Before your bone marrow transplant
Once you and your treatment team have decided on a bone marrow transplant, you will work with a transplant coordinator to start planning your clinic or hospital visits. These visits often include tests that measure your health. You will also meet with an oncology social worker to check your psychosocial health.
You can expect to have a lot of appointments to keep track of. These visits include pre-transplant tests, chemotherapy, and the transplant itself. In order to keep your schedule in order, consider bringing a special calendar or planner to keep track of your appointments or use the one found in your Patient Education binder.
There are many things to consider before your treatment. On this page, you will find information on:
- Coping with emotions.
- Choosing a caregiver.
- Preparing for transplant.
- Quitting smoking.
- Insurance and finances.
On this page, you will learn about coping with emotions, choosing for a caregiver, general transplant preparation and more. For more information on what blood and marrow transplants are, and what to expect during and after your transplant, please visit the following pages below:
How do I cope with emotions during this process?
In the process of planning for your transplant, it is common to feel stress or anxiety. Common issues causing emotional stress include:
- Changes in family roles.
- Putting work or school on hold.
- Feeling sad or depressed.
- Having unrealistic expectations about the speed or chances of feeling “normal” again.
Please know that these feelings are normal. You can manage them in several ways. It is important to have support in place before transplant. This can be as simple as talking to a trusted friend or loved one. Some people benefit from speaking to a counselor. Others need prescribed anti-depressant or anti-anxiety medicines.
What is most important is to remember that you are not alone. At UK Markey Cancer Center, we have many support services to help you, including:
- Art therapy
- Jin Shin Jyutsu
- Music therapy
- Narrative medicine
- Nutritional Counseling
- Oncology massage
- Pastoral Care
- Performing arts
- Pet therapy
- Psych-oncology services
- Tobacco cessation
- Visual arts
What you experience and how you cope are unique to you. Please speak up and let us know how we can best help you! To schedule counseling with the UK Markey Cancer Center staff, please call our outpatient oncology social worker at (859) 323-1403.
Who should I choose for my main caregiver?
You must choose a caregiver before your transplant process can begin. This person can be a spouse, family member, or close friend.
It is important to choose someone you feel comfortable with and who is comfortable with being in the hospital. Your caregiver will be your support person throughout the process. While it may be impossible for your caregiver to stay with you around the clock in the hospital during your transplant, it is important they are engaged and involved in day-to-day communications and instructions. Your caregiver can help you talk with your transplant team. The caregiver will help you follow your transplant team’s instructions and help you stay safe.
How do I get ready for my transplant?
Before your hospital stay, eat healthy meals that are high in protein and calories. Good nutrition during transplant will help you heal faster. Eating right can make you feel better, lower your risk for infection, and keep up your strength and energy.
These foods are high in protein:
- Milk products, such as cheese, yogurt, ice cream and milkshakes.
- Meats, poultry and fish.
These foods are high in calories:
- Breaded meats.
- Whole milk products and cheese.
- Vegetables with sauces.
- Starches such as potatoes, rice, and pasta.
- Fruits and vegetables with toppings or dips.
- Sweets and desserts.
If you have any questions or concerns about nutrition before your transplant, please contact the UK Markey Cancer Center Outpatient Dietitian at (859) 323-4769.
If you need to contact a dietitian while you are in the hospital for transplant, please ask your transplant doctor to make a referral to the In-patient Nutrition Department, or call (859) 257- 2113.
Our dietitians are more than happy to help develop a nutrition plan specific to your unique needs and answer any questions you may have regarding nutrition during the transplant process.
Most patients lose their hair during chemo. You may want to cut your hair short before your hospital stay. This will make it easier to care for and may cause less upset when it starts to fall out.
You may want to wear a wig, hat, scarf, or turban. We often keep a supply of hats or scarves on the transplant unit. We can also put you in touch with the American Cancer Society for a free, or low cost, wig.
To contact the American Cancer Society Patient Navigator at Markey, please call (859) 323-4632.
Chemotherapy can affect the fertility of women and men. Chemo may cause early menopause in women and make it hard for them to reproduce naturally. For men, it may cause loss of libido or erectile dysfunction. Radiation therapy may damage the ability to make sperm.
It may be a hard topic, but it is important that you discuss preserving your fertility with your doctor before receiving chemo or radiation treatment. One option may be cryopreserving. This is when samples of eggs or sperm are frozen.
Planning in advance may help reduce stress. UK Markey Cancer Center has specialists to help you preserve fertility. To arrange an appointment with a specialist, ask your transplant doctors to make a referral.
Tests and exams before transplant
Before you have your transplant or conditioning, you will have a series of physical and blood tests. This may take several days to complete. These tests are performed before your hospital stay so your doctor can see how well your major organs are working. Learn more about each of these tests below.
- X-rays let us look at bone lesions in selected parts of the body.
- CT scans take pictures of structures and organs inside the body.
- Bone marrow biopsies are when the doctors take samples of marrow.
- Blood laboratory tests check for viruses, such as HIV, CMV, Epstein Barr Virus, and hepatitis. They also tell us the health of your kidneys, bone marrow, and liver.
- PET scans show body functions and metabolic activity.
- ECHOs are ultrasounds that measure heart and heart value function. ECHO is short for echocardiogram.
- Pulmonary Function Tests (PFT) measure lung function.
- Electrocardiograms (EKG) measure the electrical activity of the heart.
Your transplant doctor will discuss any abnormal test results with you. Since high-dose chemotherapy puts stress on the body, abnormal results may affect your safety during transplant.
Depending upon your health, blood counts, and type of transplant, you may also need dental treatment before transplant. It is safer to do this before transplant because you will not be able to fight infection as well after chemo and transplant. Talk with your transplant doctor to determine if you need dental work performed as part of your pre-transplant workup. If you need a dental exam, please consider having the following procedures done before transplant:
- Teeth cleaning.
- Cavities filled.
- Gingivitis or other infections treated.
- Major repairs or teeth pulled.
Smoking or using tobacco products is prohibited. You will not be able to smoke tobacco or marijuana products at any point during the transplant process. This means no cigarettes, e-cigs, cigars, dip or pipes. Fungal spores in these products could cause respiratory infections that make it harder to heal after transplant. In addition, the nicotine also increases the risk of blood clots, which can also be life-threatening.
During your transplant, you can use patches or gum to curb cravings. We recommend you take this time to consider quitting smoking for good. This will help you heal faster and will benefit your long-term health. If you are interested in quitting smoking, please let our team at UK Markey Cancer Center know. We can put you in contact with low-cost resources that can help you quit.
Insurance and finances
Part of your workup will include insurance approval. Your transplant coordinator will work with your insurance to make sure your transplant will be covered before treatment. Tell your transplant coordinator right away if your insurance changes or could change. This may affect your approval.
To get financial help, you must meet certain criteria. Our transplant coordinators, social workers, and discharge planners at UK Markey Cancer Center will be happy to help you enroll in programs that may reduce your costs. If you need help, please let our team know.
Markey has financial counselors to help with your insurance and billing. If you have concerns with your insurance – or if you do not have insurance – contact our financial counselor at (859) 257-8072.