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Dr. Bob is Robert Hsiung, MD,
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Posted by gardenergirl on February 3, 2004, at 20:30:15
Howdy,
I am going to be going to a dinner in Chinatown in DC in the near future as part of a work thing. I am wondering how to handle the MAOI diet restrictions without coming across like Meg Ryan in "When Harry Met Sally" (the high maintenance, not the deli scene :) Anyone have any advice on what's generally safe to eat in Asian restaurants within MAOI diet restrictions?Otherwise I was thinking of printing out a card with the restrictions listed on them and handing it to the waiter to give to the cook. I would ask them to recommend something.
I don't want to call too much attention to myself at this get-together as I will be a low person on the totem pole and want to make a good impression.
Any advice is welcomed.
gg
Posted by stoked on February 3, 2004, at 21:47:37
In reply to MAOI diet and Chinese restaurants--any advice?, posted by gardenergirl on February 3, 2004, at 20:30:15
Hey.
I posted on this a while back but the stuff keeps getting buried. I guess it all has to, sooner or later, but it can make it hard to find stuff.
I've got a bud who loves Chinese food, and eats at this one place all the time. He's had really bad depression that hardly ever goes away for years, and he started Parnate a couple months ago, and it was the first thing that ever nailed it.
Well, he mostly gets the sweet and sour dishes, and never had a problem, but once he got Kon Pao chicken, since he hadn't had a problem with small amounts of soy sauce. Well, this stuff must have been swimming in it, cause when he got home he felt a little weird, and checked his bp, and it was like 220/90. He hauled butt to the ER, and they got him taken care of all right.
So now he won't touch any dark oriental sauce that might have soy sauce. He looked it up, and it's the really good soy sauce that's the worst.
So now he just eats sweet and sour stuff with white rice. Gets a little boring, but at least he can still eat Chinese. I think the veggies and egg rolls have some soy sauce in them, but not enough to cause trouble.
So I hear everyone's different, but I'd say tell them you can't have any sauces with soy sauce or red wine. Probably the sweet and sour stuff or the stuff with white sauce is your best bet, but be sure to ask.
Hope that helps.
Posted by sb417 on February 3, 2004, at 22:20:37
In reply to MAOI diet and Chinese restaurants--any advice?, posted by gardenergirl on February 3, 2004, at 20:30:15
Hi. How "progressive" is the restaurant? There are several in my neighborhood that have "pure," unadorned foods, with no sauces of any kind. You can get steamed chicken and vegetables or steamed vegetables and rice, etc. Many people do not like the thick sauces used in Chinese restaurants, and there are many people who can't tolerate Chinese food, not just those on MAOIs. Many people can't tolerate MSG (monosodium glutamate), which is in many Chinese dishes. Some friends tell me they've ordered dishes, specifically requesting that MSG be omitted, but afterwards they are sure that MSG was not omitted. Why don't you just avoid anything with soy sauce or any sauces? Get a steamed dish with absolutely no fermented foods or sauces. Play it safe. A hypertensive crisis is not a minor nuisance. It is dangerous. Order something safe and bland. If you're really worried, ask your doctor to give you an rx for a fast-acting blood pressure medicine. I can't remember which ones are used now. Nifedipine sounds familiar, but there are probably newer and better ones. It's good to keep a small bottle in your pocketbook.
Posted by cubbybear on February 4, 2004, at 3:25:47
In reply to MAOI diet and Chinese restaurants--any advice?, posted by gardenergirl on February 3, 2004, at 20:30:15
>
> Otherwise I was thinking of printing out a card with the restrictions listed on them and handing it to the waiter to give to the cook. I would ask them to recommend something.Your own idea is a good one--have a card made up. It's easy to make jokes about this--but I have a feeling that you'll need to get the sentence about soy sauce translated and written in Chinese. And don't hesitate to get the Chinese words for "it's a matter of life and death." [or nearly so]
Posted by gardenergirl on February 4, 2004, at 6:36:44
In reply to Re: MAOI diet and Chinese restaurants--any advice? » gardenergirl, posted by cubbybear on February 4, 2004, at 3:25:47
Oh Lord, I never thought about translating it into Chinese. Someone else suggested sweet and sour. I personally don't like that since when I was a child that was the only Chinese food I would eat, but maybe that is a good suggestion.
Or just bring my own PB & J? :)
Thanks for the advice.
gg
Posted by sb417 on February 4, 2004, at 11:37:06
In reply to Re: MAOI diet and Chinese restaurants--any advice? » gardenergirl, posted by cubbybear on February 4, 2004, at 3:25:47
The OP said she didn't want to draw too much attention to herself or appear to be high maintenance. Printing a card, whether in Chinese or English, with the words "It's a matter of life and death," is certainly going to draw attention to herself. Why not just play it safe and stick to the blander foods until you are no longer on MAOIs? The MAOI diet is NOT a game. It is serious, and there ARE life and death reasons for adhering to it. A hypertensive crisis can be a crisis that will resolve OR it can progress and cause a cerebral hemorrhage and/or death. Cerebral hemorrhages are devastating and nearly always fatal. One reason many doctors refuse to prescribe MAOIs is that they fear patients will not take the MAOI restrictions seriously. If you or someone you know and trust do not prepare your food, there is no way you can know what ingredients are in it. Printing a card is a good idea, but will the cooks read it? Can they read? Will they understand it? The kitchen may be filled with knowledgeable people, or they may be overworked, lowly paid illegal aliens who can't speak a word of English. If they speak Chinese, how do you know which dialect to use? By the way, a friend of mine who is on an MAOI ate some hamburger meat at home. He prepared it himself and used no forbidden ingredients. He ended up with a hypertensive crisis. As it turned out, the meat was a few days old and had begun to age. Aged and/or fermented foods are to be avoided at all costs. If you are unable or unwilling to follow the dietary restrictions, then it's best not to take an MAOI.
