I hope you have been enjoying this series and have already taken the first step and added MCT oil to your routine (Step 1, Guide to Step 1, and taking MCT oil to the MAX). I would love to hear from you and see how you are doing so please feel free to email me at madcapnarcolepsy@gmail.com or comment on the posts.  (If you are new to this series please check out the very first post here otherwise you are going to be so, so lost in this post, eek!) If you have integrated MCT oil into your routine it’s now time to get down to the nitty gritty of the big changes to your diet so put on your seatbelt and get ready for the ride! If you will recall from the introduction to this diet, I am taking you down a path toward carbohydrate reduction because our orexin/hypocretin is extremely sensitive to carbs (see part 1 and 2 on the Science-y tab if you need background on this).  But I’m NOT taking you down the path to the full on ketogenic diet.  This is because 1) the ketogenic diet is a hard diet to wrap your head around and right now you may be just too sleepy to do it, and 2) MOST of the folks I work with don’t have to go that drastic to get some really great symptom management. In this post I’m going to detail to you the route I take with my clients to get carbohydrate intake reduced.  The Madcap Route.  My family and I have succeeded and failed at diet for narcolepsy for about 7 years now.  We are fully aware of how difficult dieting is.  BUT we have spent the last 7 years making it narcolepsy friendly.  We put in this effort because, darn it, the diet works and is worth doing.  In order to stay on the diet and reap its benefits we HAD to find a way to make it sustainable and EASY… narcolepsy easy.  By this I mean that each step of this diet has been broken down into bits that are easy to understand, easy to integrate, and easy to build on.  We have cut corners everywhere possible so that we get the core benefit without the extreme focus and exhausting effort.  I call this the Madcap Route. “Madcap?”  Wha-huh?  Check it… My nickname has been Madcap Miss since before I can remember.  It’s because I’m always coming at things in zany, eccentric, and unconventional ways.  ALWAYS.  I’m no different in my approach to diet changes.  If going from A to Z won’t work for me who says I can’t go from B to X to O to A, etc., etc.?  If it works, why not?!  So that is exactly what I did with the ketogenic diet.  I flipped it on its ear and broke it down into the steps that would impact people with narcolepsy the most without having to make the sweeping changes the full on ketogenic diet requires. So what’s the plan on the Madcap Route?  What’s the B to X to O to A, etc., etc. route to getting more wakefulness, energy, and mental clarity?  Right off the bat we talked about getting you thinking more clearly and getting you a tad more energy via the MCT’s.  And though that is a great first step, it is not enough.  Now you knew that at some point you would need to actually make some dietary changes, right?  It’s a hard fact that what we eat affects our symptoms.  But change, especially sweeping change, is hard.  That’s why the Madcap Route is a process eases you into making changes without all the heartache of yanking all of your favorite foods from your menu all at once. The heart of the Madcap Route is the 3 R’s:

REPLACE REDUCE REMOVE

REPLACE – In this step I educate you on which foods are good and which foods are bad.  Then I teach you how to find yummy REPLACEments for the “bad” ones.  In this stage, you can still eat the bad versions but you will eventually find a REPLACEment for all of them. REDUCE – Once you have found some yummy REPLACEments, you can begin to REDUCE your intake of the bad versions and instead eat the yummy, good versions.  The good news is that when you have been finding REPLACEments you are naturally nudging the bad versions off your plate and have already begun this step before actually having to enforce it. REMOVE – Here is where you buck up and get rid of the bad versions altogether.  Buck up Buttercup!  But see, there’s a secret here… you have already REDUCED your consumption of these so it is WAY WAY WAY easier to take this final step where you REMOVE them. Each step of the 3R’s will get you higher levels of energy and wakefulness, and less brain fog throughout the day.  But if we applied the 3R’s to everything you eat all at once that is still too much change so… we break it down even further into food groups that work well together when making changes.  You will apply the 3R’s to each food group and won’t move on to the next one till you are a master in the current group.  By the time you get to the last food group you will be a mega pro at this and it will be super easy.  The groups are broken down as follows:

• Protein and Dairy
• Veggies and Fruit
• Beverages and Alcohol
• Snacks and Desserts
• Corn and Potatoes
• Misc. Grains, Rice, and Beans
• Breads and Pasta

