Preparing for consultation & BMT transplant

Posted by itlooksunny @itlooksunny, Feb 11 8:54pm

My husband is preparing for BMT transplant. All the side effects scare me, as caregiver. He has had radiation & shots & pills (targeted treatment) with very little side effects but the strong chemo is new to us. Dale had plasma cytoma that returned & is now MM. Consult, 3days of testing is coming in the next few weeks. Three weeks after that BMT transplant. My typing ability is poor so my posts are short. Any suggestions, support would be appreciated. I am terrified!

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@itlooksunny

Transplant classes? Videos or with real people? Says in caregiver guide I have to be with him 24/7? Can I not go for a walk or go to exercise room?

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Good morning @itlooksunny! First thing I want you to do is breathe in…hold and then a nice long exhale as you feel the tension leave your body. Then we’re going to have a nice long chat. 🤗
There’s a lot of information flying at you and your husband right now…and wow, it’s a lot to process. But I promise, you’re going to get through this one day at a time, step by step.
You mentioned there are appointments coming up for Dale. They should be listed in his portal but more may be added or rearranged as they are popped into place. By the time the first appointment date is near they should be locked in final order.
You and Dale will both be present. For some tests you’ll be in the waiting room so bring your phone, tablet/charger, book, snacks, water…
Mayo is very thorough with their educational programs. They want both you and your husband well informed and comfortable with what is taking place. The appointments will be for Tests/procedures , Consultations with BMT doctor, BMT Nurse Coordinator, and possibly other members of the BMT team (social work, psychiatry, etc.)

As caregiver you are expected to be with Dale at all appointments as a 2nd set of ears. If he has sedation for some tests like a bone marrow biopsy you are required to be waiting for him. You’re Team Dale.

The classes are with real people, such as the nutrition class. Joy or one of the other dietitians will lead the small class to go over diet, food, food handling to avoid infection and the like. These are easy classes! No tests at the end. ☺️
You’ll also be taken on a tour of Station 9-4 The transplant floor. That way you’ll get familiar with where Dale will be for a few days until an outpatient again.

As caregiver yes, you’re expected to be available 24/7. But that doesn’t mean you can’t leave or take time out. The first 2 weeks after transplant are generally the most challenging for the patient with some weakness, fatigue and nausea being the chief complaints. So you’ll need to be available for support, for taking him back and forth to appointments at Mayo, sometimes one or more times daily for infusions or follow up appts. Early on he may need some minor assistance walking or being pushed in a wheel chair for a few days. (They’re available at the clinic for free) You’ll need to prep food and maybe help him while getting dressed if he’s weak. Things like that. But if he’s feeling well and comfortable you can certainly duck out for a food run, take walks, exercise and such. It’s not like having an infant where you can’t leave.

You will also be given a card with phone numbers to call 24/7 for Station 94. The team is always on standby to help you or Dale with any questions and concerns you might have! The team is like a security blanket. ☺️

Dave is lucky with requiring only one dose of chemo. This will be less harsh with fewer side effects. And I promise YOU are going to be fine and together you two will be amazed at what you can accomplished together. ☺️

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@itlooksunny

My husband is being treated at Mayo in Rochester, MN. Should we be proactive and shave his head instead of waiting for hair to fall out? GVHD I dont know what that stands for? My husband, Dale, is 68. Oh by the way my name is Bev!

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Hi Bev,
My name is Deb and I am 61 years old; had my allogeneic/donor stem cell transplant in November of 2023 for CEL (chronic eosinophilic leukemia). I wanted to give my 2 cents on shaving hair. For me, with hair below my shoulders, I waited to buzz it until about a week after the intense chemo when I noticed it falling out quite a bit. I buzzed to about 1/4 inch so it was unlikely to nick or cut - but check with your doctors to make sure you can wait. I was very happy with that decision because for me it psychologically helped to look and feel like myself while going through the chemo. And when all my hair started falling out a few days after the buzz cut, it was easier for me to deal with lots of 1/4 pieces of hair vs long hair. So, bottom line - I'm glad I waited a little to cut it but glad I cut it before large clumps were falling out. Make sure you bring "chemo hats" because you'll want them for warmth and it helped me to not see my bald head every time I looked it the mirror. Also, regarding chemo side effects - it varies greatly. I was told of so may side effects that I was very scared going into the transplant. But my reality was much better - I had nausea which took about a week to get under control. But no other tough side effects. I know that was very lucky but I wanted to let you know it is possible that your husband may have very few side effects. That's not to say it's easy but it may not be as bad as they warn you of. Also, I was very anxious before transplant but the transplant teams are so organized and on top of things in the hospital that I actually felt almost no stress at all once I was admitted. All my best to you and your husband.

