• Fatigue – expect fatigue for 6-8 weeks or more
• Mouth Sores – to avoid mouth sores: fill your mouth with ice chips the entire time you get Stem Cell Transfer infusion. If you can talk, you don’t have enough ice chips in your mouth!
• Plastic utensils – use plastic utensils to reduce mouth irritation
• Stay hydrated – hydration is important: drink 3 L water daily. Especially when on medications.
• Feeling cold – you will probably be cold, as your hemoglobin will be very low. Your head may be continually cold so take a toque. Take layers of warm clothes, fuzzy socks and a cozy blanket or two.  If you have access to a clothes dryer, the blanket can be heated up for comfort.
• Occupy yourself – you may have long days sitting in a lounge chair at the hospital while you have IV Fluid or Blood Transfusions. It is helpful to have books, playing cards, crossword puzzles, sudoku, phone or video games, knitting or other crafts to pass the time.  Audible app – listening to books can be helpful during treatments & recovery.
• Exercise – try to get some exercise every day: walks, stretching/yoga, swimming.
• Beware: green tea, turmeric, and grapefruit juice may interfere with chemo effectiveness.
• Protect yourself – limit or avoid exposure to plants & animals to prevent the risk of infection. Do not visit gardens, farms, or tulip festivals etc., following a transplant.
• Identify yourself – Following your transplant, it is recommended that stem cell transplant patients wear a medical bracelet indicating their requirement for “irradiated blood products only” in case a blood transfusion is ever required.
• Communicate with your BMT health team – the side effects of a transplant seem to be different for everyone. You must let your nurse know what you are suffering.  Do not minimize any effects, as there are things that can be done to lessen most side effects. There is no benefit in being “a stoic patient.”

Stay hydrated

It is important to drink lots of water, which helps to aid & regulate digestion, lubricate joints, make saliva which helps with digestion, balance your body’s chemicals, deliver oxygen to your body, and regulate body temperature.

Oral hydration solutions such as hydrolyte can be beneficial to improve your body’s electrolytes and glucose balance and increase your energy level.

Exercising during chemotherapy or stem cell transplant

It is very important to continue to exercise to maintain your strength and circulation and help lessen the side effects of your treatments.  Daily walks improve and maintain your cardiovascular health, mental health, and endurance, which are known to decrease cancer related fatigue. 

If you feel nauseous or unwell, do what you can, but here are some suggested exercises after being discharged from the hospital:

• Marching on the spot is good to keep strength and balance – lift foot approximately 6inches off the ground – make sure to hold on to something (windowsill or furniture or countertop) – start with one minute
• Daily walks – laps around the house or out in a non-busy community area to avoid infections – start with a short distance (e.g. a neighbours house or a tree) then increase a little bit every day
• Spend time sitting up in a chair
• Try to work up to 150 minutes per week of moderate aerobic exercise – walking or cycling
• With a Hickman line, avoid resistance exercise on that side, and no swimming since you don’t want to get the port line wet. The maximum lifting weight is 10lbs.
• Good posture is important for strength and balance, so keep good posture throughout the day
• Do some strength exercises such as resistance bands, light weights (max 10lbs) 2 to 3 times per week
• Set up a daily schedule with goals to help keep you motivated

• It is very important for recovery to eat, even when not interested in food.
• Try frequent small meals or snacks
• Drink lots of water: 2-3 litres per day
• Juicing, smoothies, and shakes may help to increase nutritional intake
• High protein energy drinks such as Boost or Ensure may help
• High-calorie snacks like avocados/guacamole, energy balls, ice cream, milkshakes
• Popsicles & rice crackers might help
• Cannabis can increase appetite
• Watch the food network

• To help with bone pain, take extra-strength Tylenol every 4-5 hours. Consult your doctor.
• Do not take Advil as it can lead to kidney problems
• Drink lots of water to avoid cramps and pain.
• Magnesium may help with the pain, but to avoid side effects of diarrhea, magnesium glycinate may be preferable to magnesium citrate or gluconate
• Heating pad or ice may help.
• Request a prescription for codeine to have on hand in case of need.
• Some people take Claritin to ease bone pain side effects of Neupogen injections. Please consult your doctor.
• Try medical cannabis (CBD) for pain.

