Tradition...Tradition!!!

     The fall and winter are loaded with holidays!  I suppose I was never really awed by this until recently, when I began to mentally list them: Halloween, Fall Festivals, Thanksgiving, and shortly thereafter Christmas and New Year's!  Along with these holidays comes "the way" they are celebrated.  This is the essence of tradition.  
     One of my favorite Christmas traditions growing up was making fried apple pies with my mom on Christmas morning.  Every Christmas morning since I was a senior in High School we would wake up, put on our aprons, flour the counter top and roll out biscuits to make apple pies that we would fry in a pan of oil.  If you have never made fried apple pies before, it is truly a southern art!  If the oil is too hot the pie will burn, if it is not hot enough the pie absorbs the oil...gross...but, if you get the temperature of the oil just right the pie transforms into a crispy scrumptious treat.  This was an important tradition that I carried into my marriage and hoped to continue with my child one day.

One of our favorite fall traditions is apple picking!

     Fried Apple Pies!  Are you trying to calculate how much fat is in one fried apple pie? Don't try, your brain will explode. Our first Christmas together with Christopher I was rolling out dough to make pies when it hit me that this would be a tradition I couldn't share with him, at least not in the way I had experienced it.  I remember saying to my mom, "How could we make 'Christopher-Friendly' fried apple pies?"  What seemed like an oxymoron, led to a great conversation, and starting a new tradition! This was just the first of several traditions that needed to adapt or be left behind.  
     It's hard as a parent to give up the ways we have always done things, and it can challenge our creative prowess to attempt to adapt our traditions to new situations.  I just want to encourage every reader that it can be done!  There are lots of reasons as to why our traditions may need to adapt.  I think the biggest key to creating change is having parents who are on board and are able to get those around them excited about the new way of doing things!  This is not always easy, but it is possible...and perhaps the process can keep us young with new ideas.  If you already have kids and it is an existing tradition that you are trying to change, include your children in the problem solving effort.  If you are needing to change a tradition and it's your first child, like us, including our extended family and friends in the problem solving process has helped us feel loved and supported along the way. Below are ways some of our traditions have metamorphosed:   
     Pumpkin Pie-  Yes, you can make filling for pumpkin pie virtually fat free pretty easily.  You just substitute eggs for egg whites, and evaporated milk for fat-free evaporated milk.  When Christopher was small we just used custard dishes with no crust...and it was still yummy!  As he has gotten older, and can have more fat, we have created a graham cracker crust using "Erewhon" graham crackers (the lowest in fat I have found) and non-fat yogurt. 

Can't beat cookie making!

Sugar Cookies- Soon I will include a post with an amazing sugar cookie recipe made with MCT butter. Once a dear friend from Canada shared with me her recipe for MCT butter, it made the Christmas tradition of sugar cookies possible. Christopher LOVES making sugar cookies with his friends, and everyone can enjoy a cookie or two without worrying about upset tummies from the MCT oil.  
     Pizza-  What kid doesn't look forward to a movie night with pizza and friends?  And how many birthday parties do we go to a year where pizza is the main medium of food!  Pizza is a fun treat, but when you go out or order pizza there is just way too much fat for a kid who can only have 9 grams of fat for the entire day!  This tradition has adapted significantly in our family.  Pizza nights are no longer the "laid back" nights where I get a break from cooking.  Instead, they have become a creative adventure we experience with friends, neighbors and family.  We make our own dough at home, with no oil.  We roll out our own pizzas and then we all get to decorate however we would like!  I have found that this has not only become a fun family tradition but a lot of Christopher's friends enjoy 

Another successful pizza making adventure!

coming over and participating in this process.  Many kids in this day and age have never made their own pizza, so there is a huge since of accomplishment and surprise when they roll out the dough, decorate, and partake!  Christopher loves loading his pizza with veggies and uses non-fat cheese on top...and we can take extra slices of his pizza for him when there are celebrations where this kind of food is present.    

