When can I expect to feel better after transplant?

When can I expect to be feeling better? How long will it take to fully recuperate from the autologous stem cell transplant?

So that's a very interesting question on how long does it take for the patients to recuperate after the stem cell transplant? And we get this question a lot because a lot of our patients want to understand the big picture first.

Right.

And what we usually what I usually tell my patients is that I would say split this post-transplant period into three big periods. That early post transplant, 0 to 3 months after the transplant. This is a time when you feel more vulnerable, more fatigued, more sick. This is a time when you still encounter the complications of the conditioning regimen that high dose Mel plan.

If we, let's think about multiple myeloma. For example, for the first two weeks, patients are in the hospital, you know, we are kind of there is a notion of moving more toward the outpatient transplant. But still, about 50% of the patients eventually have to come in because they are not feeling well. They are fatigued.

The counts are very low.

They might have just GI effects like nausea, bloating, know diarrhea, vomiting. And sometimes they are not able to compensate with how they eat.

You know, they lose weight because of that. They're not able to drink enough fluids. Again, I'm just using those drastic examples of, some patients do just fine. They might have a little bit of, a little bit of fatigue and bloating, but they're still able to manage through.

But, a lot of time patients have to come in for the first two weeks. The counts are low. And this is expected is a side effect of the hydrogen elfalan. And it is what we expect. And sometimes patients may develop fevers and have to come in for the idea antibiotics to get treated after this two weeks.

I would say the side effects are getting better. They're slowly the GI effects nausea, vomiting, diarrhea slowly, slowly subsides in about 4 to 6 weeks post-transplant. Fatigue starts to get better with these bodies. Crawl back and start, you know, encountering this, you know, pleasure of eating again. You know, it's surprising. It's very revealing of how much we enjoy eating.

It's not only what we use for leaving, but how much we enjoy the pleasure food, the food that we like, you know, and it's very revealing to the patients when they, when they say like, I don't like coffee anymore. I used to be such a big coffee drinker, and I'm no longer a coffee drinker, or I can't even take the orange juice because I have the mouth sores and, then things, and we have to just educate the patients and say, well, I know you're going through this now, but it's going to get better.

And usually by three months, patients feel like two thirds back to normal. And then we have this intermediate period for post-transplant 3 to 6 months.

This is a time when patients continue to recover. The getting more strength, the getting more stamina. They are able to eat the usual food. They ask to go out. Some patients are like, can I go back to work?

And you know, and after six months I would say up to 1 to 2 years post-transplant. This is what we consider the late, post-transplant recovery period. And usually 1 to 2 years after the transplant, patients will feel back to normal.

so the time that you are here with us is about three weeks.

We always say three, four weeks is three weeks, because while the stem cells collection is in outpatient setting, you know, before then, you count the day of chemotherapies minus one, then the day zero, you got the stem cells infusion, and then the first week you'll see the count dropping down, and then we start the growth factor support.

By day five. And then the counts start to recover by day 12

But the next week everything will start to come back. And so by three weeks the majority of patients are back home.

Now for the first few months we recommend to stay quite protective. We don't recommend to go back to work or to travel.

It takes another couple of months for the immuno system to recover.

And, so for patients going back to work, we say at least three months from the chemotherapy.

So how long can does it take to feel fully recovered from a transplant? It just depends. Everybody's a little bit different. I have some patients that are back at work, you know, 2 to 3 months after a transplant, you know, working 60 hours a week.

I have some people that it takes months, sometimes longer, sometimes they can't go back to work because they just don't have the energy they need to perform their job. So I think, I think it really is very individual. I think there's no I think what people should know is there's no reason to expect kind of at the beginning that this means that, you know, for like a year, they're going to be totally out of commission, but everybody is a little bit different.

And so to to just listen to your body, if you feel like you're, you know, you you feel like it's taking you longer, that's that happens.

It just depends. For most people, they kind of feel kind of mostly back to normal by a month or two months, but everybody's a little different. And everybody, everybody deals with the side effects differently.

And so it's just takes time and just, you know, if you're taking longer, that's okay. I mean, you probably want to make sure there's not something else going on, but, you know, give yours, you know, don't don't be too hard on yourself.

Is there anything an individual can do prior to transplant to help with the recovery process?

I think being sort of in general good health is a sort of a prerequisite for doing a transplant. And so, you know, I think just trying like I earlier, I was joking, oh, this is not a marathon.

You don't have to train for it, but you have to stay healthy. You know, certainly if you're smoking try to quit smoking. You know, we we usually advise people not to drink excessively, you know, and certainly doing a transplant, probably a good idea, you know, to sort of avoid for a while.

Some patients, you know, they will they just won't drink for a few months, drink alcohol for a few months until the transplants done. You know, trying to keep your body sort of in tough, physical condition as best for you doesn't mean you need to train for it. But just trying to stay healthy, trying to improve any bad habits you might have.