What do you Hemo folks actually find to eat?

[kickingandscreaming]

I'm on PD  (now) with threats of being switched to Hemo.  I just spent 3 day in the hospital where, of course , they wanted me to eat from the renal menu (even tho PD doesn't have the same restrictions)  And the diabetic menu.   Everything I tried to order they said was off limits to me,  So I'm wondering what you guys actually find to eat on Hemo?

[rcjordan]

From my spreadsheet, starting with baked goods:

Nabisco Good Thins -The Corn One, Sea Salt
Nabisco Good Thins -The Rice One, Simply Salt
Pita - white, unenriched Toufayan Classic White
Sesmark Ancient Grains, Brown Rice Sea Salt
Thomas Cinnamon Raisin Bagel
Thomas Original Nooks English Muffin
Flour Tortilla 8" - La Banerita
White Bread - Wonder
White Corn Tortilla 6" - Mission

Beverages:
Ocean Spray Diet Cran-Cherry
Black coffee

Cereals:
Kellogg's Rice Krispies
Grits

Dairy:
Egg Substitute
Sherbet, Any Flavor
Cream Cheese - Philadelphia Origina
Soft Goat Cheese
Sour Cream
Unsalted Butter
Rice Dream Original Rice Milk

Friuts:
Apple
Applesauce, Unsweetened
Fruit Cocktail - Canned, In Water
Peach Half, Canned in Lite Syrup
Blueberries, Unsweetened, Frozen
Pear Half Canned in Lite Syrup
Pineapple Slice, Canned In Lite Syrup

Meat & Seafood:
Beef, Rib Eye Steak
Chicken Breast roasted
Chicken Thigh Meat Only Roasted
Deli Low Sodium Turkey Breast, Sliced
Hamburger, 15% Fat
Minced Eastern NC Style Pork BBQ (vinegar & butter based)
Lamb
Roast Pork Loin, Lean
Shrimp, mixed species, cooked, moist heat
Flounder, cooked, dry heat
Tuna, fresh, bluefin, cooked, dry heat
Cod, Atlantic, cooked, dry heat
Salmon, Atlantic, farmed, cooked, dry heat
Scallops, (bay and sea), cooked, steamed
Veal

[rcjordan]

Pasta & Grains:
Egg Noodles Dry 1.5cup - Muellers
Elbow Macaroni -cooked
White Rice, Long Grain, Cooked
Rice Noodles - Taste Of Thai
Noodles, Chinese, Mung Bean Threads -50g
Noodles, Chinese, Rice Sticks -57g

Snacks:
Lemon Drops - Brachs 17g
Lemon Drops - Sugar Free - Gold Emblem 15g
Mini Marshmallows
Murray Vanilla Wafer Cookie
Mars Starburst Original Fruit Chews
Peppermint Puffs Hard Candy 16g - Gold Emblem
Rice Krispies Treat
Starlight Peppermints Hard Candy 15g
Sugar Free Peppermint Hard Candy
Spice Drops Candy (Gum Drops)- Great Value
York Peppermint Patty Mini Classic

Vegetables:
Carrots, steamed
Cauliflower - Boiled, No Salt
Celery Stalk
Chayote -pear squash raw
Cubanelle Pepper
Green Peppers - Sweet, Boiled, No Salt
Jicama - Boiled, No Salt
Onion - Chopped
Pickles cucumber dill reduced sodium
Potatoes - Double Boiled Leeched
Radishes
Shiitake Mushrooms cooked
Spaghetti Squash - Baked or Boiled, No Salt
Sweet Onions raw or cooked
Tomatillos
Turnips Boiled Drained Without Salt
Yellow Beans, Boiled, No Salt
Cabbage, raw shredded
Corn On The Cob, 1 Medium Ear
Cucumber, Peeled raw
Green Beans, Frozen
Green Bell Peppers - Sweet, Sauteed
Eggplant cooked boiled drained without salt
Iceberg Lettuce chopped 1/2" pieces
Leeks (bulb And Lower Leaf-portion) Cooked Boiled Drained Without Salt
Napa Cabbage boiled & drained
Pickles, cucumber, sweet, low sodium  bread and butter

[rcjordan]

