Archive | June 2012

Cholestyramine

Every morning, Jackson, Misha and I get to wake up and drink our glass of Cholestyramine.  One scoop is mixed with 12 ounces of warm water, taken on an empty stomach, and thirty minutes after, we’re supposed to eat something fatty (for me, it’s almond butter and banana).  The drink’s grainy, lemony taste isn’t wonderful, but it’s not the worst. I do have to say that this is the one medicine Jackson hates:(  Misha has to hold him while I put the oral syringe in his mouth and squirt away.  It’s not the most fun to wake up to every morning.  You can imagine how excited we were (note the sarcasm) when our LLMD said we need to now up the Cholestyramine to 3 times a day!  Ick!  I really only feel bad for Jackson…now, our schedule is Cholesyramine right when Jackson wakes up in the morning (6:30am), right after nap (2:30pm) and right before dinner (5:30pm).  If it’s taking all the bad stuff out of Jack’s body, then I’m fine with it.  Bring on the Cholestyramine!
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From  http://www.survivingmold.com/docs/CSM_Fact_Sheet.pdf

What to Expect from Cholestyramine (CSM)

Cholestyramine (CSM) is an FDA-approved medication used to lower elevated levels of cholesterol. It has been used safely for over forty years in millions of patients who have taken the medication for extended periods of time. You have been given a prescription for CSM to be used for only a short period of time to treat your chronic, biotoxin-associated illness. The FDA (6/28/99) ruled that there was no reason to expect an increased risk to health from use of CSM in a group of patients who have biotoxin illnesses (such as Pfiesteria, ciguatera, mold, Post-Lyme) and blue green algae syndromes compared to those who don’t. Therefore such use is exempt form repeating FDA clinical trials to show safety. Your prescription is given to you under this FDA exemption.

This use of CSM is called “off-label.” Off-label use is completely legal, ethical and is part of standard medical practice. There might be a few physicians somewhere in the US who don’t use drugs off-label but I haven’t met any yet. You need to know that your prescription is for CSM being used off-label.

Cholestyramine is not absorbed. It helps you get better but it adds nothing to you. All it does is take things away. Provided that CSM is not taken with food, it binds cholesterol, bile salts and biotoxins in the small intestine. Because it binds biotoxins tightly, the biotoxins cannot be reabsorbed; the CSM-biotoxin complex is excreted harmlessly in the stool. Provided there is no re-exposure to sources of biotoxin or reacquisition of biotoxin, the CSM treatment will remove the biotoxin from tissues over time, providing the first step needed to resolve the chronic, biotoxin-associated illness. The illnesses of some patients can be resolved in two weeks, but depending on the amount of biotoxin in your body, and the inflammatory problems initiated by exposure to biotoxins and inflammagens, the time to regaining health may be longer. CSM will not correct presence of MRCoNS, low VEGF, high TGF beta-1 or low levels of CD4CD25 cells, for example.

Used at the FDA approved dose of 9 grams of CSM, or 4 grams of Questran Light (note this product contains aspartame), taken 4 times a day, there are gastrointestinal side effects that are potentially annoying but are usually not dangerous and should not interfere with your treatment program. Some people who are sensitive to chemicals might want to have compounded form of CSM (“MCS-CSM”) that has nothing other than Stevia in it. Some people who tend to be constipated even before using CSM will need to be very careful to prevent CSM making their stools become too hard, as such brick-like stools can cause bleeding from the rectum when they pass out of the body. Our treatment protocol attempts to anticipate the possible troublesome side effects; you will be given additional medications to keep on hand “just in case.”

Reflux of stomach acid, also called heartburn or indigestion, is commonly experienced early on in treatment. The symptom abates spontaneously in most patients within a few days. A medication to stop over-production of stomach acid, taken before beginning the CSM doses, can prevent heartburn. Mixing the CSM in apple juice, cranberry juice or dissolving CSM, first in luke-warm water and then adding ice, helps reduce heartburn. Bloating and belching can also be cause initially by CSM. Fortunately, those side effects are rarely a major problem.

As mentioned, constipation is commonly seen. Many patients simply increase their consumption of fruit or fiber products, such a psyllium (Metamucil), to avoid this problem. A non-absorbable, sweet tasting liquid, Miralax, available without a prescription, can hold water in stools, making bowel movements soft, thereby preventing constipation. Even though Miralax tastes sweet, it will not make your blood sugar rise or make you gain weight.

