I was having a conversation with another Keto parent the other day that spurred an interesting question for me: if I had to re-live the most difficult parts of Nora’s epilepsy, what would I do differently? What have I learned that I would tell my past self if I could?

Float like a butterfly. Have you ever watched how a butterfly flies? They flap furiously, then glide for a short time, then flap again, then glide. They don’t try to keep an even pace. I think that when I was really in the weeds with my stress about Nora’s epilepsy, I felt like I had to “handle” it with grace, that I should be calm and in control. But then when I couldn’t handle it, I felt even worse because I knew I was failing.

In retrospect, I would allow myself more ups and down. I would find people that could listen or validate my fears and anxiety, to allow me to acknowledge my hard feelings so that the “down” phase could allow me to rest and vent. Then I would lean in harder on pursuing things that give me joy and space, so that I had an “up” phase, to pick me up so that I was ready to head back into battle against the anxiety and day-to-day grind.

So perhaps don’t focus on trying to be bulletproof and always on top of everything. The grind will eventually wear you down, no matter how strong you think you are. Instead focus on having strong means of renewal, so that you can keep diving back in. Think of what gives you joy and peace, and lean on those things more than ever so that you can be rested for the hard work. Flap and glide, flap and glide,…

Mediate and breathe. Meditation and breathing exercises don’t need to be fancy. All you have to do is take a moment to interrupt your rumination to give yourself a little break. I was describing this visualization to my therapist the other day: have you ever watched a vortex form at the drain of a bathtub? It starts weakly, then extends down from the surface down to the drain as it builds. But sometimes when the vortex is still just forming, a drop of water from the faucet will fall and interrupt the vortex formation, and it slowly has to start building again. I think of that vortex as my swirling, busy thoughts, and I visualize that drop of water splashing into the vortex, rippling out, and stopping it. I think if we regularly check in with our brains and interrupt these swirling thoughts throughout the day, we can give ourself a little break, and keep from exhausting ourselves. Visualize that drop of water sending a calm ripple across the water of your mind, leaving stillness in its wake.

Be vulnerable but resilient at the same time. This relates quite a bit to the “float like a butterfly” idea, but if I had to do it again, I would be better about telling myself things like: “I know I will get through this, that there is a light at the end of the tunnel, but today has been really hard, and I’m struggling.” It is possible to feel hopeful while simultaneously expressing grief, and it is possible to acknowledge your fears and frustrations while knowing that you eventually make it through. You can live in both places at the same time.

Epilepsy is really hard. Keep going; one foot in front of the other. Each hard day you make it through is one less on your path. Embrace your sources of joy, keep filling your tank, and keep diving back in.

As everyone heads back to school, we think about everything our kids need on a daily basis and communicating those needs to their teachers and school staff. When Nora was on the keto diet, we shared our experience in 3 parts:

Bringing keto to kindergarten, part 1
Bringing keto to kindergarten, part 2
Bringing keto to kindergarten, part 3

Now that she is a big 5th grader who has been seizure-free for 6 years (whoo!), back to school time is a little less stressful.

However, she is still a special little one. I got a call from the school district nurse during the first week of school, which took me by surprise. She was again checking in to see if Nora had any new seizures or treatments that the school should be aware of. I was grateful for the call, and reminded of the importance of continuing communication with the people around her. I told them that although we have weaned her from the keto diet, and from MAD, we still think about what “eating healthy” looks like for Nora, which is avoiding high sugar intake–the possible “sugar bombs” that can come with school events (although her school has adopted a smart “healthy snacks” policy that should work for her now too!). Nora is also a pro at evaluating food presented to her, and politely declining if she is in doubt. She also has some preferences developed through her diet experience that we are happy to continue to support.

For breakfast, she asked me to make some of her MAD About Granola about a month ago. However, it largely sits untouched (I eat it with yogurt some days), because she has discovered a kind of cornflakes that she really likes. But she still prefers half and half on her cereal! She has tried whole milk, but doesn’t like it as much. So each day starts with a bowl of cereal with half and half.

She still packs a lunch for school each day, which she does herself. Her Mission Balance Low-Carb tortilla are still her favorite, usually with butter, peanut butter and a drizzle of honey. She often takes cheese and a piece of fruit on the side.