Condiments, Spreads, Sauces, Adders:
Chow Chow Hot - Mrs. Campbell ##
Cider Vinegar
Ghee Butter - Carrington Farms ##
Ginger/Pepper Sweet Sauce - Ginger People
Honey
Jalapeno Pepper
Karo Light Corn Syrup
Ken's Lite Sweet Vidalia Onion Salad Dressing
Ketchup - Low Sodium - Great Value
Low Sodium Peanut Butter - Simply Jiff
Marshmallow Fluff Cream Topping
Salsa - fresh
Salsa - Mild Tomatillos - Green Mountain Gringo
Strawberry Jam - Smuckers
Tomato Soup - no salt added
Unsalted Beef Stock Broth - Swanson
Unsalted Chicken Stock Broth - Swanson
Unsalted Vegetable Stock Broth - Kitchen Basics
Dried Cranberries, Sweetened
Jellied Cranberry Sauce
Lucky Leaf LITE Apple Pie Filling - No Sugar Added
Lucky Leaf LITE Cherry Pie Filling - No Sugar Added
Cool Whip Non Dairy Whipped Topping
Thousand Island Dressing
Avocado Oil
Extra Virgin Olive Oil
Mayonnaise
Dried Cranberries, UNsweetened 40g

[rcjordan]

"Th-Th-The, Th-Th-The, Th-Th... That's all, folks!"

[Alexysis]

Any d@mn thing I want, within reason. I've pretty much taken the bid potassium sources out of my diet; bananas (no great loss), avacados, mushrooms, potatoes, orange juice.

[rcjordan]

>Any d@mn thing I want, within reason.

Agreed.  Even had Pastrami Pizza over the Fourth. (But that was pushing the envelope, I'll admit.)

[kickingandscreaming]

Clearly, neither of you need to avoid half of the stuff on your list that is diabetic-unfriendly.  When you overlay that, there isn't much left.

[UkrainianTracksuit]

What exactly do you mean by diabetic menu? Just for some clarity, you know. I was born with Type 1 diabetes (so I had the diabetic restrictions), the renal restrictions and then, self-imposed vegetarianism. I still found things to eat on hemodialysis. Sometimes it felt like the only thing left to eat was cardboard, but I made it through.

If I had rice, pasta or couscous, I adjusted my sliding scale of fast-acting insulin to make up for the carbs. Are you on insulin, pills or manage with your diet? That would matter a lot here. To me, the diabetic diet (my whole life) pretty much came down to avoid sweets (regular pop, ice cream, cake, pastries, pies, candy... you get the idea) and keep a balanced plate. The key was to keep it all balanced and regular.

For instance, it was very easy, while on hemo, to throw together a couscous salad of a few cut cherry tomatoes (very minimal potassium at that point), feta (lower phosphorus), red onion (low potassium), some pieces of cucumber (smaller pieces keep the liquid and potassium down), some olives, parsley, dash of lemon juice (or balsamic) and oil. Add in a piece of chicken and there's a decent meal. So many ways to make an omelette (even if just scrambled egg whites) with low potassium veggies. Pasta salad with fish. Cottage cheese and friendly fruits. I make a lot of ethnic food, like golubtsi that have a lot of acceptable ingredients for the diabetic and kidney diets.

You can make your own (or buy your own) unsweetened applesauce that is still considered diabetic friendly.

There are a lot of items on renal diet lists that accordingly work well for diabetics. We have to remember that MANY people end up with kidney disease from diabetes so dieticians take this in regard. Most renal friendly recipes (and many are simple) show their diabetic values as well.

For instance, here's a random one: https://www.davita.com/diet-nutrition/recipes/pizza-sandwiches/chicken-teriyaki-pita-sandwich Scroll down to the "renal and diabetic values."

I'm willing to help as I've been in those shoes so let me know what you're working with. But, I hear you on the hospital food situation: diabetic and renal diet together was depressing. When they lifted the potassium restriction, it made a world of difference... I got a muffin and juice! 

[kickingandscreaming]

Im type 2 and don't use insulin.  So I have to regulate  my diet of low carbs.  So no pasta, little bread, no rice, no applesauce, etc.   I have always opposed the use of insulin (exc for type 1's).  I think it is often used to compensate for bad food choices.  If a type 2 didn't have the piece of cake they wouldn't need to cover it with insulin  (which can cause insulinemia, and weight gain).   And yet, when I was in the hospital, every thing I put in my mouth (including lettuce) raised my BS.

[UkrainianTracksuit]

Please don’t take this as a rude answer but I think you have a flawed and prejudicial view against some with Type 2 diabetes. I agree with you that there are cases where some ended up needing insulin due to resistance to change and kept bad food choices. On the other hand, there are those that due to other comorbidities, needed to take pills, because they could control their diet, but they could no longer exercise. As someone with severe arthritis, I am sure you can appreciate that. It sucks. Further, there are cases where a Type 2 patient’s pancreas simply slows down or the body does not use its own produced insulin properly. It is much more complex (in many cases, not all) to call insulin a crutch.



Insulin isn’t a cakewalk either. It’s a hard price to pay for indulging in cake. Without a good balanced diet, expect highs and lows that turn out to be life threatening.


