Allogeneic Stem Cell Transplantation: Caring for Yourself

MD Anderson Cancer Center
Date: February 2012

>> Once you leave the hospital, there are some important things you need to know to take care of yourself.  Wash your hands.   Hand washing is the number one best way to prevent infection.  Wash your hands after using the bathroom, before eating, and at other times often throughout the day.  Shower and change your clothes daily.  Use a mild soap, one with the moisturizer if your skin is dry.  Apply moisturizer to your skin after bathing.  Since your hair will be thinning over the next one to two weeks, you may want to consider having your haircut or shaved at the MD Anderson beauty shop at no charge. 

>> Chemotherapy causes skin to become more sensitive to the sun therefore, try to stay out of direct sunlight.  When you go out, use a sunscreen of SPF 30 or higher, wear a hat and sunglasses, and wear lightweight garments that keep your arms and legs covered.  Remember to reapply sunscreen often. 

>> Continue doing light exercise like walking as soon as you feel able.  Though keep in mind you probably will tire more easily.  Increase your activities slowly and take frequent breaks.  Check with your care team before driving, returning to work, or doing any heavy exercise.  Because you may feel weak and/or taking medications that cause drowsiness, you are in a very high risk for falling. 

>> There are simple things you can do to make walking in your home safe.  Keep floors clear and remove loose rugs that may cause you to trip.  If you use a walker or other device to help you get around, be sure to inspect it for worn out rubber tips or loosening hardware.  It may help you to use a shower chair or bedside commode for a while until your strength returns.  You can rent these items if needed. 

>> It is okay to have fresh plants or flowers in your home.  However, do not handle the fresh plants and avoid yard work and gardening because there are many organisms in the soil that can lead to infection in someone who has a weak immune system.  You should avoid animals.  Although it is safe to be around household pets, limit the amount of close contact you have with them.  For example, do not let them lick your face or sleep in the bed with you, and make sure to avoid contact with any pet urine or stool for at least 6 months after your transplant.  Do not handle litter boxes or birdcages and be sure to tell your doctor before you leave the hospital if you will be staying with a pet. 

>> Wash your hands before preparing meals.  Defrost food in the refrigerator or microwave.  Do not leave anything out on the counter to thaw.  Eat foods that are high in protein and calories, especially if your appetite is poor.  This will help you recover your strength and continue to heal.  Sometimes it is easier to drink when your appetite is poor.  Protein supplement drinks such as Boost®, Ensure®, or Carnation Instant Breakfast® are excellent examples, but they may cause diarrhea. 

>> If you or your nurse practitioner is concerned about your diet, he or she can refer you to a clinical dietitian.  Do not eat raw or undercooked seafood, fish, meat, or eggs.  Do not eat rare or medium rare meats, sunny-side up eggs, or sushi.  Try to drink some fluids such as water, Gatorade, milk, juice, or lemonade.  In addition, most patients will receive IV fluids at home until your counts have recovered.  Avoid caffeine and alcohol as these may interact with the medicines you are taking and lead to negative reactions.  Food must be cooked thoroughly for at least 165 degrees Fahrenheit to kill any harmful bacteria.  You may eat at restaurants, but do not eat from buffet tables or salad bars.  Your APN or physician will tell you when it is okay to start eating fresh fruits and vegetables.  Make sure that all fruits and vegetables are thoroughly washed before you eat them. 

>> Do not smoke or use tobacco products because they increase the risk of pneumonia, fungal infection, and scarring of the lungs.  As long as you have an absolute neutrophil count of at least 2,000 and a platelet count of at least 50,000, it is quite safe for you to engage in sex.  Use a water soluble lubricant like K-Y Jelly to reduce friction.  Safe sex practices are important.  Many patients feel less desire for sex or they have other concerns.  For example, many women have vaginal dryness after high dose chemotherapy.  There are remedies such as hormone replacement that can help.  If you have concerns about sexual intimacy, please speak to your nurse practitioner.  He or she might refer you to a specialist.