I am almost 16 months post transplant. What precautions do you take in regards to food safety when eating out, at friends houses, parties etc.? Based on advice from my transplant center, I avoid not only undercooked meat and fish, but also ice, water and any raw greens, veggies and fruit-basically following the CDC’s advice for not getting Montezuma’s revenge when you’re in Mexico lol. Just wanted to check in with others to see what works for you. My dad had a transplant and lived for 29 extra years and ate everything!
Also, I read an interesting study which found the chemical in peppers, capsaicin, can cause gi cramping/ pseudo colitis in people taking tacrolimus especially when there is a history of irritable bowel syndrome. I’m starting to connect this with some of my own occasional G.I. issues. Seems whenever I eat peppers or something with chili powder, paprika,etc my G.I. tract shows signs of irritation. Has anybody else noticed a connection?
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Jamok
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Hi Jamok. No experience with peppers especially but I just use common sense when eating in general. I think the food safety rules apply to everyone, not just transplant patients. I am 11 months out and have gradually loosened my grip on extreme carefulness. Pretty much eat everything, apart from dodgy food. No problems as of yet. X
I tend to err on the side of caution. I had a PRA of 100% when I received my transplant . So depends on your own comfort level and how susceptible you are. In general, I stay away from raw foods including salads and cut fruit at when eating out. So no raw fish or oysters. Meat/ fish cooked well done. No buffets. Even with all the precautions, I have had several bouts of e-coli.
I check health scores of restaurants.
I try to ask friends to triple wash veggies and fruit or offer to prep them or bring the salad.
If I notice people coughing into their hands, licking their fingers and not washing after or not taking proper hand hygiene while cooking, then I might claim that I not hungry or snack on something I know they haven't touched. If they are good friends, I try to remind them before they start. Even then, it's not that comfortable to remind people and not always well received.
For pot luck meals, I try to be first. Or ask the host to prep a plate for me before everyone else.
And when in Mexico or elsewhere with street food definitely avoid the salsa, cilantro, onions (any uncooked veggies) on your food. And if they use plastic plates make sure they use something on the plate like parchment paper in between the food and plate.
Thanks for your reply! Yeah, family/ friend gatherings-that’s the hard one! It’s amazing how few people wash their hands before or after prepping food! If I remind people to wash their hands, I get attitudes, so I just don’t eat too much when I go to these things. At Thanksgiving, I watched my brother-in-law, carving the turkey and licking his fingers in between placing the slices on the platter. Yuck! And no one seems to worry about washing their hands before eating and that’s just common sense. Then you risk offending people if you don’t eat their food. it seems to me we had to watch films about good hygiene in school and we always had to wash her hands before lunch. It’s not a new concept. Sorry for the rant! What do you think about ice and restaurants? Transplant Center said to avoid since bacteria built up in the line.
Rant away. I am 100% with you! Washing your hands before you eat was something our grandparents were taught. And definitely something we were all taught in school. Not sure where that got lost along the way as we grew up. Crazier that folks still don't have proper hand hygiene after 3 yrs of covid! So many people lick their fingers when handling and serving food. And eating. It's one thing if it's just your own food but when you are sharing. Eww. I know we all do it (no idea when it became so commonplace) but when I know I am doing it, I don't touch others food or use a napkin to handle shared serving utensils or go wash my hands first.
I don't know why people get so offended when they are reminded to wash their hands?! It's for everyone's sake including theirs.
I try to avoid ice in restaurants and also soft serve icecream, frozen yogurt. For the same reason. The machine and the lines don't get cleaned that often and it's not worth the risk.
you’re right about the ice cream machines. Oh well, not good for me anyway. Yeah my downfall is while I’m cooking. I use a spoon to taste for seasonings. I try to be more conscientious about rinsing it off in or using another one but sometimes I just figure it’s hot and the heat will kill the germs if I reuse, but this is just for my own self and husband. Try not to do that when serving a group.
We all do what we can. None of us are perfect. I catch myself all the time. I couldn't believe how much I had changed from when I was growing up when I got sick and had to be a stickler about hygiene. At least, we acknowledge and try! That's really all we can ask for. Happy 4th!
I’m 17 months post and I still don’t eat what other people make at potlucks. I bring my own. People are disgusting. I was using sanitizer and wipes before the pandemic, since 2009, when I caught H1N1 and just got tired of catching other people’s germs. I only eat cooked vegetables at restaurants. I don’t eat meat at all, it’s hard on the kidneys.
Yep that’s kind of what I am starting to do as well. Offered to bring some thing and then I can eat that. And I busted my daughter. A salad and doesn’t even bother washing off the herbs and veggies she was using to make the salad. Yikes. I can’t understand this at all. I mean yeah back in the day my dad would grab an apple at the store, wipe it on his shirt and eat it while he was walking around. He thought I was over-the-top in regards to germ consciousness, back then. This was in the 1990s
My hubby, with the transplant, has gone back to a relatively normal life. His restrictions were in place during the early months of the transplant when his immunosuppressants were very high. Later, after the immunosuppressants were lowered, the restrictions were eased - but we asked in advance. Our nephrologist told us to live life, simply being mindful. Apparently stomach acids return to take care of a lot bad bugs. Also, the issue surrounding buffets isn't so much the food, but the handling of of serving spoons, the proximity of people surrounding them, etc. We just look around and judge for ourselves. Nothing is "off the table" as such. Food in the US is generally prepared in very sanitary environments and with clean running water. If one does travel to lesser developed nations, eating things that are raw can be an issue since they can soak up polluted water. Hence, food should then always be boiled including drinking water (or substitute hot teas, bottled water, etc.). Your comment re spicy items caught my attention. When I was abroad, I was told me that locals in rugged nations used peppers and related, particularly those packing a lot of heat, to naturally kill bacteria and viruses internally. They do carry wallop! A lot of people from western nations, including myself, couldn't handle that. Anyway, like you, my husband has become more sensitive to certain foods - so he, too, limits onions, salads, and so on. It has to be med related - that's what we think, anyway.