Because many patients with chronic biotoxin associated illnesses have diarrhea or more frequent, softer stools, the constipating side effect of CSM can become a welcome, early benefit.
CSM has been extensively tested in multiple clinical trials involving patients with chronic, biotoxin associated illnesses. The benefit of use of CSM has been confirmed by two double-blinded, placebo-controlled crossover studies. To date we have looked for, but not found benefit from CSM substitutes such as charcoal, chitosan, clay in several forms or any herbal remedy. We will use Welchol as a CSM substitute for those unable to take CSM. It is taken with food in a pill form. It is far easier to take but it is only 25% as effective as CSM.

Your physician will be following your case carefully. If you have questions regarding any phase of your treatment, please notify your doctor’s office promptly. You will be given special tests of visual contrast sensitivity (VCS) on a regular basis. Your treatment will continue until your symptoms have resolved and your VCS is normal. Your physician will review your case in detail as your treatment progresses.

CSM Protocol

  1. On an empty stomach, take one scoop of CSM (9 grams), mix with water, or juice, 4-6 oz.
  2. Stir well and swallow. Add more liquid, repeat 1 above until done.
  3. Drink an extra 4-6 oz of liquid.
  4. After 30 minutes, you may eat or take meds (wait at least 2 hours before taking thyroxine, digitalis, theophylline, Coumadin and others; ask your doctor for information).
  5. Take CSM 4 times a day!
  6. If you eat first, wait at least 60 minutes before taking your next CSM.
  7. Reflux, constipation, bloating and bowel distress are not unusual.
  8. Use acid blocking medications as needed.
  9. Use Miralax to relieve constipation

Bills, Bills, Bills

Who knew this adventure of helping Jackson overcome Autism/Lyme Disease would be so costly, financially and time-wise.  I was more than willing/happy to give up a year of teaching to concentrate on helping Jackson, but living in California and the Silicon Valley,  it’s almost expected that both parents work full time.  My parents and Misha’s have been amazingly, overly generous with their resources and have dedicated so much money to Jackson and our family’s cause.  Every LLMD doctor’s visit is out of pocket.  Every supplement, herb and pricey prescription copays are out of pocket.  I don’t have an ongoing tally, but I’m sure we are well beyond $10,000 by now.  Probably even $15,000.  Actually, with all the mold stuff, probably more like $20,000.  Misha and I are so incredibly thankful to our parents.  They could’ve had 20 vacations around the world by now, but they are committed to seeing Jackson recover.  I stay strong every day and do what needs to be done because we are all so invested in Jackson.  We do submit our office visit receipts to our insurance company, but on average, out of $1,000 we turn in, we get back about $100.   Below is our latest stack of LLMD visit bills that we mailed today for reimbursement.  I don’t even really keep track of what we pay and what we get back from insurance because it’s so minimal.

Pardon the old, dump-bound pee-stained mattress below, but I’ve laid out the empty medication/supplement/herb bottles we’ve been through.  Just one of those little one ounce herb droppers is $100.  I think I counted 20 of them, so right there is a significant chunk of change.  I know this time, effort, sacrifice and money is worth it, and recovery is coming.  Jackson is worth it, the time is now, and on we go.

So many people love you, Jackson!  Keep up the fight!

Valtrex, Day 2

The past six months, since I read Jenny McCarthy’s books, and found out about Stan Kurtz and his son, Ethan, I became part of the ‘mb12valtrex’ Yahoo group that Stan started.  It is then that I became familiar with Valtrex as a part of a protocol that was helping so many autistic children.  I have read many Yahoo posts from parents who experienced many different ‘die off’ symptoms, from fever, regression, rashes, poop-smearing, fatigue, etc.  So far with Jackson, on 250mg once in the morning, I haven’t noticed any changes.  Jackson has never shown any noticeable herx reactions to any of his meds or supplements, so I’m eager to see if he responds at all to Valtrex.

Jackson had his first dentist appointment this morning, an appointment I’ve been putting off forever since I knew how uncooperative he’d be.  It’s not that he’s uncooperative, he just doesn’t like being forced to do something he doesn’t understand.  He had no problem being in the office and even sitting in the big chair with and without me (I wish I had taken a picture, he was so cute!), but trying to get him to open his mouth for the dentist to look inside just wasn’t going to happen.   We tried the iPad, him in my lap, me holding him down, prying his mouth open, but it wasn’t going to happen.  Right now, the dentist is the least of my concerns.  We made an appointment for six months from now, hoping to the high heavens above that we’ll have made some gains and Jackson will be able to open his mouth willingly on his own.  Time will tell.  We left so quickly out of the dentist’s office that I didn’t notice the two Thomas kaleidoscopes in Jackson’s hands that we’ll be borrowing (see pictures below).

