UTMB Texas Transplant Center: Social Work and Dietitian Education

UTMB Texas Transplant Center: Social Work and Dietitian Education

November 4, 2019 0 By William Morgan


Welcome to the UTMB Texas Transplant Center’s
Social work and dietitian video. The Texas
Transplant Center offers excellence in patient
care. We have a dedicated team of transplant
social workers and dietitians who will assist
you along the way during each phase of transplantation.
The video provides a short introduction to
the information shared with you by our social workers and dietitians.
Before the transplant,
the social worker will meet with you to talk
about your support system, insurance, financial
situation, coping skills, compliance and adherence,
educational resources, and will address any
problems or needs that you may have.
The social worker will also talk about the
medications you will need for survival of
your kidney. It is your responsibility
to pay for medications including co-pays.
Medicare Part B may pay for some of your immunosuppressants.
It is important to save at least $2,000 for the first month of expenses, mainly for medications.
For example, Valcyte, a medication you may need to take,
is covered by Medicare Part
D, but the copay can be very high.
If you receive American Kidney Foundation grants,
they will stop paying for premiums after the transplant.
Medicare Parts A, B, and D will
stop 3 years after the transplant. It is crucial
to develop a plan in preparation for this
eventually. Your insurance will be verified
before you are put on the transplant list.
Remember to talk to your dialysis social worker
if you do not have kidney health care (KHC).
KHC can help with transportation and medication copays after the transplant.
The social worker will talk to you about organizations and fundraising
that can help lighten the financial burden
of kidney transplantation. National agencies
can provide guidance or sponsor your fundraising
efforts.
Here is the list of resources.
Communicating
with your donor’s family is an option, however,
donors are usually anonymous. If you know
your donor’s family and wish to write them
a letter, you can contact your post-transplant
coordinator to organize it. You cannot identify
yourself in the letter to your donor’s family.
Some other patient responsibilities include campus parking and housing.
Some hotels may offer
a discount to UTMB patients.
Remember to have an advanced directive and power of attorney.
It is important that you choose someone you trust
to carry out your wishes regarding your medical
treatment if you are unable to make decisions
on your own behalf. If you need to speak
with a social worker, please call 800-323-4109.
The dietitian will do a complete nutritional assessment
for you during the pre-transplant evaluation.
It will include diet history, medications
and food allergies, factors affecting nutrition,
and a physical assessment.The physical assessment
determines body mass index by measuring height
and weight. The assessment will also determine
weight distribution by measuring waist and
hip ratio, muscle and belly fat. As mentioned
before, the body mass index is the relationship
of height and weight. It helps figure out
how much you should weigh. An underweight
BMI is less than 18.5, a normal BMI is 18.5
to 24.9, an overweight BMI is between 25 and
29.9, and an obese BMI is 30 or greater. In
general, the guidelines for a kidney transplant
is a BMI below 38. However, the transplant
team prefers it be less than 30. If you are
receiving a kidney from a living donor, your
BMI should be less than 30.
Being overweight or obese, or severely underweight can cause or affect many conditions and/or diseases
before and after transplant. Abdominal obesity
or belly fat could interfere with the transplant. There
are many complications of being overweight
or obese such as stroke, cardiovascular disease,
high blood pressure, diabetes, high cholesterol,
chronic kidney disease, arthritis, gout, degenerative
joint disease, some cancers, sleep apnea,
and fatty liver disease. There could be complications
due to weight issues such as slow organ or
poor organ function, short organ survival,
poor surgical healing, bleeding, infection,
longer hospital stay, and rejection.
What leads to being overweight or obese? Some medications, eating more than you need, not being physically
active enough, and absorbing excess calories
from peritoneal dialysis solution.
What leads to being underweight? Some medications, eating less than you need, some medical conditions, and genetics.
If you are not a healthy weight
during the transplant workup, you can work
with your doctor and dietitian to make a food
and exercise plan.
One of the most important aspects of your health after the transplant surgery is hydration.
Increase your water intake to 8, 16-ounce water bottles per day.
In addition, you may need to watch your potassium
and phosphorus intake for a short period of
time after the transplant.
This is extremely important for the life of your new organ.
We look forward to working with you. Thank you from all of us at UTMB!