Wednesday, September 27, 2017

The Foodie Returns

My foodie came back.

And I didn't know it was gone until it returned.

In the past I've enjoyed experimenting with recipes, learning to make new recipes, and practicing creativity in the kitchen. But when Ed was so sick in May, choosing even a simple menu felt impossible. Ed's intense headaches caused (we know now) by his brain tumor, caused severe nausea and vomiting. He lost fifteen pounds in a few days (and he was already thin.) I could hardly choke down food myself and dropped five pounds. But my children needed to eat even if Ed and I couldn't. I remember wishing that someone would bring us supper, but of course I was far too proud ask.

I muddled through and a couple days later the church prayer chain buzzed with the news that Ed was diagnosed with a brain tumor. Immediately our closest church neighbor brought our favorite poppy seed chicken casserole, Ed's sister dropped by with a box of yummy goodies, and another friend brought her amazing cinnamon rolls and chicken potpies. From then on the casseroles and boxes of cookies walked through the door so fast that I stacked them in the freezer. What a blessing to not have to think of meal prep in that next month of endless doctor appointments.

Three weeks after Ed's surgery, he decided to join a clinical trial testing the effect of the ketogenic diet on glioblastoma. The thought of preparing food for a radical diet overwhelmed me though I wanted to support Ed. Then we found that the study was providing all the meals in order to make the diet more accessible. What a relief.

The meals the doctor provided were frozen and all Ed needed to do was thaw and reheat them. After the first week when Ed's body adjusted to no sugar, he felt well on the ketogenic diet. But after a few weeks, he was weary of eating frozen/reheated food. I think maybe if it had been winter, he wouldn't have minded. But this was summer and in our garden was fresh spinach, kale, and broccoli. He longed to eat fresh salads and raw veggies. So Ed made the decision to continue the ketogenic diet but to prepare our own food.

The ketogenic diet is a low carb, high fat diet. If you google ketogenic you'll find that it is presently a very popular diet for weight loss.  There are oodles of resources online on the keto diet. But we quickly found that most of the information would not work for Ed without adapting.

Ed is on an extreme version of the keto diet. He isn't doing keto for weight loss (though that was a side effect) but for medical/therapeutic purpose. In addition, he was significantly restricting his calories to result in a fasting diet. There is very little human research done on brain cancer and diet, but we do know that cancer feeds on sugar. When sugar/glucose is eliminated from the diet, cells can burn fat/ketones for energy. The theory is that cancer cells do not have the ability to make this switch. The goal of the ketogenic diet for brain cancer is that the cancer cells will starve, weaken, and die because of lack of fuel.

In the mice studies that have been done, the best results have been from significantly restricting not just glucose, but protein and calories as well. So the goal of Ed's doctor is to give Ed only enough calories to keep him from losing too much weight and give him needed to energy to function, but have no spare calories or protein that could convert into fuel for his cancer.

Ed has always been thin. I cooked for him for fifteen years, and thought I was doing a good job, but he never gained a pound. While we ate reasonable healthy, we still loved our desserts and consumed a ridiculous amount of Turkey Hill ice cream every summer. Never in his life had Ed went on a diet or counted calories. So we were in for a big change.

I was determined to learn to cook for Ed since he desired fresh-cooked food, even though it looked overwhelming. The therapeutic keto diet requires exact measurement of ingredients and concise balance of fats, protein, and carbs. Ed's goal was a 3:1 ratio of fat to combined protein and net carbs. In other words 3 fat grams to the combined number of protein and net carb grams. And ideally he would increase that ratio to 4:1. His goal was to have less than 20 net carbs a day, ideally only 10. And he tries to keep his calorie intake to about 2,000.

That is a daunting list. A 3:1 or 4:1 ratio means that everything Ed ate had to be swimming in fat. (Which usually means yummy. Think rich sauces and dips.)  It also means he can eat very few vegetables. He eats mostly low-carb veggies such as spinach, celery, broccoli, cauliflower, and cabbage. He takes supplement to help with some of the vitamin deficiencies. But the fact is, when you know you have an aggressive cancer in your skull, and you think you have even a small chance of slowing it down, a vitamin deficiency doesn't seem like a big deal. To put it bluntly, if you'll be dead in a few months if you don't do something, you don't worry about losing your teeth or eyesight thirty years from now.

 I stocked up on carb free fats such as heavy whipping cream, mayonnaise, mascarpone cheese, coconut oil, and olive oil. Ed had always drank his coffee black, but now he poured in the cream. I also bought lots of nuts such as pecans, brazil nuts, and macadamia nuts plus flours such as almond flour and coconut flour.

