April 29, 2024 • 18 mins
Unlock the secrets to safeguarding your child's neurological health with the brilliant Dr. Fernandes, a pediatric neurologist who brings the latest insights on the concerning rise in pediatric headaches since the dawn of the pandemic. It's more than just an episode; it's a journey into the complexities of a child's brain, where Dr. Fernandes unravels the impact of disrupted routines, excessive screen time, and the pivotal role of diet and sleep. As parents grapple with these challenges, our conversation steers toward practical advice on how to adapt and foster a healthier lifestyle for our youngest generation. Furthermore, we navigate through the intricacies of managing conditions like autism and seizures, emphasizing the importance of early diagnosis and strategies to improve medication adherence.
Prepare to be enlightened by the therapeutic potential of low glycemic index diets and various ketogenic diets, which serve as more than just meal plans but as a beacon of hope for children dealing with epilepsy and migraines. Dr. Fernandes and I dissect the importance of complex carbohydrates, the risks of processed sugars, and the tailored applications of each diet type. We stress the cruciality of professional guidance before embracing these specialized diets, ensuring your child's unique health needs are met safely. Concluding our dialog, the spotlight turns to sleep – the cornerstone of brain health in children – and the responsibility that falls on you, the parents, to arm yourselves with knowledge and advocacy when it comes to your child's healthcare journey. This episode is an invaluable resource for any parent seeking to champion their child's neurological well-being.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Hokehe Eko (00:00):
Hello everyone, welcome to another episode of
Brain Power with Dr.
Eko.
I have an amazing guest today,Dr.
Fernandes.
She's a pediatric neurologistand she is simply amazing.
So, without further ado,welcome to the podcast, Dr.
Fernandes.
Dr. Cecilia Fernandes (00:15):
Thank you , Dr.
Eko.
Thank you so much.
It's such a pleasure to be here.
Dr. Hokehe Eko (00:19):
Thank you.
So please tell our listenersall about the amazing work that
you do.
Dr. Cecilia Fernandes (00:24):
Yeah, I'm just going to introduce what I
do, because a lot of times whenyou say pediatric neurologist,
people are like what is that?
Did someone say urology?
So it's by instinct I like toget into.
You know what I do, what I do.
(00:47):
So we are child brain doctorsand most people don't understand
that children can actually havea lot of brain developmental
issues and the very commonthings I see are seizures,
headaches.
These days, headaches more thanseizures.
Actually, seizures used to be abig part of my clinic but since
the pandemic I've seen such ahuge rise in the number of
headaches and in all age groups,starting with small toddlers
(01:08):
all the way up to, you know,teenagers and older.
So I think that's a big part ofwhat I do.
Other than that, of course,developmental issues, like
developmental disease, you know,co-concurrent autism.
So we see a lot of childrenwith autism and seizures.
So it's a very interestingplace with a lot of multitude of
(01:29):
things we do and I love what Ido isn't that the key?
Dr. Hokehe Eko (01:32):
you better love what you do for sure, because if
you, you want to find somethingthat you can do, that doesn't
feel like work, and so that wayyou're giving your very best
right.
So I want to talk aboutsomething you said real quick.
You said that since thepandemic, you've seen headaches,
the rise of headaches inyounger and younger children.
(01:53):
So is there any research aroundwhy that's happening and, if
yes, what is it and what canparents do to help their kids?
Dr. Cecilia Fernandes (02:02):
Yeah, so that's very interesting that you
asked.
I think most of the researchleads us to one spot where you
know they were basicallydisconnected from their routine.
So a lot of times when you aredisrupted from your routine, you
don't get enough sleep, you'renot eating the right things,
you're snacking throughout theday.
So you know that forms thefoundation of everything to do
(02:23):
with brain health, which is diet, sleep.
And then throw into that, youknow, the fact that they were on
screens throughout the day.
Parents had to keep them onscreens, even to keep them
occupied, because they couldn'tleave the house, not having that
social structure, not beingable to play outside.
So all of those things arecontribution to you know, what
we are probably seeing right.
(02:44):
So, in addition to, of course,some of them have had COVID and
they've had the infection, sothere's some kind of, you know,
inflammatory component to it aswell.
But I think a large part of itis really disruption of routine
which leads to where we are, andso you know parents can really
help by getting their child backinto a routine.