After school snacks are now much more conventional. She loves Coconut Bliss ice cream (preferably chocolate peanut butter) or bars (chocolate). The ratio is quite good, even though it has more carbs than she used to get a day. We have also had apple pie and apple crisp around the house, thanks to our apples and pears trees this year. We are happy to let her eat those homemade treats now, and more open about similar kinds of treats in small servings, preferably paired with some fat.

We are still getting used to the idea that she can eat a typical diet, although we want to hang on to the healthy aspects of the keto diet. It’s a nice lesson to reiterate that a healthy diet is low in sugar. But I don’t want to give either of our kids food/control issues as they enter their teen years. We continue to strive for a healthy relationship with food, remembering that “healthy” can mean something different for everyone, depending on their food allergies, intolerance, treatments, and preferences.

Caring for an epileptic child is extremely stressful.  Not only do you have the immediate stress of not knowing when the next seizure hits, but you have the long-term stress of uncertainty about your child’s prognosis and development.  I’ve written a bit about this before (http://blogs.oregonstate.edu/oregonketokids/2015/08/16/caring-for-the-caretakers/) and today I’d like to add a few more specific steps you can take.

First, understand that you are not alone.  There are millions of people in the world dealing with epilepsy.  Somewhere in the world a child had their first seizure today, and the parents and caretakers are freaked out.  Somewhere in the world there are parents and caretakers that are worn down, stressed out, and sick with worry.  It’s OK to feel that way.

If you have an epileptic child, let me say I am so sorry.  I am sorry you have this uncertainty and stress in your life, and that you are so worried about your child.  We hear your pain because we feel it too.  We are with you.  We can walk this road together.

Second, practice breathing exercises to keep your stress in check.  When I was really, really struggling with Nora’s epilepsy, I started experiencing panic attacks.  I went to see a counselor and she showed me that, by breathing deeply and making an effort to relax my body, I could actually make it impossible for my body to develop a panic response.  By breathing deeply and slowly, you are forcing your heart rate to stay down; you are manually intervening in what would otherwise be an autonomic response.  That doesn’t mean you are not upset, or sad, or angry, but at least it keeps you in control of your body.

You don’t need any fancy books or videos to learn how to breathe.  The technique that works best for me is to draw in a breath, and release that breath in twice the time.  For example, start with drawing in a breath for a count of 4 seconds, then count to 8 seconds as you exhale (for a total of 12 seconds).  If this feels comfortable, go to a 5 second inhale and a 10 second exhale.  Keeping adding 1 second to the inhale and 2 seconds to the exhale until you reach a level that feels very comfortable; you don’t need to push it or make yourself uncomfortable.  (Pro tip: the breathing doesn’t need to be even.  I like to inhale evenly with a sharp full inhale at the end to top-off my lungs, and the same on the exhale, evenly, with a strong final push to clear my lungs before the inhale.  This trick uses the full lung capacity regardless of the breath time.)  Keep breathing this way for 5 minutes or so.  This simple technique will keep your heart rate and blood pressure down, thus actively interrupting your flight-or-fight response.  It’s not going to make you feel happy if you are sad, but it will put your body at peace so that you can think clearly.

Third, practice cognitive therapy techniques.  (I studied this method to actually help me with another, unrelated chronic problem I have: tinnitus.)  We experience some stimulus A (e.g., a child’s seizure), and then we experience a response C (e.g., worry, panic, etc.).  The cognitive therapy method is to mindfully interject a new step B between A and C.  The new step B should acknowledge and validate A, but help us to arrive at a new C.  For example, our child has a seizure.  We recognize this and we interject by very actively telling ourselves “I’m really stressed about this seizure, I don’t like it, it makes me upset, BUT we will get past this and we will keep working and there will be better times ahead.”  The key to this is to keep using it, and after much practice, we start to re-train ourselves how to think and feel about something.  We eventually learn to associate A with a new and hopefully better C.  We can also use the same technique to reinforce a positive thought.  For example, event A could be something good and encouraging.  We can then interject step B that helps us to recognize and value the event, thus building a stronger connection between our ability to notice these good events and how they make us feel.

(And please let me note that the idea here is not to interrupt grieving, which is extremely important.  We all need to feel sad sometimes and we shouldn’t always be too quick to try to shake it off.  Sometimes we need grieving before healing.  The cognitive therapy method is instead to be applied to recurring thought patterns that we’d like to change.)

