The Charlie Foundation's Position on Marijuana Derivatives for Epilepsy Treatment

The Charlie Foundation was founded on the principle that the medical standard of care needs to be be a process of informed, joint decision making between a patient or caregiver, and his/her health care provider. We have the highest regard for the value and necessity of science. We have much less sympathy for the intervention of government in this process. What's more, science doesn't always lead the way. Frequently there is a painstaking period while science takes a great deal of time to substantiate or rule out what may be fact. Many don't have the luxury of that time. That's when factors such as anecdotal evidence and risk/benefit ratio need to be considered without government interference. That's where it appears we are with CBD today. If we had waited for a randomized controlled study to be published on the efficacy the ketogenic diet, Charlie would have been seventeen years, rather than 20 months old before he started the diet, and I don't know that we would still have him today. What's more, to paraphrase "first do no harm": "To pretend that multiple drug treatments for children with difficult to control epilepsy are science and then argue against CBD is the cruelest of double standards."

Jim Abrahams, The Charlie Foundation

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Frozen Yogurt Tubes (keto Go-Gurts or Yo-Sqeezers) ***UPDATED 5/23/13***

Frozen Yogurt Tubes (keto Go-Gurts or Yo-Sqeezers) ***UPDATED 5/23/13***

Making home-made yogurt tubes is not the quickest process, however I can think of numerous occasions where I would have LOVED to have a keto meal ready-made, in a tube, frozen and ready to eat.  I can't think of a better meal to send with a keto kid to school, camp, grandparents houses, birthday parties, picnics, the beach, you name it.  After these are made, you can throw them in a cooler with ice packs and hit the road (just remember a small pair of scissors to open it!)

Here is the process broken down step by step.  It took a little trial and error to get the right size tube for my particular recipe, and there is definitely a little more waste of the food saver bags than I care for... but to have this in the freezer and be able to travel with it is worth it in my opinion.

***UPDATE***  A new, MUCH EASIER way of making these pops is now available! Please click here to order Zipzicle bags (pictured above).  OR you can continue with the original method ;)

 

Step 1

Make the yogurt. The recipe I am using is my fruit yogurt.  This is a peach version.  Please not that this has changed slightly since our move since my brand of cream is different.  I was using Organic Valley Cream, but now I'm using Trader Joe's which is 40%.  The entire serving of the recipe is 118 grams, the how much needs to fit inside the yogurt tube, WITH room to spare for it to seal properly.

3.5:1 Ratio

about 290 calories

21g peaches

15g 40% heavy cream

62g Stonyfield Yogurt, Plain Whole Milk

10g walnut oil

10g coconut oil

Again, total weight is 118g per serving. This is how much you need to fit into the tube.

I use a blender to make a large batch of yogurt.  You will lose a few grams of it in the process, if this concerns you, you will have to puree the peaches separately then mix each serving separately as well.

I make 6 serving at a time.  Multiply each ingredient by 6 and blend it all together in the blender until it is completely smooth.  It helps to have the coconut oil melted when you first mix the batch of yogurt.  This will help it incorporate completely.

Step 2

Make the yogurt tubes. Make a tube bigger than you think the first time, so you get an idea of how much space your recipe needs.

To held enough for this recipe, you will need a roll of 11 inch FoodSaver plastic.  For each tube, you need about 4.5 inches.  Once you have cut the first length, seal the first side. When the Foodsaver starts to "suck" to remove any moisture or air, hit the stop button to by-pass this and go straight to the heat sealing step.  You should have this...

Next seal the other side.  Again, hit the stop button to stop the air removal.  Now you have an empty tube that is sealed on all 4 sides. The middle portion is where the yogurt will go and it as about 2 inches across.

Trim one of the short ends (factory sealed edges) to make the top opening.

Put the empty tube in a tall cup on your scale and ZERO the scale. Use a funnel or just hold the tube open with one hand and carefully pour in the yogurt mixture (whoops, first tube I made was too small! Do you see it only weighs 86g?)  If you over fill, use a syringe to remove any extra.

This is why you need at least 2 inches extra room at the top.  Now you have to seal the top opening.  I had no problem sliding in the extra and getting it to seal. Make sure you hit the stop button to prevent it from sucking out the yogurt!!!! Now you should have this...

