Bruce is fifty-three years old and was a patient in the new Post-Transplant Rehabilitation Program at The Salvation Army Toronto Grace Health Centre (TGHC). Prior to being admitted to the TGHC, Bruce had been admitted to Toronto General Hospital (TGH) for a kidney transplant.
A recent rise in the number of transplants performed at the University Health Network (UHN) has resulted in an increasing number of patients requiring post-transplant rehabilitation. In July 2016 the TGHC formally implemented a program in partnership with University Health Network (UHN) to provide post-transplant rehabilitation for patients from TGH.
For over six years Bruce was on dialysis. Dialysis is the artificial process of eliminating waste (diffusion) and unwanted water (ultrafiltration) from the blood. Our kidneys do this naturally. Dialysis is merely a form of treatment, it does not make kidneys well again or cure kidney disease, and it does not fully replace your kidney function. Unless a patient receives a kidney transplant, they must continue to have dialysis for the rest of their life. On the day Bruce began receiving dialysis at Brampton Civic Hospital they put him on a waiting list at TGH for a kidney transplant.
In February 2016, Bruce received a call from the transplant team at TGH telling him a kidney was available. Before his surgery, Bruce had extensive tests done on his blood as well as his organs; specifically his heart and lungs, to ensure no complications would develop during the transplant procedure. Typically, if there are no complications a kidney transplant patient can return home between two or three weeks after surgery. However, after Bruce’s surgery he developed complications. He had a difficult time getting out of bed as well as walking. As Bruce recalls, “I felt paralyzed.” The health care team discovered that Bruce was septic and he was treated for a severe infection before being discharged for rehabilitation.
Bruce was admitted to the TGHC for rehabilitation in July 2016. The rehabilitation team at TGHC began working with Bruce on transferring from his wheelchair to a walker as well as his bed. After a short time, he had increased his mobility to the point that he was only using a rollator walker, and eventually he could walk with a cane. However, for Bruce to live independently at home, he would need to climb stairs. “Eighteen steps to be exact” said Bruce. To help him develop muscle strength in his legs, the rehabilitation team had Bruce work on the stationary bike as well as practice stair climbing.
Kidney trouble has not been the only major health issue that Bruce has had to cope with. Twenty-years ago, Bruce was also diagnosed with bipolar disorder, and he continues to take anti-psychotic medications. Now he must also manage his immuno-suppressants – anti-rejection drugs for his kidney transplant. Bruce must take these medications for the rest of his life. To help Bruce live independently, the rehabilitation team worked with him on organizing and managing his medications, as well as on preparing food and coordinating and economizing his movements.
The Post-Transplant Rehabilitation Program at the TGHC is very comprehensive and the health care team at TGHC works closely and in collaboration with the transplant team at TGH. If there is a medical change with the transplant patient at the TGHC, a designated transplant coordinator at TGH is immediately contacted. On two occasions Bruce developed complications that required him to return to TGH, and his condition to be assessed and further managed by the transplant team.
Despite these necessary return visits to TGH, Bruce was very motivated to return home before Thanksgiving weekend. After his return from TGH, Bruce was able to make a steady recovery. He regained his strength and endurance and was able to manage his own medications as well as directing his own care. Bruce was discharged on October 7, 2016 and home before Thanksgiving weekend.
Bruce believes the TGHC provides excellent care. “From the beginning they welcomed me with open arms. The nurses were attentive and caring,” he told me, smiling. “Very motherly.” “They would even help me in the evenings with my exercises and accompany me when I walked around the unit – everyone was really helpful.”
“Everyone was supportive,” continued Bruce, “my rehab team, the nurses, even Ron, the pharmacist, who helped me with my medications.” He also enjoyed his chats with the chaplain when she would visit and found Sunday morning services quite peaceful.
I asked Bruce if he attended any of the programs in recreational therapy. He said he had and that he particularly liked the coffee and news program; where patients gather together for coffee and discuss the daily news. Bruce was motivated to attend because as he said, “I like to put in my two cents worth.”
By Gerry Condotta