National Kidney Foundation. Kicking for Life

Published by the for transplant recipients of all organs and their families.© Copyright 2005National Kidney Foundation, Inc. ISSN# 1524-7635

01-70-1106

Transplant Chronicles is a Program of the National Kidney Foundation.Spring 2005Volume 12, Number 2

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In 2000, after my second kidney trans-plant, I was 50 pounds overweightwith little energy. I wanted to getback to the things I did prior to goingon dialysis in 1998. Although I hadthe desire, I just couldn't seem to getthe actual plan going.

My son started taking tae kwon do inOctober 2000. While I sat on the side-lines, I became fascinated watchingthe students develop their skills. Istarted wondering if I could do it. InFebruary 2002, I finally got up the

courage to start taking classes. I’lladmit I was intimidated because I feltthat I had to be the oldest and mostout-of-shape student to ever start amartial arts training program. I finallyrationalized that the worst thing thatcould happen was that I would findout really quickly that I didn't havethe stamina to keep up with the rest ofthe students. I guess, at the time, deepdown I really didn't believe I couldphysically do it.

What a surprise! With the guidanceand encouragement from my instruc-tors and fellow students, I becamestronger and could go further witheach class. I also discovered achesand pains in places I didn't knowexisted. My sore muscles even hadsore muscles. I usually felt like awalking toothache the morning aftereach class, but I also looked forwardto going back for more. I startedworking out two or three times aweek. I had a treadmill at home, butuntil now had always found a reasonnot to exercise.

As the weeks went by, my weightstarted dropping and I started to feel

better, bothphysically andmentally. Ifound it easierto get my pro-fessional workdone and hadenergy leftover at the endof the work-day to dosome of thethings that Iwould usuallyput off (likemowing thelawn and otherhousehold chores).

The big surprise came when I wentfor my six-month checkup. Not onlyhad I lost weight, but my labs lookedbetter than ever. My cholesterol leveland blood pressure were down, andthe rest of my lab values were exactlyon target. Before I started sparring, Italked to my transplant nurse abouttechniques to protect my kidney. Mostimportantly, the other students werecourteous and cooperative. My stand-ing joke was “If you take out my kidney then I get one of yours.” Ithelped get their attention.

In our tae kwon do training center,there are 10 colored belts and 14testings to go from the white belt

(beginner) to first-degree black belt.With every promotion, new skills areintroduced and the bar is raised a little

In this volume ofTransplant Chronicles

� Intimacy AfterTransplantation . . . . . . . Page 3

� Over the CounterMedications . . . . . . . . . . Page 4

� The Graying of the Transplant Population . . Page 5

� Teens Talking Transplantation . . . . . . .1

� Toothbrush Selection . . Page 15

Continued on page 12

Kicking for Life� By Richard Link

“WHAT IN THIS WORLD WAS I THINKING? I'm way too old andout of shape for this sort of foolishness.” Those were the thoughts goingthrough my head as I lay panting on the floor of the training center, try-ing to complete 50 sit-ups.

Richard Link

editor’s desk editor’s desk

We in the Midwest have alllooked forward to the begin-

ning of Spring. It is a time of newbeginnings and renewed energy as wesee the trees and flowers bloom, thegrass grow, the sunshine and often asurge in positive attitudes. This issueis also a “new beginning.” As we haveso many great contributions, I willkeep my editorial column short. Onthat note, I would like to give you thewords of Kobi Yamada an author ofmany books in a series called TheGood Life:

Laurel WilliamsRN, MSN, CCTCEditor-in-Chief

2 Transplant Chronicles, Vol. 12, No. 2

Transplant Chronicles is published by the NationalKidney Foundation, Inc.

Opinions expressed in this publication do not necessarily represent the position of the National Kidney Foundation, Inc.

Volunteer Editorial Board:Laurel Williams, RN, MSN, CCTCEditor-in-ChiefUniversity of Nebraska Medical CenterOmaha, NE

Kay Atkins, MS, RDSamaritan Transplant ServicesPhoenix, AZ

Dean S. Collier, PharmDUniversity of NebraskaOmaha, NE

Ronald N. Ehrle, RN, BSN, CPTCLifeGift Organ Donation CenterFort Worth, TX

Jack FassnachtChicago, IL

Joshua S. Goldberg, teen editorEncino, CA

Shirley Schlessinger, MDUniversity of Mississippi Medical CenterJackson, MS

Victoria L. Schieck, RN, BSN, CCTCUniversity of Michigan Health SystemAnn Arbor, MI

Debra J. Tarara, RN, BSN, CCTCMayo ClinicRochester, MN

Lara Tushla, LCSW, MSWRush University Medical CenterChicago, IL

Chris L. Wells, PhD, CCS, ATCUniversity of MarylandBaltimore, MD

Jim Warren, MSTransplant NewsBaltimore, MD

Editorial Office:National Kidney Foundation, Inc.30 East 33rd Street, New York, NY 10016800-622-9010, 212-889-2210www.kidney.org

Editorial Director: Catherine Paykin, MSSWExecutive Editor: Gigi PolitoskiManaging Editor: Sara KosowskyPublications Manager: James McCannProduction Director: Sunil VyasDesign Director: Oumaya Abi SaabEditorial Assistant: Helen C. Packard

Believe in your dreams.Believe in today.Believe that you are loved.Believe that you make

a difference.Believe we can build a better

world.Believe when others might not.Believe there's light at the end

of the tunnel.Believe that you may be that light

for someone else.Believe that the best is yet to be.Believe in yourself.

HAPPY SPRING.

Laurel Williamsfor the Editorial [email protected]

{“The challenge of 2005 will require that we encourage the system tomove forward and address those concerns that will benefit familieswho want only one thing—the opportunity to use the word 'tomor-row' in their everyday vocabulary.” —Charlie Fiske, founder ofFamily Inn in Brookline, MA, a place where families of people wait-ing for an organ transplant can stay. He is a father whose daughterreceived a transplant 22 years ago at 11 months old.

Let Your Voice Be Heard!Last issue we asked “What advice, tips would you give for family/friends caring for recipients during illnesses or crisis?”

And you replied:

“I personally found that knowing I could speak about what I was thinkingand/or feeling and (having) the support person just listen and not try to fixme, made me feel comforted.” —Loie

“Just be supportive and patient. Just remember when loved ones are notfeeling their best, they tend to get a little cranky, and impatient. They donot feel in control. They just want their full lives back.” —Barbara Morarity—Van Dyke

“I prefer when family and friends offer their help, but don't fawn over me. Idon't like it when a big deal is made out of my illness or crisis. I believethat maintaining a positive attitude and being easygoing about the situa-tion really helps.” —Deepa Prasad

Now log onto www.kidney.org/recips/transaction/shareRecipVoices.cfm andlet us know: “How have you acknowledged or helped your loved oneswho have cared for you during your illness?”

