When you leave the transplant center after a bone marrow or cord blood transplant (also called a BMT), your family or friends should prepare your home for your return. They can clean and plan any changes needed to your household routines. The main goal of these changes is to protect you from infections.
Your infection risk
After a transplant, your immune system is very weak and cannot fight infections. Until your immune system becomes stronger, infections can be life-threatening. You will be at higher risk for infections for as long as a year or more. If you are taking drugs to treat graft-versus-host disease (GVHD), you will be at higher risk for infection as long as you take them.
Many germs (bacteria, fungi and viruses) that can cause infections may be present in your home. They are very common and do not usually cause healthy people to get sick. After your transplant, your body may not be able to fight these common germs. You and your family and friends can take steps to make your home a safer place for you.
Cleaning your house
Your house or apartment should be cleaned thoroughly before you come home from the transplant center. Steps your family or friends should take include:
- Shampoo the carpets and wash the floors
- Clean drapes, blinds and furniture
- Change air conditioning and furnace filters
- Turn off humidifiers
- Keep windows and doors closed
- Remove any fresh or dried flowers
You should not do any remodeling to your home at this time. Pulling up old carpeting or opening walls can release many fungi into the air. A common fungus called aspergillus is often found where buildings are being remodeled or at construction sites. Aspergillus can cause very serious infections.
Handwashing and visitors
Washing your hands may be the single most important thing you and others can do to prevent the spread of infections.
- Wash your hands every time you come home after going out.
- Ask everyone who comes into your home to wash their hands as soon as they come in.
- Wash your hands after using the bathroom, changing a diaper, touching a pet or blowing your nose. Others in your house should also wash their hands after doing any of these things.
- Wash your hands before eating or preparing food.
You will also need to be careful about contact with other people. You may need to limit the total number of visitors who come to your home. While your infection risk is very high, it is best if only a few people visit. In addition, instruct your friends and family to stay away if they are sick or have been in contact with anyone else who is sick in the past few days. Children who have been given a live virus vaccine within the last four weeks should also stay away. You might want to put a note on your door as a reminder.
If you have children at home, talk with your doctor about how your family can limit your risk of infections. Children tend to get many colds and other common infections, but these infections can be life-threatening to you until your immune system recovers. Things to think about include:
- Who will care for young children. It is usually recommended that they not attend day care, because they are exposed to many childhood illnesses there. However, while you are recovering from your transplant, you may not be able to handle childcare yourself either.
- How to reduce risks of catching illnesses brought home by school children.
- How to handle your children's immunizations. They should not get live vaccines while your immune system is weak.
Each family is different. Talk with your doctor and family to find a plan that works for you.
Caring for pets
Most indoor pets you had before your transplant will probably be able to remain in your home. However, if you have reptiles or some kinds of birds, you may need to find new homes for them. If you have barnyard animals, such as horses, you may need to avoid any contact with them as well. If you have pets, you can follow some precautions:
- Do not expose yourself to your pet's waste — do not change a cat's litter box, pick up the dog's waste or clean a bird's cage.
- Do not sleep with your pet.
- Do not bring any new pets into your home, and stay away from other people's pets.
- Wash your hands after touching your pets.
Transplant centers vary in their recommendations about contact with pets. If you have pets, talk with your doctor and follow your doctor's instructions.
You will need to ask others to do some household chores while you are at risk for infection. Some chores could expose you to bacteria, viruses or fungi that can cause infections. Some tasks you may need to avoid include:
- Any yard work, including gardening, mowing the lawn or raking leaves
- Caring for plants — any task that involves contact with indoor plants or potting soil
- Dusting or vacuuming or even being in the room when dust is in the air
- Carpentry or home repair projects
- Any tasks that would expose you to lots of dust — for example, if you live on a farm, stay out of the barn
- Grocery shopping, errands or other tasks that would expose you to crowds — you may be able to go to public places during times they are not crowded, such as late at night — follow your transplant center's instructions
Transplant centers vary in their recommendations. If the instructions from your transplant center are different from what you read on this Web site, follow your transplant center's instructions. Talk to your doctor if you have any questions.