Daily Disciplines – Reaping A Harvest!
The other day I received a question on what supplements Autumn takes. I thought it might be helpful to list out everything – just so that if you have come to this blog as a “newbie” you can get a rough idea on what supplements might need to be taken. However, it is EXTREMELY important for you to be working with your dietician as to what YOU will need for yourself, or your child. Again, EVERYONE is different.
When we first started the diet, Autumn could not swallow pills – to this day, she still has a hard time. We tried practicing early on, but it seemed to cause more stress than progress. She can take very small capsules, but found it very difficult to swallow anything large. So what was our solution? Being faithful to what she could do. I could not do what she does, and I would prefer her to do it my way 😉 but as long as she gets the vitamins down – all is well!
Here is a picture of all her vitamins: It looks overwhelming, but…
It is split up three ways during the day:
First AM:
Autumn always has at least 1 Tablespoon of Coconut oil – it is either part of her breakfast food– as in the Apples and P-nut butter recipe – or straight off the spoon. And I take mine right along with her!
We just put some in a metal cup and melt it on the stove:
After breakfast:
1 – Levo-Carnitine* – crushed on a spoon and taken with a bit of water.
½ – kphos (Prescription) tablet dissolved in water.
1 – 5g Iron
1 – A and D capsules (When we had her check-up lab work, we found her to be low in these.)
This is what the Carnitine (a before and after of the pill crushed up) and K-phos look like:
Late Afternoon:
Every afternoon around 4:00 Autumn has her “Vitamin Snack:”
We measure out about 5 grams of butter, and add:
½ tablet daily vitamin – crushed up.
2 – Bone Basic capsules are opened up and added into the butter.
¼ of a Kelp capsule open up and added in to butter.
All of this is stirred up and spread on a “Keto Cheese Cracker” (See page 118 in the Keto Cookbook or check out my post: “You can’t eat Just one.”
She then somehow puts that all in her mouth and drinks water at the same time to swallow it down – again, not my way, but it works – and she does not complain!
She also has 1 more Levo-Carnitne, and another ½ kphos in water.
She has this, along with Kale chips, cheese and pecans – and sometimes her “keto soda” or “keto-tea”- and she has had this everyday since May of 2012! This works for her – she enjoys it (well maybe not the butter vitamin cracker 😉 ) – it may not work for you, or your child might like some variety. The point is, it is doable – you can work something out.
Evening:
In the evening before going to bed, she takes one last levo-carnitine (crushed up with a little water on the spoon). If I feel she might be getting sick – or if there is sickness in the house, I also have her take some of the Vitamin C powder – which also has magnesium and that can help with constipation.
There have been times when Autumn’s TC02 levels were too low and her Anion Gap too high so our Dieticain advised that she drink approximately 1/2 tsp baking soda in water and have her drink it twice a day to bring the acidity down.
*A note on Carnitine: When we first started Autumn on the diet we did not know if we should use carnitine or not. On her first set of follow-up labs, her carnitine was low so we started her on an over-the counter brand. Initially that helped, but then her levels became low again. Several months later on another follow-up lab test we found her to be low again- despite quite a high dose of the over-the-counter, so we started her on the prescription strength, levo-carnitine. The result has been an improved carnitine ratio which increased her ketone levels. This allowed us to lower her ratio and thus were able to add more fruits and veggies. The dose she is on is actually lower than what is typically prescribed for her weight, but with her ketone levels raising quite high, it was a good dose for her. Once again, I have found the blood ketone monitor to be an indispensable tool. Without having the monitor, we would not have seen the levels rise. Here is an explanation of carnitine from our dietitian:
It is quite common for carnitine levels to go low on the diet. Carnitine is like a shuttle bus that carries fat into the mitochondria, where it is burned for energy. A normal diet would be analogous to having a shuttle bus show up when there are 5 people at the bus stop. Everyone can get on the bus. A ketogenic diet is analogous to having a crowd waiting at the bus stop, and not everyone can get on the bus unless more shuttle buses are added.
