|
Immune System
Your child's immune system will not return to normal for many months
following bone marrow transplant. For this reason, your child is susceptible
to infection and specific guidelines must be followed. Your child should
avoid crowded areas, areas of construction, and persons who smoke or have
colds or infections.
|
|
Your child should continue to wear a mask when in public areas. A filter (white)
mask is worn when the child is outdoors and a lighter weight (blue) mask when
indoors.
Your child may go shopping or to movies; however, this should be done at the
least busy times. When in a closed-in place, especially during the cold and
flu season, it is best to sit far away from people. (For example, go shopping
in the afternoon during the week and if you want to go to a movie, ask to sit
in the balcony).
Your child's immune system will be checked periodically to determine the return
of normal function. The results of these tests will determine when your child
can return to school, when they may lessen some restrictions, and when your
child can stop wearing a mask.
Cleaning Your Home
When you are given the okay to return home, your child's immune system will
still be weak. Your child may get infections easily. Prior to returning home,
your home should be thoroughly cleaned. This includes:
|
__Dusting all surfaces, window sills and mini blinds.
__Wash hard floors.
__Vacuum rugs and furniture.
__Scrub sinks, tubs and toilets with an abrasive cleanser.
__Wash tile shower walls to remove mildew (bleach works well).
__Wash shower curtain or replace.
__Rinse drains with bleach.
|
It is not necessary to repaint walls, steam clean/shampoo carpets, lay new
flooring, etc. If you do plan to do any of these, it should be completed one
week prior to your child's return home.
Once you are home, it is important to maintain a clean environment, and your
home should be cleaned once a week, including dusting all surfaces, vacuuming
rugs, washing hard floors, scrubbing sinks, tub/shower and toilets, and changing
bed linens.
Many families elect to obtain air filters for their home though it is not required.
When looking for an air filter, make sure that it has a hepafilter. Place the
filter in the room of your home in which your child spends the most time. Some
insurances will pay the cost of an air filter for your child.
|
Activity
It is important for your child to get some form of exercise when you
leave the hospital. Your child may feel weak and tired, but must be pushed
a bit. It is much easier to maintain the strength by exercising than if
they let themselves get worn down.
Exercise does not need to be strenuous. Walking or riding a stationary
bike are good examples. Exercise is important for everyone, but especially
if your child is on higher doses of steroids as the steroids will make
them feel even weaker.
|
|
Your child may play outside, but needs to wear a mask. Your child can play
outside in the winter (snow) as well. It is advised that your child not play
in dirt, mud or sand boxes as these areas may contain bacteria and fungus.
Swimming
Swimming is allowed and is a good form of exercise. It should take place
in an un-crowded pool or the ocean. Special care of your central line must be
taken if you are swimming. Cover your entire catheter and dressing with an occlusive
dressing (tegaderm). A dressing change should then be done soon after your child
is finished swimming. Swimming is NOT allowed in rivers, lakes or ponds.
Plants and Animals
It is okay to have house plants after the transplant. As long as it is not
in excess, it is acceptable to have plants or flowers at home in the living
area.
Another area of concern to many people surrounds pets and animals. You should
not have a house cat for several months after your transplant. If you visit
someone who has a cat, you should avoid contact with it and the litter box.
|
- Dogs are okay; however, your child should not directly care for a
dog, kiss it or sleep with it.
- Your child can pet animals as long as the pet does not lick them,
especially on the face.
|
|
|
- Fish tanks are allowed. Your child may help feed the fish, but should
not clean the tank or bowl.
- Fishing is allowed; however, your child should not bait the hook,
take the fish off the hook, or clean the fish.
|
Always wash your hands after any of these activities.
Guidelines for Skin Care Following BMT
Following the bone marrow transplant, you will notice that your child's
skin becomes very dry. Symptoms such as itching and/or burning may accompany
this and dryness may persist for many months. The radiation they received is
the major reason that the skin becomes dry and it can be further aggravated
by the chemotherapy, the medications taken, GvHD, the dry air in the hospital,
and the daily bath or shower that your child takes.
Proper care of dry skin is very important. Your skin provides protection from
the environment and is your body's first line of defense against injury and
infection. The following are general guidelines for care of your skin after
you leave the hospital.
|
1. Bathe or shower daily, but use warm, not hot water and avoid long
soakings. Prolonged or repetitive bathing, especially in hot water, tends
to breakdown the water holding capacity of the skin.
|
|
2. Frequent use of practically any soap tends to dry the skin. Oil-based or
superfatted soaps such as Dove or Tone may be less likely to cause dryness,
but they too should be used sparingly. (It is not necessary to use an expensive
or special formula soap).
3. Avoid harsh deodorant soaps.
4. Avoid bubble bath preparations as they are particularly drying.
5. Add 2-3 capfuls of baby oil or Alpha Keri oil to your bath water or apply
directly to your skin in the shower.
|
6. Moisturize your skin by applying a cream or lotion after your bath
and whenever needed during the day to keep your skin moist and smooth.
Products that have a high oil content may be especially harmful if your
skin is extremely dry. There are many products on the market and it would
be difficult to compile a comprehensive list, much less evaluate them
all. Whichever cream or lotion you choose, keep the following points in
mind:
|
|
- Apply after the bath or shower while the skin is still moist.
- Use a cream or lotion that works for you and that you can easily afford;
the most expensive is not necessarily the best.
- Creams contain more oil by volume than do lotions.
- Lotions may be easier to apply.
- Avoid rubbing alcohol or any skin care product that contains alcohol as
these destroy natural oils on the skin and make it dry out faster.
- Avoid skin care products that have fragrance added.
7. Symptoms will be more severe in the winter as exposure to dry heated air
intensifies loss of water from the skin.
8. Swimming in a chlorinated pool or the ocean may also cause an increase in
your dry skin symptoms. (Swimming is permitted; just be sure to pay special
attention to skin care and apply lotion after swimming).
9. Avoid the sun as it further dries the skin. (See instructions on the use
of sunscreens).
10. Protect the skin from wind and temperature extremes.
11. Wear loose-fitting, lightweight cotton clothes.
12. Notify your doctor if you experience any of the following:
- Increased redness of your skin.
- scaling.
- tenderness.
- itching that interferes with sleep or comfort.
- any new open areas or sores on the skin.
13. Check with your doctor before using any new skin care product that has
medications or unusual additives in them.
Title
Page
|
