This is a generalized list of no, no’s for immune compromised patients.

Animals
Whatever type of animal you have, ensure that they are kept as clean as possible. We brush our dogs daily and bathe them weekly. I use the hand wipes to wipe them down because I worry about the dirt that they bring into the house.

Beaches can be dangerous.  Before going check on the Internet for Red Tide and tests for bacteria.  MRSA and Staph have been found at some of our local beaches and although we really wanted to go we decided against it.  This bacteria and others found can be very dangerous for the immune compromised.  Here is a link to the full news article http://www.usatoday.com/news/health/2009-09-12-staph-superbug-MRSA-beaches_N.htm

Botulism as referenced by the CDC. Botulism is a rare but serious paralytic illness caused by a nerve toxin that is produced by the bacterium Clostridium botulinum. There are three main kinds of botulism. Foodborne botulism is caused by eating foods that contain the botulism toxin. Wound botulism is caused by toxin produced from a wound infected with Clostridium botulinum. Infant botulism is caused by consuming the spores of the botulinum bacteria, which then grow in the intestines and release toxin. All forms of botulism can be fatal and are considered medical emergencies. Foodborne botulism can be especially dangerous because many people can be poisoned by eating a contaminated food.

We never eat at buffets because the food sits out for too long.  Per Dr. Tierno food starts to grow bacteria within twenty-minutes, especially foods with thick sauces.  Avoid any food that sits and avoid raw honey due to possible contamination from botulism bacteria.

Cat Litter
Wear a face-mask while cleaning cat litter. Read the disclaimer on the litter box or bag and you will see why. Try to get a litter that does not emit fine powder when cleaning.

Crowds
If your counts are low avoids crowds of any kind.

Enema
Some chemotherapy drugs may thin the lining in the intestines, because of this the doctor told me to never use enemas or suppositories. With pediatric patients even using a rectal thermometer is not recommended. Rule for any cancer patients, never insert anything into the rectum. If there are problems with constipation Fiber-Sure is a great fiber remedy for constipation and it has no added ingredients. Check with your medical professional before purchasing. Drinking lots of water is also helpful for constipation.

Fake Nails and Eyelashes
I was going to have false eyelashes done for my daughter Kayla because the loss of her eyelashes upset her more than losing her hair. When I questioned the doctor I was told not to do either the lashes or nails because they increase the chance of a fungal infection. Where the skin touches glue, moisture can collect and create fungus. It is a known medical fact, that immune compromised patients have an increased chance of infection. Therefore anything that comes into prolonged contact with the skin can harbor bacteria and is a big no-no.

Gardening
Gardening is not recommended for immune compromised patients due to soil fungi. Any forms of fungus can be lethal for weakened immune systems. If you really want to garden wear a good face mask and gloves.

Grapefruit
No consumption of grapefruits while on medications. “To metabolize grapefruit, you use the same enzymes in your liver and lower intestines that you use to digest many drugs. If you eat grapefruit or drink grapefruit juice before or within eight hours of taking certain drugs those liver and intestinal enzymes will be occupied by the juice and not able to break down the drug. This means more of the drug will reach your bloodstream, which can increase its effect and chances of being toxic.” Taken from the book YOU The Smart Patient, by Michael F. Roizen, M.D. and Mehmet C. Oz, M.D. (This is another excellent book I highly recommend!)

Herbs
Check with your doctor before taking any herbal supplements. During heavy chemo therapy Kayla was not allow to take any herbs even as tea.  Once off the heavy treatment our oncologist allowed her to drink Green Tea and Chamomile tea.

In-door Plants
Plants and soil may contain Aspergillus, a fungus that can be lethal to immune compromised patients. All in-door plants and/or fresh flowers should never be allowed in the hospital room or home.

No Folic Acid
Folic Acid is an essential B vitamin. Folic Acid has been studied and is proven to increase Leukemia cells, therefore any Leukemia patient is strictly forbidden to take any supplement that contains Folic Acid. Other cancers could have similar idiosyncrasies, so again, always check with your doctor.

Pre-qualify Visitors
Before anyone comes to visit our home, I check to ensure that no one is sick in his or her family. I will ask, “Are there any sniffles or coughs?” You would not believe how many instances I have had with ill people trying to come and visit our home. Prior to the visit, ask the potential visitor several questions that ensure there is no illness in their home or around them. If the potential visitor answers yes to any of the questions tell them they cannot visit. When visitors do arrive have them wash and sanitize their hands. 

Restaurants
Only go to restaurants where you can see that the food is prepared fresh.  Otherwise you are risking your health due to food contaminated illnesses.

Self Medication
Do not self medicate under any circumstances without the express permission of your doctor. Even over-the-counter drugs should not be used with out doctor consultation. This is particularly true with immune suppressed patients. Tylenol, Motrin, Baby Aspirin, and any other medications along with any vitamins or herbs, must go through your doctor first. For instance, Methotrexate (chemo) does not mix with vitamin C and vitamin E. Certain herbs could counteract the effects that the chemo/medication is trying to achieve. Please, always check with your doctor before taking anything. 

Showering
Apparently shower heads can become loaded with bacteria.  To lessen this load run the water very hot for a few seconds before you enter.  Turn down the water temperature to a desired temperature. Wait until the water has been running before putting your face up to the water.  Here is an article on what was found in shower heads http://livingwithmcl.com/daily_bathroom_showers.pdf  It is recommended to have a metal shower head instead of plastic as the metal harbored less bacteria. 

Sunshine
There are medications that are known to magnify the sun when they come out through the skin.  As a precaution use sunscreens liberally and only take the suns rays in small doses.  Our doctor told me medical horror stories of patients badly burned within twenty minutes because the medications caused the skin to become very sensitive to the suns rays.

Turtles and Snakes
Patients with immune system compromise should never touch turtles, snakes or frogs as they carry bacteria that are dangerous to humans.