Your white blood cells, red blood cells and platelets will be very low about seven to ten days after the start of chemotherapy. You are at the greatest risk for an infection and bleeding during this time. Once the donor stem cells are infused into your blood stream, they begin to move into your bone marrow where they will grow and start to make new blood cells. The new stem cells will help replace the bone marrow destroyed by the chemotherapy and/or radiation.
During your transplant recovery, you will need to wait for the transplanted stem cells in your bone marrow to start replacing the blood cells that were destroyed by the high dose chemotherapy. This process is called engraftment. This may take two to three weeks but can sometimes be longer.
Daily things that will happen during your stay in hospital
- During your transplant recovery, you will be assessed by a physician and/or nurse practitioner daily.
- You will likely get blood work daily every morning between 3:00 a.m. and 5:00 a.m.
- Will we take your temperature, blood pressure, heart and breathing rate regularly
- We will weigh you or ask you to weigh yourself and write it down on a paper. There may be a weigh scale in your bathroom. If there is not, a scale will be brought to your room each day.
- We will check your body for signs of bleeding, bruising or infections.
Let the nurse know if you:
- See any bruising or little red spots on your body
- Have blood in your stool or urine
- Have a nosebleed
- Have a fever, chills or a cough
- Have skin redness, tenderness and/or swelling around your central line
Depending on your test results and how you are feeling, you may need:
- A transfusion of red blood cells or platelets if your counts are low
- Antibiotics (medication to fight infection) through the central line
- Extra intravenous fluids to help you stay hydrated
- Nutrition support either by mouth or through the central line
- Other tests, such as chest x-rays, ultrasounds, urine tests, or CT scans. Often these are done to look for sources of infection
What should you eat and drink during your hospital stay?
Drinking
Try to drink at least 1 to 1.5L (four to six cups) of fluid every day. Water, juice, soups, and even Jello or popsicles are all good fluids. Some patients find it hard to drink this much fluid, but most patients can manage by drinking small amounts throughout the whole day. Acidic juices (like orange) may bother your stomach, and caffeinated drinks (tea, coffee, cola) should not be taken in large amounts.
We have milk, juice, Powerade and ginger ale at the hospital. If you like other drinks, you can bring them in and we can get you ice.
Eating
You can order foods from our menu. We also have a small kitchen where staff can get you other foods such as toast, broth, popsicles, ice cream, cookies, cheese and crackers. If you need assistance with making food choices, ask to meet with our Dietetic Assistant.
We recommend choosing high protein or high calorie foods if you are not eating very much. If you are having a hard time keeping up your calorie intake, we also have meal replacement drinks.
If your mouth is dry, you will find drier foods, such as bread, bagels and muffins hard to eat unless you use butter or margarine.
If you have nausea that is made worse by smells, you should choose cold menu items as hot ones often have a stronger smell.
If you family wishes to bring in food for you, it must be brought freshly prepared and eaten the same day. We do not have a place to store food that needs to be refrigerated. If food needs to be heated, please use the microwaves in the cafeteria.
Visitors during your stay
Children under 12 are not permitted to visit during your stay.
Children may be contagious even if they do not have any signs or symptoms of being sick. Your infection fighting ability will be low and you are at high risk of getting an infection. Even a common cold can be serious.
No visitors are allowed to sleep overnight in the room.
If there is a medical emergency, sleeping visitors may delay us in giving you emergency medical care. As well, we want your caregivers to be able to rest while you are in hospital. They will need to help care for you when you are discharged home.
Mobility
It is important to keep active during your hospital stay. Keeping active will help you prepare for discharge home and recover after the transplant.
It is safe for you to leave your room and walk around the oncology inpatient unit. We recommend you avoid visiting other patients. We also recommend you avoid other busy areas of the hospital and going outside when your blood counts are low. We strongly recommend you wear a mask, wash your hands before leaving the room and when returning to your room. If you need mobility aids such as a cane or walker, we can provide you with these resources while you are in the hospital.
