חוברת מידע למטופל המשתחרר מבית חולים (אנגלית)

Dear patient,
The department staff is happy to accompany you as you leave the ward.
The time you spent in our department was not easy, from the diagnostic stage, the treatment, side effects and everything else.
In preparation for your discharge from the department, this pamphlet contains some important information and explanations regarding the continuation of your care at home.
For any additional information or questions upon your return home, the department staff is available and happy to answer questions at any time and at any hour.
The department's telephone numbers are: 02-6776685 / 02-6776686.

Follow-up and treatment after discharge:

Upon discharge from the department, it is essential to coordinate the continuation of your treatment with your attending physician. To do so, please make a follow-up appointment at the hematology out-patient department's (ishpuz yom) reception. If your treatment will be continued in the hematology clinic, appointments are made through the Hadassah call center at 02-6776701.
When calling to make an appointment, make sure to have your ID number and information regarding the reason for your visit ready.

If admission to the department is required for your next treatment, please refer to your doctor regarding the preferred date of the treatment, and be in contact with the department's reception desk prior to arriving. We make every effort to ensure that the hospitalization date is on schedule, but sometimes other urgent admissions may delay your arrival for a number of days.
We thank you for your understanding and cooperation regarding this matter.

For your pre-planned admission, please ensure that you have an appropriate confirmation of coverage from your health fund (kupat holim).


When should you seek medical attention?
Patients receiving chemotherapy are at risk for serious infections due to the weakening of their immune system. Therefore, you should be alert to any signs indicating the development of infection.

Signs and symptoms of infection:

  • Fever above 38 degrees and/or chills.
  • Little or no urine.
  • Suspected contact with a patient with an infectious disease, especially chicken pox.
  • Continuous diarrhea (over 4-6 times a day) and/or abdominal pain.
  • Repeated vomiting (4-6 times a day).
  • Weakness, extreme fatigue and pallor that was not present before.
  • Appearance of blue bruises on the body and/or the appearance of bleeding.
  • New pain, or any other change in your condition.

If there are any signs of infection as described above, follow these guidelines:

  • On Sunday to Thursday between 8:00-14:00 go to the hematology out-patient department (ishpuz yom).
  • At all other hours go straight to the emergency room (miyun).

Even in the emergency room, the department staff is responsible for your care and will come to examine and treat you.

IF YOU HAVE FEVER, SEEK TREATMENT PROMPTLY AND WITHOUT DELAY.

Visitors and crowded places:
You are not required to avoid contact with other people and there is no need to wear a mask. Receiving visitors is important and recommended. However, a few rules should be observed:

  • Avoid visits by friends and family members who are unwell (fever, sore throat, runny nose, cough, diarrhea, etc.) or who have sick children at home.
  • Limit the number of visitors at any given time.
  • Require visitors to wash their hands upon arrival.
  • The house should be properly ventilated during visits.
  • Avoid visiting crowded places such as malls or cinemas (you may visit these places during quiet hours).
  • Avoid eating in public places. 

Preventing Infection:
While undergoing chemotherapy, the body is more susceptible to infection. As such, it is important to adhere to the following guidelines:

Home ventilation:
Make sure to ventilate your home properly.

Washing your hands:
Wash your hands thoroughly after coming into contact with an unclean environment or leaving the bathroom, and especially before preparing food.

Enema use:
Do not use enemas when the immune system is weak.

Toilet:
We recommend using a separate bathroom if possible, especially when your blood count is low. If this is not possible, sanitize the toilet thoroughly before and after use to prevent transmission of infection.

Renovations:
You should avoid home renovations during the treatment period, and steer clear of any construction sites or places undergoing renovations. The dust produced during construction contains harmful fungi that can cause serious infection.

Pets:
You may be in a house with dogs or cats, but avoid close contact with them and do not clean up their litter. Regarding other animals – consult the medical staff. Make sure pets are immunized, de-wormed and closely monitored by a veterinarian. Wash hands thoroughly after any contact with your pet.

Emptying the trash:
It is recommended to avoid emptying the trash during and immediately after chemotherapy treatments.

Diet:

  • Maintain a protein-rich diet including eggs, meat and dairy products.
  • Fruits and vegetables should be washed thoroughly with soap and water. Fruits and vegetables that can be peeled are preferred.
  • Cooked vegetables are recommended.
  • Avoid eating vegetables that grow close to the ground (and cannot be peeled) such as fresh parsley, dill, berries and the like.
  • Do not eat raw meat or fish (including sushi) and unpasteurized dairy products.
  • Drink plenty of water. Hydration is of the utmost importance!
  • Avoid alcoholic beverages.

You are welcome to consult with a hospital dietitian or the nurse in charge of your treatment with any question regarding nutrition.


Oral hygiene:
One of the side effects of chemotherapy is direct injury to the epithelial cells of the digestive system. The phenomenon in which the mucosa of the oral cavity (which is part of the digestive tract) is damaged is called stomatitis, and can appear a few hours after chemotherapy treatment and last for a week to ten days after treatment. Stomatitis can range from unpleasant to very painful but is preventable (or at least its intensity can be reduced) by adhering to strict oral hygiene practices before, during and after chemotherapy:

Brush your teeth and tongue regularly with a soft bristle toothbrush. Additionally, you should rinse your mouth at least twice a day with salt water and/or an alcohol-free mouth wash, preferably after meals and before going to sleep.

Avoid very hot foods and beverages, pickled or spicy foods, as these tend to stimulate the oral mucosa.

Bodily secretions:
Chemotherapy is excreted through bodily fluids, including saliva, urine and feces. To reduce your relatives' exposure to secreted chemotherapy, make sure that they don’t come in contact with said fluids. Do not share the same cup or cutlery, and if possible use a separate bathroom at home.

Sexual Relations:
There is no impediment to maintaining sexual relations during treatment, provided that you are protected and hygienic. Proper protection and hygiene practices are of the utmost importance in order to prevent infection while your blood counts are low, and to prevent exposure of your partner to chemotherapy agents in your bodily fluids.

Ensure adequate methods of contraception during the treatment period, as the chemotherapy drugs may cause damage to a developing fetus.


Activity and rest:
Fatigue and exhaustion are common among patients after chemotherapy treatments. It is recommended to continue light physical activity, such as walking, while planning rest periods as necessary.
Physical activity improves the way you feel and preserves the body's functioning.

Sun exposure:
Chemotherapy treatments increase the skin's sensitivity to the sun and can cause spots on the skin.
Avoid direct exposure to the sun and use appropriate protective measures: hat, sunglasses and sunscreen.

We wish you a speedy recovery,
The Department Staff

Department phone numbers:
02-6776685 or 02-6776686 / fax: 02-6776755
Hematological Day Care: Sunday to Thursday 08:00 - 15:00
02-6776701 / fax: 02-6778761
Patient Admission Office: 02-5842111
Written by: Tovi Dimentman, Dr Adir Shaulov, Chani Itinberg
Advisor: Prof. Dina Ben Yehuda
Edited by: Tal Atzmon

 

The information appearing in this publication is for educational purposes only and does not constitute a medical opinion and in any event, is not a substitute for professional medical advice. All rights reserved to Hadassah © Do not photocopy, duplicate or make any commercial use without written permission from Hadassah. The booklet is intended for both men and women. 2017. Additional informational material can be viewed at the Hadassah web site: www.hadassah.org.il :
"Patient Information Sheets"