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@loribmt

Good morning @itlooksunny! First thing I want you to do is breathe in…hold and then a nice long exhale as you feel the tension leave your body. Then we’re going to have a nice long chat. 🤗
There’s a lot of information flying at you and your husband right now…and wow, it’s a lot to process. But I promise, you’re going to get through this one day at a time, step by step.
You mentioned there are appointments coming up for Dale. They should be listed in his portal but more may be added or rearranged as they are popped into place. By the time the first appointment date is near they should be locked in final order.
You and Dale will both be present. For some tests you’ll be in the waiting room so bring your phone, tablet/charger, book, snacks, water…
Mayo is very thorough with their educational programs. They want both you and your husband well informed and comfortable with what is taking place. The appointments will be for Tests/procedures , Consultations with BMT doctor, BMT Nurse Coordinator, and possibly other members of the BMT team (social work, psychiatry, etc.)

As caregiver you are expected to be with Dale at all appointments as a 2nd set of ears. If he has sedation for some tests like a bone marrow biopsy you are required to be waiting for him. You’re Team Dale.

The classes are with real people, such as the nutrition class. Joy or one of the other dietitians will lead the small class to go over diet, food, food handling to avoid infection and the like. These are easy classes! No tests at the end. ☺️
You’ll also be taken on a tour of Station 9-4 The transplant floor. That way you’ll get familiar with where Dale will be for a few days until an outpatient again.

As caregiver yes, you’re expected to be available 24/7. But that doesn’t mean you can’t leave or take time out. The first 2 weeks after transplant are generally the most challenging for the patient with some weakness, fatigue and nausea being the chief complaints. So you’ll need to be available for support, for taking him back and forth to appointments at Mayo, sometimes one or more times daily for infusions or follow up appts. Early on he may need some minor assistance walking or being pushed in a wheel chair for a few days. (They’re available at the clinic for free) You’ll need to prep food and maybe help him while getting dressed if he’s weak. Things like that. But if he’s feeling well and comfortable you can certainly duck out for a food run, take walks, exercise and such. It’s not like having an infant where you can’t leave.

You will also be given a card with phone numbers to call 24/7 for Station 94. The team is always on standby to help you or Dale with any questions and concerns you might have! The team is like a security blanket. ☺️

Dave is lucky with requiring only one dose of chemo. This will be less harsh with fewer side effects. And I promise YOU are going to be fine and together you two will be amazed at what you can accomplished together. ☺️

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Thank you!

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Dale was on Revlamid they had me so terrified! I slept in the same room as he for 2 weeks fearful I would not hear him! We have a 1911 house, bedrooms & bathroom are upstairs. Have made Dale a bedroom out of our dining room. Dale had an 8.5 hour surgery, tumor was intertwined with his spine so mobility is also an issue!

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@loribmt

Hi Bev, Dale is using his own cells, which means he’s having an autologous stem cell transplant. Generally, recovery time for that transplant goes a little faster and without the danger of gvhd because the cells are not foreign to his body.

As you mentioned, the preconditioning chemo will be new to him. It is a bit more aggressive than what he’s had previously. I don’t know how many days he’ll have chemo but I do remember a woman who had MM with an auto transplant the same time I was in. She had one day of chemo and that was all. I had 5 days. So it all depends on the doctor’s orders.
The strong chemo is necessary to completely clear the cancer cells from his bone marrow in order to make a squeaky clean environment for the infusion of his prepped cells. There can be some side effects associated with this preconditioning such as nausea, mouth sores, fatigue and hair loss.
You’d asked about hair loss. From experience, it does start its exodus about 10 days after the chemo. So he may want to go ahead and get a buzz cut before that happens. The chemo will lower his blood numbers as the cells die off, which will make him more prone to infections. So his team will likely discourage a buzz cut after that to avoid any nicks or cuts.

There are many members in the forum who have had auto transplants and have shared their stories here. I’ll give you a couple links which will take you to their replies that I think are helpful accounting the process for an auto transplant.
This from @countrygirlusa
https://connect.mayoclinic.org/comment/716285/
~~~
Another from @capthondo https://connect.mayoclinic.org/comment/747475/
~~~
I also have a Caregiver’s Guide from Mayo. https://connect.mayoclinic.org/blog/caregivers-for-bmt-car-t-and-hematology/tab/transplant-journey/#ch-tab-navigation

The BMT teams at Mayo are extremely attentive and will do everything they can to assure Dale is safe and comfortable. Don’t hesitate to ask questions or express concern. They will take care of both of you!
You’ll both learn a great deal with Dale’s upcoming appointments. Besides the routine pre transplant testing, there are educational classes which are filled with useful details.
Do you have any specific questions for me?

