this is very interesting and explains a lot about the Ketogenic Diet that Hannah is starting. The date has been changed to November 27. I just realized that her spinal fusion 2 years ago was 11/29 the Monday after Thanksgiving and this is the Tuesday after Thanksgiving!
RE Ketogenic
Diet
To Whom It
May Concern:
Hannah Jones
is a 17 year old young lady with a diagnosis of static encephalopathy secondary
to a chromosomal abnormality (1q21325 deletion) resulting in significant mental
retardation, complex partial seizures with secondary generalization,
hypothyroidism, deafness and blindness. Hannah's seizures have remained
intractable despite being tried on multiple medications to include,Topamax,
Dilantin, Tegretol, Depakote, Lamictal, Zonegran, Phenobarbital, Gabatril,
Keppra, Klonopin, Trileptal, and Banzel. For this reason, our next
step is to try the Ketogenic Diet as treatment for Hannah's uncontrolled
seizures.
The Ketogenic
Diet is a rigid mathematically calculated diet that has been an approved mode
of therapy for children with intractable seizures. The diet has been in
existence since the 1920s and it NOT EXPERIMENTAL. It is a high
fat, low carbohydrate, low protein diet designed to maintain a patient in a
constant state of ketosis. It is ketosis that serves to abate
seizures. Statistics from Johns Hopkins University Hospital show that
about 25% of the children placed on the diet have their seizures controlled,
50-60% show significant improvement, and 25% have little improvement or are not
able to tolerate the diet for other reasons.
Many centers
do not use the diet or are not familiar with it because of its strict
requirements and the commitment in knowledge and energy required on part of the
Epilepsy Center staff to effectively implement the diet. At The Alfred I.
duPont Hospital for Children we have a team of individuals who have been
trained in the use of the diet. The team includes the pediatric
neurologist, an advanced practice nurse, dietician, pharmacist, and
psychologist. Our inpatient nurse staff, who have been trained in the use
of the Ketogenic Diet, are also very important to successful implementation.
RE: Hannah
Jones
DOB: 7/9/1995
MR#: 10323085
Induction of
the diet involves approximately a five day hospital stay. During the
first 48 hours, the child is fasting to deplete carbohydrate stores and achieve
ketosis.
Hospitalization
is necessary to closely monitor and treat hypoglycemia as well as medical
toxicity. The high fat diet is then slowly introduced over the next three
days. Complications during this period may include hypoglycemia, or low
glucose, excessive ketosis, nausea, vomiting, and diarrhea.
In addition,
hospitalization provides time for extensive teaching, and impresses upon the
parent the seriousness of the diet. While the latter is not the
foundation for why we choose to do this inpatient, it helps to assure success,
commitment, and compliance to the diet once the family goes home.
What we hope
to achieve through the use of the Ketogenic Diet is complete cessation of
Hannah's seizures, or atleast significant reduction of them. We would
also like to achieve an elimination or significant reduction of some of the
medications Hannah is on, thus making her more alert throughout the day and
improving quality of life. With the cessation of, or reduction in the number
and severity of her seizures, and the possible reduction of anticonvulsant
medications, this should ultimately reduce the number of ER/hospital admissions
in the future.
Hannah is
scheduled for admission to the Alfred I. duPont Hospital for Children on
11/27/2012. If you have any questions, or if I can be of further
assistance, please do not hesitate to contact my office at 302-651-5930.
Thank you for
your time and consideration.
Sincerely,
Chief of
Division of Neurology
SJF/hgs
