The Diva Diet - Part III: Odds and Ends

This is my last installment of The Diva Diet – or what I call my post-kidney transplant diet. This one focuses on general, but important stuff.

As you read through these posts, please remember that this is what works for me.  Everyone is different.  You may need to adapt it for yourself and for the meds that you are taking.

Balanced Diet?

Maintain a balanced diet. For my meals, I try to adhere the Choose My Plate guidelines: combining protein, grains, and a good focus on vegetables. Although I am sometimes not successful, I usually try to add veggies with my meal – some of them pretty hidden (I don’t like peppers that much).

Also, as I mentioned in a previous post, I can now add whole wheat and other grains in my diet. Since I do not have any phosphorus restrictions, I can now experiment with different grains. When I was in dialysis, I was pretty much limited to white rice and white bread, which probably created havoc with my digestive system. Now, I can have quinoa, barley, corn meal, oats (my favorite) and oat bran.

I still need to be careful though; immunosuppressants may increase potassium in one's system so you may need to watch high-potassium foods like bananas, mangoes. and coconut. If this is the case, moderate your potassium a bit – just like when you were in dialysis. My guilty pleasure is usually bananas or mangoes. I’ll have only a third of a banana in my cereal and about third of a mango.

Key is everything in moderation. My meals are usually 4-5 ounces of protein, whole grains (I still have a bit of white rice added for flavor), and lots or veggies. I try to practice Meatless Mondays or just have Meatless lunches. Actually, when I have a meatless lunch, I am more alert in the afternoon and don’t get that 2:30 slump.

When in doubt, ask your nutritionist. Since I've been experimenting on different foods, sometimes, I find things that may be iffy. A few recent examples are celery seed (as a replacement for salt) and wakame salad (seaweed salad). I usually start with my own research, but if I don't find any relevant information, I consult with my transplant coordinator or my nutritionist. They are the experts on this, not me.

Keep moving.  This means what you think it means: exercise. I find that when I walk, my body (and mind) is able to function more efficiently. I make it a point to exercise at least 20-30 minutes at least five days a week.

Me in aikido class - one of my favorite activities

Do vary it. Example, I practice a martial art called aikido, practice hula dancing, and do regular cardio like walking or doing the elliptical. I am trying to incorporate stretches and core strengthening exercises, but I feel at this point cardiovascular exercises are more important in maintaining a good blood pressure.

Be cautious not to overdo it – and believe me, I have. While it is important to move, again do it in moderation and consult your doctor before you start a new routine. I have to keep reminding myself that my surgery was not too long ago. Rest and recovery are still equally important.

Keep hydrated. My new kidney needs to be constantly hydrated, so I need to drink plenty of water. Actually, everytime I see the word “hydrate”, “drink”, or “water”, I drink some water. I guess it’s my version of a drinking game.

I believe hydration is key in keeping your creatinine low. Now, that it’s winter, like me, you probably don’t want to drink water, but continue on hydrating. Choose low-caffeine or herbal teas. Soups are okay too, I think – just be cautious of the sodium content.

 

I try to keep these tips in mind everyday. Although some of these we really need to adhere to (like food safety), the ones that are optional, I try not too obsess over (too much). It’s the holidays, and it is time to celebrate with family and friends. I plan to relax, be careful, and enjoy my new kidney.

Bon Appetit!

You might also enjoy:

The Diva Diet - Dining In

The Diva Diet - Dining Out

The Diva Diet - Part II: Dining Out

Now that Thanksgiving is over, as always, most of the challenge in sticking to your diet when eating out: office parties, group parties, get-togethers with visiting friends or relatives, etc… The list is endless.

As a kidney transplant recipient, I still have restrictions, but there is no reason why I cannot enjoy these holiday get-togethers. Here are my ideas for keeping your diet during the holiday season while dining out.

Be Mindful of Food Safety When Dining Out. As I mentioned in a previous post, we need to continue to be careful of infection, from all sorts of germs or bacteria. I can understand why this is a concern. After watching shows like Kitchen Nightmares and Restaurant Impossible, we have seen problematic kitchens and food gone bad that were still served to the public. All of us need to ensure that the establishment has passed health safety guidelines and that the food is stored and prepared well in a very sanitary way. Since my transplant, my husband and I have been very picky in selecting restaurants when we eat out. We often limit ourselves to nice, very nice restaurants, but this can get expensive.

 

No Buffets. This is a follow-up to the food safety issue. With buffets, the food has been exposed to different people, so you never know who touched what or what temperature it has been kept. With food exposed to different people, you never know what germs they may carry. Again, after watching Restaurant Impossible and seeing buffets that were not kept at the correct temperature, I can understand why this continues to be a concern.  Served Hors d’Ouevres are out now too: same principle as buffets, except now your food is traveling.

