Hi,
I was transplanted a week ago and am still getting my head around what I can't eat. Principally the risk from non pasteurised foods, I love cheese and especially camembert and blue cheeses but am told to avoid them. Does anyone know if cooking makes them safe, eg pies made with stilton pastry.
The main risk is from listeria but this cannot survive beyond 74 degrees so I figure cooking makes it safe, does anyone know. Also does anyone know of safe pasteurised substitutes for these foods.
Thanks - Keith.
Diet post transplant - what can't I eat?
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Helen Rambaut
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cheese
Well I havent been given the talk about cheese (somehow avoided it) and I have been eating all kinds and I think most of it has come out of the chiller cabinet.
Post tx my phosphate levels dropped sharply which often happens so it was a great excuse to eat all those things I hadnt been allowed to eat while on pd.
Smoked salmon, prawns, cream cheese, camembert, yoghurt, blue cheese, you name it I ate it!
Maybe just lucky but seem to be pretty well on it.
Post tx my phosphate levels dropped sharply which often happens so it was a great excuse to eat all those things I hadnt been allowed to eat while on pd.
Smoked salmon, prawns, cream cheese, camembert, yoghurt, blue cheese, you name it I ate it!
Maybe just lucky but seem to be pretty well on it.
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JMan
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Star fruit and some citrus (grapefruit I think) can alter the rate at which some immunesuppressants are aborbed. Unpasteurised cheeses, etc. Other than that, and food that hasn't been prepared with regular hygiene your OK:)
J
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Helen Rambaut
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cheese cont.
Hubby just looked up Rustique Camembert which we bought this morning and it says made from pasteurised milk with the taste of unpasteurised.
Think if a cheese is unpasteurised milk it will probably say so as a selling point.
H
Think if a cheese is unpasteurised milk it will probably say so as a selling point.
H
Post tx I was asked to review the nutrition information for Tx patients at my unit (they were issuing new leaflets) and was able to quiz them about the advice. Our unit gives the same advice for a tx patient as for pregnant women. I was told that was because there has been no specific research so this is a prudent approach.
So no raw products (including smoked salmon), unpasturised or blue cheeses, under done meat etc etc. As for other things - no grapefruit with immunosuppression, star fruit and (as I am on warfarin) no cranberries or cranberry juice.
Now - do I follow that to the letter - quite a bit of it (all at the beginning) and don't break all the rules at once. Essentially no one can tell you the exact risk so it is your judgement - personally I chose to follow it more strictly when eating out than eating food I know the providence of and have prepared myself. I feel it to be a very small price for a fantastic gift.
So no raw products (including smoked salmon), unpasturised or blue cheeses, under done meat etc etc. As for other things - no grapefruit with immunosuppression, star fruit and (as I am on warfarin) no cranberries or cranberry juice.
Now - do I follow that to the letter - quite a bit of it (all at the beginning) and don't break all the rules at once. Essentially no one can tell you the exact risk so it is your judgement - personally I chose to follow it more strictly when eating out than eating food I know the providence of and have prepared myself. I feel it to be a very small price for a fantastic gift.
Thanks Helen & Mandy, just looked up on a pregnancy site and it says avoid camembert even if pasteurised, now I'm confused. Oddly it says that parmesan is ok even if not pasteurised, it seems the divide is over hard/soft cheeses.
http://www.babyworld.co.uk/information/ ... t_safe.asp
http://www.babyworld.co.uk/information/ ... t_safe.asp
You sure about cranberries as it was never mentioned to me post transplant, in fact it was recommended as helps prevent UTI's?
Looking up on the royal free website only mentions avoiding cranberry with warfarin and nothing about avoiding it with tacrolimus?
http://www.royalfree.org.uk/pip_admin/d ... d_1091.pdf
Looking up on the royal free website only mentions avoiding cranberry with warfarin and nothing about avoiding it with tacrolimus?
http://www.royalfree.org.uk/pip_admin/d ... d_1091.pdf
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bigbuzzard
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The last thing that happened before I left hospital after tx was the pharmicist making second visit with some phosphate pills, and instructions to eat plenty of all that good stuff that Helen listed. Somehow i hadn't been given a diet lecture, so I went straight across the road to Neals Yard dairy in Borough market, and spent £20 on a selection of hard & soft, pastuerised and not.
General guidance is to avoid unpasteurised cheese, but I've since been old by a cheese maker that the long storage process involved in making hard cheese gets rid of the risk from any bacteria that might have been there.
So like many things, I think there is a lot of over-cautious generalised advice dished out, but if it's something that matters to you, and you take the trouble to look into it more closely, then there are many 'risks' that are actually very small - so you can make an informed choice about specific elements of the general advice.
General guidance is to avoid unpasteurised cheese, but I've since been old by a cheese maker that the long storage process involved in making hard cheese gets rid of the risk from any bacteria that might have been there.
So like many things, I think there is a lot of over-cautious generalised advice dished out, but if it's something that matters to you, and you take the trouble to look into it more closely, then there are many 'risks' that are actually very small - so you can make an informed choice about specific elements of the general advice.
Thanks for clearing that up Mandy 
I have to say I agree with bigbuzzards advice above most of the others and I have found that different units give different advice anyway. I specifically asked whether I would be allowed shellfish and was told basically yes and what you really have to look for is how the food is prepared and stored not what the food is.
For example avoid unpasturised mayonnaise made by a friend but mayonnaise sold in suopermarkets has to be made to a certain hygiene standard so it will likely be ok. You can never be 100% sure anyway and doesn't really make much difference if you are pre or post transplant with things like salmonella, listeria and ecoli!
Really the only advice you need is be sensible, have a bit of common sense and know how your food has been prepared and stored.
