Bone Marrow Harvesting

WHAT YOU SHOULD KNOW

• Allogeneic (AH-lo-jeh-NEY-ik) : This type of transplant is taken from an unrelated individual. Before the marrow is harvested, the donor must undergo a variety of tests to make certain that his or her marrow will match the recipient's as closely as possible
• Syngeneic (SIN-jeh-NEY-ik) : Here the transplant is taken from the recipient's twin. Despite the close relationship, careful testing for a close match still is required.
• Autologous (aw-TAHL-uh-gus ): This is a transplant of the recipient's own marrow---harvested, treated, stored frozen, and later returned to the body. If you are acting as your own donor, after the marrow is taken you'll need to go through a conditioning program in which all your remaining marrow is killed with high-dose radiation or chemotherapy (cancer drugs).

Risks

IF YOU'RE HEADING FOR THE HOSPITAL...

Before You Go

• The Week Before the Procedure:
• • You'll probably need to stop taking aspirin and ibuprofen; the doctor will tell you when. If you're taking aspirin for your heart, don't stop without asking the doctor first. Also ask whether you can take any over-the-counter medicines.
• The Night Before the Procedure:
• • The doctor may suggest you take a sleeping pill.
  • Just before the procedure, you should not eat or drink anything (even water). Your doctor will tell you when to begin fasting.

When You Arrive

• Check with your doctor before taking insulin, diabetes pills, blood pressure medicine, heart pills, or any other medication on the day of the procedure.
• Do not wear contact lenses to the hospital. You may wear glasses.

What to Expect While You're There

• Taking Vital Signs: These include your temperature, blood pressure, pulse (counting your heartbeats), and respirations (counting your breaths). A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm.
• Blood Tests: You may need blood taken for tests. It can be drawn from a vein in your hand or from the bend in your elbow. Several samples may be needed.
• Chest X-ray: The doctor will check this picture of your lungs and heart to make sure that you're healthy enough to undergo the procedure.
• Heart Monitor: (Also called an electrocardiogram [e-LEK-tro-KAR-di-o-gram] or EKG). Typically, three to five sticky pads are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen or to a small portable box (telemetry unit) that shows a tracing of each heartbeat.
• IV: A tube placed in your vein for giving medicine or liquids. It will be capped or have tubing connected to it.
• Pulse Oximeter: With a little clip connected to your ear, finger, or toe, this machine measures the oxygen in your blood.
• Anesthesia: You'll need a painkiller during the operation. For bone marrow harvesting, the following options are available:
• • Spinal Anesthesia: This type of anesthesia requires an injection in the spine. You will be awake during the procedure but will be numb below the waist. Feeling will return in about 2 hours.
  • Epidural Anesthesia: With this type, a tiny tube is positioned near the spine, allowing administration of additional medication during the operation. You will be awake during surgery but will be numb below the waist. Feeling will return to your legs when the anesthesia wears off.
  • General Anesthesia: This alternative puts you completely to sleep throughout the operation. The anesthetic is given either as a liquid in your IV or as a gas through a face mask or endotracheal (END-o-TRA-kee-ull) tube placed in your mouth and throat.
  • Local Anesthesia: This is simply a pain-killing injection at the site of the operation. You'll remain awake, and may feel some painless pressure or pushing.

During the Procedure

After the Procedure:

• Ice: For pain or swelling, you may put ice in a plastic bag, cover it with a towel, and place it over the incision for 15 to 20 minutes out of every hour as long as necessary. Do not sleep on the ice pack. Treatment with ice is most effective when started right after the procedure and used for 24 to 48 hours.
• Heat: After the first 24 to 48 hours you may use heat for pain or swelling. Apply a heating pad (turned on low) or a hot water bottle, or sit in a warm water bath for 15 to 20 minutes out of every hour as long as you need relief. Do not sleep on the heating pad or hot water bottle. Heat brings blood to the area of the operation and helps it heal faster.
• Medicines:
• • Antibiotics: These medicines help prevent bacterial infection. They may be given by IV, as a shot, or by mouth.
  • Pain Medicine: To ease pain after the procedure, your doctor will probably prescribe medication to be given by IV, as a shot, or by mouth. Tell the doctor or your nurses if the pain won't go away or keeps coming back.
  • Anti-Nausea Medicine: This medicine calms your stomach and controls vomiting. Your doctor may suggest you take it at the same time as your pain medicine, which sometimes upsets the stomach.

After You Leave

• Take any medicine you've been prescribed exactly as directed. If it doesn't seem to help, let the doctor know, but keep taking it until told otherwise. If you've been prescribed antibiotics, be sure to use them up, even if you're feeling better. If a medicine makes you drowsy, avoid driving or using dangerous machinery.
• Eat healthy meals from all 5 food groups: meat and fish, fruits, vegetables, breads, and dairy products. This will increase your energy level and promote faster healing.
• Unless instructed otherwise, drink 6 to 8 large glasses of liquid, such as water, juices, and milk, each day. Limit caffeinated beverages, such as coffee, tea, and soda.

Call Your Doctor If...

• You are running a high temperature.
• The area where the bone marrow was taken becomes red, swollen, or tender. You may have an infection.

Seek Care Immediately If...

• You suddenly have chest pain or trouble breathing. You could have a blood clot in your lung or an allergy to one of your medications.
• Your bandage becomes soaked with blood.
• You develop a high fever.
• Your legs become swollen or painful.

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