December 2, 2009

A Bad High School Chemistry Problem

This is a recent post from a ketogenic diet support group mailing list. I wonder who could've written it?

My son is only 23 months-old. He is at the 50th percentile for weight (12.5kg) and about the 40th for height (33.5in). We started the diet at 3:1 ratio, a little over 2 weeks ago. The dietitian refused to give me her calculations (personality clash), but he supposed to have 4 meals of 40.7g KetoCal 3:1, or 162.8g KetoCal (1137 Calories) per day.

Based on the past two weeks and my prior calculations, I think this is too high. Using "The Ketogenic Diet" book, my calculations for fluids matched the dietitian's at 1150 ml per day. However, I got a RDA of 1125 Calories (160.9g KetoCal per day)--85% of that RDA would be 995 Calories (136.6g KetoCal per day).

My son is struggling to drink his 1150ml of fluids, I think, because he is too full. He likes the KetoCal, so that isn't the problem. (Before the KD he hated juice, water or anything not milk.) His average fluid intake has been 856.9ml per day. Therefore, this puts his KetoCal intake at 137.1g per day or 85.2% of the RDA I calculated.

If those Calories seem fine according to the Johns Hopkins book, why am I bothering you? Because his dietitian has said she will lower his ketogenic ratio from 3:1 to 2.5:1 if he is not getting the fluids in! BUT WE ARE SEEING RESULTS AT 3:1! From over 30 drops per day down to no drops the past week! And only 4 myoclonus today, with far less absences and partial complex seizures! If anything, the ratio goes up!

Furthermore, his glucose, etc. are fine. His CO2 was a bit off, indicating some mild dehydration, and I am worried about that. Should I test diluting the KetoCal further, doing the fewer Calories (which he has been doing anyway)? I am tired of fighting with my son, especially when I think he is right.

None of this would be an issue if we could have an open dialogue with our dietitian. But, our dietitian dislikes us, her job, or something. We even heard the nurses talking about what "a bitch" the dietitian was being to us (or possibly in general). I think she may have threatened lowering the ratio just to keep me from emailing her. I've only emailed her 3 times in 2 months--not excessive!

*Sigh.* Nobody claimed the ketogenic diet would be easy. :)

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