Preparing for Isolation

We have put this article together for patients preparing for a stem cell transplant and hospital isolation. If you have any additional questions, speak to our doctors or medical staff, they will help clear any doubts you may have.
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What will I be allowed to do?

At first, you will be required to stay in your room at all times. In order to prepare for this, you should bring lots of activities to keep you busy. Once you have undergone your stem cell transplant, there may be periods where you feel fatigued and have trouble concentrating. Therefore, it is important to ensure the activities you have prepared are not too demanding.
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When will I be able to leave my room?

As your blood cell counts start to rise, you will be allowed to leave your room. You may even be able to go outside for a short duration. Our doctors will determine whether or not you are allowed to do so as they will be monitoring your recovery and progress.
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Will I be allowed visitors?

Yes, you are allowed to have some friends and family visit. However, it will be a few named visitors, and they will be required to wear protective equipment and take precautions to lower the risk of infection. If you are a parent, your children may be able to visit your ward. However, they may not be allowed into your room.
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How long do I need to be in isolation?

The duration for which you will need to be in isolation varies for individuals. Your blood cell counts will determine how long you need to stay in isolation. Our medical team will check your blood counts daily to keep an eye on your progress.
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Why is protective isolation necessary?

Your immune system may need some time to develop once you have received the donor stem cells. You will be at a higher risk of developing an infection during this time, so you will need to take precautions.
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Preparing for Hospital Isolation

You will either be placed in protective isolation before your transplant or in the days leading up to it. If you have been diagnosed with blood cancer, you may have been through protective isolation following your chemotherapy. The purpose behind this is to ensure a germ-free, sterile environment while your blood cell counts are given time to recover.
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During protective isolation, you will be in your own room. Your room will be equipped with a shower, toilet, and bed. Your room will also come with an emergency button should you need immediate help.
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Your room will have a HEPA filter system to help keep the air inside clean. Both your windows and doors need to be kept shut for the duration of your stay. The room will be cleaned daily, and your bedding will be changed, as well. Clean your belongings daily by wiping them often.
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These measures are in place to reduce the risk of infection by keeping your environment as clean and sterile as possible.
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Your visitors and medical team will need to sanitise their hands with an alcohol wash before entering your room. They will also be required to wear protective gowns and gear.
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During the first few weeks following your stem cell transplant, you will put on a special diet to help reduce the risks of contracting an infection from the food. This diet will be void of bacteria-rich food, for example, yoghurt and soft cheeses.
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How to prepare for protective isolation?

Packing a bag

When you are preparing for protective isolation, you will need essential items like clothing, pyjamas and a toiletry bag. However, you will also need to think about what activities you want to bring along with you.
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Here is a list of some things you might want to consider packing:

• Books, magazines, and other reading materials
• Electronic tablet
• Mobile phone
• Craft supplies
• Earplugs
• Eye mask
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Asking for help

Patients may worry about who will handle their affairs while they are in protective isolation. Do not hesitate to ask for help and support when it comes to your children, pets, or home. Your friends and family will be happy to help. While many are eager to help you wherever possible, they may not know how. Therefore, try asking them for help with specific tasks such as feeding a pet, keeping home affairs in order, or watching your children.
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Planning a visit

Before you go into protective isolation, find out whether or not you can receive visitors. This can help you prepare for what you are to expect during your stay.
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Asking questions

Preparing for isolation, like any new situation, can seem daunting if you are not prepared with what to expect. Clear any doubt with our medical team – even if they appear smaller and more trivial. Do not be afraid to ask questions about parking at the hospital, food, if there is Wi-Fi.
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Your time in isolation

Routine

Many stem cell patients who have undergone protective isolation say that a daily routine helps the time pass easier. It may be a simple routine; however, it will help you feel more normal.
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Make an effort to do things you would do at home. For example, getting out of bed and taking a shower can help you feel more normal than you realise. If you find there are days that you are too tired to do this, try to get out of bed just for your meals.
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Keeping your mind busy

