My BF is trying to decide if he should have his SCT done on an in-patient or an out-patient basis. We're trying to understand the pro's and cons of each option. If you were faced with a similar option when you had your SCT, I'd love to hear which option you chose, and why. Also, if you had an SCT on an outpatient basis, I'd love to hear your thoughts.
Thanks much!
Lyn
Forums
Re: In-Patient vs. Out-Patient SCT
Hi I'm not sure how the outpatient works? My hospital only does in patient. As an in patient I was constantly hooked up to IV fluids through the hickman line. For me, this proved to be necessary! My kidney function was poor from the chemo. I could not concentrate urine. So other then continuously being in the washroom I was loosing a lot of fluid and kept dropping my blood pressure. I almost ended up in the ICU because it was so low. like 80 over 40. I had to have extra litres of fluid in the second line all the time to try and bring my pressure up.
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Anonymous
Re: In-Patient vs. Out-Patient SCT
I had both of my SCTs outpatient at Vanderbilt Clinic. Since we live a couple hundred miles away, my various caregivers and I stayed in an apartment near the hospital for about six weeks each time. Each morning, I would go to clinic's stem cell transplant unit, which was set up similar to an emergency room. I'd have my blood drawn, vitals, weight,temp, etc. taken, Then they'd give me whatever IV's/meds I needed based on the results (platelets, magnesium, antibiotics, etc). This usually took an hour or two a day. Then I'd return to my apartment. If my temp went over 100.5, I would be admitted into the actual hospital. This did occur once for each transplant, usually for about a 3-4 day stay till everything was back to normal. I thought this worked out well for me. I had more choices about food, could get around a little more (had to wear a hospital mask in public); better for my stamina, I thought. One thing that was required: a thorough record of everything I ate, drank, urinated, and excremented (for lack of a better word). And of course, had to keep track of my own medications, but they gave me a good medicine log for that. A nutritionist met with me about diet, etc. Overall, I think this was better than being in the hospital. My insurance paid for the hotel room, and even my caregivers meals (but I admit I have very good insurance).
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lyndaclark - Who do you know with myeloma?: Self
- When were you/they diagnosed?: August 2005
- Age at diagnosis: 49
Re: In-Patient vs. Out-Patient SCT
I had both auto and allo transplants done on an outpatient basis at Seattle Cancer Care Alliance.
This worked well for us. We stayed at a patient facility run through the UW hospital with a van that made frequent trips to the clinic. SCCA does all transplants on an outpatient basis partly, I'm sure, because of cost. They report though that infection rates are lower on an outpatient basis and that the increased activity level is beneficial for patients. It does require that you have a full time caregiver who can stay with you. IV hydration and some drugs are administered through a small back pack that allows you to be totally mobile. I did have to be hospitalized a few times with infections etc but these were very short term. I would only do this on an outpatient basis if I could live very close by as appointments are every day and fatigue levels after transplant can be very high. Good luck with whatever you decide!
This worked well for us. We stayed at a patient facility run through the UW hospital with a van that made frequent trips to the clinic. SCCA does all transplants on an outpatient basis partly, I'm sure, because of cost. They report though that infection rates are lower on an outpatient basis and that the increased activity level is beneficial for patients. It does require that you have a full time caregiver who can stay with you. IV hydration and some drugs are administered through a small back pack that allows you to be totally mobile. I did have to be hospitalized a few times with infections etc but these were very short term. I would only do this on an outpatient basis if I could live very close by as appointments are every day and fatigue levels after transplant can be very high. Good luck with whatever you decide!
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karenh - Name: Karen Hendrickson
- Who do you know with myeloma?: myself
- Age at diagnosis: 59
Re: In-Patient vs. Out-Patient SCT
I had an Auto and an Allo transplant at MD Anderson Cancer Center in Houston Texas. We lived nearby in a temporary apartment as we live in Florida. I never spent one night in the hospital and it was all outpatient. Much more comfortable at the apartment and less infection risk. IV supplies were delivered by a service and with the back pack type pump we did it ourselves. You MUST have a full time care giver but you need that anyway.
We walked a mile to the hospital several days a week for testing and PT. This was not easy, could have taken a bus, but my wife pushed me and my recovery went more quickly!
This is the way to do it in my opinion, if your up to it condition wise and your doctor agrees!
Hugh
We walked a mile to the hospital several days a week for testing and PT. This was not easy, could have taken a bus, but my wife pushed me and my recovery went more quickly!
This is the way to do it in my opinion, if your up to it condition wise and your doctor agrees!
Hugh
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turbineman - Name: Hugh
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: Jan 2006
- Age at diagnosis: 61
Re: In-Patient vs. Out-Patient SCT
lyndaclark wrote:
> I had both of my SCTs outpatient at Vanderbilt Clinic. Since we live a
> couple hundred miles away, my various caregivers and I stayed in an
> apartment near the hospital for about six weeks each time. Each morning, I
> would go to clinic's stem cell transplant unit, which was set up similar to
> an emergency room. I'd have my blood drawn, vitals, weight,temp, etc.
> taken, Then they'd give me whatever IV's/meds I needed based on the results
> (platelets, magnesium, antibiotics, etc). This usually took an hour or two
> a day. Then I'd return to my apartment. If my temp went over 100.5, I
> would be admitted into the actual hospital. This did occur once for each
> transplant, usually for about a 3-4 day stay till everything was back to
> normal. I thought this worked out well for me. I had more choices about
> food, could get around a little more (had to wear a hospital mask in
> public); better for my stamina, I thought. One thing that was required: a
> thorough record of everything I ate, drank, urinated, and excremented (for
> lack of a better word). And of course, had to keep track of my own
> medications, but they gave me a good medicine log for that. A nutritionist
> met with me about diet, etc. Overall, I think this was better than being
> in the hospital. My insurance paid for the hotel room, and even my
> caregivers meals (but I admit I have very good insurance).