Trim the extra off the sides and put it in the freezer.

You could put anything in here, it doesn't have to be yogurt..., pudding, applesauce, ice creams, really anything that is pureed.  After eating the frozen pop, if there is anything remaining in the plastic I would recommend adding a small amount of water and swishing it around.  You would have to then drink the water... or cut it open and let the kids lick it out ( I know my kids would not have a problem with that!)

Also... did you know, you can re-seal store-bought yogurt tubes!  The only downside it that they are much smaller and only hold 56g. After cutting off the top and taking into consideration the room needed to re-seal, your recipe could only be about 30g total weight.  If you have a fruit puree or need small 50 or 100 calorie snacks, these might work for you!

 

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Sprinkle Birthday Cake

Sprinkle Birthday Cake

I wanted to re-create "Funfetti" boxed cake mix... It was always one of my favorite mixes in the cake section! I really did not want to include nuts so it could be considered "school friendly", so I included xanthum gum in this recipe.  Some people may not be familiar with xanthan gum, however, it is an indigestible fiber, and does not need to be calculated into a ketogenic recipe. It is what makes the cake spongy and retain the rise from baking.  It also helps hold all of the oil and keep the ingredients emulsified.  It is not an ingredient I would choose to use on a daily basis, but sometimes you need to eat cake! I have never seen any adverse reaction to xanthan gum, but please run it by your dietitian just to be sure.

India Tree makes a great 100% all natural vegetable based food coloring, but if you prefer to avoid food coloring or just want a plain white cake,  just leave the sprinkles out and use all plain coconut flour.  I frosted the cake with about 50g of Buttercream Frosting flavored with almond and lemon extract.  I sincerely hope this recipe helps make a keto birthday special!

Sprinkle Birthday Cake
256 Calories

3:1 Ratio

5.2g Protein

3.0g Carbohydrate

Makes one single serve birthday cake

For the sprinkles:
Combine 1 tablespoon of coconut flour with equal parts water. Stir to combine. Add 1 drop of food coloring (natural food coloring is preferred) to the coconut flour andwater. Make sure the color is evenly distributed. Spread the colored coconut flouron a piece of parchment paper until it is very thin. Allow it to air-dry overnight. When it is thoroughly dried, break it into very small pieces and store in an airtight jar. Each color is made separately using the same process.*Please note: for the following recipe, only 2g of the colored coconut flour sprinkles are used. Continue to use “coconut flour” in recipe calculations
to include the sprinkles. Since the amount of food coloring in the cake recipe is so minimal, the food coloring can be counted as a “free food” item.

For the cake:Ingredients:
23g oil, use a plain flavor such as sunflower, safflower, canola
12g coconut flour, Bob’s Red Mill (10g from the bag, 2g of the colored sprinkles)
1g xanthan gum (*Optional & does not need to be calculated)0.5g baking powder0.5g vanilla extract (an additional 0.5g almond extract adds a gre
at “cake” flavor)
32g egg whites, whipped into soft peaks½ tablespoon waterPinch of salt Sweetener of choice (5g of Truvia was used for testing)

Directions:
Pre-heat the oven to 350 degrees.

Mix 10g of plain coconut flour with the oil. Stir until smooth. Add the xanthan gun, baking powder, extract, water, salt and sweetener. Stir again until all of the ingredients are very well combined.

Add about 10g of the egg whites plus the additional 2g of colored coconut flour. Stir until the egg whites are incorporated and the batter has “loosened” slightly.
Add the remaining egg whites and carefully fold them into the cake batter. Continue folding the egg whites into the batter until evenly distributed. Pour the batter into a greased baking dish or silicone mold (a 1-cup glass Pyrex container was used for testing).

Bake the cake at 350 degrees for 5 minutes. After 5 minutes, turn the oven down to 300 degrees. Continue to bake for an additional 25-30 minutes. The cake should spring back when the center is pressed lightly with your finger.

Allow to cool before slicing or frosting. 

Notes:
If possible let the cake cool upside down (similar to an angel food cake), this will help prevent it from collapsing. It will sink slightly as it cools, however it you find it is going flat, it may have been slightly undercooked.

