Life after Bone Marrow Transplantation

Life after Bone Marrow Transplant is transition Period between “Home Coming” to leading a life which is “new normal.” Dharamshila Bone Marrow Transplant Team will be there to help you to recover fast and stay healthy physically and emotionally.

Returning Home

Before leaving the hospital, patient and patient’s family will need to prepare the home and plan for your care giving needs.

The first months after transplant are important to the healing process. Being prepared will help you stay healthy and reduce your risk of getting infections.

Care at Home

Any of the following sign or symptoms of infection should be reported immediately to your doctor or BMT coordinator. Signs to watch for

Sign or Symptoms of Infection

• A fever above 38°C or 100°F. Do not give your patient paracetamol, which will hide a fever, without speaking to a physician.
• Any breathing or respiratory problems, or a cough, runny nose, sore throat or cold.
• Stomach complaints, such as diarrhea, nausea, vomiting or cramps.

Signs or Symptoms of GVHD (for patients with a donor transplant only)

• A new rash on the body, palms of the hands, or soles of the feet.
• Watery diarrhea.
• Loss of appetite with weight loss.
• Jaundice, a yellow colour in the whites of the eyes or in the skin.

Sign or Symptoms of drug side-effects

• Trembling of hands
• Persistent Headache
• High Blood Pressure
• Vomiting and nausea
• Skin rash

Visitors

Visitors at home are allowed but they must be carefully screened. Family and friends should not visit if they are ill. Visiting children have greater chance carrying contagious diseases because they are more exposed to them in the school environment. Chickenpox, measles, mumps and cold sores are of particular concern.

Please report any known exposure to these diseases to the BMT doctor as soon as possible.

Skin care

Make sure you take a bath or shower every day using non-irritating soap and shampoo. It is important to clean the groin and the arm-pits every day. If skin is dry apply Vaseline or any other approved moisturizer to the skin. Protect your skin from the sun, especially if you had radiation or have GVHD.

Follow these guidelines: -

• Cover your patient skin as much as possible with clothing.
• Make sure your patient wears a hat, especially until his or her hair has grown back.
• Use lots of sunscreen on your skin.

Mouth care

• Make sure you take care of your mouth at least 3 times a day, preferably after meals.
• Use a soft toothbrush. Use any mild toothpaste with fluoride.
• Make sure that the areas where the gums meet the upper and lower cheek is brushed thoroughly. Report any white patches, called thrush, or mouth sores to your physician.

Medications

You will still need medications at home. Your nurse and the doctor will explain the medication to you. Before you leave the hospital, please be sure that you understand what all the medications are for and how to take them.

Some of these medications can be expensive. Before you are admitted to the hospital, it is important that you discuss your financial condition with he BMT doctor to make sure that these medications are afforded for.

Unlike solid organ transplantation, you do not need to take medicines to suppress your immune system for the rest of your life. If there is no GVHD or infections, all major medicines are stopped by one year. You only continue with one antibiotic to prevent certain infections.

Vaccination

You now have a new immune system and all the major vaccinations you had as a child would need to be repeated 6 months to one year after the BMT. You should not take any 'LIVE' vaccines such as BCG or POLIO, or you should not come in contact with those children who have had these vaccines in the last 6 weeks.