Over the next four years, Mark's metabolism was controlled by giving him an extremely regimented low protein diet. His staple was potatoes, which he enjoyed with ketchup. He was not able to eat meat, dairy, or poultry products. Unlike most kids, Mark never ate traditional birthday cake or ice cream. Despite the family’s strict adherence to this strict diet, Mark continued to suffer approximately three metabolic crises a year. These crises occurred when amino acids accumulated in his blood leading to the swelling of his brain. Even something as simple as a cold or the flu affected his amino acid levels and sent his metabolism into crisis. “We cannot continue to live in constant fear that a minor infection or a simple cold or ear infection could kill our son. Even though we are doing everything we are supposed to, he is still getting sick and we are afraid we may lose Mark,” Emily said as she dried her tears. “When I think about how we lost our first child and I see other parents of kids with this disease grieving over the loss of their child, I’m so afraid of losing Mark. I do not want to watch him become brain damaged or dead because of a simple sore throat or even having just one too many french fries.” Jack agreed. “We know that some children with this disease have had a liver transplant and they are effectively cured. But that is major surgery and he is so small and frail. Would he survive the surgery? On the other hand, the alternative for my son is a life of uncertainty that could end in death at any moment.” The family was directed by Dr. Martin to Children’s Hospital of Pittsburgh, where transplant experts agreed to list Mark for a liver transplant. Jack and Emily learned that children who received a liver transplant would have to take strong immunosuppressive drugs for the rest of their lives. It was also clear there was a 40% possibility that Mark could reject the liver and need a second transplant (which also might be rejected) or he could die from surgical complications. Jack and Emily had to decide what to do. **What options do Jack and Emily have for the care of Mark? What are the pros and cons of each choice?

Ebk:Nutrition & Diet Therapy
10th Edition
ISBN:9780357391747
Author:DEBRUYNE
Publisher:DEBRUYNE
Chapter6: Metabolism, Energy Balance, And Body Composition
Section: Chapter Questions
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Over the next four years, Mark's metabolism was controlled by giving him an extremely regimented low protein diet. His staple was potatoes, which he enjoyed with ketchup. He was not able to eat meat, dairy, or poultry products. Unlike most kids, Mark never ate traditional birthday cake or ice cream.

Despite the family’s strict adherence to this strict diet, Mark continued to suffer approximately three metabolic crises a year. These crises occurred when amino acids accumulated in his blood leading to the swelling of his brain. Even something as simple as a cold or the flu affected his amino acid levels and sent his metabolism into crisis.

“We cannot continue to live in constant fear that a minor infection or a simple cold or ear infection could kill our son. Even though we are doing everything we are supposed to, he is still getting sick and we are afraid we may lose Mark,” Emily said as she dried her tears. “When I think about how we lost our first child and I see other parents of kids with this disease grieving over the loss of their child, I’m so afraid of losing Mark. I do not want to watch him become brain damaged or dead because of a simple sore throat or even having just one too many french fries.”

Jack agreed. “We know that some children with this disease have had a liver transplant and they are effectively cured. But that is major surgery and he is so small and frail. Would he survive the surgery? On the other hand, the alternative for my son is a life of uncertainty that could end in death at any moment.”

The family was directed by Dr. Martin to Children’s Hospital of Pittsburgh, where transplant experts agreed to list Mark for a liver transplant.

Jack and Emily learned that children who received a liver transplant would have to take strong immunosuppressive drugs for the rest of their lives. It was also clear there was a 40% possibility that Mark could reject the liver and need a second transplant (which also might be rejected) or he could die from surgical complications.

Jack and Emily had to decide what to do.

**What options do Jack and Emily have for the care of Mark? What are the pros and cons of each choice?**

 
 
 
 
 
 
 
 



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