Xanthan gum is a stabilizer and emulsifier that gives the cooked cake a spongy texture and helps hold all of the oil. It allows it to rise and hold the tiny bubbles created by the baking powder. If the xanthan gum is not used, the texture of thecake will be denser. Xanthan gum does not contribute to the overall flavor it only helps improve the texture.

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In-N-Out Salad

In-N-Out Salad

No matter how healthy you eat on a daily basis.... When you live in California, you eat at In-N-Out on occasion! For those of you not "in the know", there is a process to ordering your meal at In-N-Out.  The menu has 3 options: Hamburger, Cheeseburger and Double-Double (2 patties), Aside from fries and fountain drinks, that's all that is posted on the menu.  BUT... there is a "secret" menu and specific terminology when it comes time to order.  Two of the most popular are "animal style" (includes grilled chopped onions, pickles and mustard) and "protein style" (a burger without the bun and wrapped in an iceberg lettuce leaf instead).  

Lots of people who eat low carb diets order "protein style" and it is not at all uncommon to see people eating burgers with a lettuce instead of a bun.  In-N-Out also has a "spread" that is very similar to Thousand Island salad dressing... the spread and "protein style" gave me the idea to calculate a salad using the same ingredients and flavors.  For older kids and adults, a small hamburger patty wrapped in lettuce would be a great option to bring with you.  On average, a hamburger patty at In-N-Out weigh about 30g, a lettuce wrap in place of the bun weighs about 65g (I have gotten as little as 30g and needed to ask for more) and 2 slices of tomato is about 30-40g.  Here are links tot he main In-N-Out Burger website, the nutrition information (some of you may be able to actually order right off the menu!) and a link to a post detailing the "secret menu"  (make sure you click the slide show) because there are even more options than what they tell you on the In-N-Out website!

Makes 1 serving

3:1 ratio

298 calories

7.79g protein

1.81g carbohydrate

In-N-Out Salad

 

Ingredients

70g iceberg lettuce

25g 85% ground beef, cooked (I roll tiny meatballs and pan fry them.  I store them in the freezer)

10g dill pickles, Bubbies brand

20g mayonnaise, Hellmann's

9g coconut oil (I think they add sweetener to the "spread". The coconut oil adds a little sweet flavor instead of using an oil like olive.  But, use whatever you would like!)

5g tomato puree, canned (you could use sugar-free ketchup as well)

5g dill relish, Bubbies brand

salt/pepper

Directions

Chop or shred the lettuce.  Top with the meat and pickles.

Mix the mayonnaise, coconut oil, relish and tomato puree together to make the dressing.  Season with salt and pepper.  Toss the dressing with the salad and enjoy! (Ask for a free water while you're at it!)

Notes

You could add tomatoes or chopped hot chilies if you would like.

The dressing can hold more oil if needed to increase the ratio.

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Cooking Chicken

Cooking Chicken

Having pre-prepped ingredients stored in the freezer is a major time and sanity saver! This is a great way to cook chicken so the flavor and texture after thawing do not taste like leftovers.  By cooking chicken using this method, it will remain soft, you can avoid using added fat during the cooking process, it will not dry out, and once frozen, it is ready to pull out of the freezer one piece at a time.  It is also ready to process further for other recipes that require shredded or pureed chicken.

Step 1: Gather Supplies

Boneless, skinless chicken breast, a clean knife and plastic cutting board.   Fill a pot with enough water to cover the amount of chicken you have. Put the pot over high heat and bring the water to a boil.

Raw Chicken Package

Step 2: Slice the Chicken

I slice the chicken into small bite size pieces. The are wider than they are thick, about 0.5 - 1 inch in size. I choose to wear disposable gloves when handling raw meat, it is a great way to help prevent cross contamination with other ingredients.

Cut Chicken

Step 3: Cook the Chicken

Once the water has boiled, put all of the sliced chicken into the water and stir to prevent the pieces of meat from clumping to each other. For the size pieces that I cut, 60 SECONDS is all it takes to cook. The water will not come back to a boil after adding the chicken.  Before removing all of the chicken, check a larger piece to see if it is cooked through. The internal temperature of the meat should be 165 degrees and no longer look pink.  I use a strainer to scoop it out into a clean bowl.

If you would like to freeze the chicken, cover the cooked bowl with plastic wrap and allow it to cool completely in the refrigerator. I use gallon size zip top bags and lay them flat on a freezer shelf, making sure the chicken pieces inside are relatively spread apart.  Once they are frozen, shake the bag to break them apart and squeeze the air from the bag.  They will thaw in only a few minutes when I need them.

