1 AnswerA Trifusion catheter is a long-term catheter used for drawing blood and giving intravenous fluids. This particular catheter is also suitable for the rapid withdrawal and return of blood, necessary for apheresis (the collecting of your cells). The tip of the catheter is in a large vessel near your heart. The other end will exit below your collarbone. The portion between is tunneled under your skin. The catheter is three tubes in one inside the body and separates into three tubes outside the body.
1 AnswerDuring your stem cell transplant recovery, the role of your care team is to:
- Review the general plan of care each day with you. Your care team will individualize your care as much as possible. Please tell your care team if you have special needs -- for instance, if a person is coming at a particular time for your stem cell reinfusion.
- Teach and review with you how to perform your self-care activities -- mouth care, central venous catheter care, and skin care. Your care team will give you the supplies you need.
- Do a full physical assessment every shift. This includes looking in your mouth, inspecting your skin, and listening to your lungs, heart, and stomach with a stethoscope. Your care team will watch you closely for signs of side effects such as nausea, vomiting, diarrhea, infection, fluid balance changes, bleeding, etc.
- Weigh you twice a day.
- Measure and record all urine, stool, and vomit.
- Give you medications and blood products as ordered by your doctors.
- Disconnect your intravenous (IVs) or help you with them when you shower. IVs are not disconnected during your high-dose regimen, but they may be disconnected for short periods during your recovery. Your care team will teach you how to disconnect your IVs so you can be more independent.
- Change your linens daily and see to it that your room is clean.
- Bring you your meals and snacks.
- Obtain needed specimens such as blood, urine, or stool.
- Try to give you rest periods. It is important to space out your activities and take rest periods during the day.
- Answer your call light as soon as possible.
- Answer any questions you or your family may have or refer you to someone who can answer them.
1 AnswerHere is a list of activities that are necessary for your best recovery possible after stem cell transplant:
- Sit in a chair at least at meal times. More often is better. This will allow your lungs to expand more fully and possibly decrease the chances for pneumonia and infection.
- Shower once a day with antibacterial soap. Tell the nurse if you prefer to shower at a time other than the morning. Showering decreases the amount of bacteria on your skin.
- Ensure daily care of your central venous catheter.
- Mouth care is necessary at least four times a day, to help remove bacteria from your mouth. Tell your nurse about any changes or mouth sores as soon as you notice them.
- Clean your perineal area well after each urination and bowel movement to remove bacteria from the area.
- Do deep breathing exercises every four hours while awake to help decrease the chances of pneumonia or infection.
- Use a specimen "hat" every time you urinate or have a bowel movement.
- Write down and report everything you eat or drink. Doctors need an accurate account of intake and output to give you the best care.
- Take part in the exercise program the physical therapist outlines with you. This will help keep up your strength and decrease the chance for infection.
1 AnswerYou may not feel like doing much of anything after stem cell transplant, and any little activity may feel as if it takes more energy than you have to spare. However:
- Try to move around as much as possible.
- On days when you don't feel you can walk around much or exercise, even just getting out of bed and sitting in a chair several times for short periods will help keep you stronger.
- Each day you will have a shower, mouth care several times, and a dressing change of your central venous catheter. Because you are so prone to infection, cleanliness is very important.
1 AnswerAfter radioiodine therapy (used to treat overactive thyroid glands and thyroid cancers), any radioiodine that is not absorbed will leave your body through your urine. Small amounts may leave through tears, saliva, sweat, vaginal secretions, and stool. Most of it will be gone two days after treatment. Radioiodine is found in breast milk, so breastfeeding is not allowed during treatment.
1 AnswerYou must avoid all bright direct light for at least 30 days -- from the sun, lighting fixtures, fluorescent lights, or any bright light source like red Christmas tree lights. Exposure can cause severe burns to the skin, similar to severe sunburn. Thirty days after your photodynamic therapy, talk with your doctor, who will go over the sun re-exposure schedule with you. You will start with brief intervals of 3 to 5 minutes in early morning or late afternoon, and increase each day. During this time be careful when riding in cars or sitting near a window for prolonged periods of time. If you have any redness, swelling, or tenderness (sunburn) during this time, go back to following safety precautions and call your doctor right away.
1 AnswerExposure to bright direct light after photodynamic therapy can cause severe burns to the skin, similar to severe sunburn. Follow these guidelines at home:
- Lightly filter the light at home. Ambient room light is okay; total darkness is not needed. Keep windows covered with shades or curtains (have someone do this before you go home).
- Stay away from uncovered windows and doors. Light through a windowpane will magnify the effects of sunlight. Sit on the opposite side of the room from windows and lights.
- Avoid the sun! Its rays can cause burns even on cloudy days (and even through the window) or when reflected off of snow. Sunscreen will not protect you from skin burns during this period.
- Do not sit next to floor or table lamps with the light shining down on you. All lamps should be well shaded. Postpone activities requiring bright direct light, such as needlework or reading, for at least one month.
- Plan outside activities during evening hours. If you must go out during the day, wear a broad brimmed hat, sunglasses, long-sleeved jacket, gloves, long pants or thick tights (regular nylons are not good enough to protect you), and socks.
1 AnswerFor the photodynamic therapy, you will be admitted to the hospital as either an outpatient or inpatient. You will be taken to the operating room by cart. The room is designed to protect you from exposure to bright light. During the treatment you will wear special laser glasses. If you have general anesthesia you will be taken to a special recovery room with dim lighting.
To protect you from bright light while you are in the hospital:
- You will be in a special room with shades drawn, lights dimmed, and all bright lights turned off. The switches for the overhead lights will be covered so they cannot be turned on.
- If you are taken by wheelchair to another department for tests or any reason, you will need to wear socks, long pants, long-sleeved robe, gloves, sunglasses, and a broad brimmed hat (or cover your head with a sheet).
- If you are taken anywhere on a cart, your body will be covered with a blanket. Your face will be protected with a thin sheet loosely placed over your head. There will be plenty of room to breathe. It is best to wear your sunglasses whenever you are out of your room.
- If your activity is not limited, your nurse will dim the hall lights after visiting hours in the evening so you can have a short walk in the hallway. Let the nurse know before you leave your room and when you return.
- Your discharge will be arranged for the evening hours. If you must ride in a car during the day, be sure there is no exposed skin.
1 AnswerDuring photodynamic therapy, you will be given a drug, Photofrin, through an injection in your vein. This drug travels through the blood and enters all the cells in your body. It concentrates in cancer or abnormal cells but enters normal cells, too. It is gradually released from normal or abnormal cells, usually within 48 to 72 hours.
You will not feel different from the drug, but your skin and tissues will be very sensitive to light. You must avoid all bright direct light for at least 30 days -- from the sun, lighting fixtures, fluorescent lights, or any bright light source like red Christmas tree lights. Exposure can cause severe burns to the skin, similar to severe sunburn.