When to know when you have C diff again?

[Shaun3k]

Hi everyone. My mom had c diff for a few weeks. She just got done with a about 6 day hospital stay where they thankfully said her C Diff is gone. She was taking a different antibiotic in the hospital I am not sure what it was called, but it was a liquid. She was suppose to be taking it at home but her health care service place for whatever reason couldn't get a hold of the antibiotic she was prescribed. So they put her on Metronidazole for 10 days. She is currently on day 3. She also has Colitis I believe. Not sure if that clears up but her colon was inflamed when she arrived at the hospital. She also has an Ulcer.

When she had C Diff she had constant watery diarrhea and pains in her stomach. And then maybe for a day or two she might be constipated. Today is day 3 of being home she says she has no pain, but she has had diarrhea 4 times from 2 am to around 8am. Yesterday she started having diarrhea again after a day and a half of not using the bathroom at all. She says nothing much comes out and that it is not watery. She says it is soft. That she thinks it might come out thin but when it hits the water it dissolves more.

When is it a cause for concern? The Doctor at the hospital told her when she was discharged that she may be having diarrhea. Is this normal after being told you don't have C diff? She got pretty sick last time because she doesn't want to leave the house to see a Doctor because fear of going in her pants. Now she cancelled a doctors appointment(non c diff related) because of not wanting to go in her pants waiting or on the trip there. The only reason she even went to the hospital was because someone came and drove her after finally convincing her to go. If it is just diarrhea and no pain/fever should she be fine for now? Or should we be thinking hospital again? She is currently on a antibiotic not sure if that is also causing it.

[roy]

The liquid in hospital was probably vancomycin.
It's readily available to any care facility.
It's more expensive than metro and has to be refrigerated so that might be the reason.
VERY poor decision to switch though and defiantly not in her best interest.
NO hospital can say a patient is clear of c.diff 6 days after starting meds.
Symptoms resolved yes but not clear!
Do you know what the additional antibiotic is?
Her chances of a relapse are greatly increased if she is on certain antibiotics, I hope it's not cipro.
Her symptoms are borderline and could be recovery but if she is scared to go out she might not be telling you the whole truth.
Ask her to keep a stool chart and record her doings.
If she is going very soft or water 3x a day or more she needs to see a Dr.

[amyc]

Is your mother in a nursing home? Did she go a few days with zero medication after her hospital discharge while they screwed around with her prescription situation? You probably need to call the hospital to find out more about her illness, and if the D continues she may need to go back.

Is her nursing home practicing good infection control? They should be wearing disposable gowns and gloves and using precautions when caring for her or cleaning her room until she is cured.

Does she have her own primary care doctor? You should communicate with that doctor so they will know about her illness. You may need to request an appointment with a specialist.

[Shaun3k]

roy wrote:
> The liquid in hospital was probably vancomycin.
> It's readily available to any care facility.
> It's more expensive than metro and has to be refrigerated so that might be
> the reason.
> VERY poor decision to switch though and defiantly not in her best interest.
> NO hospital can say a patient is clear of c.diff 6 days after starting
> meds.
> Symptoms resolved yes but not clear!
> Do you know what the additional antibiotic is?
> Her chances of a relapse are greatly increased if she is on certain
> antibiotics, I hope it's not cipro.
> Her symptoms are borderline and could be recovery but if she is scared to
> go out she might not be telling you the whole truth.
> Ask her to keep a stool chart and record her doings.
> If she is going very soft or water 3x a day or more she needs to see a Dr.

Sorry I didn't make it clear at the end the only antibiotic she is currently on is Metronidazole for the c diff. I wasn't sure if that causes diarrhea a lot. She was on the liquid antibiotic in the hospital a few days ago, but the hospital kicked her out late on a Friday. The pharmacy they said to pick up her antibiotic was closing so her health care service place tried to deliver her medication but they said they didn't have that antibiotic supposedly they were looking at CVS and places like that. They contacted the Doctor that prescribed to ask if they can change it to a different antibiotic so she got the Metronidazole delivered Saturday. She seemed fine probably mid Saturday. She started going to the bathroom again sometime Sunday and the diarrhea hit her Monday around 2 am. Monday morning like past 10 she seemed OK again. Supposedly she is going to see her Doctor tomorrow morning, but I know if the diarrhea hits her again she is going to not want to go.

I think the doctor at the hospital just wanted to kick her out because she was there for a few days already. She told her the C diff was gone. She also told my brother this. Mind you he said this without even testing her stool again. Her health care place told the hospital they had to do a stool sample before they would release her. They were already trying to kick her out so they did the stool sample but they kicked her out before giving her the results.

[beth22]

If your mom was taking medication for the c difficile, the stool sample is useless anyway, as it would be negative while she is under treatment. Only in rare cases where it may not respond to Flagyl, for example, or if the dose is too low, it might be positive.

Yes, Flagyl can give D and possibly that is what is happening to your mother. I would encourage her to go to the doctor and ask the doctor to switch her back to the vancomycin - assuming that is what she took, but it sounds like it. If she won't go, call her doctor and explain what is happening and ask for them to call it in for her.

[Shaun3k]

amyc wrote:
> Is your mother in a nursing home? Did she go a few days with zero
> medication after her hospital discharge while they screwed around with her
> prescription situation? You probably need to call the hospital to find out
> more about her illness, and if the D continues she may need to go back.
>
> Is her nursing home practicing good infection control? They should be
> wearing disposable gowns and gloves and using precautions when caring for
> her or cleaning her room until she is cured.
>
> Does she have her own primary care doctor? You should communicate with that
> doctor so they will know about her illness. You may need to request an
> appointment with a specialist.