Chicken in pot

Step 4: Shredding

For recipes like chicken salad or chicken nuggets, I use shredded chicken. To shred the chicken,  use a standard food processor.  Just put the warm chicken into the processor and pulse it a few times.  That's it!

shredded chicken

Step 5: Pureeing

Once you have shredded the chicken, you can move onto pureeing.  After it reaches the shredded state, just keep the food processor running. It will take about about 5 minutes total.  The chicken will never turn into a puree, it will begin to look very dry and clump together.  Once you start to see it clumping together, it is ready.  Take a piece out and rub it between your fingers. It should be very fine, with no large pieces interspersed.  DO NOT add any water while pureeing! The water will add weight to the chicken and when added to a ketogenic meal, you will end up with less chicken than you should.  It is best to puree while the chicken in still warm. Once it has cooled, it never seems to get a fine of a texture. Once the chicken is blended with other ingredients such as cooked vegetables and fat, it will thin in consistency from the added moisture from other ingredients. At this point, you have cooked, pureed chicken breast that is ready to be added to a keto recipe or freeze!

ground chicken

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Updated Keto Pantry List & Printable!

New printable format of the Keto Pantry!

Use the keto pantry to determine food preferences prior to starting the diet OR use it to expand your current diet.

CLICK HERE: Keto pantry printable PDF

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Most Frequently Eaten Meal...

Most Frequently Eaten Meal...

This is a super fast meal that can be eaten anytime of day.  Sometimes the eggs are scrambled, sometimes they are fried, I even microwave them if I'm in a huge rush.  The side fruit or vegetable is interchangeable and depends on what is currently available!

Of course, part of the ease in preparation comes from taking oil in syringes. Learning how to consume oil in this method allows for ingredients to be eaten plain (as many people like), not swimming in fat. This is a skill that is best learned slowly using small amounts of oil to start with.  Overtime, people master this technique and are more easily able to consume the fat.  You could swap some oil out for cream, mix some of the oil (or even mayonnaise) into the eggs and scramble them, but most likely you will have to have some oil or fat on the side if you are at a higher ratio.

288 calories (will vary slightly depending on the fruit or vegetable)

3.5:1 ratio

Ingredients

10g coconut oil

10g olive oil

5g butter

50g raw egg (usually 1 large egg is about 50g)

40g raw tomato

OR

Replace the tomato with any other fruit or vegetable of your choice.  Keep the egg, oil, butter measurements the same and write down the different amounts of fruit or veggies needed to replace the tomato on the same card.  A few examples:

26g blackberries

23g strawberries

31g baby-bella mushrooms

32g asparagus

Directions

Pan fry the egg in the butter. Scrape all of the butter out of the pan on to the top of the egg.  Serve the tomatoes on the side, cut in half and sprinkled with salt and pepper.  Serve the oil in 2 10ml syringes.

Notes

You can include some of the fat in the egg if you scramble them.  50g of egg will hold about 10g of oil plus some cream if you are using it.

Some vegetables are great if they are cooked in the egg like an omelet.  Spinach, mushrooms, peppers and onions are all good options.

In the background, you see un-sweetened decaffeinated black iced tea.  Use only decaffeinated tea for ketogenic diets! Tea is a great source of many antioxidants and is considered a "free" beverage.

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How to Freeze Avocado

How to Freeze Avocado

If you are avocado lovers, this is a great tip! Avocados are great for the ketogenic diet.  It's one of the few foods that can be eaten "straight up"with nothing added and still remains balanced at a 4:1 ratio with the fiber subtracted.  The instructions are super simple...

1. Peal and remove the pit from the avocado.

2. Keep the entire halves intact, cut into cubs or mash into a puree.

3. Place into freezer zip top bags or use a Foodsaver.  If you want individual portions, use the snack size baggies.  The most important part is that you remove all the air from the bag.  This is what prevents the avocado from turning brown.

4. Thaw in the refrigerator and use as soon as it is soft.  The consistency will be different than a fresh avocado, but it works very well for including into other recipes such as guacamole or smoothies.

Here is a link to the Hass Avocado Board for more instructions, tips and information.

