Modified Atkins Diet for Epilepsy

Last summer, I wrote about how my son was switching to the Modified Atkins diet after nearly seven years on the Ketogenic Diet. Since it has been a year on the new diet, I wanted to share an update on how it is going, as well as a few tips and foods we’ve depended on with the new diet.

The Ketogenic Diet is a special high-fat, low-carb diet that can help control seizures for some people with epilepsy. We started on the diet soon after my son began having seizures, and after it became clear that we would need more than medications to prevent his seizures.

Keto was initially a struggle, both in terms of finding foods and ways to introduce fat into my son’s diet and the effort and logistics involved with measuring every ingredient and preparing meals separately from the meals my wife and I ate. We would bring his food with us to restaurants and, when we traveled, extended trips required a place to stay that had a kitchen. But we made it work because the diet, along with medication and a VNS, helped manage my son’s seizures. We have never been seizure-free, but we found the right balance between medication and quality of life, even if my son mostly ate the same handful of meals.

The Atkins diet is a low-carb diet from the 1970s. Similar to the idea behind keto, the idea is to limit the number of carbs. The Modified Atkins diet blends the low-carb approach with adding more fat. For my son, it opened up a new world of food, especially since the popularity of Atkins and other low-carb diets have introduced a number of products on the market that are easily available on the shelves of most grocery stores.

My son now gets a set number of net carbs a day and a minimum amount of fat that he should have, although we’re always trying to add more fat into each meal. He can have as much protein as he wants, which he demonstrates by piling up the hamburgers and hot dogs onto his plate (he’s less excited when chicken and fish are on the menu). Net carbs are calculated as total carbs minus fiber, so fiberous vegetables in a salad are a mainstay, as well, and my son hasn’t seen this amount or variety of vegetables since before keto.

When we transitioned from keto to Modified Atkins, we monitored my son closely to see if there were any changes to his seizures as well as any changes to his cognition…there are some reports of keto helping improve cognition. In both cases, we haven’t seen any meaningful changes so far. His seizure frequency and duration are the same, and we haven’t noticed any worsening in his cognition.

The most significant change that we’ve seen is his quality of life. My son was so excited to have a sandwich for lunch, just like the other kids in school, rather than the fat-heavy ice cream we usually sent him with. He can also have a small bowl of low-carb cereal for breakfast, just like his friends. And now we eat the same meals at dinner, just in different proportions.

I was wrestling over the past few years with the Ketogenic Diet as I saw my son notice how his food differed from his friends. I started questioning the value of the diet and pushing to get him off it while the doctors were convinced that it was helping him. The Modified Atkins diet feels like a step in the right direction. Even though it is still a medical diet, there are enough options that it doesn’t feel as much like a restrictive diet as keto did.

Overall, the change has been a positive experience for my son and our family. While it may not be an option for everyone, it is worth having a conversation with your doctor if you’re looking for alternatives to the ketogenic diet to help manage seizures.

If you’re on or thinking about the Modified Atkins diet, first check with your doctor. But I wanted to pass along a few items that are staples for us that have made the diet more manageable and delicious.

Catalina Crunch Cereal – There are a few low-car cereals (5g net carbs per 1/2 cup) on the market, but we’ve found Catalina Crunch to be easily available and tasty. You can find them in the cereal aisle at Whole Foods, or try a sample pack of flavors through Amazon or direct from the manufacturer.

Schmidt Oldtype 6/47 Bread – At 6g net carbs per slice, this is the bread that allows my son to have a sandwich at lunch. The taste and structure are close to that of other breads and it holds up well. The bread comes in a few varieties, as well. There are other 6/47 options like buns and bagels, but those have more net carbs. The bread is available at our local Acme grocery store.

Outer Aisle Sandwich Thins – Found in the frozen section of Whole Foods, we toast these in the oven and use these as hamburger buns. Two slices is only 2g of net carbs.