Jackson and I went to the park after the dentist.  The park is adjacent to a dog park, so after going down the slide once, Jackson wandered over to the dog are and stood behind the fence, watching the dogs.  I don’t know if he was just zoning out or really interested in the dogs, but he stayed there about 10 minutes, quiet, content, staring.  We made our way back to the park and Jackson mostly wandered around, occasionally starring at other kids playing.  After swinging, Jackson got down and spotted a graham cracker on the ground.  He immediately knew he wanted it, reached down and picked it up until meanie mommy took it from him.  Not GFCF AND dirty, no, no, no.  Jackson got super mad, stomping his feet and whining.  I tried to distract him and point him back to the park, but he was done, his mind was set on the graham cracker.  Our park trip was over:(

    

Ethan’s Recovery Video

This is the video that got me started on the Biomed road.  I remember watching it about 6 months ago, seeing almost exact similarities between Jackson and Ethan.  I wanted to share the video again.  Ethan was on a strict diet, and was on anti-viral, anti-fungal meds, B12 shots (among other interventions and supplements I’m sure).

Copy, paste, and watch!

http://recoveryvideos.com/video/ethanweb.mov

You can also visit Stan Kurtz’ websites http://www.recoveryvideos.com and http://www.stankurtz.com

Viral Treatment

I’m starting to research viral treatment and how other families dealt with their children on Valtrex/anti-virals.  A question I have for our doctor next time I see him is about the dosage.  Jackson was prescribed 250mg a day (half of a 500mg capsule).  Is it best to split the 250mg dose in half so that he gets two smaller doses, one in the morning, one in the evening?   Here goes my Google University for viral treatment!

http://savingsavannah.org/category/viral-treatment/  :

Posted on June 11, 2012

Viral tegument

It’s reported that about 1/3 of ASD kids respond to viral treatment. It is recommended to put off viral treatment until you have done around 50 rounds of chelation.

The reason to wait?  Viruses are not really alive, so they don’t die. Viruses are kept in balance within the body by an immune system that is somewhat intact. It’s well documented that metals will impact the immune system to the point where viruses will proliferate and the immune system will not be able to balance or control effectively. I’ve seen lots of people try to treat viruses before the year of chelation and most were not successful. It usually creates a lot of discomfort in children when you attempt to treat the viruses, so best to wait until the Mercury load comes down.

So, here we are at about round 50, getting a little bored with chelation. Let’s face it, it’s not exciting like it was in the beginning when we were oohing and aahing over all the improvements.

Let me say up front here, to not do as we did and attempt viral treatment in the winter (never occurred to me that this wasn’t a good idea). There are all kinds of nasty viruses around in the winter and you never quite know for certain if what you are seeing is the result of your viral treatment or some random virus that is circulating around your community.

If you wait until June, when there are much fewer viruses hanging around, you are  more certain what the viral treatment is actually doing. We first tried Valtrex, being unaware of the advantages of natural antivirals, the main one being that natural antivirals target many viruses, Valtrex only a few. The Valtrex (only 1/3 of the tablet, with the blue coloring washed off) produced complaints from her that there “were knives” in her stomach and she didn’t eat a single thing all day. She was, as I have mentioned a hundred times, anorexic, so this was a deal for me with Valtrex.

So, we started giving Virastop along with a few other natural antivirals and we noticed that she was certainly more motivated and independent. Every single natural antiviral we used produced these same improvements. She also had a number of viruses where for the first time, she spiked very high fevers, 106 with Ibuprofen.

You’ve no doubt heard of ASD kids who are runners, who will bolt at any opportunity, we had the opposite kind of ASD kid. The one who was stuck to your side, who rarely left it, who would play with toys sitting right beside you on the couch and it was enough to sit beside you, she had to be touching you.

With Virastop and the other natural antivirals; the art supplies would come out and she would produce her artwork while sitting at the kitchen table a whole TEN whole feet away from me, miraculous. Motivation and independence were qualities that we were lacking and very much needed.

You can read all about viruses and the Virastop Protocol here. I can say that we never did this high dose protocol. I just didn’t like the idea of giving over 20 Virastop capsules per day, seemed excessive to me.

