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Outpatient Visits after Autologous or Allogeneic Transplant

您的移植医生和协调员将在整个BMT移植治疗过程中跟随您. 你会做血液检查,如果有必要,还会给你静脉注射药物或液体.

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Problems That Should Be Reported Immediately

  • Temperature over 100.5 degrees Fahrenheit or 38 degrees Celsius
  • Chills, sweating
  • Redness, swelling, pain or discharge around the central line
  • Bleeding
  • Coughing, shortness of breath or chest pain
  • Persistent nausea or vomiting
  • Frequent or painful urination, blood in the urine
  • Weight loss greater than 5 pounds
  • Painful blisters on the skin
  • 皮疹、腹泻、腹部绞痛或疼痛、皮肤发黄或眼白
  • Inability to keep medications or fluids down due to nausea

Keeping Healthy

在移植后的至少三个月里,即使你的身体重新开始产生白细胞,你感染的风险也会比正常人高. 风险最高的是出院后的第一个月,在这段时间里,你应该大部分时间呆在家里,远离人群. You should not go to the supermarket, church, 电影院或任何可能有大量人群的地方. You may have visitors, but people who are ill should not visit. If there are family members or household members, including kids, who are ill, you must do your best to keep away from them, 要么住在不同的房间里,要么与他们保持距离. To help prevent infection, do the following:

  • Stay away from anyone that is ill or is coughing
  • Wash your hands often
  • If you feel you may have a fever, take your temperature and if you have a fever, call the clinic or after 5 pm, call 315-464-5540 and ask for the transplant doctor on call.
  • 在BMT后一年内不要进行任何免疫接种,并且避免儿童接种活病毒疫苗四到六周
  • 接触宠物后要仔细洗手,不要清理动物粪便. 这包括猫砂盒,你的狗在院子里的粪便等.
  • 避免在湖泊、河流、公共游泳池或热水浴缸中游泳
  • 在血小板计数超过50,000之前不要使用牙线. Use a soft toothbrush to clean your teeth.
  • When near a construction site, wear a mask. Avoid them if possible.
  • 避免接触可能是感染源的灰尘或污垢的活动
  • 只有当你的计数恢复正常后才能戴隐形眼镜
  • Do not smoke

Bleeding Precautions

当你出院时,你的血小板计数可能不会回到正常水平. If it is low, take the following precautions:

  • Use an electric razor instead of a straight edge razor
  • Do not blow your nose forcefully
  • If you tend to be constipated, 使用大便软化剂,这样你在排便时就不用费力了
  • 不使用直肠体温计或栓剂、灌肠剂、卫生棉条或灌洗剂
  • 避免有可能受伤的剧烈运动或活动
  • 在血小板超过10万之前不要服用阿司匹林或阿司匹林制品.

如果你受伤流血,在受伤的地方施加压力. 持续按压直到出血停止,这可能需要几分钟. If the bleeding does not stop, apply ice, 保持压力,打电话给你的诊所医生或去急救中心.

Good Nutrition Habits

出院时你的食欲可能还没有恢复, so you may have to try harder to get the calories you need. 你的营养师可以在你出院前帮你计划膳食. 下面列出的指导方针可以帮助你维持或改善你的营养状况.

  • 每天少吃零食,少吃五六顿饭,而不是三顿大餐
  • Eat high-calorie, high-protein snacks such as milk shakes, cheese and crackers, nuts, high-calorie supplements, etc. Add gravies and margarine to foods you already eat
  • Drink eight large glasses of fluid daily. 尽量摄入含热量的液体(速食早餐、运动饮料等).) and avoid excessive amounts of caffeine (i.e. colas, coffee, tea)
  • 避免酒精饮料,因为它们会与药物相互作用,可能会伤害你的肝脏
  • 不要从沙拉吧里吃东西,也不要从杂货店的散装容器里买食物, as the food may contain bacteria that can cause infection
  • 不要吃生肉或生海鲜(包括生蚝、鱼或寿司)
  • 不要吃生的水果或蔬菜,直到你的中性粒细胞计数超过1000, then wash them thoroughly
  • Watch for stomach cramps, diarrhea or gas after eating or drinking milk or milk products, which could indicate an inability to digest lactose

Caring for Your Skin

Your skin will be drier than usual after treatment. 使用含有保湿成分的肥皂和保湿乳液, especially after bathing or showering. 洗头后使用洗面奶或护发素来滋润头发和头皮. 白天外出时尽可能戴上帽子、穿长袖和长裤. 一定要涂抹防晒霜(SPF 15或更高),并限制在阳光下的时间.

Resuming Sexual Activity

你可能对移植后的亲密关系和性活动有疑问,应该随时咨询你的医生或护士. 你的伴侣也可能有问题,想要参与任何讨论.

You may feel free to hold, kiss, 拥抱和睡在同一张床上,除非你的伴侣生病了. 当你的血小板计数和中性粒细胞计数足够高时,你可以恢复性生活, such as a platelet count of about 50,000 and neutrophil count of about 1500.

许多人注意到对性行为的欲望或兴趣发生了变化, 哪一种通常与化疗导致的激素变化有关. 这是一个暂时的情况,并不是你的爱的感觉或需要亲近的变化的反映.

美国癌症协会(ACS)有一本名为“性与癌症”的小册子(一本针对男性和他的伴侣,一本针对女性和她的伴侣),这本小册子可能会有所帮助,并且可以获得.

如果考虑到这一点,应该在接受移植前做好精子或卵子的储存.

An interruption in the menstrual cycle is common in women. 然而,一小部分男性和女性都可能保留生育能力. 你应该和你的家庭医生或妇科医生讨论激素替代. 避孕措施应用于防止意外怀孕.

After BMT

恢复工作的适当时间因病人而异. Check with your doctor about your expected return to work.

您可以在这里继续您的随访和护理,或者一旦您从移植中恢复,您可以回到您的转诊医生那里. 在三个月的时候,你可能会对你的癌症进行评估. This may include X-rays, CAT scans, PET scans, blood tests, urine tests and possibly a bone marrow biopsy. 你将被安排在一岁时开始接种疫苗,就像新生儿一样. You may never have the live herpes vaccine. Although you will be followed by your local doctor, 移植后,您可以随时与我们联系.

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