(03:06):
Routine really helps childrenwhen they know, you know what
time they have to eat, what timethey have to sleep and sort of
getting them back in thatroutine is the first step to it
and decrease screen time.
Dr. Hokehe Eko (03:18):
Oh yes, believe it or not, the screen doesn't
teach your kids.
You teach your kids, and yourkids learn from using their
senses right, Not from watchingTV.
Dr. Cecilia Fernandes (03:28):
That is true, yeah.
Dr. Hokehe Eko (03:30):
And something else I wanted to ask about that
you mentioned.
You said you see a lot of kidswith seizures and with autism,
and I know that particularcombination can be really severe
and really give parents a lotof concern.
So let's talk some more aboutthat.
Dr. Cecilia Fernandes (03:48):
Yeah.
So firstly, it's very importantfor parents whose children have
autism to be able to one acceptthe diagnosis so that the child
can get the right care.
And I see a lot of parentsbecause, you know, when the
pediatrician has made thediagnosis of autism, oftentimes
they have questions and they'relike we want to see the brain
doctor and so when they come tous you know we don't have
(04:08):
anything else to offer becauseideally it's based off of
symptom science that thisdiagnosis of autism is.
And once you know a child has adiagnosis of autism, it's
really not a disease but it'sreally a type of behavior.
You know they are justdifferent in their type of
behavior so you have to handlethem in a specific way.
So we recommend, you know,getting them into behavioral
(04:30):
therapy sooner.
So having a diagnosis helpswith that.
Now, 30% of our children withautism have seizure disorder,
epilepsy.
And so it's very, very commonthat we have an overlap and in
our children with seizures, nowobviously they have difficulty
taking their seizure medicines.
So, you know, parents have tofind different loopholes, mixing
(04:51):
those medicines with, like youknow, liquids that they like.
I even had a parent like put itin a fruit loop, like their
medicine in a fruit loop, andmake them eat.
So it's very, very challenging,I would say, to have the
combination, and so, when wehave epilepsy, I think it's very
important for parents to knowthat there are different
modalities of treatment.
(05:12):
So most of us neurologists willtouch upon that.
One of them is medications, oneof them, you know, ketogenic
diet, and then, of course, themore advanced treatments are
surgery and devices.
Dr. Hokehe Eko (05:27):
Right, that's how it is Okay.
So usually by the time we seethe kids, the kids are already
on medication for seizures andthe parents are asking so what
else can I do with my child?
Or I've heard about theketogenic diet and I've heard
that it helps my child.
So how exactly am I going tostart a ketogenic diet in a
child that's a picky eater andalso has autism?
(05:52):
So you may or may not be ableto communicate why you're
changing the diet, and if theirdiet is already restricted, then
that's a whole nother barrier,right?
So walk us through what youwould say to a parent like that.
Dr. Cecilia Fernandes (06:06):
Yeah, so I think here it is based on how
severe the autism is.
If you have a child who's ahigh functioning autism, you can
actually work with them some,but if you have a child who is
more in the moderate or severecategory, then it becomes pretty
challenging because you have toknow what your child likes to
eat.
Most children with autism areeaters, so it becomes a little
difficult.
(06:27):
Now, ketogenic diet typicallyhas different types of
variations.
You would say so you have yourclassic ketogenic diet, which is
where you take up to 90-95% ofyour diet.
You take up to 90-95% of yourdiet is just fats.
Okay, now if your child lovesbutter, loves cream cheese,
loves heavy cream, bacon so ifyour child likes all this, then
(06:48):
you're in a good spot.
It's a win-win, because allthat is fatty, you know heavy
fatty foods.
Another option is you know,those children who are drinking
milk or who are younger.
We do have diet formulations sothat can be introduced.
But otherwise having anutritionist really helps
because they can help to matchwith your kids' diet some.
(07:10):
If that doesn't work, then youhave other variations where you
have low glycemic index, youknow treatment or LGIT diet, or
you have the modified Atkins,and that is just a variation of
the amount of carbohydrate.
So, like I said, you know whereketogenic, classic ketogenic
diet is like 90% fat, then youhave just 4% of carbohydrates
(07:32):
and rest is all protein.