English: Simplistic overview of the main viral...We would keep her on the natural antivirals for 3-4 months and then stop to see if the improvements held. It took over a year of treatment with natural antivirals for the improvements to hold.

During the year of antiviral treatments we used many other natural antivirals with the Virastop. Elderberry brought out 10 quarter size chicken pox lesions on her right shoulder blade, complete with blisters and intense itching. She did have the Varicella vax and when I took her to the ped who said….If I hadn’t vaxxed her myself I’d swear those where chicken pox. Hmmmm.

Of course we continued to chelate the entire time we did the antiviral protocols, low/frequent dose chelation, which is safe and effective. Still with us was her anorexia, fine motor issues, inattention when yeast flared and some social issues.

For more detailed information about how to treat viral issues, please see the book Fight Autism and Win: Biomedical Therapies That Actually Work!”

The Good and The Bad-Viral Protocol Part Two

Posted on June 19, 2012

English: Transfer factors and Th1 (cell-mediat...

We have skipped around just a bit, but for those following along, we’re at round 73. This takes us up to “the” June before Kindergarten; we had some pretty big decisions to make about whether to send her to school or homeschool in a short 9 weeks.

Cognitively she was solid, language was spectacular and attention was as good as I had ever seen. Gross motor skills were age appropriate. She was still anorexic and the nervous joke around our house was that someone was going to have to go to school at lunch time and feed her.

Social kept improving all along but we still had that little bit of discomfort when around children her own age,  Fine motor was okay, but certainly not what I would have considered age appropriate, although I found later she was within “the range” of age appropriate.  So, a mixed bag.  Most of our requisite kindergarten skills were there, but not complete enough to make me comfortable and I didn’t want to send her too early and set her up to fail. In particular, the social was the most concerning to me.

We are still on antivirals at this point and getting improvements but everytime we tried to take her off the natural antivirals we would lose the gains. I surmised that adding an immune modulator might help us and we chose Transfer Factor. Transfer Factor is an immune messengers, found in mother’s milk, transferred from mother to baby to educate the immune system. You’ve heard about the enormous benefits of breastfeeding and it is largely due to these “transfer factors”.

Transfer Factors, the product, work much the same way. You can read about and order Trasnfer Factor here.They even have a chewable product now that was not available when we were using it but the taste of the powder is not bad at all and can be mixed with cold, soft food such as apple/pearsauce or yoghurt. They also have a Transfer Factor (Transfer Factor Plus) with Cordycepsmushrooms but I was always concerned that the more ingredients that were in a product, the higher chance there was for a reaction.

I do have to stop and report that I never had, nor do I now have any other relationship with the company that manufacturers or sells Transfer Factor, other than that of any customer buying the product. There is a representative I spoke to at the company, Suzette Lawrence, who was very helpful in answering my questions.

A week after putting Savannah on Transfer Factor (only 2 capsules per day) we got two very nice improvements. The first with yeast, that is the yeast left, was gone. Many parents report yeast gets a lot easier to handle after 50 rounds of chelation, we had not noticed that here. Transfer Factor made the yeast GONE, not just easier to handle and what a welcome relief that was. Only parents of children with severe yeast can truly understand how wonderful this event was.

A week after being placed on Transfer Factor I had enrolled Savannah in a very relaxed, social-only, preschool/daycare for a few hours a couple of days a week. We were moving into a new school district in October and I thought maybe she could meet some children who she would start Kindergarten with if we did decide to send her to school as this preschool was in our new district.

The following is a little unbelievable but it is a true report: I went to pick Savannah up a week later after she started Transfer Factor and got there 20 minutes early. There were some kids coming on the playground at the time I pulled in. It was not time for Savannah’s regular playground time but I decided just to sit outside and watch the children.

As I watched the children, I became focused on one little girl who was in the middle of all the kids and who seemed to be in charge of directing all the activity. I saw several children calling to her and asking direction and where this little girl went, they followed. Oh, how I envied the social skills of this little girl and how I ached for Savannah to be so in charge and at ease with children her own age, just like this little girl.

I must have watched this interaction between this little girl and the other children for another five minutes when it dawned on me that this little girl and Savannah had on the same little jean skirt. And then I noticed that this little girl also had on the same color shirt as Savannah. I have to tell you at this point that I am very nearsighted, didn’t have my glasses, but did remember that I had a pair of binoculars in the glove box of the car.

