Begin Your Conditioning Regimen
Conditioning is treatment with high-dose chemo and/or radiation therapy that usually takes about a week or two. This is the first step in the transplant process.
There are three reasons this process must take place.
- It makes room for the transplanted stem cells.
- It suppresses the patient’s immune system to lessen the chance of graft rejection.
- It destroys any remaining cancer cells in the patient’s body.
No two transplant patients are alike and your treatment plan will vary depending on the type of cancer you have, the type of transplant and whether you’ve had chemotherapy or radiation in the past. If chemotherapy is part of your treatment plan, it will be infused into your central venous catheter. If radiation therapy is planned, it’s given to the entire body, known as total body irradiation (TBI). TBI may be given in a single treatment session or in divided doses over a few days.
Unfortunately, there are many possible side effects from chemotherapy. To help you through this process, your physicians and nurses will explain how to overcome these hurdles in more detail. Some possible side effects include nausea, vomiting, diarrhea, mouth sores and hair loss.
What to Expect During Your Hospital Stay
NewYork-Presbyterian and Weill Cornell Medicine is dedicated to your comfort and care while undergoing a transplant with us. The amount of time you will spend at the hospital will vary based on what type of transplant you need, your condition and your recovery. An estimated time period is between three and six weeks. Please feel free to bring items that will make you feel at home, including comfortable clothing, pillows, a blanket and any games or hobby supplies.
When you arrive, you will be admitted to the Bone Marrow Transplant Unit on 10 West or 10 North. 10 West is a 16-bed state-of-the-art, private room specialty unit on the 10th floor of the Greenberg Pavilion. 10 North is a 19-bed state-of-the-art unit on the 10th floor in the Bone Marrow Transplant Unit. You will have many amenities available to you. Please see a detailed list below.
- Each patient will have a room to themselves. Rooms have a free telephone, television, Wi-Fi connection, and refrigerator.
- Rooms may also have a stationary bicycle (if available and approved by your physical therapist).
- A nutrition room is available, which consists of a water/ice machine, refrigerator, freezer, microwave and a locked cabinet with extra crackers, cookies, nutrition supplements and a few carbonated beverages.
- A patient and family lounge is available and has a computer, microwave, refrigerator and freezer. The lounge overlooks a million-dollar view of the East River and 59th Street Bridge.
- If patients have a long stay, we encourage bringing comforts from your home such as a pillow, pictures and things to do such as a personal laptop or books.
- Visitors are always welcome. Note that visitors should be healthy. If they are feeling under the weather, we ask that they stay home until they have recovered. One visitor may stay overnight and a cot will be placed in your room, based on availability, for that person. Any visitors under the age of 18 must be supervised by an adult (other than the patient) at all times.
- When your visitors are not able to come see you, they can still call and request information regarding your care but they must provide a “password” when calling. Upon your request, a common password can be chosen during your stay to share with family and friends of your choice. They can use this password to request information regarding your care.
- Your close friends and family members may also write to you during your stay. We will provide a mailing address so that you can provide this to them.
Your Medical Team
- Your medical team will consist of members of the inpatient stem cell transplant team including:
- An attending physician
- Physician assistants
- Other members of your team may include:
- Chemotherapy pharmacist
- Social worker
- Discharge care coordinator
- Chaplain services
- Physical therapist and recreational therapy
Typical Daily Schedule
A typical day while you’re in the hospital will include a variety of assessments and consultations. Vital signs are taken every four hours and weights are taken daily. Your nurse will bring you any medications and perform an initial assessment, including listening to your heart and lungs. After the nurse sees you, he or she will speak with the physician, nursing support assistants and other members of your healthcare team to talk about the day ahead. Any number of the following things may occur in a day: blood transfusions, tests such as an X-ray or MRI, or chemotherapy. Your nurse will visit you throughout the day and see what your needs are.
How to Cope Through the Transplant Process
Transplantation offers great hope for patients. However, going through the process can be a difficult experience for patients and their families. While going through the transplant process, you may notice certain areas of your life will change, including employment, family and parenting responsibilities and your energy level. It’s important to remember these changes may only be temporary. The more you accept these changes and find a support system that will help you along the way, the better equipped you will be throughout the process.