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Epilepsy & The Ketogenic Diet at School

Epilepsy & The Ketogenic Diet at School

My mom, Arlene, has been a Registered Nurse (RN) for almost 40 years.  Through her career she has worked in the OB/GYN, Pediatrics, Med Surgery, Oncology, and Dialysis.  For the last 16 years she has been the school nurse in the same elementary school where I attended as a kid.  During her time in school, she has experienced a vast range of medical issues in her students including blindness resulting from a detached retina, scoliosis,  brain tumors, "lost" erasers in noses, severed finger tips, leukemia, bone fractures and even seizures. There have been two kids treated with the ketogenic diet come through her office as well. My mom has an interesting and uncommon perspective of seeing the diet work! Her answers to the questions below are in italics.

Please note that I am not providing any medical or legal advice in this post.  I am sharing personal tips and links to other information that I have found to be helpful!  Everyone's situation is unique and will require your own personal research and education before implementing the ketogenic diet at school.

In General, what are the most important pieces of information you need from parents?

BEFORE or ON the first day of school, you need to have:

1. Current contact information for emergency and non-emergency events.

This means have correct and current phone numbers for parents and emergency contacts for home, work and mobile phones.  One of the biggest problems can be contacting a parent when needed. On average it takes me 5-6 phone calls to reach a parent or caregiver.  For emergency contacts, make sure the person(s) listed is aware they are an emergency contact and they are LOCAL, not grandparents 5 states away!  Fill out and return the school emergency card immediately!

2. Required Medication WITH Dr.'s orders.

For medication that needs to be taken on a daily basis while at school, most of the time it requires forms from your school or state to be filled out by the prescribing physician with the name of the medication, reason for taking, and instructions.  It is also important to list possible side effects the medication can have.  Make sure the orders on the form match the instructions on the bottle!  Sometimes doses are changed over the phone and prescriptions (instructions) are not updated.  Make sure this is fixed before school starts.

Some states allow health offices to administer Children's Tylenol without parental/caregiver consent.  If (in the case of the ketogenic diet) you do not want this to be given, you need to opt out or specify not to give it in writing.

ALL medications in school, even over the counter (OTC) vitamins and supplements require Dr's orders.

3. Make sure EMERGENCY medications are in the health office WITH Dr.'s orders.

This includes inhalers, epi-pens, and Diastat type medications.  Even if there has not been an asthma attack, seizure or any other known acute medical event in a significant period of time, it is best to keep emergency medications in the health office in the case of a life threatening medical event.  The school health office is NOT a mini hospital, during a life threading medical event, the nurse or health aid will administer emergency medication if provided and call 911.

Here is some specific information on the laws regarding the administration of emergency medications in school settings.  Please know that currently, there are NO states that prohibit the administration of rectal medication with proper written orders.

Here are some helpful printables to provide to your health office.  Keep in mind that there will be a substitute nurse from time to time. It is best to provide very clear instructions on how to administer emergency medications.

How to administer Diastat

How to administer Intra-Nasel Medications (Versed, Midazolam)

Now onto the ketogenic diet specifically.  What accommodations were made to help maintain it properly at school?

When the student was first started on the diet, she chose to eat lunch at a small table in my office when she was having a rough day or just needed a break from the busy cafeteria. This also was to provide extra supervision to make sure meals were eaten properly.  We also provided refrigeration for cream and food.  She had access to a microwave if meals needed to be heated.  Eventually (by 5th grade) she ate lunch in the cafeteria everyday with minimal supervision.  In 5th grade she was also weaned off the diet, her whole class celebrated with her, they all ate a Jello cake!

There was always a "special treat" stored in the refrigerator for birthdays and class parties.  In her case it was usually sugar-free Jello and heavy cream. A "free" flavored popsicle is also a great option since it will last a long time in the freezer.  If your school has a "No Food in the Classroom" policy, this issue will be much easier to deal with.

Eating lunch and snack at school is usually the biggest concern regarding the ketogenic diet.  You may even have to adhere to a "nut free" policy if your school has one.

1. Pack meals that are easy for your child to eat.  I personally prefer all-in-one meals for school, such as cheese crackers, crunchy chicken salad, yogurt, mac & cheese, scrambled eggs & cowboy sushi type meals.

