Your best tips for raw food safety post transplant.

Posted by jolinda @jolinda, Aug 3, 2019

Does anyone have good guidelines for eating raw food post transplant. I am specifically interested if anyone remembers the things you were taught about raw fruits and veggies. As an example I was told it is ok to eat prewashed lettuce if you rewash it or that fruit with bumpy skin, like cantaloupe can't be washed well enough to avoid contaminating the fruit when cutting through it.

MODERATOR'S NOTE
The knowledge exchange shared in this discussion helped to create this article written for the Mayo Clinic app. Knowledge for patients by patients and beyond Mayo Clinic Connect.

– How to safely enjoy fruits and veggies after a transplant https://www.mayoclinic.org/CPT-20514171

Interested in more discussions like this? Go to the Transplants group.

@loribmt

I’d be much less concerned with eating the micro greens from your local farmer. He’s seems pretty attuned to the bacterial issues. If you wanted to go the extra step to safety, you could do a soak in some vinegar water and spin dry. (Salad spinner)

What to avoid (or what I’ve been told to avoid) would be the sprouts or pre-washed lettuce and veggies in bags from commercial sources or pre-cut veggies and fruits from a grocery store. Especially chopped iceberg lettuce in bags. They seem to test high in bacteria. Also still on my no-no list are any deli meats unless heated to 160 degrees…which defeats the purpose of cold cuts and tastes awful! LOL And of course, avoiding buffets or raw foods where I don’t know the cleaning process.

We use packaged fresh spinach soaked in vinegar water first. Most of our spinach is sautéed or eaten in soup anyway. Leaf lettuce I generally wash each leaf after soaking the head in v-water.

No way will I eat at a potluck unless it’s food I make myself or really know the cook! It’s no biggie. I grew up going to church pot lucks with my mom gently touching my wrist and almost imperceptibly shaking her head if I was reaching for a spoon in a dish of unknown parentage. Her quiet action screamed, “Don't touch that!” Haha! As I got older, I appreciated her behind the scenes knowledge of the cooks!

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Hi all,
Love this discussion…it's so helpful to a first year transplant like me! Question – do you ever eat soup out at a restaurant or cafeteria? If so, do you ask them to microwave it to make it steaming hot or is it okay as served? Also, I have my annual Mayo visit coming up. What kinds of things do you order at their cafeteria or small restaurants for lunch in between doc appointments? Thanks everyone!!!

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@hello1234

Hi all,
Love this discussion…it's so helpful to a first year transplant like me! Question – do you ever eat soup out at a restaurant or cafeteria? If so, do you ask them to microwave it to make it steaming hot or is it okay as served? Also, I have my annual Mayo visit coming up. What kinds of things do you order at their cafeteria or small restaurants for lunch in between doc appointments? Thanks everyone!!!

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Glad to help. Just keep in mind I had a bone marrow transplant, not solid organ. So your continued aftercare protocol for diet might be different than mine. I just know what I need to do as long as I’m still on the tacrolimus. I’m on my last taper right now and hopefully completely off soon. Then some of my restrictions will ease. You will be on an immunosuppressant life-long so that your body doesn’t reject your transplant. It’s perfect that you’re heading to Mayo soon! Ask your team…have a list of notes handy for the nurse coordinator.

As for soup, restaurants are required to keep foods at a certain temperature to avoid bacterial growth. I suppose it’s not a guarantee it will be safe, but I wouldn’t hesitate to eat hot soup. Maybe if it’s like a clam chowder or cream based I’d be a little more cautious? I’d be anyway, even without a transplant.

