Stop Vanco, Begin Probiotics???

I didn't know whether to continue my vancomycin pulse dose treatment for c-diff or discontinue vanco and start high dose probiotics. I took 1 vanco every 48 hours for 8 days now. Just before I took the next vanco (48 hours after the previous dose) I got diarrhea. Then I take the vanco and I have normal stools for 48 hours. So I may still have c-diff spores causing the diarrhea. Taking the vanco kills those for awhile, until more spores morph into bacteria and cause more diarrhea. I want to take more probiotics because I bruise very easily now (symptom of low good bacteria). However vanco will kill the good bacteria. So I don't want to waste the high dose probiotics while I continue to take vanco. This pulse dose therapy is a real crap shoot (pardon the pun). LOL

Nevertheless, I decided to continue my orginal plan: stop taking vanco after 8 days of every other day capsules (after the previous month of tapered dosing) and begin high dose probiotics. I knew my good bacteria were very low after I got 3 bruises on my hand (finger/palm joints) while playing tennis this morning. Next time I'll use my padded biking gloves. I have never bruised so easily. So I decided I really need those high dose probiotics.

Also taking vanco yesterday morning did not alleviate the diarrhea. So I suspect I'm either eating too many home grown grapes (and tomatoes) or I just need more good bacteria. I don't think c-diff spores caused the diarrhea, because I don't have any other c-diff symptoms (like cramping pain, nausea or dizziness). I did have cold symptoms (sore throat, sinus pain and fatigue) today. So I took more zinc and drank ginger tea (as well as ate all those fresh tomatoes LOL). I did not take any pain pills, but the sinus pain and sore throat completely disappeared after dinner, when I again took zinc, drank ginger tea, ate a fresh vegie salad with tomatoes and took the high dose probiotic. Only time will tell how the probiotic affects my diarrhea, but my cold symptoms decreased dramatically.

Amazingly I didn't react badly to the higher dose probiotics (127 billion viable bacteria vs. the 8-12 billion capsules I had previously taken). I only have slight bloating and no gut pain. Maybe the vanco didn't kill all the good bacteria in those previous 8-12 billion capsules. Maybe I have built up enough good bacteria by taking lower dose probiotics during tapered vanco dosing, so that my gut doesn't have a big adjustment (bloating and gas) to higher dose probiotics. Again only time will tell, but so far, so good.

Embrace Hunger, Resist Fullness

My post title was inspired by Linda Moran's slogan "Embrace Stress and Resist Greed" in her book "How to Survive Your Diet". However, I need a more precise slogan to remind myself that hunger is okay, because I NEED to feel hungry before I eat, and that fullness is overeating, but satisfaction or 'just enough' is desirable. I finally realized why I'm still struggling with 3 extra pounds which cling to my waist area. While I was sick with c-diff and enduring nausea from flagyl, I learned to eat when I was NOT hungry and even ignore fullness, while I continued to eat. When I learned normal eating 7 years ago, I embraced hunger as normal and necessary and resisted feeling full but especially 'stuffed'. However, while I felt ill, I abandoned everything I knew about 'normal eating' and comforted myself with too much food too often. Although I recently changed what I ate, I'm only just 'dieting', if I don't change when and how much I eat.

I also decided to embrace my body and resist the scale. Everytime I lose a pound or 2, I return to overeating, as I rationalize that I can 'get away with' a little extra. Of course, I immediately gain back whatever I lost by overeating. So I intend to avoid weighing altogether. I need to focus on the process (eating less) which will produce the desired product (less inches around my waist). My weight is still within normal healthy range (for me), but the extra fluff around my waist makes several garments too tight. I've heard that belly fat moves (disappears) quickly with decreased intake. So I'm anxious to test out that theory. I suspect I will lose inches all over, but notice it more in areas where I don't want to lose. Meanwhile I'll keep doing my situps and other stomach exercises to firm up the flab. Nevertheless, I can only eat less if I embrace hunger and resist fullness.

