Always follow the advice of your care team.
What to Expect While in the Hospital
This video provides an overview of the inpatient experience, including how to prepare for your hospitalization, what to expect while in the hospital, your inpatient care team, and discharge planning.
Undergoing stem cell transplantation is a challenging, lengthy process. Your care team will do everything possible to make you comfortable during your time in the hospital. For your protection:
Daily Routine
A responding clinician will manage your daily care. This is usually a physician assistant (PA). An intern or resident who is a member of our house staff will cover care on weekends and holidays.
We will closely monitor your blood and platelet counts through daily blood draws to see how you are responding to your treatment and transplant. Blood counts are often low after transplant.
How You May Feel
From the time you receive your stem cells until engraftment, you may experience several side effects. These may include:
What You Can Do
Try to be involved in your own care while in the hospital, including personal hygiene, mouth care, eating, and light exercise. Work with hospital staff to improve your own well-being. You may walk outside your room within the doors of the unit. You may also be able to get a stationary bicycle for your room, depending on availability and whether you are clinically stable to ride it. This can be requested by your inpatient care team if you qualify.
1. Maintain a good personal hygiene routine.
2. Maintain mouth care habits to prevent mouth infections.
You will be shown a new way to care for your teeth. It is used because the “usual” way of brushing your teeth can irritate or scratch your gums. Gum injuries can invite bacteria. One of the most important things to remember is to be gentle when brushing or flossing.
3. Visits from Your Clinical Social Worker
While in the hospital, you can request a referral to meet with an inpatient clinical social worker to help you and your family cope with and manage the emotional, psychological, and other cancer-related issues that may arise, and help you find resources.
Palliative care specialists can also be helpful through all stages of illness. Early on, it can help make medical treatments more tolerable; at later stages, it can reduce suffering, help you carry on with daily life, assist you in planning for future medical care, and provide support for living with a life-threatening illness.
4. Diet and Nutrition While in the Hospital
While in the hospital, it is important for you to follow our program’s guidelines for a special, low-bacteria diet while your immune system is compromised, and infection is a major concern. The dietitian on your care team can answer your questions, make sure that you receive the proper nutrition, and help you with your food choices. This is especially important when you may not feel like eating.
Most patients do not eat very much while they are in the hospital. This is common. We encourage you to eat when you can, and we will support you with fluids or other care as needed.
Nutrition Resources
5. Physical Therapy and Exercise
During your hospital stay, activity is an important part of your treatment so you can maintain strength, endurance, and be as independent as possible when you go home. A physical therapist may evaluate and follow your progress during your hospitalization to help maximize your physical abilities. We encourage you to maintain everyday activities, such as bathing, dressing, and walking as able, as well as a regular exercise program as outlined below.
Physical activity will help offset the effects of treatment and/or prolonged hospitalization that may include muscle weakness and physical decline, fatigue, stiff joints, swollen extremities, and balance problems. Staying active is important and will aid your recovery after discharge. You may want to track or record your activity levels.
Although activities can be tailored to meet your individual needs, most programs include:
General Exercise Guidelines
- Everyone who goes into your room must first wash their hands and put on gloves and a mask.
- You will need to wear gloves and a mask when you leave your hospital room. You do not need to wear a mask while you are in your room.
Daily Routine
A responding clinician will manage your daily care. This is usually a physician assistant (PA). An intern or resident who is a member of our house staff will cover care on weekends and holidays.
- Morning Rounds: Your inpatient transplant attending physician will conduct rounds each morning.
- Afternoon Rounds: Based on patient needs, the PA team may do a visit in the afternoon rounds to follow up on specific issues or concerns.
- Vital Signs: We will check your vital signs every 4 hours, including several times during the night.
We will closely monitor your blood and platelet counts through daily blood draws to see how you are responding to your treatment and transplant. Blood counts are often low after transplant.
How You May Feel
From the time you receive your stem cells until engraftment, you may experience several side effects. These may include:
- Fever
- Nausea
- Fatigue
- Difficulty sleeping
- Skin rashes
- Mucositis and esophagitis, which are mouth and throat sores and can make it difficult to eat or drink
- Diarrhea. This may persist even after you return home.
