect funds and provide the program when it is ready (around Jan 1.)