Sunday, July 8, 2012

Making Progress

While we’ve spent most of the week under a terrible heat wave, we have made good progress with Alex. Last weekend, a doctor diagnosed him with a yeast infection of the skin and gave us oral and topical antifungals to treat the condition. Knowing Alex’s past history with yeast infections, however, we suspected that he likely had the yeast overgrowth internally, as well. After his initial dose of Diflucan, we began seeing curd-like substances in his mouth and nose, a sure sign that yeast had invaded his digestive system and perhaps other organs, too.  In the wee hours of Monday morning, we heard him coughing and discovered that he was coughing up more of the curdy yeast, a necessary step to his healing. On the bright side, the yeast rash on his face responded well to the topical cream and began to disappear. Fortunately, the doctor had told us that his condition is not contagious, so we didn’t have to worry about his spreading it to other people.

On Monday, we went again to visit the day program where we want to enroll Alex and met with our intake coordinator and the facility director. When we arrived, all of the staff and clients were outside, despite the intense early afternoon heat. Our intake coordinator immediately came to tell us that the smoke detectors had gone off, forcing everyone to evacuate the building until they could establish that no fire risk existed.  Once the source of the smoke that set off the alarm—an art project that involved melting crayons with a hair dryer—was established, everyone was allowed back into the building. Guided by the school’s friendly director, Alex toured the building for the second time, trying out Wii bowling, scanning through a set of encyclopedias that caught his attention, and checking out the touch screen computers he found intriguing. Seeing him engaged in the various activities and comfortable in that setting makes us hopeful that he will be able to participate in the day program soon.

On Tuesday, we took him to a psychologist to begin behavioral assessment as part of his enrollment for the day program. Prior to our appointment, I had completed nine pages of forms regarding Alex’s health and development, going back to the womb. Although we explained that we were convinced Alex’s diagnosis of autism was correct, the psychologist had me complete an autism rating scale as well as one for attention deficit disorder. As I was completing those forms, Ed had to ask Alex 370 questions for a personality inventory. While Alex was patient and compliant to answer all of these true/false questions, we suspect that he didn’t understand what some of the questions were asking, such as “Is your sex life fulfilling?” or “Do you get embarrassed when someone tells a dirty joke?” The inventory also asked, “Do you love your mother?” and “Is your mother a good woman?” Since he answered both of these questions in the affirmative, I’m hoping that he did understand those questions and was being truthful. After we completed the assigned tasks, the psychologist wanted us to come back on Friday for more assessments.

Since Wednesday was the Fourth of July holiday, we had no appointments scheduled and just enjoyed a quiet day at home relaxing.  Even though people in our neighborhood were setting off loud fireworks throughout the day, Alex seemed unfazed by the noise and never became agitated. In fact, we had noticed that every day since he took the Diflucan on Saturday, his behavior seemed to be improving as he became calmer, more pleasant, more alert, and better natured. A quick review of my books and some online research showed that yeast overgrowth can cause behavioral issues in autism, including agitation and aggression. As Alex’s physical symptoms improved this week, his behavior improved, too, giving us hope that addressing his yeast overgrowth could help him return to his calm and pleasant self.

On Thursday, we had an appointment with the nurse practitioner who oversaw his medication while he was hospitalized in the Behavioral Medicine Department. After we gave her a quick update on his status, she decided to keep him on the same medication regimen but told us that we could decrease some of his sedatives by halving the doses or eliminating them if he seemed calm enough not to need them. She indicated that she wanted to see him again in three months, and she gave us lab orders to be run in six months to check his various levels. In addition, she agreed with my decision to add a multivitamin and probiotics to his medicines as a way to address his yeast overgrowth issues, and she wrote a prescription for two more rounds of Diflucan. After our appointment, I felt thankful that she is handling Alex’s case because of her expertise with autism and her personality that makes working with her very easy and comfortable.

On Friday, we returned to the psychologist’s office, where Alex was to work with one of the staff on a battery of tests, but the psychologist was not there. After one set of tests, the evaluator told us that she wanted to use a different test with Alex, but she didn’t have it there and would have to reschedule in a couple of weeks because she would be out of town the following week. I told her that we needed to have testing completed before Alex could be considered for the day program and asked her to have the psychologist call me. Once we were home, I contacted another office whose counselors have experience with autism and scheduled a behavioral assessment for this upcoming week. When the psychologist called, I explained that while I appreciated all the tests she was willing to run with Alex, we did not need I.Q. testing for him, simply a behavioral assessment. She didn’t seem to agree with me, and she referred me to another psychologist with more experience in autism; however, I know from other parents that agency has a waiting list and is not taking new clients. After thanking the psychologist for her time, I was glad that we were able to find another place to have Alex tested and hopeful that they would know how to assess him.

Although the changes in plans for Friday seemed like a setback, they were actually a blessing because Alex had a die-off reaction later that morning. Often, about seven days after beginning yeast treatment, a person will experience a yeast die-off, which is characterized by vomiting and extreme fatigue. After vomiting twice, Alex spent most of Friday sleeping as his body was coping with the die-off reaction. Even though he probably didn’t feel well, he was very sweet and pleasant and didn’t become upset by his physical symptoms. In fact, every day this week, we saw improvements in his behavior, which we are hopeful is a sign that healing in taking place in every part of his body. Yesterday, he had a minor episode of setback in behavior, but he willingly went to his time out spot and complied in serving his time without complaint. Moreover, as soon as he got there and I explained why he had to have a time out, he immediately apologized, which was surprising and gratifying. He took his second dose of Diflucan yesterday, and we pray that as it heals his body, he will continue to improve his behavior so that we can have our consistently sweet and obedient son again. Seeing several glimpses of the real Alex throughout the week has encouraged us that we are making progress toward that goal, and that God is fulfilling the promise of hope and healing.

“So let’s not get tired of doing what is good. At just the right time we will reap a harvest of blessing if we don’t give up.” Galatians 6:9

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