Eating out / takeaways after a transplant

[SONIA]

 Hey All,

I have had my transplant 3 months ago in India and the doc / dietician in india were extremly strict about eating food in restaurants or getting takeaways basically not allowed only to eat freshly cooked food at home. Also he stopped me from non -veg for 6 months so am on a veg diet only. Has it been the same for the rest ? Or how soon did anyone of u start eating out and any issues with it ?

[jbeany]

Mine only said to avoid "all you can eat" buffet set-ups, due to the amount of germs on everything, and the risk of food poisoning from things sitting out too long.  Restaurant food was not put off limits otherwise.  They didn't suggest a vegetarian diet, either.

I was on IV nutrition for the first 3 months after transplant, due to complications, but I ate out as soon as they put me back on semi-solid food.  I haven't had any problems.

[okarol]

Jenna had similar restriction as jbeany. Also no raw eggs like in cookie dough, no sushi, but she was encouraged to eat meat and protein.

[st789]

No restriction from my doctor though, but i am a vegetarian the last 2 years.

[RichardMEL]

Yes, my understanding is you need to avoid stuff like salads and stuff in bay maries/heaters (like in a buffet) because that stuff has been there for - well you don't know how long - and can have harmful bacteria.. so if eating out make it fresh and hot as possible and try to avoid things like salads (hey my dream!!) unless you do it at home so you're aware of how clean it is and all that. I think it's common sense.

Never heard of going veg after transplant though.

I'm curious.. was the transplant in India.... did you buy the kidney or was it a living donation from a relative/someone you knew? I am just curious, not judging.

[kellyt]

Same here - no buffets unless I'm the first one there and the food was just placed out (still don't do buffet's though), absolutely no salad bars (miss that), no cookie dough (miss that), no sushi (don't miss that), no grapefruit (don't miss that), etc.   I have gone to Luby's, for those of you in the States that know what Luby's is.  It's a cafeteria style place.  Doctor said that Luby's was fine, but just to choose something that has just recently been placed out and not something that looks like it's been sitting for a while.  Also, he said it was fine because it was being served to you by people using gloves (hopefully) and such.  If we do go to Luby's we try to go right when they open.  If not, I choose something that is fresh and new on the line.

Great..now I'm hungry...

[SONIA]

Hey RichardMel,

No Problem on asking that question, my husband was my donor. They were actually very strict in India had to present a lot of paperwork to the hospital eg proof of relation and stuff like that before they consented for the op. Am veg for only 6 months of which 3 are over  cant wait to dig into a juicy burger .I thought everyone had similar restrctions, I guess they a little bit more cautious in India as hygiene there is not good .

Glad to read what others have said can ease out a lillte on eating as have not been out to eat for over 3 months now.

Hey Kelly I just had lunch an hour ago .....hungry as well  now 

[BrandyChloe]

I received the same instructions as others - no more salads in restaurants (can't guarantee how clean the veges are), no buffets, no salad bars, no raw meat, beef cooked at least medium, no sushi, no deli meat.

No mushrooms, broccoli, green onions, asparagus, strawberries, etc. for at least 6 months because it's next to impossible to clean all the dirt out (even at home).

[openboat]

I'm following the same precautions - no salads, no buffets etc.  I also carry a small container of hand sanitizer with me wherever I go, I use it after touching menus, chairs, doors, or pretty much anything else in public.  I get some funny looks, but I just let 'em think I'm seriously OCD.  They're probably right.

[RichardMEL]

lol yeah I plan to carry a bag of wipes and pretend I'm Adrian Monk! 

It's funny actually because every so often I think about stuff like this when I use the restroom at work, or I'm out somewhere and I am forced to use a handle on a door or something.. and I think "OK, post transplant I'm going to need to use sanitiser or something on my hands after that" and mentally thinking about having something at my desk etc.

Is that weird?

[kellyt]

No, that's not weird.  I open bathroom doors (when leaving the bathroom) with my pinky finger if I don't have a papertowel.    You can't get too worked up about it though, cause it will make you nuts.  When I have trouble is when I'm at the grocery store and I go to get one of those little plastic bags to put my fruits and veggies in.  I can never get those open unless I lick my finger.  So now I touch some of the veggies that are wet from a recent spray and use that hand to open bags.  Crazy.   

[jbeany]

Not crazy, kelly - I have the same problem!  If you put the opening between your palms and rub them together really fast, that works too.

[Wattle]

I have had the same restrictions as everyone above. I was not told to go vegetarian.

Except...... Kelly I do miss Sushi and grapefruit!   

I am a little suspect on all food. Just make sure the restaurant looks clean and well patronized! Then be careful with what you choose.

