A focus on organ transplants

Jan. 1, 2005
In 1999, Cheryl Thomas, RDH, began a journey that has transformed her life. In that year, she became a kidney organ transplant recipient as a result of end-stage renal disease.

In 1999, Cheryl Thomas, RDH, began a journey that has transformed her life. In that year, she became a kidney organ transplant recipient as a result of end-stage renal disease. By sharing her personal experiences in a program titled “Organ Transplantation and Dentistry: Pre- and Post-transplant Dental Needs,” Cheryl empowers dental professionals to prepare for any patient who is on an organ transplant waiting list, and to provide the professional with the ability to manage the post-transplant recipient with competence and confidence.

Cheryl’s program explains how UNOS (the United Network for Organ Sharing) determines who receives the “gift of life.” Dental professionals will learn about organ matching criteria, genetic predisposition to renal disease, cyclosporine use and its effects on gingival overgrowth, pre- and post-transplant dental protocols, hemodialysis and peritoneal dialysis. The program also includes the signs and symptoms of rejection and infection, and discusses controversial topics such as antibiotic and ibuprofen use. An insight into research for the future of organ transplantation is also discussed.

Approximately 17,000 organ transplants are performed each year in the United States, with approximately 80,000 patients on the national waiting list for a transplant. To be placed on the waiting list, a patient must have “dental clearance.” This means that all active dental disease is eliminated, thereby eliminating any site of bacterial foci prior to transplantation. Today, with improved surgical techniques, living donors are becoming the norm. In addition, with advanced surgical procedures, transplantation patients are living longer, fuller lives. These patients are often seen at the general practitioner’s office. Organ transplantation is no longer just a thing of the movies; it happens in hospitals all across the country. Since pre- and post-transplantation issues pose problems in both the preventive and operative procedures, Cheryl feels that her program benefits the entire dental team, especially since she is a firm believer in the “team” approach to patient care.

After she received her transplant in 1999, Cheryl began researching her disease. Her father always told her “knowledge is power,” and she was looking for some kind of “power” over her disease. During her research, she found that there was a lack of uniformity in the transplant community regarding the dental management of patients after transplantation. For example, some transplant centers recommended antibiotic prophylaxis, while others did not. Cheryl’s goal and mission is to bridge the information gap between the medical and dental professionals when it comes to transplantation and to act as a liaison within the two communities.

In October 2000, Cheryl unveiled her first lecture to the local component of the Greater Fort Worth Hygiene Society. The group is located in the Fort Worth, Texas area, and although Cheryl has moved since then, she still maintains contact with this group. The response to this first program was so overwhelming that she then decided to expand it and take it “on the road.”

Many hygienists know of someone with kidney disease, or on dialysis, or who is an organ transplant recipient. She is rewarded by sharing her story, but to hear the stories of others inspires and motivates her.

Cheryl’s program is presented in PowerPoint, and she has a handout that shares treatment recommendations and information regarding further resources. When Cheryl first began presenting, she would often “hide” behind the podium. But she now loves the interaction she gets with the audience and even has an exercise for volunteers to get a “glimpse” of dialysis! She is currently expanding her program to become a half-day seminar. Her Web site, dentalinspirations.org, posts her speaking engagements and publications. She is also a volunteer speaker for the Southwest Transplant Alliance, where she is a promoter of organ donor awareness.

A graduate of the Tarrant County College in Texas, with an associate’s degree in dental hygiene, she began a degree completion program with Texas Women’s University, but had to interrupt her studies due to her diagnosis and treatment.

One of her funniest events during a course occurred while giving a review of renal anatomy and physiology. Many participants needed a bathroom break and quietly left the room before Cheryl finally realized what the power of suggestion had done!

Knowing firsthand how life can change in the “blink of an eye,” one of Cheryl’s passions is to deal with quality-of-life issues. She doesn’t put off important things in her life anymore, such as family. Her brother gave her a second chance at life by donating a kidney, so family is that much more important to her. Also, they never let her give up, even during her darkest moments. Carpe diem - seize the day - has become her motto. In addition, her love of animals has taken on another facet. Animal companionship helped her through depression and also aided her recovery. She admits that there are no words to express the comfort that furry friends can give.

Her biggest concern regarding dental hygiene stems from preceptorship. As an immunocompromised patient, she fears the lack of education from any health-care provider could jeopardize her health.

One of the things Cheryl likes about giving presentations is hearing participants’ stories. She was recently touched by a story told by a dental hygiene student at one of her programs. Many people at her programs comment on her work with patients regarding end-stage renal disease and transplantation. However, this participant’s story was especially thought-provoking. She mentioned that her family had donated her brother’s organs when he had passed away several years earlier. The student was so supportive of Cheryl’s efforts to “get the word out” about donors and transplantation. Up to that point, Cheryl had not met a family member of someone who had chosen to donate a loved one’s organs. The student’s endorsement of Cheryl’s program and efforts is the most meaningful comment she has received to date. It makes her aware that her “journey” is all worthwhile.

Ann-Marie C. DePalma, RDH, BS, has been a clinical hygienist for more than 25 years and is a graduate of the Forsyth School for Dental Hygienists, is active in the Massachusetts Dental Hygienists’ Association, and is a Fellow of the Association of Dental Implant Auxilliaries and Practice Management. Ann-Marie has written articles and presents programs on dental implants, TMD, and developmental delays and can be reached at [email protected].