{

Transplant Chronicles, Vol. 12, No. 2 3

Hugs, Kisses and More: Renewing Intimacy After Transplantation

(First in a series)

Communication: The Key in a Caring Relationship� By Barbara J. Shroeder, MS, RN, CNS

Warmth is one method to help con-nect a couple. So what is warmth?Warmth is the glue that bonds ustogether in a relationship. It's themagnetism that draws us in to closerintimacy with each other.

Warmth makes us feel welcomed byeach other, relaxed and joyful. It isthat sense that your partner is gladyou are there. Warmth is one way wetell someone we love them and careabout them. Warmth and caring in arelationship provide support for bothpartners.

So how do you communicate in a car-ing way to your partner? Respect foryour partner communicates accept-ance of their ideas, feelings and expe-riences. Showing respect communi-cates that we value you as a person.It says: “You are important to me.”

How do you show respect in your relationship? It's the little things you do like:� Looking at your partner when you

talk to them.� Offering them your undivided

attention.� Maintaining eye contact. � Smiling at them when appropriate.� Connecting with them by touch,

such as a hug or pat on the back.

Another way to show caring in arelationship is to give your partnerreassurance. Take the time to rein-force your partner's good qualities: � Compliment them on their abilities

and talents. � Take the time to reinforce all of

the good qualities that attracted you to each other.

� Tell your partner what you appreci-ate about them.

� Remind them that you do care about them.

� Concentrate on the positives whenyou talk to each other.

� Focus on the unique gifts your partner brings to your relationship.

Improving Daily Communication asa Couple

Create an open-minded, loving atti-tude toward your partner. Believe thatyour partner has your best interests inmind. So give each other the benefitof the doubt.

Because life is very busy, it is impor-tant to keep in touch. You can nurtureyour relationship by keeping yourpartner informed about what is goingon with you on a daily basis. You cancreate a message center or calendar tokeep each other informed.

Watch out for generalizations in yourconversations with each other. Avoidstatements like, “He or she never lis-tens.” This automatically puts up awall between the two of you.

Many minor disagreements and com-munication breakdowns happenbecause one person is feelingunloved. The more you can start aconversation with “I appreciate you

and love you,” the less often you willend up misunderstanding each other.

Trust is an expectation, often unspoken,that someone will be there for you.Trust can be broken, physically, emo-tionally and spiritually. What can youdo to foster trust in your relationship?Talking with each other in a caring waycan facilitate trust. Telling the truthwith each other is the place to start.Then look at these five ingredients fordeveloping trust in a relationship:

1. Say what you are going to do.Communicating to your partnereliminates the guesswork.

2. Do what you say.Have your actions match yourwords.

3. Live in the present.Keep in the present and don't keeptrack of your partner's previousfaults.

4. Look at yourself first.Before pointing a finger at yourpartner, consider your own behav-ior. What is your behavior sayingto your partner?

5. Time, time and more time.Time plays a major role in thedevelopment and strengthening of trust.

So how do you create a caring rela-tionship with your partner?

Communication is the key. Otherqualities that will help make yourrelationship successful are:

ONE IMPORTANTTHING that can either

enhance or hinder a roman-tic or sexual relationship iscommunication. Communi-cation is the key to a caringrelationship.


� Love� Sense of humor� Support� Commitment� Tolerance� Respect

� Realistic expectations

� Caring� Nurturing� Enjoying one

another


This kind of thinking can be dangerousas many over-the-counter (OTC) medications may have unwantedeffects when one is also taking othermedications prescribed by a doctor.Here are some points to keep in mindwhen using OTC medications foraches, pains, coughs and sniffles of the season.

Congestion (stuffy nose or sinus)Decongestants are the most commonOTC treatment for congestion. Thesemedicines are taken orally or appliedtopically in the nose in the form ofsprays or drops. The main active ingre-dients in OTC decongestants includepseudoephedrine, phenylephrine,oxymetazoline and naphazoline. Thesemedications work to decrease conges-tion by shrinking the blood vessels ofthe sinuses. An unwanted effect ofthese medicines is higher blood pres-sure, as they can also shrink or reducethe size of blood vessels outside of thesinuses. Because of the risk of higherblood pressure, these medicines shouldnot be used by people who are beingtreated for high blood pressure, espe-cially if the blood pressure is not wellcontrolled.

An alternative to decongestants isdiphenhydramine (Benadryl), an anti-histamine. While antihistamines mayhelp with congestion, they are morefamiliar as medications used to treat arunny nose or sneezing caused by aller-gies and as a sleep aid. Becausedrowsiness can occur with antihista-mines, caution should be taken whendriving or using machinery.

A second alternative is the use of asaline nasal spray to help loosen nasalsecretions and soothe irritated nasalpassages.

A doctor's advice should be sought if congestion does not go away afterseven to 10 days, or if a fever is also present.

CoughTwo types of products are used to helpwith cough; expectorants and antitus-sives. Expectorants are best for produc-tive coughs—coughing caused by lotsof mucous in the lungs. Antitussivesare best for nonproductive coughs,where there is little or no mucous (adry cough).

Guaifenesin is the only OTC expecto-rant available. Taking an expectorantfor a productive cough may help thinmucous in the lungs, making it easierto clear. While guaifenesin is well tol-erated and can be taken without regardto prescription medicines, it may bethat simply drinking more water duringa productive cough will help loosen themucous and relieve the cough.

OTC antitussives include dextrome-thorphan, diphenhydramine, and, insome states, codeine. These drugs areused to relieve dry, nonproductivecoughs. They should not be taken whenthe cough is productive.

Antitussives may be safely taken withmost prescription and OTC medica-tions, except for MAO inhibitor med-ications. MAO inhibitors are used for anumber of reasons. If you have beenplaced on this type of medication, bothyour doctor and pharmacist shouldhave already counseled you on medica-tions and foods to avoid. All types ofcough products do have the potential tocause drowsiness.

Other options to relieve cough includethe use of cough drops, humidifiers andvapor rubs to help soothe irritatedthroats and airways.

When treating cough with OTC prod-ucts, it is important to remember that ifthe cough persists for longer than fiveto seven days, worsens within this timeperiod, or is accompanied by a fever,evaluation by a doctor is necessary.

Pain and FeverSeveral products are available to treatpain and fever associated with coldsand flu. Most transplant centers willrecommend acetaminophen as the onlyacceptable medicine for aches, painsand fevers for their patients. Otherfamiliar OTC medicines, such asibuprofen, naproxen, ketoprofen (allknown as NSAIDs) and aspirin canalso relieve such symptoms, but theyare more likely to interact withimmunosuppressive medicines pre-scribed to transplant patients. Specifi-cally, the combination of the abovementioned pain relievers with cyclos-porine or tacrolimus can worsen kidneyfunction. For this reason, they shouldbe avoided. Aspirin may be recom-mended by your doctor for reasonsother than pain, for instance to protectthe heart. In these cases, the daily dosesare lower than those used for pain andthe benefits to the heart outweigh therisks to the kidney.