Outer Aisle Pizza Crust – Also from Outer Aisle and available in the frozen section at Whole foods is their pizza crust. When we were on keto, we made crust out of soy flour, mayonaise and egg. These are bigger (and already made) and only have 3g net carbs per crust.

Mission Carb Balance Tortilla – These are available in most grocery stores and offer a low-carb option for burritos, quesadillas, and wraps. At only 4g net carbs per tortilla, my son can have two good-sized quesadillas for dinner with cheese and meat or beans snuck inside. Pro-tip: If you slather on some mayo and then add the cheese, it’s a good way to add more fat to the meal, too.

Atkins Bars – Atkins bars are great to have for a snack. There a meal replacements, snacks, and treats, each with differing amounts of net carbs. But we usually add one of these to my son’s lunch box for school (Snickerdoodle is his favorite). In most stores, Atkins products are near the pharmacy and health section, not in the granola or Kind bar aisle.

Impastable Noodles – These are the best low carb pasta we’ve found so far. They come in different types, allowing us to mix up different recipes including traditional spaghetti or mac and cheese. I usually cook it a little longer than recommended to get a better texture, but we all eat these now on Spaghetti Sunday.

The Right Path

I spend a lot of time wondering how I am doing as a parent. I often feel like I’m focused on correcting and not always celebrating behavior. Rather than settling into a positive, I stay on guard and wait for the next negative. When I focus on the negative, it often becomes the only thing I see. But every once in a while, my son will do something that gives me enough pause to reflect on where he is and where I am as a parent, and it makes me feel like I’m doing okay.

For the past few months, my son has been obsessed with AirPods. My wife and I both have a pair, but my son had been using his tired over-the-ear headphones. We eventually got him an inexpensive knock-off set of earbuds to try out. They were red and came in a case that lit up, and he liked them, joining the “What?” crowd that comes from talking to someone who has earbuds in their ears that you can’t see. As much as he liked them, he still had aspirations of getting a set of authentic AirPods.

A few weeks ago, my wife and son met up with my son’s friend from school and his family at one of those arcades that also has laser tag and go-karts. Another thing the arcade had mixed among the video games was claw machines.

We love claw machines. There’s a hotel we stay at in the mountains that has a small arcade in the basement, and we’ve spent more time and money on those claw machines than the other games in the arcade. There was a claw machine at the Walmart near my parents’ house in Florida that we would hit regularly. Basically, if we are anywhere with a claw machine, we’ll play it.

My wife is the Queen of the Claw Machines. I’m pretty sure she is the one that got us hooked. If there was such a thing as a professional claw machine player, my wife could go pro. She also has a natural feel for it. Me, I have to look at the machine from different angles to line up my approach. Sometimes I’ll do the same for my son. I try to get the claw in the correct position, checking from the top and both sides, before giving him the nod. We’ll watch the claw slowly lower and grab our target and hopefully carry it over the prize chute.

At the arcade with his friend, my son played the role of a spotter. From the side of the machine, he called out instructions while his friend commanded the control stick to navigate the claw over the prize. Once it was lined up, his friend pushed the button to release the claw. They watched as the claw lowered and came to a rest before lifting upward. The moment of truth with a claw machine is on the rise, seeing if the claws can wrap themselves around the prize.

They did.

The next test is whether the claws have a firm enough grip to withstand the shaking when they reach the top and then jerkily slide over the chute. Between the shaking and the elevated chute designed to knock the prize out of the claw, even second of that journey is tense and often leads to heartache.

The boys watched as the prize made it safely through each obstacle and came to a stop over the chute. The claws loosened and released their grib on the small white box. Excitedly, my son’s friend reached his hand into the collection box and pulled out a new set of AirPods.

The details of what transpired next are fuzzy, but my son’s friend said he would give the AirPods to my son. It was such a sweet gesture, but I’m sure he really wanted them, too. My wife stepped in and said that because it was his friend at the controls, he should be the one to keep them. I’m sure my son was disappointed, but he didn’t pout or argue or throw a fit. After all that time wanting those AirPods, he was just happy for his friend.

