Life after transplant for acute myeloid leukaemia

Gradually you will put on weight and start to feel stronger. But it takes a long time to get over intensive treatment such as a bone marrow or stem cell transplant. It is not unusual to have to go back into hospital once or twice. And it may be a year before you really feel you are on the road to recovery. You will have your central line in until you no longer need platelet transfusions or blood transfusions. You will probably get at least one infection that needs hospital treatment. It will take a while to get back to normal in a few areas of your life such as those mentioned below.

For the first few months

• Eat only freshly cooked food
• Avoid undercooked eggs
• Avoid soft cheese and creamy cakes and puddings
• Wash salads and fruit very thoroughly
• Don’t drink too much alcohol
• Avoid takeaways and fast food restaurants

Apart from the alcohol, all these precautions help to prevent infection. Too much alcohol can slow the recovery of your bone marrow. Ask your doctor if alcohol will interfere with any medicines you are taking.

Reduce your risk of infection by

• Avoiding crowded public places (cinemas or public transport for example)
• Avoiding 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 to be sure.

You will not be able to go back to normal daily activity until your white blood cell levels are almost normal. It is 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 may also want to think about whether you would like them to talk to your colleagues about your illness and treatment. Or whether you would like to do this yourself.

Exercise will help you to get your strength back. But while your platelet level is still low, you have to be careful about getting any knocks. Choose something gentle like walking. When your white blood cell level is normal you can go swimming.

Once all your blood counts are getting back to normal you can do just about whatever you like.

If you want to go abroad, talk to your doctors. They will need to know that 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 can’t travel by plane if your platelets are too low.

After the first year, you can go where you like. But you need to avoid some vaccinations. There is information about vaccinations in the main chemotherapy section.

Whenever you go away from the hospital that treated you, it is helpful to carry a doctor's letter. The letter gives information about your treatment and 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. They also won't want to provide insurance for 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.

There is information about travel insurance in the financial matters section.

We have a whole section about travelling with cancer with information about how cancer and its treatment might affect your travel, taking medicines abroad and some travelling tips.

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)
• 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 both feel.

You can find detailed information about sex, sexuality and cancer in the coping with cancer section.