• Exercise regularly – moving your body will keep your bowels moving, too.
• Check your diet – eat more fiber
• Stay hydrated
• A cup of coffee in the morning can help
• Adjust your toilet posture – squat, raise your legs or lean back can help
• Supplements or foods containing prebiotics, like bananas and oatmeal, and probiotics, like yogurt and fermented foods, may help.
• Start moving first thing in the morning.
• Massaging your stomach may encourage bowel movements
• Over the counter constipation remedy such as RestoraLAX can help.
• keep a log of daily bowel movements to track whether you’re having less bowel movements than normal.

As a last resort take laxatives – this should be for short term only.

• Stay hydrated – drink lots of fluids (6 to 8 glasses/day) of water ideally but also fruit juice, caffeine free soda, salty broth. Be careful not to drink to much too fast as may cause stomach pain. Drinking a sip every 10 minutes may work for you. Drink 1 full glass of water right after a loose bowel movement.
• Keep a log – track your daily bowel movement – severe diarrhea means 6 to 8 bowel movements (loose or not) a day.
• Oral hydration solutions – take oral hydration solutions such as hydrolyte to improve your body’s electrolytes and glucose balance.
• Imodium – Imodium has shown to be effective in reducing diarrhea but may also swing you to constipation – half a pill every morning may wok for you.
• Fiber supplements – finer supplements such Metamucil increases the bulk of your stool as well as increases the levels of water in the stool, making the stool softer and easier to pass.
• Prescription medication – prescription medication such as Olestyr (cholestyramine – a bile acid sequestrant) can reduce diarrhea.
• Prescription medication – prescription medication such as Lomotil can reduce the pain/cramps associated with diarrhea.

• Brush your hair gently using a soft hairbrush.
• Consider cutting your hair short before transplant. Longer hair comes out more easily and makes hair loss more noticeable.
• Wear soft hats, head scarves or wigs to keep your head warm and protected.
• Visit the Look Good Feel Better website 
• Visit the BC Cancer website 
• Additional information can be found under our Resources – Other Local Services – Vancouver Area Hair Loss Services.

• Keep the dressing over the IV line DRY at all times.
• Cover your IV-line dressing prior to bathing as the dressing itself is NOT waterproof.
• If you have a detachable shower head, try to aim the water away from the covered IV line dressing.
• Use cling wrap or silicon patch that is slightly sticky on one side, allowing it to cling to your skin and to itself (buy at a grocery store).
• DO NOT allow the IV line to be submerged under water even if protected by a cover.
• DO NOT remove the IV line dressing yourself in the event of it getting wet
• To increase comfort, create a ‘sling’ type apparatus around the neck and tube ends. Securing the tube ends with either soft yarn, shoe string or ribbon provides support to the tubes.

• Take short naps of 15-20 minutes during the day.
• By being active during the day you will get a better nights sleep.
• Wake up and go to bed at the same time every day.
• If you’re looking starting with natural supplements before taking prescription sleeping pills consider:
  • Cannabis THC – gummies seem to work best.
  • Melatonin supplement can be very affective for insomnia
• If sleep is still challenging you can ask your doctor to prescribe sleeping pills – especially on your dexamethasone days. Note that some are more addictive (zopiclone) than others (trazodone).
• Relax before bedtime – have a warm shower, listen to music, read, listen to audiobooks or podcasts. Try to avoid screen time – TV, cell phones and other electronic devices.
• Avoid caffeine consumption at least 6 hours before bedtime. Note that caffeine is found in coffee, non-herbal tea, chocolate and soft drinks. 
• Avoid heavy drinking or meals 2 hours before bedtime.
• Ensure your sheets, pillows and mattress are comfortable.
• Block out distracting light, sound with ear plugs and/or sleep mask.
• Wake up and go to another room to read or relax if you are tossing and turning in bed. Stay there until you feel sleepy and return to your bed.
• Consider sleeping alone on your dexamethasone nights.
• Some feel taking dexamethasone at night as opposed to morning lessens its side effects. Note dexamethasone should be taken with food.