And I have carried hand sanitizer since I started on dialysis. Because I was on PD, I had to be extra careful with my hands. I have always opened restroom doors with my sleeve or top! 
I also trained my two children to use it a t school! I was (and still am) paranoid about them bring bugs home. My daughter said most of the kids have it in their locker now or are always asking her if they can use hers!

Oh and the bags!!..........       I thought it was only me. They are soooo hard to open without licking your finger!!

[SONIA]

I am also a great suspect on all my food....wash my veges like crazy ........my hubby thinks am going nuts as have become a cleanliness freak now and i tell him i would rather go a mile for myself and he says u r going 2 miles 
Another thing that freaks me out is using public toilet seats and toilet doors as well 

Also forgot to mention the doc also mentioned having sauces/ pickles etc from satchets and not bottles as once opened the bottle starts collecting stuff from the air which may not be good ....have u guys been doing that too or u have sauces from the botltes as normal ?

[Chris]

Jenna had similar restriction as jbeany. Also no raw eggs like in cookie dough, no sushi, but she was encouraged to eat meat and protein.

This is true to what I was told from my transplant Center. First week I was out, I used the drive thru take out to grab a bite to eat when I went to visit friends and doctors and also ate at the hospitals cafeteria before or after my follow up appointments.
 
As for sauces and pickels, I haven't changed a thing. I agree about public toliets, even in the clinic. I carry paper napkins or stuff paper towels in my pocket to open doors, after washing hands, more paper towels to shut off the water and open the door. I prefer home because I clean with disinfectant cleaners.

[jennyc]

i was told soft cheeses like feta and uncooked/unpasteurised milk and egg products (eg whole egg mayonnaise), grapefruit and pomello's (and anything else that is metabolised in the liver as it interferes with the tac). As for takeaway it depends upon where you are i guess. With India they would be stressing against getting food from street stalls, no chai from street stalls etc.

I was pretty much told to use my comonsense. We've eaten out a few times, been to our local Korean BBQ (becuase i know they are really clean but avoid the cabbage becuase it's fermented), Japanese restaurant (just don't have anything with miso). and there are 2-3 cafeteria takeaway that i go to becuase i trust them, aside from that everything else is home cooked. I've grabbed mcdonalds breakfasts a couple of times when late for hospital but only because i know they are safe.

As to sauces i've been eating as normal, i also carry hand sanitiser around.

As to raw veg they must be washed first. If you have acess to nurti-metics products they have a soap (OLC??) that is edible and designed for washing vegetables. It not only removes the bacteria but also the chemicals, i've been using that.

I've pretty much been avoiding things that are known to cause food poisoning eg... chinese take-away, (sorry) Indian Takeaway and anywhere i don't trust. As for meat, we are encouraged to eat more protein so i have a good butcher, a good fish monger and i just go to them or the major chain of supermarkets here becuase i know their standards.

I've pretty much been doing most of my own cooking though, generally for weight maintenance becuase i know what i'm putting into my body and can control the calories. That way i can stay to the 3.5kgs i've put on since the transplant and not gain anymore.

[RichardMEL]

I was eating lunch today when it suddenly occured to me - what about airplane food? I know, no jokes about it OK?  I mean seriously I will have to ask about that one as one of my post-tx goals is to do as much global roaming as possible (well obviously not to some 3rd world countries where hygene standards and access to decent medical help would be a problem) but if you're on a 14 hour flight to the US, you have to eat. Now, I like to sit up the front, so the "quality" of the food is better, but you'd have to wonder about that. I guess I'd not eat salads and stuff, but the meat & veg cooked up should hopefully be OK.

Jenny you commented about things fermented in the liver - so what's the take on alcohol from your transplant team?

[SONIA]

 I had asked the doc/dietician abt airplane food as i was going to travel bk home after the op . And was told anything hot is ok...u can have toast n stuff on plane although i was not too sure abt their main meals as dont know how long ago it was prepared so i took some dry snacks on the flight .

Am also curious to know abt alcohol. Is it ok to have an occasional drink ?? 

[Chris]

Sonia, you should ask your center, their protocol maybe different than mine. I am allowed to have ocassional alcohol drinks. Preferrably beer or wine, but stay away from the hard alcohol I am told. So I have had ocassional drinks of beer, but not to where I am drunk, just one or 2 bottles.

[BrandyChloe]

I have been advised to drink in moderation but I wasn't a heavy drinker before transplant (maybe 1 - 2 beers or glasses of red wine a week) so it's not a problem for me to cut that down to once a month.

Hadn't thought about containers except to wonder who used it before me and did they wash their hands?

I wasn't told anything about miso though. The only food restriction I have is the grapefruit and cranberries but that's only until I'm off the Coumadin.