So in summary:

1. Understand you are not alone in your feelings.
2. Use mindful breathing to gain control of your body, to help your mind.
3. Use cognitive therapy techniques: interject a step B between event A and feeling C to help train yourself for new thought patterns.

Maintaining Nora’s low carb diet in Norway has gone fairly smoothly, aided in part by shipments of Mission low carb tortillas in care packages from friends and family back home. But we’ve also found some local products to integrate.

One such product is a compressed-seed cracker, very similar to “Flackers”. Nora has been using them for breakfast lately.

The total weight of the package is 230 g, and there are 10 crackers. Each cracker is 23 g. In Norway, the nutritional information is given per 100 g for all food (instead of per serving like in the US). Therefore, each cracker is 23/100 of the nutritional information listed on the back. Assuming 1 tbl of butter and 1 tbl of jam on the cracker:

1 Cracker: 2.8 g net carbs, 3.9 g protein, 6.7 g fat, 3.2 g fiber (ratio of 6.7 g /(2.8 g + 3.9 g) = 1.0)
1 tbl butter: 11 g fat
1 tbl jam: 10 g net carb

Total: 12.8 g net carbs, 3.9 g protein, 17.7 g fat, and 3.2 g fiber
Ratio: 17.7 g / (12.8 g + 3.9 g) = 1.1

Pretty reasonable ratio for Nora at this point. To crank up the ratio for a more full-keto approach, simply reduce the jam, or top the cracker with only cream cheese.

As a point of interest, I also ran this calculation with a heavy fiber seed bread that is available here. I was curious to see if any kind of bread — even a very high fat and fiber type — can work. Running the same calculation as above (one slice of bread with 1 tbl jam and 1 tbl butter) yields a ratio of 0.75. A bit low. This leads me to conclude that you should likely assume not to use any bread on the keto or MAD diets, as a matter of course.

2018 brings us to Trondheim, Norway! We’re here on a sabbatical for 6 months until July. For me, Christy, and Anders, this is a homecoming of sorts, as we lived here in 2004-2005.

Things are going well for our family. Nora continues to thrive and has integrated nicely into the local school. I’ve had some apprehension about living abroad with Nora: new foods, new routines, and away from our familiar foods and resources. And such a trip would have been unthinkable a few years ago. But we’ve adapted, and, so far, so good.

Disembarking the airplane with Nora in Trondheim, our new home for 6 months.

Trondheim in the evening light. It’s a beautiful city.

Snow! Still a novelty for Anders and Nora, as it rarely snows in Corvallis, and rarely enough for sledding.

First day of school. I was so impressed with Nora in her courage in starting school in a different country, away from her friends and her native language. The school was so kind about accommodating her.

We’ve also found the Norwegians to be very accommodating of Nora’s dietary restrictions. In general, they seem to very aware of gluten and peanut (and other allergy) concerns — we see it frequently on menus — so it’s been easy to extend that to Nora. We generally don’t explain the whole keto diet idea, but simply state that she must have reduced sugar.

At this point we’ve slightly liberalized Nora’s bread allowance, to the point where I feel comfortable with a limited amount of bread-heavy foods like pizza that come with a large dose of cheese or other fat/protein.

Nora prepares some hot chocolate: half cream, half whole milk, about a teaspoon or two of cocoa powder and a little bit of honey to taste.

Taking a break from skiing with a peanut butter and jam sandwich. We’ve found a great whole grain and seed bread at the local grocery storage with high fibre, high protein, and about equal amounts of net carbs and fat. With some peanut butter, butter and brown cheese, or with melted Jarlsberg cheese, it makes a good low-carb friendly snack.

Another day of skiing and a break at the ski cabin, which has a sitting/warming area and a cafe. We are enjoying waffles with jam and brown cheese. I can’t say this is terribly low-carb friendly. Well, let’s be honest, it’s not. But we try to load it up with as much fat and protein as we can. At this point for Nora I try to focus more on a healthy day-to-day routine, and trust that she has some ability to absorb the occasional sweet treat. Note, this is not acceptable when applying the diet strictly for seizure control. In that case, we feel strict consistency is extremely important; no cheating! However, with Nora now having almost 6 years of seizure freedom and several of those years off strict keto, hopefully we can trust she is solid.

