Hi guys,
I saw a "very important" dental surgeon yesterday because of osteomyelitis in my jaw bone. I wanted to know his opinion on treatment options in the face of C Diff. Before I even got a chance to explain my case and ask my questions, he was offering his knowledge on c diff and started rambling and showing-off facts and figures.
He said it had now been proven that Clindamycin was actually not a big offender for C Diff and was muuuch safer than Cephalosporines and that it in fact got used in the treatment against C Diff. Yes, right - I thought I had misunderstood him... I almost burst out laughing. What a know it all!Or have I missed something, can this actually true?
He then announced after I had managed to issue a few confused words on my situation that the pain in my jaw was not the result of the inflammed bone (which he confirmed was clearly visible on the CT and definitely there) but of muscular stress in the jaw joint (which is about 5 cms from the area that is most sore) due to my very stressful profession (which I didn't agree I had). So, it's all psychological...
Grrrr.... Honestly, what a waste of time! And he is supposed to be "one of the best". Not for me anyway, he's not seing me again.
Maybe we should all try some Clindamycin against our C Diff? ;-)
Clever doctors
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carrie
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Man can I relate, my gyne said my hormone issues would have nothing to do with c-diff, okay is all I could muster up - was not in the mood for a challenge. I have a whole list of experiences over the last 9 months where I've left just wishing I had decided long ago to be a physician so I could truely be present with the patient. The tough part is how do you find the specialist that you can really connect with without spending all your time at appointments. Also all the information is accessible to all physician/specialists from every appointment you were ever at so if one physician writes something it seems to influence the rest. As I laid in the ER cramped over and the ER doc saying I think it is IBS - I say drop the I and it would be more accurate.
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cindym
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Carrie- You will find anytime you are forced to go to ER with cdiff related problems you will be treated like you are an idiot!!! Been there and done that so many times that I quit counting. I have now come to the conclusion that the only way I will go back to ER is if I am bleeding to death or having a heart attack! My initial cdiff was brought about by misdiagnosis in ER and too many antibiotics!
Cindy
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ClDif
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All info is accessible to all doctors? Is that how it is in the US? Where is the info stored? Not that way over here in Germany. True, one opinion will tend to influence others, but the other extreme is not ideal either. Over here doctors never know what the others have done, said or thought unless they bother to write letters to each other which they hardly ever do or unless I as a patient make a point of keeping track.
This has almost become my new profession over the past months. I feel like all I ever do is translate, communicate, pass on info, interpret, weigh up between all the many people, their opinions, their knowledge and my gut feeling for my body and common sense... I actually enjoy that kind of "work" and I am capable of doing it, but what about all those who don't have a chance due to limited time, resources, education I often wonder... They are pretty much left to fend for themselves and lucky if they have good doctors.
This has almost become my new profession over the past months. I feel like all I ever do is translate, communicate, pass on info, interpret, weigh up between all the many people, their opinions, their knowledge and my gut feeling for my body and common sense... I actually enjoy that kind of "work" and I am capable of doing it, but what about all those who don't have a chance due to limited time, resources, education I often wonder... They are pretty much left to fend for themselves and lucky if they have good doctors.
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Jenny
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I'm lucky in that I have been quite happy with my doctors here in Houston, they are all within one very large clinic. My OB, PCP, RH and GI all share the same file on me, this really helps. The IDD is the first Dr I will see out of the clinic but he will be sent a copy of all my records. I think this will help a great deal. It ceratinly helps with keeping track of the meds. I have also given them a copy of the antibiotic list from this site to put in my file. They even have a weekend walk in clinic, no good at night though, but beats going to the ER. I haven't had to do the ER trips thank goodness. I really feel for you that have had go through that ordeal. Last year I took my husband to the ER, 5hrs later we left with phenergan and pain meds for kidney stones. I can't imagine being there with D.
