Stem cell transplant can be outpatient treatment for some

Before I cut and paste this story, I must give my own views on this.  I’m not convinced that this is safe for the patient.

Although Dom’s transplant was over 5 years ago, it was SO MUCH DIFFERENT…. for the better, I believe.

Firstly, after living in this home for 25 years, there was no way that I’d bring my husband home to 25 years of “stuff”.

Instead, we moved into an apartment a few weeks prior to his procedure.  I hired a guy to come in and “sanitize” the apartment. (A fog and a spray).

After the transplant, he was in the hospital for several (?) weeks.  Once he returned to our new home, he was not permitted to eat ANY fresh vegetables or fruit.  Canned, only…. as long as the cans were washed with warm soapy water and opened up by hand.

It was a couple of months before she allowed him to go out for pizza and a movie….. the movies were matinees, and the meals would be during “off hours”, so as to pretty much have the restaurant to ourselves.  (MASK)

His mother was in poor health in her mid-nineties.  NOPE.  Finally, our doctor allowed him to put on his mask, park in her driveway to allow her to visit her only child.

If we had to do it all over again, we’d choose the same method.  He’s worth it.  *winking and smiling*
Bringing a major medical treatment home. Patients once spent weeks in the hospital. Now they can get a stem cell transplant and go home. It means tackling a lot of hurdles, but this new idea is offering tremendous relief to patients.

She passes the time with a little knitting … and a visit with her doctor. Then there’s a quick flush of the central line in her chest, placed this past summer before Rebecca Zoltoski began a four-month course of chemotherapy to fight myeloma – cancer of her bone marrow.

Rebecca Zoltoski, stem cell transplant patient: “You do what you have to do.”

But this is not a doctor’s appointment. This is day three of Rebecca’s stem cell transplant. Her doctors are ready to infuse a batch of new cells – her own – with the hope they will grow into healthy bone marrow.

Dr Michael Bishop, University of Chicago Medicine, medical oncologist: “Think of the stem cells as the seeds of the bone marrow. It takes time to start growing and maturing and appearing in the peripheral blood, and that’s about a 10-day process.”

As the cells grow, patients wait. It’s an intense process that typically requires a 21-day stay in the hospital. But Rebecca is an outpatient. And after her daily check in – she’s ready to head out.

Dr Michael Bishop: “We would take her and monitor her blood counts, monitor her kidney and liver functions and make sure she’s doing ok. If everything looks cool, we send her on her merry way with very strict instructions that in that interim, before we would see her the next day, if she developed signs of infection, fever, cough, diarrhea, that she immediately gives us a phone call.”

It’s a new program at University of Chicago Medicine – the outpatient stem cell unit has been up and running for about three weeks.

Rebecca Zoltoski: “This afternoon I hope to get out and get a good walk in so I can try to get some of my energy back because I find that helps me a lot. I wouldn’t really be able to be outside if I were here as an inpatient.”

Dr Michael Bishop: “Knowing you are going home every day, that’s the psychological advantage. They have the comfort of their own home, own bed, foods they are used to and like.”

Rebecca Zoltoski: “I did have some concerns about things that could happen, negative things that could happen.”

And there are risks. Patients undergoing a stem cell transplant have weak immune systems and extremely low blood counts – their ability to fight infection is severely compromised.

Dr Michael Bishop: “Most of the time, 75% of the time the patient is going to be fine. One in four will have to be admitted to the hospital primarily for signs and symptoms of an infection.”

That’s why doctors place constraints on outpatients.

Dr Bishop: “Limited to no crowds, wear a mask, strict hand washing.”

Still, the outpatient process appealed to Rebecca.

Rebecca Zoltoski: “I have an 11-year-old at home, and it’s nice to be able to see her. And it’s nice for her to be able to see me, and know I’m doing ok. That’s been the positive of it.”