Saturday, July 27, 2013

What is Owen Eating? (Ketogenic Diet)

 The Ketogenic diet is VERY strictly controlled. All of the ingredients have to be weighed out on a gram scale. The recipes must be followed EXACTLY. I have to scrape out all the containers and bowls used to make sure I don't lose a gram of something. Owen is getting 1198 calories a day based off of the 4 day "normal" diet plan I sent the dietician and his age, size, and activity level. He gets the calories in 4 equal meals of 265 ( plus or minus 4) calories and 1 bedtime snack of 138 calories to give him his medicine in. All 5 of those meals have to be at his 2:1 ratio of fat to protein/carb. What this means on a practical level is that all of Owen's food has to be prepared from carefully calculated ( thankfully there is a computer program) recipes. I can't substitute ingredients without completely re-working  the recipe.
Owen's pizza on an egg based crust
 The dietician sent us home with a day's worth of meals and several pre-made recipes. The problem is that I have to have the exact same brands as the recipe states or I need to re-work the recipe. We couldn't find all of the listed brands, so I've been re-doing recipes while Rod has been going to every grocery store in the county to see who has which brands. If I have a recipe for pancakes( egg and macadamia nut or a special keto baking mix) and strawberries, I can't just trade out the strawberries for blueberries. There are some "exchange" lists, but our dietician doesn't want us to use them for a few months until we find out how sensitive Owen is going to be.
Measuring out ingredients in the hospital
  We were sent home with 4 recipes for scrambled eggs. One with cheese, one with bacon, one with sausage, and one with kielbasa. When I got home I realized the the bacon and cheese recipes hadn't gotten switched over from the hospital's 38% cream to our local 36% cream. I also couldn't find the right brand of kielbasa or sausage. That meant I couldn't even make him something as simple as scrambled eggs without re-working the recipes. Eggs with cheese was pretty easy I just had to add a few grams more cream to make up for the fact that ours doesn't have as high a fat content. The sausage recipe I just placed on the back burner for a while since the store carries it, they were just out at the time I was there. The bacon recipe changed a few ingredients and the kielbasa recipe is quite a bit different.

Eggs and Bacon 38% cream
13 grams cream
14 grams bacon cooked crisp(weighed after cooking)
45 grams of egg (raw, well mixed)
11 grams butter

Eggs and Bacon 36% cream
12 grams cream
14 grams bacon cooked crisp(weighed after cooking)
46 grams egg (raw mixed well)
12 grams butter

 I know these seem like tiny little changes, but they make enough difference to matter on the diet. I'm not sure if I'll be spending more time at the computer calculating recipes or in the kitchen making them in the next few days. Once we have our recipes fine tuned things will get easier, at least until they change our ratio (current plans are to go up in a week or 2) at which point I will have to re-do everything again. 
 Owen has perked up a lot today. He didn't take a nap for the first time since starting the diet. He seems more alert and aware in general. We had a little bit of twitching last night as he fell asleep, but very little compared to usual.  His ketones are staying high and he's still eating everything even if it is under protest. We are trying new ways to get all of his supplements in him as adding them to the food is making it pretty unpalatable.
 This is his bedtime "med" snack. I'm not sure if you can see how big that pile of white powder is, but it's a lot for a couple of ounces of yogurt. Hopefully the diet will control his seizures and we can start to eliminate some of the medications in the next few months! The supplements will have to continue for the duration of the diet.




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