Sunday, 3 June 2018

I had a fecal transplant and it saved my life

As disgusting as the idea was of having feces injected into my body, my husband’s poop literally saved my life, writes Tracy Tuft in HuffPo. Read on: 

If you had once told me that someday I would not only agree to have someone else’s poop put inside my body, but would enthusiastically welcome it, I never would have believed you. I, like most people, would have been repulsed by the very idea. But when you’re fighting for your life, the ick factor just doesn’t matter.

My unexpected encounter with a fecal transplant began in May 2011, when I developed a tooth infection that required an antibiotic. I was on an immunosuppressant drug for my multiple sclerosis, which made me more susceptible to infections. I’d never heard of Clostridium difficile, a potentially life-threatening bacterium more commonly known as C. diff, and so I didn’t know I was even more vulnerable to developing it while taking a strong antibiotic. In my mind, I felt safe from infections because of the antibiotic. Little did I know what was awaiting me.

A couple of weeks after taking a seven-day course of Clindamycin for the tooth infection, I began having odd intestinal symptoms. The first and most alarming was waking up at 4:00 one morning and feeling what I thought was a need to have a bowel movement. When I sat on the toilet, I felt like I was going to have diarrhea and be sick, but nothing came out. I also had excruciating pain in my rectum and the surrounding area that I’d never felt before, even when I’d had fissures and hemorrhoids. It felt like someone had beaten me on my backside with a baseball bat. The next day, the pain subsided until midday, when I felt like I needed to relieve myself again. When I finally went, all that came out was a glob of thick, tan mucous with a small amount of blood in it. I had never seen or heard of anything like it. It looked like something out of a horror movie or medical drama and I was absolutely horrified.

I called my primary doctor and was told to go to an urgent care clinic, as she wasn’t able to see me that day. The doctor at the clinic couldn’t figure out what I was experiencing, so she gave me the number of a specialist. The specialist turned out to be a surgeon, not a gastroenterologist, and I found myself at a dead end. I was frustrated and terrified and had no idea what to do next.

I didn’t have diarrhea, the most common symptom of C. diff, so it made it even more difficult to determine what was happening to me. After a couple of weeks, my symptoms ― which now included nausea, cramping, mucous in my stools, a lack of appetite and pain in my entire pelvic region ― remained and I found myself getting even sicker. At this point I was spending so many hours curled up on the bathroom floor that I finally headed to the emergency room. It was there that the doctors first raised the possibility of C. diff and asked me to provide them, as best I could, with a stool sample for testing. Before the results came back, I was sent home with a prescription for Flagyl (metronidazole), the first antibiotic doctors turn to in order to treat C. diff. At this point, I still had no idea how serious C. diff is or how difficult it can be to cure.

All that came out was a glob of thick, tan mucous with a small amount of blood in it. I had never seen or heard of anything like it.
The next morning the hospital called with the test results. They were positive for C. diff. OK, no big deal, I thought. I’ll take this medication for a couple of weeks and then I’ll be fine. Because of my aforementioned immunosuppression, I was told to take my prescription for four weeks instead of the usual two. Soon I began to feel better and I was able to resume my monthly infusions of MS medication, which I had postponed because I was dealing with the C. diff.


A few days after my first infusion post-C. diff, I began having symptoms again. My doctor asked me to collect another stool sample and bring it in to be tested. I was now getting pretty good at collecting samples and taking them to the hospital lab in a small butter container I’d washed out and, once filled, tucked into a brown paper bag, all while trying to act like it was no big deal. The results came back the next day — positive. Again. I started another monthlong round of Flagyl. This time my symptoms were worse, and the medication’s side effects ― nausea, stomach pain, cramping, headache, dry mouth, metallic taste, and dizziness ― were less tolerable. At this point, I had been dealing with my stomach and bowel issues for approximately 22 weeks. I was exhausted from both the C. diff and trying to treat it. Unfortunately, I was only off the Flagyl for a couple of days before the C. diff came back with a vengeance.

