Nutritious, Delicious, possibly Treacherous

I went with Jodie to the appointment with the nutritionist this past week and it was a lot of information to assimilate. Due to being immunosuppressed, she will need to be very careful to reduce risks of food-borne infections. From how I understand it, after the surgery she will be on multiple medications - for the rest of her life - that will purposefully suppress her immune system so that her body does not attack the transplanted heart. As the heart would be detected as an intruder, her immune system would  attack it and that would be bad.

Some of you may know of the neutropenic diet; however this is thankfully not quite as strict. Essentially, all of her food will need to be thoroughly de-contaminated before consumption. The easiest way to do this is to cook everything, but we will have a little flexibility with fresh fruit and vegetables that have been very carefully washed.

From what I understand of the biology (admittedly not a lot beyond "cells are squishy"); bacteria can grow on almost any exposed surface, much more quickly with an energy-source, i.e. food. In order to mitigate the risks of bacterial growth, we will need to be very careful to not let her food become contaminated between preparation and serving. One of the things we are going to need to get used to will be when serving meals with many other people, Jodie will need to serve herself or be served first or she won't be able to eat.

Below is a list of some broad-strokes don't do items - with some examples of how they apply to our situation.

1. No buffets - high risks of the food being contaminated by other people and because it is sitting out for a long time
2. No raw meat - raw sushi, raw oysters, and rare meat not recommended
3. Nothing unpasteurized - most goat cheese, some other cheeses, some juices and ciders, and raw/runny eggs (fully cooked with firm yolk is ok; or pasteurized eggs)
4. Nothing fermented/pickled - pickles, miso, those yummy eggs in ramen, sauerkraut
5. No cold meat - lunch/deli meats, lox
6. No nuts/seeds in shells - nuts and seeds will need to be shelled and roasted
7. No herbal products - can affect some transplant medications in unexpected ways

As mentioned before, none of this was too surprising; however there were some items we did not expect (like no pickles, miso, or eggs over easy), and some things we knew about but Jodie is dreading not being able to eat (sushi, oysters, raw cookie dough). Additionally, Jodie is going to need to continue with her current low-salt diet: salt makes you retain water, which means the heart needs to work harder. 

So in the coming however long it is until transplant, we would love to be able to make the most of the foods that she won't be able to enjoy after the surgery. If you're local, feel free to let us know if you want to go out to eat for some of these foods that Jodie is most likely to miss not being able to eat.