2. Try to avoid sending cream to drink as part of the fat, too often it is spilled or not finished.  If you do use cream, ask to keep extra in school with instructions on how to deal with spills.  You will also need to provide a scale to keep at school.

3. If eating a keto lunch in the cafeteria is too stressful for your child or causes too many problems, ask for an alternative location to eat lunch.

4.  Make sure the aids or teachers understand the importance of finishing meals and scraping bowls clean.  Ask to stay for lunch during the first week of school to help train them personally.  If you are unable to do this, make sure it addressed in meetings prior to the start of school.  A reminder note in the lunch never hurts either!

Did the student have a 504 plan or IEP?

Where we live, a 504 plan was not needed to have her needs and accommodations met.  The ketogenic Diet team provided written Dr.'s orders stating that the diet was a medically necessary treatment for epilepsy and that she needed to eat only the food provided by her family.  It also stated that she was never to eat anything that was not packed in her lunch.  Her team was not concerned with topical items like glue, play dough, lotions and soaps, so this was not a problem. If this is a concern, a 504 plan may be needed.  She did not have an IEP because she was not a special education student.

For help understanding 504 plans and IEP's please click HERE.  To sum it up, a 504 plan is a plan written to ensure accommodations are provided for ALL disabilities to ensure the student has the "least restrictive environment" for learning. These can include anything from a ramp for a wheelchair, a nut free table/classroom to providing an Aide.  An IEP is only needed when a child meets the requirements for "Special Education".  It will include very specific educational goals and accommodations such as special education classes, devices, programs and even physical accommodations.

The bottom line is: 504 plan is to ensure accommodations are met for any type of physical disability.  An IEP is for special education students only.  IF the special education student also has physical disabilities, accommodations will be written into the IEP.  The IEP will over-ride the need for a 504 plan.  Only ONE type of plan is needed and this depends upon your specific needs and district guidelines.

Laws vary GREATLY from state to state and even from county to county.  Here is a great link to State guidelines for School Health Services in EVERY state.  Educate yourself on what your child is entitled to receive at school!

 

Her is a link to a WONDERFUL, easy to understand document from the USDA.  It clearly describes the guidelines for Accommodating Children with Special Dietary Needs in the School Nutrition Programs.  You should print this and bring it to school meetings!  It provides ideas on how to make accommodations, how to find funding for the accommodations and what should and should not be provided by the school. Thanks Tina for passing this along!

Were there problems with compliance from the student or teachers?

There was never any compliance issues from the student at school.  She tolerated the diet very well and did not try to cheat in any way.  Interestingly, it was the teachers who were a little more skeptical at first.  For this particular student, she experienced seizures at night and while waking up.  Since the teachers never saw any seizure activity, it was hard for them to understand the desperation of the family to control a problem which they could never see.  It's not that they didn't believe she had epilepsy, but it was the first time any of them had ever heard of a dietary treatment for epilepsy.  After some education from both the parent and the ketogenic diet team at her hospital, there were never problems with compliance.  

For educational materials, Ask your keto center if they offer anything specifically geared towards school professionals.  The Epilepsy Foundation has a good overview of the diet.  Click HERE to view the information.  I always recommend printing educational materials and to include them with Dr.'s orders. 504 plans and IEP's.

Here is a child friendly overview of starting the ketogenic diet from Matthew's Friends.  This breaks down starting the diet in very simple and easy to understand terms.

Also from Matthew's Friends (Although Matthew's Friends in based in the UK, the information is still applicable to the US!)

Overview of the diet

Managing the Diet in School

What are the steps to a smooth, happy school year?

During the summer, before the start of school:

Schedule an appointment with your child's doctor.  Bring the school forms with you to be completed by the doctor.  Make sure prescriptions are written correctly!

Gather all of your educational materials and medical documentation needed to support your requests for accommodations in school.

Make sure daily and emergency medication prescriptions are filled and properly labeled in their original containers.  Some insurance companies will grant a "vacation request" and refill a prescription earlier than usual.  This is a good way to make sure there is adequate medication at home & school.

To prepare for 504 or IEP meetings:

Know what your child is entitled to receive in school.  The more you educate yourself on school law and policy, the more smoothly your meetings will go.  Contact a state education advocate before the start of the school year if you have questions.