Well wishes to you all,
Jenny
Well wishes to you all,
Jenny
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carrie
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Yup that is the way it is in Canada, at least Alberta. Everything is electronic charting and it all goes into a shared medical net with every appointment and lab result you'd ever like to review. Certainly has helped in some situations and in others I felt information sharing influenced a different physicians view of my medical condition. I also have had two wonderful physicians to work with, it is the specialists I'm struggling with.
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fire7163
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fire7163
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Jenny
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Fire,
OMG, I can't believe a Dr would be so cruel, fatalist. I'm glad they kicked him out. I hope he lost his license. It's so unfortunate that so many Dr's don't care about their profession and the people they treat, just the money.
Different experience but an old boyfriend of mine, his father beat up the dr who delivered his son. The Dr was very negligent and lets just say the baby didn't make it. The Dr just said, "well these things happen". Dr still got to practise and the Dad ended up in Jail for several months. It wasn't so easy to sue Dr's in the UK back then.
At least in the US most of the time you can pick your DR's except for the ER of course. Despite those Dr's that are in it just for the money, I still like the US healthcare more than the UK.
Take Care of Yourself
Jenny
OMG, I can't believe a Dr would be so cruel, fatalist. I'm glad they kicked him out. I hope he lost his license. It's so unfortunate that so many Dr's don't care about their profession and the people they treat, just the money.
Different experience but an old boyfriend of mine, his father beat up the dr who delivered his son. The Dr was very negligent and lets just say the baby didn't make it. The Dr just said, "well these things happen". Dr still got to practise and the Dad ended up in Jail for several months. It wasn't so easy to sue Dr's in the UK back then.
At least in the US most of the time you can pick your DR's except for the ER of course. Despite those Dr's that are in it just for the money, I still like the US healthcare more than the UK.
Take Care of Yourself
Jenny
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Bobbie
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CIDiff,
Just saw this post & don't think I commented on it. I has osteomyletis in my left jaw-- ground teeth because of stress of C. diff., broke several, teeth, big "screw-up" with dental surgeon. Usually PenVK will work in the mouth. Didn't for me. I was on 6-8 wks. IV Vanco.Did the job. Had to have mouth rebuilt -- braces, bridges, etc. Gold crowns are best -- don't have to "take" tooth down as far.
If you have osteomyletis, you will have horrible pain. I've never had anything like it. Have high level of pain & was gulping pain pills every 3 hrs. Went to work, but was miserable.
They diagnosed my osteomyletis by a MRI. Hope you don't have it!!! Your
"expert" is all wet. Clindamycin was lst antibiotic every linked to C. diff.
Fire,
What a disgusting remark for doc. to make. Good for you!!
Just saw this post & don't think I commented on it. I has osteomyletis in my left jaw-- ground teeth because of stress of C. diff., broke several, teeth, big "screw-up" with dental surgeon. Usually PenVK will work in the mouth. Didn't for me. I was on 6-8 wks. IV Vanco.Did the job. Had to have mouth rebuilt -- braces, bridges, etc. Gold crowns are best -- don't have to "take" tooth down as far.
If you have osteomyletis, you will have horrible pain. I've never had anything like it. Have high level of pain & was gulping pain pills every 3 hrs. Went to work, but was miserable.
They diagnosed my osteomyletis by a MRI. Hope you don't have it!!! Your
"expert" is all wet. Clindamycin was lst antibiotic every linked to C. diff.
Fire,
What a disgusting remark for doc. to make. Good for you!!
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ClDif
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Thanks Bobbie!
I am not in horrible pain, just in modest, very unpleasant pain. My symptoms are more systemic, but I don't know if the jaw bone is the cause of that. Acupucture helps a great deal, but only for a few days at a time.