Three Weeks to Go

3 weeks from today my husband and I will fly to Maui for a 3 week vacation. This will be our first vacation in 2 years. Last year we spent a 'stay-cation' at home having our crawl space converted into a bonafide basement. We also spent vacation money on my Invisiline teeth correction program. So we both anticipate a real get-away and worry about getting everything done before we leave

This morning my orthodontist gave me my last 2 invisiline aligners which will straighten my lower teeth enough to allow another dentist to restore a tooth which was crooked and smaller than the others. Then my ortho will take impressions for a permanent retainer (stronger material than flimsy aligners), which I will only wear at night to 'retain' the correction which the aligners did to my teeth during the past 18 months. Originally we anticipated 12 months of alignment. However Invisiline and my ortho overlooked the size of the tooth which had laid in front of another tooth. When that tooth finally shifted into the proper place, we noticed it was much smaller than the others. So Invisiline designed aligners to move that tooth into a position where another dentist could increase the size of the tooth (with bonding, rather than a more expensive veneer).

2 weeks from today the restoration dentist can make the smaller tooth match the rest and correct my 'bite'. Then I will receive the permanent invisiline retainers, which I only need to wear at night. So I will no longer need to remove retainers, eat, brush teeth, floss teeth, brush retainers and reinsert retainers everytime I eat while on vacation. That will make eating picnic lunches as well as restaurant meals much easier.

If we weren't leaving for Maui on October 6, I would continue with pulse (tapered) doses of vancomycin to prevent c-diff recurrence. Currently I'm on once a day fpr another 4 days. Then I switch to once every 2 days for another 8 days followed by a week of high dose probiotics. If I had more time I'd do another 2 weeks of once every 2 days. My husband suggested taking vanco with me just in case. However, if I'm completly off vanco and start taking it full dose to treat c-diff symptons, I'll get side effects of massive diarrhea, which will interrupt my vacation and confine me to the condo bathroom. So I hope my abbreviated pulse dose plan will prevent c-diff recurrence when I'm in Maui.

The big question for both my husband and me continues to be: Will we fit into our usual Maui clothes, like swim suits, lighter weight shorts, etc.? Both of us gained weight this year. I still weigh 3 pounds more than I usually weigh when I'm in Maui. Those 3 pounds mostly translate into an extra 1-1/2 inces around my waist and a 1/2 inch around my hips. I gained that weight while taking flagyl and vancomycin to treat c-diff. My husband accumulated at least 12 pounds since our last Maui vacation, because he eats to cope with job stress. His job stress remains high. So he still has not lost that weight. I've changed what I ate. So I eat much more fruits and vegies and no sweets (like ice cream or cookies). However, my scale tells me that I still overeat, because I haven't lost the extra weight.

I also suspect I'm eating too much salt and not drinking enough water. I've eaten so many garden fresh tomatoes lately, but I always overly salt tomatoes. Hopefully cutting back on salt will eliminate water retention, which returns me to the higher weight every few days. However, I also know I just need to abstain from those unnecessary between meal snacks and mealtime excess food. I certainly developed some bad habits while I was taking flagyl and initially vancomycin. Mostly my attitude changed from "I don't need food when I'm not hungry" to "I will eat for nausea and worry about weight gain later". Now I want to do more than worry. I want to lose those excess pounds and inches.

Between now and October 6 (when we leave) we face many appointments, errands, meetings and prevacation chores, as well as our usual daily schedules. If I didn't have so many 'unknowns' about weight, c-diff, my teeth, getting it all done would seem exciting, rather than stressful. However, I feel so overwhelmed with all the unknowns that I'd gladly cancel the vacation to eliminate all the stress. I certainly don't need a vacation deadline to motivate myself to change my eating habits and lose the extra weight. My winter clothes will also fit better without those extra inches.

Rebellion or Boredom?

Whenever I decide to do or eat something different, I eventually tire of that action or food. I also dislike following rules dictated by other people. I prefer choice and variety in my actions and food. Am I rebellious or easily bored?

