Life after a transplant for acute lymphoblastic leukaemia (ALL).
It takes a long time to get over intensive treatment such as a bone marrow or stem cell transplant.
You have your central line or portacath in until you no longer need platelet or blood transfusions. You will probably get at least one infection that needs hospital treatment.
Gradually, you will start to feel stronger. But it can take a while to get back to normal. It might be a year before you really feel you are on the road to recovery.
Eating and drinking
For the first few months following a transplant:
- eat only freshly cooked food
- avoid undercooked eggs
- avoid soft cheese, blue cheese and creamy cakes and puddings
- avoid shellfish
- wash salads and fruit very thoroughly
- avoid takeaways and fast food restaurants
- don't drink too much alcohol
Apart from the alcohol, all the precautions above help to prevent infection. Too much alcohol can slow the recovery of your bone marrow. Ask your doctor if alcohol will interfere with any drugs you are taking.
Your social life
Reduce your risk of infection by:
- avoiding crowded public places (cinemas or public transport for example)
- avoid anyone who you know has come into contact with infections such as chicken pox or measles
Once your white cell count has recovered enough you will be able to go just about anywhere. This takes roughly 3 to 6 months, but check with your doctor or specialist nurse to be sure.
School, college or work
You will not be able to go back to normal daily activity until your white blood cell levels are almost normal. It's a good idea to start part time until you have got some of your strength back. Talk to your employer, teacher or tutor about this.
You might also want to think about whether you would like them to talk to your colleagues about your illness and treatment. Or you might prefer to talk to them yourself.
Sport and exercise
Exercise will help you to get your strength back. But while your platelet count is still low, you have to be careful about getting any cuts or bumps. Choose something gentle like walking. When your white cell count is improving you can go swimming.
Once all your blood counts are getting back to normal you can do just about whatever you like.
Holidays and travel
If you want to go abroad, talk to your doctors. They will feel happier if they can contact a treatment centre near to where you are going and let them know you are in the area, just in case you have any problems. You cannot travel by aeroplane if your platelets are too low.
After the first year, you can go where you like. But you should avoid some vaccinations. And following a donor transplant, you should not have live vaccinations.
Whenever you go away from the hospital that treated you, it is helpful to carry a doctor's letter with information about your treatment and giving a phone number for emergencies.
To start with, you are likely to have difficulty arranging travel insurance. Most companies will cover you for loss of luggage, delays and cancellations by the tour company. But at first, they will not want to cover you for the cost of medical treatment abroad. Or if you need to cancel your trip. If a company agrees to insure you, they will almost certainly ask for a letter from your consultant about your fitness to travel. As the time since your treatment increases, you will find getting travel insurance easier.
Your sex life
A transplant does not physically stop you from having your normal sex life. But you may find that your sex drive is low for a while. This may be due to:
- the treatment
- lack of strength and energy
- worry about the future
- feeling upset about losing your fertility
- lack of confidence after the changes in your appearance that a transplant causes at first (for example, hair loss)
- getting used to changes in sex hormone levels
Some of these effects take time to get used to. Some will get better on their own - for example your hair will grow back and you will put on weight. It is important to give yourself time to recover. It can also help to keep talking to your partner, if you have one, about how you are both feeling.