Here is a link to the U.S. Department of Education, Disability Discrimination page.

Make a list of accommodations, large and small that you want to be included in your child's plan.  Imagine what your child will be doing through on a daily basis at school.  Think about things like supervision in the bathroom, help opening containers at lunch, supervision while eating, notice of parties or food based lessons well in advance, and possibly even notice of lessons where contact with topical ingredients (play dough, rice, oatmeal, glue, ect..) may need to be considered.

By the FIRST day of school:

Return Emergency contact cards to the health office!

Make sure all medication is in the health office WITH Dr.'s orders.

Make sure your seizure care plan is written the way you want it.  Specify EXACTLY when to give emergency medications and when to call 911.  It may be your schools policy to call 911 after administering emergency medications.  If you are able to meet the ambulance at school before they leave, you may be able to decline going to the hospital.  If they leave before you get there, the school may have to follow certain rules that require the child be transported to the ER.

Most importantly, the school nurse or aide is the person who is responsible for taking care of your child's medical needs while they are at school.  It is important to build and foster a relationship with this person based on FACTS, education, patience and understanding.  It is important to do your part first!  Gather all of your required paperwork and fill it out properly.  Be patient and well prepared when you are first describing the specific requirements of the ketogenic diet. It may take time for the school team to learn about the diet and figure out how to incorporate it into a 504 plan or IEP in a way that works for everyone.  Yelling and threatening a school team usually leads to more frustrations and resistance!

Keep in mind that everyone already has their eyes set on the SAME GOAL: to educate your child! It can be complicated in the beginning of the year, I have experienced accommodations that I thought were NOT what I wanted or asked for.  After giving them time, I saw that the educators really do know what they are doing and make decisions based on years of experience and success.

I hope you all have a happy and UN-eventful school year!  Please send me your school tips, I would love to hear other suggestions! This email address is being protected from spambots. You need JavaScript enabled to view it.

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Product Review: Hamilton Beach Half Pint Ice Cream Maker

Product Review: Hamilton Beach Half Pint Ice Cream Maker

I'll save you time if you don't want to read the whole review, DON'T BUY THIS PRODUCT!  I really wanted this product to work.  In fact, I have purchased this little machine twice now, it just looks so keto friendly; it's small, it comes in fun colors for kids, it looks easy to use, you can take the cordless one anywhere, ect, ect... However, I have now spent more money on wasted ingredients than I have on the total cost of both machines.

Last summer I bought the model with the cord, this summer I thought maybe they improved the overall design when they came out with a model that takes batteries.  Nothing has changed since last summer except for the fact that you now have to pay for batteries and you only get 1 freezer bowl instead of 2. I tried several different ice cream recipes, one with heavy cream and whole milk, one with heavy cream and coconut milk and just straight coconut milk.  I just could not get any keto recipe to turn out.

In my opinion, the biggest problem with this product is the fact that the lid does not attach to the bowl.  Once you add ice cream to the bowl and begin to churn, the liquid starts to freeze to the sides of the bowl.  This is how ice cream makers are supposed to work!  However, as the paddle attachment spins around in the bowl, it is supposed to scrape the frozen cream OFF the sides and repeat the process until the entire mixture has frozen.  Can you see the lid lifting up from the bowl?  It should be sitting flush against the silver edge of the bowl.



With this model, the ice cream will freeze to the sides of the bowl and continue to form a thin layer of frozen ice cream, one on top of another.  The paddle does not scrape the layers off, resulting in the lid gradually rising up higher and higher until the lid is spinning and the paddle is doing nothing.  All you are left with is a layer of frozen solid ice cream filled with a center of liquid ice cream.  Can you see the layer of frozen ice cream around the edges of the bowl?  This was about 15 minutes into the churning process (the ice cream should have been done according to the directions). This is also partly a result of the ketogenic recipe. Sugar is an important factor in ice cream making that keeps the final product softer. Since there is no sugar in ketogenic ice cream, it will always freeze harder.



In the directions it states that you may have to "apply gentle pressure" to the lid to keep it from doing this.  Of course I did this, but it made no difference.  In fact, the amount of pressure it needs to scrape the bowl is enough to make the paddle stop spinning; the motor is just not strong enough.

So my final recommendation is DON"T BUY THIS MACHINE!

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