When using acetaminophen (Tylenol)to treat pain or fever, it is important toremember that too much can causeliver dysfunction. The maximum doseper day for an average-size adult is4000 mg while the maximum dose perday for children and smaller individualsis based upon body weight and can bedetermined by asking your pharmacistor doctor. This dose of acetaminophenshould not be taken on a regular basisbut only as needed for short periods of time.

Pain and fever should be reported toyour physician or transplant teamimmediately. The physicians will beable to help you determine the cause ofyour pain and the appropriate and safesolution.

An Over-the-Counter Medication Review

� By Jennifer Nieman, Doctor of Pharmacy Candidate,

and Dean Collier, PharmD

IT IS COMMONLY THOUGHT that because a medicationdoesn't require a prescription, it must be safe.



People are living longer! In theUnited States, the average life

expectancy rose dramatically from 54years of age in 1920 to 77 years in2000. Now, in 2005, the fastest grow-ing group of elderly people is over theage of 85 years and they are beingcalled the “oldest old.” The goodnews is that solid organ transplantrecipients are living longer also!Transplant programs are now witness-ing 10-year, 15-year and 20-year sur-vivors. As a result, the age of many ofthese patients may be 70 years ormore. This presents a new challengeto transplant patients and their med-ical teams. Besides the usual trans-plant problems of infection, rejection

and the many medications and theirside effects, the effects of age-relatedchanges may complicate the plan ofcare, making the assessment of whatis “normal” vs. “abnormal” harder.

We all know about the obvious physi-cal changes that happen to everyone,such as wrinkling and sagging of theskin and the graying, thinning, andloss of hair. You may also realize thatyour senses, such as eyesight, hearing,touch and taste will change and thatyour muscle strength will decreaseand bones will weaken. This mayhave already happened with long-termuse of your immunosuppressant med-ications so your chances of having

problems as you age increase. Yourability to balance and walk may alsobe altered and, as a result, the possi-bility for you to fall may increase (ie.,in the USA, falls are the seventh lead-ing cause of death in people over 65years of age). In fact, every system inthe body is affected by aging, and thiscan affect the ability to care for one'sself. Because of this, it is importantfor transplant patients and their transplant teams to be aware of theexpected changes that occur withaging and begin to prepare in order to hopefully prevent problems beforethey occur. And remember, anyone,transplant recipient or not, might needto consider these issues!

The Graying of the Transplant Population:No One is Immune to Old Age

� By Debi H. Dumas-Hicks, RN, BS, CCTC

Continued on page 6

eating righteating rightNutrition Counseling—It’s Your Right

� By Kay Atkins, MS, RD

The law for Medical NutritionTherapy (MNT) being paid for byMedicare became effective in January2002. Only two illnesses areaffected: 1.) Chronic kidneydisease and kidney transplanta-tion and 2.) diabetes. As of2005, high-risk screening fordiabetes and heart disease isalso covered.

MNT, which may include dietcounseling, is designed to helpyou learn to eat right, so youcan better manage your illness.With a doctor's referral andwritten prescription, Medicare

will cover 80 percent of the cost ofMNT for people with diabetes, withchronic kidney disease, or who are

post-kidney transplant, after they paytheir annual Part B deductibles.

Medicare will generally cover threehours of medical nutrition therapy forthe first year and two hours everyyear thereafter. It may cover morehours if your doctor says you need

them. In order to have Medicarecover MNT, a registered dieti-tian must provide these services.Talk to your doctor if you thinkyou qualify for this benefit.

Adapted from the MedicareRights Center Web site: www.medicareinteractive.org

ICAN'T TELL YOU how many times the doctors and nurses have called me to the transplant clinic to counsel a recipi-

ent about nutrition.

As a registered dietitian I can help by:• Assisting you in changing your diet• Helping you to better control your blood sugars• Helping to treat and manage disease conditions

with proper nutrition• Reducing or cutting out your need for

prescription drugs• Assisting you in reducing unpleasant side

effects from your disease• Overall, helping to improve your health and life

through proper nutrition.


The purpose of receiving an organ transplant was to continue to participate in life with your family and friends. It isimperative to follow your transplant team's advice and to communicate to them problems that you are experiencing.After all of your efforts to protect your transplanted organ, don't let aging catch you unprepared!

Action Plan For Aging Transplant Recipients

Update Your Support Systems

When you were being evaluated for your transplant, youwere asked to identify people who would help you afteryour transplant. These people may have changed throughthe years, so the first area you want to address in plan-ning for “old age” are your support systems. Your socialnetwork may need to be widened to accommodate futureneeds. The support persons you identified at the time ofyour transplant may have changed and/or probably willchange in the future.

Potential Problems:1.) Spouse not available—divorce; illness; death2.) Children not available—may have moved away; may

have their own families and jobs; illnesses3.) Your parents, if alive, may need YOUR care. 4.) Church /Community—don't feel comfortable asking

anyone to helpAction Plan: Don't assume someone will be there foryou! Be pro-active in your future!

1.) Meet with your family and friends. Ask “what if” questions: � What if your spouse becomes ill? Is a friend avail-

able to help?� What if you become the “caregiver” for your fam-

ily? What can you do or not do with the normalhousehold routines?

� What if you and your spouse cannot drive any-more? Is transportation available?

� Can you make a “pact” with neighbors and othermembers of your community to help each other?

And the list goes on and on, depending on your circum-stances ….

2.) Create a list of community resources.� Check with your transplant social worker for

guidance.� Call your local government for numbers for serv-

ices offered for the elderly.� Check the Web for ideas and services. (Note: A

good inclusive site: www.aarp.org/internetresources/)

Your Living Space: “Elder-Proof” Your Home

The second large area that you need to address is yourliving space. Your goal should be to reduce hazards inyour home to prevent injuries, especially fractures, whichare a major cause of mortality in the elderly. It isimportant to simplify your lifestyle in order to aid youand others assisting you in the event that your vision andother senses deteriorate.

Potential Problems:1.) Major hazards for falls/fractures

� Stairs� Slippery floors and throw rugs� Poor lighting � Too high or too low shelves, chairs, beds, etc.

Action Plan: Start now to fix your home! Get help!

1.) Assess your home for major hazards and ask “whatif” questions:� What if you became immobile? Could you use a

wheelchair in your home?� What if your vision becomes impaired? Could you

easily find what you need to care for yourself?� What if your hearing becomes impaired? How

will you know if the phone and/or doorbell isringing, smoke alarm is buzzing?

� What if your sense of smell is impaired…how willyou know if there is a gas leak?

2.) Start slowly to give away and/or store items youdon't need every day.

3.) Fix or get rid of the obvious problems such as slip-pery throw rugs, unstable chairs and tables and furniture that obstructs your path in your home.

And the list goes on and on….

