TASHMAC,
I have been following your posts as I was in a similar situation when I was diagnosed with aplastic anemia. I was 41 and clueless that I was anything more than tired from working and taking care of my family. Because my blood counts were seriously low at diagnosis, I was rushed to ATG treatment. Afterwards, I did not feel "sick" but had very little energy for a long time. I slept a lot and couldn't do much more than take care of myself. Luckily, my children were older (11 and 14 at the time) so my husband was able to provide most of their care and do all of the housework. It took about 6 months before I was feeling close to normal and my blood counts starting coming up substantially. It took nearly a year for my platelets to get up to 50.
Overall, I would say that ATG is not fun, but not painful and certainly very survivable. You will need help given that you have such young children. You will also need time off work to recover and to avoid potential sources of infection that accompanying being in the workplace.
To answer your specific questions:
a) I think most people feel very weak after ATG. Of course, everyone is different and people recover at different rates. Your general health apart from aplastic anemia and nutrition will play a big role in how you feel as you recover from ATG.
b and c) I had very few whole blood transfusions after ATG, but needed several platelet transfusions. Again, it depends on how fast your counts come up. Most people are on several different medications in addition to cyclosporine (for example, prednisone, antibiotics, antacids, anti-hypertensives). You will be monitored very closely, so expect frequent trips to the hospital for blood counts and other tests.
You are certainly justified in your concern and worry about having a BMT. What do I think about BMT? Well, mine saved my life so I can't be other than an enthusiastic supporter. My diagnosis was changed to MDS about 18 months after my ATG. I probably had MDS from the start but my bone marrow was so empty they couldn't really detect any abnormalities until I got some recovery from ATG. I know there are many variables that go into achieving a successful outcome. For me, there were three keys: a perfectly matched donor (my siblings matched each other, but not me; my donor came from the national registry), a top-notch transplant facility (City of Hope near Los Angeles), and the care of my husband who was with me every single step of the way. I recently celebrated the 14th anniversary of my transplant and 16th anniversary of my original diagnosis with aplastic anemia.
You can read more about my history and treatment
here. I am happy to answer any questions about my experience.
Regards,
Ruth