Nora re-enacts a Say Yes to the Dress scene with Beanie-Boos.

Nora enjoys some fish soup way up north at the ice hotel in Alta, well north of the Arctic Circle. We took a trip up here to enjoy the arctic environment, visit friends, do some dogsledding, and stay in the Sorrisniva ice hotel.

Family portrait with the Northern Lights outside of the ice hotel in Alta, Norway. This was actually a pretty mild display. When Christy and I lived here in 2004, we were once treated to a phenomenal, otherworldly, indescribable display in Tromsø, Norway.

Some sort of winter Olympics-inspired event involving a duster. Nora has been happy and energetic.

She has adapted well to life here, as have we.  The plan for now is to continue with a processed-sugar-avoidance diet for Nora, and hopefully she will continue to thrive!

April 24 2017 marked Nora’s 5 year seizure free anniversary.  We didn’t celebrate.  Just a little high-five and the knowledge that life goes on, more challenges lay ahead, and an appreciation for moments of simple happiness.

Nora’s period of seizures lasted only about 18 months total.  From a few tonic-clonics in the fall of 2010 to a horrendous period of myoclonics in the fall of 2011 to eventually getting her seizure free in the spring of 2012.  I estimate she had something like 10 tonic clonic seizures, but she had at least 1,000 myoclonics, and probably several thousand more that we didn’t document.

On one hand 18 months doesn’t sound long, but anyone that lives with epilepsy knows it brings life to a crawl.  You are always on guard, always waiting for the next seizure to come out of the blue sky.  The fall of 2011 felt like a lifetime to me.

Nora doesn’t really remember any of it.  She asks what the seizures were like.  She knows that her diet and a period of seizures are part of her identity, but she does not remember.

I can see now that we have been unlucky and lucky.  Nora was unlucky to have to deal with seizures.  She was unlucky to have epilepsy.  Unlucky to have a nasty epilepsy.  Unlucky to have a refractory epilepsy.

But we were lucky that the ketogenic diet worked so well.  We were lucky to pull her back from the edge.  We were lucky to have the dedication and resources to apply the diet strictly and completely.

My heart breaks for people still looking for answers; still looking for their good luck after the bad luck.  Please hang in there.  Please keep going.  Things will get better.

Nora is doing well.  She is a very normal kid.  She attends a dual language school (English/Spanish).  She likes math when phrased as silly word problems I challenge her with when we hang clothes together, but can get frustrated with the notation and worksheets at school.  She has many good friends.  She loves to dance and perform.  She has very good pitch when singing, even though she hasn’t had any voice training.  She plays piano, reluctantly.  She listens to countless audio books.  She has grown tall and lean and — surprising to us — recently shown running aptitude: she has a runner’s gait.

Her diet is still restricted, but only a little.  Our only remaining rules are that she not have any refined sugar (no soda, no candy), limited bread, and that any fruit be balanced with a roughly equal amount of cheese or nuts (by volume).

We’ve actually gone out for gelato a few times this summer.  When I first had the idea for it a few weeks ago, I checked with Christy to see if she felt comfortable with it.  When we agreed, I suggested it to both kids.  Nora was ambivalent, and responded with “but we’re out of my ice cream,” referring to the coconut ice cream she was anticipating that we would bring with for her to have while everyone else had gelato.  I told her “no, you get gelato too.”  Those little moments are nice.  She licked her bowl clean.

She’s waited patiently for five years.

(A few days later one evening she suggested with as much casual indifference she could manage “Maybe we can go downtown and have dinner and then have gelato.  If you want.”)

I will always be grateful for how Nora has embraced the diet’s role in her health.  She is so responsible and so thoughtful about it.  To our credit I think we have always been very open with Nora about the benefits and challenges of the diet, so that we can sympathize with her when she is frustrated, and celebrate with her when she gets to exchange Halloween candy for toys.

Practically speaking, Nora still has the same breakfasts and lunches as she has for years.  Breakfast is our special granola (Nora’s MAD About Granola) with half and half.  Lunch is Mission low-carb tortilla roll-ups with turkey and cream cheese, some nuts or cheese, and some fruit.  Dinner is very often Mission tortilla quesadillas with cheddar cheese and avocado and carrots.  Her main treat is Coconut Bliss chocolate bars and Coconut Secret coconut bars.