Cafeteria-style food may be okay. Assess the situation and figure out if this option is safe. Do not be tempted by really yummy food – your life is more important. An alternative may be to wait until you get home and just simply nuke it.

Order your own entrée. As I mentioned before, when dining out, meals really need to be made for me only – Hence, the name “Diva Diet”. If it is just my husband and I, we usually share an appetizer and an entrée, but we move it to separate plates. When we go with a group, I would stick to my own dish.

Family-style food may be okay, as long as they use serving spoons, AND no one is sick.

No raw meats or eggs. Unfortunately, that includes raw sushi and oysters – my old favorites. Again, it’s a question of bacteria. So, I must say goodbye to my beloved salmon rolls, ahi pokes, oysters-on-the-half-shell, and tuna tartars. Even smoked foods like salmon are also out of the question. Sigh, at least, I think, I can still have cooked sushi (ebi and unagi anyone?) and usually there are other items on the menu.

Be careful of raw eggs too. This may mean aioli, Caesar salad dressings, certain meringues (baked meringues are probably fine), and eggnog! No more eggnog lattes. The only raw thing that would be safe would be fruits and vegetables.

Deli Sandwiches. Improperly reheated cold cuts and soft cheeses can contain certain bacteria that can cause illness and possibly death to a kidney transplant patient. That means no more cold cuts, or for that matter cold, deli sandwiches. Also, the coleslaws and potato salads are probably not a good idea either. Some possible alternatives: hot sandwiches or a bagel and cream cheese … and get them from a high-end deli.

Craving for Tacos? Make it yourself.

A word on fast food. I do not normally eat fast food, but a sucker for some of them, especially tacos or hash browns. I think occasionally it’s okay: I am going to limit myself to maybe once a quarter. Surprisingly, since I’ve been eating fresh food and whole grains, I do not have any craving for fast food anymore, except for tacos and hash browns.

Limit dining out. I’ve noticed that every time I eat out, I gain at least two pounds. To make the food really-really yummy, most chefs season their food rather well. Most of the weight that I gain is from water retention and it impacts my blood pressure. Can you imagine what happens when I eat out all the time? My blood pressure can go through the roof. If you can limit dining out, you can give your body a chance to get rid of the excess water.

Again, Do have fun! As a former dialysis patient, I have memories of food restrictions and evaluating how many binders to take if you had some pizza. Yay! Gone are those days. So even if you do have restrictions, try new places and new types of food. As an example, for Oktoberfest, we found a German restaurant nearby that was just awesome. My husband said it was just like what his Dad made. They gave us gigantic portions: so my husband halved the entrée and still had a full meal, and with a to-go box!

The key is to enjoy your new life while still keeping safe. As an old saying goes - “Life is to be enjoyed, not endured.”


Final installment: Other important stuff.

The Diva Diet - Part I: Dining In

With another off-site at work coming up, a friend at work asked me whether I still needed to bring my lunch. Our department usually provides our lunches and snacks during off-site meetings, but it is served buffet style. It is great for most people, but it does not really work for someone who had a transplant.

I explained to her that I probably will need to bring my lunch to off-sites forever, or at the very least, arrange for or order my own food. I explained that I need to have my meals made for me; it’s like a “Diva Diet.” It’s got to be made for me, because I am special (wink).

 

I have written about my diet in bits and pieces in previous blog posts. However, with the holidays coming up, the parties and various gatherings may prove to be challenging. I would like to socialize, but sometimes it is fairly difficult to explain my situation, especially around happy occasions like the holidays. I think writing this post will help me figure out how to deal with my situation in social gatherings and also will be a great reminder for me.

Guidelines for the “Diva Diet”: Cooking at Home and Dining In

Dining in is now fun because I have a bit more variety on what I can cook. I would call this the “Iron Chef” or the “Chopped Kitchen” diet, but I think “Diva Diet” is a little bit catchier.

Make sure that everything is cooked thoroughly. This means no more runny eggs, medium rare meats, ceviches, or sushi with raw fish. With a big turkey, make sure that it is thoroughly cooked (I bought a meat thermometer for this purpose).

Everything should be well done. With my immune system lowered, cooking must kill any lingering germs since this could be detrimental to my new kidney. As an example, the nutritionist at UC Davis said that certain salmonella can considerably damage my new kidney. Better avoid and live another day.

Important note: eggnog could be problematic because it does contain raw egg yolk. Also, I should avoid of aiolis since they traditionally contain raw eggs (Although I have seen cheater ones, but why take a chance).

