Post Transplant Nutritional Guidelines

I did it. I altered the nutritional information from Dana Farber. I couldn’t take the idea that someone else may be exposed to such boredom. Really, cancer patients are sick, tired, and probably throwing up considering food. The family is stressed and unable to concentrate. We want the information quickly and efficiently.

Make it stick and quickly.

Make it simple so we can stick it on the fridge for consultation.

At the end, give the numbers of the people we should call to reference

Lastly, give us extra pages attached to make our new gocery lists.

Make it like BMT 30 minute meals, ala Rachel Ray.

Possibly consider giving us meal ideas or suggestions regarding the best frozen foods, because this could be a huge change in lifestyle.Pack in some coupons for motivation

While I’m on it, what if I was Indian or Hispanic or Haitian, I don’t see any foods that pertain to me. Can I eat conche?

What about the new vegan anti-cancer diet kick? Are wheat grass shots okay?

This was possibly the most boring posting I made myself do, but IT IS IMPORTANT. Education needs to take into consideration compliance. No one is going to be compliant, or even read the information, in the current format.

We all want to be healthy, we really due, but its been proven that scare tactics have no effect on health actions. Don’t even try the scare stories. The most important factor in compliance is convenience.

Make this diet change as easy as possible, with coupons, simple recipes, suggestions of the best frozen dinners, my favorite personal advice is to use a slow cooker. How are cancer patients supposed to cook during their busy schedule of sleeping and throwing up.

I plan my cooking 30 minutes after taking my anti-emetics in the morning. I make dinner and stick it in the fridge or the slow cooker, this way, at 5:30, the meal is done or just needs to be shoved in the stove with some canned sides.

Microwavable food was a great idea. . . . in college. Now that I’m a grown-up, it makes me feel disgusting. Healthy choice makes it easier.

This would not be my final design for post transplant nutritional management, but the text is okay. It does need a little something to grab attention, like to make a shopping list along side a nutritionalist or resource manager.

I apologize in advance. My beautiful formatting is not so nice on blogger, but use your imagination.

In summary, it needs to be kept simple and convenient, then patients will comply.


NUTRITIONAL GUIDELINES AFTER YOUR BONE MARROW TRANSPLANT
It is important to continue following a liberalized low bacteria diet until your immune function returns to normal. your diet will be further liberalized at day 100 of your BMT.

The following are general guidelines for food shopping and preparation post transplant
:
• Check expiration dates on all products prior to purchasing.
• Wash tops of cans prior to opening.
• Wash counters, cutting boards, utensils, etc. with soap/cleanser and hot water prior to, and after contact with foods.
• Frequent handwashing by food preparers is recommended. Dry hands with paper towels.
• Wash dishes in hot soapy water or dishwasher. Air-dry dishes (do not use cloth towel).
• Replace dish towels and washcloths daily.
• Replace sponges every 2 weeks, disinfect with 1 tsp. Bleach per quart of water daily and throw in dishwasher or laundry every day or two to keep bacterial count down.
• Perishable food should be kept very hot or very cold. Avoid leaving perishable items out (at room temperature) for longer than 10-15 minutes at a time.
• All perishable foods should be cooked thoroughly
• Cook eggs until whites are cooked and the yolk begins to thicken
• During food preparation avoid tasting food with the same utensil used for stirring.
• Thaw frozen foods in the refrigerator overnight or quickly in the microwave. Do not thaw or marinate food on the counter.
• Do not refreeze defrosted foods.
• Use airtight containers to store leftovers. Refrigerate promptly.
• Leftovers may be used if stored properly and used within 24 hours.
• Grill only on gas grills with clean grills and test food temperatures (insert thermometer into thickest part)

Type of Meat Temperature (˚F)
Beef 165
Poultry 180
Pork 170
Ground Beef 170 (cooked with no pink remaining)
• Avoid free food samples at food displays at restaurants.

Microwave Cooking

• Rotate dish a quarter turn once or twice during cooking if there is no turntable in the appliance.
• Use a lid to ensure thorough heating and stir several times

Permitted Foods

IF YOU DO NOT SEE A FOOD YOU WOULD LIKE, ASSUME IT IS UNSAFE
UNTIL CONSULTING YOUR DOCTOR, NURSE, OR NUTRIONIST

FOOD CATEGORY PERMITTED

Beverages
- All types of beverage:
- Boiled well water
- Tap water
- Distilled water, such as Aquafina or Dasani


Meat, Fish - Canned or shelf-stable smoked seafood, pate, and
Eggs, Poultry meat spreads
- Well cooked meat, fish, eggs
- Home prepared tuna & egg salad
Well-cooked shellfish
- Factory-packaged sandwich meats, heated or steamed

Dairy Products - Pasteurized milk/Lactaid milk
- Yogurt
- Prepackaged ice cream and frozen yogurt
- Prepackaged hard cheeses:
cheddar, colby, Monterrey jack,
Swiss, American, mozzarella
- Prepackaged soft cheeses:
cottage cheese, cream cheese, ricotta


Breads, Cereals, - Prepackaged or homemade
Potatoes, Rice, breads, muffins, bagels, cakes, rolls,
and Pasta donuts, cookies
- Boxed hot or cold cereals (except
those with dried fruit or nuts)
- Cooked potatoes, rice, noodles
- Packaged crackers and snack food

Vegetables - Cooked vegetables
(wash well and cook thoroughly)

Fruit - Cooked or canned fruit
- Raw, thick-skinned, well-washed,
fruits, if unbruised:
oranges, grapefruits, melons,
bananas, tangerines, avocados; mangoes


Nuts - Processed peanut butter
- Packaged roasted nuts
- Cooked nuts (in cookies & cakes, etc)

Spices/Condiments - Cooked fresh or canned spices
(Add at least 5 minutes prior to the end
of cooking)
- Ketchup, mustard, pickles,
mayonnaise, sugar, jelly

Miscellaneous - Thoroughly cooked frozen dinners,
frozen pizza and canned entrees

Restaurant Food - No restaurant food
- No takeout food
- Avoid ALL salad bars and buffets for at least one year

OTHER NUTRITIONAL CONSIDERATIONS

It is very important to maintain your weight after you leave the hospital. If you have a scale, weigh yourself weekly. If you notice a weight loss of 5 pounds or greater, call your doctor. You may not be able to eat large amounts of food, therefore, you are advised to maximize the calorie value of the foods you eat by:
- Eating small, frequent meals/snacks.
- Adding margarine, butter, gravy, cheese, and non-fat milk powder to appropriate items.
- Consuming nutritional supplements like ice cream frappes, Carnation Instant Breakfast, Ensure, Boost, or other commercially prepared supplements. Making frappes with enriched milk.**
- Taking a daily multivitamin, folic acid.

**Enriched milk
Mix 1 quart of milk with 1 cup of dry milk powder, stir well and keep refrigerated. This will increase the calorie, protein, vitamin content of the milk.


You need to consume at least 2 liters (65 oz) of fluid per day to prevent dehydration and kidney damage.
Some people may have trouble digesting milk products after a BMT. Watch for symptoms of bloating, gas, cramps, or diarrhea after consuming milk or milk products. You may want to switch to Lactaid Milk, or chew Lactaid tablets when eating dairy products. Discuss this with your dietitian or doctor.


If you are being treated at Dana Farber Cancer Institute: Individual nutrition appointments may be scheduled by calling the nutrition scheduling coordinator, Nakiea Santos at 617-632-3006.