At first I kept it very basic. What could I add to a fried egg to make the right ratios? What kind of dip or dressing could I make so that Ed could eat with raw broccoli, cauliflower, and spinach? Could I make pancakes with almond flour? Ed didn't have much variety in those first weeks. But slowly I tackled new foods and came up with more options.

 Such as a replacement for bread with his burger.

I began obsessing over every label. My digital scales was used many times a day as I weighed his food by the gram to figure exact ratios. We made mistakes (and still do) which was quickly reflected by testing. At first the doctor had Ed checking his blood ketone and glucose levels every morning and evening with a finger prick test that diabetics use. The study provides all the strips for Ed and the ketone strips are expensive so now Ed only checks them twice a week and uses ketone urine strip tests morning and evening. Once a month or so the doctor orders thorough blood work. There are some serious side effects that are possible with an extreme diet like this and we are grateful for the support of doctors who understand the diet. I wouldn't recommend doing an extreme version of the keto diet without a doctor's oversight.

For cooking keto I found the most helpful information online on sites such as the Charlie Foundation that use the ketogenic diet for therapy for children with epilepsy. Our doctor recommended the Keto Cookbook written by a mom of an epileptic child that was hugely helpful because every recipe is a 4:1 ratio. Suddenly I had far more options.

And little by little I found I was having fun. Yes! The foodie had returned. I could enjoy being in the kitchen again. I began to freeze some meals so I didn't have to be always worrying about what he would eat at the next meal. I found shortcuts, like serving Ed the same meat that the rest of the family ate and adding a high fat side dish.

And best of all, once I got the basics down, I could enjoy making snacks and desserts that were compatible with the keto diet. Ed is so grateful for any of my attempts and willing to try new things that it truly does make it fun for the cook. One of the things he really enjoyed was iced coffee. With whipping cream, de-caf coffee, cocoa powder, and stevia I could make a yummy treat that helped him forget about ice cream.

We don't know if this diet is reducing Ed's cancer, but we are grateful that he feels so well. Maybe the diet is contributing to his good energy levels this summer.

Anyone who has done a special diet knows that the worse part is eating away from home. I never realized how many meals we eat away in the summer. Every weekend we had a picnic or reunion or a fellowship meal. Or maybe all three! We usually brought food for Ed as sometimes there was nearly nothing that he could have eaten. Potato salad, iced tea, baked beans, corn-on-the-cob, fried chicken, watermelon, and those luscious dessert - none could Ed eat. On the other hand, often he could join a picnic with only a few adjustments. He'd skip the roll and wrap his burger in lettuce. Grilled chicken, lettuce salad, and raw veggies could be enjoyed if he added extra mayo and sugar-free dressing. Our families went the second mile in preparing menus that Ed could enjoy at family picnics. He has just learned to put the blinders on when walking past the dessert table at fellowship meals.

Last week, when we ended up with an emergency trip to Hershey with our son, I wasn't sure how Ed would stay on his diet. When Ed stopped by our house for a change of clothes, he grabbed some his keto food out of the freezer and threw them into an ice chest. That gave him several meals and a bunch of snacks that we knew were okay. For the remaining meals, Ed picked through the cafeteria and came up with several good options such as a scrambled egg and bacon with a topping of mayonnaise. We decided that we'd do as good as we could and not stress about it. And when we got home two days later and Ed was able to test his ketone level, he was just fine.

I've learned a lot this summer about food. I've found out that even though I'm super thin, I still crave food too much. I don't want to admit how grumpy I have been this summer that I couldn't share my favorite foods with Ed. I didn't want to make Ed's diet restrictions any harder than necessary so I cut out that bowl of ice cream after working in the garden or the shared chocolate after the children went to bed. Ed always raved over my homemade bread and it was no fun to make bread he couldn't eat. Food is the way we celebrate, fellowship, and bond. Take it away, and, well, I felt like whining.

But I know that Ed is doing this diet for me. If Ed was single, he would still desire to live, but I'm not sure he'd be making any huge effort to stay out of heaven. But Ed wants to live for the sake of his family and diet is part of that effort.

And I'm so glad that my foodie has returned to make cooking fun again.

I tried to answer the questions we've been asked about the ketogenic diet. Feel free to ask if I didn't hit your question. For more information about the ketogenic diet and brain cancer here are some links.
Charlie Foundation
Ketogenic Resources for cancer
KetoNutrition - huge list of resources
Can a Keto Diet Treat Brain Cancer?

