Autologous Transplant Guide: Treatment and Side Effects
High dose chemotherapy
Chemotherapy will probably begin the day you are admitted to the hospital. Your doctor will discuss all of the drugs you will receive and their side effects. 你的执业护士、住院护士和药剂师也会回答你的问题. In addition, you may receive written information on these drugs in the consent form.
Some precautions are taken to minimize side effects from these drugs. For example, when receiving some types of chemotherapy, 患者必须每天彻底淋浴两次,以清除通过皮肤排出的药物,以帮助防止严重的皮疹. The inpatient nurse will review any special precautions that you may need to take.
Nausea is one of the most common side effects of chemotherapeutic drugs. 在你的化疗开始之前,你需要立即服用止吐药物,并且在最后一次化疗完成后的24到48小时内,你需要持续服用止吐药物. 医疗团队会不断评估你对止吐药物的反应,努力将你的不适从恶心降到最低. The antinausea medication can make you feel tired, so you may sleep more than usual during the chemotherapy. 如果你认为你需要更多的止吐药物,告诉你的护士、药剂师或十大赌博平台排行榜.
通常,化疗在住院的前两到八天进行.
Total body irradiation
Some patients receive total body irradiation (TBI) in addition to chemotherapy. 当你讨论你的治疗方案时,你的诊所十大赌博平台排行榜会告诉你是否得了脑外伤. 这种放射疗法旨在摧毁残留的癌细胞,进一步抑制免疫系统. 放射治疗十大赌博平台排行榜会和你讨论治疗的细节和副作用.
创伤性脑损伤的治疗在放射治疗部门进行,通常持续三到四天. The treatment itself is painless, but there may be uncomfortable side effects after treatment, such as mouth and throat sores, nausea, stomach and intestinal irritations, and skin redness. Antinausea medication is usually given before each treatment to reduce nausea. Additional medications will be given as needed.
The transplant procedure
移植手术将在你最后一次化疗后的一到三天内进行,或者在你最后一次放疗后的任何时间进行. The day of transplantation is referred to as Day 0. You may have a family member in the room with you during the infusion if you wish.
移植手术类似于简单的输血,将在你的病房里进行. 实际的过程大约需要45分钟,取决于干细胞的体积. If you are receiving bone marrow, the infusion may take several hours. The blood stem cells will be infused through your central venous catheter. Your nurse will check your blood pressure, temperature, breathing and pulse, and will watch for any side effects.
Usually there are no side effects, but occasional patients may experience a funny taste in the mouth, chills, flushing of the face, nausea and vomiting, headache, and changes in blood pressure and breathing. Your urine also may be tinged red for the first 24 hours after transplantation. If your urine remains red after this time or becomes red later, tell your nurse.
Delayed side effects
人体在移植后大约一周会感受到化疗或放疗的影响. When your blood counts are low, you will feel fatigued. You may feel like you have the flu and may not want to do much. This will last for about two weeks and will decrease as your blood counts improve. You may notice a number of other symptoms as well.
Loss of appetite
Appetite loss occurs frequently. 避免食用会引起不适的食物,或者有时不讨论饮食和食物会有所帮助. Try to eat small amounts but more frequently – become a nibbler. Eat what you have cravings for and don't eat what is not appealing. Your appetite will begin to improve when your blood counts get better.
你需要摄入至少1000卡路里的热量,喝一夸脱的液体才能排出. 在你的中性粒细胞计数上升之前,你的胃可能还没有完全恢复到这个程度.
Chemotherapy, 创伤性脑损伤和一些药物可能会暂时改变你的味觉,有时还会改变你的嗅觉. Many patients state that suddenly food tastes like paper or cardboard. As the taste buds begin to recover, you may find foods taste too sweet, too sour, too salty or too bitter depending on which area of the tongue is recovering first. 大多数患者发现他们的味觉在创伤性脑损伤或化疗后的第二或第三周开始恢复, but full recovery may take months.
Nausea and vomiting
化疗,创伤性脑损伤和有时抗生素可引起不同程度的恶心和/或呕吐. Your doctor will order medication to control the nausea and vomiting. The medication will be given as you call for it. Ask your nurse if you need antinausea medicine.
Some foods, especially the odor of hot foods, may increase the nausea or vomiting. If this occurs, 最好在几天内尽量避免这些食物,只选择那些让你更舒服的食物, such as cold foods and beverages. Avoid greasy foods and eat small, frequent meals instead of large amounts.
