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.
Wednesday, September 9, 2009
Tuesday, September 8, 2009
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.
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.
Thursday, September 3, 2009
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.
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.
"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.
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
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
Wednesday, September 2, 2009
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
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
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