Doctor’s Order. Honest.

“I should go do what?!”

“When you leave here, go buy some Coke and drink it.  Right away.”

I bet you’ve never been given an order like that at your doctor’s visit.  It is SO odd for me to hear that, not only because Elizabeth, my nurse practitioner, just prescribed something so unhealthy, but also because for the last year my dietician’s mantra to me was Avoid high phosphorous foods!  Worst culprit: Dark sodas.  Never, never, never drink that!

Too little Phosphorous.  Today, however, my phosphorous level was “critically low.”  And consuming a Coke or root beer is a good way to get a lot of phosphorous in you fast.  So what is phosphorous? It’s a mineral in your body that helps with important functions (keeps bones strong, helps make energy, etc.).  In addition to dark sodas,  high phosphorous foods include meat, dairy, nuts, beans, soy, whole grains, and processed foods.  If the level becomes dangerously low, muscle weakness develops, followed by stupor, coma, and death.  I’m nowhere near that but the drop was steep, and the trajectory is worrisome.

Too much Phosphorous.  Pre-transplant, my phosphorous level was way too high because my sick kidneys couldn’t filter out the excess. My dietician said I was “a bit of a conundrum” as to why my level was so high despite my meticulously careful diet to avoid high phosphorous foods.  She prescribed phosphate binder pills for me to take with every meal to limit my phosphorous intake.  (The pills bind with phosphorous, making them too large to be absorbed into the body.)  Too much phosphorous and I lose calcium, dangerous given my osteopenia (precursor to osteoporosis).  By the end of my life on dialysis, I was popping 5 or 6 of those huge pills every time I ate.

Until my body figures it out.  Now, post-transplant, I’ll be taking phosphorous supplements.  Why?  Elizabeth says, “YOU know you got a transplant, but your body doesn’t necessarily know it.”  It has been working so hard for so long to get rid of phosphorous that my great new healthy kidney is working “too” well.  So now until my body figures it out, I have to feed my body extra phosphorous.

New normal, indeed.

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The view from the Connie Frank Transplant Center at UCSF.

More Salt.  My first follow up visit to the transplant center today was dotted with a few other surprises. I should now also eat a full (regular) sodium diet.  Right now a slightly high blood pressure is good to get blood to new baby kidney. (Ideal systolic number: 130-150).  So no need to withhold the salt!  Marty rejoiced at that new dietary directive.  The whole family in general was eating low sodium because I was.

Sushi.  The most surprising order came from my transplant pharmacist: “No sushi for the first three months.”  Wait! What?  I thought no sushi for LIFE?!

He said, yeah, I don’t know why they tell everyone for life, but just first three months when your immune system is at its weakest.

Hmmmm, I’m going to have to check on that because everyone at the hospital last week told me no more sushi.  Ever.  Any transplant recipients out there, can you leave me a comment about your experience?

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What food do you wish your doctor prescribed for you to eat more?