     Halloween-  Halloween and trick or treating is something we only did until I was in third grade, and then we did fall festivals.  I loved dressing up as a kid, it allowed my inner actress to come out and be thoroughly represented.  Christopher did not fall far from the tree!  This year he dressed up as Chewbacca from Star Wars.  He practiced those noises for hours!  (Perhaps we should have encouraged a different character...)  In years past we have not encouraged trick or treating.  Ryan is a teacher at the local school and a lot of his students come by our house, so Christopher was very content to dress up and pass out candy.  This seemed perfect because then we didn't have to go through the process of sorting out candy, and belabor what he can and can't have.  This year was different. Christopher really wanted to go trick or treating.  We talked about the fact that there would be a lot of things he couldn't consume, but he still wanted to go, so we thought we would let him try.  He and his best friend from school, Ireon, dressed up and we all went out together.  This whole experience was heart touching, and believe me I never thought Halloween would feel sentimental.  I had three neighborhood families contact me to make sure they had treats that Christopher could have, and then the evening of Halloween when I took Christopher 

Look at all of their Halloween booty!

and Ireon out, they had a ball!  After the first house Christopher was so excited, "Mom!  I can have everything that they gave me!"  Then at the second house he traded with Ireon something he couldn't have.  Then at the third house when a neighbor tried to give him chocolate, his friend Ireon spoke up for him and said, "He can't have chocolate, he is allergic."  The neighbor just smiled and asked Christopher, "What can you have sweetie?"  To watch neighbors and his peers love him in this way meant so much! 

     Christmas Day-  Do you remember as a kid waking up Christmas morning and dragging your parents out of bed, going to the Christmas tree and opening presents first thing?!  We wanted Christopher to have this experience too, but he has to fuel up!  At first I was really frustrated at the fact that his LCHADD had to take priority in his life this day too...why can't one day out of the year he just not have to think about "fueling up"?  I think we all have those moments where we just feel like it is not "fair" and wish we could do things the way we have always done them .  Yet, I am continually reminded that the more I am able to embrace our new routines and traditions the easier it is for Christopher...and for him these routines are nothing other than "normal".  On Christmas morning our routine is to give Christopher Lipistart right when he wakes up so he has some immediate

Dad, Christopher and Uncle Joey enjoying breakfast!

fuel.  Then we let him open a couple of presents from Santa, make a family breakfast of apple pies and eggs, all eat breakfast together and then open presents together as a family.  I love it, and have really appreciated this adaption.  It allows our Christmas morning to go at a slower pace, and really enjoy each others presence.
     Fried Apples Pies-  Did you notice I said apple pies in the above paragraph?  Yes! Upon feeling defeated about our Fried Apple Pie tradition, my mom suggest that we try baking some apple pies.  Not only did it work, but I have found the pies just as tasty! Christopher loves the baked apple pies and now can participate in the tradition!  Truth be told my mom and I still fry a couple for ourselves for old times sake, but honestly I love the baked pies!
     Traditions are so important, not only to kids but their parents too!  I find so much hope in knowing that adaptions can allow us to participate in the traditions that are most important to us.  G.K. Chesterton put all of this into perspective for me in his selection, "Enjoying Floods and Other Disasters."  In this writing he shares a story about a man who every day struggled to open a drawer in his dresser.  Every day the drawer was jammed and every day he would become more and more frustrated.  Chesterton suggested to his friend that how one views the situation can vitally change one's outlook.  If everyday you get up and you view yourself going to battle against this drawer, of course you will end up angry and frustrated, but if you can wake up and imagine, as you are pulling on the drawer, that you are "tugging a life-boat out of the sea" or "roping a fellow-creature out of an Alpine crevass" then the problem becomes an adventure.  He goes on to say, "An adventure is only an inconvenience rightly considered. An inconvenience is only an adventure wrongly considered." (G.K.Chesterton, "Enjoying Floods and Other Disasters", Spiritual Classics, 303) Chesterton pushed me to view my greatest moments of defeat, frustration and uncertainties as a way to access my ability to be creative.  And when changing a tradition  feels utterly overwhelming, I think about that drawer-and how our kids' situations give us the opportunity to become more creative and adventurous than we ever thought possible.
      