The other diets you can allow alittle more carbohydrates, so
your amount is a little more,but you're still maintaining low
glucoses.
What I would recommend isworking with a provider, not
trying to do this on your ownbut, working with a provider or
a nutritionist to help you,because this will then move you
(07:53):
forward.
If you're looking at it as atreatment for seizures, don't
look at just diet as the soleand just stop all the medicines.
That doesn't help either.
It has to be a balance.
Everything in medicine is abouta balance, so we do want side
effects, but we want benefitsalso, right that's what I would
say absolutely and when.
Dr. Hokehe Eko (08:16):
When you say work with the provider, so for
me, I'm an integratedpediatrician and I do testing to
see what's really going on withthe child.
So so instead of just blindlyin the dark taking things out of
the diet or adding things in,you want to work with somebody
who can figure out is your childsensitive to something that
(08:39):
even could be the trigger forthe seizures?
And if that's the case, youwant to take that out while we
craft a personalized diet planfor your child.
So I'm glad you said that,because you definitely don't
want to stop the meds.
You want to do both at the sametime and then work with your
doctors to see if maybe the medscan be decreased, especially if
(09:01):
there are side effects.
Dr. Cecilia Fernandes (09:02):
Yeah, I think you bring up a very
important point you know withespecially children who have
chronic illnesses like epilepsy.
When we talk about medications,when we talk about that, you
know, always most of usproviders are open to discussion
before we move forward.
You know, and if you don't feelcomfortable, you don't trust
your physician.
You can always change and findsomebody that you feel you know
(09:24):
can trust you, that you feel youknow can trust you.
But definitely having adiscussion with your provider
because our knowledge base,where we are coming from and
wanting to provide this, is onlyfor the family.
You know we're not doing thisfor ourselves, we're really
doing it for the family.
So I'm glad you brought that up.
Dr. Hokehe Eko (09:38):
Yeah, yes, definitely.
So you mentioned low glycemic,and somebody might say what in
the world is that?
So can you explain what goeslow glycemic index, what?
What kinds of foods fall intothat category?
Dr. Cecilia Fernandes (09:53):
yeah, yeah, yeah.
So I think it's very.
It's also coming up as a youknow more of a fad now, a lot of
people doing this sort of lowglycemic.
So there are foods which don'tspike your glucose throughout,
you know, and they are morecomplex carbohydrates, really
easy things that we eat, thingsthat is in everybody's diet,
mostly starting with oatmeal inthe morning, doing you know sort
(10:16):
of rice or wheat in theafternoon.
But again, this is not we arenot talking about ketogenic, but
we're not talking about aspectof things, because there you're
going to cut down a lot on thecarbohydrates and you're going
to keep really fatty diet but atthe same time, bearing in mind
that these you're not givingintermittent bursts of sugar to
(10:36):
increase the amount of sugar inthe bloodstream, right?
So you're maintaining a certainamount of glucose in the
bloodstream and that isessentially that idea of low
glycemic index.
Where it gets messed up for alot of us is we end up eating so
much of processed sugar if youlook at all the cereals on the
store in the store, full ofprocessed sugar and you're
(10:58):
creating a huge spike in thebaby's blood, right, or the
child's blood, so spike ofglucose.
So it's very important for usto be mindful, to start getting
into that habit of reading thelabels, checking the amount of
sugars there are.
I just started doing that a fewyears ago and I'm so surprised
I'm yet to find a good granolawith low amount of sugar.
(11:20):
Hey, you can make it yourself.
Dr. Hokehe Eko (11:23):
I know, I have started doing that.
I know Me too.
Same thing happens to me.
I said I read the names, I waslike, wait did I just see
fructose at the top and thencorn syrup.
So now they're splittinginstead of high fructose corn
syrup.
Now everybody says, don't do it.
So now you see fructose andthen corn syrup in the other end
.
Dr. Cecilia Fernandes (11:43):
You're like, oh wait yeah, these are
all those marketing strategies,and and and.
When you start getting educatedabout this which is, you know,
the goal of much of what we doin terms of your podcast as well
, I feel like so phenomenalwhere you've been giving these
to, it's all really good.
Dr. Hokehe Eko (12:02):
So you mentioned that there are several kinds of
ketogenic diet, right,depending on the child.
How do you which diet goes withwhich child?
