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Medical appointments and planning ahead

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Pre treatment appointments

The conditioning therapy and the transplant itself are big undertakings for your body. They will probably cause some short and long-term side effects that could be difficult to cope with. This means it’s important to check that you are otherwise in good health before treatment can go ahead.

You will have the chance to discuss all possible side effects with your consultant and transplant team before consenting to treatment. During these appointments, the following tests are likely to be performed: 

  • A bone marrow biopsy and/or CT-PET scan to confirm that you are in remission.
  • Electrocardiogram (ECG) to check the rhythm and electrical activity of your heart.
  • Echocardiogram (ECHO) to look at the heart and nearby blood vessels.
  • Lung function tests to determine the capacity of your lungs.
  • Blood tests to check how many blood cells are present and to test your liver function.
  • EDTA blood test to assess how well your kidneys are working.

I am sometimes concerned when meeting a new doctor. Will they know about my circumstances? Will I have to explain everything again? But that's not been the case.

Nigel, who had a transplant in 2016. You can read his blog on preparing for it here.

Central Venous Catheter (CVC)

Before, during and after your transplant you will need lots of medication and supportive therapies, as well as other treatments such as your chemotherapy. To make this as straightforward as possible, you will be fitted with a central venous catheter (sometimes called a Hickman line) shortly before your chemotherapy is due to start. This is a thin tube that goes through the skin near your collarbone and into the big vein that leads into your heart. Alternatively, you may have a peripherally inserted central catheter (PICC) line in your upper arm. Both lines enable the nurses and doctors to take blood samples, deliver treatments and the stem cells themselves without using a needle every time.

After your transplant your CVC can be at risk of causing infection, so it will be removed as soon as it’s no longer needed, but it’s usually in for a few months. Removing it is normally done at the outpatient clinic using a local anaesthetic – you may need a stitch or two to help the wound heal. Many people see its removal as a positive step in their recovery.

It took a few days to get used to my Hickman line, and it was quite sore for a little while, but in a really weird way I do quite like it. It certainly helps in relation to my treatment, as it means that I no longer have my arms pricked with cannulas.

Adam had a CVC fitted in 2015. You can read his story here.

Dentist

Worrying about the state of your teeth might not be high on your list of priorities right now, but it’s important to have a dental check-up.

If you know of any work that needs doing, it should be done before you start treatment because there will be a risk of infection once it begins. Your hospital team will usually organise this for you.

General health and fitness

Nutrition and exercise are both key factors when preparing for your transplant. If you can maintain a healthy lifestyle during this time, it’s the best possible starting point for your recovery. Even though you might feel quite unwell now, making a few small changes could have a huge benefit.

Diet – if you are struggling to eat enough calories and maintain a healthy weight, it can start to affect your general health. Simple things, like eating little and often or fortifying with protein or calorie rich ingedients, could make a big difference. 

Exercise – it doesn’t have to be anything strenuous but gentle exercise such as walking, swimming or cycling can improve your stamina and strength. Exercises like yoga can strengthen muscles, make you more flexible and help you relax, which could also be good for your mental health.

Your transplant team or GP will be able to give you more specific advice and suggest some things to try that are tailored to your specific situation.  

Hair loss

Most people will lose their hair after chemotherapy treatment but it usually grows back within a few months.

Your scalp will need to be covered by either a hat or scarf to prevent losing heat in the winter and getting sunburnt in the summer. If you would prefer to wear a wig, your hospital should have a scheme in place to provide one for free.

Some people take the opportunity to experiment with new hairstyles they have not dared to try before. If you have long hair, you may want to try out some shorter styles before treatment starts.

Look Good, Feel Better provide women undergoing cancer treatment with skincare and make up advice through free workshops. The Little Princess Trust and the Teenage Cancer Trust’s Hair 4 U provide free wigs for young people who have lost their hair following treatment. Most hospitals also have their own wig service, too.

Information published: 24/05/2021
Next review due: 24/05/2024

Related links

Having a stem cell transplant

Recovery in the first year

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