FMT questions

[Zapper]

Hi all,
Not my first post but I'm 28 yr old female battling c diff since 11/2015. I failed all flagyl and vanco treatments. Scheduled for an FMT on 4/28 and feeling nervous.
Colon prep seems longer than my other colonoscopies and wondering if this is normal? Usually I have a prepopik prep for 12 hrs. This time around in our off food for 48 hours liquid diet and 23 hour prep laxatives at 4pm followed by 2 doses of prepopik at 10pm and 10am for a 4pm procedure. Seems excessive but wondering if it is different cause it's an FMT?
And... this may be TMI. But I am the last colonoscopy of the day at 4pm cause I am considered still infecious disease.. this puts me at a 5 to 5:15pm discharge home during Rush hour traffic (a 1 - 1 1/2 hour drive home). I hear a lot of people not being able to hold the transplant in.. should I wear a depends for the drive or would I be able to hold it?
Please advise. I am such an over thinker and over planner. I can't stop thinking about not being able to pull over and having an "accident".
Any other tips for getting thru the FMT are welcome!!!

Thanks guys.

[beth22]

Hi Zapper - I am not familiar with the longer prep that you are doing. I just did the regular colonoscopy prep, which was liquid diet the day before and starting the laxatives in the late afternoon/early evening of the evening prior to the procedure. However, my procedure was early in the morning. Perhaps they mean a liquid diet for 2 days because they are including the day or your procedure, although I thought the day of a procedure you can't have anything 8 hours prior, even liquids. I would speak to your doctor (not the nurse) and clarify all of your questions. If the nurse won't put you through, ask if you can send an e-mail. With some doctors, that is the best way.

As far as holding in the FMT, I took Imodium shortly before the FMT and upon waking up, I was given 2 to take. This does help. You have to stay in the recovery for a little while anyway, at least I did because I had propofol, which puts you out completely. Wearing a depends is not a bad idea. It will give you some peace of mind at least. I would lay down in the back seat of the car if I were you, so bring a pillow.

The prep seems a bit much to me too. Are you still having D? Unless you are C, I doubt you would need that much. I only drank half of what they told me to drink and it was more than enough. Check with the doctor though.

[Davidtm]

Hi zapper,
Congrats on your upcoming fmt! I'm hoping that does the trick for you and cures you of this. I've had two fmts and never a colonoscopy before hand. I don't know what other preps people have had and I'm sure it varies from clinic to clinic. For me I went on a liquid diet for 3 days before my first fmt. 2 days for the second one. My prep consisted of a gallon of galvolite started 18 hours before my appt. drinking half spread out that evening and the other half early in the morning. The second time was modified to be 2/3rds in the evening spread out and then 1/3rd in the early morning for my 12pm appt.
I was told to take Imodium before the procedure and after the procedure was finished. This was the same the second time. The second time was much easier to hold in than the first for me. I had mentioned to the administering dr about how the trapped air made it difficult the first time and the second time I think he made some adjustments to make that easier. I wore depends to my appt and brought an extra pair to wear home. My discharge was around 3:30-4 and the start of rush hour so it was a good 2 hours home for me both times. The Imodium helped me not have an accident but I was prepared. So to sum up I would ask the dr about the prep if you're concerned. I think they just want to make sure you're very cleaned out so they can see everything and seed the gut. And yes as Beth said bring a pillow for the car!
Wish you all the best on your fmt and don't be afraid to ask the dr any questions you have about the procedure and after care.

[georgina]

Zapper
Glad you have been scheduled for FMt , hope it does the trick. I had a naso-gastric FMT and needed to have a cleanse but it was not like yours , your prep seems a bit harsh. I had to drink 1 gallon of Fortrans and keep a liquid diet 24 h before the procedure . In the morning of the procedure i wasn't allowed to ingest anything (not even water) and to take 2 Immodium pills. After the procedure i took another 2 Immodium and then i had a five hours trip with the trian to get back home . Had some mild cramps and gurgling but no accidents in the train .

[linnyg]

I just had my 2nd FMT. I did the suprep double prep each time- the dose first at 6 pm the night before, the 2nd dose at 7 am the morning of-procedure was noon, both times. I went to the hospital wearing a depends just in case, and brought one for the ride home, too. I was instructed to take 2 Immodiums before I left for the hospital, 2 more when I got home and one at 10 pm. The only thing I wish I had done differently was to drink more gatorade the 2 days before the procedure. I was very dehydrated this time and it was hard for them to get an IV in- I bruised so bad it was insane.

[Bobbie]

linnyg,

Different docs do the FMT differently. God forbid, this should be easy.

Depends are a good idea.

You will retain most of the FMT. Most lose some but have enough left to work. After the procedure, lie on your left side in a fetal position as long as you can. As Beth said, the back seat of the car is ideal.

Ask your doc about adding fiber to your diet after the procedure.

Good luck.

[Zapper]

Well, today is 1 full day off vanco prepping for the FMT Friday... I'm already showing signs of an active c diff infection again (b & m).
Is this normal? Do I just wait until the FMT?

[roy]

That's very fast for a relapse but blood is a big concern.
Call your Dr right away.
I don't know if the advice would be to go ahead with the FMT if your guts bleeding.
I am not a Dr but my thoughts are that it should be postponed.
Blood means theres a wound that could give the FMT bacteria access to your blood stream.
Very much a medical question and very much one that needs addressing.
Have you started the prep?

[Zapper]

I left a message but waiting for a call back. Have not started prep yet either... that's for 10pm tonight. I really hope they call me soon.
I just started with a fever. :(

[amyc]

Oh gosh, I am so sorry. Call again if you don't hear back right away. The fever and return of symptoms so fast...wow. You may need to do Dificid or high dose vanco for 10 days and reschedule, but that's a doctor thing.

If they choose to still do the FMT, verify those prep instructions. They sound like you're doing double prep? Could have been a mistake?

Finally, for the discharge, does the center close before 6 pm? I would do whatever I could to not drive home through rush hour. Stay at the center as long as you can, just so the ride home won't be so stressful. You have dealt with enough stress in your young life. Don't let them shove you out the door.

[amyc]

If you are the last procedure of the day ask if you can recover for a few extra minutes in the actual procedure room before going to the recovery area. They already have to clean that room for C diff, so if they use common sense they should agree. Having worked in surgery, eh, they probably won't. But it's still worth asking.

[Zapper]

They responded. Said since it's not above 101.9 we are still moving forward with the procedure tomorrow. I told them I've had about 8 episodes of D but that doesn't seem to bother them. (Bothers me of course cause I haven't even done the prep yet!)
Doc says that I'll have faster results by waiting for the FMT rather than taking vanco now.

Looks like I'll be having a very long night/day tomorrow.

[roy]

Same here!
Not c.diff related but I start the prep for upper and lower in around 9 hours.
We can be toilet buddies!

[Zapper]

Awesome! Nice to know I'm not the only one suffering. :P

[georgina]

I'm sorry you are having symptoms again , if i were you i would talk to your doctor to extend the treatment period for a few more days until you remain symptom free and then go ahead with the prep , just to make sure that the colony is eradicated. You do not want to put good bacteria on top of pathogen bacteria , as the good bacteria might not survive.
Prayers that everything goes well !