Tapioca Enters Our Life

     I think Christopher was about two years old when it hit me that he had endured oatmeal before bed every night for at least six months.  We went in for his bi-yearly metabolic appointment, where I asked the dietitian for other complex carb ideas for night-time snacks.  She suggested potatoes, rice and "of course" tapioca.  
     Tapioca?  At the age of thirty I had heard of tapioca but never tried it.  All of my knowledge of this substance came from the movie "Benny and Joon."  Joon and Sam go to their local diner for a late night snack and Joon orders this white creamy pudding. Before eating it she takes out the "shriveled grapes" and has a long conversation about why raisins are disturbing...the thought still makes me giggle!  I wrote down all of the dietitian's carb ideas and went home to see if I could find a low-fat/fat-free recipe for tapioca.

     Okay, so for any of you that are totally lost right now and don't understand why in the world I am carb-crazy at night with Christopher, let me explain.  Many dietitians encourage their LCHADD patients to have a complex carbohydrate before bed when they are starting to go longer than 3-4 hours at night without food.  Christopher started this around age one and a half.  By age three we were encouraged to give Christopher a high carbohydrate snack and his Lipistart with raw cornstarch before he went to bed.  The idea is that the extra carbs will store in the liver and slowly release throughout the night to provide him energy, thus preventing fatty acid oxidation.  At age 7 we have switched things up a bit, with the same basic principle.  We give him a high complex carbohydrate snack before bed and then 3 hours into his sleep give him his Lipistart with cornstarch.  This is so that when he is healthy he is not going longer than 8 hours without food.  Back to my story...
    So I went on-line in search of a recipe...and to my surprise tapioca is typically made with yolks, and often consists of half and half or whole milk!  It is one thing to substitute an egg white here or there to reduce fat in recipes, but when I started thinking about how to make tapioca "Christopher Friendly" I felt like it would be equivalent to turning chocolate fudge or butter into something fat- free!
     Then I read somewhere about someone using coconut milk instead of real milk in their tapioca.  I knew that using full fat coconut milk was not an option, nor using only coconut milk because the Tapioca would still be too high in fat, but I thought some substitution might bring back the creaminess and the flavor.  All of this went into producing the recipe below! 
   A couple clarifications:  First, if you have MCADD, DO NOT USE THIS RECIPE!  Coconut milk is comprised of 60-80% medium chain fats which your body cannot process well.  For the LCHADD, VLCADD or TFP child this recipe should be perfect!  Check with your dietitian, about  how they would like you to calculate fat grams for this recipe.  Our dietitian felt that there was such a little amount of long chain fats in a serving that we did not need to count it toward his daily allotted amount of long-chain fats.  That being said, if you use Trader Joe's light coconut milk with this reciepe at 8grms of fat per 2/3 cup, you are at about 3.2 grms of fat for the entire recipe or 0.6 grams per 3/4 cup of Tapioca.  Again, talk with your dietitian about how they would like you to calculate fat.  And don't shy away from having a bowl yourself!  I love this stuff, even with the "shriveled grapes"!!!

                      Tapioca

 Ingredients:

• 2 1/3 cups Fat Free milk
• 2/3 cup low fat coconut milk (or “Light” coconut milk)
• 1/2 cup pearled tapioca (not quick cooking)
• 1/4 cup sugar in the raw
• 1/4 teaspoon sea salt
• 3 egg whites
• 1 teaspoon vanilla extract or 1/2 tsp almond extract
• 1/4 cup raisins

 Directions:

1. Soak ½ cup tapioca in 2 cups of water overnight or for at least 5 hours.  Drain off excess water and continue with recipe.
2. Stir together milk, coconut milk, tapioca, sugar, and salt in a medium saucepan. Bring the mixture to a boil over medium heat, stirring constantly. Reduce heat to low.  Cook and stir 5 minutes longer.
3. Whisk 1 cup of the hot milk mixture into the beaten egg whites, 2 tablespoons at a time until incorporated. Stir the egg mixture back into the tapioca until well mixed. Bring the pudding to a gentle simmer over medium-low heat; cook and stir 2 minutes longer until the pudding becomes thick enough to evenly coat the back of a metal spoon.
4. Remove from heat and stir in vanilla/almond extract and raisins. Pudding can be served hot or chilled. 