For example, I used to LOVE my allergy free ice cream, especially after allergy diagnoses precluded me from eating ice cream brands. When I discovered store bought (coconut milk based) allergen free ice cream, I bought and ate that regularly. I even binge ate whole pints occasionally. Then during flagyl treatment, I often ate ice cream to offset the metallic taste of flagyl and relieve nausea. Eventually I began to associate my favorite ice cream flavors with that horrible metallic flagyl aftertaste. Later I was advised to take vancomycin with high fat foods 4x daily. So I decided to take my last late night vanco dose with a few bites of ice cream. Eventually I realized I could take the vanco with a large glass of water and no food. Now I'm relieved that I don't have to eat before bed (when I'm still full from dinner) and I don't have to eat ice cream. Maybe I will crave ice cream when I'm in Maui and can't buy my allergen free brand locally. However, for now, I have absolutely no cravings for ice cream, maybe because I associate it with taking medication, rather than a delicious treat.

Likewise I had to stay up late enough to space my last vanco dose 4-5 hours after dinner. As the days became shorter and darker much earlier, I felt tired enough to go to bed at 9pm. However I often had to stay up until after 11 pm to take my vanco 4hours after dinner. Now I'm taking vanco 2x a day, 10am and 10pm. So I'm very relieved to take that last dose much earlier and get to sleep earlier. I suspect my wake/sleep cycle is affected by daylight. Ironically I used to habitually stay up until 11pm or later. Even though I believed I needed the sleep, I stayed awake reading or watching tv. Now I feel soooo relieved to take that last vanco earlier so I can get to bed even earlier, because I don't HAVE to stay up to take a pill.

Amazingly Karen Koenig (author of "Rules of Normal Eating") posted on her blog today an article entitled "Are You a Rebel Without a Cause?" Some of her comments totally nailed my behavior. She said:

"If you want to become a “normal” eater, you have to/must/need to ditch your rebellious attitude. Got to do it. Unless you’re living with someone who is trying to control your eating (and, why, as an adult with free choice, would you choose to live with this kind of person?), your thoughts of, “He can’t make me eat healthy,” “I’ll show her, I'll do what I want," ... are empty threats made to no one about nothing. If you’re still acting out your anger at parents who were controlling, dominating, rigid and manipulative, it’s time to let it go and move on ... Doing what people want you to do and doing the opposite of what they want you to do both back you into a corner. Automatically rebelling—You can’t make me, and I’ll do whatever I want—robs you of the chance to make wise decisions. It keeps you childlike and stuck in childish behaviors."

I realize that as a child I disliked my mom's efforts to control everything I did and was. I did not openly rebel as a child, because my mom also physically abused me. I feared corporal punishment for open rebellion. So I learned to rebel surreptiously, like sneak eating cookies after school when nobody was home, because she forbade me to eat sweets or anything between meals. As a high school senior I also climbed out my bedroom window to meet my boyfriend for late night trysts. My mom suspected I ate the cookies, but she never discovered my late night trysts.

Ironically I even rebel against rules I create for myself. Perhaps I just don't like boredom with food or activities. However, I suspect I dislike loss of choice. I prefer moment to moment freedom to decide what I want to do, say, eat, wear, etc. So when I want to create a new habit or eliminate an old one, I need to totally convince myself that I CHOOSE that habit change for positive reasons or benefits, rather than fear of negative consequences.

Karen Koenig also mentions adolescent rebellion in her blog post:

"Maturity means not making decisions solely to please or piss off other people. Anything else is immature reaction. Adolescence is full of rebellion because the goal of this developmental stage is to separate from parents. Teens push and pull to be unlike parents to move through this phase and individuate to become emotionally independent adults. Unless you’re an adolescent, if you’re still sabotaging your eating or weight because you don’t want to give someone the satisfaction of doing what they want or making them right, you are psychologically stuck. Now it’s time to define what’s right for you—no matter what anyone else thinks. Remember, you’ll be doing it because you want to, not because they want you to. Therein lies the (very big) difference."

