A large multidisciplinary team provides care for leukemia/blood and marrow transplant patients. All of us have the goal of working with you to achieve the the very best treatment for your disease. Our health care team consists of the following members:
Upon diagnosis and initiation of treatment with the Leukemia/Bone Marrow Transplant (BMT) Program, you will be assigned to a primary hematologist.
A hematologist is a doctor who specializes in finding and treating conditions that arise in the blood and blood-forming tissues, including bone marrow. Your primary hematologist will oversee all the treatment you receive.
The Leukemia/BMT Program is also staffed with the assistance of a group of Bone Marrow Transplant Fellows and Clinical Associates. “Fellows” are physicians who have completed training in internal medicine, hematology or oncology and who are doing further training in the Leukemia/BMT field. “Clinical Associates” are general practitioners working in the Leukemia/BMT field.
It is likely that you will meet several doctors from the Leukemia/BMT Program throughout your treatment. The doctors work in rotations that change every one to two months with the exception of the clinical associate doctors, who work exclusively on the Leukemia/BMT Outpatient Unit. Your medical care will be consistent regardless of changes in the rotation.
Every day that you are on the unit (inpatient or outpatient), the doctor(s) will review your case. If necessary they will examine you, and make any needed changes to your treatment.
If a referral is required to another specialist, such as a cardiologist, the Leukemia/BMT Program will organize that.
If you are an outpatient, the nurses you meet will perform specialized treatments, monitor your progress and help you learn about medications and any adjustments during the treatment and recovery phase.
Inpatient nursing care is delivered via a primary care model. This means that a primary nurse and up to four associates work closely with you throughout your treatment. In addition to performing specialized care, the inpatient nurses help both you and your family learn about treatments, and ways to cope with side effects, hospitalization and recovery. They will also assist you with preparations to return home when you are discharged.
Inpatient nursing staff includes Registered Nurses, a Patient Services Co-ordinator and a Clinical Educator. Registered Nurses work 12-hour shifts that change at 7am and 7pm. Each Registered Nurse who specializes in Leukemia/Bone Marrow Transplant nursing has completed a specialized educational program and a period of orientation with an experienced preceptor.
A Patient Services Manager is responsible for all multidisciplinary staff in the Leukemia/Bone Marrow Transplant Inpatient and Outpatient Units at Vancouver General Hospital. She is available should you have questions, concerns or comments about any element of patient care.
A Clinical Pharmacist will be a member of your health care team. He or she is a Pharmacist who has a Pharmacy degree and often a clinical doctorate degree and specialty training in a hospital. The Leukemia/BMT Program’s pharmacists have advanced specialty training in leukemia and bone marrow transplantation. They work directly with patients and the health care team, and are responsible for providing unbiased, patient-specific drug prescribing information and for identifying, preventing and resolving drug related problems.
There are three Clinical Pharmacists in the Program – two on the Inpatient Unit and one in the Outpatient Unit. Clinical Pharmacists assist the physicians in selecting drugs and their doses. They are also available to help you and your family learn about chemotherapy and supportive care medications. In addition they will monitor all your medications to ensure that you are on the most appropriate medication at the best dose for you.
At the beginning of your transplant treatment and again at discharge, the Clinical Pharmacist will provide written and verbal information regarding your medications. You should keep this drug information with you at all times.
The Clinical Pharmacists will work closely with the Social Workers to help sort out any financial issues that may arise with the discharge medications.
The Clinical Pharmacists work 8-hour shifts from Monday to Friday.
There are four case coordinators and two unrelated donor coordinators with the Leukemia/Bone Marrow Transplant Program.
BMT Coordinators are the primary point of contact for answering questions about and organizing the peripheral blood stem cell and bone marrow transplants. They are involved in arranging tests, coordinating donor searches, providing education information about transplant and assisting patients and donors with travel and accommodation concerns. Some patients may have already ‘met’ one of the Coordinators over the telephone.
If you have questions about any aspect of your transplant or peripheral blood stem cell or marrow collection, feel free to contact the BMT Coordinators’ Office at 604-875-4863.