Yeah, I know we can be here foranother hour discussing how we
determine that, but just as abroad overview, what parents
here are curious about.
Okay, so now you just mentionedthree things.
How do we determine which oneis which?
(12:24):
And again, as I'm asking thatquestion, I'm reminding parents
remember she said you need towork with somebody who knows
what they're actually doing.
But just so that you can have adiscussion with your provider,
go ahead yeah, so there.
Dr. Cecilia Fernandes (12:39):
So when you have epilepsy, ideally the
classic ketogenic diet is whatyou need, because classic
ketogenic diet is a treatment.
You're basically forcing thebody to think it is in
starvation okay, and when yourbody goes into starvation it
conserves all that energy and itreduces that hyper excitability
(13:03):
which is happening in right.
So basically, how I like totell families is you're moving
your fuel for your brain frombeing glucose to being ketones,
or ketones are a byproduct offat for everybody to understand.
So basically you're moving thatfuel.
You know, like in your, in yourcar, your petrol diesel, so you
(13:23):
change the fuel.
So it's just like you changethe fuel of your brain to
ketones.
So children with seizures,typically, a good, strong,
ketogenic diet would be very,very helpful.
Now there you have to bemonitored, you have to be
admitted.
It's good to have your epilepsydoctor, neurology, your
integrative medicine doctor.
You know everybody workingtogether, your nutritionist, so
(13:45):
sort of everybody needs to worktogether.
We check labs very often andnot everybody meets criteria to
start ketogenic diet becausethere are some bodies which
don't have the right chemicalsto break down fat.
So in those bodies they cannotbe put through a ketogenic diet.
Their body is going to startbreaking down.
So we have to be very carefulwith the type of children that
(14:07):
start diet.
Then the other aspect is the lowglycemic index or modified
Atkins diet.
Now, that can be.
You can work with yournutritionist and your primary
care provider to actuallyimplement that.
You don't need lab work forthat.
You don't need to follow labsfor that as such in terms of
monitoring.
But classic ketogenic dietdefinitely so.
(14:28):
Classic ketogenic is forepilepsy.
The others are helpful inchildren who have migraines and
you're trying to move towardsyou know more of a headache
management.
Then you could use agluten-free diet you can use,
you know, anti-inflammatory diet, which is like Mediterranean
Indian food.
You know African food has a lotof anti-inflammatory components
(14:49):
to it and lastly, you knowmodified diet.
Dr. Hokehe Eko (14:54):
Okay, wonderful.
Thank you for explaining thatfor parents so they have some
idea when they're having thediscussion with their providers.
Because it's good for us, it'sgood for parents to be informed
about the discussions, and Ialways tell parents if you don't
understand, ask them to explainit to you.
Don't just accept whatever theysay if you don't understand
(15:15):
what they're saying.
So, and don't be afraid to dothat, because you're your
child's first and best advocate.
So, speak up and ask when youhave to go see, like the
neurologist or any specialistyou're seeing, especially if
your child has both seizures andautism together.
So thank you for all thatyou've shared.
(15:36):
Do you have any last tips onany last brain health tips for
our kids?
Dr. Cecilia Fernandes (15:44):
Sure, sure yeah.
So, I think you know, withchildren definitely sleep.
I would say sleep is so, soimportant.
So you know, if parents canwork with their children on
making sure that they get atleast eight to nine hours of
rest, it really helps the brainwith development.
It helps the brain with justclearing all that debris and it
(16:05):
prevents future diseases likeAlzheimer's disease, parkinson's
.
We're seeing a lot ofcorrelation with lack of sleep.
So sleep for both parents andtheir children is very important
.
Dr. Hokehe Eko (16:15):
Yes, I like that .
You made that last point, thatyou're saying there's a
correlation between lack ofsleep and Alzheimer's, and
parents we may think, okay,we're young, alzheimer's is down
the road, but there's so muchevidence to show that it
actually starts in our earlylike, with the habits we have
and they're not sleeping and allof that, and I know that's a
(16:37):
whole nother topic.
Dr. Cecilia Fernandes (16:38):
But yes, stay tuned for that prevention
is better than cure, correct?
Yeah?
Dr. Hokehe Eko (16:44):
no, so parents, don't put it off.