No my mother isn't in a nursing home. She went around I believe 16 or 17 hours in between the liquid antibiotic in the hospital and having her Metronidazole delivered. So we are doing the best we can about cleaning. Her room is full of stuff though. Including important papers not sure how that would be disinfected. The floors were cleaned and her bedding cleaned with hot water and a very small amount of bleach.

Thanks for the help amyc and roy.

[beth22]

You don't need to clean off papers and furniture, other than what she sat on, her bed, night table she may have touched with dirty hands. Clean the bathroom well as you have done.

[Shaun3k]

Thanks Beth.

[georgina]

Shaun
I'm so sorry that your mom is going through this.Beth is right , it sounds like her symptoms are not improving much with Metronidazole and she should be switched to Vancomycin or Dificid so you should go back to her doctor and discuss about one of those two antibiotics . Flagyl seems to be failing more and more this days.Also check CDI section for tips about cleaning , hygiene , diet. Is she taking any probiotics?

[roy]

I am assuming your mom is elderly.
Be her advocate and make sure she gets the best possible treatment.
Vancomycin comes in 2 forms, pills and the powder that is mixed with sterile liquid and used in an IV drip.
The pills are very expensive but the powder is a lot cheaper but they are the same medication.
In hospital the pharmacy would have mixed the powder with a syrup so she could take it orally, it's a cost related decision and there's nothing wrong with doing it.
Some even say the powder form is better.
At home you are normally prescribed pills but need good insurance, cost without insurance would be around £2000 for a 10 day course.
The liquid can be made up by a compounding pharmacy and should be readily available.
Without insurance it should cost around $100.
To get it the Dr must write liquid on the prescription.
IF she needs more meds call around and find a compounding pharmacy.
US posters will chip in with suggested pharmacy names that can dispense liquid vanco
If your not happy with her progress be very insistent that she sees the Dr and stay involved with her treatment.
Even if it means upsetting a Dr by saying Flagyl is not appropriate.
Keep us informed about how she is doing.
None of us are Drs but together we know how quite a lot about c.diff.
Sensible cleaning of high touch areas is all that is needed.
Bathroom, light switches, telephone, etc.
Your home is not contaminated.
Most important is sensible hand washing with soap under running water. (Not overdoing it) so that it removes any spores before they get transfered to the mouth.

[roy]

It's best not to use the quote feature.
It uses up space and makes it harder to read your posts.
Just mention the posters name:-)

[Shaun3k]

Ok thanks Roy.

She did end up going to her Doctor today. As she was doing better. They took a stool sample. She had trouble producing for the sample until she did slightly (a few small balls). She doesn't seem to have diarrhea right now and she has been eating regularly so as of now she is doing alright. From what she has told me she hasn't had any pain/fever since like the day after she was released from the hospital. They also told her to monitor what she eats and that different stuff can upset her stomach so she has to keep track of what food works for her.

As for her medicine they didn't change it back to the one she was getting in the hospital. They said they will never have it there because it is too expensive. She has medicaid so I am not sure if it covers it, but I assume so because they were giving it to her in the hospital. She was asking if they can give her a prescription and she can pick it up elsewhere but they didn't really give her an answer just told her she wouldn't be able to get it there. Hopefully she is doing alright with the Metronidazole. After the 10 days of that if she isn't cured hopefully she can get back on the other one. Today is day 4 of her taking that after switching from the one she was taking in the hospital.

[roy]

That's good!
She is responding to the meds.
Medicare will provide vanco, they are making excuses and to be honest what they said is disgusting.
Be prepared if she relapses and don't let them use flagyl again.
If you want to really freak them out ask for Dificid its $3500 for 20 pills and they will say no.
Be prepared with your reply that you want them to apply to Merck and use their assistance program, it's possible to get that med for free.
Here's the link to the application.
How old us your mom?

http://www.merckhelps.com/DIFICID

[Shaun3k]

Thanks Roy she is 69. I will keep that in mind if she needs a antibiotic again after this round of antibiotic finishes.

[Kalani]

I've been pouring over info since finding out I have CDiff. Never heard of it but daughter works in hospital as CNA so when she saw my stool results she was really worried about me and told me about it. I wasn't in hospital or on antibiotics. I presented with extream lower abdominal pain. First they did CT and thought I had IBD, or Colitis. I have an atypical auto immune disease so have had IBS with only diarrhea since 1993. Doc order 2 antibiotics. Could only take a couple of days. I have MCS with my disease. I knew I could take one of the scripts but wasn't sure about the other. Turned out the Flo made me sick so since Tuesday I have been on the Vancomycin. My colon was really inflamed and doc is concerned about rupture so said if any blood, pain, etc, get to hospital. I wasn't/am not having multi bouts of diarrhea or foul smelling BM, just cramping and on the Vancomycin, extream rectal itching. I'm afraid to the point of paranoid because I already have so many health issues. Doc said I had to of gotten this out in public. I'm already a neat freak but I have disinfected my house in the extream over the last week. I'm terrified I'm not gonna get rid of it or it will come back. Especially with all I'm reading. I see from threads it will do no good to do stool test again for a couple months at least after I finish the script in another 3 days, but this whole time my cramping hasn't subsided. Nurses tell my daughter I shouldn't still be having them. I know I sound like a baby here but I'm scared. I'm just glad I found this thread/group. I feel ashamed and embarrassed and even my daughter can't really help me.

Aside to the above, a year ago I saw another doctor because I thought I might be hypoglycemic. My regular GP thought not because I'm petite. The new doc did all kinds of tests and it turns out I am but one of the tests was a stool test and I didn't have any CDiff in that test result. I understand the spores are active for 70 days. It's why I have super sanitized my house. I feel like if I contracted this out in public, I need to wear rubber gloves everywhere so I don't get it again that way.