To say I whipped the binoculars out of my glove box in a nano second is not an exaggeration. And what I discovered much to my surprise was the little girl I had spent almost 15 minutes admiring her self confidence, leadership and ease among the children WAS Savannah. I really wish someone had been able to capture the look on my face.

I must have set there for another hour just watching, I was way late picking her up but they were keeping the children on the playground and I wasn’t going to miss a minute. I can also say that although I thought or feared that these new found social skills might be fleeting, that did turn out to be the day that her social skills came on board and never faltered at all, ever. I’ve often thought I should write a book called “Things That Would Only Happen To Me” and  I would include this story for certain.

Was Savannah’s new found social ease due to the Transfer Factor?  I will never know for sure, I don’t know a whole lot of other children whose parents reported this upswing of social skills with Transfer Factor, but a few did. I will never know with absolute certainty but I  will always think that the Transfer Factor had something to do with it, maybe in conjunction with chelation?

As the weeks went by and the social gains held it became apparent that Savannah would start to school as social issues were really my last “big” area of concern. Her appetite had picked up a little, her fine motor skills were coming along, everything was falling neatly into place for that all important first year of school.

Only Biomed parents will appreciate and understand what happened next. I turned around a month later and notice Savannah’s attention was OFF. Really? Wth? How could this be? so many times you fix one or two things with our kids and you get another problem but this was a return of an issue that hadn’t been an issue for sometime.

My mother noticed she seemed a little “tipsy” even but there was no yeast. The other thing that can cause this drunk-like behavior with slightly slurred words was high ammonia. Other symptoms of high ammonia can be; excessive sleepiness, confusion or hand tremors.  We called for a blood test for high ammonia and yes, she did have high ammonia. The Dr, who was a Dan! actually said the levels were high but within the norm so recommended no treatment.

Again, my mother said no, this is not normal. Through research we learned that high ammonia levels can lead to portosystemic encephalopathy with resulting damage to the liver. Alpha Ketoglutarate (Or AKG) was the preferred treatment to “chelate” out the ammonia. The protocol for this was (1) 300 mg capsule of AKG per meal for 4 months. Sure enough, within 4 days of giving the AKG, Savannah’s attention was back to normal.

Autism and high ammonia are related. Some have postulated that high ammonia is a methylation issue and it could well be. I will fully admit at this point that although she looked much like every other typical child, she was far from healthy. We were not done treating or chelating. She only had this ammonia issue once, we used the AKG for four months and never saw the issue again.

You should also know that if you get your child tested for high blood ammonia, the sample has to be prepared according to specific instructions; namely the sample has to be put on ice IMMEDIATELY because ammonia will naturally accumulate in any blood sample kept at room temperature causing a false positive.

If the lab technician or phlebotomist doesn’t appear with a container of ice when they come to take your child’s blood, ask them nicely to get one. If they get agitated or say they are going to put it on ice as soon as they leave you, this is not good enough. Ask for the manager of the lab or the patients’ relations office or some other person in charge and nicely explain that you want the sample put on ice IMMEDIATELY.

Even if you are nice and calm, this will sometimes make the phlebotomist a little perturbed. The choice between the lab  technician getting a little angry and my child getting accurate results from a test so they can get well? Not a choice for me that I have to spend anytime thinking over. There are a few lab technicians in the area I live in that aren’t too happy with me but again, my child is well so I do not lose any sleep over this fact.

Tune in next time to find out what happens when you put a very nearly, but newly recovered ASD child into a regular Kindergarten without an aide or without disclosing anything to the school. Boy, do I know how to live on the edge, or what? 

 

Starting Valtrex…Anti Viral, Here We Come!

Today we also met with our LLMD.  We went into the meeting (with Jackson), uneasy about the fact that we’ve seen so little (if any) progress with Jackson in these last 4 months.  Our LLMD had hoped to see some more progress out of Jackson, but reminded us how much we’re dealing with in Jackson’s case: parasites (just about gone), Lyme (making huge progress), PANDAS, mold (possibly?), methylation cycle issues, Marcons, and now, he’s found a viral component.  He made me feel a whole lot better that we are treating what needs to be treated and to steer the course.