It's important for you to dowhat you need to do to enhance
your sleep as well as your child.
So thank you.
You so much again, Dr.
Fernandes, and before we go,can you tell the listeners where
they can find you?
Dr. Cecilia Fernandes (17:02):
Yeah, so please do share my link.
I'm ceci_fern on Instagram.
I practice in Atrium Health inCharlotte, North Carolina, so
you can find me there and I'mhappy to take care of your kid.
Dr. Hokehe Eko (17:18):
Yes, wonderful.
Yes, please go see her ifyou're in the state of North
Carolina, in Charlotte.
So thank you again, and pleaseshare this episode with any
members of family of your familyor friends that need to hear
about this.
So have an amazing day.
Until the next episode, takecare.
Hello everyone, welcome to another episode of
Brain Power with Dr.
Eko.
I have an amazing guest today,Dr.
Fernandes.
She's a pediatric neurologistand she is simply amazing.
So, without further ado,welcome to the podcast, Dr.
Fernandes.
Dr. Cecilia Fernandes (00:15):
Thank you , Dr.
Eko.
Thank you so much.
It's such a pleasure to be here.
Dr. Hokehe Eko (00:19):
Thank you.
So please tell our listenersall about the amazing work that
you do.
Dr. Cecilia Fernandes (00:24):
Yeah, I'm just going to introduce what I
do, because a lot of times whenyou say pediatric neurologist,
people are like what is that?
Did someone say urology?
So it's by instinct I like toget into.
You know what I do, what I do.
(00:47):
So we are child brain doctorsand most people don't understand
that children can actually havea lot of brain developmental
issues and the very commonthings I see are seizures,
headaches.
These days, headaches more thanseizures.
Actually, seizures used to be abig part of my clinic but since
the pandemic I've seen such ahuge rise in the number of
headaches and in all age groups,starting with small toddlers
(01:08):
all the way up to, you know,teenagers and older.
So I think that's a big part ofwhat I do.
Other than that, of course,developmental issues, like
developmental disease, you know,co-concurrent autism.
So we see a lot of childrenwith autism and seizures.
So it's a very interestingplace with a lot of multitude of
(01:29):
things we do and I love what Ido isn't that the key?
Dr. Hokehe Eko (01:32):
you better love what you do for sure, because if
you, you want to find somethingthat you can do, that doesn't
feel like work, and so that wayyou're giving your very best
right.
So I want to talk aboutsomething you said real quick.
You said that since thepandemic, you've seen headaches,
the rise of headaches inyounger and younger children.
(01:53):
So is there any research aroundwhy that's happening and, if
yes, what is it and what canparents do to help their kids?
Dr. Cecilia Fernandes (02:02):
Yeah, so that's very interesting that you
asked.
I think most of the researchleads us to one spot where you
know they were basicallydisconnected from their routine.
So a lot of times when you aredisrupted from your routine, you
don't get enough sleep, you'renot eating the right things,
you're snacking throughout theday.
So you know that forms thefoundation of everything to do
(02:23):
with brain health, which is diet, sleep.
And then throw into that, youknow, the fact that they were on
screens throughout the day.
Parents had to keep them onscreens, even to keep them
occupied, because they couldn'tleave the house, not having that
social structure, not beingable to play outside.
So all of those things arecontribution to you know, what
we are probably seeing right.
(02:44):
So, in addition to, of course,some of them have had COVID and
they've had the infection, sothere's some kind of, you know,
inflammatory component to it aswell.
But I think a large part of itis really disruption of routine
which leads to where we are, andso you know parents can really
help by getting their child backinto a routine.
(03:06):
Routine really helps childrenwhen they know, you know what
time they have to eat, what timethey have to sleep and sort of
getting them back in thatroutine is the first step to it
and decrease screen time.
Dr. Hokehe Eko (03:18):
Oh yes, believe it or not, the screen doesn't
teach your kids.
You teach your kids, and yourkids learn from using their
senses right, Not from watchingTV.
Dr. Cecilia Fernandes (03:28):
That is true, yeah.
Dr. Hokehe Eko (03:30):
And something else I wanted to ask about that
you mentioned.
You said you see a lot of kidswith seizures and with autism,
and I know that particularcombination can be really severe
and really give parents a lotof concern.
