1. Record Keeping

2. Importance of Record Keeping  Success for monitoring KT greatly relies on the data recorded by caregivers

3. Daily Diary Ketone and Specific Gravity  Ketones Compliance Correlation to seizure control  Specific Gravity Hydration status

4. Daily Diary Ketone and Specific Gravity Records  Check twice per day (am/pm)  Tips: If you child wears diapers try placing a cotton ball in the center of the diaper to catch the urine, then squeeze the urine onto the multi-stick Check reading on multi-stick after indicated time on package Checking the multi-stick after a long period of time may give a false reading. Keep multi-sticks in a dry place Humidity and moisture can affect their accuracy.

5. Daily Diary Seizure Records  If seizures are not seen for a day record “0”  Don’t use terms such as “many, several, occasional, few, or all day”  Neurologists will classify type, you can describe the seizure/seizures in your own words

6. Sample Daily Diary Medication Records  Record all medication and supplements and corresponding dosages when you begin the therapy.  It is not necessary to record them everyday but make sure to record any changes that are made.

7. How to Record Other Issues  Record all GI issues including nausea, vomiting, diarrhea, constipation  Number of bowel movements and any illness

8. What is a Diet Recall?  Diet recalls consist of everything your child has eaten in a 24-hour period  Assign letters to each of meal Write the corresponding letter to the meal your child ate on the records

9. How will Diet Recalls benefit my child?  Since it is not known why KT can decrease seizure frequency, we hope that this investigation will give us further insight into the mechanism behind the diet.  As we learn more about why the diet works, it is possible to tailor meals to increase effectiveness of KT.  We expect that this will not only help your child, but help every child on KT. We can learn from your child’s success and help other children improve their seizure control, and vice versa.

10. Sample Daily Diaries

12. Use of Records  Seizure records,medication records will be graphed and used to analyze progress on therapy  Ketones/SG records will be graphed with total seizures to see if there is a relationship  Diet Recalls are diet analyzed by the Nutrition Data System for Research (NDSR) This database will give us information on over 170 different types of nutrients and indices Nutritional analyses can be compared to your child’s seizure records

18. Don’t forget!  Record as you go! Do not wait until the end of the day or week to record from memory  Records can be faxed, mailed, emailed or brought in during each clinic visit.  Records can be personalized to fit your needs. They can be made in a monthly calendar, weekly or daily record form.  Make sure to record any deviations to the therapy  If you have nursing care or need records taken at school, we can have Rx written so that nurses or staff can keep records as well.