Negotiating Holiday Nutritional and Emotional Minefields

This beautiful holiday season—from Thanksgiving to New Year’s Day—is in turn magical, peaceful, elegant, and joyful then crass, over-commercialized, and stressful. On top of that, folks either struggle with the decision to indulge (overindulge) in many once-a-year delicious treats or to be mindful of nutrition and best health practices.

It’s enough to make you feel like Scrooge, Nephew Fred, and Tiny Tim all in the same day. Diseases don’t take holidays, so our vigilance shouldn’t either. That doesn’t mean we need to live in the Burgermeister’s Sombertown, but we need to ensure we don’t emulate Buddy the Elf’s sugar consumption either.

I always suggest bringing a dish or two to pass to every gathering. At least you know you’ll have one food you can eat that meets your nutritional restrictions. Go heavy on fresh veggie platters—except tomatoes because of their high potassium content. Be mindful of dips and cheeses because of their high phosphorus and sodium contents. If you’re not on fluid restrictions and feeling festive, one of the healthier drinks are 100% cranberry or apple juice mixed with seltzer water. Avoid seltzers that include sodium phosphate or anything that begins with “phos.” Assume everything has more sodium and sugar than expected until you confirm differently. Read labels!

I’m fortunate right now that I have no nutritional restrictions, but pre-transplant when my renal function was poorest and could not regulate my electrolytes, I was on a low- protein, sodium, calcium, potassium, phosphorus diet. My nurses joked that I could eat mayonnaise and gumballs. I am twice fortunate because I’m not a diabetic and not subject to carb counting—although everyone should eat fewer carbs that we all do. It’s just healthier. These restrictions most closely tie to trying to avoid or minimize heart disease and heart attacks. This Is Serious! Too high or too low potassium or calcium can lead to catastrophic heart failure. An excellent, detailed explanation of the heart/kidney connection may be found here: https://www.kidney.org/atoz/content/heart-and-kidney-connection

Now that we have the tools to manage our holiday feasting it comes time to celebrating with others. This can be hard. If you’re not feeling well or know a family member/friend is “a bit sick,” we often stay home and miss out on the fun to try to get/remain healthy. It’s not fun to always be the sick person in the room or to stay home alone, but most renal patients and transplant recipients do so to ensure a healthier tomorrow.

Holidays exacerbate the loving feelings of togetherness and the grief of those missing. To my friends who have lost family members and to those who are donor families, I empathize with the sadness they carry with them. Organ recipients from deceased donors often feel survivor’s guilt enhanced during the holidays—knowing that we can create precious memories with our families only because another family suffered great loss. The best we can do it to live well and honorably as a tribute to our donors. I get a sense that we may feel a bit more deeply the preciousness of each day leading to Christmas. As we light each Hanukkah candle and commemorate the miracle of the oil, it parallels our amazement at having lived longer than our original diagnoses, thanks to modern medical technology. We may be a bit more pensive on New Year’s Eve before the ball drops as we realize our bodies held on another year.

And as we all watch A Christmas Carol, keep in mind that top doctors have reviewed Dickens’ work and have theorized that Tiny Tim had renal tubular acidosis which would have led to renal failure and death. Known medical treatments from the 1830s—available only with the generous financial support from Mr. Scrooge and those of his ilk ensured that Tiny Tim could live. Had Scrooge not had a change of heart, Tiny Tim like many renal patients would have “decreased the surplus population” within a year.

(http://jamanetwork.com/journals/jamapediatrics/article-abstract/516441)

My wish for my fellow renal and transplant patients is to feel comfortable not shaking hands with fellow parishioners at Christmas services to avoid germs; to make as merry as our bodies and stamina allow; to smile broadly for family pictures—no matter how plump and unwieldy our steroid bodies are; and to all be alive for another trip ‘round the sun and celebrate the end of a happy, healthy 2017.

God Bless Us. Everyone.

 

-Amy Nash, Two-time kidney transplant recipient