Xiao B has been ketogenic for more than 4 years and 2 months. Last week, she went to Shanghai Deji Medicine to have her first 12-hour EEG in four years, and the results are not completely normal yet. Looking back on 4 years of ketogenic experience, it is very emotional to see that Xiao B started ketogenic at the age of 20 months and miraculously did not have any seizures once he fasted on that day, but in the first year, he always had small seizures intermittently and repeatedly, and only after a year did he get them under control completely. I’ve compiled some of the ketogenic failures that I’ve wanted to hit the wall during the past four years for the reference of children with “ketogenic sensitivity that cannot be easily controlled”: 1. Too much hot card: children with sensitive ketogenic type are very particular about hot card. What is too much heat card? It is the weight after discharge from the ketogenic hospital as a standard, after returning home each month’s weight increase of no more than 0, 17 kg, sometimes 2 months without adding weight is not a big problem, small B first year because of several times too much heat card, weight gain too fast, resulting in the appearance of small seizures. 2, the ratio is often adjusted: these days we have been discussing one of the reasons why the EEG has not been well penetrated so far, whether it is caused by not adhering to a high ratio (more than 3:1) during the year? Ketogenic very difficult to control children need to be drugged to adhere to high ratios, because 2 years ago little B had an acidosis, so every summer we are trembling to reduce the ratio, which ~ ~ ~ whether to half-dead power generation brain cells a chance of rebirth? 3, have not done 24-hour long-range dynamic EEG: small B a year after the seizure control, we do every six months a 20-minute sleep EEG, ketogenic 2 and a half years after the EEG shows normal, ketogenic nearly 4 years when the EEG has 3 times are normal, which makes us relaxed vigilance, diet began to relax. It wasn’t until nearly a month ago when I first woke up after going to sleep at night and occasionally had a 2-second freeze that I raised my guard and remembered to do a 24-hour EEG confirmation. If we had done the 24-hour EEG earlier, maybe we would not have relaxed our diet. Now the ignorant me know: small B epithet did not seize, so the general 20 minutes of sleep EEG is not caught. 4, meals ignore sugar control: Xiao B drank whole milk for a whole year, and only later slowly added homemade meals, after feeling and Dr. Wang Man’s guidance, we began to pay attention to the importance of protein and sugar in meals, and now Xiao B’s all-day meals, sugar is controlled at a total of 5. 5, always did not adhere to a really strict diet: four years we can do each meal with more oil weighing 0, 5 grams into the loss; can Can do to the little B a day of snacks even 2 grams of pumpkin seeds 3 grams of cucumber slices are calculated into the total calories throughout the day; can do each meal calorie distribution with the interval, sleep, exercise, etc. to do the analysis of the scientific golden ratio; but can not adhere to a few years not to give little B extra food (at this time really want to slap themselves a few)! Because we thought we had it under control, we would always think we were smart enough to give Little B some meat bones, some broth, or even some egg drop soup with lots of sesame oil. …… For a sensitive ketogenic child – this is the biggest failure of ketogenics! It’s a failure! At this point, my face is swollen, my tears are dry, and the walls are dented… There are still a lot of tips I want to share with parents: for example, what about the lowest ketogenic seizures in the morning? What if constipation can also cause seizures? How to drink water in a scientific way? How to use urine ketone test paper? How to give children at home recovery? I’m ready to fight the battle of the twenties! I’ll talk to you later when I have a chance. Conclusion: As a “national team ketogenic-sensitive player who is not easy to control”, Xiao B has been well-controlled for more than four years, all of which has been reduced from Western medicine, learned to walk, communicate normally with others, compose children’s songs, and read stories aloud from books. On behalf of my family, I would like to thank Shanghai Deji Hospital – Dr. Wang Man, for all the help along the way! (I would like to give a kiss at this time) The road of ketogenesis is full of thorns and bumps, maybe this road is long and long, but I firmly believe in the direction, I would like to hold Xiao B’s hand tightly, accompany her step by step to explore forward! I will always whisper in her ear: “Child, a good life belongs to you, go! Postscript: Great parents give their children not only care and love, but also a layer of perseverance and endurance that is unimaginable to ordinary people. The ketogenic diet, a diet high in fat and low in carbohydrates that requires strict restrictions, has been hated by many