Keeping your mind occupied and entertained will help the time pass quicker. Read books, watch movies, listen to music or podcasts.
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Your smartphone or tablet will prove very useful during this period. Use it to keep in touch with your friends and family. Make use of social media to stay up-to-date with world events.
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Unlocking your creative side might feel a little tricky during this time. However, it will help your time in isolation go by quicker. Try to use it as a means of expressing the things you are feeling. Many find it easier to express themselves in this way as compared to talking about their feelings.
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You might find that at times it is difficult to concentrate or focus. However, bringing along a hobby is recommended for when you find that you have the energy for it.
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Managing your expectations

You may find that there are times when you do not have the energy to do the things you enjoy. Keep in mind that some days will be more difficult than others.
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Do not be too hard on yourself if you find that there are days that you only want to stay in bed and watch television. However, on the days that you feel better, try to take advantage of them by filling your time with an activity you enjoy.
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Staying active with exercise

Small bouts of movement and exercise can help improve fatigue and your overall mood. Try to stretch by moving around your room. Speak to your physiotherapist and see if they have any specific exercises or stretches to recommend. Try different breathing techniques which you can practise regularly. This will also reduce your chances of developing a chest infection.
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Adjusting your sleep cycle

Getting your body to adapt to new surroundings can be a difficult task, especially when it comes to falling asleep. Additionally, your sleep may be disrupted by the medical team as they come in to check your progress every few hours.
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To ease the adjustment period, keep your curtains open during the day. This allows natural sunlight into your room, which helps your body feel more awake in the day and tired at night.
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Staying in touch with family & friends

You will be allowed to choose two to three people who will be allowed to enter your room during your isolation period. You may ask them to bring you anything you may have forgotten. Aside from these selected few, other people may visit you, but they will not be allowed into your room. You can use the intercom or mobile phones to speak to them.
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Remember that it is okay if you feel like there are days when you do not wish to have any visitors. Do not feel guilty for those days. Your health and wellbeing are most important during this period. Your loved ones will understand this.
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Risk of infection

You may be worried about the risk of getting an infection from your family and friends. However, this should not be the case. Your isolation unit will have rules in place to minimise any risk of infection. Remind your visitors that they must be healthy when they come to visit you. This is of utmost importance.
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Staying connected

You can stay connected by making use of the Internet and social media. Alternatively, you might want to choose to start writing a blog. Both these ways help keep you connected to your loved ones and the outside world. Many patients find it therapeutic to document their experience and their emotions related to it, whether these are good or bad emotions.
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You might also want to ask your selected visitors who are allowed into your room to help you keep other loved ones informed on your behalf. This can relieve you of the need to keep repeating your story to different groups of people, a process which can be emotionally and physically draining.
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Children coming to visit

Unfortunately, most isolation wards do not allow children to enter patient rooms. Children may be at higher risk of carrying an infection that they picked up through school.
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However, children will be able to speak to you through the intercom even though they are not allowed into your room. You may also want to try video calling your children daily so they will be able to see you face-to-face.
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Protective isolation & and your emotions

How to cope with your emotions?

How you choose to cope with your emotions depends entirely on you. Think about the ways which you use to relieve stress or help you feel more at ease on a regular day.
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Each individual is different; however, here are some things you can try:

• Deep breathing – helps to calm you down.
• Meditation – download a simple meditation app to help you focus on the present instead of worrying about the future.
• Learn something new – learning about new things enables you to distract your mind from your current situation.
• Laugh – rewatch your favourite comedies or ask friends for recommendations.
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Noticing signs of something more serious

During your time in protective isolation, you may find yourself with much extra time on your hands. You may find yourself feeling low and listless. However, it is crucial to look for signs that something more serious is going on.
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Pay attention to the thoughts you are having and the moods you are going through. This can help you identify if you need to speak to someone about how you are feeling.
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If you notice you are feeling these things, reach out to your medical team:

• You’ve been feeling down for an extended period – more than two weeks.
• You are anxious more often.
• You do not have control over your thoughts and feelings.
• You lack the motivation to do anything – including necessary tasks.
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Disclaimer:
The information on the Centre For Clinical Haematology website is intended for educational use.  It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.