Debi H. Dumas-Hicks RN, BS, CCTC, is a Senior Heart Transplant Coordinator at Ochsner Multi-Organ TransplantCenter, New Orleans, LA. T

C

Continued from page 5


New Secretary of theDepartment of Health andHuman ServicesMike Leavitt, the former adminis-trator of the EnvironmentalProtection Agency, has replacedTommy Thompson as Secretary ofthe Department of Health andHuman Services. In his testimonybefore the Finance CommitteeConfirmation Hearing, Leavitt listed welfare reform, Medicare,Medicaid and health care afford-ability as high on his agenda.Leavitt's views on organ donationwere not discussed during his hear-ing. However, as Governor of Utah,Leavitt and his wife Jackie weresaid to be among the first to sign upfor the state's organ donor registry.

“Breakthrough Collaborative”The Breakthrough Collaborative isa partnership committed to spread-ing known best practices to theNation's largest hospitals to achieveorgan donation rates of 75 percentor higher in these hospitals. In the12 months since the launch of theBreakthrough Collaborative, therecord for most donors in a monthwas broken five times and the aver-age number of donors throughoutthe country increased substantiallyfor the first time in a decade.

When asked why this unprecedent-ed increase in donation took placewhen so many other initiatives andprojects have not in the past, JimBurdick, MD, the Director of theHealth Resources and Services

Administration (HRSA) Division ofTransplantation (DoT), said that abig reason was that the current pro-gram includes all corners of thetransplant community.

Examples of the process workinginclude:

The nation's 240 largest hospi-tals reported that, following theimplementation of the collabo-rative process, 90 percent ofpotential donors were referredto their OPO (Organ Procure-ment Organizations) by the hospital in a timely manner.The average prior to the Collab-orative was 50 percent, withsome hospitals not reportingany potential donors at all.Donation rates in hospitals thatare participating in the Collab-orative are up 14 percent in thepast year (2004) compared to a7 percent increase in non-Collaborative hospitals.Since the initiative's inception,the average monthly number of standard criteria donorsthroughout the U.S. increasedfrom 370 to 430 (a standard cri-teria donor is defined as oneunder 70 years of age). The rateof 370 had remained virtuallyunchanged for the past 10 years.The longest donor-before-a-non-donor streak (a newCollaborative-driven measure-ment) currently stands at 21 in arow by the Theda ClarkRegional Medical Center inNeenah, WI.

As to the future, Burdick says thenext challenge is to increase the“yield and spread,” which can beinterpreted as increasing thenumber of organs recovered fromeach deceased donor, while at thesame time increasing the numberof hospitals with the largestpotential to be involved in theexisting collaborative. TheCollaborative has set a goal ofincreasing the number of organsper donor procured to 3.75.Ultimately, Burdick fits organdonation into the larger questionof what end-of-life policies hos-pitals have in place. He says,“The family (having an) honestchance to make an informeddecision, having all the informa-tion needed regarding the end oflife of a loved one who isextremely ill and likely to die, iswhat they deserve. (This) willautomatically give the family the information they need tomake a decision on organ donation as well.”

Pediatric Organ AllocationRevisions to OPTN/UNOS alloca-tion policies will give kids andadults an equal chance of gettingan organ transplant.

In an attempt to assure that chil-dren have the same chance asadults of receiving a lifesavingkidney and liver transplants, theOPTN/UNOS Board of Directorsadopted a series of revisions to the

Transplant News DigestTransplant News Digest

Jim Warren

from the editors of Transplant News� By Jim Warren, editor and publisher

Transplant News, edited and published by Jim Warren, is a twice-monthly newsletter for the transplant commu-nity focusing on developments in organ, tissue, eye and bone marrow procurement and transplantation. TransplantNews Digest is written exclusively for quarterly publication in Transplant Chronicles. For more information aboutTransplant News visit: www.trannews.com

Continued on next page


pediatric organ allocation policies.The new policies restructure theway pediatric candidates are consid-ered for kidney and liver organoffers.

Pediatric Liver Allocation Policy:

Livers from donors younger than 18will continue to be offered to themost urgent (Status 1) children andadult patients, first locally and thenwithin one of the 11 regions nation-wide. However, under the new poli-cies, pediatric donor livers will thenbe offered in the following order:

candidates age 11 or youngerwithin the donor's regionlocal adolescent patients with aPELD (Model for Pediatric End-Stage Liver Disease) score of 15or higher on a 40-point scale

local adult candidates with aMELD (Model for End-StageLiver Disease) score of 15 orhigherregional adolescent patients witha score of 15 or higherregional adult candidates with ascore of 15 or higherremaining candidates locally andregionally, with adolescentsreceiving priority over adults.

In addition, the Board also separatedthe criteria for the most urgent cate-gory of pediatric liver candidates(Status 1) into two subgroups toensure that the candidates who arein the utmost medical urgencyreceive first consideration for donat-ed livers. Both children and adultscan qualify as Status 1 if they are atimminent risk of death without atransplant.

Revised Pediatric Kidney Alloca-tion Policy:

The board also adopted a revisedkidney allocation policy thatreplaces an earlier system of allow-ing children extra allocation pointsbased on their age. Kidneys fromdonors younger than age 35 will beoffered to pediatric candidatesbefore any adult patients, with thefollowing exceptions:

a perfect or nearly perfectimmune system match betweendonor and candidatecandidates whose immune sensi-tivity limits the number of med-ically suitable offerscandidates awaiting other organsin addition to a kidneycandidates who have previouslybeen a living organ donor

2004 is the year the rules for get-ting a life-saving organ transplantchanged forever

� By Jim Warren

“I need a liver. Please help savemy life.”

Those simple sentences posted on abillboard in Houston, TX, alongwith a series of newspaper ads andmedia appearances, got ToddKrampitz, a 32-year-old newlywedwith liver cancer, a life-saving liverdonated by an out-of-state donor.Despite widespread criticism of hisend run around the waiting list,Krampitz's success clearly resonatedwith many on the waiting list, andmedia campaigns began popping upall over.

Just two months later, an obscureInternet company calledMatchingDonors.com successfullybrokered its first kidney transplant

for a registrant who was paying$295 a month to list his name in anattempt to get a donor. Bob Hickey,58, ultimately got a kidney donatedby 32-year-old Bob Smitty, a totalstranger who said he only wanted to“do something big.” In the monthsthat followed, reports of patientsadvertising for donors on billboards,in newspapers and on the Internethave surfaced all over the country.

Mark 2004 as the point in timewhen the rules of organ donationchanged forever. It began in Januarywhen Wisconsin became the firststate in the US to allow live organdonors to deduct up to $10,000from their state income tax to coverexpenses incurred by the donation,including travel, lost wages, foodand lodging. A month later, police inSouth Africa announced they hadbroken up an international organtrafficking scheme (paid for by theIsraeli government) which featureddonors from a poor community in

Brazil being recruited by brokersfrom South Africa to provide organsfor mostly Israeli citizens.