people, and has made many unfortunate families lucky. The most touching thing about chatting with Xiao B’s mother is that her understanding and view is far beyond that of ordinary parents or even doctors, and she has a very accurate grasp of illness and life, from which you can truly appreciate how to fulfill your responsibilities and responsibilities as a parent. When I look at the chat records in the group, I often find that late at night, Xiao B’s mother is still painstakingly giving guidance to families in the confusion of ketogenic, choosing ketogenic, insisting on ketogenic, giving up ketogenic, taking many detours and relying on ketogenic again, some families want to see the results after a week, some families still feel that ketogenic is not effective after a month of doing it, some children simply do not follow the requirements to complete the developed diet plan Some children do not adapt to ketogenesis at the beginning and experience vomiting, diarrhea, refusal to eat and other gastrointestinal discomforts, and some children’s blood ketones do not rise, so families simply fast or eat one less meal per day or give very low calories. The family should calm down, the child with epilepsy is a chronic disease, you need to follow the epilepsy patient’s diet to eat, and drug double-pronged to achieve effective results. If it were another family member, they would have given the death sentence to the ketogenic, and three months without seizure reduction would have been considered ineffective. I’d like to elaborate on a few of the statements made by Xiao B’s mother: 1. The problem of excessive calories, ketogenic because the calories eaten are only about 70%-80% of normal children, so many children will cry, which is normal, we can control the child’s seizures as soon as possible, can not increase the amount of children cry, the initial weight of ketogenic must be reduced, whether it is obese children or children who are already very thin. The family must understand this point. Half a month after the discharge of ketogenic will be based on the child’s weight, seizure control and blood ketones, blood sugar fine adjustment, weight not only to weigh, but also to weigh every week, must be accurate. 2, the ratio is often adjusted: ketogenic diet ratio should be adjusted according to the child’s seizure control, the normal human body is no ketone bodies, all ketogenic children’s bodies are in a state of ketosis, the reason why they do not show it is because the child’s metabolism of the three major nutrients is normal, and the difference between diabetic ketoacidosis is that the diabetic acidosis is a state of high blood sugar, ketogenic The difference between diabetic ketoacidosis and diabetic ketoacidosis is that diabetic ketoacidosis is a hyperglycemic state, while ketogenic ketoacidosis is usually normal or low blood sugar. After this state of acidosis appeared in Xiao B, she was asked to check her blood gas, PH value is low, partial pressure of carbon dioxide is low, need to deal with reducing the ratio is an optimal choice. 3, 24-hour EEG must be done: EEG monitoring to the scalp EEG, for children with more discharges, the interictal period is relatively short, so when to do EEG can be found abnormal, but for small B this has been completely controlled, EEG is significantly better, EEG background is normal, the interictal discharge frequency is very low, 20 minutes or 3-4 hours during the day without deep sleep This does not mean that the child is completely well. This does not mean that the child is completely well. It must be a long-range EEG, done every six months, and each time is normal, and the child’s intelligence is also significantly improved to represent your epilepsy is well, otherwise the discharge is not completely eliminated, need to continue to fight. 4. The control of sugar in the meals is the key to ketogenic control. The actual fact is that you will be able to get a lot more than just a few of the most popular and popular items in the marketplace. It’s going to be less and less. Many families come up with meals according to the software, calories are right, the ratio is also right, the fat is fixed, but we found that the same meal some children eat on the control is very good, some are not effective, the reason is that the ratio of sugar and protein is not controlled, a meal in the protein is at least 3 times more than the sugar, while the sugar is controlled below 10g a day. Adolescents can reach 15g, adults 20g amount. 5. True strict ketogenesis is the secret weapon of ketogenic victory: for sensitive children, all soups and all snacks should be calculated into calories. Different children should be treated differently. Only the family knows the child best, and only the family wants the child to be controlled as soon as possible, so strict ketogenesis, precise calculation, accurate recording, timely reporting, regular review, and effective communication of epilepsy as a persistent disease can be completely eliminated by you.