For now, I am thankful for these routines, and this quiet anniversary.

(P.S. As I write this, Nora and Anders are on the trampoline.  It’s 9:00 PM on a dusky warm spring night.  Anders is explaining to Nora how evolution works, and using Nora’s epilepsy as an example of mutations.)

Wow! It has been way to long since I have posted something on this website. A lot has happened in our life in the past year. We had another baby, Jaron hit the 2 year seizure free mark, was weaned off his diet, and celebrated another year seizure free. I plan on writing about all these events, but for now here is a post that I had been meaning to post a year ago.

It is not unusual for Keto Kids to struggle with stomach pains. My stomach would probably struggle with trying to digest that much fat, too. Jaron started having stomach issues within the first month of being on the diet. But we worked with his dietician and were able to keep it manageable over the past 2 years. If your keto kid is struggling with stomach issues, here are some options you can discuss with your dietician.

1. Make sure he has regular bowel movements. Jaron’s stomach pain in the first month was due to irregularity. It took us awhile to find the right amount of Miralax to keep things flowing, but not flowing too fast. After a couple of months we found the balance and that helped his stomach out a lot.
2. Make sure he isn’t getting too many calories. After we got the pooping situation under control, Jaron was still having some pain. The dietician noticed that Jaron was gaining weight too quickly. She suggested go down on his calories to see if the reason for the stomach pain was a belly that was too full. Sure enough after we went down, the stomach pain went away.
3. Smaller Meals more frequently. After about 6 months, the stomach pains came back. Our dietician suggested giving Jaron smaller meals. The smaller meals would be easier on his stomach to digest. This was more work for me, since I had to make more meal, but it helped his stomach.
4. Sugar Free Tums. Another 6 months later the stomach issues came back. Dr. Wray suggested Sugar Free Tums as an antacid. We only wanted to give Jaron one a day so we gave it to him in the evening when his stomach was most upset. This helped him sleep better at night. If you get a yummy flavor, this will be a treat for your keto kid.
5. Probiotic. Jaron was on the Tums for a while when he started having kidney stones. The dietician thought we should discontinue the use of the Tums because maybe Jaron was getting to much calcium which aided him forming kidney stones. To replace the Tums, she told us to give Jaron a probiotic. She suggested the brand Culturelle as it has minimal carbs. After 3 days on this, Jaron’s stomach pain went away and we haven’t had issues since.  I guess his digestive system was running low on good bacteria at this point.

There are many options for helping keto kids deal with stomach discomfort. If yours is struggling, I hope these ideas help you and your dietician come up with a way to ease the pain.

The end of summer is upon us; Nora and her brother will be starting school this week, with Nora entering the third grade.

It’s been a good summer.  Nora has been healthy and happy, enjoying countless hours listening to audiobooks and setting up playdates with friends.  Last April we quietly celebrated four years of seizure freedom, and about two years on a reduced version of the ketogenic diet.  For the last year and a half or so we’ve been estimating Nora’s portions, focusing more on limiting carbs and matching carbs with fat and protein in proportions roughly equal by volume.  For example, if Nora wants some fruit, we ask her to eat an approximately equal amount of cheese or nuts (she usually prefers cheese.)  Ideally we’d be at something like a 1:1 ratio, which would be close to a MAD diet, but I think many days it is probably less than that and something more like a low glycemic-index diet.

We’ve felt more comfortable traveling.  We took the train back to North Dakota — a nearly 30 hour ride — to visit family this summer and had no trouble feeding Nora with a combination of carefully selected retail food or foods we brought with us.

For a fun treat we’ve recently found the “Coconut Bliss” brand of ice cream, which is around a 1:1 ratio.  Nora loves it, and I admit I feel a great delight in allowing her to enjoy an off the shelf ice cream product without much restriction.  It has 17g of net carbs per serving, which would have been much too high to fuss with back when Nora was restricted to 10 g of carbs per day, but now I feel comfortable with her having it due to the 19 g of fat that goes with it.  (As an added bonus, it’s made nearby by a Eugene, OR company.)

Nora has grown tall and strong, with absolutely no signs of any growth delay she may have had while on the carb and protein restrictions.  As I type this, she is swinging and climbing in a small tree in our backyard, like the primate she is.