I did a scintigramme (??) and a CT and inflammation is clearly visible in a limited area of the bone. It's not dramatic but it is there. Saw another dental surgeon in the mean time. He doesn't doubt that the inflammation is there but is reluctant to recommend surgery due to the c diff. He said if he does operate he would only do that with antibiotic cover. Either with a minimal amount of Pen G prior to and during the surgery or by implanting gentamycin chains into the gap left in the bone. The latter technique would mean that the wound would have to be re-opened to have the chains removed later, hence more of a risk for infection (and ABs). Plus gemtamycin doesn't have the best spectrum for coverage of pathogens in the mouth, not so good with anaerobes I don't think. Deosn't seem like an antibiogramme can be done prior to the surgery either. Seems like that alone requires surgery. Or else they are lazy...
I am now trying to find out whether or not I am allergic to penicillin. I think I am, but need to be sure. Apparantly, dermatologists do those tests. Not sure though. I insisted on IV Vanco and they insisted that I absolutely must leave that for the future for life-threatening emergencies. Didnt really understand the strong reaction - does one get resistant that quickly? For them, IV Vanco was completely out of the question. And I made my point very clear I think and explained why I thought that was my only option. Hmmm... I got asked what I did for a living. I think the doc was expecting something medical... You never know though whether they end up thinking you are really smart or that you are a nutcase of a hypochonriac with too much time on your hands. ;-)
I wonder if this inflammation could cause my elevated ESR. The "clever" doc said it could, the last and seemingly more clever and definitely more likeable one said it could not. Great. It seems to be up to me to decide what to do and I have absolutely NO clue. I feel terrible, really weak, nauseaus and dizzy, have been like this for weeks now - but how am I supposed to tell if my jaw bone is to blame and if it is worth the risk of surgery and ABs??
I am not in horrible pain, just in modest, very unpleasant pain. My symptoms are more systemic, but I don't know if the jaw bone is the cause of that. Acupucture helps a great deal, but only for a few days at a time.
I did a scintigramme (??) and a CT and inflammation is clearly visible in a limited area of the bone. It's not dramatic but it is there. Saw another dental surgeon in the mean time. He doesn't doubt that the inflammation is there but is reluctant to recommend surgery due to the c diff. He said if he does operate he would only do that with antibiotic cover. Either with a minimal amount of Pen G prior to and during the surgery or by implanting gentamycin chains into the gap left in the bone. The latter technique would mean that the wound would have to be re-opened to have the chains removed later, hence more of a risk for infection (and ABs). Plus gemtamycin doesn't have the best spectrum for coverage of pathogens in the mouth, not so good with anaerobes I don't think. Deosn't seem like an antibiogramme can be done prior to the surgery either. Seems like that alone requires surgery. Or else they are lazy...
I am now trying to find out whether or not I am allergic to penicillin. I think I am, but need to be sure. Apparantly, dermatologists do those tests. Not sure though. I insisted on IV Vanco and they insisted that I absolutely must leave that for the future for life-threatening emergencies. Didnt really understand the strong reaction - does one get resistant that quickly? For them, IV Vanco was completely out of the question. And I made my point very clear I think and explained why I thought that was my only option. Hmmm... I got asked what I did for a living. I think the doc was expecting something medical... You never know though whether they end up thinking you are really smart or that you are a nutcase of a hypochonriac with too much time on your hands. ;-)
I wonder if this inflammation could cause my elevated ESR. The "clever" doc said it could, the last and seemingly more clever and definitely more likeable one said it could not. Great. It seems to be up to me to decide what to do and I have absolutely NO clue. I feel terrible, really weak, nauseaus and dizzy, have been like this for weeks now - but how am I supposed to tell if my jaw bone is to blame and if it is worth the risk of surgery and ABs??