Do I still rebel against control, when I resist making beneficial changes in my behaviors? More precisely can I choose to change habits without feeling controlled? After I choose to change habits, I often I slip back into older, comfortable, more practiced behaviors. Does that mean that I am rebelling against my mom's control during my childhood? Or does slipping back into old behaviors just mean I need to consciously practice the new behaviors until they become 'comfortable' and automatic?

I could find hidden psychological reasons for everything I do or don't do. However I might more easily change my behaviors by simply staying aware of my choice to change. According to eating disorder therapists my abusive childhood gave me psychological reasons to continue bingeing and purging. However, I realized those habits no longer served me as an adult. So I successfully replace those habits with more effective ways of coping with emotions and physical problems. As Karen Koenig emphasizes in her recent blog post, it's time to decide what's right for me, no matter what anyone else says or ever said to me about my choices.

Vanco Tapered Doses

I'm halfway through the first week of tapering vancomycin. If you missed my previous entries, cutting my vancomycin daily doses in half theoretically will allow the c-diff spores to morph into bacteria. My current approach is one vanco every 12 hours. So during the 12 hour break, some spores will become bacteria only to be zapped by the next vanco dose. On Saturday I begin once a day doses. That will give the spores 24 hours to morph and get zapped. During the following week I give remaining spores 48 hours to morph and get zapped. During the last week before I leave for Maui, I repopulate my gut with high dose probiotics.

My husband keeps asking me how the tapering process is going. Maybe he wants to know whether this is working. Frankly, I DON'T KNOW. LOL I no longer have obvious diarrhea, but now have rather normal soft stools. I also noticed that when I take my low dose probiotics (8-12 billion good bacteria per capsule), motility dramatically increases (I have to go several times afterwards). I hope the high dose probiotics will do the same thing. Also how much I 'go' depends on how much fiber I consume. That's a huge change from what I experienced during 500mg daily vanco treatment, when I had diarrhea several times a day no matter what I ate. I also have no nausea, dizziness, chills, cramping pain or extreme fatigue, which were my other (non stool-related) c-diff symptoms.

I had expected to experience some c-diff symptoms as the spores morph into bacteria, before vanco killed them. However, I suspect that more spores will morph during once a day or once every other day vanco doses. Again, I'm playing wait and see. I have no other guidelines beyond what I read in that one study about pulse dosing and another doctor's website report of success with tapered dosing. Nevertheless, those are more promising than any other recurrent c-diff treatment approaches I read.

Thoughts about Recovery

Today marks 24 weeks since the last time I binged and purged. Not quite 6 months, 24 weeks is the longest period I previously abstained from those binge/purge habits until this year. During the year when I previously abstained 24 weeks, I binge/purged 44 times before and after my long abstinence period. 3 years later I binged/purged 50% less often (19x). Then I continued to average 1-2x a month, until this year when I binge/purged 3x before I began the 24 week abstinence. I know I won't use those habits any more, because I strongly dislike eating to the point of discomfort and can't stand throwing up. Does that mean I 'recovered' from bulimia?

I also dislike assigning disease sounding labels to symptoms, like 'IBS' for bloating, irregularity and gut pain. Likewise I dislike assigning disease sounding labels to habits like bingeing and purging. Labeling those habits with a disease sounding name implies that the person using those habits is not responsible for their behavior, because they have a 'disease'. I believe that the only true diseases are caused by viruses, bacteria, parasites or fungus. All other medical conditions are just that ... 'conditions' caused by lifestyle habits. Likewise many mental health 'disease' labels are assigned to counterproductive thinking and believe habits. Many of those 'labels' were created by drug companies in order to market their drugs to treat those symptoms and thinking processes. For example the term "IBS" was created to market Zelnorm. The term 'social anxiety disorder' was created to market Paxil as an antianxiety drug, rather than just an SSRI like Prozac. So I never really liked the term 'bulimia', even though I used habits characteristic of that mental health 'label'. I always believed I used those habits because I didn't know other ways to get what those habits gave me.

