‘You can’t have that’: The diet restrictions since my transplant

Before I was diagnosed with idiopathic pulmonary fibrosis (IPF) in January 2017, I had only one dietary restriction: cucumbers, which were my nemesis. I wasn’t allergic, but they gave me immediate and intense heartburn. At that time, I had no idea about the dietary restrictions imposed on lung-transplant patients.

Once I was approved for my transplant, I began to learn more about those restrictions, thanks to patient education sessions conducted by the Inova Advanced Lung Disease and Transplant Clinic in Virginia, where I live. I want to share some changes I had to implement immediately following my bilateral lung transplant in July 2021.

In my post-transplant journey, the medications I take are intended to suppress my immune system, which reduces the risk of my body rejecting my transplanted lungs. Now I’m taking 34 pills every day, including a combination of medications, vitamins, and supplements. Certain foods have the potential to interact with them.

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The food safety guide from the U.S. Food and Drug Administration (FDA) includes information for organ-transplant recipients. I’m advised to avoid foods that might interact with my medicines. It’s not that they render the antirejection drugs ineffective; instead, they increase the amount of antirejection medication in my system, which could be harmful.

The most common foods I’m advised against eating are grapefruit, pomegranate, pomelo, blood orange, and black licorice. Any food product containing marijuana or marijuana-derived products has a similar effect.

Foods to avoid

The most difficult adjustment for me was with vegetables. Raw or uncooked unwashed vegetables pose a greater risk, especially if they’re consumed outside of the home. If I want a fresh salad, for instance, someone has to wash its vegetables, including the lettuce. Inova had me use apple cider vinegar to wash vegetables at home.

Having a salad outside of the home, where I can’t be confident about how the raw vegetables are cleaned, is ill-advised. The days of an all-you-can-eat salad bar are behind me. Additionally, my care team has advised me to avoid public buffets because of the unknown sanitary habits of those who’ve been there before me.

Sliced meat and cheese from a delicatessen are also on my foods-to-avoid list, with certain exceptions. Before, I’d enjoyed sliced deli products for making sandwiches and appetizer trays at home. I can still enjoy them if I heat the product to 165 F. This restriction also applies to precooked meats, such as hot dogs.

I should consume milk and eggs only if they’re pasteurized. I’ve always enjoyed eggs over easy or poached, but post-transplant, eggs with a soft or runny center aren’t allowed. Likewise, soft cheeses, such as brie, feta, or Camembert, should be avoided unless they’re clearly labeled as made from pasteurized milk.

Proteins such as meats, poultry, and seafood shouldn’t be consumed raw or undercooked. This guidance eliminated sashimi and many forms of sushi from my diet. Red meats should be cooked to at least a medium temperature, while the recommendation for poultry was 165 F.

The FDA’s food safety guide is a handy reference for transplant recipients. I shared it with my family so they could better understand my dietary restrictions and the steps I must take to protect my transplanted lungs. I still love sushi  — on occasion, it’s a craving — but I’ll pass. Following my care team’s dietary recommendations is how I can make every breath count.

Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.