Makes Approximately five 3/4 cup servings.

* For a twist and to cut down on the sugar you can use :1/8 cup sugar in raw, 67g cup banana puree and 67g mango puree

Our First Backpacking Adventure

       By the time Christopher was two I was already posing the question to his metabolic specialists, "Do you think backpacking will be a safe activity to do with Christopher, or do you think it will be too much for him?"  They couldn't give me a clear answer then, but I felt the uncertainty.  As parents, Ryan and I have really enjoyed sharing with Christopher things that were meaningful to us growing up; anything from holidays, to sports, to classic movies (like "The Goonies").  The possibility that I might not be able to share with him the solitude and triumph that one feels during backpacking weighed heavy on my spirit, but like so many other things it was out of my control and only time would tell.
        Fast forward to last fall.  It was our second attempt at car camping.  "But mom, when can we camp at a site where no one else is around...in the middle of the woods?" asked Christopher.  Music
to my ears.  "Well, buddy...We have to be sure that you can hike without us having to carry you for at least four miles."  I didn't say this lightly.  By age six, we had taken Christopher on several hiking excursions, fueling up about every 20mins and stopping often to take breaks.  Yet, we still often ended up carrying him the last leg of our trips if we hiked longer than 3 miles, because he would complain of leg pain and we just weren't sure if it was related to LCHADD.  In my mind if Christopher could hike four miles without getting tired, then he could probably backpack 2 miles,  safely.  Little did I know that he would take this challenge so seriously.  The following day we headed for a loop hike that was a little over four miles, and with many stops and very little complaint he hiked the whole trail by himself.

        During that hike Ryan looked over at me and said, "You have to ask yourself, is it ever safe to push a kid's physical limits when they have LCHADD?"  I shared his fear and said, "I know, it is so hard because we won't know what Christopher's limits are until tomorrow...when he does or doesn't wake up with rhabdo!"  Let's be clear, I don't play the lottery, I don't gamble...I would lose every single time if I did!  So the notion that we just have to try things with Christopher and hope for the best, is scary and unnerving for me...but at this time there really is no better option.
       Last weekend was a monumental experience for our family.  Christopher and I sat down Friday night and packed his first 15 pound backpack, in preparation for a 1.5 mile backpacking trip on Saturday.  We headed up to Fort Mountain State Park in Georgia early Saturday morning, enjoyed a short hike without our big packs, and then by 2pm started our first family backpacking trip!

         Christopher loved it!  After about 15 minutes he said, "Whew this bag is heavy!"  But, he kept going sometimes leading the way, sometimes hanging in between Ryan and I.  We stopped three times to take off our packs and have a major fuel up/rest time.  He drank Gatorade with MCT oil, enjoyed fruit, and ate a granola bar at different rest points.  Other times he would just grab his Lipistart and drink while he was moving.  Our main objective was to keep Christopher fueled up and remain loud enough on the hike to scare off any bears, as there were multiple sightings in the last couple of days.  I think when you hike with a seven year old child though you have a natural noise maker, which makes for good bear deterrent!

       As always, food was a major part in navigating how to make this trip happen.  I weighed out his Lipistart powder ahead of time, put it into zip-lock bags with scoopers, then put it back in the original can, and bagged the whole can.  We couldn't afford for this to get wet for any reason!  I made special granola bars that are a little higher in protein, low in fat and fortified with MCT oil to eat throughout the hike.  We brought a lot of fresh veggies and canned beans to roast in our fire at camp.  I packed two small bottles of MCT oil in my pack and left an extra in the car, in case a bottle leaked on our trip and he needed more MCT oil right when we got back to the car.  We brought enough Gatorade for our first day of hiking, and Gatorade chews for the second day so we didn't have to worry about more powder.  We finished our packing trip Sunday with a tuna packet, mixed with mct oil and crackers.  I wanted to end our trip with a lot of protein, in case there was any muscle breakdown, this would help rebuild the muscle.
       I am not going to lie, I held my breath until Monday morning.  Did we push him to hard?  Did we try this to early?  Sunday night I snuck in two extra feeds during his 12 hour night sleep.  Monday at 5:30am, as I was packing his cooler for school I kept thinking, "This was an amazing weekend, we couldn't have had better weather, he thoroughly enjoyed the experience...and it is even more special because I never thought we would get to do this as a family...But was it too much?  Will we go to the hospital today?  Will it be our last hike?  Am I crazy (well the answer to that is yes!...)?"  But he woke up at 6:45am excited to go to school and share his experience!  After, I dropped him off at school I exhaled and smiled.  We did it, and hopefully this is just the beginning!
    So, what were Christopher's highlights of the trip?   Probably just what you are imagining...lounging in the tent, getting to use a flashlight, playing card games...AND pooping in the woods, of course!  Gotta love it!


