Rehabilitation

On discharge from hospital you should be independent in managing  your personal care.

The Wound

The wound is securely fastened at the time of surgery and by discharge it will be healing well.  However, it takes 2 to 3 months for complete healing of the bone and wound and as you begin to do more, you may feel unusual aches and pains in the muscles of the chest and in the shoulders, neck and back.  These pains will gradually diminish but may need pain relief tablets in the early days.  You will be prescribed these before your leave hospital.  No special treatment should be needed for your chest wound.  This may be washed with unperfumed soap and water as usual.  If the would becomes discoloured or discharges, you should contact your doctor.

Concentration and Memory

Patients frequently notice difficulty with their memory and concentration in the weeks following surgery.  This slowly improves and over a period of two to three months should return to normal.

Tiredness
This is common after all forms of surgery. You should increase your activity slowly, avoiding sudden bursts of activity such as running or climbing stairs quickly.  As a general rule, physical activity is good for your heart and lungs and the recovery of muscle strength.

Moods
It is common to have mood swings after major surgery and these can be most pronounced around the time of discharge.  The drugs, particularly Prednisolone, can also have an effect on mood.  If they persist or you feel they are effecting your recovery, pleas talk to the Clinic Nurses, your doctor or your social worker.

Activities
Each person varies a great deal in their rate of recovery and you should use your discretion as to what you are capable of doing.  If you are concerned about undertaking any activity, consult your Occupational Therapist or your Physiotherapist.

In the first few days following discharge, you will probably tie very quickly and may need to limit visitors.  You will benefit from the a rest during the day.  Light daily tasks should be commenced within the first week, e.g. folding light washing, making a cup of tea/snack ,washing dishes.  Gradually introduce more tasks into your daily routine.  You will need to be aware of your individual level of physical endurance and grade the introduction of tasks appropriately, which your Occupational Therapist can guide you with. 

Major restricting factors for participating in domestic tasks are usually muscle fatigue, poor endurance and lack of confidence.  Due to the time required for the would and bone to heal, you should avoid lifting heavy weights, for example anything anything heavier than a full kettle or moving furniture for two months after the transplant.  Use of heavy vibrating machinery, e.g. vacuuming, lawn mowing, power tools, should be avoided for three months after transplant.

You can commence shopping and other tasks in the community as soon as you feel capable, keeping in mind restrictions on lifting weights.  You can begin to use public transport, grading form non peak time to peak times.  Leisure activities can also be commenced taking into account your individual physical endurance, lifting restrictions and confidence and following the guidelines of warm-up, period of activity and cool-down.  Begin suitable leisure tasks as soon as possible for self esteem and life enjoyment.

Vaccinations

Prior to your transplant you should have:

• an annual flu vaccination

• the Pneumovax vaccine which only needs to be given every 5 years - this si to protect you from contracting meningococcal pneumonia

• polio booster

• Hepatitis B                                                                                               
  These vaccination can all be arranged by your local doctor

Following transplant you must still have

• an annual flu vaccination but you will need two vaccinations 6 weeks apart.  Because you are immunosuppressed you will not achieve immunity with one dose of the vaccine.  After your transplant you must not have any vaccination that is made from a "live" virus, e.g. Measles, Mumps, Rubella, B.C.G., Yellow fever vaccine, Polio Sabin (oral), Typhoid (Typh-vax oral)

• Irt is safe for you to have Tetanus, Diphteria, Pertussis (ADT, CDT, Tex, Tripple Antigen)Cholera, Hepatitus B (energix B, HB Vax 11):  Influenza, Menningitis (Mencevax AC):  merieux Inactivated Rabies Vaccine; Pneumovax; Typhoid(not oral form).

• You should avoid contact with anyone who has recently been vaccinated with the Polio Sabin (oral) vaccine or the Typhoid (Typh-Vax oral) for 10 days/.