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Will Mayo give me a copy of caregivers guide when we get there?

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@itlooksunny

Will Mayo give me a copy of caregivers guide when we get there?

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Hi Bev, as part of the educational program of the pre-transplant routine, you’ll collect several folders, each with a notepad and informational booklets & articles for the classes or sessions you attend. Lots of reading material to back up what you learn first hand with the instructors.

It can feel overwhelming at the time. But when Dale actually begins the process from cell collection, to chemo, to cell re-implantation and recovery, all of it will unfold and make sense.
You’ll also do well to rely on his BMT team. They are very good at what they do. While this is ‘your first rodeo’, it is not theirs. The transplant staff have seen and coped with everything.
I was reassured with my doctor and his staff telling my husband and I that we need to leave the worrying to them, (the BMT team) so that my husband and I could relax and concentrate on recovery without constant anxiety. That was a huge comfort! It was a unique experience to be able to place full trust in my medical team to take care of me! It really works out the best when we follow their guidance, taking meds on time, drinking the amount of water recommended and getting the rest needed for the body to heal itself.

I know you have a great amount of anxiety which is difficult to rein in. Have you talked to your doctor about possible anti-anxiety meds to help you? There are also very helpful mindfulness exercises to help with anxiety and coping skills. Have you tried calming meditations or an APP such as Headspace.com?

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@loribmt

Hi Bev, as part of the educational program of the pre-transplant routine, you’ll collect several folders, each with a notepad and informational booklets & articles for the classes or sessions you attend. Lots of reading material to back up what you learn first hand with the instructors.

It can feel overwhelming at the time. But when Dale actually begins the process from cell collection, to chemo, to cell re-implantation and recovery, all of it will unfold and make sense.
You’ll also do well to rely on his BMT team. They are very good at what they do. While this is ‘your first rodeo’, it is not theirs. The transplant staff have seen and coped with everything.
I was reassured with my doctor and his staff telling my husband and I that we need to leave the worrying to them, (the BMT team) so that my husband and I could relax and concentrate on recovery without constant anxiety. That was a huge comfort! It was a unique experience to be able to place full trust in my medical team to take care of me! It really works out the best when we follow their guidance, taking meds on time, drinking the amount of water recommended and getting the rest needed for the body to heal itself.

I know you have a great amount of anxiety which is difficult to rein in. Have you talked to your doctor about possible anti-anxiety meds to help you? There are also very helpful mindfulness exercises to help with anxiety and coping skills. Have you tried calming meditations or an APP such as Headspace.com?

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I have a prescription but one medical professional told me take the a.m. another bedtime! Confused. Don’t drive until you know how it affects you! I am my husbands driver! Hydrobromide 10 mg. I am very sensitive to medicine so I did not take it!

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insight timer app to has wonderful meditations and pieces to listen to for quiet.
This unfolded for me just like Lori said. I believe being the caregiver is tougher as you are not living the path, you are walking it. Your husband's body is living it. The pretests were manageable. One at a time. My hair cut was spoken about in another post. I had 2 chemo does in the hospital. I asked how soon my hair would come out, found out the Positive Image Center would come to cut my hair in my room, so i scheduled the date and time.
You may have checked the posts out, but there are posts for caregivers on Mayo Connect. How you fell, what you fear, the what ifs will likely be shared on those posts.
It is real for you, and finding resources that ease your anxiety will benefit your health. You as Lori said are team Dale. Your good health is a must.

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@katgob

You will have lots of posts by tomorrow. I had MDS and a BMT in April of last year. We do not all get all the side effects and just know that the transplant medical team is all over any side effect we might get. The chemo i got was not fun. I lost all my hair in a few days, but my nausea was treated in so many ways. They take your vitals every 4 hours while in the hospital. I was in the hospital for Day 5 before transplant to Day 26 after transplant. I was blessed going home to have little wrong. I had been in a research study to prevent GVHD and up until today, day 307 past transplant I have had few real problems. I will say i follow all directions as best as i am able. Medications, eating, walking, sleep. Be good to yourself.
Where is your husband being treated?

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My husband is plus Day 26 after transplant. He also had MDS. Your posting was so reassuring as we continue to navigate this journey. Thank you for posting.

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chefra. I pray his experience was like mine. I took every med they had for me daily and i drank half my bodyweight in water to flush my system. Then i started walking which from Day 60 after transplant i have kept up.

I hope you have heard what many of us here. That is, we are bonded for life. Once a transplant patient, always one. This year in May i will get to attend an annual transplant reunion at City of Hope. By then I will be one year and one-month past transplant. The kind words and support you find in the mayo contact connect world is a valued tool for recovery. A tool and gift straight from the heart!!

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