I'm heading towards my sct at Vandy under the same program. I'm a little more than half way through my induction chemo so its looking lie sometime in May.
I have a set a goal after I recover: My daughter's wedding.
> I had both of my SCTs outpatient at Vanderbilt Clinic. Since we live a
> couple hundred miles away, my various caregivers and I stayed in an
> apartment near the hospital for about six weeks each time. Each morning, I
> would go to clinic's stem cell transplant unit, which was set up similar to
> an emergency room. I'd have my blood drawn, vitals, weight,temp, etc.
> taken, Then they'd give me whatever IV's/meds I needed based on the results
> (platelets, magnesium, antibiotics, etc). This usually took an hour or two
> a day. Then I'd return to my apartment. If my temp went over 100.5, I
> would be admitted into the actual hospital. This did occur once for each
> transplant, usually for about a 3-4 day stay till everything was back to
> normal. I thought this worked out well for me. I had more choices about
> food, could get around a little more (had to wear a hospital mask in
> public); better for my stamina, I thought. One thing that was required: a
> thorough record of everything I ate, drank, urinated, and excremented (for
> lack of a better word). And of course, had to keep track of my own
> medications, but they gave me a good medicine log for that. A nutritionist
> met with me about diet, etc. Overall, I think this was better than being
> in the hospital. My insurance paid for the hotel room, and even my
> caregivers meals (but I admit I have very good insurance).
I'm heading towards my sct at Vandy under the same program. I'm a little more than half way through my induction chemo so its looking lie sometime in May.
I have a set a goal after I recover: My daughter's wedding.
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Chip - Name: Chip
- When were you/they diagnosed?: 20 November 2010
- Age at diagnosis: 58
Re: In-Patient vs. Out-Patient SCT
I live in Western Australia and I had STC in December and was offered the home program which I was very happy about, far preferable from my point of view, of being in hospital and out of my comfort zone.
My daughter flew over from Sydney to be my carer (a requirement to be on the program) and and nurse visited me every day to take bloods (via a central venous catheter) and do daily observations/monitoring administering iv anitibiotics/fluids etc as required. The nurse also educated my daughter to administer iv antibiotics as well (that turned out to be necessary). My daughter always had support via telephone to the hospital when I would spike a temperature, however apart from going into the hospital a couple of times for blood transfusion/platelets I was able to stay at home which certainly from my point of view was the preferred option.
I am now feeling much better, stronger and currently am just monitored monthly at the haematology outpatient clinic and not on any medication apart from monthly infusions of Zometa (zoledronic acid).
My daughter flew over from Sydney to be my carer (a requirement to be on the program) and and nurse visited me every day to take bloods (via a central venous catheter) and do daily observations/monitoring administering iv anitibiotics/fluids etc as required. The nurse also educated my daughter to administer iv antibiotics as well (that turned out to be necessary). My daughter always had support via telephone to the hospital when I would spike a temperature, however apart from going into the hospital a couple of times for blood transfusion/platelets I was able to stay at home which certainly from my point of view was the preferred option.
I am now feeling much better, stronger and currently am just monitored monthly at the haematology outpatient clinic and not on any medication apart from monthly infusions of Zometa (zoledronic acid).
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Elena - Name: Elena
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: August 2010
- Age at diagnosis: 62
Re: In-Patient vs. Out-Patient SCT
Chip: Good luck with your SCT. All my caregivers and I were extremely impressed with the professionalism, intelligence and care shown by the Vandy staff.
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lyndaclark - Who do you know with myeloma?: Self
- When were you/they diagnosed?: August 2005
- Age at diagnosis: 49
Re: In-Patient vs. Out-Patient SCT
My experience was in-patient, given the severity of my situation, I wound't have made Thu if it was outpatient, The team @ Danna Farber lead by Dr. Paul Richardson did an outstanding job for me. Even my food was costumized to suit my needs, cound't ask for a better place to be under the circumstances! I believe the concept of integration of the chemical treatment, spiritual and psychological, helped me focus on my treatment and be ahead of schedule for discharge.
in-patient is the best approach .
in-patient is the best approach .
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mobile ant
Re: In-Patient vs. Out-Patient SCT
Thank you all for your responses! This has been a whirlwind of information and decisions for us. We initially thought EJ was ready to have his SCT at the end of March, but some of his bone marrow test results were misread and it turns out he needs to go back on the Velcade/dex for two more rounds. Frustrating! When we initially spoke to the transplant doc a few months ago, it seemed like he was leaning towards doing the SCT on an outpatient basis. When we spoke with him a week or so ago, his team seemed to be leaning towards doing it on an inpatient basis. We were very confused! We talked with the folks at Dana Farber and they only do it on an inpatient basis, so I think this is the way EJ is leaning. Now that he is back on the Velcade/dex, he has a little bit of breathing room before he has to make up his mind.
Thank you all again! It's nice to have a place we can go to ask questions and get input from people who have "been there".
Lyn
Thank you all again! It's nice to have a place we can go to ask questions and get input from people who have "been there".
Lyn
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Christa's Mom - Name: Christa's Mom
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: September, 2010
- Age at diagnosis: 53
18 posts
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