Re: Speeding up the wean?--

[Guest guest]

--

Truly, if you can possibly avoid two changes at once, please go with just one.

There are emergency circumstances where you have to do two at once, but it makes

a mess of deciphering what's helping and what's hurting. So much of this diet

is patience, and if you hurry to fix something, you'll spend ten times as long

trying to sort out what's gone on (don't ask how I know...). There really is a

reason that " one change at a time " is the keto motto.

Since you had early control, I'd also vote with those who suggest that Lamictal

is your culprit and start reducing. If the diet hasn't changed, chances are

excellent that Langan's body is changing the way she handles Lamictal. We saw

huge shifts in the way our daughter metabolized her medications starting at the

two-week mark on the diet.

Much against many listmates' experience, we came close to following our neuro's

recommended wean schedule, which was also cutting 12.5mg/week as yours suggested

(though in a different post it looks like he was suggesting 25mg/week?). We

slowed it down to every two weeks instead. It actually worked pretty well, even

though I was on pins and needles from reading other people's experiences of

trouble even on agonizingly slow weans. We had a little withdrawal fallout

about 10 days after each drop. But for our daughter it was much better than

dragging things on and on.

One more thing...adjusting medications can alter ketone levels (increasing or

decreasing them, depending on the child). If you adjust ratios AND drop a med

level, you won't get a clear picture of the impact the med reduction has on

ketone levels.

So there you have a couple things to think about.

Rose-Marie,

mom to , age 7 1/2

[Guest guest]

Thanks, Rose-Marie. Unfortunately, I already changed the ratio. It was from

3.4 to 3.6, and I am told that is not a major change. I didn't realize that the

meds could effect ketones- should have known that- and I was concerned about her

having seizures during low ketones. I also didn't want to wean the lamictal

while ketones were hitting such a low mark in the mornings. Who knows if that

was right or not but we did get some nice high ketones today right after her

breakfast and we'll see how it goes tomorrow.

I held off on the lamictal wean today, against my initial plan. I just had a

gut feeling that I needed to at least let the new ratio have a few days. If we

start seeing consistently high ketones in a few days, I will probably start the

wean at 12.5. Two weeks sounds like a good idea. The neuro's suggestion of 1

week doesn't even take into account the withdrawals that everyone seems to

experience at 10 days. (Of course, he said to cut 25 mg and that there are no

withdrawals from lamictal so why would I listen to him anyway??). I don't know

if we'll get a good idea of what is working or not if I do these that close

together but I don't want to wait much longer on the lamictal. Langan is

teaching me patience and I am better at it than before she came along, but

seeing her so lethargic and so wildly cranky- and knowing that these seizures

could be a part of it- makes me want to get rid of lamictal ASAP. But I did

decide to slow things down. I just hope I didn't do it backwards with starting

with the ratio and then the wean.... Oh, well, hindsight, right? = )

Thanks for the advice. I really do put so much value on what you guys think

since you have been there!

Re: Speeding up the wean?--

--

Truly, if you can possibly avoid two changes at once, please go with just one.

There are emergency circumstances where you have to do two at once, but it makes

a mess of deciphering what's helping and what's hurting. So much of this diet

is patience, and if you hurry to fix something, you'll spend ten times as long

trying to sort out what's gone on (don't ask how I know...). There really is a

reason that " one change at a time " is the keto motto.

Since you had early control, I'd also vote with those who suggest that

Lamictal is your culprit and start reducing. If the diet hasn't changed,

chances are excellent that Langan's body is changing the way she handles

Lamictal. We saw huge shifts in the way our daughter metabolized her

medications starting at the two-week mark on the diet.

Much against many listmates' experience, we came close to following our

neuro's recommended wean schedule, which was also cutting 12.5mg/week as yours

suggested (though in a different post it looks like he was suggesting

25mg/week?). We slowed it down to every two weeks instead. It actually worked

pretty well, even though I was on pins and needles from reading other people's

experiences of trouble even on agonizingly slow weans. We had a little

withdrawal fallout about 10 days after each drop. But for our daughter it was

much better than dragging things on and on.

One more thing...adjusting medications can alter ketone levels (increasing or

decreasing them, depending on the child). If you adjust ratios AND drop a med

level, you won't get a clear picture of the impact the med reduction has on

ketone levels.

So there you have a couple things to think about.

Rose-Marie,

mom to , age 7 1/2