I found one more journal entry that’s proving especially helpful as we wage this second great battle against yeast overgrowth in Martin’s belly. It’s dated 16 February 2011, not long after we started biomedical recovery:

Martin has been—autistic. Like, really bad. Worse than Asperger’s Syndrome, way below high-functioning. His sing-song self-assurance speech has come back, he walks on his toes, he has no focus, the percentage of times he responds to his name has tanked, and the nights have been hell. Just hell. He’s up for hours at a time, unpredictably. Sometimes 1:30-4:50 a.m.. Sometimes 3:20-5:45 a.m. Sometimes he wakes at 5:05 a.m., and that’s it. He’s up. Adrian and I are beyond exhausted. Last Saturday the hopelessness set in, and I broke down, weeping at my desk as Adrian promised that it would get better. That it had to. (Since then Adrian has taken more of the burden at night, and I’ve rebounded. Not a finally-getting-back-to-the-gym kind of rebound, but I make it through the day without tears. That’s what this fight does to me. Some days there are tears, and better days there aren’t.)

I would be freaking out about Martin’s apparent regression, but I remember the process Kathleen mentioned once before. It’s called die-off. Martin has yeast overgrowth in his belly. Our first goal is to starve the yeast, to kill it off through attrition. That’s why we’ve cut sugar, such as juice, from his diet, and why we’re drastically reducing carbohydrates, which break down into sugar. The medium-chain triglyceride oils he takes are intended to help kill yeast. When the yeast begins starving, it flares up and causes a temporary spike in autistic symptoms. That’s die-off.

It’s been two-and-a-half weeks since we cut all gluten and soy from Martin’s diet, and one week since we started giving him the MCT oils. In response to my desperate questions, Kathleen assures that enough time has passed for die-off to start. I am skeptical. Two-and-a-half weeks? Before we’ve cut all grains? I can’t believe it’s so easy to reach the die-off stage. I had assumed a longer, more arduous route.

It is absolutely possible, Kathleen says. These are signs of die-off. We’re making progress.