Staying Healthy While Traveling with Transplanted Organs

For the first couple months of my recovery from a heart-lung transplant, I had a one-hour radius from the hospital. A woman I met in a waiting room assured me that eventually, I would be able to travel internationally. “They just load you up with antibiotics and you’re good to go,” she said. I remained skeptical.

Twenty months later, I found myself driving a rental car on the left side of a freeway at night in pouring rain. Traveling through Europe last month increased my independence and confidence in my own strength and adaptability. The trip challenged me to adapt to different languages, time zones, currencies, and transportation systems. It would have been an adventure even without the added complication of my compromised immune system and regimented medications.

One week supply of pills. (Photo by Kathleen Sheffer)

I was over-prepared for the trip. A month and a half supply of medication for 30 days of travel. A stack of Wet Ones packs, protein bars, three N99 masks. Homeopathic cold and flu shortening treatments, and a full course of antibiotics just in case. I made a spreadsheet with an emergency hospital assigned to all eight of the major cities we visited.

But the only emergencies I had were Emergen-C packets stirred into glasses of water before each flight. (I’m just as horrified as you that I wrote that sentence. And left it.) I didn’t get sick and my pulmonary function remained stable. My labs looked good the week I returned, so I didn’t need to adjust any medications.

I proved to myself that I could carry my own suitcase and backpack up staircase after staircase (appreciating the impact of the Americans with Disabilities Act along the way), wear an N99 mask for the duration of a long flight, and avoid illness while traveling.

How did I not get sick during a month of foreign travel on immunosuppressant medications? It wasn’t all luck.

Food safety

Most of the precautions I took revolved around food. First and foremost, I did not share food or beverages with anyone, except the occasional pretzel or mass of sauerkraut, if and only if my sister and I portioned it out before starting to eat. Not exchanging saliva is key to avoiding illness. Yuck – even the word saliva is gross.

Enjoying a giant pretzel and alcohol-free beer in Munich. (Photo by Monica Sheffer)

Not only are transplant recipients more susceptible to foodborne illnesses, we are more likely to experience a longer period of illness, be hospitalized, or even die, should we contract one. I ate only at restaurants that appeared reputable, checking reviews and health department ratings whenever possible. No street kebab for me. I was especially careful about eating meat, frequently opting for vegetarian options that typically come with fewer food safety issues. Twice I sent food back because the meat was undercooked.

In the United States, restaurants generally serve only pasteurized cheeses, and it’s easy enough to ask a waiter to check with the chef, but it was hard to be sure at restaurants in Europe. I stuck to hard cheeses, avoiding ingredients like feta and blue cheese, which are often unpasteurized.

Hydration

I bought a lot of pricey glass bottles of water at restaurants in Germany. Staying hydrated with clean water (none of those questionably clean pitchers filled with questionably clean ice) was well worth it. Transplant medications take a toll on the kidneys, so drinking plenty of water is always critical for me.

Rest

My sister and I are two hip young women in our early 20s … who value our sleep. I don’t think we were ever up past midnight the entire trip. When I traveled with pulmonary hypertension, jet lag took a greater toll on me than on my companions. Fortunately, I experienced very little fatigue on this trip. We had jam-packed days with hikes and trips to rock climbing gyms combined with museum tours and urban exploration. I was thrilled to be able to get through each day without napping, go to bed early, sleep through the night, and wake up rested — all without supplemental oxygen.

Calton Hill in Edinburgh, Scotland. (Photo by Monica Sheffer)

Mask on

I wore my Vogmask N99 mask in crowded areas: on buses, trains, and planes, in gyms, museum elevators … wherever I felt like I might breathe the air another human coughed out. I’m constantly redefining my comfort level, wearing my mask whenever my anxiety about infection outweighs my enjoyment of mask-free breathing. Lots of transplant patients never wear a mask, but it gives me peace of mind and so far has proven effective.

Tram in Prague. (Photo by Kathleen Sheffer)

As much as I wanted to go on this epic trip, I feared it was too great a risk to take. Unwilling to trade my newly stable health status for a trip to Europe, I was deeply worried about getting sick or rejecting my transplants while abroad. As with all the risks I take (see: rock climbing), I approached it with preparation and caution. I did it as safely as I knew how. It paid off: Now I can write about staying healthy while traveling!

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