This time, my doctor put me on a compounded oral version of IV Vancomycin, another antibiotic used to treat C. diff when Flagyl fails. I took that for two weeks, was off for a week before I relapsed, and was then prescribed it again for another two weeks. The C. diff wasn’t going away. Worse, with each relapse it seemed to get stronger and more resistant. We were running out of options. My body wasn’t fighting the infection and my organs were going to start shutting down. I was losing my hair and losing weight from my already underweight frame, and I continued to be the sickest I’d ever been.

Terrified that I could literally die from my infection, I began to research how others had fought and eventually beat C. diff. What I found took me completely by surprise. I learned about fecal transplants — the literal transferring of feces from one person’s gastrointestinal tract to another, via a colonoscopy-like procedure. Basically, a donor’s stool sample is blended with a saline solution to make a slurry. Then, using a tube, the concoction is inserted into the patient via the anus. The premise is that the healthy bacteria in the donor’s stool will hopefully take hold inside the patient’s infected colon and begin to replicate. It’s actually a brilliant idea, when you think about it: What better way to encourage the replenishing of the millions of healthy bacteria that a body needs than to use the real thing?

After yet another relapse, while I was taking a second round of Vancomycin, I asked my doctor if we could try a fecal transplant. He had never heard of the procedure, which surprised me, since he was a gastroenterologist. He said he would do some research and get back to me. A few weeks later, and six months after the first symptoms of my C. diff infection began, my doctor asked me if I was still willing to try a transplant. I didn’t even have to think about it: I was on board immediately.

For the next few months, I was put on a combination of Flagyl and Vancomycin, just to keep me somewhat stable while my doctor went to work setting up the protocol for the transplant. He consulted doctors in other states who had experience doing fecal transplants to educate himself about the procedure and to prepare me for what would take place.

At one point, the doctor looked at me seriously and said, “You can’t ever tell your husband ‘Don’t give me any more crap!’”
My donor was my husband. I mean, we agreed to “for better or for worse,” right? At one point, the doctor looked at me seriously and said, “You can’t ever tell your husband ‘Don’t give me any more crap!’” We laughed about that for months.

With the preparation complete, and after my husband underwent some blood tests to make sure he didn’t have anything he could pass to me through his stool, I was scheduled to have the transplant on March 2, 2012. We were instructed to purchase a new blender to bring with us to make the slurry, and my husband was told to collect his stool the morning of the procedure and bring that too. I prepared the same way you would for a colonoscopy, to ensure my gastrointestinal tract was as clean as possible to create the optimum environment for the healthy bacteria to move in and set up house.

I was the first patient to have a fecal transplant at that hospital, and possibly one of the first in Utah. I remember my doctor coming into my room whistling and smiling that morning. “This is a very auspicious day for us!” he said. He was so eager to do the procedure and for it to be successful — not just for me, but also because he had a growing list of patients who could benefit from a fecal transplant if it worked. I’ve honestly never seen someone so excited about poop, except maybe when one of my kids was constipated and then finally was able to go! I was just excited for the possibility of feeling better — not to mention not dying.

The procedure went incredibly well. I woke from the anesthesia feeling immediately better. The cramping and pain were gone and I was hungry. It was an instant cure! The goal was for me to hold the “medication” inside my body for as long as possible, and everyone was ecstatic when I was able to wait until the next day to relieve myself. I have to admit I was unprepared for the smell that accompanied that first bowel movement: My stool and gas smelled exactly like my husband’s! If he farts, I can walk away, but I couldn’t walk away from myself! It was bad. We still laugh about that. But it was a small price to pay to be healed, and as unsettling and admittedly gross as it was, his bacteria were doing their job and that’s all that mattered.

Later, my doctor told me that if the transplant hadn’t worked, my colon would have become entirely overrun by the C. diff. Not only would it have been unable to absorb the nutrients my body needs, but eventually my organs would have begun to shut down one by one until I finally died.

I’m so thankful I was able to receive a fecal transplant, and grateful that my doctor listened to me and took the necessary steps to make it happen. Even though they’re still considered highly experimental and many doctors ― even specialists ― aren’t familiar with them, fecal transplants have a dramatic success rate and can work when nothing else has. If I hadn’t lived through it, I never would have believed it. But now that I have, I want as many people as possible to know about them, because it could mean the difference between life and death for someone else. As disgusting as the idea was of having feces injected into my body, my husband’s poop literally saved my life.

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