When we’re at Mayo it’s generally a 2 or 3 nights in Rochester. We always stay in a hotel connected to the clinic. (Same one we lived in for months). Our room has a full kitchen so we just bring our own food for all meals. If we are out at lunch, as much as I’d like a cold Turkey/bacon wrap I have to opt for a hot chicken sandwich. Things just need to be cooked. We adapt and move on, ☺️

Congratulations on your first year anniversary coming up! No better place to celebrate than the Mother Ship where it all happened. 😘

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Thank you @loribmt for all of the good info! I am on tacronlimis and Cellcept so I will look for cooked foods too! I like your hot chicken sandwich idea. I am headed to Jacksonville Mayo where my transplant took place. It's such an unbelievably wonderful hospital! I am a little concerned about the covid surge in Jacksonville since I will be driving four hours and staying at a hotel (with no antibodies). My plan is to just continue to be SUPER careful and stay in my room between doc appointments. By the way,…a different topic…did you experience any hair loss with Tacronlimis? I am definitely shedding!! Just curious if you heard any transplant or Tacronlimis patients' remedies for hair loss?

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@hello1234

Thank you @loribmt for all of the good info! I am on tacronlimis and Cellcept so I will look for cooked foods too! I like your hot chicken sandwich idea. I am headed to Jacksonville Mayo where my transplant took place. It's such an unbelievably wonderful hospital! I am a little concerned about the covid surge in Jacksonville since I will be driving four hours and staying at a hotel (with no antibodies). My plan is to just continue to be SUPER careful and stay in my room between doc appointments. By the way,…a different topic…did you experience any hair loss with Tacronlimis? I am definitely shedding!! Just curious if you heard any transplant or Tacronlimis patients' remedies for hair loss?

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@hello1234, You have re-introduced a very important topic for discussion for transplant patients. For us 'oldies' food safety and travel have become a habit. However for the 'newly' transplanted members, like yourself, there is much to be gained by sharing with each other while you are experiencing your first footsteps into your post-transplant life. I am happy to share some relevant discussions.

How do you stick to your dietary plan when traveling for medical care?
https://connect.mayoclinic.org/discussion/how-do-you-stick-to-your-dietary-plan-when-traveling-for-medical-care/
Tips: Traveling to Mayo to get medical care safely during COVID-19
https://connect.mayoclinic.org/discussion/your-tips-traveling-and-getting-medical-care-safely-during-covid-19/
What do you order when eating at a restaurant?
https://connect.mayoclinic.org/discussion/what-do-you-order-when-eating-at-a-restaurant/
@athenalee, @karmamamma, @melody12, @linmarie, @jackie421blfdgurl, @la4hope, @terry14, @craigmorris,

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@hello1234

Thank you @loribmt for all of the good info! I am on tacronlimis and Cellcept so I will look for cooked foods too! I like your hot chicken sandwich idea. I am headed to Jacksonville Mayo where my transplant took place. It's such an unbelievably wonderful hospital! I am a little concerned about the covid surge in Jacksonville since I will be driving four hours and staying at a hotel (with no antibodies). My plan is to just continue to be SUPER careful and stay in my room between doc appointments. By the way,…a different topic…did you experience any hair loss with Tacronlimis? I am definitely shedding!! Just curious if you heard any transplant or Tacronlimis patients' remedies for hair loss?

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We’re worried about going to Florida too! We generally spend winters there and missed last year because of Covid. We were prepared to be heading back in October. But now, with the surge again and the ‘powers that be’ not encouraging compliance, we’re really leery about heading down.

For your quick visit to Mayo though, you should be fine just following your normal stringent precautions for Covid. When we’re at any hotel we take along a container of Clorox or Lysol wipes. Both my husband and I know the routine. We start with each room and go around wiping doorknobs, doors where we’ll touch, horizontal surfaces of counters, tables, light switches, water faucets, tv remotes…and give the toilets a wipe down too. Since my transplant we even take Lysol spray to nuke around the toilet and floor, shower curtain. Yup, sounds severe but it has kept us safe. Oh, and do NOT drink out of the glasses in the bathrooms unless it’s the plastic cups sealed in a baggie. Take some Dixie cups along… Only takes a few minutes and then you’re not left wondering about safety. The clinic will require masks and have sanitizer everywhere! They’re so cautious you’ll be fine there.

