Meeting the 3 Requirements for Hospital Discharge After Lung Transplant
On Aug. 14, 2020, around 10 p.m., my successful lung transplant was completed. Now I was in the daunting recovery phase. Before being discharged from the hospital, I had to meet three requirements:
- Walk 1,000 feet without supplemental oxygen.
- Walk continuously on a treadmill for 30 minutes.
- Have all my chest tubes removed.
After hallucinating and fainting on my first day of recovery, I wondered what would go wrong while accomplishing these tasks.
Walk 1,000 feet
On Aug. 16, the physical therapist (PT) took me for a walk in the hallway.
Imagine having four chest tubes connected to a chest tube drainage system, an IV pole, and an oxygen tank, then trying to go for a walk. It challenged me because of all the equipment. I pushed a wheelchair that held the chest tube drainage systems and the oxygen tank. The PT had the IV pole, and another nurse pushed a chair behind me.
I went 100 feet. It wasn’t far, but I wasn’t too concerned because it was my first walk with new lungs. Because I had my transplant during the pandemic, I had to be extra careful to protect my immunocompromised body. Wearing a mask made it difficult to breathe and to walk.
The next day I walked farther, but it was only 220 feet. At the end of my walk, I was tired and a little lightheaded. Later, I found out I had gone into atrial fibrillation.
These results were discouraging. My goal was to be discharged within two weeks, but I believed I wouldn’t be able to accomplish it.
On Aug. 18, my walk was different from the previous days. Instead of pushing a wheelchair, I used a walker with wheels that didn’t work. I walked 320 feet. It didn’t feel like an accomplishment to walk farther, even with more restrictive tools.
Finally, on Aug. 19, I walked 1,000 feet without stopping. The physical therapist gave me a great tip that made it easier to breathe while walking: She said to use a small cup with the end cut off inside the mask. This cut down on the hot air and made a world of difference.
I met the first requirement. Then, the doctors ordered the discharge education training to begin. I had high hopes of being discharged on Friday, Aug. 28. I was ready to take on the treadmill.
Walk on the treadmill for 30 minutes
The following day, I attempted the treadmill walk. When I stood up to get on it, my chest tube dressings started to fall off. They were soaked because my incision had two small holes draining fluid. However, the leaks didn’t hamper my pulmonary rehabilitation. As I walked, more bandages kept falling off, and liquid fell onto the treadmill belt. My wife said the pulmonary rehabilitation technician kept wiping off the belt.
Although it was messy, I completed my 30-minute walk on the treadmill on my first try. My discharge education appointments were scheduled for Monday and Tuesday, three days before I hoped to be discharged. I was delighted about the possibility of discharge on Aug. 28.
Chest tubes removed
I had four chest tubes. You can see their approximate position below the clamshell incision on my lung transplant Shadow Buddy, pictured above.
The nurse practitioner pulled the two interior tubes on Aug. 16. I was ecstatic because I believed the others would be out soon.
The two small holes in my incision hampered getting the last two tubes removed. My surgeon said they would heal up with no problems. However, every time I sat down in the chair, my chest sounded like a whoopee cushion.
On Aug. 31, a nurse practitioner pulled my right chest tube. Unfortunately, they had to put in a right-side pigtail chest tube a couple days later. The reinsertion of a chest tube was demoralizing, which increased my depression. It frustrated me to take one step forward and two steps backward.
On Sept. 3, I had an exploratory wound surgery that fixed my incision issue. Initially, I worried about having another surgery, which to me represented another setback.
On Sept. 11, the final chest tubes were taken out, ticking the last box required for me to go home.
Thirty-one days after my transplant surgery, I was finally able to say, “The eagle has landed!” I was discharged from the hospital and went to our apartment on Sept. 14. To celebrate, I drank my first post-surgery “wine,” which was actually just a bottle of water. Nevertheless, I felt human again.
Time in the hospital can significantly vary for everyone. My stay was longer than I’d hoped, but I know two people who only stayed in the hospital for a week. Others stayed longer than me.
What was your experience preparing for hospital discharge like? Please share in the comments below.
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