There are two Social Workers with the Leukemia /BMT Program. They both look after patients and their loved ones on the Inpatient and Outpatient Units. Every patient who is admitted to the Inpatient Unit meets with one of the Social Workers to assess how you and your family are coping, any needs that may arise and practical concerns such as local accommodation, application for income replacement assistance and drug coverage. The Social Workers also meet with patients who are in the Leukemia/Daycare Outpatient Unit either by the request of the patient or referral by a nurse or doctor. Whether you meet with one of the Social Workers as an inpatient or an outpatient, they are here to help you throughout your involvement with the Leukemia/BMT Program. The Social Workers can also link you or your family with community agencies close to home with issues such as counselling for yourself or family members, as well as practical concerns such as transportation, accommodation, financial aid, insurance and disability claims, legal and immigration issues.
Social Work Services
Upon request, Social Work services include the following:
- Psychosocial Assessment. All inpatients receive an in-depth psychosocial assessments to determine whether patients have the financial, emotional, and spiritual resources and coping skills in place to deal with a life-threatening illness; ensuring that patients are referred to and connected with whatever supports are available; and advocating for same to be in place as necessary. The same is available for outpatients as required or requested.
- Practical Matters. Patients and their families can get assistance with practical matters including income replacement (such as EI Sick Benefits, Short and Long term disability from employment, CPP Disability and Social Assistance for Persons With a Disability) medical and drug coverage, child care, accommodations, transportation, legal issues (including immigration and refugee status). Your Social Worker can assist you with medical documentation and completion of forms, and ensuring that they are aware of and/or accessing benefits and services to which they are entitled.
- Counselling & Support. BMT Social Workers can provide counselling and support (including meditation and relaxation techniques) to patients and their families as they experience changes in family roles, functions and dynamics as a result of the disease process.
- Resources & Support to Children. Support and resources are available to children to facilitate coping with their parent’s illness including referrals to counsellors, support groups and working with teachers and school counsellors as indicated and/or requested.
- Adjustments to Transitions. Patients and their families can get help adjusting to the many transitions of a life threatening illness, i.e., from acute to more chronic stages of disease, from outpatient to inpatient and back to outpatient, from acute care to intensive care, from illness to recovery, etc.
- Crisis Intervention. BMT Social Workers can provide crisis intervention services as needed.
- Family Meetings. BMT Social Workers can help arrange and facilitate family meetings and conferences.
- End of Life Issues. BMT Social Workers can provide orientation, education and support to staff, patients and their families around issues relating to loss, anticipatory grieving, and end-of-life issues (including transition to Palliative Care, Advanced Directives and DNR’s, death and dying, and bereavement).
If you require Social Work Services, please do not hesitate to contact us at the contact numbers below. We look forward to meeting with you during your treatment.
- 604-875-4941 – T15 Inpatient Unit office
- 604-875-4697 – CP6 Daycare Outpatient Unit office
Proper nutrition plays a vital role in the healing and recovery of patients with blood cancers or disorders who may require stem cell transplants, chemotherapy or other related medications.
Eating well can be very difficult due to the side effects of the treatment and/or transplant. The Dietitian on the health care team meets with patients who have not been able to eat well and may offer suggestions such as: eating small frequent meals, eating nutrient-dense foods and liquid supplements, etc.
Ask your nurse or doctor about meeting with the Dietitian if you have questions regarding nutrition at any point in your treatment.
Occupational Therapy was developed to help people do the things they want and need to do. If any of these activities are difficult, the Occupational Therapist, or OT, is available to work with you Monday to Friday, on the Inpatient or Outpatient Unit. Ask your nurse to let the OT know that you would like an appointment.
Some of the things the OT can help you with are:
- Basic Activities of Daily Living (ADL’s) – If pain, stiffness or low energy makes it hard to do things like get dressed or get up from the toilet, the OT can help you find ways to make these things easier and safer.
- Energy Management – If feeling tired is affecting your life, the OT can talk with you about ways to manage your energy effectively and to balance doing what you have to and getting the rest you need.
- Wheelchairs – If walking is unsafe or tires you out, the OT can arrange a wheelchair that will let you get where you are going safely and comfortably.
