MY DEAD LINE CHANGED TO LIFE LINE BY AN ANGELIC HAND
As soft as sponge, in a bony crunch, form blood cells and fight
with infection shells… getting it correctly; “The bone marrow”
which produce body’s blood cell including red blood cell as oxygen
carrier, white blood cells as germi shield commander and platelets
as blood clotter. Malfunction of this bone marrow can create a
radical change in the meaning of life.
The malfunction of this bone marrow produced immature and excessive
quantity of the above cells and hence creating a malformed cell
markets in the body. This is can be in the case of aplastic anemia,
leukemia or some immune deficiency disease. The immature or
defective blood cells interfere with the production of normal blood
cells, accumulate in the bloodstream and may invade other tissues.
This malfunction in the bone marrow can be cure with three of the
modalities: 1) Chemotherapeutic agents, 2) Radiation therapy and 3)
Bone marrow transplantation. Large doses of chemotherapy and/or
radiation can destroy the abnormal stem cells and abnormal blood
cells. These therapies, however, not only kill the abnormal cells
but can destroy normal cells found in the bone marrow further can
destroy healthy bone marrow too. While bone marrow transplants do
not provide 100 percent assurance that the disease will not recur,
a transplant can increase the likelihood of a cure or at least
prolong the period of disease-free survival for many patients.
A bone marrow transplant is a physically, emotionally, and
psychologically exhausting procedure for both the patient and
family. A patient needs and should seek as much help as possible to
cope with the experience. "Toughing it out" on your own is not the
smartest way to cope with the transplant experience.
The bone marrow transplant is an unbearable experience. Imagine the
symptoms of a severe case of the flu - nausea, vomiting, fever,
diarrhea, extreme weakness. Now imagine what it's like to cope with
the symptoms not just for several days, but for several weeks or
may be for several months.
During this period the patient will feel very sick and weak.
Walking, sitting up in bed for long periods of time, reading books,
chatting on the phone, visiting with friends or even watching TV
may necessitate more energy than the other patient has to spare.
Complications can develop after a bone marrow transplant such as
infection, bleeding, graft-versus-host disease, or liver disease,
which can create additional discomfort. The pain, however, is
usually controllable by medication. In addition, mouth sores can
develop that make eating and swallowing uncomfortable. Temporary
mental confusion sometimes occurs and can be quite frightening for
the patient who may not realize it's only temporary. The nursing
staff will help the patient deal with these problems.
Nurses play a vital role in the care of the patient undergoing bone
marrow transplantation. Responsibilities include supporting
patients through the procedure and the recovery phase, by
monitoring changes in their condition and administering a range of
therapeutic interventions (such as blood products or antibiotics).
BMT recipients are usually cared for in protective environments.
During the experience of isolation intensive caring relationships
are likely to be established between patients, their families and
staff whose primary focus will be on achieving disease control or
cure. Here the nurse is playing a two way supporter angel between
the family and patient. The motto of the bone marrow transplant
nurse is: “with the patient for the patient; a guardian angel in a
form of nursing agent”.
Moreover, the nurses in BMT are also playing as a counselor and
educator for patients and family. Different teaching methods are
used and patients are approached toward the new dimension of BMT
including side effects, complication, and the care during
transplant. Further patients who are suffering with the different
side effects are managing by nurse accordingly. The patients who
are on complete bed rest during transplant time have daily sponges
and daily health hygiene care by nursing staff. The nursing staff
is using all the time using a sterilize technique even for handling
minute stuff and is acting as germi sheild commander foe the bone
marrow transplant patients.
The psychological and emotional stress is also one of the issues in
bone marrow transplant patient. First, patients undergoing
transplants are already traumatized by the news that they have a
life-threatening disease. While the nurse offers hope for their
recovery at this stage.
The long weeks of waiting for the transplanted marrow to en-graft,
for blood counts to return to safe levels and for side effects to
disappear increase the emotional trauma. Recovery can be like a
roller coaster ride: one day a patient may feel much better, only
to awake the next day feeling as sick as ever. Here the role of
nurse is to fully support the patient and family and to build a ray
of positivity in them.
In nut shell, the nurses are playing a helping hand for bone marrow
transplant patients in all aspect of care…
Maryam lakhdir (BScN)
Nadia Mulji (BScN)