BMT Schedule

Dear family and friends,

We attended a counselling session at Ampang Hospital today, to prepare everyone for Min Ser's bone marrow transplant. 
Was a very informative session with a lot of details, will try to summarize below:

12 July
- Admit to Ampang Hospital Transplant Ward (Ward 7D)
- This is a special ward in a highly controlled environment; even care-givers cannot use the same toilet as the patient, and cannot eat in the same room
- Anyone entering the ward has to go through 2 checkpoints, must wear a mask and apron, and change their shoes
- Strictly no visitors allowed; only one immediate family member at a time
- Food brought in from outside the ward needs to be checked by the nurses
- Because of the severity of the transplant regime, there will be one nurse dedicated to 3 patients max (this is even better than most private hospitals)

15 July
- Consultation and preparation for radiation therapy at KL General Hospital
- Interestingly, Min Ser won't be able to use soap or any lotion for 2 weeks (to avoid any skin reaction due to the radiation exposure)

18 July
- Insertion of Hickman Line in Min Ser
- Will be used for the next 3 months; inserted near his neck and used for all IV purposes

23 to 25 July
- Commencement of radiation therapy
- Will be a full body irradiation, so expected to have quite strong side effects

26 to 27 July
- Commencement of high dose chemotherapy
- This will be the last and strongest dosage (to date) that will permanently destroy his stem cells, just prior to the transplant
- Praying that Min Ser won't have too severe side effects...most patients do

25 to 28 July
- Preparation of donor (Sue Min) for stem cell harvesting
- She will be taking GCSF shots daily to increase the body's production of stem cells

29 July
- Bone marrow stem cell infusion
- This is the actual 'transplant' of Sue Min's stem cells into Min Ser
- 3 million of Sue Min's cells will be harvested in the morning, and if all goes well, will be transplanted in the afternoon to Min Ser
- Successful grafting of the donated stem cells will be the only way for his marrow to start producing blood again
- The following 2 weeks will be the most high-risk period
- Main focus will be to combat infection and to prevent rejection of the donated cells (GVHD: Graft Versus Host Disease)

Mid August
- Expected date of discharge from hospital (if no complications)
- Strict quarantine at home for next 3 months (still high risk of infection and GVHD)
- No exposure to direct sunlight (apparently UV rays can trigger GVHD)
- No exposure to crowds (visitors discouraged)
- Visit hospital twice a week for tests and monitoring

Mid November
- Critical period over; visit to hospital once a week for next 3 months
- Recuperation of cells expected, and immune system starts strengthening
- Visitors allowed at home, but monitored

Mid February
- Hopefully back to 'normal'; visit to hospital once a month
- Low risk of infection and GVHD at this stage