In April, a study in the journalHealth Affairs reported thatincreased competition for scarcedonor hearts may have encouraged“gaming” of the waiting list by anumber of cardiologists from someof the most prestigious transplantcenters in the U.S. In response tothe ethically questionable, but per-fectly legal, sidesteps around thewaiting list, the Organ Procurementand Transplantation Network(OPTN)/United Network for OrganSharing (UNOS) Board of Directorsand the American Society ofTransplant Surgeons (ASTS)Council issued strongly-wordedcondemnations of the vigilanteactions. “Organ donation is a gift,not a transaction,” said RobertMetzger, MD, UNOS president.“We strongly oppose public or private appeals that effectively put

C O M M E N T A R Y


the needs of one candidate above allothers and pose concerns of fairness.Transplant candidates rely on thepublic's trust in the fairness of theallocation system and support thatsystem through donation. Publicappeals may jeopardize that trust.”The ASTS statement reads in part:“The ASTS is strongly opposed tothe solicitation of organs (deceased)or organ donors (live) by recipientsor their agents, whether this isthrough personal or commercialWeb sites, billboards, media outletsor other forms of advertising whenthe intent of such solicitation is toredirect the donation to a specificindividual rather than according tothe fair policies of allocation(UNOS policy on organ donation)which all members on the waitinglist abide by. We believe that suchsolicitation and directed donationwill undermine the trust and fairnesson which the system of organ trans-plantation depends. Society, in par-ticular potential recipients and theirfamilies, must believe that the cur-rent organ allocation system is pro-tected from discriminatory practicesthat will disadvantage certain classesof individuals.”

It is hard to argue with UNOS’ andthe ASTS’ ethically and morally cor-rect positions and yet I can't help butcompare it to former First LadyNancy Reagan’s “Just Say No” cam-paign slogan in her highly publi-cized effort to fight drug abuse. Allthe finger wagging pronouncementsabout preserving the fairness of theallocation system are likewisefalling on deaf ears as patients andfamilies decide playing by the rulesis stupid if it is an automatic deathsentence. The worldwide transplantcommunity is clearly at a crossroadsand must stretch the boundaries of what is acceptable to procure asmany organs as possible to meet theincreasing demand.

But transplantation is a victim of itsown success. Transplant surgeonshave never been better trained.

Immunosuppressive drug regimenshave never been more effective incontrolling rejection. Patients andfamilies with the financial means todo so are not going to accept certaindeath on a waiting list if they canafford to advertise for, or eventuallypurchase, a lifesaving organ.

The options for a quick fix arefew and often controversial.They include, in no particularorder of preference:

Increase Donation After CardiacDeath (DCD). This has thegreatest potential to provide ahuge boost in organs. Expertsestimate the potential to besomewhere between 1,500 and2,500 new donors per year. Thesuccesses enjoyed by the Gift ofLife Program in Philadelphia,PA, and the University ofWisconsin Medical Center, and, more recently, the Midwest TransplantProgram in KansasCity, MO, clearly indi-cate establishing pro-grams in hospitals isboth do-able and pro-ductive.Begin a national cam-paign to get all 50states to adopt a lawlike Wisconsin's, pro-viding compensationto live donors for trav-el, lost wages, etc. Inaddition, begin lobby-ing the new Secretaryof Health and HumanServices (HHS),Michael Leavitt, toestablish a nationalregistry of livingdonors to assure thatthe new patient, i.e.,the live donor,receives lifelong medical follow-up. Continue to push for atrial to determine ifoffering meaningfulfinancial incentives

will increase the number of peo-ple willing to donate. Implement presumed consent,mandated choice, first-personconsent, state registries, and anyother program that has a prayerof increasing donation. There islittle to lose and much to gain,given the fact that so many peo-ple in need of a transplant aretaking matters into their ownhands anyway.

Transplantation is clearly at a cross-roads. With more than 87,000Americans, and thousands moreworldwide, on a waiting list for anorgan, and with the list growing, therules for getting a life-saving trans-plant have changed forever.... T

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Consult your tax advisor


THE PRIMARY PURPOSE for usinga wheelchair is to increase your abili-ty to be independent within the com-munity. As society makes the envi-ronment more accessible to peoplewith handicaps, wheelchairs are mak-ing people free to work, shop andeven participate in recreationalsports.

HAVING STATED THE PURPOSE,you do not want to surrender yourability to walk. There are many arti-cles that report the link betweenwalking, quality of life and mortality.Immobility is associated with manyadverse effects, such as the decreasein bone density, muscle weakness,joint contractures, constipation, skinsores, and the decrease in heart andlung function. If you use a wheel-chair frequently, you need to partici-pate in an exercise program thatincludes stretching, strengthening andweight bearing exercises, and aerobic training to avoid the adverse effectsof immobility.

AS A PHYSICAL THERAPIST, Irecommend the use of a wheelchairfor individuals waiting for transplan-tation and for those recovering fromsurgery in order to prevent isolationand concentrate their energy towardsrehabilitation. For people with chron-ic impairments like complicationsrelated to diabetes, a wheelchairmight allow the individual to remainan active member of their family and

community. Using a wheelchair canhelp remove the loss of self-controland social isolation, and allow anindividual to complete some of theirgoals.

THE FIRST DECISION SHOULDADDRESS whether you should havea manual or an electrically poweredchair. Benefits of a manual chairinclude the fact that you need to pro-pel the chair, therefore getting someexercise to maintain your health. Ifyou are going to use the chair on adaily basis, you should have a physi-cal therapist measure you for a prop-er fit to assure comfort and avoidproblems. If you are only going touse the chair for occasional commu-nity outings and someone will escortyou, a manual chair is a good choice.You should select a chair that is lightin weight, and can fold to be easilypushed and transported in your vehi-cle. The manual wheelchair is lessexpensive and is easier to maintainand repair.

MOTORIZED WHEELCHAIRShave certainly opened up opportuni-ties for patients with long-termimpairments. These chairs are veryexpensive and typically require med-ical documentation from a physicianand physical therapist for insurancecoverage. The chair is typically cus-tomized to meet your needs. The dis-advantages of an electric wheelchairinclude the fact that they are heavy,

have limited battery use, and requirea vehicle that has the space andcapacity to have a mechanical liftinstalled to load and unload the chair.

ELECTRIC SCOOTERS are avail-able if you do not need the special-ized features of a customized powerwheelchair. The four-wheeled scoot-ers have increased stability, whichwould be important for clients whohave problems with balance, obesity,or who will be driving their scooteron uneven ground. A three-wheeledscooter has less stability, but it has atighter turning radius, which maymake a difference when operating insmaller spaces. You must considerhow you get on and off the scooter.With some scooters you need to havethe strength, flexibility and balanceto step over the controls to sit down,while other scooters have a swivelseat or have the driving controls onthe arm rest. Many of the disadvan-tages that were discussed with pow-ered wheelchairs are the same withscooters.