Our bodies can make carnitine, but many children can’t make enough carnitine to meet the added demands of the ketogenic diet. A carnitine deficiency can cause ketones to go low, weight loss can occur because not all of the fat is utilized and the body doesn’t get enough calories, and children can have more fatigue and less endurance. In more severe cases, carnitine deficiency can cause metabolic acidosis and cardiomyopathy (heart problems). So it is important to make sure children are routinely tested while on the ketogenic diet, and to supplement with carnitine if a deficiency develops.
Some people have asked what labs we do:
Suggested Laboratory Tests For Ketogenic Diet
Once again, this is posted as a general guideline for testing. Please be working with your doctor/dietitian to be covering your needs!
Baseline lab draw, then after 3 months and then every 6 months:
Comprehensive Metabolic panel
Lipid profile
CBC with Differential
Betahydroxbutarate (if you are testing with your own monitor, this may not be necessary)
Carnitine, Free, and Total
Uric Acid
Vitamins A,D,E
Zinc
Selenium
If on meds, Anticonvulsant medication levels
Check with Dietitian/Dr. on: Acylcarnitine Profile, Quantitative
Optional
Vitamin C
Copper
Vitamin B12, folate
Ferritin
Iron Saturation/Binding Panel
Clotting screen
Notes on Autumn’s Labs:
Make sure to give a Vitamin D supplement, especially if you live in the northern part of the country.
Autumn’s neutrophil levels and platelets have tended to run on the low side on the diet. Some research literature suggests that that is a side effect of the diet. We were quite concerned so we did take her to see a pediatric hematologist, and although he did not know why, he felt the diet was probably causing the lower levels. Her over health has been excellent so he was not concerned.
We always kept an eye on the TC02 and Anion gap as that was an indeiation of acidity in the body. When those numbers were off, we made sure Autumn was drinking baking soda daily to bring the acidity down.
The faithfulness of taking these vitamins daily have lead to some of the best lab work since she has been on the diet – and it has been almost 22 months!
As with all things in life, it is the daily discipline in all the small stuff – taking the vitamins, exercise, daily watching what you eat, how much money you are spending, brushing your teeth, watching your tones and attitudes – daily – that often pay off big dividends over time. Yes, it can be boring, wearying and tedious, but….
“Do not grow weary in well-doing, for in due season you shall reap, if you faint not.” (Galations 6:9)
“He who is faithful in the little things, will be faithful in much.” (Luke 16:10)
“A man reaps what he sows.” (Galations 6:7)
“Sow a Thought, and you reap and Act;
Sow an Act, and you reap a Habit;
Sow a Habit, and you reap a character;
Sow a Character, and you reap a Destiny.”
The diet that helps build a Destiny 😉 – Keto Joy!
“Munch-Time” Sandwiches – No bread required!
One of Autumn’s favorite super-quick meals that she has for lunch or dinner are salami “sandwiches.” Hormel has an all natural, nitrate/nitrite-free brand. Now, I know “Natural” does not necessarily mean “perfectly free from anything bad,” but hey, it is a step in the right direction.
So, here you go: Salami, cheese, butter, carrots, lettuce, cream – with chocolate drops if you like, and either coconut or fish oil – oh, and a bit of mustard – it is missing from the picture, but you gotta have a bit o’mustard to with that salami. 🙂
(Click on “Recipes” tab for exact measurements)
First, measure out ratio requirements of all ingredients:
Then, spread the butter unto the salami and put together a sandwich:
Add a glass of milk, which is cream mixed with water, yes she gets the yummy creamy stuff – add a few drops of chocolate – or any other flavor if you like.
For the added fat needed (depending on your keto-ratio) you could add more cream, use some mayonaise or add some nuts. I am a big proponent of getting in oil at every meal – and Autumn actually prefers oil to mayo – which is fine by me. Sometimes we do coconut oil, sometimes cod liver – the health benefits are super with either. She just takes the oil right off the spoon before eating.
And then it’s “Munch-Time” 🙂
Keto-Joy!
Joy, in Blood Draws?
Well…yes, no, and sort-of 🙂
I will say this, Autumn out does all her brothers – and her dad, when it come to getting poked with a needle!
When Autumn was first hospitalized trying to get her seizures under control, there were lots – and I mean LOTS – of blood draws. There were IVs that would not stay put and veins that exploded.
Last week, Autumn went in for her usual 6-month lab workup. There are a great deal of tests to run, which means MANY viles of blood to be taken. Autumn has never been able to make it through the blood draws without fear and crying.