我们不建议你在恶心和呕吐时强迫自己吃东西, because often this can worsen the nausea and vomiting and cause problems later, 比如长期不喜欢这些食物,因为你把它们和生病联系在一起(食物厌恶)。.
Rest after meals and keep your head slightly elevated. If nausea is severe, 每隔几分钟喝少量的透明液体,而不是一次喝一整杯.
Changes in vision
有些药物可能会让你昏昏欲睡,或者在服药后的几个小时内难以集中你的视力. 如果视力持续变化,请告知护士,以便评估其他可能的原因.
Mouth and throat soreness
After chemotherapy, your mouth may become red and tender, and your gums may bleed. This is known as stomatitis or mucositis.
每天用柔软的牙刷刷牙四次,用盐和苏打溶液漱口,保持口腔清洁是很重要的, Ampho B mouthwash and peridex every two hours while awake. 你也会被给予抗真菌漱口水两性霉素一天几次. 不要使用商业漱口水,因为其中的酒精可能会使你的口腔疼痛. If your mouth is too sore to brush your teeth, then just use the salt/soda rinses.
Be sure to tell the nurse if your mouth is sore or your gums are bleeding. 可能有必要尝试其他漱口水或止痛药,让你感觉更舒服.
Diarrhea
Chemotherapy, TBI and some antibiotics may cause diarrhea. This can lead to skin breakdown and infection around the rectum. A stool sample may be collected to rule out infection as a cause of diarrhea.
Medications are available to decrease diarrhea, and creams or sitz baths may soothe the irritation around the bottom. Please let the nurse know if you are having any discomfort around your bottom.
Sleeping problems
It is not unusual for patients to have trouble sleeping in the hospital. Hospital personnel involved in your care may interrupt your rest at intervals. If you have trouble finding enough time to sleep, 让你的护士帮你安排时间表,这样你晚上就能有一些不受打扰的休息时间. A sleeping medication can be ordered as well. Try not to sleep during the day.
Infection
感染是住院期间中性粒细胞计数低时最常见的并发症之一. However, after the white blood cell count comes up to normal, resistance to infections is still decreased, 部分原因是你将接受的药物治疗,部分原因是你的新免疫系统需要时间来生长. This may take as long as two years. 我们会监测你免疫系统的恢复情况一旦感染风险降低我们会通知你.
Strategies aimed at controlling exposure to infectious organisms include:
- Private rooms
- Limiting the age and number of visitors
- Special diets
- The use of a mask when the patient leaves the room
- Personal hygiene, including daily bathing with antimicrobial soap and oral care with chemobrush, salt and soda rinse, peridex and amphotericin mouthwash
In addition, antibiotics will be administered to prevent infections. 出院后你还要继续服用,以防止感染.
Infections can occur anywhere in your body. 向护士或十大赌博平台排行榜报告任何感染的迹象或症状是非常重要的. Signs and symptoms include:
- Chills and/or fever
- 呼吸短促、咳嗽和咳痰(一种粘液样分泌物)
- Loose, watery stools or stomach pain
- Blisters, rashes, mouth sores, sores or redness at a catheter site, and irritation or sores around the vaginal or rectal area
- Headache or inability to bend your neck forward
- Sore throat, difficulty or pain in swallowing, toothaches and earaches
- Pain during bowel movements or urination
- 脚趾甲或手指甲周围受感染的倒钩或皮肤,包括任何红肿
当怀疑感染时,十大赌博平台排行榜会要求采集和培养样本. These may include samples of urine, blood, sputum and stool, swabs from your throat, rectum, catheter site and any suspicious skin break. You also will have a chest X-ray taken. Additional antibiotic medication may be given to fight the suspected infection.
Hair loss
Hair loss generally occurs one to two weeks after chemotherapy or TBI. This is temporary and the hair is expected to grow back. 我们建议剃须或把头发剪得很短,以防止脱发时发痒.
Wigs are not recommended during your hospital stay, because they cannot be cleaned properly, but you may want to purchase a wig or hairpiece after you are discharged. These are tax-deductible medical expenses. Some medical insurance covers these costs.
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UCSF Health medical specialists have reviewed this information. 它仅用于教育目的,并不打算取代您的十大赌博平台排行榜或其他医疗保健提供者的建议. 我们鼓励您与您的供应商讨论您可能遇到的任何问题或疑虑.