So I could stop bingeing and purging after I realized how I could get what I believed bingeing and purging gave me. For example bingeing allowed me to eat whatever I wanted. Purging allowed me to binge without feeling guilty and then relieve the discomfort of gross overeating. When I allowed myself to eat whatever I wanted in comfortable portions, I no longer needed to binge or purge. Of course, I still sometimes felt guilty when I overate, but I didn't let that guilt overwhelm me with fear so that purging seemed like the only solution. I changed how I thought about bingeing or purging. I didn't need to take a drug to change how I thought. Perhaps the right therapist could have helped me change my beliefs or thought patterns to eliminate my binge/purge habits. However, I didn't encounter a cognitive behavioral therapist when I was seeking therapy to overcome those habits. I later read about CBT in various books and slowly used that approach to change my counterproductive beliefs about eating.

I don't miss bingeing and purging. However, I feel a bit disappointed that my life did not change dramatically after I eliminated those habits. Perhaps I believed all those eating disorder recovery suggestions that recovering from (eliminating) disordered eating habits would greatly improve my life. Perhaps I made recovery oriented changes before my 24 week abstinence. Perhaps those changes in my thinking and behavior facilitated that abstinence. Nevertheless, I still struggle with a few extra pounds (which I recently gained while taking meds to treat c-diff). I still feel guilty when I overeat, probably because I want to lose 3 pounds. Perhaps, if I didn't plan to wear a bikini on Maui beaches 4 weeks from today, I might not worry about the extra weight (or extra inches around my waist or loose skin hanging from my upper arms). Does my desire to lose 3 pounds and firm my upper arms mean I still have an 'eating disorder'? In this culture, those may be normal desires for someone planning a warm climate vacation.

During that previous year when I abstained from bingeing and purging for 24 weeks, I believed that eliminating those disordered eating habits would relieve my ongoing gut symptoms (bloating, gas, irregularity, cramping pain). Several ED 'experts' claimed that bingeing and purging caused those symptoms. 5 years later I learned that I actually had celiac disease, food allergies and bacterial infections in my gut, which caused those symptoms. Ironically an ED website claims that ED habits cause celiac disease! However, I now know that accidental ingestion of my allergens as well as bacterial, parasitic or fungal gut infections can cause uncomfortable symptoms no matter how long I abstain from bingeing and purging.

So how did eliminating binge/purge habits change my life? Most of all, I trust myself. I know I won't intentionally harm my body in a moment of despair or hopelessness. Of course learning to abstain from gluten, dairy, soy, eggs, cane sugar, vanilla and nutmeg gave me the confidence that I can consistently choose foods which will nourish, rather than harm, my body. Likewise learning to stop eating when I feel any discomfort, rather than continuing to eat until I'm so full that I naturally reflux (I never forced myself to throw up), proved that I can trust myself not to harm my body. Furthermore, resisting throwing up to relieve nausea, when I felt nauseas all day for 17 days while taking flagyl to treat c-diff, proved that I won't use extreme measures to cope with discomfort.

I wish I could say that abstaining from disordered eating habits positively transformed my body and my life. However the reality is that eliminating disordered eating habits freed me to deal with underlying problems (food allergies and bacterial dysbiosis) which made binge/purge habits appeal to me. Eliminating those habits freed me to cope with the problems I tried to escape when I binged. Changing the thought patterns that rationalized bingeing and purging gave me the confidence that I can logically resolve other problems and situations in my life as they occur.

Pulse Dosing for Recurrent C-diff

As I noticed more symptoms of depleted good bacteria, I began to wonder whether I want to continue full strength (4x125mg daily) doses of vancomycin for another week. So I researched 'pulse dosing for recurrent c-diff' and found a JAMA article which referenced a local study. They had good results with prolonged tapering pulse dosing with vancomycin in patients with 2 recurrences of c-diff. The author of the JAMA article described a longer schedule than I had planned. He used the initial 2 weeks of vanco 4x daily, then one week of vanco every 12 hours (2x daily), then a week of once daily, then 8 days of vanco every other day (4 total doses), and finally 1 vanco every 3rd day for 5 doses (total 15 days).

