Section 5 · For the companion

The caregiver
& spouse guide.

Written for the person traveling with the patient: what to expect at the hospital, on the trip home, and in the weeks after.

day
On site
min
Infusion
wks
Home watch
min
Read time

Prefer to watch?

You're on this trip too.

This page is an 8-minute read. The video walks the companion through the one day on site, what to pack, and what to watch for in the two weeks at home. Keep scrolling for the full version.

Rather read? The full breakdown continues below

You are more important than you think.

This is the only page in the Learn library written for you and not for the patient. The person traveling with a stem-cell patient (usually a spouse, adult child, or close friend) does work no one else can do. You hear instructions the patient won't remember in two hours. You notice the slight pallor that the patient will report as "fine," and, in the weeks after, you notice the improvements the patient is too close to see: the deeper sleep, the longer walk, the easier morning. The changes build gradually over weeks and months, some small and some substantial, and the people around the patient are usually the first to register them. You manage logistics on a day the patient is allowed to think about nothing but their own body. None of that is in the brochure for a reason: brochures sell to patients. This page tells you what your week actually looks like.

It also says, plainly, that you matter as a person on this trip, not just as the patient's support. Caregiver burnout starts on the airplane. We've written the last section of this page for you specifically.

§ Hours on duty

One full day

Concentrated on Day 0, the one on-site day. The travel around it is light.

§ Your role

Witness, scribe, advocate

Not nurse. The clinical work is the hospital's. Your job is the parts the hospital can't do.

§ Time off

Real downtime

The evening you arrive is light. Plan to read, walk, sleep, not to be on call.

Schedule 011dThe trip, hour by hour

One day on site. The rest is travel.

The patient is on site for a single day. Treatment happens at Hospital Angeles in Tijuana: the coordinator picks you up in San Diego, drives you across the border, the infusion runs under an hour, the patient is observed briefly, and you are back across the border to San Diego around midday. Patients who live in southern California can do the whole thing same-day. Most who travel from farther fly into San Diego the evening before and fly home that same afternoon, so the door-to-door trip is about two days with one day on site. Some couples choose to add a few San Diego days on either end and make a small trip of it. That is entirely optional and has nothing to do with the medicine. Below is the caregiver's version of the one demanding day, and the easy travel around it.

Day −1 · optional

Travel in

  • TravelFly into San Diego. Coordinator on call.
  • Check-inHotel in San Diego.
  • EveningLight dinner. Early sleep.
  • PatientNo fasting. Hydrate well for the infusion.
  • YouFree evening. Nearby patients skip this day.
Day 0 · the on-site day

Infusion & home

  • 9:00 AMPickup in San Diego.
  • ~9:20 AMAcross the border. Coordinator handles it.
  • 9:30 AMHospital Angeles check-in. Pre-infusion labs.
  • 10:00 AMInfusion. ~45 to 60 minutes.
  • 11:00 AMObservation. You can stay.
  • 12:00 PMBack across to San Diego.
  • AfternoonFly home, or stay the night if you'd rather. Records sent digitally.
  • YouThe one heavy day. Plan nothing else.

The times above are typical; the coordinator confirms your pickup time the evening before. It is a full day with stretches of waiting between steps, so bring whatever makes the time pass. Some patients work through it, some read, some nap. It is an IV, not surgery.

Your job is the parts the hospital can't do. Witness. Scribe. Advocate. Not nurse.

Pack 02What to bring

Three categories, one short list.

The packing list below is what makes the difference between a smooth trip and one with friction. Starred items are non-optional; we ask about them at pre-trip confirmation.

Figure 5.2.2 · Caregiver packing list
Documents
  • Patient passport + your passport
  • Pre-treatment records (we hold a copy too)
  • Medication list with doses
  • Insurance card (for travel insurance, not coverage)
  • Emergency contact card with U.S. physician
  • Printed itinerary & hotel confirmation
For the patient
  • All daily medications in original bottles
  • Loose, comfortable clothing for infusion day
  • Slip-on shoes (easier post-procedure)
  • Compression socks for the flight
  • Reusable water bottle
  • One book or podcast queue (low-energy media)
For you
  • Notebook & pen (you will be asked to remember things)
  • Power bank + charging cables
  • Headphones
  • Snacks that travel well (Day 0 lunch is unreliable timing)
  • Cash in small USD bills
  • Something for the flights that isn't a screen
Watch 03What to look for at home

Three things to watch in the first two weeks.

You will get home before any meaningful clinical signal appears. The first two weeks are about not missing anything that warrants a phone call. Below are the three things to track, what's normal, and what to do.

Figure 5.2.3 · Home observation: what to track, what's normal, when to act
What to watch · What's normal · What to do
Temperature, twice daily for 7 days.
Normal: Up to 37.8°C / 100°F in the first 72 hours. Returns to baseline by day 4.
Act: Over 38.5°C / 101.3°F at any point, or any fever past day 5. Call the after-hours line.
IV-site appearance, daily for 5 days.
Normal: Faint bruise; small bump; mild tenderness fading by day 3.
Act: Expanding redness, warmth, hardness, or discharge. Photograph and send to coordinator.
Energy & mood, ongoing.
Normal: Better sleep and a small energy lift somewhere in the first few weeks, though when it lands varies a lot from person to person; possible mild fatigue 24 to 72 hours after the infusion; occasional flat affect during the slower build toward the strongest gains around two to five months, with improvement that often keeps building well beyond. All trend up.
Act: Severe withdrawal, refusal to eat, or escalating low mood. Worth a check-in call.

You are not the patient's nurse. You are the person who sees the patient often enough to notice the changes in either direction, the improvements as they build, small or large, as well as anything drifting the wrong way, which is something a physician on a screen can't do. Trust the small observation more than the patient's self-report; people minimize their own symptoms when they're trying not to worry the people they love, and they often miss their own progress because they live inside it.

You 04For the caregiver, specifically

The part nobody says out loud.

Caregivers underreport their own exhaustion at roughly the same rate patients underreport their own symptoms. Below are four things, in plain English, for you specifically. Read them; share them with the rest of the family.

§ 5.2.4 · Caregiver self-check

You are also on this trip.

Sleep is not optional. You will be tempted to "stay up just in case" on Day 0 night. Don't. The patient is monitored remotely; the coordinator answers the phone. Sleep.
Eat on a schedule. The patient's eating will be off on Day 0 with the early start and the border crossing. Yours doesn't have to be. Bring snacks; eat them.
Take the easy days for yourself. On any day that isn't Day 0, the patient genuinely doesn't need much. Walk somewhere alone. Get a coffee somewhere quiet. This isn't selfish; it's how you stay useful through the two weeks at home.
Don't be the doctor. Your job is to notice, to ask, and to call. It is not to diagnose, treat, or reassure. When something seems off, the right move is to call us, not to look it up online.
The bottom line

One day on site. The rest is travel and watching.

Day 0, the one on-site day, is the heavy one. The travel around it is easy. Pack the document and medication essentials, the rest is comfort. Watch three things at home for two weeks. And take the easy hours for yourself. You are part of how this works, not just on the side of it.