While preparing for my family to visit at Christmastime, I was reminded of when my mom, Holly, was discharged from the hospital after her double-lung transplant. We had to make adaptations to make our rented apartment a safe environment for her.
She had been in the intensive care unit for three months and had lost a lot of strength and mobility. Daily walks in the ICU kept her strong enough to accept the donated lungs, but after 12 hours on the operating table, she couldn’t walk out of the hospital under her own power.
The first task in ensuring our home would be safe for my mom was finding one that was more or less accessible, according to the Americans with Disabilities Act standards. This is no small task in San Francisco — but that topic deserves its own column.
The ground-floor apartment that we rented had three small steps to get in the door. We moved some furniture to ensure that she could navigate the space with a walker, and removed trip hazards such as rugs and cords.
It was tricky to find seating that she could safely get into and out of. The “clamshell” surgical incision from a double-lung transplant was relatively large, as the sternum is cut crosswise to access the chest cavity. To protect the healing sternum and intercostal muscles, patients mustn’t pull with their arms — or be pulled by them — reach overhead, or lift anything heavy for six months after surgery. Combined with weakened leg muscles, this makes getting up from a low seat nearly impossible.
We came up with solutions to make it easier to get on and off the couch, and to use the restroom. We adapted a recliner with armrests by stacking pillows to provide more elevation. We found that starting with the hips above the knees is key.
In the bathroom, we placed a commode over the toilet. The frame was adjustable, so we made the seat high enough that she could stand up on her own, using the built-in armrests for support.
For bathing, we tried three shower chairs before we found the ideal one. A transfer bench can be placed with two legs in the tub and two legs out. It has a positionable backrest, as well as handles that snap on and off on either end. This allows the user to sit down on it outside of the tub, slide over and move their legs into the tub, and lean back. We found it to be the most efficient and safest shower chair. Combine with a showerhead on a hose, and you have a luxury bathing experience.
Now nine months post-transplant, my mom has regained a lot of strength and coordination. I didn’t have to take mobility and accessibility concerns into account to host my parents for Christmas. But I did have to consider the cleanliness of my home.
My mom’s immune system strengthens a little more every day, but having had a lung transplant means that she is chronically immunosuppressed. When we were preparing the apartment for my mom coming out of the hospital, my aunt, Shari, and I were obsessive about disinfecting surfaces multiple times a day. We vacuumed up dust bunnies and made sure that there was no goose-down bedding or other allergens in the home.
Though we were vigilant about keeping the space clean, the most important part of preventing the spread of bacteria and viruses is hand hygiene. We bought antibacterial soap for every sink, used paper towels, and washed cloth towels more frequently. We placed bottles of hand sanitizer around the house and wipes in the kitchen and bathroom for easy cleanup. I continue to follow this routine at home.
When cleaning my house for the Christmas visit, I had another element to consider. In Washington state, mold will grow on you if you move too slowly. Just kidding — but windowsills and bathrooms in particular host mold in most homes in the Pacific Northwest. While most mold doesn’t affect people with a healthy immune system, fungal infections can be a serious problem in lung transplant patients.
I run a dehumidifier in the house for a few hours every day to prevent mold growth, but I still discovered patches of it around our windows and sliding glass door. Vinegar can kill mold on porous surfaces, so I use that on painted wood window ledges.
I was a bit of a nut about environmental risks when my mom first came out of the hospital, but at this point, it’s easy to go the extra mile to make my house a safe space for my mom to stay.
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