Pediatrics Hematology/Oncology

Helping Your Child Get Ready for Discharge

During your child's stay in the hospital, the health care team will watch your child's health closely. When they see your child is able to do the following, they will help your child get ready to go home: 

• Keep a stable body temperature
• Take most medicines by mouth
• Have an ANC (Absolute Neutrophil Count) over 500 for several days 

As caregivers, there are certain things you must be able to do before your child can leave the hospital. This includes:  

• How to do a central venous line (CVL) dressing change.
• How to flush and change caps for the CVL.
• How to give IV medicines and TPN/IL feedings if needed.
• Understanding your child's medicine schedule and what side effects to observe and report.
• How and when to schedule follow-up visits for your child.
• What problems and/or changes to report to the health care team.

Follow-up Visits

Before your child leaves the hospital, the health care team will work with you to schedule follow-up appointments for your child. Your child will visit the health care team often for the first few months. They must watch your child closely to see if the new immune system is developing properly and if there are any signs of problems.

The follow-up visits will be designed to meet your child's specific health needs. Because certain tests will be done as part of these visits, plan to spend several hours at the hospital for each visit. The health care team will let you now what to do beforehand to prepare your child for each visit.

When to Call the Health Care Team

Once at home, you will need to watch your child closely for any changes in his or her health. If your child has any of the following signs or symptoms, call the health care team right away. 

• Temperature over 101.3º F or 38.5º C. Depending on your child's condition, the health care team will let you know if a different temperature guideline should be used.
• The "chills" or shakes that last longer than a few minutes. Check your child's temperature immediately. After the chills stop, check it again to see if the temperature has gone up.
• Fast breathing or having a hard time catching his or her breath.
• Blue or gray skin color. If your child has this plus a temperature or breathing problem, this is a medical emergency. Call "911" for emergency help.
• Runny nose or nasal congestion with green-colored- sputum.
• A dry cough that occurs often throughout the day.
• White patches or sores in the mouth or on the tongue.
• Skin rash.
• Pain with urination.
• Frequent urination.
• Bloody urine or blood clots in the urine.
• Blood in the stools.
• Redness, swelling, tenderness or drainage anywhere, especially at the site of the CVL.
• Diarrhea.
• Nausea or vomiting that affects your child's ability to eat, drink or take medicines.
• No urine output for 6 to 8 hours because of nausea or vomiting.
• Pain, especially within a new area of the body.
• Headaches that occur often or stay for a long time.
• Any bleeding such as bruises, nose bleeds, bloody urine or stools, blood vessels showing in the whites of eyes, bleeding gums or cuts that will not stop bleeding.

Not feeling well or does not act like himself or herself (more irritable than usual, more tired than usual).

When a child is ready for discharge from the HOT Unit, they will require very close follow-up care in the HOT Clinic. Visits may be daily and decline to several times a week.

There are various accommodations available for the child and family. The child's social worker will assist with arranging for a room at the Ronald McDonald House or other places.

Care of siblings is another important area. Again, the social worker will assist in placement in the Wauwatosa Public School system.

The goal of CHW BMT program is comprehensive, family centered care.