Cognitively Nora is sharp and very strong with language; she has a very large vocabulary and greatly enjoys mystery books and theater.  She speaks well and reads well.  She’s a natural organizer.

She does struggle with certain abstract concepts, such as music notation, analog clock reading, and mathematical procedures.  Of course these are not unusual struggles for any kid, but I would say Nora seems to struggle just a little more than average — whatever that may be — with these sort of abstractions.  I wonder sometimes if these minor struggles are related in any way to any cognitive delay that would have been related to the epilepsy, as myoclonic epilepsies are usually correlated with cognitive delays or regressions.  But I feel there’s really not much evidence of that; it’s quite likely that Nora is just a very normal kid with some strengths and some areas to improve.  Watching her develop I’ve never lost the gratitude that she is doing so well.  I will never take her health for granted.

It was about one year ago I wrote a post about Caring for the Caretakers.  Nora’s epilepsy really took off in the fall of 2011, so I think I associate the fall with those difficult times.  This fall I find myself thinking of it again, about our journey and also about those that are still struggling or will soon be sent tumbling down that path.  So again we want to remind our fellow parents and families that you are not alone.  Epilepsy can be so difficult, and scary, and unfair.  It is OK to acknowledge how hard it is, how scary, how unsettling, how frustrating, how limiting.  When we are hurting, we must take some time to acknowledge our pain, and also to have our community and supporters acknowledge the pain.

To all the parents and caretakers and families out there, I say: I am so sorry this has happened.  I am so sorry this unfair and scary thing has set upon someone you love.  I am sorry it hurts.  Cry and rage if you need to; give yourself space to acknowledge the hurt.

When you’ve had time to be with your pain, pick yourself up and put one foot in front of the other.  Keep going.  Each difficult day you make it through is one less you’ll have to deal with.  If you are in the midst of a miserable time, remember that it will not last forever, there is a better day out there in your future, for you and your child.

We are here to help.  Please leave a comment if you need an encouraging word, or a space to vent.  No one is alone in this.

This week we are refreshing our blog! After almost 5 years of living with the reality of epilepsy, treatment and recovery, we are taking stock and updating our blog to reflect where we have been and where we are going.

Keto Parent Meeting. Photo credit: Amanda Cowen, Corvallis Gazette Times

You will notice the new look at the new name: Oregon Keto Kids. Now that Nora is almost 3 years seizure free and we are weaning her from the diet, we are turning our attention toward supporting other families as they use the ketogenic diet to overcome epilepsy. Of course, this blog is always for everyone, no matter where you live, but it is also a central part of the more hands-on support group we will form for parents who are starting the diet at OHSU Doernbecher Pediatric Neurology’s Ketogenic Diet Program. The first step is working with other families who are emerging from their journey with the ketogenic diet armed with the experience to reach out to support others.

Thus, we welcome Amanda and Jason Swick as co-bloggers at this space. Their son, Jaron, was diagnosed with Doose Syndrome when Nora was about 1 year seizure-free. They connected with us after Nora’s story was in our local newspaper. We are all grateful that our story was told and that another little person and family could use the ketogenic diet to overcome epilepsy. The Swicks are an amazing family and they are also ready to reach out and support others.

During the next few weeks I will be updating many of our main pages. I haven’t looked back at them in ages, and see how out of date they are!  It’s time to re-write Nora’s story and call on our experience to re-write the other general informational pages.

It’s an interesting experience to look back at those times, remember what we were feeling and experiencing, and to see the journey to now. We are thankful that it went as well as it did. Ted and I feel that we don’t have a lot more to say on a regular basis and are not making as many recipes anymore, so maybe we will spend some time curating the blog for the “best of” and doing some summary posts of the challenges that we faced.

Amanda will be blogging about Jaron’s experience (you can read Jaron’s Epilepsy Story now, and look for updates in the future). She also has experience with Doose Syndrome, the Keto Calculator, reflux, kidney stones, camping and more, so you will learn a lot from her experience and perspective.

Our blog-refresh plans are not done yet, so we will keep you posted as we make changes so that you can stay in touch. We are always happy and grateful to hear from other parents and supporters.

And we are looking for support! If you want to help get the support group off the ground, we will be looking for volunteers to help us get donations to buy basic supplies for families, print a welcome packet, buy books about living with food restrictions for kids, etc. We would also like to contact some of the companies that make good keto foods to get coupons or other discounts (for coconut oil, macadamia nuts, nut flours, cream, etc.) Please contact us if you want to pitch in; donations will go through the Doernbecher Foundation and will be tax deductible!