Wednesday, September 20, 2017

The Widow with Oil - A Woman with Vision

Over a year ago, I wrote this article as part of the series looking in detail at Proverbs 31 and applying it to our lives as women today. But this week I needed this reminder to be a woman who places her hope in our God of Abundance.

The Widow With Oil - A Woman With Vision

She is like the merchants' ships; she bringeth her food from afar. (Proverbs 31:14)

She was a widow with no source of income. Because of her debts, her creditor threatened to sell her two sons into slavery and she was desperate to save them.

Some women would have given up in despair, but she had a faith stronger than her circumstances. Second Kings 4 tells us that her husband had feared God, and apparently she knew the same source of strength.

The widow sought out a man of God, Elisha, and begged for help. She could have feared that he would laugh at her problems. Surely there were many other desperate widows in Israel; he couldn’t help them all. But she decided it was worth the risk.

And the prophet did listen. But he didn’t dig into his pocket and hand her some coins. He asked, “What do you have in your house?” and then gave her a strange task. “Go to all your neighbors and borrow pots and fill them with oil from your small jar.”

How is this widow like a merchants’ ship? 

Like the merchant, who loads up his products and heads for foreign ports, she took a risk. The merchant doesn’t know if he can make a profit. He could encounter storms or pirates or a plague and lose everything, even his life. But he takes risks hoping that, by trading goods, he can acquire money to support his family. The potential benefits are worth the risk.

The widow, despite the possibility of ridicule or misunderstanding, obeyed the prophet and begged her neighbors for pots. Not just one or two, but many pots. With her sons’ help, she gathered the jugs, then closed the door of her house. 

Did she pray, this widow surrounded by borrowed pottery and two excited boys? Did her hands tremble as she picked up her small jug of oil and began to trickle the liquid into the depths of the first empty pot? Did her excitement grow as she filled one pot, then two, then three, and finally every jug in the room? Was she weeping or laughing as she realized that this oil, a valuable resource in that era, could be sold and save her sons from bondage?

My sons are not in danger of slavery, but too many days I despair over the wickedness of the world, the frustrations of child training, or my own bad habits. 

I want to be creative in seeking solutions, even ones that look as unpromising as borrowed crocks. 

I want to have my view of God expanded, to know that He is still in the business of filling my emptiness with His abundance

The God of Abundance, that the widow served, still gives generously today. He provides abundant grace, but not just enough to survive, to rescue from sin’s bondage, to escape hell. That would be more than I deserve, but He gives even more. He gives grace for victory over habits, grace for peace in a tumultuous world, grace for hope for our children’s future.

If I have a vision of God's power, what risks will I take? 

Like the widow, I will believe His Word and choose to trust God's goodness and love even when I don't understand. I will share the God of Abundance with the hurting ones I meet. I will submit to God (and my husband) even when it appears foolish. I will be willing to risk appearing silly or radical to help others find victory through Christ. “Where there is no vision, the people perish: but he that keepeth the law, happy is he.” (Proverbs 29:18)

The widow had vision that allowed her to seek help from God in her darkest day. When I realize I can't control life's circumstances, but choose faith and obedience, I'll watch God's unlimited grace overwhelm my small pot of oil.

(Published in Keepers At Home magazine - Fall 2017)

Monday, September 18, 2017

Nothing Like Your Own Bed

We were able to take Trent outside to enjoy the lovely weather on Saturday. His pain level was tolerable and his leg only hurt when it was moved.

On Saturday evening my parents brought our other children to the hospital to visit Trent. It was nice to be all together as a family, even if for only a short time.

We were all very tired and eager to go to sleep. And so we tried. I have a new sympathy for parents with children in the hospital. I knew it was hard, but now I had a taste first hand.

Trent's room was tiny though we loved that he was at the end of a quiet hall. During the night Ed and I took turns staying with him on the recliner by his bed. Just down the hall was the NICU department which had a family room sponsored by the Ronald McDonald House. We were able to freely use this facility which was nice. It gave us a quiet dark place to rest that wasn't interrupted by nurses. But if several exhausted parents collapse on couches in a small room, you are bound to have one snorer. If you ever find yourself in such a situation, I'd recommend bringing earplugs. It was a long night.

We had to be up early Sunday morning to get Trent ready for his second surgery. But this was Sunday, and nothing was prompt. He didn't go into surgery until nearly 9:00. We were impressed with the doctors and other staff that we interacted with at Hershey. Trent's orthopedic surgeon had called in a plastic surgeon to help. If the skin could not be closed, he would do a skin graft.

