Planning Ahead

The planning phase begins when the patient first considers transplant as a treatment option. The goals of this phase are to make the decision to accept transplantation, to gain access to treatment, and to make preparations to initiate treatment.

Choosing A Transplant Center
Generally four factors affect a patient's decision to select a given center for transplant:

1. Opinion of the referring physician
2. Geographic location of the center
3. Insurance reimbursement issues
4. Personal preference

Click here to find out more about factors to consider in choosing a transplant center.

Patients choosing to undergo a transplant through the Fred Hutchinson Cancer Research Center's Bone Marrow Transplant Program are admitted to the Seattle Cancer Care Alliance (SCCA) for their patient care.

Assessing Financial Coverage
A finance representative will be assigned to work with the patient in financial planning matters throughout treatment. The patient will be given information on what is required financially to begin treatment and an estimate of the total cost. A financial representative will work with the patient and the insurance company to develop a financial plan that covers the costs of treatment. If financial shortfalls are identified, information will be made available for alternative funding through such activities as fundraising. To contact an SCCA financial representative call (206) 288-1113.

Advance Directives
Advance directives includes such documents as "Durable Power of Attorney for Health Care" and living wills. Completing these documents enables a patient and family to specify someone who shall be legally responsible for making decisions about medical treatment should the patient become incapable of making them. Prior to your arrival you will receive information in the mail about Advance Directives.

Selecting A Caregiver
Because it is now possible for a patient to receive much of the transplant regimen outside of the hospital setting, a caregiver is necessary to assist with daily activities, as well as to assess the patient for symptoms that should be reported to the transplant team. Additional responsibilities for the caregiver may include dispensing of oral medications and administering of intravenous fluids, antibiotics, and antiviral agents via an infusion pump. Such sophisticated care can be delivered only by a responsible adult who has been educated by the transplant team.

Schooling
The Hutch School is a fully accredited program for grades K through 12. The program provides education for both school-aged patients and family members. Patients are tutored on a one-to-one basis, both as inpatients and outpatients.

Childcare
Spouses of patients with small children have found it difficult to juggle the roles of parent and caregiver. It is recommended that the patient designate a person to provide childcare and select another person to be caregiver. We are unable to provide childcare services for young children. A list of local childcare agencies will be provided upon request.

Planning To Stay In Seattle
A specific social worker will be assigned to work with the patient throughout the transplant process. They will provide assistance with housing and school arrangements, airline letters for changes in flight plans and verification of the medical circumstances to an employer. Volunteer services are available to patients and families and will be assigned on an individual basis. Services depend upon the patient's individual needs and can include airport pickup, orientation tours of the Seattle area, errands, shopping, and so on.

• SCCA Social Work Department can be reached at (206) 288-1076.
  
  
• SCCA Housing Coordinator can be reached at (206) 288-1078.
  
  
• SCCA Volunteer Program can be reached at (206) 288-1075.

Special Preparation

• Dental Preparations: One of the most common sources of infection is the mouth, so the SCCA Oral Medicine Department routinely examines the patient for dental problems before therapy begins. To avoid a delay of the transplant, the patient should see a dentist before arriving in Seattle. The dental visit should include a thorough examination to detect cavities or other problems. Ideally, these problems should be treated and healed before the patient arrives for treatment.
  
  
• Immunization: Families and patients are encouraged to receive flu shots prior to arrival.
  
  
• Fertility: The expectation is that patients will be sterile following transplant. Storage of sperm or ova should be considered, if having children is a part of your plan for the future.

	Planning Ahead
	Preparation
	Conditioning
	Transplant
	Waiting For Engraftment
	Engraftment And Early Recovery
	Long Term Recovery