Bone Marrow Transplant Exercise Manual While You Are in the Hospital Why Do I Need to Exercise While I Am In The Hospital? You will feel tired and weak because of your cancer treatments. Exercise helps to fight cancer-related fatigue and weakness. Cancer-related fatigue What is cancer-related fatigue? (CRF) CRF is an overwhelming sense of tiredness or lack of energy, which interferes with everyday activities CRF feels very different from the fatigue you may have experienced before your cancer diagnosis. CRF can be severe and last weeks or months. CRF is often not relieved by sleep or rest. How do I know if I have cancer-related fatigue? You may feel any of the following symptoms: Weakness Drowsiness Feeling bone tired Difficulty concentrating Feeling listless or bored Difficultly or unability to do everyday activities How will cancer-related fatigue (CRF) affect my daily activities? CRF may affect how you feel about yourself. CRF may limit your daily activities o Difficulty working o Trouble concentrating o Feel less like participating in social activities o Have less interest in sexual activity. What is the best way to improve cancer-related fatigue? Exercise It is natural to want to rest when you feel so tired. However, you must try to exercise on days that you feel that you are able.
Muscle weakness Your muscles can become very weak because of medications that fight cancer and keep your body from rejecting the bone marrow transplant. Which muscles should I expect to become weak? Hip muscles are often weak Signs that your hips are weak o It is hard to climb the stairs o It is hard to get out of a chair Is It Safe To Exercise After My Bone Marrow Transplant? Exercising safely is very helpful and important following your bone marrow transplant. Before you get started, you will need to know your blood counts and how hard to work. BLOOD COUNTS Chemotherapy and radiation can cause your blood cell counts to be low. Information on blood cell counts will help you to know when it is safe for you to exercise. Anemia Anemia is low hemoglobin. Hemoglobin brings oxygen to your body so that you have energy to move. How will I feel if I am anemic? Extremely tired Dizzy Short of breath, even while not moving Leg cramping Should I exercise if my hemoglobin is low? Your doctor or nurse will tell you your hemoglobin level. Use this as a guideline to let you know when is is okay to exercise. Less than 8 Do not do your exercises. Save your energy for daily activities, such as dressing/bathing. Between 8 and 12 Do the following activities, as you feel able: Walk short distances Use the stationary bicycle for 5 to 10 minutes. Do your leg exercises. More than 12 Increase your activity very gradually. It is fine to walk, bicycle and do your exercises.
Absolute Neutrophil Count (ANC) The absolute neutrophil count is the number of germ-fighting white blood cells you have in your blood. When your ANC is below 1000/mm3 you will need to be on neutropenic precautions. What needs to happen when I am on neutropenic precautions? You must wear a mask when you leave your room. All visitors must wash their hands before they come into your room. Visitors or staff who have a cold or know someone who is sick must wear a mask while in your room. Thrombocytopenia (Low platelet count) Platelets help your blood to clot. When your platelet count is low, you may have bleeding of your gums, stomach, throat, urinary tract, and the small blood vessels in your eyes. To help prevent bleeding Do not walk or exercise if your platelets are below 10,000 If you must blow your nose, do it very gently. Wiping your nose is a better idea. Do not hold your breath while having a bowel movement or exercising. Be extra careful not to cut or injure yourself. Avoid bumping into objects. Do not lift weights or lift/move/carry heavy objects (need a specific weight limit from Jackie) If you need a platelet transfusion You will take Benadryl; this can make you tired and unsteady. Please ask for help while walking or exercising. Exercising Guidelines for Low Platelet Count Less than 10,000 Walk in your room with assistance No stationary bicycling No exercises Look for signs of bleeding or bruising From 11,000-50,000 Walk in your room or the hallway Stationary bicycle- NO resistance Active exercises- NO weight lifting Increase your exercise effort and time slowly Over 50,000 Walking in your room or the hallway Stationary bicycle- NO resistance Leg exercises- NO more than 5 pounds of resistance Increase your exercise effort and time slowly
Tips on EXERCISE LEVEL and Intensity Exercise can help to improve your energy level and strength, allowing you to increase your activity. Exercise Intensity How Hard Should I work? Use theborg Scale BORG SCALE 6 no exertion at all 7 extremely light 8 9 very light 10 11 light 12 13 somewhat hard 14 15 hard (heavy) 16 17 very hard 18 19 extremely hard 20 maximal exertion Rate of Perceived Exertion 6 7 Very, very light 8 9 Very light 10 11 Fairly light 12 13 Somewhat hard 14 15 Hard 16 17 Very hard 18 19 Very, very hard 20 Begin with 5 minutes of exercise. Slowly increase your exercise time and effort. Leave some time and energy for activities that you enjoy. Your exercise intensity needs to be between 9 (Very light) and 11 (Fairly light). Gradually increase your effort (how hard you work) and your workout time. You should be able to talk while you are exercising. If you cannot carry on a conversation, you are working too hard. Should I exercise after I leave the hospital? It is very important to continue with your exercise program after you go home. Try to exercise at least 5 days each week. Be sure to walk AND do your leg exercises. The leg exercises help to keep your legs strong. The walking works your heart, lungs and muscles. Other exercise ideas o Yoga
o T ai Chi o Stationary bicycle o Elliptical trainer Do not lift weights until you doctor/nurse give you permission. o Ask your doctor/nurse how much weight you are able to lift. Please read the Abramson Cancer Center s booklet Walking For Fitness for more details. If you find that you become less active when at home, please call your doctor/nurse. They will be able to arrange for a visit by home care physical or occupational therapy.