I wasn’t there, but my wife and son relayed the story to me that night. I suspect there was still a tinge of disappointment inside, but my son was still happy for his friend and proud of his role in winning the AirPods. When it was time to get ready for bed, he popped in his red knock-off earbuds and pulled up Spotify. I could hear him singing as he brushed his teeth, the pitch of his voice muffled as the toothbrush changed the shape of his mouth.

As much as I want him to have everything, it’s these moments of unguided generosity and empathy and friendship that reveal the kind of child that we are raising. I sat with that feeling as long as I could, alongside my wife, who was equally as proud of him as I was.

We never know how things are going to turn out, the only thing we have is now. And, in that moment, it felt like we were doing okay.

When we went upstairs, he way lying in his bed. I said something to him that he didn’t hear, and he pulled out one of his earbuds.

“What?” he asked with a smile.

My Wife Is A Superhero

This summer, my wife and I attended a concert at an outdoor venue outside the city. It was a warm night, the sun beating down on us as we stood in line to enter.

I scanned the crowd. The energy was good. I noticed a family sitting on the ground towards the end of the line. I didn’t think much of it, other than that the lines must have gotten long enough to reach where they had decided to sit.

Moments later, there were screams.

“Daddy!” a young voice yelled.

I looked over and saw the father of that family lying on the ground. People started to pull away and a small circle formed, watching.

“Daddy!”

I turned to see, as everyone else was backing up, my wife dashing towards the sound.

Security arrived and started moving everyone back. Enough space cleared to see that the man was beginning to come around. My wife was on the ground with a young girl who was crying and calling for her dad and a young boy who stood frozen, watching as people arrived to attend to his father.

I watched as my wife comforted the children, surrounded by the commotion and chaos of the crowd, watching and whispering as the staff pushed them back. Eventually, the father was sitting up, and I could see that he was talking. A wheelchair arrived. The man made it into the chair, and a medic pushed him through security with his wife at his side. My wife followed, holding the hands of the two children as she continued to calm their distress.

This wasn’t the first time that I saw my wife step up in this way. She’s done it for our son hundreds of times, reacting to the sound of our son having a seizure and rushing to his aide. She’s done it for her students over the years. And she’s done it when we are out in public, and the need arises. It’s always instinctual, it’s always kind, and it’s always genuine.

It’s always inspiring.

The world needs more of that. We’re afraid to step in. We’re indifferent. We’re so eager to attack anyone in our space and to not accept help. We’re too selfish to be altruistic. We’re too polarized to have empathy for the “other.” Stories like this are anomalies, which is why they get so much attention when they happen. Kindness is so rare that stories and videos showing it are treated as curiosities, like catching sight of an endangered species.

I sometimes take it for granted that not everyone is capable of giving or receiving kindness and empathy. I see my wife’s example and how she instills that same kindness in our son. Because of her, I notice it in the other people in our lives, as well.

Maybe someone who saw my wife jump in will feel compelled to do the same the next time they see someone who needs help. Perhaps they’ll be inspired to demonstrate even a small act of compassion, understanding, and love. We are capable of such wonderful things, but without more empathy and kindness, we will eventually become the endangered species ourselves.

After we entered the venue, we grabbed some food and sat on the lawn that overlooked the city. People slowly strolled up the path past us to start finding their seats.

“There she is!” A familiar voice led my eyes to a little girl with her family in the distance who was pointing at my wife. Her face beamed as she waved. I saw the mother mouth “thank you” to my wife as they slowly made their way along the sidewalk. The father cast a glance of deep appreciation to my wife as they continued on their way. My wife waved back, and I could see her eyes water as she took a deep breath.

I know superheroes exist because I married one, but we need more of them. If we can find them, or if we can become them, maybe there is hope.