Early warning signs
It is important to stay on the lookout for warning signs of infection and GVHD. Some drugs used to treat infection, GVHD and other symptoms have side effects of their own that must be monitored and controlled. Watch for signs of chronic GVHD (cGVHD) so that if it occurs, it can be treated promptly. Some early signs of cGVHD could also be caused by other problems. If your doctor is not a transplant specialist, encourage him or her to discuss your symptoms with your transplant team.
Take your temperature twice a day, and any time you feel ill or suspect a fever. Fever is an early sign of infection.
Weigh yourself twice a week. Let your doctor and dietitian know if you lose five pounds or more in seven days. Parents should check with their child's doctor as to what kind of weight loss to watch out for.
Examine yourself daily and note any changes. Pay particular attention to the following:
- Skin - Skin rashes are a common early sign of GVHD. If you notice a rash on your skin, or redness or yellowish-ness, swelling, bruising, blisters or tightness tell your medical team right away, as it might be an early sign of GVHD.
- Extra dry or sensitive skin. Frequent washing and bathing can contribute to this problem. You also should discuss this problem with your medical team. They might prescribe special lotion or recommend a product you can buy at your local drug store.
- Fingernails and toenails - texture or brittleness.
- Eyes - Dryness or irritation, blurred or double vision.
- Mouth - Dryness, trouble swallowing, pain, sensitivity or sores.
- Vagina - Dryness or irritation.
- Joints - (fingers, wrists, elbows, ankles and knees) - pain, stiffness, range of motion.
- Diarrhea, frequent urination, blood in your urine or stool, abdominal pain, or any other difficulty using the bathroom.
- Stomach cramps, diarrhea or gas after eating or drinking milk or dairy products (ice cream, cheese, yogurt).
- Persistent nausea or vomiting.
- Severe fatigue.
- Coughing, shortness of breath or chest pain.
- Severe headaches.
These symptoms are often associated with chronic GVHD and its treatment.
- Symptoms of early menopause (hot flashes, mood swings, etc.)
- Changes in memory or concentration
- Changes in weight
- Excessive facial hair in women and children
- Sexual problems
Act Fast to Address Symptoms
Keep your medical team's phone list where it is easy to find. If you experience any of these early symptoms or become seriously ill, call your medical team as soon as you notice any of the warning signs. Provide as much detail as you can about what you're experiencing, noting the circumstances, the timing, etc. This will help your team figure out the cause of the symptom, and the best way to treat it.