Nora and I took the perfect keto kid field trip! We visited an Organic Valley dairy farm just 30 minutes from our house, makers of Nora’s brain-healing heavy cream. We are very good Organic Valley customers and Nora was happy to meet the cows that make “her” cream. She keeps asking to have her own dairy so that she can sell milk door-to-door. I keep telling her that the city will not allow us to have a cow in the backyard. She should focus her attention to her chickens. Visiting cows is the best that I can do.

Double J Jersey dairy farm is run by the Bansen family, Jon and Juli and their four children. Their oldest, Ross, is now a part-owner of the farm after getting a business degree in Iowa and traveling the world for a year visiting dairy farms. Their other children have their own responsibilities on the farm, the youngest is a senior in high school. They moved to the farm with a 2 year old and a newborn, then in 2000 they converted to organic pastured production and joined Organic Valley, a cooperative of 1,800 dairy farmers across the US committed to the economic success of mid-sized family-owned dairy farms along with the environmental benefits of organic production.

Keto families also love Organic Valley because our dietitians tell us that it is the only cream that is reliably free of carbs. The whole milk comes from the cow, and the cream is then separated at the creamery but some of the lactose in the milk could remain with the cream. Many other brands of cream report 0.5 g of carb per serving, some report zero, but in reality might be up to 0.5 g to 1 g of carb after processing. Keto dietitians recommend Organic Valley because in their experience it is all fat, just the good stuff. When we calculate Organic Valley cream for Nora’s meals, we count it as 40% fat, 60% water. Nothing else.

Nora displays her butter. Photo courtesy of Ann Shriver.

Our first farm activity was taking those familiar cartons of heavy cream and making our own butter! We poured some cream into a glass jar and shook for about 10 minutes. It got thicker and thicker until it didn’t even seem like anything was sloshing around in there, then all of a sudden it was a clunking chunk of yellow butter! The buttermilk that had separated was thin and I let Nora drink it right from the jar, along with tasting that yellow buttery deliciousness. It was the softest, most buttery butter I had ever tasted. Where else can you take a tour and get perfect high-quality fat for samples? Try it yourself. It’s like magic!

All of the Bansens who gave us the tour were wearing Organic Valley t-shirts that said “who is your farmer?” In this world of industrial food from nowhere, we are privileged to see the origins of our food, and the cows are fortunate to live such a comfortable life. The milk truck comes to their farm every other day and takes it to creameries in Portland, where Organic Valley rents processing facilities from other creameries (Darigold and Alpenrose, in Portland) to process and package the raw milk into the dairy products that we buy at the store. The organic milk is run first thing in the morning when the machines are clean. If you look at the printed code on your milk or cream carton you can see where your milk was processed before being delivered to the grocery store. Nora’s Organic Valley cream has the code 41-33. Put that code into this website: Where is my milk from? It was processed at Alpenrose Dairy creamery in Portland, OR, but it came from an Organic Valley dairy. There is a good chance it came from Jon Bansen’s Jersey cows, but alternatively his cousin Dan and niece Jamie also have their own Organic Valley dairy in Oregon;  brother, Bob, runs the dairy the boys grew up on in Yamhill County, Oregon; and Jon’s older brother, Pete, operates the original family dairy back in Ferndale, California. It is highly likely that Nora’s Portland-processed cream came from a Bansen cow!

Happy cow, waiting to be milked in a few short hours.

In the pasture where the cows would be grazing later in the day.

We walked out to the pasture with Jon, where he told us about his rotational grazing method and his real job: to take care of the bacteria that make a healthy soil to grow nutritional pasture, which in turn takes care of the bacteria in the cow’s gut to break it down and turn it into nutritional milk. He moves the herd through paddocks with movable fencing every day when the plants are just the right height for grazing: healthy long green tender plants up to our shins that let the cows eat their 300 pounds of grass per day (really?!?), but have not become so tall and fibrous that they are hard to digest. He could count 15 different species in the pasture, some of which are “weeds” that the cows eat and many of which he planted with a no-till process that keeps the soil intact and healthy. The cows munch down the pasture so that the plants can spring up again, while working their “nutrients” into the soil to fertilize (I stepped in some of those “nutrients” in the barn!). Cows have 4 stomaches and are “fermentation vats on legs,” as Jon told us. The plants turn sunlight into food to grow, the cows turn those plants that we can’t digest into milk (sugars, protein and fat), and if we take care of the pasture and cows we get the nutritious milk and cream. It’s a pretty sweet deal and we should thank our farmers.