As we entered the lab room, she just looked at all the tubes and her “hurting eyes” then looked up at me. I just looked at her and said, as I always do, “Hey, you are going to do great, it will be all over in just a few minutes.” There are usually about three nurses in the room to help, and once again the great staff at Dekalb Memorial Hospital did all they could to get her through.
We settled in the chair, they put the tourniquet band tightly around her arm, she buried her head into my side and the needle went in.
Autumn was silent. Not one tear! She even smiled at the end instead of being in her usual heap of tears! The whole room was filled with smiles!
I really wished I had had a camera – it would be felt so much more if the pile of blood viles next to Autumn’s smiling face could be seen.
Yesterday, as I was reviewing the results of those tests, I realized some were missed – ug, I had to tell Autumn we needed to go back again in the morning.
So, this morning at around 7:00 am off we went in the -14 degree, bone-chilling winds and ice-covered roads to the hospital lab.
We went in as usual, settled in the familiar chair and Autumn nestled in next to me. The nurse found the vein she was going to poke and then put the needle in – except this time she was having some trouble getting the blood to come out – even though the needle was already in Autumn’s vein- so she was having to move the needle around in the vein. Autumn did not move. The nurse called for help, but then, thankfully, the blood started flowing into the tube – whew, I could breathe – and so could Autumn.
And you know what? Again, not one tear from Autumn. And yes, she even smiled, again! To the prize drawer she went where she picked out a pencil covered with hearts and an eraser.
My prize was in my heart. 🙂 We are coming up on almost 2 years on the diet and she keeps persevering through it all.
I know I have mentioned it before but, “Consider it pure joy whenever you face trials of many kinds, because you know that the testing of your faith develops perseverance. Perseverance must finish its work so that you may be perfect (mature and complete), not lacking anything. (James 1:2-4)
Time…it changes things…keep pressing on!
“Those who sow in tears, reap in joy.” (Psalm 126:5)
“Keto-Joy!”
Berry Stylin’ with PB & J!
There are probably more carbs in one traditional peanut and jelly sandwich than what are allowed in an entire week on the keto diet – BUT that doesn’t keep Autumn from enjoying one! This recipe once again comes from Dawn Martenz’ Keto Cookbook. We just quadruple the recipe and bake it in a pan instead of putting into muffin cups, although when we first started the diet we always used muffin cups – do what works for you!
Here are the ingredients for the bread/muffins:
(Click on “Recipes” tab for exact measurements.)
You can with use either Whole Ground Flaxseed Meal or Golden Flaxseed Meal.
Measure out all ingredients.
This shows 2 quadruple batches. Put in 35 degree oven and bake for approximately 15 minutes
Once cooled, cut the bread into small squares and weigh the entire amount:
Weigh the entire bread amount and then divide by 4 to get weight for 4 individual portions. Measure that individual amount out and place into a small ziplock bag:
Place all your bags in a container and store them either in the refrigerator or freezer. Whenever you are going to make a sandwich just take a bag out to thaw for a bit before using.
Ok, so when you are actually ready to make a good old peanut butter and jelly sandwich, here is what we do:
Measure out the peanut butter and butter and mix together:
Then spread it evenly on your bread – although Autumn often licks quite a bit from the spatula before it makes it on to the bread 🙂
Then measure out your fruit. A note here: You can use whatever fruit you like – just check your amounts in the ketocalculator. You will see a picture here of measuring out blueberries. However, she often takes raspberries and stirs them up with a pinch of stevia to make a jelly – see the very first picture at the top of this post. You can use either fresh or frozen berries.
And its Keto Joy PBJ ala blueberry style…
Or Raspberry style!
Keto-Joy stylin’ all around 🙂
2014…Think on These Things…
The Unknown
Many of us faced some unexpected life events this past year – some good-some not so good. Life-changing events…life-ending events. And as sure as the sun is going to come up tomorrow, we are going to face those same unknowns in this upcoming year. I think of our own family. At some point this year, we will start weaning Autumn off the diet…wow…has it really been almost 2 years? And guess what? I know that I don’t know what is going to happen. Will there be seizures? If there are, will we be able to get them back under control? Will she do just fine? What if they come back a year from now? And so on and so on with the “What abouts?” and “What ifs?”
