When you are feeling unwell, do what you can. Regular exercise can simply mean getting up and walking for 15-20 minutes several times a day. It is important for you to stay out of bed during the day as much as possible.
While you recover, walking is probably the best activity to start with. Over time, your stamina and strength will improve. Your physiotherapist can help you plan a re-conditioning program that includes gradual increases in activity.
Here are some activities you can do to keep up your strength while in hospital and at home:
Walk in the hallway at least 3 times a day. 5 times a day is better!
Walk after breakfast, before lunch, after lunch, before dinner, plus once in the evening.
Do at least 2 laps around the Unit; 3 or 4 laps each time is great. If you feel tired, once around is better than nothing.
Walk to the bathroom instead of using a urinal or commode chair.
If you feel unwell, do what you can – a short walk several times daily is better than only one big long walk.
Sit in a chair to read or watch television instead of lying in bed. Sit in a chair for all of your meals.
Marching on the spot is a very good exercise to keep up your strength and balance. Stand up and lightly hold a windowsill or stable furniture (not the IV pole). March in place, lifting your foot at least 6 inches off the ground. Watch a clock and march for about a minute or until your legs are a little tired. As you get stronger, start increasing the time. Good posture is important.
Do leg and arm exercises daily, especially if you are not walking much.
If you have a Hickman® Line or PICC line, you can move that shoulder in any direction but avoid strong swinging or forceful stretching. Avoid heavy resistance exercise on that side and be careful not to pull on the line.
Try to spend as much time out of the bed as possible. The bed is for sleeping or when you are feeling too unwell to be up.
Exercise is very important but there may be some restrictions at first. For example if you have low platelets, you should not be participating in high impact activities such as running and skipping. These activities may cause trauma to the muscles/joints and you may be at a higher risk for bleeding. Mention any exercise activities to the BMT doctor before engaging in them.
There are three blood counts to keep in mind when deciding how much activity is appropriate. Remember that a low platelet count can put you at risk for bleeding (Normal count = 125 - 400). Certain exercises should be avoided until your count recovers. Here are a few guidelines:
Platelets cells that help stop bleeding when tissue is damaged. When you exercise, especially against resistance, you can cause very small injuries to tissues and small blood vessels. This is normal and usually heals easily, causing no problems. However, when your level of platelets is low, bleeding may not be stopped as effectively. Here is what you need to know:
When platelets are less than 15 – limit your activity. You may need to receive a platelet transfusion.
When platelets are 15 to 20 – exercise gently without resistance. You can do sitting or standing exercises, gentle stretching and walking.
When platelets are 20 to 40– you may use some resistance, such as weights or elastic tubing or theraband. You can walk more briskly and practice step-ups or stairs.
When platelets are 40 to 60 – activities such as stationary cycling and golfing are acceptable.
When platelets are over 60 –you may do more vigorous resisted exercise and aerobic exercise such as biking or jogging. However, wear appropriate gear and continue to avoid injuring yourself.
There are no restrictions on exercise once your blood counts return to normal. However, ask your doctor before taking up sports and activities that put you at risk for injury such as contact sports and skiing.
Hemoglobin is in the red cells of your blood. Hemoglobin carries oxygen around your body, which every cell needs for energy to carry out normal processes. Normal hemoglobin levels are: 115 to 150 for women and 135 to 170 for men.
If the hemoglobin count is less than normal, you may tire more quickly. You may find it helps to go more slowly and do shorter periods of activity more frequently. If you get short of breath or tired, slow down or rest before continuing.
White Blood Cells
White blood cells, especially neutrophils, are the part of the blood that helps fight infection. Normal white cell count is 4 to 11. Normal neutrophil count is 2 to 8.
When admitted to the hospital and the neutrophil count is low, you should remain in the Inpatient Unit (except for tests). At home, you need to wash your hands often, avoid being around anyone who is sick, and avoid areas where a building is being torn down or under construction.
When your neutrophil count is improved, the nurses might give you permission to go off the Inpatient Unit with an N-95 mask firmly in place. Do not remove the mask while off the unit but still within the hospital. You may only remove the mask when you are actually outside in the “fresh air” and away from other people. Avoid crowded areas like the cafeteria when it is busy during peak times, and stay away from active construction. Wash your hands before and after, and avoid touching anything while off the unit.