I was just wondering what is considered an inpatient stem cell transplant, and what is considered an outpatient stem cell transplant?
What is the main difference between the two that makes one an "inpatient" transplant, and the other an "outpatient" transplant?
If you are in the hospital for a approximately 5 days and then have to be within 30 minutes of the facility for 20 more days, is this outpatient or inpatient?
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dogmom - Who do you know with myeloma?: husband
- When were you/they diagnosed?: December 2015
- Age at diagnosis: 58
Re: Inpatient, outpatient stem cell transplant: difference?
Good morning, Dogmom:
This is one of the many issues that differ from center to center, and it also differs over time as outpatient is becoming a bit more the trend.
My wife had her autologous stem cell transplant at Memorial Sloan Kettering Cancer Center (MSKCC) last February. At that time, about half the patients started out as outpatients. Starting out as outpatients, the intent was the entire procedure was done that way, and not to be admitted into the hospital at all. Of those outpatients, about half of them developed a fever or other condition requiring admittance.
In my wife's case, she had a bad screening test (turned out to be a false alarm) so they required inpatient on a heart monitor the entire time, originally they slated her (and we accepted) as outpatient.
So I would look at your logistics as partial inpatient/partial outpatient, in that you are planned to go inpatient for a portion of the time. If during the outpatient portion of the procedure, a condition develops out of certain range (for instance a fever), I would expect your husband would be quickly admitted.
Good luck to you.
This is one of the many issues that differ from center to center, and it also differs over time as outpatient is becoming a bit more the trend.
My wife had her autologous stem cell transplant at Memorial Sloan Kettering Cancer Center (MSKCC) last February. At that time, about half the patients started out as outpatients. Starting out as outpatients, the intent was the entire procedure was done that way, and not to be admitted into the hospital at all. Of those outpatients, about half of them developed a fever or other condition requiring admittance.
In my wife's case, she had a bad screening test (turned out to be a false alarm) so they required inpatient on a heart monitor the entire time, originally they slated her (and we accepted) as outpatient.
So I would look at your logistics as partial inpatient/partial outpatient, in that you are planned to go inpatient for a portion of the time. If during the outpatient portion of the procedure, a condition develops out of certain range (for instance a fever), I would expect your husband would be quickly admitted.
Good luck to you.
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JPC - Name: JPC
Re: Inpatient, outpatient stem cell transplant: difference?
Yes, what JPC said.
Inpatient: the standard procedure is to admit the patient to the hospital right away, and keep them there through the whole thing, even if things go perfectly.
Outpatient: the standard procedure is for the patient to stay in nearby housing, like a patient house (like Hope House in Boston) or an apartment and come to the clinic every day. My transplant was outpatient, and I spent every week day between 8 and 3, and part of every weekend (one hour check in with the nurse) in the clinic, but then would go "home" to my apartment the rest of the time. Here, the patient only gets admitted to the hospital if something crops up, like fever or intractable vomiting or something like that.
There's plenty of evidence that patients do better with mobility vs debility, recovery and depression as an outpatient. Who could blame them? But when things start going wrong, there are things that can only be accomplished IN the hospital. That's the fundamental question - can we accomplish what needs to be done as an outpatient? If not (for whatever reason), then into the hospital you go.
Each institution does it a little differently, and the risks of auto stem cell treatment are a little different for the different indications, too. There's also the condition of the patient to begin with (hardy vs fragile) and how much trustworthy support they have outside the hospital. A frail eldery-ish patient with only a frail, elderly partner for support is very different than a hardy 35 year old with husband and parents right their side every day.
Inpatient: the standard procedure is to admit the patient to the hospital right away, and keep them there through the whole thing, even if things go perfectly.
Outpatient: the standard procedure is for the patient to stay in nearby housing, like a patient house (like Hope House in Boston) or an apartment and come to the clinic every day. My transplant was outpatient, and I spent every week day between 8 and 3, and part of every weekend (one hour check in with the nurse) in the clinic, but then would go "home" to my apartment the rest of the time. Here, the patient only gets admitted to the hospital if something crops up, like fever or intractable vomiting or something like that.