- Seating – If you are not comfortable in a chair because you have back pain or fragile skin or because the chair is too hard or just the wrong size, the OT has some options that might help.
- Relaxation – The OT can help you to retrain your body to relax. This might help you sleep better and have less pain and nausea.
- Leisure Program – Even in hospital it is important to do things you enjoy, not just to keep from being bored but because feeling more positive helps both your mind and your body. There is a range of activities available on the ward. For example, on the walls you will see lots of colourful tiles that our patients have painted. You are welcome to put your mark on the ward too.
The Physiotherapist on the health care team can help you maintain your physical fitness during treatment. The Physiotherapist will see you soon after you are admitted to the Inpatient Unit or at your request or the nurse’s if you are in the Outpatient Unit. S/he will design an exercise and activity program based on your previous activity level and individual needs.
The Physiotherapist will regularly monitor your progress and make necessary adjustments to your fitness program. Treatment may also be provided for any conditions or injuries that would normally need physiotherapy intervention, such as respiratory or musculoskeletal problems.
The health care team also includes a Psychiatrist. A Psychiatrist is a medical doctor who specializes in difficulties with mood, thinking, and coping. Such difficulties can be due to physical factors, psychological factors, spiritual factors, or a combination of these.Bone marrow transplant patients can experience emotional ups and downs due to the illness itself, medication side effects, and a range of psychological or spiritual issues related to being sick and in hospital for prolonged periods with a life-threatening illness. Upon request, the Psychiatrist will see patients to help identify causes of emotional difficulties and to assist in treatment.
Oral Medicine Specialists
All patients on the Leukemia/Bone Marrow Transplant Inpatient Unit are seen by the Oral Medicine team, which includes a dentist and an oral hygienist. Subsequent visits depend upon whether a patient has developed soreness or inflammation in the mouth.
The mouth normally contains bacteria. However, infections can be a common problem in the mouth and around the gums (gingiva) when infection-fighting cells are reduced by chemotherapy or radiation, which can also directly damage the mouth lining. The Oral Medicine Specialists will work with you to combat and manage this side effect.
Pastoral Care Chaplain
A non-denominational interfaith Chaplain from the Pastoral Care Department is available to attend to religious and spiritual needs. The Chaplain provides spiritual care that is sensitive to and respectful of the diversity within our multicultural milieu. The Chaplain’s primary focus is to enable people to draw upon their religious or spiritual strength as they face the challenges before them. Support, counselling, and sacraments are also part of the services provided by the Chaplain.
You may ask for a visit from the Chaplain through the nursing staff, day or night. You may also call Spiritual Care and Multi-Faith Services directly at 604-875-4151. The department can provide information about churches/temples/synagogues and other places of worship in the area.
An On-Call Chaplain is available in the evenings and on week-ends and holidays to respond to spiritual care emergencies. Specific denominational needs may be accessed through the Leukemia/BMT Chaplain.
The Clinical Research Group is composed of Research Nurses, Research Assistants and a Data Coordinator, all of whom have specialized training and education in conducting clinical trials. Clinical research may be focused on developing better ways to treat cancer, and/or the symptoms of cancer and cancer treatment.
Research Nurses have specialized training in both clinical research and in blood disorders and cancers. The Research team works together, along with the members of the Leukemia/Bone Marrow Transplant Program, to bring clinical research to patients of British Columbia.
The Research Nurses are the primary point of contact for answering questions and providing information about a clinical trial. Research Nurses will help both you and your family learn about a study, what assessments and procedures are needed during the study, and ways to cope with potential side effects. Along with your physician, the Research Nurses will monitor you throughout your participation in clinical research.
Please visit the Research section of this web site for more information about clinical trials. If you have questions about clinical research, please contact the Clinical Research Office at 604-875-4863.
The Leukemia/Bone Marrow Transplant Program has a full staff of administrators, information technology specialists, data coordinators, research assistants, secretaries, and clerical staff whose job is to support the day-to-day operations of the Program.
Staff are involved in tasks and projects such as transcription of physician notes for patient charts, coordination of physicians clinics, data collection, administration of budgets, research projects, clinical trials and strategic planning in order to make our Program and your care and treatment the best possible.