My New Food Restrictions

Would you believe that one of the things I was worried about when I started chemotherapy was that I would lose my appetite and get sickly thin? Har har har. I should have known better. It will take more than a few poisons to kill my appetite.

There are however food restrictions that come with chemotherapy. In the beginning, my ABVD drugs just had general guidelines. Because they lower my immune system, I have to stay away from foods that are at a high risk for bacteria. Things like sushi or smoked meats. I stay from berries or other produce that are hard to clean. I stopped eating citrus as it can irritate the deteriorating lining of my mouth. I also try to cook my foods well to kill off any bacteria and make for easier digesting.

My new drug regimen however includes a pill called Procarbazine, which comes with a slew of whacky food restrictions. I’ve been putting off mentioning it on the blog because, well, I’m not sure if I quite understand it. I know there are a lot of smart science-y folk who read my blog and I don’t want to offend them by butchering any sort of explanation. I try really hard to keep up with the science of this cancer stuff, but sometimes I read a sentence over and over again and am still left sitting there dumbfounded.

So, basically, all I can tell you is that the Procarbazine drug inhibits MOA, which has something to do with oxidizing and amino. When I eat foods that contain Tyramine (which is an amino of sort, from what I can gather), it reacts with what the drug is doing to my body and causes a “hypertensive emergency.” From what I understand, that can cause migraines, mild to severe high blood pressure, and even irreversible organ damage.

This chemo stuff is fun, no? (that’s dripping with sarcasm, by the way)

Anyways, apart from the confusing reasons as to why I can’t eat certain foods, the list of foods that I can’t eat are also downright wonky.

  • spoiled, pickled, aged, smoked, fermented, or marinated meat
  • processed meat (I’m pretty sure that includes bacon)
  • cheese (except cream cheese, cottage cheese, and ricotta)
  • sour cream
  • yogurt
  • soy sauce
  • tofu
  • tempeh
  • miso
  • sauerkraut
  • fava beans
  • green bean pods
  • snow peas
  • avocados (I’m allergic anyway)
  • pineapple (I’m allergic anyway)
  • eggplant
  • figs
  • red plums
  • raspberries
  • bananas
  • Brazil nuts
  • peanuts
  • coconuts
  • yeast (like Marmite or Vegemite)
  • chocolate (oops, I didn’t know about this one!)
  • alcohol

I bolded some of them as those are the ones I miss the most! There seems to be no rhyme or reason to this list, but apparently something happens to these foods during the fermentation or decaying process that effects the level of tyramine and makes them react with my drugs.

The oncology pharmacist also told me it’s nothing to freak out too much over. A little bit here or there won’t kill me, it’s just better to stay away from these things to be on the safe side. Especially those that are higher in tyramine than others.

I went out for brunch the weekend after starting my new drug regimen and quickly realized how difficult it is to order off a brunch menu when you’re not allowed bacon or cheese. My mom, sister, and I went to Café Maelström here in Moncton, forgetting that they specialize in cheesy, smoky meat paninis.

So I’ve been sticking to the sweeter side of things:

A Belgian waffle smothered in Nutella, custard, and fresh fruit (that I had to special order to keep the restricted fruit off). Crazy delicious, but significantly lacking in bacon.

Lunch is just as difficult. I also had a hard time ordering at Café Archibald when I went there this week with a friend. They specialize in savoury crepes stuffed with (again) smoked meat and cheese. I instead opted for a hummus and chicken pizza without the cheese, then tested my luck with a spinach salad topped with a few bacon bits.

Ordering dessert however was a cinch. Apple Crumble Crepe!

That would be actual scoops of apples and crumble topping inside a light crepe, topped with sticky caramel and vanilla ice cream. So good. If only I could just live off of dessert on this new diet.

In reality, I mostly live off of toast, cream cheese, and fried eggs doused in pepper and sea salt.

