As the saying goes, “three parts disease, seven parts nourishment” and “three parts treatment, seven parts care”, the care of the patient’s family after transplantation is a very important part of the patient’s recovery. Especially in the early stage (within 3 months) after HSCT, the patient is still weak, immunocompromised and at high risk of acute rejection. The following are some considerations for the patient’s family during life care, dietary care, and disease care, respectively.
Living Care
- The patient’s living environment is recommended to maintain a room temperature of about 20 degrees in winter and 25 degrees in summer, as comfortable as possible for the patient, not too hot or too different from the outside temperature.
- The room should be frequently ventilated by opening windows or using an air purifier.
- The air conditioning filter and the inside of the air conditioner often have a lot of dust and mold, and need to be cleaned frequently.
- When cleaning, patients switch to other rooms first and use wet rags and mops to clean.
- Flowers and pets are not recommended in the room where the patient lives.
- Patients do not need to wear a mask for protection at home, but need to wear a mask when they go to public places.
- Family members of patients with respiratory infections (e.g., “colds”), chicken pox, shingles, measles, diarrhea, etc. in the home should be isolated from the patient.
- Visits from friends and family should be few and short, visitors should avoid smoking in the patient’s room, and the patient should avoid attending alcoholic beverages and meals.
- Patients need moderate physical exercise to regain strength. Low-intensity exercise is appropriate, such as walking indoors or in a neighborhood or park, and can be increased gradually according to the patient’s ability.
- Patients’ personal hygiene and cleanliness are still important. Long-term application of antibiotic-containing eye drops, eye ointment, mouthwash, and disinfectant sitz baths are generally no longer required, and they can brush their teeth, wash their faces, shampoo their hair, and bathe as ordinary people do for daily cleaning.
- When taking a bath, pay attention to keeping the bathroom warm and dry it as soon as possible with a large bath towel to avoid getting cold; for patients with PICC (peripherally placed central venous catheter) catheters, wrap the arm around the catheter site with plastic wrap before bathing and seal both ends with tape to avoid getting water. After washing, you can apply emollient lotion or moisturizer all over the body to avoid dry skin.
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Dietary care
To ensure a clean and hygienic diet is the most basic requirement. You should try to avoid raw and cold foods that are not easy to clean, such as melon seeds, peanuts and walnuts in their shells, candied fruits, pickles, ice cream, raw fish, etc.
Starchy foods are the easiest to digest (rice, noodles, etc.), followed by proteins (various meats), and finally fats (fatty meats, oils and fats). If you have had diarrhea or a poor diet for a longer period of time, it is recommended that you add foods in the order of starch, protein, and fat, and that you gradually transition to a normal diet, just as infants add complementary foods. It is important not to add too many different kinds of diets each day. The patient’s bowel movements should be noted:
- If no diarrhea or abdominal pain is present, continue to add;
- If the patient develops diarrhea, first review the food of the day and the previous day for any foods that may have caused diarrhea.
Salt, soy sauce, vinegar, and other condiments may be added to the food, but spices are generally avoided (according to individual diet).
For those who do not have special reasons to control their diet such as diabetes, they can eat fresh fruits, preferably easy-to-clean fruits that can be peeled, such as apples, pears, and oranges. Patients who have lost more weight than before the transplant can eat smaller and more frequent meals, pay attention to increasing the amount of protein in their food, and exercise moderately to promote muscle recovery.
Disease care
Mainly, this refers to assisting patients with a variety of records that will help the physician determine their condition and adjust medications as well as assisting patients with timely access to care. For example, we organize outpatient follow-up laboratory reports in order, record the doses of various oral medications and the reasons for their adjustment, and record whether the patient has fever, rash, diarrhea, cough, sputum, frequent urination, painful urination, and other various symptoms, the time of their appearance, their severity, and the triggers for their aggravation or remission.
- It is recommended to give the patient a daily weighing in the early morning after waking up and emptying the bowels, which is a very easy and simple way to monitor the presence or absence of edema and recovery of the patient’s physical status.
- Weekly outpatient follow-up is recommended for three months after transplantation, with longer follow-up intervals after March as appropriate.
Patients should be seen promptly and urgently in the event of high fever, shortness of breath, syncope, more significant bleeding at any site, or intolerable pain at any site.