So let's talk some more aboutthat.
Dr. Cecilia Fernandes (03:48):
Yeah.
So firstly, it's very importantfor parents whose children have
autism to be able to one acceptthe diagnosis so that the child
can get the right care.
And I see a lot of parentsbecause, you know, when the
pediatrician has made thediagnosis of autism, oftentimes
they have questions and they'relike we want to see the brain
doctor and so when they come tous you know we don't have
(04:08):
anything else to offer becauseideally it's based off of
symptom science that thisdiagnosis of autism is.
And once you know a child has adiagnosis of autism, it's
really not a disease but it'sreally a type of behavior.
You know they are justdifferent in their type of
behavior so you have to handlethem in a specific way.
So we recommend, you know,getting them into behavioral
(04:30):
therapy sooner.
So having a diagnosis helpswith that.
Now, 30% of our children withautism have seizure disorder,
epilepsy.
And so it's very, very commonthat we have an overlap and in
our children with seizures, nowobviously they have difficulty
taking their seizure medicines.
So, you know, parents have tofind different loopholes, mixing
(04:51):
those medicines with, like youknow, liquids that they like.
I even had a parent like put itin a fruit loop, like their
medicine in a fruit loop, andmake them eat.
So it's very, very challenging,I would say, to have the
combination, and so, when wehave epilepsy, I think it's very
important for parents to knowthat there are different
modalities of treatment.
(05:12):
So most of us neurologists willtouch upon that.
One of them is medications, oneof them, you know, ketogenic
diet, and then, of course, themore advanced treatments are
surgery and devices.
Dr. Hokehe Eko (05:27):
Right, that's how it is Okay.
So usually by the time we seethe kids, the kids are already
on medication for seizures andthe parents are asking so what
else can I do with my child?
Or I've heard about theketogenic diet and I've heard
that it helps my child.
So how exactly am I going tostart a ketogenic diet in a
child that's a picky eater andalso has autism?
(05:52):
So you may or may not be ableto communicate why you're
changing the diet, and if theirdiet is already restricted, then
that's a whole nother barrier,right?
So walk us through what youwould say to a parent like that.
Dr. Cecilia Fernandes (06:06):
Yeah, so I think here it is based on how
severe the autism is.
If you have a child who's ahigh functioning autism, you can
actually work with them some,but if you have a child who is
more in the moderate or severecategory, then it becomes pretty
challenging because you have toknow what your child likes to
eat.
Most children with autism areeaters, so it becomes a little
difficult.
(06:27):
Now, ketogenic diet typicallyhas different types of
variations.
You would say so you have yourclassic ketogenic diet, which is
where you take up to 90-95% ofyour diet.
You take up to 90-95% of yourdiet is just fats.
Okay, now if your child lovesbutter, loves cream cheese,
loves heavy cream, bacon so ifyour child likes all this, then
(06:48):
you're in a good spot.
It's a win-win, because allthat is fatty, you know heavy
fatty foods.
Another option is you know,those children who are drinking
milk or who are younger.
We do have diet formulations sothat can be introduced.
But otherwise having anutritionist really helps
because they can help to matchwith your kids' diet some.
(07:10):
If that doesn't work, then youhave other variations where you
have low glycemic index, youknow treatment or LGIT diet, or
you have the modified Atkins,and that is just a variation of
the amount of carbohydrate.
So, like I said, you know whereketogenic, classic ketogenic
diet is like 90% fat, then youhave just 4% of carbohydrates
(07:32):
and rest is all protein.
The other diets you can allow alittle more carbohydrates, so
your amount is a little more,but you're still maintaining low
glucoses.
What I would recommend isworking with a provider, not
trying to do this on your ownbut, working with a provider or
a nutritionist to help you,because this will then move you
(07:53):
forward.
If you're looking at it as atreatment for seizures, don't
look at just diet as the soleand just stop all the medicines.
That doesn't help either.
It has to be a balance.
Everything in medicine is abouta balance, so we do want side
effects, but we want benefitsalso, right that's what I would
say absolutely and when.
Dr. Hokehe Eko (08:16):
When you say work with the provider, so for
me, I'm an integratedpediatrician and I do testing to
see what's really going on withthe child.