Not sure I had hair loss from Tacro. I lost my hair 3 times from Chemo. Took a while after the 4th round to have it make a reappearance. I’m on such a low dose of tacro that I don’t think it’s having any impact on my hair.
I do know that any surgery, illness, anesthesia that could disrupt the growth cycle of hair will take time to regenerate. You might just be going through that phase of loss with no regrowth yet.
We have other members such as @ladydidehart, @gaylea1, @jolinda who have had success with Biotin. Their discussion is here in transplant an anti rejection med discussion. https://connect.mayoclinic.org/comment/308556/

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@loribmt

We’re worried about going to Florida too! We generally spend winters there and missed last year because of Covid. We were prepared to be heading back in October. But now, with the surge again and the ‘powers that be’ not encouraging compliance, we’re really leery about heading down.

For your quick visit to Mayo though, you should be fine just following your normal stringent precautions for Covid. When we’re at any hotel we take along a container of Clorox or Lysol wipes. Both my husband and I know the routine. We start with each room and go around wiping doorknobs, doors where we’ll touch, horizontal surfaces of counters, tables, light switches, water faucets, tv remotes…and give the toilets a wipe down too. Since my transplant we even take Lysol spray to nuke around the toilet and floor, shower curtain. Yup, sounds severe but it has kept us safe. Oh, and do NOT drink out of the glasses in the bathrooms unless it’s the plastic cups sealed in a baggie. Take some Dixie cups along… Only takes a few minutes and then you’re not left wondering about safety. The clinic will require masks and have sanitizer everywhere! They’re so cautious you’ll be fine there.

Not sure I had hair loss from Tacro. I lost my hair 3 times from Chemo. Took a while after the 4th round to have it make a reappearance. I’m on such a low dose of tacro that I don’t think it’s having any impact on my hair.
I do know that any surgery, illness, anesthesia that could disrupt the growth cycle of hair will take time to regenerate. You might just be going through that phase of loss with no regrowth yet.
We have other members such as @ladydidehart, @gaylea1, @jolinda who have had success with Biotin. Their discussion is here in transplant an anti rejection med discussion. https://connect.mayoclinic.org/comment/308556/

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Thank you so much @loribmt and @rosemarya . You are both a wealth of information! I am so happy I found Mayo Connect. 🙂

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@hello1234

Thank you @loribmt for all of the good info! I am on tacronlimis and Cellcept so I will look for cooked foods too! I like your hot chicken sandwich idea. I am headed to Jacksonville Mayo where my transplant took place. It's such an unbelievably wonderful hospital! I am a little concerned about the covid surge in Jacksonville since I will be driving four hours and staying at a hotel (with no antibodies). My plan is to just continue to be SUPER careful and stay in my room between doc appointments. By the way,…a different topic…did you experience any hair loss with Tacronlimis? I am definitely shedding!! Just curious if you heard any transplant or Tacronlimis patients' remedies for hair loss?

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I had severe hair loss from Tacrolimus. I started taking 5-10,000 mcg/day (highest recommended dosage). My hair gradually stopped falling out shortly thereafter. Since my Tac dosage has been reduced I now take 1,000 mcg biotin/day. My hair is healthy and growing nicely.

Be sure to stop taking biotin at least three days prior to labs, and a week prior if you are having thyroid tests (TSH), as it interferes with the lab results,

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@loribmt

I’d be much less concerned with eating the micro greens from your local farmer. He’s seems pretty attuned to the bacterial issues. If you wanted to go the extra step to safety, you could do a soak in some vinegar water and spin dry. (Salad spinner)

What to avoid (or what I’ve been told to avoid) would be the sprouts or pre-washed lettuce and veggies in bags from commercial sources or pre-cut veggies and fruits from a grocery store. Especially chopped iceberg lettuce in bags. They seem to test high in bacteria. Also still on my no-no list are any deli meats unless heated to 160 degrees…which defeats the purpose of cold cuts and tastes awful! LOL And of course, avoiding buffets or raw foods where I don’t know the cleaning process.

