What should hematopoietic stem cell transplant patients pay attention to in terms of diet, hygiene, and activities after being discharged from the hospital and returning home?

Author: Yan Xia, deputy chief nurse, Peking University People's Hospital

Reviewer: Ren Dajiang, deputy chief physician of the Seventh Medical Center of the General Hospital of the Chinese People's Liberation Army

In the first six months after hematopoietic stem cell transplantation, the body is still relatively fragile and needs to recover gradually. So, what issues should hematopoietic stem cell transplant patients pay attention to in terms of diet, hygiene, and activities at home after being discharged from the hospital? Let's learn together.

The first is diet. After hematopoietic stem cell transplant patients are discharged from the hospital, the intestines should gradually restore normal function and gradually accept normal flora, which will help prevent graft-versus-host disease in the future. Therefore, after being discharged from the hospital and returning home, there is no need to have excessive requirements for diet, as long as it is clean, fresh and hygienic. Patients are advised to eat at home and eat less out, and meals must be cooked before eating. The cutting board should be placed in a ventilated environment and kept dry to avoid bacterial growth. In addition, be careful not to eat too hard food, such as ribs and crabs. It is recommended to remove the bones before eating to avoid puncturing the oral mucosa and causing ulcers. Because the immune function has not fully recovered, ulcers may cause systemic infection.

The second is personal hygiene. After being discharged from the hospital, patients who have undergone hematopoietic stem cell transplantation are advised to take a bath every day. The bathing time should not be too long. The first bath should not exceed five minutes. They should sit on a stool and have their family members help them wash. They should not exert too much effort because they may feel uncomfortable in a hot environment. In addition, it is important to keep hands clean. Pay attention to washing them at any time. Wash your hands with running water, hand sanitizer, soap, etc.

Figure 1 Original copyright image, no permission to reprint

The third is activity. After hematopoietic stem cell transplant patients are discharged from the hospital, it is recommended to move around early and go out early, which is good for preventing lung infections, and also has a very positive effect on psychosomatic rehabilitation. At the same time, it is also helpful for resuming work earlier in the future. At first, you can take a walk around the house to see if you are tired, whether you feel flustered or tired. If you feel tired, you should rest quickly and reduce the amount of activity the next day, because fatigue will reduce resistance, easy to catch a cold, and prone to lung problems. After there is no problem with activities at home, it is recommended to start with 10 minutes when going out, and come back after 10 minutes. Don't wait until you are tired to come back. After a week, gradually increase to 20-30 minutes, and after another week, you can stay around the house for 30-40 minutes, and you can go to a nearby park to relax. But be careful, you must wear a mask when going out, this is very important.

Figure 2 Original copyright image, no permission to reprint

What time period is better to go out? For example, in winter, when the air quality is excellent or good, it is better to go out between 2 and 4 pm; in summer, avoid 2-4 pm because it is hot during this period. Except for 2-4 pm, you can go out at other time periods when the air quality is good; in spring and autumn, as long as the air quality is good and there is not much pollen outside, you can go out at any time period. If the platelet and red blood cell counts are low, do not go out and just stay at home.

How long it takes to resume normal study and work after hematopoietic stem cell transplantation also varies from person to person. If the general condition is good, you can try to work half a day every day. The patient with the shortest time went back to work nine months after the transplant. Some patients have some complications after the transplant and may have to stay at home.

After hematopoietic stem cell transplantation, if there are no serious complications, it is best to have a checkup twice a week for 1-3 months after transplantation, because continuous evaluation is required. Sometimes the patient feels that there is nothing wrong, but there will be problems in the evaluation; three to six months after transplantation, check once a week; six months to one year after transplantation, check once a month; one to two years after transplantation, check once every three months; two to five years after transplantation, check once a year. Generally, checkup is required until five years. After five years, the condition is stable and there are no symptoms, so there is no need for checkup.