So true about stomach acid although I’m on Pepcid so that reduces it. I guess it all comes down to common sense. The fact that your husband also notices a difference with food lays media think those studies have something to them.
In addition to being careful about how food is prepared, I follow a low salt, low protein diet. When I visit family, I bring my own food with me so I have a backup meal if I’m not comfortable with what is being served or how it’s being prepared. I end up eating my own food more often than not. When I do eat the same food as everyone else, I choose items I can throw in the microwave to reheat. It’s difficult to explain all this to friends and family, so I try to keep it simple and just say it’s what my doctors recommend. I get the feeling some people are offended, while others think I’m overdoing it. I’ve been doing this for over 30 years (ever since being diagnosed with kidney disease) and more so since my transplant (3 years ago). Food is such a central part of our culture that it sometimes makes it awkward to socialize, but I have gotten used to it.
I went to a big music festival. All meals were buffet style. It was at a hotel. I simply asked the main folks that served if I could have bring the meal directly to me. They did an awesome job. I did not have to go through any buffet line other than one time where I was the very first person to go through the breakfast line.
If we go out, my wife who is a nurse, always question where we can sit. If the restaurant is crowded we go elsewhere. Sitting outside is a huge plus if we can. I've gotten salads but question the staff of their cleaning methods etc and explain about immunosuppression and a kidney transplant.
I agree with some of you that people have forgotten Covid and it is still around. Check the information out there for your area. My wife talks about stomach acids taking care of most things but I never thought about the fact that I take Pepcid as well. I'll have to check that out further.
If I have questions about anything like this I always contact my nurse coordinator at the transplant center. They have been so helpful all the time. I trust their recommendations and try to follow them. That's what I would encourage all of us to do going forward.
Sounds like you have a great Transplant Center! Transplant Center is one of the top 10 Transplant Center supposedly. I get a different answer depending on who I speak to at mine.
I talk with the same nurse who refers me to my own transplant nephrologist. I also consult my primary care doctor who has known for 30+ year and my own nephrologist who was trained at my transplant center. I feel like I have a tremendous “team” of folks that look after my well being. Of course I live with a nurse practitioner and I can’t get away with much…..LOL. She must really love me.😀
yes, you’re very blessed to have a spouse that’s your advocate, and totally understands and supports what you must do to stay healthy! I love my husband to death and my children, but they think I’m a bit over-the-top when it comes to precautions I need to take and I think they find it kind of annoying. I have to remind them that what would be more annoying is me being in a hospital for a month because I’ve been careless. Just have to accept the my new normal which is a small price to pay when you look at the big picture right?
So I am almost a year out and have been getting more and more comfortable eating out with certain constraints. Sticking to hot food options unless in very rare exceptions. Avoiding lettuce and tomatoes and mayo on burgers. Trying to stay mostly vegetarian when possible. I have had no problem with peppers so far. No sushi, salad bars, restaurant buffets, salads at restaurants. My rule of thumb is will this cause me an infection as a way to filter the risk profile.
For gatherings, I have been experimenting with saying I am a bit of a hypochondriac to avoid having to explain what general food safety and health guidelines to follow (like washing your hand sadly). This way I either eat first before other people get to it or just bring my own thing and eat.
In general, your mindset is right imo to avoid costlier mistakes to protect your gift. But it is hard to navigate social situations and norms without being a broken record. I am struggling with it too and haven't cracked it yet lol.
Hi Jamok. I am 73 years old and four years post transplant. I eat most things but I wash all fruit and salads and am careful eating out. I found that eggs are problematic but trial and error with caution is the way forward. Good luck. Sean
32 years post but only recently put on Tac due to a mild rejection episode. Recently got the worst food poisoning of my life at nice restaurant in Boston - crab cakes. Sometimes you just never know. But I wonder if the tac has now made me extra susceptible. I’ve never been careful around food before - sushi’s even one of my favorite foods (only get it from reputable places though). If I can no longer have that I’ll be sad. The tac has done a number on my GI tract, I’ll have to start paying attention if pepper things make it worse. It def made bouncing back from the food poisoning longer/harder.
Nutrition guidelines post transplant are very very clear - they do not recommend raw sushi due to risk of infection or parasites. They don’t even recommend cooked sushi since there’s a high risk of cross contamination being prepared near the raw sushi. If you chose to eat it, that’s your choice, but it’s against medical advice. To me it’s not worth the risk.
In general, eating at home is recommended over eating out - and now you know why!
However, you still have to live your life.
If you get food delivered you are supposed to re-heat it until hot, even if your friends bring over potluck dishes.
No runny eggs either….sigh, I miss sunny side up eggs. But transplant is worth it. Avoid those Seville oranges - “bitter” orange. they’re in marmalade and guess what!!! Often in “orange chicken” in Chinese restaurants. Do not eat that dish. Don’t leave food out for more than an hour and don’t keep leftovers past 2 days -pitch it. Make sure what you’re cooking gets up to proper temperature - 165 usually AND what’s you’re reheating gets that hot. I have two digital meat thermometers I use.
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