It’s the only food I can always stomach, no matter what. I’ve eaten this about 5 days a week since starting chemotherapy in August. Sometimes twice a day when I’m feeling really sick. I don’t know what I would do if I suddenly couldn’t eat this anymore!

Even though my appetite is as raging as ever, there are still days where my stomach is sensitive and I’m too tired to put together anything substantial. While I try to get in my green veggies every day, sometimes I end up with something like this for dinner:

A dish of roasted potatoes with ketchup, and nothing else. It’s when I say “Fuck it, I’m sick, I’m eating what I want.” Or if you follow me on Twitter, what I also call a #chemoperk ;)

And in completely unrelated news, my Baby Bear is home!

We are both zonked today after an active couple days. It’s kinda rainy here, so I think I’ll put the slow cooker on and rest up in preparation for the weekend. Have a great one! Eat some cheese and bacon for me!!

Posted on November 4, 2011, in Buster, Cancer. Bookmark the permalink. 53 Comments.

  1. so sorry you have all these food restrictions too now…ugh! not fair!

    the waffles and crepes are about the only consolation (Sweets!) but seriously, so sorry you have to deal with this!

    • Thanks Averie! I wasn’t too upset about it in the beginning, but as time goes on it gets a little more frustrating. I joke that it’s at least given me something new to complain about. The fatigue and hair complaints were starting to get old ;)

  2. Awwww. He already looks at you like you’re the center of his world (because you are). SO SWEET.

    At least the food restrictions will be temporary! You’re going to have a blast adding them back into your diet when you can!

  3. Well, that sucks, but the only thing I can say is that it’s temporary and you are still able to eat a crap load of different foods. As long as there’s something that does still sound good, go with that? All in all, I suppose it’s better than a feeding tube!

    Plus, you can totally pull the #chemoperk card for free reign on anything you DO want to eat. You can also pull the #puppy card when you want anything else ;) Cute wins out every time…

  4. OH man.. I will totally eat some cheese and bacon for you.. soon enough you will be able to eat them too :):):)

  5. I would need to carry around a list with me because it’s so long, I can imagine it’d be hard to remember which foods are restricted and which aren’t! Sorry you have to deal with this. I’ll definitely eat some bacon and think of you.

    I will say that apple crumble crepe looks so delicious!

  6. Yeah, I’m pregnant (not to compare our trials even remotely) and with morning sickness sometimes potatoes are the only thing I can handle. One week I ate them every day without shame.

  7. It does seem awfully unfair to have food restrictions when you are going through chemo. My counts have remained good, so I don’t have any restrictions at the moment and my appetite is raging which is really surprising to me. What a wild list of restrictions that is! I’m glad that are at least some things you are able to enjoy. That waffle looked delish! Hope you get plenty of rest today and have a good weekend. Keep reminding yourself – this will not last forever, it is a temporary obstacle on your way to a wonderful life that is waiting for you on the other side of these nasty treatments! :)

  8. Way funky restrictions there! Although I suppose some make sense – like peanuts – that must be all about the hold that grows on them.

    Anywho, as long as you can still have waffles! ;)

    • Yeah, I’ve been cutting back on peanuts anyways because of the mold. Now that I know my body likes to grow cancer, I don’t want to risk anything that’s carcinogenic. I LOVE peanut butter though. Other nut butters just aren’t the same…

  9. So sorry for your food restrictions. It’s not fun to miss your favorite foods or special order at a restaurant.

    I’m glad you are doing it for your health and sweet crepes are a good consolation.

  10. My best friend was on a ridiculously strong antibiotic at one point and she couldn’t eat cheese, chocolate, or fermented foods. I remember how hard it was for her. Those are some of her (and my) favorite foods. I am actually mildly allergic to chocolate (and coffee!?!) but I eat it sometimes anyhow.