THERE ARE MANY ACCESSORIESthat can be added to the wheelchair or scooter to make activities easier.Features can be added to carry objectsand make desktop activities easier tocomplete. Holders for oxygen tanksand mechanical ventilators can besecured to the chairs. Different joy-sticks and wheels can be selected tomake the chair easier to drive.

AS YOU CAN SEE, deciding to usea wheelchair is a complex issue. Youshould spend time examining yourneeds and goals; discuss yourthoughts and feelings with your family. Work with the case managerfrom your insurance company andwith your health care team to helpyou in your decision and the selec-tion of the right equipment and tomaximize Medicare, Medicaid or pri-vate insurance coverage. T

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When a Wheelchair is the Way to Go� By Chris L. Wells, PhD, CCS, ATC

THERE ARE MANY ISSUES to examine when you

are considering using a wheelchair or scooter.

Financial resources, the ability to maintain and repair the

chair, access to the community, family support, and the

ability to operate the chair safely are just a few key issues that need to

be addressed with your family and health care team.


Allison was born with a heart valvethat was too small. You would neverknow that Allison had a heart condi-tion just by looking at her. She wasfull of life. Allison was the strongestperson we have ever met. No matterwhere she was, she showed optimisticenergy. Whenever she had to have asurgery she was very brave and shebarely ever shed a tear. Even thoughshe had so many unfair things happento her, she never once complained andwas always appreciative.

On August 9, 2002, Allison went intoher eighth surgery. When Allison told

us she would be having valve surgerywe assumed that it would be ok, justlike every other time. We were wrong.This time it didn't go ok. After weeksof problems and complications thedoctors decided that Allison wouldneed a new heart. Allison waited for aheart for three and a half weeks, butunfortunately one never came. Allisonwould have wanted to be a donor butunfortunately her organs weren'thealthy enough.

After Allison passed away, we real-ized how important life is. We startedto hang out more and we called each

other often to support each other through this.Sometimes we talkedabout memories we hadwith Allison and, othertimes, we hung out like weusually did. We didn't haveto say, “I'm here for you.”We understood that wewere there for each other.If we wanted to talk tosomeone about how wefelt, we knew that one ofour friends would be therefor us.

From Allison's expe-rience we learnedthat many people areunaware of theimportance of donat-ing their organs. Wewant to tell peopleour story and encour-age them to become

donors. We enjoy providing peoplewith information about the importanceof organ donation. We always stressthe fact that it is crucial to tell yourfamily of your wish to donate yourorgans, because your family has thefinal say.

Sara, Heather and Kayla are highschool seniors living in Vermont andare dedicated to increasing organ donation. T

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ALLISON WAS OUR FRIEND. She brought out the best in every-one. She was everything you could want in a friend. In this world

today, there are so many people who judge others just because of howthey look or may seem to be, but Allison wasn't like that. She taught usthat there is more to a person than what is shown on the outside.

Heather Sara

Kayla

Allison

A Lost Friend Inspires Action� By Sara Stowell, Kayla Gennrich and Heather Bell

New Onset Diabetes: A Guidefor Kidney Transplant

Recipients booklet released.

After a successful kidney trans-plant, many patients withoutprevious blood sugar problemsare at risk of developing newonset diabetes. Recognizingsigns and symptoms and becom-ing aware of risk factors canhelp recipients delay, prevent oreffectively monitor new onsetdiabetes, also called PostTransplant Diabetes Mellitus(PTDM).

Single copies available by calling the NKF at

800-622-9010

T E E N S T A L K I N G T R A N S P L A N T A T I O N

See page 16 for more “Teens Talking Transplantation”


The last ingredient for a caring rela-tionship is having fun together. Plantime in your day and your relation-ship for fun together. Go for a walktogether; go to a movie; get away forthe weekend; read a book together;visit an historic site; or go out withfriends to a play and have dinner. Itdoesn't matter what you do, just thatyou plan something to look forward toas a couple.

“Kind hearts are the garden; kindthoughts are the roots; kind words arethe flowers; and kind deeds are thefruit.”

-Hungarian Proverb

About the AuthorBarbara J. Schroeder,MS, RN, CNS, is theOrgan TransplantCertified NurseSpecialist at RochesterMethodist Hospital inRochester, MN.

We want to help with these issues that can be difficult to talk about. E-mail Barbara at [email protected] your concerns regarding sexual-ity and intimacy; if you are wonder-ing, chances are others are too. All correspondence will be handled con-fidentially and cited anonymously in articles.

TC

Hugs, Kisses and More…Continued from page 3

Kicking for Life


higher. The minimum time betweentesting is two months with a mini-mum of 15 one-hour classes. BecauseI travel for a living, sometimes it wasa challenge to get to class. I reallydidn't think that much about beingpromoted to black belt. I was morefocused on getting the long overdueexercise, growing stronger and get-ting back in shape. My biggest thrillwas stepping on the scales and watch-ing my weight slowly drop from 215lbs down to 165 lbs. and going froma waist size of 40 to 36. What couldbe better than that? It didn't reallysink in that I could actually achievethe black belt level until I was aboutthree belt levels away.

There was this saying that startedrunning through my head: “If youthink you can or think you can'tyou're probably right.” I decided thatI could do it.

On July 16, 2004, at 59 years young,I tested and received my first-degreeblack belt in front of my loving fami-ly and friends. I have always wornthe green transplant ribbon on myuniform to honor my anonymous kid-ney donor. I pray that he or she waslooking down with pride saying “welldone.”

I may be a bit optimistic here, but Ifeel so confident I've signed up forthe mastery program. If I pass everytest and God is willing, I'll go for mysecond degree in November 2005 atage 60.

(1) Wearing a wide protective bandunder my uniform.

(2) Before the sparring starts, boththe instructor and myself briefthe other students on the "nostrike zone" around the newkidney.

(3) Position my body so the trans-plant side is always away frommy partner.

(4) Remembering that the trainingis not about how hard you can hit—its about developing tech-niques so you don't have to takea hard hit.

Editor’s note: Always talk to yourphysician before beginning an exer-cise program.

About the AuthorRichard Link is a kidney recipientfrom Cordova, TN. T

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My Protective Measures for Martial Arts Class

IT’S OFFICIAL! The 2006 U.S. Transplant Games

will be held June 16–21, 2006 in Louisville, KY. The city is excited to be

welcoming teams from across the country to the Bluegrass State and we are

eager to help each of your teams begin planning for next year's event.

Stay tuned for more information…

The Games’Afoot!

Photo: Jay LaPrete


Education, and Related Agencies torequest $25 million in funding forthe Organ Donation and RecoveryImprovement Act of 2004.