I start with the easier groups and then move down to the more difficult groups.  The secret magic here is that by the time you get to the harder ones it will be so much easier because you are used to the process and in making changes to the easy ones you will naturally be making a few changes to the harder ones.  For instance, removing corn and potatoes/breads and pastas sound so HARD.  But in the earlier steps you are adding in some really healthy foods that will crowd out the harder items.  Eat the good ones first, and there isn’t much room for the bad ones.  MAGIC! Next week I will drill down on the 3 R’s as this applies to Protein and Dairy.  But till then, here is your HOMEWORK.  Yeah, homework because I’m teaching this to you and not doing it for you.

1. Each time you eat a protein or dairy item this week I want you to look on the package for the carbohydrate amount.  If it is more than 5g of carbohydrates per serving it is a HIGH carb item that you will need to eventually remove from your diet. Another way to look at the carb count is via tracker like MyFitnessPal.  This is an app and is also available as a website so you can check out the carbs anywhere you happen to be.  Don’t get caught going down the rabbit hole and think you have to be super exact in this tracker.  Just find something similar in the search function and check it out.  TRACKING is NOT something we do in this diet because it is tedious and will consume energy that I want you to put toward LIVING.  This is just a starter to help you see what and where carbs are in your current diet.
2. When you see that the item needs to eventually be removed, go to Google and search “Keto <insert protein/dairy item here> and see what pops up as a REPLACEMENT for what you are eating.  This is just to get you seeing what your future options are and that you will not have to forgo eating yummy foods.  I swear that there is a keto/carb friendly replacement for practically everything you currently eat.
3. When you eat your carb-y protein or dairy item, set a timer for 30 mins.  When the timer goes off, make a note of how you feel.  Rate your sleepiness from 1-10 with 10 being the worst/sleepiest.

When you do this homework assignment, you are going to begin to recognize what items you currently eat that will eventually go away, you will have an awareness of some of the narcolepsy friendly items that are out there that will eventually replace the carb-y ones, AND you will begin to make the connection between your sleepiness and what you eat. That is IT y’all.  Just a little bit of homework but not too bad, right?  AWARENESS is the key to this homework assignment.  Next week we will initiate change so I hope you come back and join me. Next WEEK?!  I know, this seems super slow and you want some fast results.  But I need you to do these things in the order I lay them out, I wouldn’t steer you wrong.  I promise that you can go faster once we initiate the actual changes next week.  IF you feel up to it, go ahead and start making some of those REPLACEMENTS you find on Google.  Up to you but don’t feel pressured. AND don’t forget to keep building up your MCT oil intake to the full 2 tablespoons per day! Till next time, Your Madcap Miss (a.k.a. Gina Dennis) *For a deeper dive into the science behind this diet, check out my 2016 presentation at the Narcolepsy Network Conference (video) OR read Posts 1, 2, and 3 in the 30,000 Foot View Science-y Series. **For an overview of all the steps in the Diet for Narcolepsy you can check out my presentation at the 2017 Narcolepsy Network Conference. Intro to this series is here:  Introducing the Madcap Diet for Narcolepsy MCT instructions are here:  MCT Oil:  The PWN’s High Octane Fuel Source (Step 1), Guide to Getting Started with MCT Oil, and MCT Oil to the MAX. BE SURE TO CHECK OUT THE NEXT POST IN THIS SERIES:  Working the 3 R’s on PROTEIN & DAIRY Let me be totally up front here…I AM NOT A DOCTOR, nor am I a nutritionist, I only have a tiny amount of formal training in such things as a Health Coach.  But I am a person with narcolepsy who uses dietary and lifestyle changes to mitigate my narcolepsy symptoms.  I’ve been experimenting with these changes since July 2011 and have successfully maintained a high level of narcolepsy symptom management since that date.  And so has my family with narcolepsy.   This website contains our personal stories, failures, and experiments.  In this website I will share with you the information that I have found most credible and some practical ideas for mitigating narcolepsy symptoms.  I beg you to check with your doctor before initiating any of the dietary changes I speak of, especially if you are taking any medications. Madcap Disclaimer