But thankfully the swelling had decreased and they were able to close the wound without any grafting. When the surgeon showed us a picture of Trent's knee after surgery I was shocked that he was able to close the wound so well. I almost thought he had showed us the wrong photo. Trent will always have a battle scar and he'll have to be in a brace for a few weeks while it heals, but once again, we are grateful it is no worse.

Here is the before and after views. (Scroll fast if you are squeamish.)

Trent is able to walk without crutches. He has very little pain, just some achiness. It seems almost miraculous that the same boy on morphine on Friday is today smiling and walking without pain. I think it might be hard to make him take it easy these next weeks.

And the best part...the surgeon gave us permission to go home. We had a few more hours of waiting for meds and paperwork on Sunday afternoon, but we were back to our own house soon after 6:00 last night.

And our own beds felt so good.

Thanks so much for holding our family up to God in prayer.

Saturday, September 16, 2017

Another Hospital Stay

I didn't expect to be writing an update from the hospital on this Saturday. But yesterday in the crowded Hershey ER I wondered how many other people woke up this morning having no idea they'd be in the ER before bedtime. We know life can change in a blink of an eye, but still, until it happens, it is easy to forget.

Yesterday morning the children started their schoolwork early, eager for the fun weekend we had planned. Before lunch, our ten-year-old finished his schoolwork and started his chore of push-mowing the lawn. Trent, our twelve-year-old, took his math book outside so that he could watch the mowing and help empty the bagger.

I'm not exactly sure what happened, but some combination of wet grass, a hill, and the turning mower, resulted in Trent falling and sliding into the mower. I heard screams from his brother that Trent had cut his leg on the mower. I dashed outside expecting the sight of dismembered feet and gushing blood. It wasn't as bad as I feared. The mower had caught Trent's knee. I'll spare you the gory details. There was hardly any blood, but this wasn't something I could fix with butterfly bandages. I knew he was headed for surgery.

I took Trent to our local hospital ER where Ed joined us. Trent was incredibly brave but by that time he was in pain. They started him on IV pain meds but it still took a while to get control of the pain. Our little local hospital didn't want to tackle surgery for a child so I rode with Trent in the ambulance to the Hershey Medical Center.

After lots of waiting, xrays, consultations, and more waiting. Trent was finally taken into surgery at just before 9:00 p.m. The surgeon was very pleased with the outcome of surgery. The injury was to the right side of his left knee and managed to miss tendons, arteries, bone, and nerves. The greatest fear is infection. They cleaned out the wound and joint well. The surgeon was able to repair the cartilage and stitch back the muscle and skin. Because of the swelling and the skin damage they were not able to completely close the wound. The plan is to go back to surgery on Sunday morning, clean out the wound again to help avoid infection and close the wound. If the swelling hasn't decreased and the skin still cannot cover it, they will do a skin graft.

Today Trent is feeling great. He has little pain, even though he isn't on anything stronger than Motrin. It is good to see him enjoying eating and playing games. He just got out of bed and tried crutches. He has had such a good attitude throughout this whole ordeal.

I admit that it is easy to say "Why us? Why now?" But when at a place like this, I am reminded that there is a lot pain and suffering in the world. In the cafeteria and waiting room I have heard heartbreaking stories of long-term emotional and physical suffering. Even here in the hospital we know that we have much to be thankful for.

The song "Lord Jesus, You Shall Be My Song" is a favorite song of Ed's which I listened to here today at the hospital. (If you are reading by email you may need to click over to the website to view the video.)

Wednesday, September 13, 2017

Question: Sewing Slips

Do any of you sew your own slips? Do you have a good source for slip fabric? Can you buy it online somewhere?

I need some new half slips for me and my daughters. I've been wearing the same ones for over fifteen years. Every couple years, I sew new elastic on the top, but by now they are truly worn out. When I shopped for new slips, I couldn't find any that were nearly long enough. And I think that a half slip would be super simple to sew if I could just find the right fabric.

And in case you are curious, for my little girls, I sew white cotton shorts. I use a knee-length pajama-shorts pattern. They are loose-fitting and suitable for church or play under dresses. In colder weather they wear leggings.

My older girls also wear knee-length shorts under their dresses for sports but like half slips for church. Any hints for finding fabric?

Saturday, September 9, 2017

Changing Frontiers - How One Family Does History With Toddlers to Teens

As a history buff and avid book collector, I love looking through book catalogs and choosing a curriculum that fits our family's educational needs.  Last year we wanted an early American history curriculum from an Anabaptist perspective which incorporated numerous biographies and historical fiction that could be used with various age levels. I couldn't find exactly the curriculum I envisioned.

