• Most post-HSCT’ers go overboard on this subject. You don’t need to be paranoid about all this, just careful and prudent. Your innate immune system (Leukocytes) is back 100% now. It is only your adaptive immune system (Lymphocytes = T-cells and B-cells) that are still not recovered which will take approximately another year. So your best defense to not get sick from here on out is the same thing that keeps people with a normal immune system healthy; common sense.

      In general you don't need to go crazy and maintain sterility when you travel. What you “touch" matters ten times more than what you "breath." For my four months following transplantation I always carried a small bottle of alcohol-based hand sanitizer in my pocket and used it often. You can't use that stuff too much. And have the people in your home use it often, also. Don't touch your face until you have sanitized your hands first (pathogens enter your body easily through the membranes of your eyes and nose). Stay away from animals and crowds of people because you can't know who is sick that might expose you to something dangerous. Stay away from any person that has an illness. You can hug and touch your kids and your partner if they are well and not sick. Don't avoid hugging your family. It's not necessary and just adds stress to everyone's life. I didn't shake hands with other people (strangers) for four months but after six months I was pretty much back to completely normal behavior. I did get a cold at +4 months, but my body handled it fine and I never had an infection emergency at any time. Because the intestinal mucosa is degraded from the chemo, be careful what you eat following transplantation. For a few months avoid “live” foods such as yogurt, miso and any unpasteurized dairy products. Most everything should be cooked well. Stay away from unpeeled fruits and vegetables that are not cooked. You want to avoid food contamination, pathogens from food and avoid food poisoning at all costs.
      Regarding your airplane flight home. . . . . . I flew from Frankfurt to San Francisco for my trip home on day +15. Be careful what you touch in the aircraft lavatory (use the alcohol hand sanitizer afterwards every time) and don’t eat the airline food or drink the beverages they serve out of open containers. Any pre-packaged or processed food products are OK. You can drink bottled beverages such as water and soft drinks. I brought my own snacks (chips, candy, power bars) to eat on the airplane which you might want to also consider doing. If you are underweight (I lost 7.5 kg following my HSCT) you may want to get some high calorie nutrition drinks to have at home.
      With all of this said there is one EXTREMELY important thing to always keep in mind for the first six months post-transplantation. . . . . . if you develop a fever of 38.6C (101.5F) or greater, this means you might have an infection. If this happens don’t delay and immediately go to the hospital emergency room and tell them you are immunocompromised following your stem cell transplant.
      Use common sense (don’t lick farm animals), and just be careful, not paranoid. No need to punish yourself or your children. Give them a big hug when you see them! It will be one of the best hugs of your life.