So so instead of just blindlyin the dark taking things out of
the diet or adding things in,you want to work with somebody
who can figure out is your childsensitive to something that
(08:39):
even could be the trigger forthe seizures?
And if that's the case, youwant to take that out while we
craft a personalized diet planfor your child.
So I'm glad you said that,because you definitely don't
want to stop the meds.
You want to do both at the sametime and then work with your
doctors to see if maybe the medscan be decreased, especially if
(09:01):
there are side effects.
Dr. Cecilia Fernandes (09:02):
Yeah, I think you bring up a very
important point you know withespecially children who have
chronic illnesses like epilepsy.
When we talk about medications,when we talk about that, you
know, always most of usproviders are open to discussion
before we move forward.
You know, and if you don't feelcomfortable, you don't trust
your physician.
You can always change and findsomebody that you feel you know
(09:24):
can trust you, that you feel youknow can trust you.
But definitely having adiscussion with your provider
because our knowledge base,where we are coming from and
wanting to provide this, is onlyfor the family.
You know we're not doing thisfor ourselves, we're really
doing it for the family.
So I'm glad you brought that up.
Dr. Hokehe Eko (09:38):
Yeah, yes, definitely.
So you mentioned low glycemic,and somebody might say what in
the world is that?
So can you explain what goeslow glycemic index, what?
What kinds of foods fall intothat category?
Dr. Cecilia Fernandes (09:53):
yeah, yeah, yeah.
So I think it's very.
It's also coming up as a youknow more of a fad now, a lot of
people doing this sort of lowglycemic.
So there are foods which don'tspike your glucose throughout,
you know, and they are morecomplex carbohydrates, really
easy things that we eat, thingsthat is in everybody's diet,
mostly starting with oatmeal inthe morning, doing you know sort
(10:16):
of rice or wheat in theafternoon.
But again, this is not we arenot talking about ketogenic, but
we're not talking about aspectof things, because there you're
going to cut down a lot on thecarbohydrates and you're going
to keep really fatty diet but atthe same time, bearing in mind
that these you're not givingintermittent bursts of sugar to
(10:36):
increase the amount of sugar inthe bloodstream, right?
So you're maintaining a certainamount of glucose in the
bloodstream and that isessentially that idea of low
glycemic index.
Where it gets messed up for alot of us is we end up eating so
much of processed sugar if youlook at all the cereals on the
store in the store, full ofprocessed sugar and you're
(10:58):
creating a huge spike in thebaby's blood, right, or the
child's blood, so spike ofglucose.
So it's very important for usto be mindful, to start getting
into that habit of reading thelabels, checking the amount of
sugars there are.
I just started doing that a fewyears ago and I'm so surprised
I'm yet to find a good granolawith low amount of sugar.
(11:20):
Hey, you can make it yourself.
Dr. Hokehe Eko (11:23):
I know, I have started doing that.
I know Me too.
Same thing happens to me.
I said I read the names, I waslike, wait did I just see
fructose at the top and thencorn syrup.
So now they're splittinginstead of high fructose corn
syrup.
Now everybody says, don't do it.
So now you see fructose andthen corn syrup in the other end
.
Dr. Cecilia Fernandes (11:43):
You're like, oh wait yeah, these are
all those marketing strategies,and and and.
When you start getting educatedabout this which is, you know,
the goal of much of what we doin terms of your podcast as well
, I feel like so phenomenalwhere you've been giving these
to, it's all really good.
Dr. Hokehe Eko (12:02):
So you mentioned that there are several kinds of
ketogenic diet, right,depending on the child.
How do you which diet goes withwhich child?
Yeah, I know we can be here foranother hour discussing how we
determine that, but just as abroad overview, what parents
here are curious about.
Okay, so now you just mentionedthree things.
How do we determine which oneis which?
(12:24):
And again, as I'm asking thatquestion, I'm reminding parents
remember she said you need towork with somebody who knows
what they're actually doing.
But just so that you can have adiscussion with your provider,
go ahead yeah, so there.
Dr. Cecilia Fernandes (12:39):
So when you have epilepsy, ideally the
classic ketogenic diet is whatyou need, because classic
ketogenic diet is a treatment.
You're basically forcing thebody to think it is in
starvation okay, and when yourbody goes into starvation it
conserves all that energy and itreduces that hyper excitability
(13:03):
which is happening in right.