    

The Ebb and Flow of this Year

He helped create this costume for a book parade.

I have started this post so many times!  First I went with the title, “School Update” and then “How to keep eating with a stomach bug!” but every time I have started writing a post Christopher has gotten sick within 24 hours, my brain became foggy and finding the right words to share about our adventures through kindergarten felt impossible.  So here I am again, hopeful to finish my peace before we gear up for another adventure!

            This year has been filled with continual unpredictability.   I must admit that for a type A personality, who takes comfort in some level of routine and organization, I have found myself continually stretched.  Although Christopher has not been hospitalized so far this year, he has missed 23 days of school due to illness and several other half days. 

            Sick days for Christopher come with varying degrees.  There are days when he is so sick that all we can do is sleep, read, and head to the toilet, but most sick days with Christopher are due to colds and viruses.  These typically leave him run down and more tired, but capable of accomplishing some educational activities.  During the first couple days of a cold he stays home to get extra rest, hydration and fuel (calories) to help fight the virus without going into crisis.  On these days I try to let him sleep in longer and add a nap mid-day.  We do at least two hours of “home-schooling” with frequent hydration/food breaks to keep his “brain fueled up”.  Then we attempt a puzzle, make a Lego creation, read books, or watch a movie.   His sick days look so different than the ones that I had as a kid, and I believe they really need to.   When I was sick all I remember doing is sleeping, reading and watching TV…but I knew early on this year that Christopher would miss more school than the average kid, and I didn’t want this to mean he missed out on the opportunity to learn!  Supplementing at home is challenging and fun; I will talk more about this in another post!

Christopher and his two best buddies at the pumpkin patch.

            This year has felt a little chaotic to me because Christopher goes to school for a couple days (max two weeks), gets sick, stays home, goes back to school, finishes getting over his cold, and then within a couple more days comes down with something else.  Yet, Christopher still loves school!  He loves learning from other caring adults, he loves his friends and he loves the challenges that being in another environment brings.  At this point Christopher seems fine with his time at school being a little different than his friends, and when I asked him if he felt like he missed a lot of school this year, he said, “No…maybe like three days!”  So although I have found our rhythm to be challenging, right now I wouldn’t consider doing anything else.  He is happy, thriving, and enjoying life!

He was so excited for his choral concert!

            I am continually reminded how every child is different and what they need to thrive with a chronic condition is not always what we expect.   For our family this has meant really seeking to understand Christopher, keeping him a part of the conversation around education and his activities, and being okay with evaluating and trying again.  For example, I thought that Skype would be a great way to keep Christopher a part of class routines this year during absences and help him transition back into the class on well days.  I knew this had helped other children!  Yet, after trying Skype a couple times at home while he was sick, he was very clear with me, “Mom, when I am at home I just want to be at home and when I am at school, at school.”  I had never imagined that Skype would be anything but positive for him!  Yet, as I think about Christopher’s personality, it makes perfect sense he didn’t want to use Skype.  He really enjoys being in the moment, and Skype can confuse that!  Also, although I worried about his transition from sick days at home to going back to school, he is an extrovert and this transition was exciting for him not anxiety producing!  So we have set aside Skype temporarily, but it’s a great tool to have and possibly use as he gets older! 

            Overall, it has been a good year!  I wouldn’t trade it.  There have been bumps and hiccups along the way, but we are all learning!  The teachers, administration, Christopher and our family are all trying to work together to understand what school will look like, and every year I am sure will look a little different.