So what to do?
“Do not fret it only leads to evildoing.” (Psalm 37:8)
Why?
Because “We know that all things work together for good to those who love God…for He who promised, is faithful to bring it to pass”(Romans 8:28 Hebrews 10:23).
How?
“Finally Brethren, whatever things are true, whatever things are noble, whatever things are just, whatever things are pure, whatever things are lovely, whatever things are of good report, if there is any virtue – and if there is anything praise worthy, meditate on these things…and the peace of God will be with you.” (Phil. 4:8-10)
The true, noble, just, pure, lovely and good….think on these things – always – whether rejoicing or weeping. We are going to find ourselves in both camps this upcoming year -either in our own lives or in the lives of those around us.
“For as a man thinketh in his heart…so he is.” (Prov. 23:7)
We need to guard our hearts by staying well-nourished -on anything praiseworthy-in the mind.
May our hearts and minds be fixed on that which is true, beautiful and good so as to walk in steadfast endurance through this New Year!
Chocolates, Chips, Crackers, Nuts and Soda – Party Time!
Ok, So if you combine the last few blog posts, you can make a great little New Year’s Eve party “snack-meal” plate to enjoy!
You might be able to add a bit of fruit and possibly a bit of cheese also, depending on ratio/calorie requirements:
Of course you can always opt for pizza and milk shakes too!
Oh, the Keto-Joy of it all – Happy New Year’s Eve!
Kale – Not just for Decorating!
Many (many!) years ago as a college student, waitressing at Pizza Hut, we used kale to cover the ice around all the condiment crocks in the salad bar. It wasn’t until years later that I realized people actually ate it – I thought it was just for decoration! For the last several years I have added it smoothies but it wasn’t until the ketogenic diet entered our world that I had the wonderful delight of tasting kale chips – yes, a delight. I love crumbling them up with buffalo chicken dip! I remember when I first made them for Autumn, most of my kids were pretty skeptical. Now, I have to keep them away from the pans of kale cooling on the counter or there won’t be any chips left for Autumn!
If you don’t already know of all the unsurpassed health benefits of Kale – just google it – you get over 20,000,000 responses! Kale is known for being one of the healthiest vegetables – super high in Vitamin K, A and C – and pretty high in fiber – all helpful when on the Keto diet.
The only ingredients needed are Kale, butter (or olive oil), and salt. (Click on “Recipes” tab for exact measurements.)
First cut the center rib out of the leaves – Autumn and her sisters do that job.
When they are finished, I just melt a few tablespoons or so of butter – depending on how much Kale I am doing – you don’t need much to coat a lot of kale – and then sprinkle desired amount of salt in with the butter (we use RealSalt). If you end up using too much butter or oil, your leaves will be a bit soggy and take a lot longer to get crisp.
I then put the kale in the pan and stir it all around with my hands making sure all the leaves get coated:
I place the kale on pizza pans so that they crisp on all sides. (I do line the bottom of the oven with foil in case any butter drips).
Place in the oven at a pretty low temp – around 200- 225 depending on your oven. Then check every 15 – 2o minutes, stirring/turning over the leaves. Keep doing this until all leaves are crunchy – can take up to an hour or so. Do not over-bake by letting them get brown – unless you like a “burnt” taste.
And viola – you have a great tasting EDIBLE decoration chip! 🙂
Keto Joy!
You Can’t Eat Just One!
Keto Cheese Crackers – Oh Yeah!
I literally have to put these in a container right after we bake these and put them away before I eat one..and then another…and another!
This recipe comes right out of “The Keto Cookbook” by Dawn Martenz. They are really quick to mix up.
Here are the ingredients you need: Macadamia Nut Butter, Full Fat Cheese, Egg whites and a pinch of salt (Click on the “Recipes tab for exact measurments):
Shred your cheese:
Add your Macadamia Nut Butter, Egg white and pinch of salt and stir:
Place a nickel size amount of mixture on a parchment paper-lined baking sheet, bake at 350 for about 10 minutes:
And out comes the lightest, flakiest bite-size morsels of cracker yumminess:
Serve up with an ice cold glass of Keto – soda!
Keto Joy! 