Another point to consider is that hospital-setting glucose levels are typically elevated. As you are currently dealing with cellulitis and ended up in hospital, there are two stressors in that situation. 1. Illness/injury contributes to physical stress which in turn elevates blood glucose levels. 2. Hospital setting and wanting to get out of there/being pissed off contributes to mental stress, another elevator. There are other factors that increase blood sugar that have little to do with what we eat. For instance, we never talk about the role of the liver, do we? 



I know you are in your senior years but I’ve had diabetic diet education longer than (I assume) you’ve been in the diabetic rodeo (again, not meant to be rude, but meant to frame my next sentences.) We’re talking three decades here, and dieticians started teaching me about diet (with rubber food) at aged 3, or at the age where they felt I comprehended the differences. My one involved parent got burned out so I made sure I was the captain of my diet by age 10. I’ve had diabetic nutritional guidance from one of the best children’s hospitals and a highly respected doctor in France. I'm not dopey. Certain approaches may have changed but the same rules remain the same.

All of that said, people are different and I don’t know your numbers and what you struggle with in regard to carbs. Are you checking 2 hours prior and after eating to know exactly how particular foods are working for you?



Just as an example, and completely different than a Type 2 situation, but in the first week post-pancreatic transplant, my blood sugar was elevated to 200 – 225, which is out of range for those with a new organ. I came down to fact it was the point where the prednisone reached its peak.



What does your carb counting regiment look like? For example, I did 80 carbs in the day spaced out through meals and snacks. My carbs were composed of low GI foods so that they released slowly and kept glucose levels steady throughout the day.

 That said, I was on insulin, so I don't know what it's like to rely entirely on diet. However, using the lowest amount of insulin was a priority, and a well-managed diet prevents awful highs and lows.

Diabetics, especially Type 2, are told to focus on foods with a low glycemic index. And ring-a-ding-ding, what do you know, rice, (certain types of) pasta and apples are on diabetes approved foods. It’s all about meal planning and a balanced plate. That lettuce that increased your blood sugar has a glycemic index of 7 (very low) so it was probably environmental and other things going on in your body. These foods are not only for those with Type 2 but also those seeking to prevent Type 2, so a definite focus on keeping blood sugars stable.

The addition of hemo simply means working within this framework where a lot of choices overlap. It also means arranging portion sizes so that potassium and phosphorus remains in check. Eggs and lean proteins like chicken don’t register so you can have that as a main with smaller lower GI foods as a side.



There is actually a lot to work with if a person is willing to look at it positively rather than a hindrance. If it is as you say so that even minimal carbs effect your numbers (1 cup of shredded iceberg lettuce has 2 carbs), then you can turn to lean proteins. It’s also fun to figure out go-to dishes and learn along the way.



Good overview of the relationship between carb counting and low GI foods: http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/understanding-carbohydrates/glycemic-index-and-diabetes.html

General list of Low GI foods; quite a few are suitable for a hemo diet: http://documents.hants.gov.uk/hms/HealthyEatingontheRun-LowGlycemicIndexFoodList.pdf

Some general info and a basic list: https://www.diabetes.ca/managing-my-diabetes/tools---resources/the-glycemic-index-(gi) 



One last thing to mention: patients with pancreatic transplants may have “beaten the Type 1 dragon” for now but, we can still get Type 2 diabetes. My doctors mention that they’ve seen it happen more than I’d like to know so, I still follow many of these tenets taught during the diabetic years. It's a good diet plan for anyone.



I mean, it’s not like engineering a Chinese surveillance satellite. Many have done this before and the sad thing is that many will continue to manage all this after us too. It’s balance, trial and error and attitude.

[Alexysis]

>Any d@mn thing I want, within reason.

Agreed.  Even had Pastrami Pizza over the Fourth. (But that was pushing the envelope, I'll admit.)

Pastrami PIZZA?  YUUUUCCCKKKK!!!

[kristina]

I'm on PD  (now) with threats of being switched to Hemo.  I just spent 3 day in the hospital where, of course , they wanted me to eat from the renal menu (even tho PD doesn't have the same restrictions)  And the diabetic menu.   Everything I tried to order they said was off limits to me,  So I'm wondering what you guys actually find to eat on Hemo?

Hello K&S,
Adding to all the thoughts mentioned by members above, I was also told to avoid spices to make sure my failing kidneys and my fragile body were not struggling unnecessarily because of heavy spices. It worked in my case and it also worked for me to eat for lunch 2-3 asparagus cooked in lots of water (to draw out as much potassium as is possible) and to drink the juice of half a lime, freshly pressed and mixed with a glass of water to keep my vitamin-intake and especially my kidney function for as long as is possible. I did all that every day for years and my kidneys kept on functioning a little bit.
Take care and best wishes from Kristina.
P.S. I also bought a bread-baking-machine to "produce" my salt-less bread etc.
And, most importantly, I had to go "back to basics" and cook everything from scratch to avoid all the usual chemicals which are in most bought food and are not good for a fragile body with fragile kidneys.

