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Pediatric Neurology: Paul R. Carney, MD
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Pediatric Neurology: Paul R. Carney, MD


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  • 1. Pediatric Neurology: Paul R. Carney, MD Zhao Liu, MD, PhD Edgard Andrade, MD Pediatric Gastroenterology (GI): Joel Andres, MD Christopher Jolley, MD Research Coordinators: Peggy R. Borum, PhD Lauren L. Jones, PhD
  • 2. Ketogenic Therapy (KT)
    • As your child’s KetoBuddy we are here to provide a support network for your family, gather information about your child, attend clinic visits, and notify the clinic staff of any non-urgent issues to be addressed
      • If you have a medical emergency, contact your clinical providers.
    • Our main goal as your child’s KetoBuddy is to improve your child’s care and explore the possible mechanism of the diet in hopes of improving your child’s therapy.
      • So what will we be doing?
      • Contacting you through phone calls and emails to get updates on your child’s progress on the diet.
      • Collecting data at clinic and presenting information to your clinical provider.
      • Provide creative ideas for meals and tailor the meals to your child’s needs.
      • Resource to assist you with all your child’s needs.
    • We DO NOT change medications or provide any medical advice.
  • 3. Ketogenic Therapy (KT)
    • KT is a neurological treatment
      • not a diet for weight control.
    • Similar to your other therapies for seizures
      • such as antiepileptic drugs (AEDs) and VNS.
    • All changes that are made must be cleared by your clinical providers.
    • For these reasons, we do not call it Ketogenic Diet.
  • 4. Overview of KT
    • Fasting was recognized as a way to control seizures.
    • Seizures would return once a normal diet was resumed.
    • In 1921 KT was born.
    • Although the therapy helps many children, we do not know how it works.
  • 5. UF Ketogenic Therapy Research Program
    • How are we different from other programs
      • KetoBuddy support system
      • Data collection used for:
        • Tailoring the therapy
        • Close patient monitoring for the needs of your child.
        • The Research Program requires more daily records from the caregiver’s part; however, they are utilized to monitor the progress and personalize your child’s therapy.
      • More frequent monitoring of your child’s overall health. (more labs, more measurements, metabolic cart)
      • Patient visits are at Shands in the GCRC.
      • All research procedures are done free of charge.
      • Inpatient visits at the GCRC are free of charge.
  • 6. Description of the Ketogenic Diet
    • High fat, low carbohydrate, adequate protein diet.
    • Ketogenic Ratio = Fat:protein+carbohydrate
    • Forces the body to utilize fat (in the form of ketones) rather than carbohydrates as the main source of energy.
    • Ketones are a byproduct of fatty acid metabolism.
  • 7. Qualifications for Ketogenic Therapy
    • Typically (but not exclusively) used for children
    • If AEDs are ineffective or produce undesirable side effects
    • If a surgical procedure is not an option
    • Intended for patients without fatty acid oxidation disorders.
      • This is something we screen for prior to your child’s initiation onto KT.
  • 8. Before Initiation
    • Food Preferences Questionnaire will help us select foods your child likes to incorporate it into their Keto-Meals
    • In order to help your child adjust into a state of ketosis easier, the weekend before:
      • Limit simple sugars and starches
      • Drink sugar-free or unsweetened liquids
    • Night before Initiation:
      • Overnight fast for at least 8 hours
      • Allowed to have water and medications
  • 9. Initiation
    • Day 1-2
      • Start on a 1.5:1 ratio of fat:protein+carbohydrate
      • Ratio increases by 0.5 every 1-2 meals
    • Day 3
      • Usually discharged between a 3:1 to 4:1 ratio
        • Procedure is subject to change depending on how your child tolerates the ratio
        • Meal schedule is also dependent on what your child usually eats.
  • 10. What to Bring to Initiation
    • Caregivers Guide
    • The foods for Initiation that you and your KetoBuddy discussed.
    • Daily home records of seizures and
    • 3 day diet recall
    • Multistix 10 SG, scale, and all medications and supplements in their original bottles
    • Videos, DVD player and DVDs, favorite toys, coloring books…something to keep your child occupied and feel more at home
  • 11. What will be provided at Initiation
    • A mini fridge, microwave, and kitchen supplies
    • Some foods may be provided by Shands’s kitchen
    • One caregiver will be provided with meals during their GCRC stay
    • Wireless internet access is available if you wish to bring your laptop
  • 12. Remember
    • You can contact your KetoBuddy with any questions you may have about Initiation