We're now halfway through his first feed at the 3:1 ratio. The goal is to get him up to 4:1, if necessary, and to send him home taking three of his four daily meals via the tube at a higher ratio and getting to eat one meal by mouth at the 2:1 ratio - we'll see what ratio formula it takes to get him into a state of ketosis.
The "child life" specialist stopped through yesterday and asked if there was anything that Reuben would particularly enjoy. I said we were pretty well set with his books, his iPad, his stuffed buddies, but then at the last minute thought to tell her how much he likes marbles. Well, as you can see above, she had something tucked away in a cupboard that was perfect for Reuben! Any of you who have been to our house know that we have literally hundreds of marbles on the floor at any given time because of Reuben's great love for them. Now we have marbles rolling around the hospital floor, too!
Today they're expecting him to hit a sort of wall as his body begins to feel the effects of the serious carbohydrate deprivation. It helps that his carbs have been limited for the last month, but with every increase in fat ratio, we're halving the carbs that he's getting. The current 3:1 ratio he's at has him getting 20 grams of carbohydrates per DAY! For those of you who aren't accustomed to counting carbs (as I am after having cared for Matt's mom's diabetes for the last nearly eight years), 20 grams is a large slice of bread, or a five or six ounce apple. And that's it. For the whole day!!! That's not a lot of sugar.
But he's been in great spirits, and Matt seems to be getting on okay at home with caring for the other nine and Grandma. Thankfully both Rose and Mira's nurse have been able to put in a few extra hours to help cover some of the busier times, and we're just winging it on the rest. Our goal is always to come through these weeks with as many children as we had going into the week. The rest of the fallout we can work with after the fact. 😉
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