[Charlie B53]

A lot of really great information in this thread!

I am Type @.  Initially I was quite indulin resistant but as I lost weight that normalized, then actually became sensitive and had to severely reduced my insuline until finally 18 months ago, I had to quit using all together.

I am very vareful NOT to overload on carbs, yet I still firmly Believe in that 'All Things In Moderation
 thing.  So while I will eat most anything,, a lot of things it may only be ONE Bite, not a serving.

Birthday Cake for example, I splurge and might have three bites, but not a regular serving like everyone else.

Learning to set limits and stick to them.  Self-Control, Discipline, Determination.  Whatever you want to call it.  YOU set your own lilmits and stick to them.  YOU know your body far better than anyone else.

I do disagree on the white bread recommendation, Course wheat digests slower and doesn't have the blood sugar peak that white does.  Setting your serving size I think makes the difference.  I reduce portions, cutting my sandwich making two seperate snack/meals instead of the one larger intake.

[kristina]

I'm on PD  (now) with threats of being switched to Hemo.  I just spent 3 day in the hospital where, of course , they wanted me to eat from the renal menu (even tho PD doesn't have the same restrictions)  And the diabetic menu.   Everything I tried to order they said was off limits to me,  So I'm wondering what you guys actually find to eat on Hemo?

Hello K&S,
Adding to all the thoughts mentioned by members above, I was also told to avoid spices to make sure my failing kidneys and my fragile body were not struggling unnecessarily because of heavy spices. It worked in my case and it also worked for me to eat for lunch 2-3 asparagus cooked in lots of water (to draw out as much potassium as is possible) and to drink the juice of half a lime, freshly pressed and mixed with a glass of water to keep my vitamin-intake and especially my kidney function for as long as is possible. I did all that every day for years and my kidneys kept on functioning a little bit.
Take care and best wishes from Kristina.
P.S. I also bought a bread-baking-machine to "produce" my salt-less bread etc.
And, most importantly, I had to go "back to basics" and cook everything from scratch to avoid all the usual chemicals which are in most bought food and are not good for a fragile body with fragile kidneys.

P.S.
During my years on dialysis-treatments, I noticed, that the more simple I kept my food-intake, plus making sure about my liquid-intake-limitation, the easier my body dealt with dialysis and the more energy I had. (Make sure and check-up with a dietician about all important nutrients etc. and keep an eye on potassium-intake etc.).
For example: after a few months on dialysis I did notice, that with different food-intakes my weight changed daily and that made it difficult & confusing for me to know, whether a weight-change was due to the different food or whether my kidneys were failing even more or whether my kidneys were picking up or what.
Because of that confusion I started to eat practically every day the same breakfast with the same amount of food, the same lunch with the same amount of food and the same for dinner, again with the same amount of food and I always had exactly the same liquid-intake, went for regular walks and every morning I checked up on my I weight.
These precautions gave me a practical chance to keep an eye on my weight and as a result on my well-being and my health.
After a little time on dialysis the body becomes a bit more sensitive/vulnerable and that makes it so important to make life as simple as possible for the body (and soul), to remain able to endure years of dialysis-treatments.
Keeping all these daily precautions, with regular walks "thrown in", kept my body and soul fit enough to be ready and prepared for the transplant-operation, which in itself was very "heavy" on my body (and soul) to start off with for the first three months.
Good luck-wishes from Kristina. 

[Paul]

I have found that the only way to survive is to treat it like a calorie controlled diet. Work out the potassium and phosphate content of the things you eat (Google will tell you this) and juggle it to keep your intake into the safe limit. (It will take a while to work out your safe limits, basically discuss with your dietitian who will only be able to give you a wild guess, as it differs widely from person to person, then watch your blood results to see if their guess is to low or too high and adjust accordingly, will take several tries unless you is a genius).

Do note, you will have to keep an eye on your monthly blood as the odds are that your kidney is still slightly active, but slowly getting less active. The worse it gets, the less potassium and phosphate you can eat.

Also note this does allow you to eat almost anything, if you take it seriously. For example a woman at the same clinic as I use managed to eat so little potassium that she could safely have a banana, and she has zero kidney activity (they have been removed), but you must stick carefully to your limits or you will have problems.

[LorinnPKD]

I had three sips of orange juice this morning.  It was heavenly.

I just had to tell someone.