[RichardMEL]

Lately when I've been eating out it's given me pause to think about these issues. Like say Subway, for example, would have to be out post-transplant. While they are pretty clean, the salad stuff sits there all day, and even the meats would be questionable I think. And even say you get a burger with the lot.. what about the tomato, lettuce etc in that? It's a potential minefield. I remember Charee said something that someone in her unit went for takeaway chicken near the hospital and came down with something - and that was a reputable chain. I was reading an article reviewing a local hotel, and they mentioned the buffet breakfast - well surely that sort of thing is out unless you get there and they just top up the hot food - otherwise how long has the hot stuff been sitting in the bay marie? Suddenly simple things become way more complex....

I understand it's common sense and you can't live in a bubble, but it seems that, specially initially post transplant, it could be quite a minefield out there - funny when transplantation is supposed to allow a relaxation in restrictions.

[jennyc]

With alchohol i'm not supposed to drink yet, anything metabolised in the liver can affect your tac levels, i'd be more inclined to ask the renal pharmacist at your clinic about the alchohol issue, though ours didn't mention it to me. she was saying that certain antibiotics are out becuase of the same issue, and that if a GP prescribed anything to give her a call and she'd ok or veto it and advise what other ones i could take.

With regards to subway, i haven't been game enough to go there since any deli meats are apparently a huge no no unless its ham that i've cooked (eg christmas ham you fry up), if going to subway i'd stick to the meatball sub with cheese (their units are refrigerated, but then again, not always covered so i guess it's a personal call). Also, Ricotta cheese i think is ok, even though it's soft it is twice cooked before being refrigerated, but i'm going to double check it because ricotta and cottage are two of my favourite cheeses.

I also guess that with airline food (at least on australian major airlines) it would be ok since the suppliers of the airlines also supply the hospitals (so what does that say about the food we get over here..... not bloody much let me tell you!). Richard, travel is also high on my list, and to go anywhere for us is a huge trip so i guess the best bet would be to happen to mention to the airline after you've booked that your immuno suppressed and that there for any dodgy food could possibly KILL you, under law since we aren't a small minority and it is very likely that someone will travel on their planes that is immuno suppressed they have a duty of care to protect us and provide us with safe and sanitary meals. But that isn't the thing i would really worry about airplanes, the food is possibly the least of the problem with air travel....... the seats on trains get cleaned on average once a month (for high rotation trains, and those with cloth seats others at least once every 6 motnhs... just the cloth seats), the actual trains get mopped etc daily or every other day (sydney trains at least), busses perhaps 3 times a year.... airplanes...................... very rarley, i believe they are lucky to be done every few years, also they aren't properly cleaned between flights, so if you travel, take sanitry wipes with you to wipe over your seat and the call buttons etc...... But hey, i'm still planing on my european vacation next year for my honeymoon and Venice is at the top of my list, so i guess i'm going to have to eat a bag of concrete and harden up!

As to hamburgers.... kind of a  no no anyway since they are so high in fat and sodium, with the transplant you gain weight just looking at food so you have to be a little healthy in your choices, but really the main issues are in the first 3 months when they are fiddling (well longer for me thanks to the rejection).

But Richard, even with having to watch what you eat it is soooo much better food actually tastes REALLY good after the first week banana's are back, oj is back. I'm not game enough to have buffet (escept korean bbq buffet since the meat never stays out long and you cook it yourself).

Miso is fermeneted soya beans, essentially they rot... so possibly not the best idea.

I've stopped eating at some friends houses, they are asian and cook their food hours in advance and then leave it out becuase they all have cast iron stomachs, so hubs and i have just put a stop on going to their houses to eat (honestly they have real stong digestive systems, they leave meat out for hours in summer and go back 5 hours later and plate up another meal)

[RichardMEL]

Thanks Jenny. I have lots to think about now in relation to this. I am *NOT* a cook, so I do often eat out (oops!) so this will be an issue for me (which is why I am thinking about it now). I mean right now I don't worry too much about that - I worry more about what I'm eating in terms of Calcium, or Potassium or whatever... but seems whenever I get the tx, I will swap one kind of worry for another! LOL.

Didn't think about the seat issue either.. but I'd have that anywhere. I use public transport a lot here so that's definitely an issue. I guess what I'd do is have some wipes with me, and some at work so when I get in to wash&wipe ASAP. I really WILL turn into Mr Monk! LOL.

Either way I'm not going to let this stuff stop ME getting back out there and travelling. One of the main reasons I want a bloody transplant is so I can get back out there and travel, see friends and places again I love, the girls of IHD, that kind of thing!!! Others do it without problem, so I know *I* can!!!

As for fat.. I'm pretty skinny as it is - I could probably use a few extra kilos (but not too many!) lol.

Thanks for the post