• Try THC for sleep and CBD for pain and anxiety.
• Hops can be steeped to make tea, which can help with insomnia. Check with your doctor or naturopath to make sure its OK with medications
• Visit the BC Greenleaf Medical Clinic which offers virtual appointments with a specialist and excellent webinars/workshops 
• BC Cancer Cannabis Trial: https://bccancerfoundation.com/clinical-trial-cannabis-cancer-related-symptoms

• Headspace app for guided meditation.
• Faith and embracing connections are helpful.
• Anxiety Canada: anxietycanada.com
• Mindshift CBT (Cognitive Behavioural Therapy) app

Inspire Health offers free meditation classes for people with cancer. Visit Inspire Health for class schedules.

• Ice chips – fill your mouth with ice chips the entire time you get the stem cell infusion. If you can talk, you don’t have enough ice chips in your mouth!
• Rinse – rinse your mouth with baking soda & water 4-5 times/day
• Candy – suck on a hard candy during chemo infusion
• Plastic utensils – use plastic utensils/cutlery to avoid the metallic taste
• Dry mouth – for dry mouth, try Magic Mouthwash or Uncle Toms mouth wash (there is no alcohol in this one)

• Ginger Gravol
• Licorice can reduce nausea – Natural Factors DGL Deglycyrhizinated Licorice root is excellent, available in Whole Foods and London Drugs. 1 minute of chewing and nausea passes
• Coconut water
• Cannabis can reduce nausea
• Ginger, ginger ale, ginger tea

• Consider a whole food anti-cancer diet
• Juicing may help to increase nutrition
• Hydrate: drink 3 L water daily. Especially when on medications.
• Beware of green tea, turmeric, and grapefruit juice may interfere with chemo effectiveness.
• Beware of taking calcium if not in remission. Check with your doctor.

Inspire Health offers free nutritional programs and webinars for people with cancer. Visit Inspire Health for class schedules.

Repeat a personal mantra to keep positive thoughts in mind and push fear and anxiety away.

For example, I am strong; I am resilient; I am safe; I am brave; I’ve got this; I can do this; I am not alone.

• Oatmeal shampoo & moisturizer, Biotin, Argan oil, Calamine lotion
• 1% cortisone cream
• Tea tree oil

• Gas, diarrhea and constipation can all cause unpleasant stomach pain. A heating pad may alleviate the discomfort.
• Stay hydrated.
• Drink spearmint or ginger tea.
• Apply heat via a heating pad
• Avoid carbonated beverages.
• Drink liquids at room temperature, not too hot or too cold.
• Avoid foods known to cause excess gas.
• Avoid artificial sweeteners.
• Eat slowly and chew your food well.
• Don’t chew gum.
• Don’t smoke or chew tobacco.
• Don’t hold in gas/farts….let it rip and blame the dog.
• For severe stomach pain, ask your doctor for pain relief medication such as Buscopan.

Naturopathic remedies and supplements:

• Mistletoe as a subcutaneous injection and an IV infusion may help control light chains. Consult your doctor.
• Some patients have tried supplements including reishi mushrooms, alpha-lipoic acid, curcumin, coenzyme Q-10, vit c & d, and cannabis to relieve various symptoms. Consult your doctor.

Calcium supplements:

Do not take calcium supplements without first checking with your doctor, as myeloma can increase blood calcium, and too much calcium in the blood can be unhealthy.