The first few months out of hospital

After you go home you will still need to go back to the hospital outpatient clinic for regular checks. Even after your bone marrow has recovered and your neutrophils are back to a normal level, your immunity will be low for a few months.

Always carry a 24-hour telephone number for your hospital or transplant unit. Contact them immediately if you feel unwell, your temperature rises, or you have any signs of infection.

You may have to take regular doses of antibiotics and anti-viral drugs to reduce the risk of infection.

Sometimes you may still need blood transfusions or platelet transfusions. These can usually be given as a day patient.

Eating and drinking

Your doctor or nurse can give you information about your diet once you are home. While your immune system is recovering, try to eat a healthy, balanced diet and avoid possible risks of infection from food. They may give you a list of foods to avoid.

Once your immune system is back to normal, you can eat whatever you like. Your dietitian or nurse will give you advice.

Check with your doctor before drinking alcohol. It slows down the recovery of the bone marrow and increases the risk of bleeding. It can also interact with some of the drugs you are taking.

Managing tiredness

Feeling you have little or no energy (fatigue) is very common after this treatment. It can take many months to get your energy back. Recovery is a gradual process, so don’t expect too much of yourself.

We have more information about managing fatigue.

Being more physically active

Being more physically active by taking regular, gentle walks helps keep your muscles toned. While your blood counts are recovering, certain types of exercise will not be suitable. You can ask your specialist about this.

After your blood counts have recovered, you can start doing whatever exercise you prefer. But it is a good idea to increase the amount gradually. Regular exercise can help with your recovery and improve your future health.

Socialising

It is important to spend time with family, friends and your partner, if you have one. You should also do things you enjoy. But try to avoid crowded places until your immune system has recovered. This includes public transport, shopping centres, cinemas and pubs at busy times. After 3 to 6 months, you should be able to have a full social life again.

You should still avoid contact with children who have infectious illnesses such as chicken pox or measles. If you are worried you have been in contact with someone who has an infectious illness, contact your transplant team.

Driving

If you feel very tired, you may find it hard to concentrate and therefore be less alert. Your reaction time will also be reduced.

It is best to avoid driving if you feel like this. Ask a family member, friend or your partner, if you have one, to drive you instead. Ask your transplant team if there is help with transport for hospital appointments.

Speak to your doctor about any concerns you have.

Your sex life

Your treatment does not stop you being able to have sex. But before going home, check with your doctor if there is any reason why you cannot go back to your usual sex life.

It is normal to have a low sex drive after treatment. We have more information about effects on your sex life and tips that may help.

Contraception

Although your fertility may be affected, it is still important to use effective contraception after treatment. Doctors and nurses usually advise you to avoid getting pregnant or making someone pregnant soon after treatment. Your doctor or nurse will tell you how long you need to use effective contraception for.

Hormone replacement therapy

Women may have an early menopause because of their treatment. As well as periods stopping, other symptoms include:

Most of these symptoms can be helped by hormone replacement therapy (HRT). You can talk to your specialist doctor or nurse about this.

Vaccinations

After this treatment, you may lose your immunity to illnesses you were vaccinated against as a child. You may need to have some of these vaccinations again. You will also need vaccinations to protect you against common infections such as flu. Your haematology doctor will talk to you about this and tell you when to have your vaccinations.

There are some types of vaccines (live vaccines) that you need to avoid until your immune system is back to normal. Your haematology doctor will tell you which vaccinations are safe for you to have and which you should avoid.

Holidays and travel

As your immune system recovers and the time between hospital visits get longer, you might think about going on holiday. Talk to your haematology doctor before booking a holiday. They usually advise you not to travel abroad in the first year after treatment.

After this, your immune system should be working well so you should be able to travel abroad. Ask your doctor about any vaccinations you may need.

When you travel, it is helpful to take a letter from your doctor explaining your medical history and giving contact telephone numbers for your hospital.

It can be difficult to get travel insurance if you have cancer, or if you have had cancer before.

We have information on travel and cancer that has helpful, practical tips about travelling.

Sun protection

For several months after treatment, your skin will be more sensitive to the sun and you may burn more easily. Use a sun cream with a sun protection factor (SPF) of at least 30, and cover up with clothing and a hat. If you notice any changes to your skin let your doctor know.

Late effects of high-dose treatment

Some treatment side effects may become permanent and others may develop years after treatment has finished. These are called late effects. They may be due to the treatment you had, or because your immune system does not work as well as before.

There are things you can do that may help reduce the risk of late effects, or to help manage them. Always let your doctor know about any problems you have.

  • Eye changes
    Your eyes may become dry and irritated. Using eye drops regularly will help this. You also have more chance of developing a cataract, which is a cloudy patch in the lens of your eye. It can make your vision blurred or dim. Cataracts can be treated with a small operation. Have your eyes checked regularly and tell your doctor if you have any problems with your sight.
  • Underactive thyroid
    Your thyroid gland, which makes the hormone thyroxine, may not work as well. You will have blood tests to check this. Having thyroxine tablets may help.
  • Bone thinning
    The drugs and treatments you have had can increase your risk of developing bone thinning (osteoporosis). Women who have an early menopause are more at risk. Taking HRT can help to protect your bones. You can also ask your doctor if you should take vitamin supplements to help protect your bones. Tell your doctor if you get any problems with your bones. Eating a healthy diet and doing regular weight-bearing exercise, such as walking, will help look after your bones.
  • Effects on the heart
    The treatment may affect the way your heart works. You may have tests to see how your heart is working. If you have pain or tightness in your chest, feel breathless, or notice changes to your heartbeat, tell a doctor straight away. These symptoms can be caused by other conditions but it is important to get them checked by a doctor.
  • Effects on the lungs
    Always tell your doctor if you develop wheezing or a cough, or feel breathless. You should also let them know if any existing breathing problems get worse. If necessary, they can arrange for you to have tests to check your lungs.

Risk of another cancer

After this treatment you have more risk of developing a second cancer. The most common type is skin cancer, so protecting yourself from the sun is very important.

Your transplant team will monitor you closely for the rest of your life. This means that any problems with your health can be found and treated early.

Going back to work, school or college

When your blood counts have recovered, you can ask your doctor about going back to work, school or college. You should do this gradually, by going part-time to begin with. It is a good idea to talk to your employer, teacher or tutor about the best way of returning. Think about if you want them to tell other people about your treatment before you return.

We have more information about work and cancer and going back to school or college.

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