When the marrow transplant shows good white blood cell production and your child
is not having any fevers and other significant complications, he/she will be discharged.
It is important to realize that even though the white blood cell count may look
normal, it can take as long as two years for the immune system to achieve normal
functioning. Many of the guidelines we recommend are extensions of precautions
we use in the hospital to prevent infections. Please follow them as closely as
possible.
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1. Avoid crowds. This includes malls, movie theaters, sporting events,
grocery stores, etc. If you must go to a store or mall, please try to
choose a time that is less likely to be crowded, such as early morning
on weekdays.
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2. Wear your mask: white mask outside, blue mask inside. It is one more
barrier between your child and an infection. In your home or apartment,
your child does not need to wear a mask unless you have several visitors.
If any visitor or family member has an illness, either the patient or
the ill person should wear a mask.
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3. No live plants: dirt and moisture provide an excellent growth site for fungus.
4. Screen your visitors. Friends and extended family, though they may provide
much support, can easily spread a cold or flu bug or other infections. Pay close
attention to visiting children and ask about recent immunizations -- some of
those immunizations contain live organisms capable of infecting an immuno-suppressed
individual.
5. Maintain good hand washing practices. It is one of the simplest and most
effective ways to prevent the spread of infections.
6. Take a temperature at least twice a day, even when the patient is feeling
fine. A patient with a slight fever may feel fine, but it may be a sign of an
infection which requires treatment. Report any fever greater than 38.0°C.
7. When out in the sun, use a sunscreen lotion with at least a level
15 protection factor. The skin is very susceptible to sun damage after
transplant.
8. Do not go swimming in fresh water lakes, ponds or rivers. Your child
may swim in the ocean or in any pool with chlorinated water. Some of the
hotels in Iowa City and Coralville allow transplant patients and their
families to use the hotel pool even if the family is not staying at that
hotel (ask your nurse if you are interested).
Length of Stay
Generally, your child will be an inpatient for 4-8 weeks following transplant.
The length of stay varies greatly dependent on the type of transplant and complications
after transplant. After discharge, your child will be seen as an outpatient
several times a week initially. We suggest that you plan to stay in the area
for at least three months and preferably up to six months. Close follow-up can
help to alleviate complications.
Dependent on your child's progress after transplant, you may be able to return
home sooner. The length of time spent in the area, is also dependent on the
distance you must travel to see a local physician who is knowledgeable regarding
complications after bone marrow transplant.
Following discharge, your child will be seen in the Pediatric BMT Clinic. Infusions,
transfusions and laboratory tests will be handled there. Patients are expected
to continue to attend school. They can either attend on the unit or arrangements
can be made for a tutor at home.
If you have any questions at any time, please call. There is always someone
on the unit who can either answer your question or notify the physician.
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