As a candidate, you are encouraged to keep in good health. Eat correctly, exercise as much as you can, review vitamin supplements with your doctor or transplant team. Also review your vaccinations. Besides the usual childhood vaccinations, some programs recommend pneumonia, hepatitis (both A & B), and the annual fall flu shot. We can't overemphasize your having all the work necessary done on your teeth/mouth as soon as you are notified that you are an organ transplant candidate. Most programs, after transplant, strongly recommend taking a general antibiotic before and after you visit the dentist. It is very important that you follow their guidelines.

People who drink alcohol heavily or regularly should discuss the use of any or all medications with their doctor prior to using them or consuming alcohol. A good rule is: Never, Never drink alcohol with any prescription or OTC medication. There should be a period of time between their ingestion. Your doctor and/or program will give you very specific guidelines in this area. It is very important that you follow them.

Transplant candidates may experience problems with fatigue, lightheadedness, and a host of other symptoms. These symptoms may be side effects of various medications. The motor vehicle departments of Virginia, Maryland, and the District of Columbia provide hanging handicap tags to allow use of handicap parking spaces when needed by patients. Check with your motor vehicle department for the proper form to have your doctor sign. Candidates that experience problems should be aware that many of us need a few months after our transplant to return to a normal level of energy. Don't stay home. These parking places are there for those who have problems getting around, get a tag and get out and USE them! And for recipients: Go out and enjoy your new gift of life! Smell the roses!

Candidates and recipients should be aware of drinking water safety by not drinking local water if there is any question. Commercial sodas and some other bottled drinks are frequently made from local water. Be alert for Cryptosporidum and/or Giadia contamination of your drinking water. These outbreaks will be announced by the NEWS media after there is an occurrence. The Water Quality Association at 800-749-0234 has a consumer information package available on filters. NSF International will provide a current list of products meeting NSF standards #53 and/or #58, call 800-673-6275. These publications are frequently updated. Reminder: these water filters require maintenance. At least one current faucet model manufactured by PUR provides a helpful feature in a visual signal when its cartridge should be replaced.

Candidates and recipients should talk to your doctor before foreign travel. Gamma globulin injections are often encouraged by the State Department (202-647-5225) for those of us with compromised immune systems or other health problems. It is our recommendation that you take a two week supply of your medications in addition to what you need for the time that you plan to be traveling. It is also recommended that you carry your medications with you and not place them in checked baggage, and that you take a two-week supply of a strong general antibiotic, and consider it safe insurance to guard against intestinal problems. (And, hopefully you won't need it and therefore end up flushing it down the toilet after you return home.) Call the Centers for Disease Control and Prevention FAX Information at 404-332-4565 from a fax machine and follow the voice prompts; you will receive the latest information for the area, or areas of the world that you request.

Discuss your plans with your transplant team. Ask for a list of doctors that you may call if you do get into trouble in a foreign country. Many foreign transplant surgeons from many countries have received training at University of Pittsburgh Medical Center. These foreign transplant programs are also listed in the yearly issued "International Transplant Directory" listed in the resources section.

Finally, carry in a safe place with you a list of your medications, or better yet, copies of your prescriptions, and the telephone numbers of your physician, transplant coordinator, and pharmacists. With improved international transport lost medications can often be replaced rapidly, even if they have to be sent from the United States. A forewarning: These will be very expensive when obtained from either foreign pharmacies or by overnight international delivery.