For the virus, he’s prescribed Valtrex.  Valtrex is an anti-viral…THE anti-viral that Stan Kurtz (http://stankurtz.com/) used with his son, Ethan’s, recovery.  I’m wondering if Valtrex could be a key piece of the puzzle we are missing in helping Jackson.  In Ethan’s case, it took about 20 horrible days of regression to finally see some gains and progress…nonverbal to verbal!  I’m a little nervous to start the Valtrex since things could get worse, but excited about the possibilities that Valtrex can bring.  So far, with all the supplements, medications and everything that’s gone into Jackson’s body, he hasn’t had any major negative herx reactions.  Will Jackson tolerate Valtrex?  Will he go through some poop-smearing days as Ethan did?  We will see!

Here’s what I’ve read about Valtrex from: http://gryffinstail.wordpress.com/tag/antivirals-101/   :

Die-off sucks.  Yes, you probably already know but really, it can suck more with antivirals.

Each child reacts differently and some will get little to no die-off and others will think their child has been possessed by the body snatchers.

I’m sure you are on the edge of your seat, waiting for me to explain what to look for when you start.  You’re in luck.

low grade fever
increased stimming
rash (sometimes it travels)
hyperactivity
aggression
whininess
discomfort
increased OCD/anxiety
canker sores/cold sores
fatigue
headache/audio sensitivity

That’s all I can think of off the top of my head.

And that’s just from the antiviral.  But again, severity is going to depend on the child.  In my son, we only saw the low-grade fever, hyperactivity and his aggression was only raised slightly.  But the whining!  Good Lord, help me.  It was a nightmare.  It really made the die-off seem much worse than it actually was. When you wait so long to hear your child speak, you’re willing to listen to anything and never ask them to stop talking.  This was tested in my house.  Turns out, it’s not always true.  You’re thankful, absolutely.  But it wasn’t too far of a leap for me to go from “please talk” to “please stop whining!”

Thank goodness there ways to help get you through (and I don’t mean that appletini after the kids are in bed).  A big part of that is to only start the antiviral/antifungal protocol 1 at a time.  You start either the antiviral or the antifungal first, and then you add the other a month later.  If you start the antifungal first, you might be able to get away with starting the antiviral 2 weeks later but not vice versa.  Starting them both at the same time will almost always just compound the die-off (plus you want to know what’s doing what.  Don’t forget to take copious notes!  This is the perfect time to learn what your child’s yeast and viral symptoms look like because those will go through the roof during die-off or they’ll disappear.  Either way, you can now trace those behaviors back to their root).  Also, when you start, start at half-dose for a week to ease into it.  It’ll help smooth the die-off so it’s not so harsh.  And just so there’s no confusion, when you start the antiviral, start at half dose and when you add the antifungal, start it at half-dose.  Go to full after a week.  So if you are Rxed 500 mg/3x a day of Valtrex, start at 250 mg 3x/day for a week, then go to 500 mg.  Discuss this with your doctor, of course, don’t take my word for it. I don’t have any medical acronyms after my name.

Activated charcoal.  There is some debate as to whether you should go with 1 hour after any supplements and 1 hour before any supplements or 2 before and after.  I’d just go with 2 just to be certain.  But that means a total of at least a 4 hour window where you don’t give any supplements/medicine (charcoal will absorb it).

Motrin.  A lot of the die off symptoms are simply caused from discomfort.  Aggression, hyperactivity, those types of things.  Like I said, die-off can suck.  How many of you out there have taken an antifungal and felt just awful for the first few days it was working (and I’m going to go out on a limb here and say there are probably more females that have to take it than men)?  Well, the same thing happens to your kids.

Water.  Antivirals clear through the kidneys.  Drink lots of water and that should help with the headaches.

Be patient.  Die-off on the antiviral can take up to a month.  I’ve even heard of a few that have gone longer.  During this time, you may see gains through the die-off.  Most do but a few don’t see gains until die-off is completely gone.  Die-off from an antifungal usually only lasts a week or two.

Probiotic during the antifungal.  Some can have loose stools or constipation from the antifungal.  This usually rectifies itself after die-off is over but probiotics can help during.  But you’re probably already giving them anyway.

Be observant.  Watch your child like a hawk because you don’t want to blow things off calling them die-off symptoms when it could be a very real reaction to the drug (I’ve not actually heard of this happening but I can’t imagine it’s not impossible – I had a severe reaction to Singulair and just about went off the deep end).  Don’t be afraid to call your doctor, that’s what s/he is there for, so call if you feel you should.  Trust your gut.  If you think it’s not die-off (or even if you think it mightnot be die-off), call your doc.

I will surely write daily Valtrex updates.