Changing frontiers

I kept coming back to Changing Frontiers, CLP's new eighth grade American history book. The book itself was eye-candy with many maps, timelines, and color photos. But eighth grade? My four scholars were in grades two to seven last year. But we chose Changing Frontiers as our spine book for our family history study, though we didn't use the book in the way CLP planned.

Books And More Books
My children learn more if they are immersed in history beyond a list of facts and dates. Since I was using the textbook for students younger than its intended age, I searched for biographies and historical fiction books to enhance the textbook.
  1. Picture books
Recently, publishers have produced a plethora of lovely historical picture books. Not only were they ideal for my younger children, but well-written picture books can also cement facts for older students. For example, JeanFritz has written memorable picture books about several early American leaders.
  1. Biographies
The textbook tells us about the movers and shakers of American history, but little about what experiences shaped their individual lives. I chose both short picture biographies and longer chapter biographies. Some books I read aloud, while others I assigned to my older children.
  1. World history
Did you know that Shakespeare was writing his plays when the first Englishmen were settling America? Neither did I. Though we focused on American history, studying about some world events enriched our understanding. We learned about individuals such as Good Queen Bess, Peter the Great, and Napoleon (usually with the aid of a good picture book such as those written and illustrated by Diane Stanley) which helped us put American history on the world stage.
  1. Historical fiction
Many of us will never forget the devastation of a locust infestation after reading Onthe Banks of Plum Creek by Laura Ingalls Wilder. Choose a well-written historical fiction book as a family read-aloud and your children won't realize you are “doing school” for their bedtime story. Our family has a habit of reading at least one book together at all times, so we chose a book that connected with our history study. We sailed stormy seas with Carry on, Mr. Bowditch, visited a colonial school house in Skippack School, and survived an Ohio winter in Cabin on Trouble Creek.

Schedules and Details
So how to pull this all together? I rarely write detailed dated lesson plans, because if we miss one day I panic. Instead I write a loose plan and adapt as needed throughout the year. With Changing Frontiers as my guide I didn't worry about missing anything important.
  1. Divide and conquer
We planned to spread our study of American history over two years. The first year we wanted to cover the years from Columbus to the Civil War—the first fifteen chapters of Changing Frontiers. I went through each chapter figuring roughly how much we would read each day. Though our school calendar has 180 days, I scheduled only 100 days of reading from Changing Frontiers, giving us time for other books. Then I divided up the sections into the school months and slipped this schedule inside the front cover of Changing Frontiers. If I had a guide of where I should be in January, I wouldn't have any rude surprises in April.
  1. Book lists
Next I searched our bookshelves and the public library to compile a list of picture books, biographies, and historical fiction. I did not assign these on particular days in our school calendar, just worked through them as we could, adding more or deleting, depending upon our time. The beginning of each chapter in Changing Frontiers lists important events and people mentioned in that chapter which is perfect for finding books to connect with the chapter.
  1. Organizing
I organized our family library in chronological order. When we finished a read-aloud, I could pull the next historical fiction or biography off the shelf. I kept a basket by the couch with the books we were currently reading. Besides Changing Frontiers, this basket usually included several picture books, a biography, and a historical fiction book.
  1. Library
Libraries are an incredible resource, especially for those who own few books, but also frustrating to a mom with many children. Any mom who has searched the library shelves while holding a baby and watching the toddler pull books off the shelf knows why I once said that I'd never go back to the library again. Then I discovered online reservations. Now each month I check Changing Frontiers for the next topics, reserve the needed books online, and pick them up at our local library.

Since we were using Changing Frontiers with a younger audience, we chose not to use the Lightunits or quiz booklets available from CLP. But without workbooks or tests, how would I evaluate our history study? We used the study exercises and class discussion questions in Changing Frontiers for informal verbal review at the end of each section. Often these discussions went down rabbit trails and became the favorite part of our school day. I also assigned writing projects connected with our history studies. For example, each child wrote a report on an early American explorer and then wrote a historical fiction story pretending they were an explorer.

School curriculum is designed to serve teachers, students, and families. The perspective of Changing Frontiers gave a solid foundation for our American history study and we were able to adapt it to fit our family's needs. 

This year we look forward to learning about modern times as we delve into the second half of Changing Frontiers. I'd love to hear what books you suggest we read to connect to our history studies. I especially looking forward to our study of the Civil War since we live near several major battlefields. I know where we'll be headed for some family field trips this fall.

This article was first published in the magazine 'Homeschooler's Friend' by CLP. This post contains affiliate links. 


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