We use packaged fresh spinach soaked in vinegar water first. Most of our spinach is sautéed or eaten in soup anyway. Leaf lettuce I generally wash each leaf after soaking the head in v-water.

No way will I eat at a potluck unless it’s food I make myself or really know the cook! It’s no biggie. I grew up going to church pot lucks with my mom gently touching my wrist and almost imperceptibly shaking her head if I was reaching for a spoon in a dish of unknown parentage. Her quiet action screamed, “Don't touch that!” Haha! As I got older, I appreciated her behind the scenes knowledge of the cooks!

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Thanks as always Lori! I do have to chuckle though, even though I know it’s serious. Guess I’ve been lucky so far.

I’m assuming you do your vinegar rinse for lettuce…even if it says it’s triple rinsed? I only by local, organic and typically hydroponic mixed greens. Probably double bad! Ugh.

I actually read a research paper on microgreens, which makes me concerned now. So, I’ll heat them when I eat them. They are definitely safer than sprouts though.

My traveling days to Mexico are certainly over…wouldn’t want to get giardiasis again!

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@athenalee

Thanks as always Lori! I do have to chuckle though, even though I know it’s serious. Guess I’ve been lucky so far.

I’m assuming you do your vinegar rinse for lettuce…even if it says it’s triple rinsed? I only by local, organic and typically hydroponic mixed greens. Probably double bad! Ugh.

I actually read a research paper on microgreens, which makes me concerned now. So, I’ll heat them when I eat them. They are definitely safer than sprouts though.

My traveling days to Mexico are certainly over…wouldn’t want to get giardiasis again!

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Yep! I’m the skeptic who gives a triple washed bag of lettuce even another one! LOL. I grew up eating carrots right out of the garden. Just dust those babies off and gnaw ‘em off. But my immune system came from some ‘guy I never met’ so I have to be careful how I treat it! 😂

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@athenalee

I had severe hair loss from Tacrolimus. I started taking 5-10,000 mcg/day (highest recommended dosage). My hair gradually stopped falling out shortly thereafter. Since my Tac dosage has been reduced I now take 1,000 mcg biotin/day. My hair is healthy and growing nicely.

Be sure to stop taking biotin at least three days prior to labs, and a week prior if you are having thyroid tests (TSH), as it interferes with the lab results,

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Hi @athenalee thanks so much! I purchased a bottle of the 5,000 mcg biotin. Did you take two tablets at the same time each day for a total of 10,000? Do you think the biotin helped or did you start to see your hair return back to normal when your Tac dosage was reduced? Also, thanks so much for letting me know to stop biotin days before lab work!!!

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@hello1234

Hi @athenalee thanks so much! I purchased a bottle of the 5,000 mcg biotin. Did you take two tablets at the same time each day for a total of 10,000? Do you think the biotin helped or did you start to see your hair return back to normal when your Tac dosage was reduced? Also, thanks so much for letting me know to stop biotin days before lab work!!!

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I started taking the biotin before my Tac was reduced. Before I began taking it my hair was falling out constantly! For me it helped reduce hair loss pretty quickly. I’d say start with the 5,000 mcg and double it if it’s not having an adverse reaction. I didn’t have any reaction, but as with any supplement you should check with your transplant nurse.

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@loribmt

Yep! I’m the skeptic who gives a triple washed bag of lettuce even another one! LOL. I grew up eating carrots right out of the garden. Just dust those babies off and gnaw ‘em off. But my immune system came from some ‘guy I never met’ so I have to be careful how I treat it! 😂

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I agree. I’m very strict on my diet and exercise to keep my donated liver healthy. So, this conversation has been very helpful…and while I’ll complain about washing my lettuce, I’ll be grateful for the opportunity! Especially since this time last year I was planning my wake.

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