Be sure to openly discuss your thoughts and feelings with your loved ones. If you feel it would be helpful to hear from others going through a similar situation, find support groups in your area you could attend. Weill Cornell Medicine and NewYork-Presbyterian offers a variety of support groups. Be your own advocate and don’t hesitate to ask questions and stay as informed as possible by asking your doctors, nurses and your bone marrow transplant coordinator any questions you have about the process.
Don’t forget to think about the logistical aspects of going through the transplant process as well. Thorough preparation prior to transplant will ease the burden during and after your transplant. The first thing you should do is designate a family member or caregiver who will care for you during your entire transplant process. They’ll need to provide transportation to and from the hospital for your follow-up visits. If you have children, you’ll also need to make arrangements for child care and pet care since you won’t be able to provide the same quality of care you’d normally be able to. In addition, you’re advised to make arrangements for household maintenance while you’re in the hospital.
One of the best things you can do is stay positive and hopeful. Having a “glass half full” type of mentality will do a lot to help you get through the process. Continue to exercise, eat healthy and get enough sleep. You need more time to recover from stressful experiences. The most important thing to remember is that you are not alone in this. A trusted physician and fully dedicated support system and loved ones will support you while you undergo your transplant.
Patient Support Resources
Undergoing a transplant is a physically and emotionally taxing experience. The hospital provides many services that will ease the burden and make you feel as comfortable as possible during your stay.
Social workers are available to assist you along the way, from transplant through recovery. They will be able to help you with coping strategies in order to deal with lengthy hospitalizations. If desired, they can assist you in communicating to your family members about your illness and treatment process. They will provide you with financial resource information in terms of applying for social security and/or disability. If you would like to address your life events in a more spiritual manner, the hospital provides chaplain services, including pastoral counseling, prayer and reflection and any other areas upon your request.
Other services that are available to you on 10 West include:
- Exercise Sessions: guided stretching, walking, and resistance exercises keep you strong and flexible. You can do this with a physical therapist if clinically necessary.
- Art/Crafts: knitting and coloring books.
- Games: card games, word search/crossword puzzles. Coloring books are available upon request.
- Milkshakes: chocolate, vanilla and strawberry milkshakes are offered on Tuesdays and Thursdays.
- Artists-in-Residence: Creative Arts Center offers this program
- Kosher suite: visitors can go to 2N of Greenberg Pavilion to get food for patients.
- Mindfulness Meditation: available upon request. A certified Integrative Restoration expert can visit patients privately in their rooms.
- Barber services: for hair loss due to chemotherapy, 10 West has an electric shaver with disposable blades for patients and families to use.
- Laundry services: coin-operated washers and dryers are available on the 6th floor. Caregivers may use those. There are also wash and fold services with pickup and delivery available in the neighborhood if you wish.
The Big Day: Stem Cell Infusion
The day will finally be upon you when you are ready to receive your stem cells. The first thing that will happen is the cells will be taken from the lab and brought to your hospital room. When the time of transplant has been decided, you will be given medications to prevent a reaction 30 minutes prior to the cells arriving to your hospital room. The stem cells will be given through your central line and will then flow through the infusion pump in the same way as a blood or platelet transfusion. Family and friends may visit you at any time during the transplant process, even during the transplant itself, although you may be sleepy from the medications given to prevent reactions.
After your transplant, you will go through a period where your blood counts will drop. At this point, it is normal to feel very tired. The most important thing to do during this time is to try and prevent infection. You can do this by frequently washing your hands, showering daily, wearing a face mask when outside the room and encouraging visitors who may be ill to remain home.
You should also stay active during this time. You are encouraged to walk around the unit, use your stationary bike and participate in physical therapy. It is advised that you spend as much time as possible out of your bed. This physical activity will also enhance your emotional well-being.
You can expect your blood cells to recover between 10 and 16 days after your transplant. Sometimes this can take longer, so do not be discouraged if your counts aren’t back to normal in that timeframe.