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Bobbie
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See an ID. That is what I did after oral surgeon extracted wrong tooth -- "insult on top of injury." He also cut a nerve, & the left side of my mouth is partially numb.Had 3 teeth extracted in all. My dentist dropped me -- another case of a professional not wanting to deal with C. diff. I wore a partial bridge for awhile -- didn't work. My teeth all shifted. Then my perio. recommended another dentist & he recommend a orthodontist -- was in braces for a year, & then "new dentist" did bridges. Bite still not right. Have to weigh two guards at night to keep teeth in line. I used to have beautiful teeth - not one cavity. They still look all right, but I do a lot of maintenace. Everytime I eat (even in a restaurant) I run in bathroom & brush & floss my teeth. Carry a "kit"in my purse. I
Since having C. diff., I've needed maintenance almost everywhere! I feel like an aging car & have decided on exterior maintenance only!
When lst oral surgeon, extracted (wrong) tooth, his hands were shaking! Not a good sign. He finally said, "Don't you want to be "out" for this." I said, "It's a little late now, isn't it?" He finally got the tooth out with pliers. When I had continued pain, I refused to see him -- saw his colleague who was great to me. He called lst surgeon in room, showed him the X-rays, & through a haze of pain, heard him lecture him.
It usually takes long to become "iresistant" to Vanco. I was on it (on & off) for 4 yrs. plus the wks. of IV. (IV Vanco. does have more riks -- major ones involve hearing & kidneys. (Did blood work twice a wk.)
Pharmacist told me on the phone the other night docs. are now using it to treat other GI problems. The reason some docs. are afraid is that it is it used for resistant staph infections & some considered it the "drug of last resort."
If your face "puffs up," get to oral surgeon or ID ASAP.
Since having C. diff., I've needed maintenance almost everywhere! I feel like an aging car & have decided on exterior maintenance only!
When lst oral surgeon, extracted (wrong) tooth, his hands were shaking! Not a good sign. He finally said, "Don't you want to be "out" for this." I said, "It's a little late now, isn't it?" He finally got the tooth out with pliers. When I had continued pain, I refused to see him -- saw his colleague who was great to me. He called lst surgeon in room, showed him the X-rays, & through a haze of pain, heard him lecture him.
It usually takes long to become "iresistant" to Vanco. I was on it (on & off) for 4 yrs. plus the wks. of IV. (IV Vanco. does have more riks -- major ones involve hearing & kidneys. (Did blood work twice a wk.)
Pharmacist told me on the phone the other night docs. are now using it to treat other GI problems. The reason some docs. are afraid is that it is it used for resistant staph infections & some considered it the "drug of last resort."
If your face "puffs up," get to oral surgeon or ID ASAP.
Last edited by Bobbie on Wed May 07, 2008 12:01 am, edited 1 time in total.
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ClDif
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Hmmm... We don't really have IDs as such over here I don't think... You get GPs with a specialisation, GIs who are also IDs etc. I hope to be seeing such a GI tomorrow - but what would he know about teeth? Knowing who to ask is half the game and I have run out of ideas and stamina at the moment... But I will ask him about the dangers of Vanco. I know about the risk of resistant enterococci, but still... Thanks again Bobbie!
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Bobbie
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CIDiff,
I was off the site for awhile when you lst began posting & didn't remember you are from Germany. Are you an American living there or a German citizen?
What is your dental situation over there? I don't think there are many "good" dentists in the UK because the NHS doesn't cover dental work. My son has lived there for over 5 yrs. & has never seen a dentist.
Hope this new GI can help you.
My osteomyletis was extremely painful. Perhaps there are different forms of it. Do ask this doc. anyway, & perhaps he can guide you in the right direction.
There are many flaws in our medical system in the US, but I still prefer it to what I've heard happens in other countries.
I was off the site for awhile when you lst began posting & didn't remember you are from Germany. Are you an American living there or a German citizen?
What is your dental situation over there? I don't think there are many "good" dentists in the UK because the NHS doesn't cover dental work. My son has lived there for over 5 yrs. & has never seen a dentist.
Hope this new GI can help you.
My osteomyletis was extremely painful. Perhaps there are different forms of it. Do ask this doc. anyway, & perhaps he can guide you in the right direction.
There are many flaws in our medical system in the US, but I still prefer it to what I've heard happens in other countries.
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