A bone marrow transplant is a major operation which requires a lot of bed rest and care. In a bone marrow transplant, hematopoietic stem cells are removed from a person and infused into another person (allogenic) or into the same person at a later time (autologous).  It takes around six months for the bone marrow to recover fully. During this crucial time period, your risk for infections, bleeding, and skin problems is higher.

One has to be very careful after this operation. Weakness and fatigue may be your companions at this time but you should take extra care. Bone marrow care involves oral care as well. Brush properly and make sure that your lips are not dry or parched. Sugar free candies and gums can be chewed after the transplant; it is better to avoid sugar. It is better to be careful and avoid contact with your pets.

If you experience any of the following symptoms, you know you need to visit your doctor:

• Diarrhea
• Severe nausea, vomiting, or loss of appetite
• Inability to eat or drink
• Extreme weakness
• Redness, swelling, or draining from any place where you have an IV line inserted into your body
• Pain in your stomach area
• Fever, chills, or sweats
• A new skin rash or blisters
• Jaundice
• Migraine/ headache that does not go away
• A cough
• Trouble breathing when you are at rest or when you are doing simple tasks
• Burning sensation while urinating

Do not hesitate and call your doctor immediately if any of these symptoms are observed in the patient.

Nutrition after transplant:

As part of the recovery process, for caring of bone marrow, good nutrition is very important.

Nutrition supplements

If you are unable to eat a well-balanced diet, it is recommended that you try over-the-counter nutrition supplements to meet your nutritional needs.

Multivitamins

We recommend you take a daily multivitamin, after being discharged. You can take children’s chewable multivitamins twice a day if better tolerated. Excess doses of some vitamins and minerals might be unsafe at this time so it is better to be careful.

Calcium and Phosphorus

Calcium is an important source for maintaining bone strength. Phosphorus is a mineral that helps to strengthen bones. Some bone marrow transplant patients often need additional phosphorus.

Dairy products high in calcium and phosphorus include:

• Milk
• Natural cheese
• Cottage cheese
• Ricotta cheese
• Yogurt
• Pudding, custard
• Ice cream or ice milk

Non-dairy products high in calcium include:

• Calcium-enriched fruit juice
• Roasted almonds
• Dried peas and beans
• Tofu
• Greens
• Canned salmon with soft bones
• Spinach
• Mackerel
• Shrimp

Additional foods with significant amounts of phosphorus:

• Brussels sprouts
• Peanut butter
• Beef and Chicken livers
• Whole grain breads
• Coconut
• Chocolate
• Avocados
• Chick peas
• Nuts
• Mushrooms
• Artichokes
• Fruitworks -- all varieties except pink lemonade
• Cool Iced Tea -- all varieties except lemonade iced tea

Calcium supplements with vitamin D are essential for those who require long-term steroid therapy, such as prednisone. Steroids cause bone loss, called osteoporosis. Taking these supplements, as well as exercising, can help minimize bone loss and prevent fractures. An appointment with a rheumatologist may be advised to monitor your bone density.

Potassium and magnesium

Antibiotics, diarrhea, and vomiting can cause electrolyte (mineral) imbalances. Even after your hospital discharge, it is common to require potassium and magnesium supplementation, which can be given by pill or intravenous infusion. Potassium is an electrolyte (mineral) that maintains normal fluid balance, supports cell integrity, facilitates the making of protein, assists in the transmission of nerve impulses, and the contraction of the heart and other muscles.

Fruit sources of potassium include:

• Apricots
• Avocados
• Bananas
• Dates, figs
• Honeydew/cantaloupe
• Oranges
• Peaches
• Prunes
• Raisins

Vegetables high in potassium include:

• Artichokes
• Bamboo shoots
• Beans
• Beets
• Chard
• Chick peas
• Escarole
• Leeks
• Mushrooms
• Spinach
• Squash
• Tomatoes
• White potatoes, sweet potatoes

Magnesium is also an electrolyte (mineral) that is involved in bone mineralization, building of protein, transmission of nerve impulses, and normal muscular contraction.

Significant sources of magnesium include:

• Legumes
• Leafy green vegetables
• Nuts
• Milk
• Whole grain cereals
• Chocolate
• Meat

Sodium and alcohol is to be avoided during the recovery period.