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Survivors' Guide for Bone Marrow/Stem Cell Transplant
What to Expect and How to Get Through It

Caring for Yourself Post-Transplant

Exercise
Regular exercise is an important part of the recovery process. By improving your stamina, muscle tone, and muscle strength, you will not only feel better physically, but also emotionally. Exercise can help counteract problems such as stiff joints, breathing problems, poor appetite and psychological lows. Seeing improvement in your physical state can be a real boost, particularly when you are adjusting to the stresses and difficulties of returning to a more normal lifestyle. Initiating an exercise routine if your energy level is low and you are not feeling well may be difficult at first. A good way to begin exercising is to take walks outside or to visit the outpatient physical therapy department in your hospital where a physical therapist can work with you in selecting appropriate exercises and building your strength and stamina. You may also be able to get your doctor to write you a prescription to buy an exercise machine such as an exercycle. If this is the case, your insurance may cover a portion or all of the cost of the purchase. A doctor’s prescription may also save you from paying sales tax on the purchase. Physical exercise is particularly important if you are taking steroids. They may cause muscle wasting and weakness and thus regular exercise can be instrumental in maintaining muscle mass and strength. When taking steroids, however, choose low impact exercises to minimize stress on your joints since steroids can cause joint damage.

When exercising, pay attention to the messages your body gives you. You should challenge yourself, but should stop or slow down if you are experiencing pain. Between a scale of very light to very arduous, an optimal level of exercise is one that you would rank as moderately hard. The best way to regain strength is through regular exercise suited to your level of physical conditioning that builds slowly to progressively higher levels of activity.

Nutrition
After the transplant, your body will require many nutrients to regain strength and to recuperate. Your nutritional requirements will vary depending on your medical condition, the type of transplant you had and the medications you are on. Your nutritional needs post-transplant may increase, requiring you to take mineral and vitamin supplements. Herbal remedies and supplements should be avoided until discussed with your transplant team. During this period it is important to consult a dietitian about food choices to ensure that your nutritional needs are met.

If you are nauseated and find eating and drinking difficult, it is helpful to eat and drink small amounts throughout the day rather than eating three large meals. Make sure to have a wide variety of appealing snacks at hand for the times that you do feel hungry. Eating in a pleasant setting or having an attractive food arrangement may also facilitate eating. During this time, you may also need to increase your fluid intake so as to prevent dehydration and to help flush the drugs and their residues from your bladder and kidney.

I had a terrible time remembering to drink enough. To alleviate this problem, I bought a water carrier and took a bottle of water or juice with me wherever I went. I also placed a bottle of water near my bed from which I drank every time I woke up during the night.

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