Keep things clean

Maintain food safety. Just as important as keeping a healthy diet is maintaining excellent food safety.  Bad bacteria in foods can make you sick, and with my new kidney, I am more susceptible to illness. Maintaining good food preparation habits when cooking is very important. Wash your hands well with soap and warm water. When in doubt, wash your hands... again and again and again.

Make sure everything is clean, and I mean everything: your kitchen, surfaces, utensils, plates, and the food. 

Wash your food thoroughly. If needed, use a vinegar and water mixture to wash your veggies. Cut your fruit before eating it to see if there is any spoilage or unexpected crawling visitors (e.g. worms).

Potlucks. Potlucks are probably the biggest challenge for me since most of our family gatherings are potlucks. I do hope that my family has safe food practices. Make sure that everyone uses a serving spoon. For this year, I have been sticking to the hot foods and zapping it in the microwave first before eating. If you don't know where the microwave is, have a back-up. At the very least, have a granola bar in your purse.

Desserts may be iffy. I always look at the tempting pies or cakes and wonder if they are safe. I generally just not have it. If it is single-serve or wrapped, it is possible to enjoy it, but if it has been hanging out for a while, I avoid it. General rule of thumb: when in doubt, avoid it. It's really not worth it.

Also, since these are your family or friends, maybe you can go first. This avoids the germ issue. This is the Diva Diet after all. Also, avoid going for seconds. The food is not as safe at that point, but if you must, nuke it.

Enjoying the bounty of the season

Most importantly, have fun. Although I have restrictions, it is not like when I was on dialysis when I had to take binders every time I eat something with high phosphorus or be wary of the potassium content of my food. Given that, sometimes it does feel that it is more restrictive. I do miss my salmon sushi, oysters, and ahi poke (a Hawaiian raw salad with ahi tuna), but I think I already had my share of this.

Feel free to experiment. I love trying out new ingredients. As an example, recently, I just tried Delicata squash and molasses. Although I still have to watch for potassium and cholesterol due to my immunosuppresants, I feel I can be more adventurous as long as I maintain a balanced diet.

 

Next installment: Dining Out

Flashbacks

Last week, one of my friends at work asked me a question about dialysis. Her husband, unfortunately, has to start dialysis soon, and they were hoping that they could postpone starting dialysis for another month. Their reason for postponing was not frivolous (and personal that is why I am not sharing it in this post), so I understood why they are thinking of delaying the inevitable. 

We had a brief, but good chat about dialysis, and I was glad to share my experience. It looks like I answered her question and gave her some good tips. At the end, she said her husband is trying his best to maintain the little kidney function that he has.

I mentioned to her that I was in a similar position when I was diagnosed and had to watch my diet closely. Although I did not share this with her, I remembered that my husband and I tried to keep my kidney function up, primarily through diet. I did have to watch my diet like a hawk to keep it from falling completely. I ate very little protein per day: only four ounces, if I remember correctly. I had to give up my favorite soy chai lattes and had to be very creative with meals. Most days, I was having no protein for breakfast, two ounces for lunch and two ounces for dinner, or some combination of thereof.  My meals were mostly carbs and vegetables. It was not the good, high fiber carbs either; it was white bread, white rice, white flour – ugh! No more brown rice, Wheaties, or multigrain muffins. I was lucky to be Asian and having white rice as a staple in our diet. My favorite meal was usually breakfast when I can have muffins! I figured since I am watching everything, I can have some sugar twice a week. Occasionally, I can have an egg for breakfast since that was considered one ounce.

I was fortunate back then; I was still peeing so I did not have any fluid restrictions. I think that was one of my treats. Since I was suffering from gout, I was drinking black cherry juice. I would have that with some of my meals, but dilute it with water and ice (black cherry juice was a bit too sweet for me).  I even considered making a faux-sangria with it by adding apples and oranges (did not attempt to do so though – not the same without wine). Speaking of sangria, I had to limit my alcohol intake. I probably just limited it to one glass of wine (or sangria) per week, if any. Yes, I became an inexpensive date (not cheap, though).

My diet back then was very restrictive. I kept (and am still keeping) a food diary so I can keep track of my intake and things that trigger my gout attacks. I can imagine that this would be trying to anyone especially if you have a “meat and potatoes diet”. I was able to stay out of dialysis for a year. During this period, my husband and I were very thankful for every .01 increase in my GFR (Glomerular filtration rate - a measure of how well the kidneys are working).

I hope all goes well with my friend and her husband. They have a lovely family and their young kids would need Dad around for a long time. I wished them well and offered my advice anytime she needs it. Been there and doing my best to give back… and not to be there again.