Six Tips to Help Your Patients through Organ Transplantation
Dr. Alin Gragossian is a physician trained in both emergency medicine and critical care medicine at Equum Medical. Beyond her clinical roles, she serves as an associate medical director at Donor Network West, a nonprofit, organ procurement and tissue recovery organization serving Nevada and California. Notably, Dr. Gragossian brings a unique perspective to her work, having undergone a heart transplant in 2019 at the age of 30.
Drawing from her personal journey, she emphasizes the importance of tailoring care approaches to individual experiences including aspects such as navigating post-transplant monitoring and fostering open communication between patients and providers. Dr. Gragossian also emphasizes some lesser-known elements of the transplant process that can facilitate a smoother transition.
1. Address new mental stressors
Recovery often focuses on the physical changes resulting from transplantation, but mental health poses a challenge to a patient’s well-being, too. These patients may experience anxiety, adjustment disorders, or psychological changes due to medications. Steroids in particular can induce mood swings and cause sleep disturbances. As a patient and a physician, Dr. Gragossian says, “I was much more prepared for the physical things that were going to happen to me post-transplant, but I do feel like psychologically there needs to be some improvement emphasizing for patients that their brain might go through some changes.” When delivering care, physicians should be attuned to these challenges for comprehensive patient care.
2. Build resilience for the lifelong journey
Transplant recipients will undergo changes post-transplant that can be difficult to accept. Dr. Gragossian says, “It’s going to be hard to get 100% back to the person you were before your transplant, and as a patient, one of the things that helped me the most was coming to terms with the fact that there is only so much that I can change.” Patients can benefit from this reminder from their care team to help them understand that “despite not being able to do what they previously could, the new normal is still great.”
3. Provide clarity and support for lifestyle changes
New needs, such as household precautions, changes in diet, and travel considerations may be overlooked by the care team following transplant procedures. Dr. Gragossian notes transplantation requires new medications that compromise the immune system. Transplant recipients must be cautious with certain foods, such as grapefruits and pomegranates, to avoid interactions with certain medications. Additionally, some medications that elevate potassium levels – so patients can only eat traditionally healthy foods such as spinach and bananas in moderation. Support and thorough explanations about newly prescribed medications are crucial to ensure patients know how to use them. Additionally, providing them with solutions for managing their new lifestyle changes is critical. Dr. Gragossian recommends creating an emergency plan for unexpected events. Dr. Gragossian suggests four travel tips for transplant recipients:
- Pack extra medications for at least 3 days.
- Bring a copy of your medical records.
- Tell your transplant team that you’re traveling.
- Be prepared with contact information for the transplant center and local pharmacy at your destination.
4. Enter each appointment with empathy and understanding
Navigating doctor appointments as a transplant recipient can be daunting. Dr. Gragossian says, “I try to remind [my physician colleagues] that when you’re seeing a transplant recipient, you’re probably the 10th doctor that they’ve seen that week and sometimes it could just get a little difficult, and stressful seeing so many health care professionals in such a small amount of time. I also, on the other end, tell transplant recipients sometimes if they go to a doctor who’s not as mindful, it’s only because they’re not used to seeing transplant recipients. There aren’t that many of us. So it’s important for everybody to just take a walk in each other’s shoes and understand that it’s a very complicated space to be in.” In addition to showing empathy and understanding towards patients, physicians need to stay informed about the transplantation world to best serve their patients by showing attention to their condition.
5. Assist patients in finding peers to relate to
As a young transplant recipient, Dr. Gragossian found a connection with other transplant recipients via social media through a supportive community through a Facebook support group for women in their 20s and 30s with heart transplants. Patients may not always know where to seek assistance and community, or even ask about it. However, questions about day-to-day life and emotional burdens that remain unanswered in the medical space can be discussed in support networks. A recommendation from the care team can encourage a transplant recipient to find and trust a community of peers for social and emotional support.
6. Support the vital role of caregivers
Dr. Gragossian also advocates for providing extra resources to families and caregivers during the transplantation process to ensure that they are informed and aware of what’s happening every step of the way. She shared, “We also have to care more about the caregivers. This includes parents and professional caregivers together. I do think that my parents – who were my primary caregivers after my transplant – went through the most trouble. To this day they remember things that I don’t because I was sedated, or I was in a coma. There just weren’t enough resources for parents, caregivers, spouses, and anyone in general who needs help with things like this.” Physicians can contribute to this cause by providing guidance, resources, and encouragement for the patient’s support system.
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