After FMO's reaction to Lamictal, that drug was off the table. There is a long list of pharmaceutical interventions to try next, possibly experience a level of success with some before the likely eventuality when they stop working. This is the most common experience with epilepsy treatment, unfortunately.
I broached the subject of Keto Diet. His neurologist said despite the effectiveness of the diet, "It is too hard for kids to stay on the diet," and, "If they sneak a cookie, it's like going off their meds." I left it alone until we met with the nurse practitioner. She was excited about the possibility of FMO doing the Modified Atkins Diet since we already bring his food with us places, hardly ever eat out, and he is home schooled. We have control over foods he is exposed to.
It took a long time to get started for various reasons. We were on vacation. The NP was on medical leave. FMO needed labs first to check his metabolism. Eventually, we did get in to the "Keto Clinic" and hooked up with the dietitian who set goal levels and walked us through how to safely keep FMO on MAD for seizure control.
So far, it has been effective. If he can achieve four months seizure-free, they will ween him off medication. It has been an adjustment switching his diet from basically all carbs to super low carbs and zero sugar, but it was way easier than when we made the switch to gluten free.
If someone told me a year ago FMO would be eating no bread, no bananas, and eating greens everyday (not hidden!), I would not have believed it.
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