Always follow the advice of your care team.
General Precautions
Follow these guidelines for 100 days after your stem cell infusion (Day 0) unless noted or directed otherwise by your care team. Speak with your care team about any specific questions you have.
Infection Precautions
Cleanliness is extremely important for you and those you come in contact with as you recover. After your transplant, you can help protect yourself from infection by following these guidelines:
Follow hygiene standards as outlined by our program and your care team. We know that there are times when it may not be possible (e.g., when you need to be in public places, etc.). Try to minimize your time in these environments and return to less risky environments as soon as you can.
Personal Hygiene
Mouth Care
Maintaining a good dental care routine will help prevent infection as you recover from your transplant. One of the most important things to remember is to be gentle when brushing or flossing. Your platelet count may still be low as you recover from your transplant, which may cause your gums to bleed a little in the beginning. Follow the guidelines here and in the comprehensive guide to help you maintain a healthy mouth. Tell your care team if you develop any soreness or pain in your mouth.
Going to the Dentist
If you have dental problems at any time during your recovery, consult your care team about seeing your dentist. Try to schedule your appointment at a time when the dentist has few patients (for example, early in the morning) to avoid contact with people who may have infections or may be sick.
You should make a dental appointment for a routine dental examination generally six to 12 months after your transplant. At your visit, you should have bite wing x-rays taken. This is especially important if the pre-transplant dental evaluation showed that you needed elective procedures that were not performed prior to the transplant, or if you have dry mouth. After this initial visit, see your dentist regularly (i.e., every six months).
Tell your dentist about your medical condition and that you have received a stem cell/bone marrow transplant. They can contact your oncologist and/or primary care physician as necessary.
Dry Mouth
Dry mouth makes you more likely to develop cavities or a mouth infection called thrush. Often, the dryness will lessen over time. The following steps may help provide oral comfort.
Mouth Infections
One of the most common infections in the mouth after transplantation is yeast infection, also known as thrush. This appears as white and sometimes red patches in the mouth, which cause soreness.
Another common infection is caused by the herpes simplex virus, the cause of cold sores around the lips. These can occur inside your mouth and resemble canker sores.
These conditions are treatable. If you see red or white patches in your mouth or develop any mouth sores, contact your care team, who will diagnose your condition and prescribe a treatment.
Please refer to the comprehensive guide - Stem Cell Transplantation: An Information Guide for Patients and Caregivers - for more information.
Infection Precautions
Cleanliness is extremely important for you and those you come in contact with as you recover. After your transplant, you can help protect yourself from infection by following these guidelines:
- Wash your hands often. One of the best ways to prevent the spread of infection is hand washing. Wash your hands frequently (and have family/friends do so as well) with soap and warm water. Carry a small bottle of hand sanitizer (such as Purell®) to make hand sanitizing easy wherever you go. (Reference: How to Handwash (PDF); How to Handrub (PDF))
- Avoid those who are sick or not feeling well.
- Do not bring a sick child into your bed.
- Avoid settings where you are likely to come in contact with people who are sick or ill (shopping malls, supermarkets, and enclosed spaces).
- Avoid people who have been ill within the last few days.
- Wear a surgical-grade mask covering your nose and mouth, and gloves when:
- Coming to the hospital for appointments or tests
- In all enclosed public places
- A mask does not need to be worn when you are:
- In your car
- At home with your family
- Outdoors (You should wear a mask outdoors if you are in crowded areas and are not able to stay distanced from other people.)
- Wear a clean mask and gloves
- To all clinic appointments at Dana-Farber or your local physician’s office.
- In all indoor public places
- When you outdoors and there are crowds
- Carry a clean mask and clean gloves with you to use in case you come in contact with someone who is ill or has been exposed to an infection. Replace these when they become soiled and after each use.
- Limit the number of visitors to your home. Check with your care team about when you may have visitors to your home.
- Visitors should be healthy.
- Visitors should wash their hands immediately upon entering your home.
- Be sure that no other member of their household is sick.
Follow hygiene standards as outlined by our program and your care team. We know that there are times when it may not be possible (e.g., when you need to be in public places, etc.). Try to minimize your time in these environments and return to less risky environments as soon as you can.
