Preparing for Transplant

If you learn a bone marrow or cord blood transplant (also called a BMT) is the best treatment option for your disease, you can take steps to prepare yourself and your family for the challenges ahead.

Planning how things will get done in your absence

It is a good idea for you and your family to make plans about how to manage your household while you arein the hospital and during recoery.

You can also organize information at home to make things easier for family and friends who want to help. That way you can focus on getting better during your transplant and worry less about what needs to be done at home.

You might want to:

• Start a phone list of important numbers for the entire family to have. Add the names and numbers of the members of your health care team and others who are helping you prepare for transplant.
• Write down important information about finances and other household concerns. Tell your caregiver where you will keep this information. You may want to find out from your bank or financial institution what you need to do to allow your caregiver to handle certain transactions for you.
• Organize how your bills will be paid while you are away. See Mapping the Maze: A Personal Insurance and Financial Guide to Marrow and Cord Blood Transplant for information on how to develop a financial plan.
• Plan who will do your household chores and other duties in your absence.
• Set up schedules and make plans for how your children will be cared for while you are away. Let your children know what the plans are.
• Provide a medical release granting your caregiver permission to authorize medical care for your children in your absence.
• People close to you will want to know how they can help. Think about giving them their own tasks to do for you and your family. See Asking for Help for ideas.
• Plan what to bring with you to the transplant center — see Getting Ready for Your Transplant — a Checklist (PDF).

Preparing emotionally for transplant

A transplant can be a stressful treatment. You will need emotional support as you plan for and go through your transplant.

• Talk with your family and friends about your feelings.
• If you have children, let them know what to expect during and after your treatment.
• It may help to talk to a social worker or counselor who has worked with other transplant patients and their families.
• You may want to talk to other people who are going through a transplant or who have already had a transplant.

You may also feel more ready for your transplant if you know what to expect from your treatment and recovery.

• Ask your doctor what you can expect, such as how long he or she thinks you will be in the transplant center. Ask what your specific treatments will be. See Questions to Ask Your Doctor About Transplant (PDF).
• Read about the steps of transplant, starting with entering the hospital, through receiving your new cells and on to early days of recovery.
• See Returning to Everyday Life to help you plan for life after your transplant.

Preparing advance directives

As you prepare for a transplant, it is normal to have fears about your disease, treatment complications or even dying. Some patients want to face these fears by completing advance directives. Advance directives tell your doctor what kind of care you would like if you become unable to make medical decisions. Being prepared for the worst may help you set your worries aside so you can go forward with a positive outlook.

Laws about advance directives are different in each state. Three types of advance directives include a living will, durable power of attorney and health care proxy. You can ask your social worker at the hospital how to set up advance directives to be included in your medical chart. Talk to your caregiver and family about these concerns as well, so they know what you want. Talking can also help relieve some of your caregiver's and family's worries.

Addressing fertility concerns

Many people who receive chemotherapy become infertile as a result of their treatment. If you want to have children in the future, there are some options you might be able to explore before your transplant.

For men

Before your transplant, you might be able to have some of your sperm frozen. Talk to your doctor about your options.

For women

Before your transplant, you might be able to have your eggs frozen or have embryos frozen. However, this can take a month or more. These approaches are not for everyone and do not always work. Talk to your doctor about your options before your transplant.

Other options

• Some couples are able to conceive a child using donated sperm or donated eggs.
• You might be able to adopt a child.
  Note: Some adoption agencies might hesitate to work with you because you have been treated for a life-threatening illness. Another option might be to work with an attorney who specializes in arranging private adoptions.
• One resource for more information about fertility concerns is the nonprofit organization Fertile Hope, found online at fertilehope.org.

Not all transplant survivors become infertile. The likelihood can depend on your age and the details of your treatment. Some transplant survivors have gone on to have children. If you and your partner do not want to have a child, you should take steps to avoid pregnancy.

Finding additional support

The important thing to remember is that you and your family are not alone during this difficult time. You can call the National Marrow Donor Program (NMDP) if you have questions or need help finding resources. The NMDP Office of Patient Advocacy provides free information, educational materials and support services to transplant patients and their families.

To contact the National Marrow Donor Program Office of Patient Advocacy: Inside the United States, call 1 (888) 999-6743. This call is toll-free in the United States. Outside the United States, call 1 (612) 627-8140. This call may have long-distance or international charges. NMDP Office of Patient Advocacy staff are available Monday - Friday, 8 a.m. to 5 p.m. Central time. You can also send an e-mail message to patientinfo@nmdp.org.

Some of the Office of Patient Advocacy's many patient materials are available on this Web site:

• Step One: An Introduction to Marrow and Cord Blood Transplant gives you information to discuss treatment options with your doctor and make health care decisions.
• The Transplant Process guide explains the entire unrelated donor transplant process.

You can also order materials using the online patient materials order form or by calling the Office of Patient Advocacy.

Other organizations

There are many other organizations and resources that can help. A few examples include: 

• The Blood & Marrow Transplant Information Network (BMT InfoNet) provides transplant information and emotional support to transplant patients and their families. To learn about BMT InfoNet, visit http://www.bmtinfonet.org.
• National Bone Marrow Transplant Link (nbmtLink) offers practical information and support services to transplant patients and their families. To learn about nbmtLink, visit the nbmtLink Web site at http://www.nbmtlink.org.
• SuperSibs! is a welcoming organization offering free support services and friendship to children who have family members with cancer. To learn about SuperSibs!, visit the SuperSibs! Web site at http://www.supersibs.org.

To look for other organizations that serve patients, see Organizations that Can Help: A Searchable Directory.