Is it safe to go back to work?

Please limit your post to questions only. You can ask multiple questions in the post. (One post per person per day about yourself. See exception in General C. diff.Discussion.)
Keri
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Is it safe to go back to work?

Postby Keri » Sun Oct 15, 2017 6:09 pm

Hello, I was diagnosed with C Diff, and started metronidazole, along with probiotics, 5 days ago. I am much better today, as I've only had loose stool once. When is it safe to go back to work, or use anyone else's bathroom? Thanks!

roy
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Re: Is it safe to go back to work?

Postby roy » Sun Oct 15, 2017 7:11 pm

48 hours after normal BMs resume UK hospital Guidlines say isolation can be relaxed.

georgina
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Re: Is it safe to go back to work?

Postby georgina » Mon Oct 16, 2017 12:18 am

Yeap , if you are feeling ok for work and you are no longer having D it should be fine to go back to work .However it would be nice if you can take a small spray bottle of bleach with you to spray on the toilet in case you are having a BM at work.

MKW
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Re: Is it safe to go back to work?

Postby MKW » Tue Oct 17, 2017 8:25 pm

Hi, each time I recurred with C Diff I went back to work 2-3 days after starting meds. I was lucky however, even though it kept coming back, I responded to meds quickly each time. There are some 10% bleach wipes you can buy on Amazon. You can take those in a ziplock baggie or small container so you can take them to the bathroom with you and wipe down if you end up and have a BM at work. Just so you can feel like you are doing your best to protect others. I found as long as the D had stopped, I was better off going back to work, rather than worrying myself to death at home all day :-)

2MG
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Re: Is it safe to go back to work?

Postby 2MG » Sun Nov 05, 2017 5:03 pm

Hi everyone - this is my biggest question.

I am currently having a first relapse of this "lovely" infection - positive toxins on culture found yesterday, starting Flagyl (again) today.

My variation on this question is: as a nurse in a hospital, when is it safe for me to go back to work? I am in the US, and can't find anything in writing about recommendations for outpatient quarantine/isolation. I can only find recommendations for hospital/facility inpatients.

I even contacted my hospital infection control department (through my charge nurse), who said that if I am feeling well and wash my hands well, I should be ok to work. That made no sense to me, knowing that inpatients would be on contact precautions/isolation.

So - does anyone have any suggestions as to where I might find this information? Thanks in advance!

Ril
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Re: Is it safe to go back to work?

Postby Ril » Sun Nov 05, 2017 6:19 pm

2MG,
I have already welcomed you to the site, explained that postings should be in one place and will continue to try to give some input here and hopefully others will as well.
Also, feel free to start your own thread.
As I already said, you did not say why you were diagnosed with c diff and treated with Flagyl the first time despite a negative test. I asked details in the previous post. You also did not say what test you had done this time but more importantly, what your symptoms are. You should be treated based on symptoms not test results.

If I indeed had a recurrence of c diff I would not take Flagyl again but would request Difficid or vancomycin. I hope you are seeing a GI or ID dr.

We cannot tell you about returning to work, especially health care and the L&D dept. You must get clarification from you IC dept. I don’t know why they are not more forthcoming. General rule of thumb is if you are not having d for a few (?) days and feel well enough to work you can, but that is not always the case. Of course meticulous handwashing and standard precautions is a given. But it is up to the individual IC dept policies to clarify their requirements.

Rita

NanciT
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Re: Is it safe to go back to work?

Postby NanciT » Sun Nov 05, 2017 6:37 pm

I would make very sure you contacted not only infection control who I would speak with directly, but I would go to administration and my physicians( ID or GI) also that you were symptom free before returning to work.
I took extra precautions, we all know patients are put in isolation, we need to take all precautions. If you read through this site, you will find many of us who were very ill with relapse after relapse( myself nearly a year of relapses) and other complications. I often see both physicians and nurses label CDIFF as simple as antibiotic induced diarrhea but it can be far more than that for so many.
Especially if you are working L&D where we are sadly seeing so many cases.
I also wanted to mention I would not be taking Flagyl for a 2nd round, I would push for Dificid.

NanciT

MKW
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Re: Is it safe to go back to work?

Postby MKW » Sun Nov 05, 2017 8:42 pm

Hi, just wanted to say another one here suggesting to NOT do Flagyl for a second round. I developed oral thrush during my second round, also it just has so many more side effects than Vancomycin, and Vanco has a higher success rate.

2MG
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Re: Is it safe to go back to work?

Postby 2MG » Sun Nov 05, 2017 11:27 pm

Thanks for the responses, folks.

Rita, you are right in that I did not explain my situation well. Let's see if I can explain it briefly.