Mike
I have to say I agree with bigbuzzards advice above most of the others and I have found that different units give different advice anyway. I specifically asked whether I would be allowed shellfish and was told basically yes and what you really have to look for is how the food is prepared and stored not what the food is.
For example avoid unpasturised mayonnaise made by a friend but mayonnaise sold in suopermarkets has to be made to a certain hygiene standard so it will likely be ok. You can never be 100% sure anyway and doesn't really make much difference if you are pre or post transplant with things like salmonella, listeria and ecoli!
Really the only advice you need is be sensible, have a bit of common sense and know how your food has been prepared and stored.
Mike
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great advice above!
I would also add that I was quite strict immediately post transplant when recovering and on higher immuno doses: I avoided all soft cheeses, anything unpasteurised, shellfish, raw eggs, raw fish etc.
About 6 months in I relaxed the cheese and shellfish rule, though I get very twitchy around raw or undercooked eggs and raw fish and avoid at all costs. I was also told to be very cautious around buffets and deli counters especially where it is exposed to other people. If there is glass between the food and me I usually am ok with that. I am also cautious aorund BBQs, though I follow a mostly vegetarian diet anyway.
As Mandy said, it is a small price to pay, and a nasty case of food poisoning can lead to transplant rejection.
I would also add that I was quite strict immediately post transplant when recovering and on higher immuno doses: I avoided all soft cheeses, anything unpasteurised, shellfish, raw eggs, raw fish etc.
About 6 months in I relaxed the cheese and shellfish rule, though I get very twitchy around raw or undercooked eggs and raw fish and avoid at all costs. I was also told to be very cautious around buffets and deli counters especially where it is exposed to other people. If there is glass between the food and me I usually am ok with that. I am also cautious aorund BBQs, though I follow a mostly vegetarian diet anyway.
As Mandy said, it is a small price to pay, and a nasty case of food poisoning can lead to transplant rejection.
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Helen Rambaut
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what cant I eat
Word fresh from the tx clinic this morning....
Me to Consultant "as far as I'm concerned my mother ate normally and until I am told otherwise I'm going to eat normally as well"
Reply "Oh I think this is much more about health & safety being cautious. You are a tiny bit more at risk from listeriosis....but if you do get it then we'll just have to treat you for it. You can eat normally."
So I will take the same precautions about eating food that any healthy person should take.
Relieved.
Me to Consultant "as far as I'm concerned my mother ate normally and until I am told otherwise I'm going to eat normally as well"
Reply "Oh I think this is much more about health & safety being cautious. You are a tiny bit more at risk from listeriosis....but if you do get it then we'll just have to treat you for it. You can eat normally."
So I will take the same precautions about eating food that any healthy person should take.
Relieved.
I eat the opposite of the renal diet.
That was weird to switch back to the good healthy diet.
Grains , nuts and plenty of protein.
I never eat "fast food".
Eat blue cheese and camenbert...never told to watch out for those.
This month will be 2 y. post transplant and I'm feeling 20 years younger!
Seasons Greetings! Jane
That was weird to switch back to the good healthy diet.
Grains , nuts and plenty of protein.
I never eat "fast food".
Eat blue cheese and camenbert...never told to watch out for those.
This month will be 2 y. post transplant and I'm feeling 20 years younger!
Seasons Greetings! Jane
Lots of common sense here and I think I must make my own mind up, I will ask the dietician but meantime I'll avoid unpasteurised foods. I'm a vegetarian so it really only applies to cheese anyway, good point about barbecues and food prepared by others. Not much of a compromise really, the key thing for me to find out is if cooking cheese into food is OK as the temperature destroys the bacteria.
Strange thing is I'm 12 days post transplant and have been given pro biotic yogurt for lunch in the recovery unit of the hospital, I did mention it but they just said they don't have any other kind - strange, just illustrates the point that you need to be responsible for your own health and not rely on others.
Feeling sore today as yesterday was the first day I felt able to walk to clinic, inevitably overdid it, still so swollen with fluid that the only footwear that fits is my slippers. Need to head into town and buy some oversized trainers to allow me to move about without looking like a homeless person.
Thanks everyone for the quick and comprehensive response.
Strange thing is I'm 12 days post transplant and have been given pro biotic yogurt for lunch in the recovery unit of the hospital, I did mention it but they just said they don't have any other kind - strange, just illustrates the point that you need to be responsible for your own health and not rely on others.
Feeling sore today as yesterday was the first day I felt able to walk to clinic, inevitably overdid it, still so swollen with fluid that the only footwear that fits is my slippers. Need to head into town and buy some oversized trainers to allow me to move about without looking like a homeless person.
Thanks everyone for the quick and comprehensive response.
Hello,
A bit late, but I've just swapped clinics and have just seen "avoid" advice about pomegranate and live yogurt. Both of which I've been troughing since my transplant!
Good advice given just after my transplant was to avoid rice when out, as many restaurants and takeaways leave cooked rice to sit warm for a long time. If you have a bad stomach after a curry, it is more likely to be the rice than the meat.
Also, and this is neurotic, I always alcohol my hands after washing them in a pub or restaurant toilet. All those unwashed hands on one little handle!
A bit late, but I've just swapped clinics and have just seen "avoid" advice about pomegranate and live yogurt. Both of which I've been troughing since my transplant!
Good advice given just after my transplant was to avoid rice when out, as many restaurants and takeaways leave cooked rice to sit warm for a long time. If you have a bad stomach after a curry, it is more likely to be the rice than the meat.
Also, and this is neurotic, I always alcohol my hands after washing them in a pub or restaurant toilet. All those unwashed hands on one little handle!