Bumgardner, an Associate Professorof Surgery at the Ohio StateUniversity, and Tipple, a Neonatol-ogy Fellow who is also a kidneytransplant recipient and member ofthe National Kidney Foundation'stransAction Council ExecutiveCommittee, testified on behalf of acoalition of 12 organizations repre-senting the Transplant Roundtable.

The testimony focused on the waysthis legislation, enacted in 2004 butnot yet funded, could expand thepool of donor organs available fortransplant in the U.S. Funds wouldbe allocated for the reimbursement oftravel expenses for: low income liv-ing donors, hospital-based “organ coordinators,” demonstration projectsto increase organ donation and for studies by the Agency for HealthcareResearch and Quality that would

develop new methods for organ recov-ery, preservation and transportation.

The Transplant Roundtable includes:the American Association for theStudy of Liver Diseases, theAmerican Association of KidneyPatients, the American Association ofTissue Banks, the American LiverFoundation, the American Society ofPediatric Nephrology, the AmericanSociety of Transplantation, theAssociation of Organ ProcurementOrganizations, the Eye Bank

Association of America, the NationalKidney Foundation, the NorthAmerican Transplant CoordinatorsOrganization and the United Networkfor Organ Sharing. T

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TRANSPLANT SURGEON Dr. Ginny Bumgardner andpediatric resident Dr. Trent Tipple presented testimony

before the U.S. House of Representatives AppropriationsSubcommittee on Labor, Health and Human Services,

Other ProductsUse of zinc products (lozenges; nasalgels and sprays; chewing gum) possi-bly stops the virus from sticking toand infecting the nasal passage. Theseverity and duration of cold symp-toms may be decreased if zinc is start-ed within the first day or two of coldsymptoms. The major side effect ofzinc products is stomach upset.

High doses of vitamin C (greater than1000 mg per day) may also decreasethe severity and duration of cold

symptoms if started early in thecourse of a cold. The major side effectof high dose vitamin C is diarrhea andstomach upset.

Finally, Echinacea is a natural productthat is thought to ward off coldsthrough stimulating the immune sys-tem. Because of the potential immune-stimulant affect of Echinacea, it is notrecommended for use by transplantrecipients.

One final reminder...When choosing OTC medications totreat cold and flu symptoms, take thetime to carefully read the list of activeingredients. Pay special attention tothe label on “multi-symptom” prod-ucts so as to avoid taking deconges-tants and NSAIDs or excessiveamounts of acetaminophen.

Note: Always talk to your doctorbefore taking any new medicines,including over-the-counter meds. T

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An Over-the-Counter Medication Review


Transplant Organizations Request Funding to Boost Donation

Trent Tipple, MD, and Ginny Bumgardner, MD, testify before the U.S. House of Representatives.

Centers for Medicare and Medicaid Services Update

The Medicare Modernization Act provides all people with Medicare theopportunity to obtain prescription drug coverage beginning in January

2006. Certain people with Medicare may also be eligible for additionalfinancial assistance to help pay drug benefit premiums and co-paymentsbased on their incomes. Social Security will be notifying these people bymail in May. Sign-up for the prescription drug cards will start in November.Be on the lookout for information about the Prescription Drug Plans in yourarea in early Fall.

Phot

o: D

ustin

May


Please join the National Kidney Foundation (NKF) Chancel-lor, actor Ken Howard, and a community of transplant recipi-ents—of all organs—for a series of three one-hour telephone discussions about some of the most important issues trans-plant recipients are facing today. Topics include: understand-ing Medicare coverage and other financial issues; getting thefacts about depression—how to recognize and treat it; and,finally, empowering ourselves to be better advocates for ourcare. As transplant recipients, we face issues related to dailyliving plus additional challenges that come with transplanta-tion. But we are not alone—we can help one another by shar-ing information and providing support.

Why these topics?

To prepare for this series of calls, the National KidneyFoundation asked transplant recipients what they wanted tolearn more about. We got a huge response, and these three topicsemerged as some of the most important, unique challengesrecipients are now facing. We then reached out to transplantrecipients and health care professionals who were willing toshare information and talk about their individual experiences.

How will these calls work?

Each topic will be scheduled on three different days and timesto allow many of us to participate.

Pre-registration is strongly encouraged. Pre-register online atwww.transplantrecipients.org under “Meetings andEvents.” Online pre-registrants will be able to preview extramaterials ahead of time. You may also register by calling 800-622-9010 between the hours of 9:00 am EST and 5:00 pmEST. You can also just join the call without pre-registeringsimply by calling 800-620-7912 and entering the passcode78383 five to ten minutes before the call—however, westrongly recommend pre-registration if at all possible,since just joining the call will not give you access to theextra materials.

CALL SCHEDULE:

“Getting the Most Out of Medicare”

May 11, Wednesday, at 8:00 pm Eastern TimeMay 12, Thursday, at 8:00 pm Eastern Time May 28, Saturday, at 5:00 pm Eastern Time

One constant about Medicare is that it is always changing.Though Medicare is a Federal program, each recipient's bene-fits under Medicare are dependent on a recipient's unique cir-cumstances (e.g., the type, date and place of your transplant;other coordinated insurance benefits; and—for the first timebecause of recent changes in Medicare—income.)

Understanding your rights and benefits under Medicare andhow Parts A, B, C and D fit your needs may feel like alphabetsoup. We will discuss the “nuts and bolts” of Medicare andthen move on to talk about changes we anticipate in the nextfew years, due to the recently enacted Medicare PrescriptionDrug and Modernization Act of 2003.

“Understanding Depression”

June 12, Sunday, at 4:00 pm Eastern Time June 16, Thursday, at 9:00 pm Eastern Time June 25, Saturday, at 3:00 pm Eastern Time

Before transplant, we focus on just staying alive. It is notunusual for us to be depressed as we hope to live and, at thesame time, know that we may not. After transplant, there maybe tremendous pressure on us to just be happy that we arealive, and usually we are! But the phenomenal experience oftransplantation brings a wide range of emotion, and learningto cope with a new set of challenges that come with livingwith the chronic condition of transplant is challenging. Wehave the same life problems as the general non-transplantedpopulation, along with other challenges. Join us as we talkabout depression and the complex issues that cause it.

“Helping Others While Empowering Ourselves”

July 10, Sunday, at 5:00pm Eastern Time July 21, Tuesday, at 8:00 pm Eastern Time July 30, Saturday, at 1:00 pm Eastern Time

After transplantation, we are grateful and proud to be able togo on with our lives. However, many of us are so thankful toour donors, living and deceased, and to our family and friendswho were there for us. Because we have learned so much onour journey that could be helpful to candidates and the newlytransplanted, we have a burning desire to help others and giveback! How do we make our experience count, how do wehelp others as they begin or travel along their journey? Let’stalk….

Write and read transAction's message board at www.transplantrecipients.org and contribute to our conver-sation threads about “Medicare Changes,” “Depression” and“Patient Empowerment.”