Kids take a walk through the fly vacuum!

Ross demonstrates the automatic cow brush.

These cows live a comfortable life. They are out on pasture from the first spring day when the Oregon winter rains break, usually in March. Jon says that the first day out to pasture is the best day of the year, even better than Christmas. When they have to be inside, during the winter or very bad weather, they are sheltered in open air barns with bedding. During the winter they eat silage that was cut from their own fields and stored on the farm. The farm has bird houses everywhere, especially up in the rafters of the barns. They are home to swallows and swifts that feast on the flies and keep the cows comfortable. There is also a fly vacuum that the cows walk through when the go to the milking parlor twice a day. It is a low, gentle suction that takes the flies off of their bellies.

The barn also has a full-body cow brush, which turns on when a cow rubs against it. They can use it whenever they want it. The ladies can come over for a full-body brush/massage when they are in the barn. Ross said that in the winter they even butt heads about getting a turn, so they put in 2 of them. In the spring when they are shedding there is a lot of hair left on the floor.

When the cows are in the barn for the winter, their waste moves into a concrete lagoon beside the barns. There was no mistaking that this was a dairy farm by the smell, but it was a clean rich odor, not a sickening manure smell. The lagoon is managed properly and the waste is spread over the fields in a thin layer 3 times per year to keep the nutrients in the cycle, worked back into the earth where the plants can take up the nitrogen and use it again in the growing cycle.

The milking parlor.

We also visited the milking parlor, a small clean room where they go twice per day. There is a heater on the ceiling for cold winter days, and large fans in the walls used in the warm summer. The cows get about 2 pounds of organic grain when they come in for milking, a mix of barley, oats, and corn. It’s a little “incentive” to come off the pasture. They don’t need the grain but it’s a treat, like “junk food” for cows. Ross told us that they like it and it gives them a little extra quick energy for making all of that milk. Nora really wanted to see how the milk and cream is put into the containers, but we will have to go to the creamery in Portland for that tour.

Nora and a 2-day old calf.

We can’t forget that cows have calves, which is the start of the whole milk-making process. There was a group of cows that were waiting to calve, the “dry cows” because they will not make milk until after they give birth and are not given hormones to increase or prolong milk production. When the calves are born, Juli Bansen becomes their caretaker. She sees that they get enough milk and food to grow. The males are sold to a nearby farm who raises them for beef, sold specially as Jersey beef to Portland restaurants. Jerseys are good at making milk, but their small frames are not the breed of choice for large cattle feeding operations. The Bansen’s special breed and organic production make them perfect for specialty beef. The females may be added to the herd or sold to other dairy farms.

Because they are an organic dairy, they may not use any antibiotics or hormones. If a cow gets sick and needs medicine they have to take her out of the herd and sell her to a conventional dairy. The Bansens said that after they switched to organic and gained experience, they almost never have a sick cow. All of the time spent on pasture and nearly 100% pasture fed means that the cows’ bodies are allowed to do what they are meant to do: ferment and break down green plants. They are out in the open and not exposed to excess waste or stress that will tax their immune systems. A happy cow is a healthy cow.

It was a pleasure to see the Bansen farm at work and listen to their experiences. It was clear that they take great pride in their dairy and the health of their animals. Their house was right next to the barns, surrounded by lush gardens lined with bird houses and a chicken run. A blue heron soared across the fields into a stand of trees while we were walking to the pasture. The calves were kept just steps from the front yard. They clearly enjoy their lifestyle and it makes a good living, so much that their oldest son is in the process of taking over the dairy so that his parents can retire. It is a special thing to see people love what they do, surrounded by healthy land and animals, both domestic and wild. It feels good to know that we are supporting their work by buying their milk and cream, which is in turn keeping Nora’s brain healthy and growing. We were there celebrating their success and we thank the Bansens and other Organic Valley farmers for giving us a healthy option for Nora that we can feel good about in every way.