  11. What a list! They should’ve given you a list with foods you can eat ;) But, on the upside, this list is temporary. But chocolate, that seems so unfair! No wonder you’re full of sarcasm, you should do a comic strip or something.
    Cancer’s a b*tch though. My brother in law had a bone marrow transplant last year and he’s dealing with the effects of chronic (mild) GVHD. He can’t eat anything acidic or drink anything carbonated/fermented – but the cancer is gone and he’s living life, so that’s something!

    • Ugh, I feel for your brother. If my cancer comes back after the chemo, I may need a bone marrow transplant as well. Another item on my list of worries! But like you said, having the cancer gone is a million times better than any silly food restriction ;)

  12. those food restrictions suck! we did an “iron chef” at work recently and the two secret ingredients were cheese and bacon. when you’re off the chemo, i’ll send some of the recipes – bacon caramels, cheese and bacon meatballs, etc – until then, i will try and help eat your share!

    ps, your hair looks fab!

  13. it’s so weird that you can stomach eggs … eggs are the FIRST thing on my list to go if I’m feeling “off”

    now I’m craving an egg, on toast, with salt, but no pepper because that’s on my restricted list ;)

  14. Those crepes look so good! You’re sweet puppy gives me warm fuzzes! He’s so stinking precious! :)

  15. ugh, i’m so sorry susan. It is a lot to take in, but….maybe it will give you a chance to play in the kichen more, right?

  16. I was diagnosed with Celiac Disease (not even remotely trying to compare that to what you’re going through) a few years ago and it meant learning to live with significant food restrictions. It was initially frustrating and very difficult but with time it got easier and cooking/ordering became less of a chore. It will get easier for you too. And you get to go back to all your favourite foods once you kick cancer to the curb!

    • I would say celiac is very comparable! And at least I get to go back to these foods when I’m done treatment. Seeing as toast is one of the few things that settles my stomach, I’d die without bread. And gluten has a way of sneaking into the strangest foods as well!

  17. Wow! That list sucks! :( I’d never survive without cheese or sour cream.

  18. What a list!! Good grief!!

    I hear you though – I’ve lived off of potatoes, eggs and frozen pasta dinners for the past 6 months. I’m at the point where I just eat whatever I want as long as it meets three requirements: Goes in, stays down, tastes half-decent. Chemoperk – I like that!

    My new best friend is tapioca pudding. Hated it before I got sick – now it’s my treat!!

  19. Gee, I’ll bet that staying away from ‘spoiled meat’ is hard! Not to worry! I have a bit of cheese every day and now that I know I’m having it for you, I’ll try to enjoy it twice as much! Hang in there!

  20. oh man, I would totally miss yogurt and bananas a lot! But your recipes made with things you CAN eat sound so good, and you are, again, making the best of it! I LOVE that pic of you and your pup! glad he’s back!

  21. Bacon is highly overrated :D Those potatoes, however, look amazing

  22. Wow, what a crazy list! Do you find that you need to carry it around with you to remember what’s on it?? I’m pretty sure I would. :) Sorry you’re having to deal with that on top of the chemo/meds- but I will say that your food still looks pretty darn good all things considered!

    • No, but I think I may have to after I realizing I was accidentally eating chocolate all along!

      Oh let’s face it, we all know I’m going to slip on the chocolate thing a few times anyways ;)

  23. Your approved choices look pretty good in the photos. It does sound complicated. Now you have me thinking about moldy peanuts, echh!

  24. My dear Sus, I admittedly always forget to read your blog and just email you instead…but please don’t forget that your best friend is also just an internship away from being a dietitian and would bend over backwards to help you, especially in figuring out food restrictions. After all, I’m fairly certain I’m the nerdiest person you know. I love you and can’t wait to see you soon <3

    • You get a free pass for not reading my blog because I always look forward to your e-mails. Plus, I give you better gossip updates that way ;) Also, I fully expect you to explain this MOA business to me when I see you next weekend. Love you!! xoxoxo

  25. sorry to hear about your food restrictions! i started reading your blog around the same time you shattered your poor elbow. (and backread every post before that too.) im inspired by your generally positive attitude! i know you have your time of anger and all, but still. the eating restrictions sound extra hard! mostly because if your appetite is already wonky, you just want to eat what you want to eat when you want to eat it. when i found out i couldnt do gluten anymore, i didnt think itd be a huge deal, but as time passes, there are times im ready to give in! im with you though- i want eggs when i want nothing else!
    i love reading your blog, susan, and im really glad you kept blogging. (also, i would like to steal that puppy away..)