I don't have time before my vacation to do the once every 3rd day regimen and still follow the vanco treatment with a week of high doses probiotics. So I'll just do the first 3 parts of the prolonged tapered plan and follow that with a week of probiotics. Although I've taken a lower dose probiotic every day that I take vanco, my symptoms of frequent bruising and intense bloating reaction to that one probiotic capsule indicate that my good bacteria are very low right now. So I definitely want to follow my vanco pulse dosing regimen with the high dose probiotics to quickly restore my good bacteria levels before I leave for my vacation.

I emailed my doc the JAMA article and the research abstract ("Breaking the cycle: treatment strategies for 163 cases of recurrent Clostridium difficile disease"). At this point I'm teaching my doctor much more than he previously knew about c-diff treatment, recurrence and pulse dosing. I finally see a purpose for as well as an end to my c-diff experience.

Stay Attuned Reassurance

I subscribe to an emagazine entitled "Stay Attuned" from the Nourishing Connections website. See http://www.nourishingconnections.com This month's edition/article was about "When Lost Weight is Found". WOW!! That title exactly describes my situation! So I felt pleasantly reassured after I read the following from that article:

"Unfortunately, our usual reaction (to unexpected weight gain) is to blame ourselves, to say that we lack willpower and that we're lazy. "If I had just controlled myself." "No wonder I gained the weight back; I ate all the 'wrong' foods." Or, if we've been responding to our body's signals and we've risked eating foods we enjoy, we despair that this has caused the weight gain. "I knew I couldn't trust my body." "How could I have believed it was okay to eat the foods I love?"

What if, instead of blaming and shaming ourselves or assuming that our bodies are not trustworthy, we consider some of the real reasons most of us gain the weight back? Understanding and honoring the reasons the weight came back on makes it clear that another diet is not the answer. Tuning into what really prompted our weight regain can help us to know what to do next to take care of ourselves.

Perhaps we were distracted and disconnected from our body's signals because of an illness and injury. Or maybe our eating became less mindful when our work, rest, and play got out of balance."

That last paragraph described exactly how I gained those 3 extra pounds. While I suffered through flagyl's awful side effects in order to fight c-diff, I remember saying, "My health is more important than my weight", as I ate to cope with nausea. Then after I was told to take vancomycin with high fat meals or snacks, I dutifully took my late night vanco dose after eating ice cream or banana bread and butter or just hazelnut milk. Despite reading that I could just take that drug with a large glass of water, I believed the (rather overweight) pharmacist who told me I should always take vanco after eating high fat foods. I may have gained a pound during flagyl treatment, but I gained the other 2 pounds while eating 4 high fat meal/snacks daily during the first 6 days of taking vancomycin.

When I realized those 3 pounds weren't just 'water retention' or irregularity, I still couldn't accept that I had gained that much. I had not binged or purged in almost 6 months. I had overeaten at several meals, but also exercised more by biking during the summer months. I certainly couldn't blame irregularity, because I had diarrhea almost daily for the past 4 months. I certainly did not want to restrict what I ate, because I already have enough restrictioins with 7 food allergies. However, I knew that I often ate before I was hungry and beyond satisfaction while fighting c-diff.

Nevertheless the Nourishing Connections "Stay Attuned" article reminded me that I chose to focus on recovering from c-diff, rather than eat mindfully. I chose to risk gaining weight while I ate extra food in order to protect my stomach from irritation while I took medication. I also knew that I would be just as healthy with a few extra pounds, after I recovered from c-diff.

Now I'm heading into the last phase of vancomycin treatment: one more week of 4 daily doses, then a week of 2 daily doses, then a week of one daily dose and finally a week of high dose probiotic packets before dinner. 4 days later I fly to Maui hopefully free of c-diff bacteria and those 3 extra pounds. If I had to choose whether I would be free of c-diff or the 3 pounds, I would choose freedom from c-diff.