Posted by Ilene on February 4, 2004, at 17:19:51
In reply to Re: MAOI diet and Chinese restaurants--any advice? » gardenergirl » cubbybear, posted by sb417 on February 4, 2004, at 11:37:06
>Printing a card is a good idea, but will the cooks read it? Can they read? Will they understand it? The kitchen may be filled with knowledgeable people, or they may be overworked, lowly paid illegal aliens who can't speak a word of English. If they speak Chinese, how do you know which dialect to use?
All Chinese languages and dialects are written the same way because the Chinese script is symbolic, not alphabetic. To express the word "fish", instead of writing F-I-S-H or P-O-I-S-S-O-N or F-I-S-C-H (English, French, and German words that all mean "fish"), the Chinese write an ideogram (sort of a picture) that means fish. It's like using the Christian fish symbol instead of writing the word.
Now we just need someone who is can compose a card in Chinese.
Remember, it's not only soy sauce--Chinese food also uses oyster sauce, hoisin sauce, black bean sauce, plum sauce, and dried shrimp. I'm almost positive black bean sauce is verboten, but the others might or might not be okay. Then there are other Asian cuisines, which use flavorings such as fish sauce.
Ilene
Posted by gardenergirl on February 4, 2004, at 17:31:52
In reply to Re: MAOI diet and Chinese restaurants--any advice? » gardenergirl » cubbybear, posted by sb417 on February 4, 2004, at 11:37:06
Thanks for your response. I am puzzled by a couple of things, though.
> Why not just play it safe and stick to the blander foods until you are no longer on MAOIs?
I'm not sure about the assumption that at some point I will not be on an MAOI. Nardil has been the only med. that works on my atypical depression. I can foresee being on a maintenance dose at some point, but why would I stop taking the only drug that has ever worked?
>The MAOI diet is NOT a game. It is serious, and there ARE life and death reasons for adhering to it.I'm not sure what was in my original post which suggested that I do not take the diet seriously. Actually, I feel I am being quite proactive in dealing with an upcoming situation in the safest manner I can.
>A hypertensive crisis can be a crisis that will resolve OR it can progress and cause a cerebral hemorrhage and/or death. Cerebral hemorrhages are devastating and nearly always fatal.
I agree with the above with the exception of "nearly always fatal." I have worked with many survivors of cerebral vascular hemorrhages. CVA's can cause lasting disability or death, but "nearly always fatal" puzzles me. I have not seen data to suggest that.
>If you or someone you know and trust do not prepare your food, there is no way you can know what ingredients are in it. Printing a card is a good idea, but will the cooks read it? Can they read? Will they understand it? The kitchen may be filled with knowledgeable people, or they may be overworked, lowly paid illegal aliens who can't speak a word of English.
I agree that eating out in restaruants is riskier than eating your own food. Are you suggesting that people on MAOI's should never eat out unless they know the cook and the source of the food? I wonder about that because I have had a number of positive experiences in asking wait staff, managers, and cooks to help me select safe menu items. More than one restaraunt even showed me their recipe so I could check the ingredients myself. Obviously, if I am in a restaraunt where I cannot trust the advice of the staff, I will not order food if there is not something safe on the menu. This is a judgement call, of course, but it's my life on the line, and I tend to be quite protective of it.
>If you are unable or unwilling to follow the dietary restrictions, then it's best not to take an MAOI.
Again, I wonder what there was about my post which suggested I was unable or unwilling to follow the diet? Incidentally, I have been quite successful to date in managing to avoid complications.
Regards,
gg
Posted by kellym on February 4, 2004, at 22:06:17
In reply to MAOI diet and Chinese restaurants--any advice?, posted by gardenergirl on February 3, 2004, at 20:30:15
The main concern with soy based sauces (assuming there is nothing else dangerous)is if it contains aged soy sauce-or at least the amount of aging. There was a fairly recent study that had indicated a great deal of variance in different brands. I believe kikkoman was one brand that had virtually no tyramine- although I would do a search to confirm this (sorry I don't have a link). I would guess that more "authentic" restaurants would be more likely to use aged, but you would never know either way unless you are able to confirm it. There is a restaurant that I had no problem with; I always ordered very light sauce. But unless you can do a "feeling out process", and even then who is to say that they might not substitute, I would avoid taking any further chances. Ultimately, of course, the safest route would be to avoid this particular kind of food all together. I think most everyone who takes a MAOI eventually comes to a comfort level for themselves, after a very strict beginning.
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