Seeking Michigan Cancer Facility to Coordinate Post-BMT Care with Mayo

Welcome to Mayo Connect, @paigegregory. As a 5+ year BMT recipient at Mayo-Rochester, I can tell you that your dad will be in the best possible care there. I was 65 at the time. I’m now 70, cancer free and having an amazing 2nd chance at life. The transplant isn’t a walk on the beach but well worth the effort.
Your dad would be expected to be near the clinic for at least 100 days (with a dedicated caregiver) while he recovers. After that period of time, he can return home but will have repeated followups at Mayo on a graduated decrease over that first year. After that, there may be a couple visits per year and eventually an annual followup for life. However, in the interim between visits to Mayo, usually the local oncology center who handled the treatments for AML would be able to do the blood work. The nurse coordinators for the BMT team at Mayo fax a standing order for blood work for a set schedule. I even have blood work when I’m in Florida for the winter. Mayo sends orders to a local lab wherever I am.

I’ve not heard from anyone that their local lab at either the hospital or local clinic wouldn’t work with Mayo. I’m really sorry to hear that! What an odd thing. Your dad would certainly have followups with his local lab for the AML so I don’t understand why they won’t work with Mayo to put the info on Epic or fax results. My insurance paid for my blood tests at both places without issue.
What was the reason given for not working collaboratively?

Thanks, Lori, and thank you for your kind reply.

My parents currently live in the northern part of Michigan’s Lower Peninsula, and their local hospital only provides infusions and blood draws for my dad between treatments. Unfortunately, they don’t have an oncology/hematology department equipped to handle his AML care. As a result, my dad travels to Detroit—about a 4.5-hour drive—for more specialized procedures like bone marrow biopsies, consolidation treatments, and so on. The cancer center in Detroit is excellent and can perform his bone marrow transplant (BMT), but my parents don’t have a support system in the area, and there are limited housing options for extended stays. Since they are able to perform the BMT at the Detroit facility, I suspect the decision to not coordinate care with another facility is financially motivated—trying to retain payment for expensive procedures rather than losing a patient to another hospital.

I work for Mayo Clinic and have the most flexibility of my siblings to help with his care, so we wanted to explore the option of him getting the procedure in Rochester, MN. However, without a facility in Michigan that can help with his ongoing AML care when he is released, Mayo Clinic would not be a viable option.

I’m fairly certain the post BMT care can be accomplished on home turf for your dad. What I would suggest is contacting your dad’s local hospital/lab/infusion center to see if they will also accept blood draw requests from Mayo for his post BMT care.

Since your dad is having a BMT, his AML journey will basically have ended. His oncologist will only be doing cursory followups. So there’s no reason for your dad to return to Detroit for post BMT followup blood draws.

If his local hospital is already doing labs and infusions for his Detroit oncologist for his AML treatment, there shouldn’t be an issue for them to preform the same type of care for your dad following his BMT. It is mostly just routine blood work that’s required, results being faxed to Mayo (or Epix). Most clinics are happy to work with Mayo. As you know from working there, the name Mayo carries a lot of weight. ☺️

His local clinic is so much more convenient than traveling the 4.5 hours back to Detroit solely for those blood tests anyway. There may be as many as 2-3 per week initially for a couple of weeks. So being close to home is best! If there are any issues that require more care, Mayo simply sends orders to your dad’s local hospital so he can be admitted or have more tests ordered, etc.. If there are tests that the local lab can’t process, Mayo sends transport boxes for tubes to be processed back at Mayo…they go above and beyond to make things easy for home clinics to comply.

In the event of an emergency and transplant related, Mayo would send transport to get your dad back to the ‘mother ship’ asap. All the orders will come from Mayo…they just need someone to do the blood work, send results and be the boots on the ground.

It’s wonderful that you work for Mayo and can help your mom and dad out through this odyssey with caregiving. The BMT teams there are outstanding! And, we have a great support group of members in Connect, along with myself, who have had bone marrow transplants. We’re here to help with whatever questions or concerns you might have. Let me know what I can do to help. But first, have your dad/mom contact his local hospital …I think you’ll find they’re willing to help him out so he can get this BMT show on the road. Will you let me know what you find out please?

Thank you for all the helpful information! I’ll get back to you with any updates as I learn more. His case is considered high-risk due to his age (diagnosed at 69, now 70), as well as the liver complications caused by chemotherapy and his pre-existing heart condition, which has led to AFib. Because of these factors, we’re likely going to need a hospital close to home that can manage these issues. The risks associated with the transplant are higher for his age group and with his existing conditions, so we want to be extra cautious.

Ideally, the process would be as straightforward as you mentioned, but given the complications he’s already experienced since his diagnosis, we’re taking a more cautious approach. My parents have already covered one airlift transport when my dad was first diagnosed (during his blast cell crisis) and are hoping to avoid those kinds of expenses moving forward.

If anyone in the community has experience with Corewell Health in Grand Rapids, MI, or any other hospitals in that area, we would greatly appreciate any suggestions or recommendations on other hospital systems to explore. We’ve consulted with the University of Michigan for a second opinion, and they agreed that being close to family support would be best. However, at this time, they’re unable to take him on for post-transplant care due to capacity issues.

Thank you again for your support and any further guidance!