Internal Medicine Department
Hematology Division

How to Prepare

Once insurance has been approved and the patient’s disease is in remission (or very close to remission) and it has been determined that it is time to move to transplant, the preparation phase begins.  The patient will return to the University of Utah Hospital as instructed by the Clinical Coordinator assigned to their case.  Hence begins the process for medical evaluation, orientation, informed consent  and other preliminary activities.  Family members will be educated at this time to assume the caregiver role.

Evaluation

The Clinical Coordinator will arrange the outpatient evaluation or “work-up” which may last from two to ten days, depending on the number of tests and the complexity of the tests.  The patient and the caregiver will meet with many different disciplines to get an overall view of what to expect during the bone marrow transplant process.  Social work will provide support and assist in identified areas of need throughout the transplant.  Nursing will teach how to give and record medications, monitor fluids as well as home care and planning for post transplant care.  Nutrition will cover safety in food preparation and management of nutrition problems at home.

A complete medical evaluation will be performed to give both baseline values as well as current organ function.  Some tests will include pulmonary function testing, echocardiogram, dental evaluation, blood tests to assess kidney and liver function, and disease specific testing which may include scans, bone marrow and/or spinal fluid evaluation and blood tests.

Prior to the start of the actual transplant or collection process, a central venous access catheter will be placed.  The bone marrow or peripheral blood stem cells, hydrating fluids, nutritional supplements, medications and blood products will be administered through this catheter as needed.  Patients who arrive with a central venous catheter already in place will have the catheter assessed by the transplant team and a decision will be made to either use the existing catheter or to replace it.

Other tests and/or consults may be scheduled by the transplant coordinator based on individual findings of the workup. After all the results have been obtained and prior to begin the preparative regimen, the patient will sit down with the Bone Marrow Transplant Attending Physician as well as the Clinical Coordinator to review the results and discuss the transplant process.

What to bring

  • Clothing
    You may bring in your own freshly laundered pajamas, loose comfortable clothing or hospital pajamas.  Button down shirts work well because you'll have a central line in your chest that will have continuous fluids connected to it and will need to be accessed daily for lab draws and dressing changes.  Laundry facilities are located on the 5th floor for your caregiver to use.
  • Slippers
    A slipper that is easy to get on and off is very important.  The floor is considered dirty and you’ll be getting up and out of bed numerous times during transplant to go to the bathroom and walk the halls.
  • Activities and Entertainment
    You’ll be in the hospital for 3-5 weeks and need activities to pass the time.  Each room contains a TV, VCR and DVD player as well as a CD player/radio.  The BMT unit has videos, DVDs and classical CDs but feel free to bring in your own favorites or rent some.  We also have a GameCube and laptop that can be cleaned to share between patients.  Let your nurse know and she can get these items for you.

    You may also bring in your own computer.  If your computer doesn’t have wireless access, you can purchase a wireless card and use our intranet.  Again let your nurse know.

    You may want to catch up on knitting, crocheting, scrap booking and other hobbies.  Many patients enjoy doing puzzles, arts and crafts and reading.  It may be difficult for you to concentrate for long periods so things you can pick up easy are great.  Keeping your hands and mind active are so healthy.  A recreational therapist is also consulted on all BMT admits to assist you in activities.
  • Toiletries
    The BMT unit will provide a soap called BASIS that is fragrance free for sensitive skin, a soft tooth brush, baking soda tooth paste, lip moisturizer and Lubriderm lotion.  You may bring in your own toiletries if you wish as long as they are fragrance free and new.  If you are receiving Total Body Irradiation, please refer to that page.  Men may bring in electric rechargeable shavers but no straight edge razors.
  • Photographs
    Bring in photos or your family and friends.  Some patients bring in favorite scenic posters of where they would like to visit when they are out of the hospital and able to travel again.  We encourage you to make your room feel more like home.
  • Hats and Scarves
    Most patients will loose their hair after transplant.  A lot of body heat is lost through a bald head.  Wearing scarves or hats prevent body heat loss and can make you feel better to have something on your head.  Patients recieving an allogeneic transplant it is important to protect their face and head from the sun since sun will aggrevate Graft Versus Host.

Visitors and visiting hours

There are really no set visiting hours for the BMT unit. Visitors are allowed to visit at any time as long as they are healthy.   A sink is located inside the room for them to wash hands.  The door handle is considered dirty.  When your not feeling well you may want to think about a system to monitor the amount of visitors and your nurse will also be able to assist you, ie. a sign out side your door.

If you would like one family member over the age of 12 to stay the night with you, there are fold out sofa chairs in each patient room. We are more than happy to accommodate those who wish to stay overnight. Visitors are not allowed to touch IV pumps or any other equipment, nor are they allowed to use the bathroom in the patient rooms.  Any visitor/family member who has been recently exposed to infections such as colds/flu/chicken pox, or who has a cold/flu, fever, cough, or a draining wound should not be visiting.

hildren may visit provided they have no active infections or have not been recently immunized with live vaccines. Young children must have adult supervision at all times other than the patient. Children are not to be in the hallway.  They should go directly to your room and directly off the unit..