Personal Hygiene
- Hand washing: Effective hand washing (with soap and water or a hand sanitizer such as Purell®) is an essential germ-fighting activity after your transplant. It is especially important to wash your hands thoroughly:
- After you go to the bathroom
- Before you eat or prepare food
- After you touch pets
- After you sneeze or cough
- If you are around others who are sneezing or coughing
- Toiletry items: Always use your own clean towel, washcloth, soap, toothbrush, and toothpaste. Do NOT share these or other toiletries with family or friends.
- Bathing: Take a bath or shower every day. Wash and dry your head, face, underarms completely. If daily showers are not possible, wash at a sink or use a basin. Avoid very hot water and use only small amounts of very mild soap.
- Hygiene products: Throw away any personal hygiene products from before your transplant (including hairbrush, comb, toothbrush, makeup, deodorant, etc.), and buy new products.
- Make-up/Creams/Lotions: Replace makeup, creams, lotions, etc. with new products. Use the same brand you used before transplant but buy new products.
- Do not share these items with anyone.
- Apply eye makeup with special care because your lashes and tears may not yet be effective in protecting your eyes.
- Watch for any skin changes after using these products and notify your care team of any rashes or changes.
- Skin Checks: Check your skin daily for rashes or changes. Use a mirror or have someone check your shoulders and back. New skin rashes or skin changes may indicate infection or graft-versus-host-disease. Report any new findings or worsening conditions to your care team immediately.
- Shaving: Nicks and cuts caused by shaving can become sites of infection or bleeding. Shave with an electric razor until your platelet count is higher than 20,000, and your neutrophil count and ANC is over 500. If irritations occur, clean the area with soap and water and apply a small bandage or piece of gauze.
- Contact Lenses: Do not wear contact lenses for at least one month after transplant. Talk with your care team before wearing contact lenses again. When you begin wearing them again, your eyes may be dry and irritated. New lens fittings may be necessary, or you may need a new prescription. Tell your care team right away if you have any pain in or on the eye.
Mouth Care
Maintaining a good dental care routine will help prevent infection as you recover from your transplant. One of the most important things to remember is to be gentle when brushing or flossing. Your platelet count may still be low as you recover from your transplant, which may cause your gums to bleed a little in the beginning. Follow the guidelines here and in the comprehensive guide to help you maintain a healthy mouth. Tell your care team if you develop any soreness or pain in your mouth.
Going to the Dentist
If you have dental problems at any time during your recovery, consult your care team about seeing your dentist. Try to schedule your appointment at a time when the dentist has few patients (for example, early in the morning) to avoid contact with people who may have infections or may be sick.
You should make a dental appointment for a routine dental examination generally six to 12 months after your transplant. At your visit, you should have bite wing x-rays taken. This is especially important if the pre-transplant dental evaluation showed that you needed elective procedures that were not performed prior to the transplant, or if you have dry mouth. After this initial visit, see your dentist regularly (i.e., every six months).
Tell your dentist about your medical condition and that you have received a stem cell/bone marrow transplant. They can contact your oncologist and/or primary care physician as necessary.
Dry Mouth
Dry mouth makes you more likely to develop cavities or a mouth infection called thrush. Often, the dryness will lessen over time. The following steps may help provide oral comfort.
- Stay hydrated. Always keep drinking water nearby.
- Use sugar-free gum to stimulate the production of saliva. Sugar-free hard candies are also ok if you are careful. These candies develop sharp edges and may cut the inside of your mouth and gums.
- Consider using over the counter dry mouth rinses, sprays and gels.
- Ask your doctor for a prescription for saliva-stimulating medications (pilocarpine and cevimeline). You can request a prescription for this from your care team.
- Apply petroleum jelly (such as Vaseline) to dry lips.
- Use prescription fluoride toothpaste, gel and/or rinse every night. You can request a prescription for this from your care team.
- Visit your dentist every 6 months so any cavities can be treated immediately.
Mouth Infections
One of the most common infections in the mouth after transplantation is yeast infection, also known as thrush. This appears as white and sometimes red patches in the mouth, which cause soreness.
Another common infection is caused by the herpes simplex virus, the cause of cold sores around the lips. These can occur inside your mouth and resemble canker sores.
These conditions are treatable. If you see red or white patches in your mouth or develop any mouth sores, contact your care team, who will diagnose your condition and prescribe a treatment.
Please refer to the comprehensive guide - Stem Cell Transplantation: An Information Guide for Patients and Caregivers - for more information.