The National Kidney Foundation gratefully acknowledges the support

from Roche for this program.

“Making the Most of Your Life: Issues for Today's Transplant Recipient”

A series of phone discussions presented by the National Kidney Foundation

SAVE THE DATES!Ken Howard


Because our mouths are host to avariety of bacteria, being immunosup-pressed makes transplant recipientsparticularly susceptible to infection.Good oral hygiene can ward off bac-terial and fungal infections.

When selecting a toothbrush youshould consider…

The ADA Seal of Acceptance—The ADA (American DentalAssociation) Seal of Acceptanceidentifies products that have beenproven to prevent plaque andtooth decay. Furthermore, theseproducts have been tested toensure they will not harm the consumer.Harder bristles aren't better.—For years, dentistry has endorsedusing soft bristle toothbrushesbecause hard bristle toothbrushesare too abrasive. Long term use ofhard bristles will result in irre-versible recession and tooth abra-sion. Remarkably, hard bristletoothbrushes remain on storeshelves.Bigger isn't better, either.—It isimportant to select a toothbrushhead that fits comfortably in yourmouth. Toothbrushes with largerheads often miss plaque in hard-to-reach areas such as the molars.A smaller head toothbrush allowsthe user to maneuver it with easeand will allow the bristles to con-tact those “hard-to-reach areas”better.Do different shaped toothbrushesreally make a difference?—Diamond, tapered or bristles in

every direction are just a fewexamples of the latest in tooth-brush design. An example of abeneficial design is a toothbrushwhere the bristles at the tip areelongated. These bristles give thetoothbrush an “extended reach” andaid in brushing hard-to-reachmolars. To determine which designis best for you, ask your dental pro-fessional. They will be able toselect a design that will help reachthe areas you tend to miss. Electric vs. Manual—Thoughelectric toothbrushes can be awonderful motivational tool andmany are now equipped with tim-ing devices, plaque can beremoved just as well with a manu-al toothbrush. Electric toothbrush-es are helpful in assisting thosewho have inadequate dexterity,i.e., the elderly, children, andthose afflicted with illnessesor medications that effect hand coordination.

Preventing the Flu and ColdsImmunosuppressed patients are par-ticularly susceptible to the flu andcolds, especially with the shortage offlu vaccine this year. Here are somesimple tips regarding your toothbrushstorage:

Never share toothbrushes.Wash your hands before and afterbrushing your teeth.Replace your toothbrush everythree months, when the bristlesfray or after any oral or upper

respiratory infection. Frayed bris-tles are poor at removing plaqueand damage the gums. Bacteriaand viruses live and grow on yourtoothbrush. You are at risk forinfection if you do not changeyour toothbrush. (Disinfectingyour toothbrush, in bleach, hydro-gen peroxide, antiseptic mouthrinses, dishwashers, or boilingwater, is not advised for it dam-ages the bristles.)Allow toothbrushes to air dry.(Covering a wet toothbrush cre-ates a humid environment that willaccelerate the growth of bacteria.)When using a toothbrush holderfor multiple toothbrushes, be surethat the toothbrush heads are sepa-rated and never touch.Toothbrushes should be stored twoto five feet away from the toilet.It is also recommended to closethe lid of the toilet when flushing.Research has found that tooth-brushes are vulnerable to airbornebacteria such as E. coli, which canbe transferred from the toilet to atoothbrush nearby.

Shopping for the right toothbrush canbe overwhelming. Choosing a tooth-brush with the ADA seal of approval,soft bristles, the right size and theright shape are important. Your health care professional is the bestsource in finding the toothbrush thatbest fits your mouth. Electric tooth-brushes can be very beneficial andfun. Furthermore, where you storeyour toothbrush and how often youreplace it can protect you from bacter-ial and viral infections. Color shouldbe the last thing you consider whenchoosing a new toothbrush, but, whenyou have considered everything else,pick something that is fun!

Cheryl A. Thomas, RDH is a dentalhygienist. She received a kidney in1999 and lives in Galveston, TX. T

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RED, BLUE, PURPLE OR PINK? Is color the most important thing when you pick your toothbrush?

Toothbrush Selection

� By Cheryl A. Thomas, RDH

30 East 33rd StreetNew York, NY 10016

(800) 622-9010 www.transplantrecipients.org

� Has your e-mail address changed or have you recently gotten e-mail? E-mail [email protected] with your e-mail address and your membershipnumber located above your name on the label.

NONPROFIT U.S.POSTAGE

PAIDNEW YORK, NY

PERMIT NO. 5327

I was going through stuff normal six-year-olds go through. But I alsocouldn't run as fast or long withoutgetting tired and weak. I needed akidney transplant, so my mom bravelydonated her kidney to me. My dadhad several responsibilities, such astaking care of my mom, my brotherand myself, so my mom wasn't theonly brave one.

I felt awesome after the surgery. I hada lot more energy, but taking medica-tions made me feel different from myfriends.

When I was about eight, my mom,dad, brother and I went to a camp forfamilies that had experiences withtransplants. Before attending camp, I was completely convinced that I wasthe only person in the world who hada transplant. Well, I sure was wrong.

I found friends that had to take med-ication too. I could talk and relate tothem about things like taking medi-cine every day; doctors; monthlyblood draws and other things I neverimagined I would have to deal with.

I continue to attend the camp. I havefun, but I also meet new people whoknow what I'm going through—and Iactually feel normal for once. My par-ents especially like it because theycan go and exchange stories withother parents. Through talking to peo-ple with similar stories, my familyand I have learned that going throughall of this was more of a gift than apain. My parents learn about newmedications and advancements intransplantation during educational andsupport sessions. I participate in bik-ing and rock climbing or sometimeswe just sit in a room and talk. Theonly bad thing about it is that it's onlyfor a weekend once a year.

I am no longer embarrassed about mytransplant. I'm actually proud of it, and I encourage people to "give the Gift of Life" and become organ donors.

I went to camp looking to makefriends. I left with not only newfriends, but with more respect for life.

Editor’s Note: Second Chance andthe Step Up Program are open to allsolid organ transplant recipients (kid-ney, liver, heart and lung) who aretreated at Children’s Healthcare ofAtlanta, GA.

Contact your local NKF office to findout more about various camps forchildren and teen transplant and dialysis recipients or visit:www.kidney.org/patients/kidney_camp/index.cfm T

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Camp Second Chance� By Kelly Zimmerman

MY NAME IS KELLY ZIMMERMAN. I am almost 15 years oldand, eight years ago, I had a kidney transplant. I was born with

under-developed kidneys and wasn't expected to live past three months.Luckily, my kidneys were able to support my body—until age six.

KellyZimmerman at Camp

Second Chance.

T E E N S T A L K I N G T R A N S P L A N T A T I O N (Cont’d)

National Kidney Foundation. Kicking for Life

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Transcript of National Kidney Foundation. Kicking for Life