However, I don't think I need to choose one or the other. I can eat less, when I know I will record every bite. I can enjoy food more, when I only eat sitting down. I may not lose 3 pounds in 4-1/2 weeks, but I will do what I can to eat less without restricting what I eat. Between my allergy restrictions and my constantly ripening vegie and fruit gardens, I eat very healthy foods, but I eat just a bit too much.

Just today I noticed that recording what I eat and sitting down to eat already helped me eat less. I like feeling comfortable, rather than full after meals. Maybe I have to retrain my eyes, not just my mouth. So I consider smaller portions as 'just enough', rather than serving myself too much and using willpower to stop when I feel satisfied.

Down, Down and Hopefully Down

My weight has not budged, despite 'cutting back' a little. The scales don't lie. So I need to get more honest with myself. I suspect my worst habit is eating standing up, when I'm hungry before a meal, rather than waiting to eat after I prepare the meal and eat that sitting at a table. My second worst habit is continuing to eat after the meal 'standup' bites of fruit. My third worst habit is eating, tasting and licking while I prepare food, even when I'm not starved, but just not full. I can eliminate all thoe stand up eating habits by committing to eat sitting down.

I can usually keep my commitments once I decide I really want/need to do something different. For example, I have not binged or purged for almost 6 months, despite suffering constant, extreme nausea during 17 days of flagyl side effects and pretreatment c-diff symptoms. The trick is convincing myself that I really want to change my behavior. Fortunately an upcoming (4-1/2 weeks away) Maui vacation can motivate me to change my behavior. Interestingly, I blogged several months ago about what I would miss if I never again ate standing up. I need to reread that entry.

I also committed to write down everything I eat (when and how much). Just the act of journalling my food can make me think about whether I want to overeat or even serve myself too much food. Seeing what and how much I eat will help me stay honest about the source of my weight gain or loss.

I hope the forementioned 2 'downs' (sit down and write it down) will make the scale move down. However, I'm more concerned about losing belly flab and hip fluff. Toning my body with exercise seems like keeping several plates spinning. I've recently concentrated on toning my upper arms and stomach with weight lifting and sit ups. I've seen a little improvement in both areas. Meanwhile I've developed some 'hip fluff' (love lumps?) on my back waist area. SIGH Perhaps overall reduction of what I consume will be more effective than spot reducing. I just need to eat less. Usually people lose all over, but notice the most loss in places they least want to lose. Whatever happens with my body, I'm committed to eat less by sitting down and writing it down. I'm going to Maui with whatever body I have, but I hope I can fit into more waistlines of my clothes before I leave.

New Treatment Plan

I'm going to my pharmacy to pick up another vancomycin prescription. I saw my naturopath yesterday. We agreed to a new treatment plan to slowly taper off vancomycin and hopefully prevent another c-diff recurrence. I plan to take another week of 1 vanco 4x daily. Then I will reduce that to 1 pill every 12 hours for a week. Then I will take 1 pill daily.

We hope the tapered dose will allow any remaining c-diff spores to come out of hiding during the long periods between doses. Then the next vanco dose can zap the c-diff bacteria which develop from the spores. I read about pulse dosing or tapering on websites about c-diff recurrence. After 3 recurrences of c-diff, I'm willing to tray a different approach to prevent recurrence. I have only 4-1/2 weeks to get well before our Maui trip. So I want to do whatever I can to eliminate c-diff.

