Organ Donor
...ients, was given a second chance. He chooses now to take full advantage of the chance that he has been given and make the most out of his life. Many patients have the initial reaction of being frightened when they realize that part of their body is failing and that there is a strong possibility that a transplant will be needed to save their lives. Ray became very emotional as he got closer to needing dialysis and realizing that he would soon have to consider a transplant. During his dialysis, Ray had a difficult time even speaking with family members and friends without becoming very sad. Dialysis comes at a time when patients are vulnerable and facing their own mortality. Some patients find “restrictions on activity, mobility, diet, and other factors to be too limiting and debilitating” to enjoy a normal life (UC Davis). Patients on dialysis continue to hope more and more that an organ will become available for a transplant. Ray was finally put on the waiting list for a transplant in October of 1993. He experienced an emotional high because he knew that there was much more hope for his health to return, but he also became very anxious. Many emotions come with waiting for an organ. Increases can be seen in anxiety, irritability, hopelessness, and even guilt. They guilt comes from knowing that their health “requires the death of another person” (House and Thompson 536). A patient’s mental state before transplantation can be key in determining what the outcome of their operation will be like. Ray, who has been successful so far in his transplant experience, maintained a very positive attitude before his operation. Patients with positive attitudes and motivations do better than those who feel they have accomplished all they want to do in their lives already. For example, a parent who wants to be able to live to see a child graduate or get married will do better post-transplant than someone who feels there is not that much left to accomplish in life (House and Thompson 536). A study by the American College of Chest Physicians showed that “the psychological status pre-transplant predicted adjustment and quality of life post-transplant (Cohen et al. 635). It is extremely important for patients to keep a healthy and positive attitude through the whole experience. Ray got the news that he would be able to have his new kidney on February 2nd, 1994. The operation went well and Ray felt great. However, he still had to go through yet more emotional highs and lows after the operation. This is not uncommon. Between 50 and 70 percent of transplant patients experience changes in mental status after the transplant (House and Thompson 538). Some of these changes can be positive, but unfortunately, there are also negative changes that can occur. It is important, as noted before, for patients to stay positive. A high quality of life is very important post-transplant. It is not only vital to functional well-being but may be a key factor in survival (Cohen et al. 640). Many patients choose quality of life over quantity of life. Even though they know there is a chance they will not live a considerable amount longer, patients look at transplants as a way to get a few more good years into their life instead of having to deal with the suffering that comes with dialysis and illness (Szabo et al. 1353). Ray’s positive emotional effects included such simple things as being able to eat and drink what he wanted and to be able to travel without his dialysis equipment. He felt better than he had in the last ten years. Many recipients feel a certain sense of “euphoria, as if a new lease on life has been granted” (House and Thompson 536). The most common mental disorder that patients experience is delirium. This “clouding of consciousness” can be easily diagnosed and treated simply by therapeutic intervention (House and Thompson 538). Another common post-transplant situation for the recipient is depression. Anti-depressants and psychotherapy can be considered for treatment. Non-compliance can also be a problem post-transplant. In most cases, non-compliance stems from a lack of education about caring for oneself after a transplant. It can also occur due to “dissatisfaction or some psychiatric difficulty, such as depression, anxiety, oppositionalism, or memory disturbance” (House and Thompson 538). There changes in mood for patients post transplant can be partially attributed to the medications they must take. These medications used to maintain health after the operation can lead to the emotional side effects that the patient experiences. Ray was prescribed Prednisone, a common steroid given to patients with an organ transplant. Ray’s experience with Prednisone made him even more emotional than he would have already been. This is normal. “Prednisone may cause altered mood states in up to 15 percent of renal transplantation patients” (House and Thompson 536). Another common medication given to transplantation patients that can cause side effects is Cy...