- Lack of appetite
What You Can Do
Try to be involved in your own care while in the hospital, including personal hygiene, mouth care, eating, and light exercise. Work with hospital staff to improve your own well-being. You may walk outside your room within the doors of the unit. You may also be able to get a stationary bicycle for your room, depending on availability and whether you are clinically stable to ride it. This can be requested by your inpatient care team if you qualify.
1. Maintain a good personal hygiene routine.
- Take a sponge bath or shower every day to decrease the bacteria on your skin and help prevent infection.
- Use the chlorohexidine wipes provided to prevent central line infection.
- Wash your hands frequently, especially after bathroom use.
- Use the lotions and creams provided to help prevent your skin from itching and drying out.
2. Maintain mouth care habits to prevent mouth infections.
You will be shown a new way to care for your teeth. It is used because the “usual” way of brushing your teeth can irritate or scratch your gums. Gum injuries can invite bacteria. One of the most important things to remember is to be gentle when brushing or flossing.
3. Visits from Your Clinical Social Worker
While in the hospital, you can request a referral to meet with an inpatient clinical social worker to help you and your family cope with and manage the emotional, psychological, and other cancer-related issues that may arise, and help you find resources.
Palliative care specialists can also be helpful through all stages of illness. Early on, it can help make medical treatments more tolerable; at later stages, it can reduce suffering, help you carry on with daily life, assist you in planning for future medical care, and provide support for living with a life-threatening illness.
4. Diet and Nutrition While in the Hospital
While in the hospital, it is important for you to follow our program’s guidelines for a special, low-bacteria diet while your immune system is compromised, and infection is a major concern. The dietitian on your care team can answer your questions, make sure that you receive the proper nutrition, and help you with your food choices. This is especially important when you may not feel like eating.
- Most foods that are cooked or have been commercially processed are permitted.
- Certain foods or methods of preparation may pose a risk of infection.
- If you follow a specialized diet at home (e.g., gluten free, kosher, vegan, specific ethnic foods, etc.), let your care team know. We can connect you with a dietitian to help you with food options while you are in the hospital.
- The nursing staff or dietitian must approve any food brought by visitors. No homemade food, restaurant food, takeout food, or fruit baskets are allowed.
Most patients do not eat very much while they are in the hospital. This is common. We encourage you to eat when you can, and we will support you with fluids or other care as needed.
Nutrition Resources
- How to Eat Safely After Transplant (video)
- Foods/Drinks That Are Safe (PDF)
- Food Preparation and Storage Safety Guidelines (PDF)
- Food Safety in Special Situations (PDF)
- Foods from Outside the Hospital (PDF)
5. Physical Therapy and Exercise
During your hospital stay, activity is an important part of your treatment so you can maintain strength, endurance, and be as independent as possible when you go home. A physical therapist may evaluate and follow your progress during your hospitalization to help maximize your physical abilities. We encourage you to maintain everyday activities, such as bathing, dressing, and walking as able, as well as a regular exercise program as outlined below.
Physical activity will help offset the effects of treatment and/or prolonged hospitalization that may include muscle weakness and physical decline, fatigue, stiff joints, swollen extremities, and balance problems. Staying active is important and will aid your recovery after discharge. You may want to track or record your activity levels.
Although activities can be tailored to meet your individual needs, most programs include:
- Daily walks on the transplant unit, with assistance if needed
- An appropriate and progressive exercise program including arm, leg, and back muscle exercises
- Stationary biking (a limited number of bikes are available)
- Balance activities
- Building stamina and energy
- Education about energy saving techniques, platelet precautions with activity, and the overall importance of daily mobility to prevent fatigue/deconditioning (physical decline or weakness)
General Exercise Guidelines
- Ask your nurse daily whether your blood and platelet counts are at a level appropriate for exercise and resistance.
- Try to perform three activities per day, with any combination of biking, walking, and strengthening exercises.
- Monitor how you feel during the activity.
- Include a warm-up and cool down. This can be 1-2 minutes of seated exercises or leisurely walking.
- Wear shoes during exercise.
- The amount and intensity of exercise or physical activity you do will depend on how you feel and your blood counts for the day. Make the activity somewhat challenging so that it benefits you, but not so much that you will be too tired afterwards or have difficulty recovering.