So basically, how I like totell families is you're moving
your fuel for your brain frombeing glucose to being ketones,
or ketones are a byproduct offat for everybody to understand.
So basically you're moving thatfuel.
You know, like in your, in yourcar, your petrol diesel, so you
(13:23):
change the fuel.
So it's just like you changethe fuel of your brain to
ketones.
So children with seizures,typically, a good, strong,
ketogenic diet would be very,very helpful.
Now there you have to bemonitored, you have to be
admitted.
It's good to have your epilepsydoctor, neurology, your
integrative medicine doctor.
You know everybody workingtogether, your nutritionist, so
(13:45):
sort of everybody needs to worktogether.
We check labs very often andnot everybody meets criteria to
start ketogenic diet becausethere are some bodies which
don't have the right chemicalsto break down fat.
So in those bodies they cannotbe put through a ketogenic diet.
Their body is going to startbreaking down.
So we have to be very carefulwith the type of children that
(14:07):
start diet.
Then the other aspect is the lowglycemic index or modified
Atkins diet.
Now, that can be.
You can work with yournutritionist and your primary
care provider to actuallyimplement that.
You don't need lab work forthat.
You don't need to follow labsfor that as such in terms of
monitoring.
But classic ketogenic dietdefinitely so.
(14:28):
Classic ketogenic is forepilepsy.
The others are helpful inchildren who have migraines and
you're trying to move towardsyou know more of a headache
management.
Then you could use agluten-free diet you can use,
you know, anti-inflammatory diet, which is like Mediterranean
Indian food.
You know African food has a lotof anti-inflammatory components
(14:49):
to it and lastly, you knowmodified diet.
Dr. Hokehe Eko (14:54):
Okay, wonderful.
Thank you for explaining thatfor parents so they have some
idea when they're having thediscussion with their providers.
Because it's good for us, it'sgood for parents to be informed
about the discussions, and Ialways tell parents if you don't
understand, ask them to explainit to you.
Don't just accept whatever theysay if you don't understand
(15:15):
what they're saying.
So, and don't be afraid to dothat, because you're your
child's first and best advocate.
So, speak up and ask when youhave to go see, like the
neurologist or any specialistyou're seeing, especially if
your child has both seizures andautism together.
So thank you for all thatyou've shared.
(15:36):
Do you have any last tips onany last brain health tips for
our kids?
Dr. Cecilia Fernandes (15:44):
Sure, sure yeah.
So, I think you know, withchildren definitely sleep.
I would say sleep is so, soimportant.
So you know, if parents canwork with their children on
making sure that they get atleast eight to nine hours of
rest, it really helps the brainwith development.
It helps the brain with justclearing all that debris and it
(16:05):
prevents future diseases likeAlzheimer's disease, parkinson's
.
We're seeing a lot ofcorrelation with lack of sleep.
So sleep for both parents andtheir children is very important
.
Dr. Hokehe Eko (16:15):
Yes, I like that .
You made that last point, thatyou're saying there's a
correlation between lack ofsleep and Alzheimer's, and
parents we may think, okay,we're young, alzheimer's is down
the road, but there's so muchevidence to show that it
actually starts in our earlylike, with the habits we have
and they're not sleeping and allof that, and I know that's a
(16:37):
whole nother topic.
Dr. Cecilia Fernandes (16:38):
But yes, stay tuned for that prevention
is better than cure, correct?
Yeah?
Dr. Hokehe Eko (16:44):
no, so parents, don't put it off.
It's important for you to dowhat you need to do to enhance
your sleep as well as your child.
So thank you.
You so much again, Dr.
Fernandes, and before we go,can you tell the listeners where
they can find you?
Dr. Cecilia Fernandes (17:02):
Yeah, so please do share my link.
I'm ceci_fern on Instagram.
I practice in Atrium Health inCharlotte, North Carolina, so
you can find me there and I'mhappy to take care of your kid.
Dr. Hokehe Eko (17:18):
Yes, wonderful.
Yes, please go see her ifyou're in the state of North
Carolina, in Charlotte.
So thank you again, and pleaseshare this episode with any
members of family of your familyor friends that need to hear
about this.
So have an amazing day.
Until the next episode, takecare.
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