    • Thank you Darien!! It’s funny how we can handle certain things, but as soon as a doctor tells us to we have to change the way we eat, all hell can break loose :P

  26. I am going to give up cheese and bacon in solidarity (and because I’m trying to drop a few pounds) but, much as I wish you well, I draw the line at chocolate :-)

  27. So sorry about your food restrictions – you’d think that chocolate could at least help you through this difficult time!!! You have an amazing blog and are an inspiration – keep up the fabulous work!!!

  28. that belgium waffle looks to die for!!

  29. I’ve only just found your blog and although the word “inspirational” is used a lot, you truly are. That sucks about the amount of food you can’t eat and I’m sure that’s only the start of it, but you’re so positive… everything crossed for you xx

  30. Your food restrictions make my heart ache. :( SO MANY THINGS. Ugh.

  31. ah! love the last photo. i am so sorry about the food restrictions. DUDE. that blows. but that crepe does look fantastic. and look at you–liking ice cream ;) <3

    • I know!! There is something about chemotherapy that makes me CRAVE ice cream now. I hear it happens with a lot of other patients. Something about the cool creaminess just sounds soooo good. Plus frozen foods are supposed to be good at preventing mouth sores :)

  32. I think I would trade cheese and smoked meat for dessert. But that’s just me. :-) wondering if there’s a larger proportion of restaurants offering smoked meat up there? You look adorable with your little baby.

    • Yeah, I never noticed how much smoked meat there is around here until I couldn’t have it! Maybe it’s the French influence? I live in a French/English city and most of the restaurants have French owners. (French food in these parts by the way is not the same as in Paris, haha)

  33. Weird food restrictions. But that’ll all be a memory soon!!! AWWWWW…love the picture of the pup. HE’s soo happy to be with you. Take care Susan.

  34. Hello! long time reader, but very occasional commenter.

    So, what’s happening is that the drug lowers the levels of the enzyme (MAO) that your body needs to break down Tyramine, which is a metabolite (monoamine) of the amino acid Tyrosine (say, when Tyrosine is fermented by the bacteria in yogurt, tyramine is created). When Tyramine builds up it can trigger the same hormones involved in the ‘flight or fight’ response and one of the effects of this is a sudden rise in blood pressure (hypertensive emergency). Some people have this reaction even when they are not taking MAO inhibitors, and so they may think they are allergic to cheese, or whatever. One of the symptoms is a serious headache. Tyramine can also mess with your other brain chemicals.

    But really, I just logged on to say your dog is so cute and could almost make me a dog person. I’m a cat person and have four of them. I think it’s a definite personality, to be a dog person or cat person. I love dogs but could never have one because I feel too tied down. With a cat, you can just leave it for weeks and get someone to feed it and when you return it just looks at you like ‘oh, you’re back’.

    • You are awesome – thank you for explaining that further!! It makes a little more sense now. I’ve gotten to the point with my chemo brain where I’m just like “No…more…science…stuff…” Haha.

      I love cats too, although I tend to love my cats more, rather than cats in general. Probably because it takes a while to get to know their personality, so they’re not a likeable unless you know them really well!

  35. When I had to do the low iodine diet for radioactive treatment, the list of food restrictions was rough. Then I realized that I had to look at it as a sort of challenge to figure out how to make enjoyable, healthy meals that didn’t taste crappy. I also realized just how there is soy in everythingggg. It was kind of cool to have to read labels so closely…and also annoying. :) I basically ate guacamole for dinner every night. The meals you’ve made look delicious!

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