There's plenty of evidence that patients do better with mobility vs debility, recovery and depression as an outpatient. Who could blame them? But when things start going wrong, there are things that can only be accomplished IN the hospital. That's the fundamental question - can we accomplish what needs to be done as an outpatient? If not (for whatever reason), then into the hospital you go.
Each institution does it a little differently, and the risks of auto stem cell treatment are a little different for the different indications, too. There's also the condition of the patient to begin with (hardy vs fragile) and how much trustworthy support they have outside the hospital. A frail eldery-ish patient with only a frail, elderly partner for support is very different than a hardy 35 year old with husband and parents right their side every day.
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Tracy J - Name: Tracy Jalbuena
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 2014
- Age at diagnosis: 42
Re: Inpatient, outpatient stem cell transplant: difference?
Thanks for your replies.
The plan is for admit, chemo next day, 24 hours for chemo to clear, stem cell infusion the next day and discharged the next day.
We could come home if we did not live an hour away so we will be staying in an Extended Stay America about 5 minutes away for approximately the next 20 days depending on how quickly his counts rise. It has a mini kitchen with stove, full size fridge, sink, microwave.
We also had the option of staying at Hope Lodge and we toured it. It is nice and would be free but they do not allow eating or drinking of any kind in the rooms, and we would prefer to be able to do that.
The Extended Stay offers a medical discount and is used by other hospitals in the area as well.
The plan is for admit, chemo next day, 24 hours for chemo to clear, stem cell infusion the next day and discharged the next day.
We could come home if we did not live an hour away so we will be staying in an Extended Stay America about 5 minutes away for approximately the next 20 days depending on how quickly his counts rise. It has a mini kitchen with stove, full size fridge, sink, microwave.
We also had the option of staying at Hope Lodge and we toured it. It is nice and would be free but they do not allow eating or drinking of any kind in the rooms, and we would prefer to be able to do that.
The Extended Stay offers a medical discount and is used by other hospitals in the area as well.
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dogmom - Who do you know with myeloma?: husband
- When were you/they diagnosed?: December 2015
- Age at diagnosis: 58
Re: Inpatient, outpatient stem cell transplant: difference?
Hello dogmom, and good luck with your upcoming stem cell transplant.
Previous posts have well defined inpatient and outpatient SCT. It will vary from patient to patient depending upon the protocol at the transplant facility and the patient's health issues.
I have atrial fibrillation so my doctor decided to do my SCT inpatient. All that means is I was monitored 24/7. The transplant procedure is exactly the same. I spent 15 days in the hospital watching the World Series, and Netflix, and a few weeks at a local hotel.
My SCT went extremely well and I think a great deal of that had to do with the attention you get as an inpatient. When nausea attacks (and it will), they were right there injecting Zofran into my port. That won't happen at the Marriott. You are going to be down and out anyway, so it's not like you are going to miss anything for a few weeks. Talk to your doctor and discuss what is best for you.
Wishing you all the best.
Previous posts have well defined inpatient and outpatient SCT. It will vary from patient to patient depending upon the protocol at the transplant facility and the patient's health issues.
I have atrial fibrillation so my doctor decided to do my SCT inpatient. All that means is I was monitored 24/7. The transplant procedure is exactly the same. I spent 15 days in the hospital watching the World Series, and Netflix, and a few weeks at a local hotel.
My SCT went extremely well and I think a great deal of that had to do with the attention you get as an inpatient. When nausea attacks (and it will), they were right there injecting Zofran into my port. That won't happen at the Marriott. You are going to be down and out anyway, so it's not like you are going to miss anything for a few weeks. Talk to your doctor and discuss what is best for you.
Wishing you all the best.
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Dano - Who do you know with myeloma?: Me
- When were you/they diagnosed?: Jan 2014
- Age at diagnosis: 65
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