My wife has CLL and is in wait and watch.
She has a lot of concern always about whether food is cooked properly or not. She is worried if the food is undercooked, she is at risk for developing an infection.
How warranted is this concern? What would she be at risk for?
There's a risk that if she has neutropenia, she is more likely to become ill from consuming any food with a high bacteria count. Given that even healthy people can become very ill from eating undercooked food, it makes sense to be more careful about food safety; cooking food at a high enough temperature for long enough to kill bacteria, putting food in the refrigerator while still hot, being careful to avoid contamination from uncooked food in the fridge that contains bacteria, consuming it within a day or so and so on.
Dieticians nowadays are generally more concerned that people with neutropenia have a wide ranging diet for adequate nutrition, rather than adhering to the classic neutropenic diet.
There's a section on living with neutropenia towards the end of this pinned post: healthunlocked.com/cllsuppo...
Neil
Your wife has probably been paying attention to what CLL specialists say about it being a disease of the immune system, which is profoundly disrupted from an early stage, well before diagnosis.
CLL patients tend to become more vulnerable to infection in the later stages of disease and during treatment, when neutrophil and immunoglobulin counts usually reach their nadir. However, that doesn't mean that early stage patients are not at risk:
ncbi.nlm.nih.gov/pmc/articl... Newly diagnosed patients with CLL have inherent immune defects that predispose them to infection, including hypogammaglobulinemia, defects in T-cells, suppressor natural killer cells, dendritic cells, neutrophils and complement system.
Food hygiene is fundamental to managing infection risk. A GI infection might be over in a day, or it could get out of hand and lead to something worse.
In this there are degrees of risk and judgement calls to be made. I would cook my steak medium rare, but I would not buy oysters from a market stall. Your wife carries the risk, so she should decide what to eat and how it should be cooked.
I love egg yolks, but with the bird flu jumping species, it's a small sacrifice to fry them all the way through (the eggs, not the species).
Moving on, when one is diagnosed, there is a big feeling of vulnerability. One doesn't really appreciate their wonderful immune system that has been guarding them every moment of their life until it is gone. In addition, that there is precious little we can do to keep what we do have, it makes any action no matter how inconsequential it may seem to others, rather important.
My opinion only, make meal time a pleasant time, it shouldn't feel like one's last meal.
In my opinion, she is right to insist that her food is correctly cooked, especially poultry, I wouldn't eat it undercooked, beef and lamb I prefer on the rare side but any poultry and pork I like to be cooked appropriately to kill off all bacteria .
I am under treatment and use G-CSF to deal with neutropenia. For me, poultry should always be well cooked. The same for beef and lamb if they have been minced. I will, however, happily eat a medium rare steak or roast lamb / roast beef since the exposed parts have been fully cooked. I never eat salads , fruit etc when out but am quite happy to at home - we wash everything thoroughly.
In the beginning of W&W I worked with a TCM doctor (Traditional Chinese Medicine). One of the suggestions he gave me was to eat nothing uncooked or raw while out dinning. If I do eat out I follow that mindset. I do not eat salads in restaurants due to being exposed to bacteria. Everything I eat out is cooked. I will eat a salad at home after thoroughly washing everything. I tend to eat a lot of cooked vegetables. It’s easier on my digestive system. That philosophy has served me well. Take care!👩🦳
I totally agree Katie, word for word.
Yesterday, I went out for a meal with Mrs ygtgo, we both ordered the same starter, one without salad ... it looked really tasty, but I wont take the chance, the same with the drinks NO ice for me ... still enjoy a good salad meal at home, washed and prepared by myself.
Glad that you’re cautious! I may come across as if I have OCD at times. Unless I know someone well I would rather not eat things that are “homemade”. If I come across a bake sale I just give a donation. 😂
Safety and protection in hospital
Food Parcels
Recalls, Market Withdrawals, and Safety Alerts 
Imbruvica and Food Issues 