In Sept, I was diagnosed with impetigo and prescribed Augmentin. Knowing that I usually have D when taking antibiotics, I took probiotics, ate yogurt, and when D did start (later than usual), I took Pepto. About 5 days after finishing the Augmentin, things got worse. Cramps, fever and worsening D. Went to an urgent care, where somehow the doc missed my concern about D after antibiotics, and diagnosed me a UTI after a urinalysis with blood and leukocytes in my urine. Gave me Cipro - sent me home. I was not convinced, and went to a different place the next day. This guy listened, rechecked my urine (which was clean), said to stop the Cipro, try his Lomotil regimen, and if no improvement, see my primary for a C. diff workup. So - the next day (Thursday), I had less D (Lomotil works well) so I continued on with my plans. Friday was ok. Saturday - I woke up and everything went downhill from there. Lots more D, achy, generally felt horrible. By that evening, I was chilled, shaky, and had fever of 103+. Slept Sunday. Saw my primary Monday. She sent me to the ER, hoping they would do a full workup. They did blood work and CT scan, gave me IV fluids and potassium replacement. Told me that they were going to treat presumptively for C. diff, and I had the choice of in or out patient. I went home with Flagyl. Three days later, I don't feel better and go back to my primary. She was confused about why no stool samples had been done, and told me to get some done ASAP since I still had D. Those samples (3 days into treatment) came back negative. (Tests included Shiga, Salmonella/Shigella, Campylobacter, and C. Diff toxin/GDH with reflex to PCR. Slowly I got better. 6 days after I finish the Flagyl, D comes back. I see my primary again. She has me do another set of samples, which I am able to do that day (1 week after Flagyl was done). She called me Saturday to tell me that the samples were positive for toxins. I don't have access to the details of those results from Quest yet.

So, I went to work Friday and Saturday, even though I had D. Saturday I needed to take Imodium to be "safe" at work. When I heard the results, I told my charge nurse. She contacted the IC nurse on for the day. Since I didn't speak to the IC nurse, and I didn't hear exactly what my charge nurse said, I am unsure that either of them understood what my question was. What I understood from my charge nurse was that the IC nurse said that it would be fine for me to stay at work as long as felt well (whatever that means) and used good hand hygiene.

I called in for today and tomorrow, and emailed a different nurse at Infection Control to see if I could clarify what I found out yesterday. Hopefully I will hear from her tomorrow.

georgina
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Re: Is it safe to go back to work?

Postby georgina » Mon Nov 06, 2017 1:16 am

If the frequent D came back after you finished the course of Flagyl and you are still testing positive you should not go to work , you should go and discuss the next course of treatment with your GI or infectious disease doctor. Do not take Imodium to be " safe" , if toxins stay inside they will do a lot of damage to your intestinal lining.

Acres
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Re: Is it safe to go back to work?

Postby Acres » Mon Nov 06, 2017 11:24 am

My c diff GI just told me the other day that he is now skipping flagyl and starting patients with vancomycin....
I am having issues right now....If I spiral down into an infection we are going right to Dificid (vanco did not do it for me last year and dificid worked)

Ril
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Re: Is it safe to go back to work?

Postby Ril » Mon Nov 06, 2017 6:06 pm

I have no idea why the hospital didn’t do stool for c diff. They can get results in a few hours if their lab does c diff testing else I am sure if they are part of a network they send it to a sister hospital and get it no later than the next day. I always have my test done at the hospital lab so I can get the result quickly.
Your test will likely come back negative once you have taken meds. That result is not reliable.

I will not comment further on the handling of your case. The point is to get you better.

If it were me I would get to a GI dr. As Georgina said, you do not take meds to hold in the d. Until you are stable you really cannot work. You do need clarification on policy but that is for later not now. I would not allow you to have patient contact. Your illness does not yet sound controlled. Hopefully that will happen soon but in the meantime keep washing your hands, clean the bathroom and see a GI dr and explain your history.

2MG
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Re: Is it safe to go back to work?

Postby 2MG » Mon Nov 06, 2017 7:29 pm

I appreciate hearing your perspective, Rita.

I have an appointment with a GI guy on the 15th (soonest available). I was able to "talk" to an IC nurse at work today. She was busy, but one of her office people was able to relay my question (should I be at work?), and relay her answer (not til the diarrhea is gone). My primary doc is out of town this week, but I left a message with her office, asking when she would be comfortable with me going back to work. Also, I spoke with my supervisor, so I "think" I have everyone informed.

So, hand washing, bathroom cleaning, BRAT(TY) diet FTW. (Oh - and Flagyl....)

georgina
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Re: Is it safe to go back to work?

Postby georgina » Tue Nov 07, 2017 12:49 am

Try to discuss about Vanco next time you see your doctor . If Flagyl didn't clear the infection first time taking another course is useless. If you have a possibility to get Dificid it will be even better.

2MG
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Re: Is it safe to go back to work?

Postby 2MG » Thu Nov 09, 2017 7:28 pm

I finally got some clarification from my hospital Infection Control folks.

10 days of Flagyl AND continent/no diarrhea and I can go back to work.

So far, that seems possible. I just have to wait and see though. Apparently recovery is not a straight line of constant improvement. Feels like I'm doing the two steps forward, one step back thing.


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