I no longer have diarrhea, but still have some cramping pain and fecal urgency. At this point I don't know whether those are still c-diff symptoms or deficieny of good bacteria. I'm getting bruises on my fingers very easily again. Yesterday I bruised my finger badly just tying my shoelaces. Any little extra pressure on my fingers or toes causes bruises, probably because my vitamin K (created by good bacteria) levels are sooo low now. I either need more leafy greens or extra probiotics. I'll go with leafy greens, because I get enough gas after I take my evening probiotic capsule. LOL

I'm still undecided about how long to continue full dose (4x daily) vanco. With the new prescription, I'll begin my 3rd week of destroying c-diff plus all my good bacteria. I hope my current 'regularity' means the c-diff is gone, rather than that I'm heading toward constipation because I have zippo good bacteria. Oh well, I can only wait and see ... SIGH

Consult with Naturopath

Before I see my naturopath and request another prescription for vancomycin, I decided to briefly describe my history with bacterial dysbiosis (bacteria, parasites and candida). He has my lab results and prescription records, but may not remember our correspondence about my symptoms, results of treatment or my reasons for more stool tests during he past 3 years. After experiencing 3 recurrences of c-diff and reading about treating recurrences, I believe I need to continue vanco for at least another week before tapering off. I still awoke with cramping gut pains this morning. Here's my bacterial dysbiosis 'history':

8/06 Klebsiela Oxytoca 4+ DD stool test, treated w/ Caprilic Acid (6) & HLC probiotic(1) daily; Candida 1+ considered normal

11/06 Bifido and Lacto both 0+ DD Stool test, treated b4 results w/ Phytofuge
12/06 started HLC Synbiotic for a week to restore B&L

6/07 Bifdo 0+, Lacto 1+ DD Stool test, started betaine HCl (less constipation)

3/08 Enterobacter Cloacae 3+ DD Stool test, treated w/ CA (6) 4 weeks total, HLC as needed (symptoms began 1/08, treated Candida with nystatin 6 weeks w/ no improvement b4 taking stool test on 3/15)

6/08 Cryptosporidum sp. +, Candida +1, DNA Microbial test. Treated w/ nitazoxanide 500x2 (3 days) and Nystatin (6 daily for 60 days), (Treated Enterobacter 4 weeks with no improvement b4 taking DNAM test on 5/09, declined Tummy Temple suggestion)

1/09 Moldy mayonnaise and hummus, headache, nausea, cramps. Emergency antifungal treatment with Nystatin and Caprylic acid for one week.

4/09 Reported continued constipation (also had fecal urgency, bloating and cramping symptoms); declined suggestions for tummy message, acupuncture and ED therapy; requested DNAM test.

5/09 Collected and sent DNA Microbial stool test

6/5/09 Clostridium difficile 9.7E+005 HIGH, Unidentifiable parasite (NO candida)

6/8/09 Started Flagyl (500 x 3) 10 days, HLC Intensive 1x daily.

6/19/09 Started HLC synbiotic 7day packets

6/24/09 Finished HLC symbiotic, started HLC Intensive 1x daily

6/29/09 Symptoms (cramping, bloating, gas, constipation) slowly increased

7/25/09 Reported symptoms (cramping pain after every meal, lots of bloating, even more constipation, some nausea and fatigue) via email

7/27/09 Began another 10 days of flagyl (500 x3) with 1 HLC daily

8/3/09 Called to report new symptoms on day 7 of flagyl: chills in a 75 degree house, headache, extreme nausea, cramping pain, bloating, metallic taste (flagyl)

8/05/09 After 48 hour break from treatment, began vancomycin (125x4) for 7 days plus 1 HLC daily;

8/11/09 Ended 7 days of vanco

8/12/09 Began 7 days of HLC synbiotic high dose probiotic packets

8/18/09 Finished HLC symbiotic packets

8/20/09 Return of symptoms (cramping pain, bloating and fecal urgency)

8/21/09 Symptoms changed from cramping pain and bloating on 8/20 to overwhelming nausea, dizziness, chills and passing mucus this morning; called IBSTC to report new symptoms and probably c-diff recurrence

8/21/09 Began Vanco (125x4) for 14 days

8/28/09 Noticed symptoms of dizziness, nausea and chills after long period between vanco doses (11+ hours from late night to breakfast doses)

9/2/09 IBSTC Consult to continue vanco and then try tapered doses