Transplant Procedures: Check-In

You can and should bring your own clothes to wear during your hospital stay.  I recommend loose, comfortable pajamas or lounge wear, along with a robe and slippers.  Of course I brought my laptop, but I didn’t use it nearly as much as I thought I would, due to the disorienting after-effects of my chemotherapy.  That will be covered later in this page.


Upon checking into the hospital you will be settled into a quarantined room.  Perhaps the ward you’re in will be quarantined as well, specifically for transplant and cancer patients.  Daily exercise is highly encouraged, although you may need to wear quarantine clothing and masks when you leave your room.  Walking the wing is the default choice, but there may be exercise bikes available as well.  Exercise is important because the high-dosage radiation or chemotherapy that will be administered will leave you in a weakened state.  Trying to keep on top of this problem from the start is difficult when you’re not feeling well, but will pay back in high dividends in the weeks and months down the road.



Your vitals (temperature, blood pressure, pulse) will be taken by a technician every three to four hours.  This is always the case for a patient admitted to a hospital, but it’s especially important for a transplant patient, whose health status may turn on a dime at some point during the in-patient process.  Unfortunately it will also affect your sleep pattern, so be prepared for that.  Exercise can help tire you out enough so that you can fall back to sleep easily.  Sometimes you may just end up staying up a while, reading a book or watching TV.  You can also ask for a sleep aid when necessary, and use relaxation techniques.



Find the solution that works for you and incorporate it into your daily routine as best you can.  I found that asking for a sleeping pill near midnight often let me drift back to sleep relatively quickly after a 3:00 am vitals check, although sometimes I ended up watching TV for a while anyway.  The hospital sounds increase dramatically at the morning shift change (6:30 – 7:00 am) so this is a terrible time to try and catch up on sleep.  Instead you might want to schedule that time for trying to eat (even if you’ve lost your appetite), showering and changing clothes.



You might find yourself uninterested in doing this – it may begin to feel like you don’t have the energy for showering, especially if you are attached to your IV stand – but the nursing staff will stay on you to keep this schedule, since it’s imperative that you stay in a germ-free environment.  Besides, after a while you’re going to start to feel lethargic and sweaty from all of the bed time you inevitably end up putting in.  Luckily they had reclining chairs in my wing, and I always used the morning to immediately move from my bed to the chair to get out of that horizontal position as much as possible.  The reclining chair really did help, though, since I needed to keep my feet elevated to try and minimize the swelling I was experiencing from fluid retention.



A refrigerator and cupboard are usually available on the wing for special food items you might like.  Finding things you can eat is important, especially if your chemo or radiation results in nausea and/or loss of appetite.  A hospital nutritionist will probably stop in to see you several times, as lack of appetite is a common problem they deal with for transplant patients at this stage.  You can bring in anything you like, or ask the nutritionist to keep it on hand for you – they will do whatever they can to find things you can eat and to try to keep you nutritionally balanced during this time.



Before you ever enter the hospital the medical staff will have a list of your daily meds.  They will review this list when you check in just to make sure there have been no recent changes.  You don’t need to bring in any of your own meds – the hospital pharmacy will supply everything, and nurses will hand out the correct dosages at the correct time every day.  In addition to your normal meds there will be other meds added to prepare your system for the high dosage radiation or chemotherapy that’s about to be administered.  You will no doubt also encounter some changes to your prescription requirements as time passes during this phase and in fact throughout the year to come.  Your medical staff will watch for any changes that occur and respond with pharmaceutical changes as required.



My sister-in-law gave me a journal and I did write in it on most days, especially once the team started giving me my daily blood count numbers.  I intended to use that data in the writing of this blog, so I’m very glad I kept up with it, but I have to say that trying to read that information, once I began to emerge from the chemo-fog that is so common in the aftermath of that extreme treatment, was downright funny, not to mention difficult.  I quickly gave up trying to make any serious in-roads on the blog at that time, outside of the notes, since my memory and ability to focus was so compromised during those days.  Expect the fuzzy-brain syndrome (more on this later), but know that it will clear up eventually!



And speaking of journals, remember that this blog can provide you with some or all of the documentation you need for your transplant, depending upon your level of interest.  There are no PAGs in this particular chapter, although the treatments done during this section are of course crucial and will have a significant impact.  In place of the numerous PAGs found in the other pages, you will find several other workbook templates to fill in, like your countdown timeline and blood count database.  Below, for example, I’ll show you my check-in schedule and include a template for your own.



My Check-In Schedule:

Day - 9: Oct. 4, 2010
Registration: 8:30 am
Settle in, IV set-up, prep meds, saline solution: 10:00 am - 10:00 pm
First Chemotherapy treatment: 10:00 pm (Busulfan)


Your Check-In Schedule:

Day ____: _________________
Registration: _____ am
Settle in, IV set-up, prep meds, saline solution: _____ am - _____ pm
First Radiation/Chemo treatment: _____ am/pm (dosage/type: _____________________)