Help needed quick!

Treatments, possible treatments, unsubstantiated/unproven treatments. Consult your doctor first.
Momo2016
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Help needed quick!

Postby Momo2016 » Mon Oct 02, 2017 11:05 pm

Hi all - I'm a 33 year old previously healthy female. Had a very uncomplicated pregnancy and delivered a healthy baby boy on 8/8. I developed mastitis 5 days postpartum and took Docloxacillin x10 days. Then unfortunately developed a skin infection and took 3 day course of Keflex. About a week later I developed diarrhea. I'm a physician myself and after the 2nd day of symptoms a light went off in my head and I just knew I had C. Diff. On day 3 of D I got severe cramps so went to local ER for stool sample which confirmed C. Diff. I started vanco because I'm breastfeeding.

Took vanco 125 mg four times daily x10 days. I responded really well and symptoms basically resolved after 1 day of treatment. Was back to one daily formed stool by the end of treatment. To be honest I did not really adhere to a great diet after treatment, eating lots of salads still and dairy. I think I was just under a lot of stress with a newborn and grabbing anything quick. Well then exactly 1 week later my D came back. After 3 days of 6-7 stools per day we decided it was a relapse so I would have to restart treatment. Now I am on Vanco 125 mg four times daily again. Initial plan was to take it for 14 days. Once again I responded great and today even had a formed stool (today is day 3). But I have talked to multiple ID DOCS. I have heard differing opinions on what my regimen should
be. I have been recommended to take 250 mg four times daily anywhere from 2-6 weeks. Since this is not a true recurrence given that I just ended treatment 1 week before I am really at a loss for what to do. I'm terrified of this relapsing but also don't want to take vanco for 6 weeks if it's unnecessary. Can anyone offer advice?? There really doesn't seem to be clear cut protocols at least in the resources I have been looking at. And of course every specialist I ask has a different recommendation. I just want this to be over so that I can properly care for my baby and no longer be so anxious :(

Also I'm taking Florastor 3 times daily and lactobacillus once daily along with kefir and yogurt. Any other reccs for probiotics??

Thanks in advance.

georgina
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Re: Help needed quick!

Postby georgina » Tue Oct 03, 2017 12:25 am

You said 6 weeks of Vancomycin , did your doctor said anything about tapering and pulsing or he just want's you to take it full dosage per day for all six weeks? A taper and a pulse of vanco after the 14 day course failed is the next line of treatment and it has a high cure rate so it might be your magic bullet. About probiotics , I personally think that taking Florastor is enough , it's the only probiotic that was studied to be effective against CDiff ,but if you want to add more probiotics try the natural probiotics :kefir or yogurt (if you are not lactose intolerant) a spoonful of yogurt contains more live cultures then the pill. Be careful about your diet , bland is what you need to heal your gut , most of us cannot touch salads , I cannot tolerate ANY leafy greens , they go straight trough me undigested.

NanciT
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Re: Help needed quick!

Postby NanciT » Tue Oct 03, 2017 12:32 am

Hello momo2016 and Welcome to the site Please read the first thread for all new posters

I am sorry you had to find us and are going through this. As you know we cannot give medical advice but can share our experiences with you.

I am also a Healthcare Provider and can tell you the medical community does not have any standard Protocol and so many of us have gone through months of trying to get an appropriate treatment plan.

In your case the issue becomes was this a relapse and I certainly understand not wanting to over treat.

I did relapse on Vanco after two weeks, never much diarrhea(3-4 am only) and that was it but I had vomiting and abdominal pain...so I knew it was a relapse. I then went on a 3 month tapered treatment. This has cured many but for me, I relapsed again. It was a long 10 months in my case and a Dificid taper that worked.

My GI never tested, we always went by symptoms which is what most tend to do. The different opinions is very common and it's very difficult. The issue is, if you do still have it you want it gone. As far as diet, it can make things seem like a relapse but I have found that only to last a day or two. If the diarrhea continued several times a day it sounds like a relapse.

Do your research and go with what you think is best. Take a look at this site under CDI, there is a great deal of information there and people have posted what has worked for them

Wishing you the best!

NanciT

Momo2016
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Re: Help needed quick!

Postby Momo2016 » Tue Oct 03, 2017 1:17 am

Hi thanks for the responses. I am seeing an ID doc who just wants me to do 250 QID for 6 weeks. She did not talk about taper or pulse dosing. She has worked in our community for 30+ years and says this is what almost always works for her patients after failing initial treatment. Anyone else out there have input on what worked for them??


anyone have luck with a 10 day course of vanco?? I am thinking I should have originally started with 14 day and maybe that would have taken care of it. Who knows...

beth22
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Re: Help needed quick!

Postby beth22 » Tue Oct 03, 2017 1:33 am

I personally think that the long courses of vanco that I took did more harm than good for me. My relapses were always worse after them and they seemed to wipe out too much flora. I would call your doctor and ask about tapering or perhaps trying Dificid, which is a newer medication, and targets c difficile while saving more good flora.

Lisa33
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Re: Help needed quick!

Postby Lisa33 » Tue Oct 03, 2017 11:01 am

After relapsing two weeks after finishing a 10 day Flagyl course back in 2014, I was put back on Flagyl, which made me sicker than the c-diff. I pushed to be switched to vanco, and after 9 days of Flagyl hell, I was switched to a 14 day course of vanco. That cured me. It's a hard decision as to what the correct thing to do is. If you go with the longer dosing, I would definitely discuss a taper. Leafy greens did not agree with me at all for quite some time after c-diff. In my opinion, the two probiotics that helped me to recover were VSL-3 and Florastor. I still take Florastor now at 3 years out. In early recovery, I also drank Kefir and ate yogurts with live cultures. Some can't tolerate a lot of probiotics, so you have to see what works for you.

Good luck and hopefully this latest round of treatment will do the trick!
Lisa

amg
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Re: Help needed quick!

Postby amg » Tue Oct 03, 2017 11:22 am

I agree this sounds like a relapse. My daughter's relapses went progressively from 4 weeks after the last dose of antibiotics, to 4 days after her last dose.

If I were you, I would definitely ask about Dificid. You don't want to get into that cycle of recurrences. Once a recurrence happens, the risk of another recurrence jumps up. Vancomycin actually may have some "pro-spore" activity, believe it or not. (I will look for that article)

I also wonder if, as a physician, you have a higher chance of having a more "hardy" strain, therefore another reason to get Dificid in there early and get those spores. (I'm a physician too, and I don't even want to know what I bring home from the hospital every day on my shoes)

Also, the anxiety is such a common part of this illness, it makes sense when you know that the gut produces a large percentage of neurotransmitters including serotonin. Combine that with the fear of relapses, or the fear of GI symptoms hitting you somewhere in public, and the lack of sleep a new mother has, and of COURSE you're anxious.

Good luck to you! This is such a wrong time for you to be sick. I hope you get rid of this quickly and enjoy your precious baby.

EDITED: Darn, I can't find the article I'm looking for, but here's another on Dificid and Vanco re: spores:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996525/

roy
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Re: Help needed quick!

Postby roy » Tue Oct 03, 2017 2:38 pm

Not medical advice.
The least amount of antibiotic that produces results seems to be the best amount.
The aim is to kill the active infection and the 125 seems to be doing that if symptoms resolved. (125 gives an active concentration that's many times that needed to kill the vegative bacteria).
Then you fool the inteligent little spores into germinating in what they think is a safe gut by reducing the dose slowly.
Eventually reducing to a small pulse dose on alternate days, then maybe every 3 days so the toughest spores germinate and the next dose gets them before they can multiply.
Stay on a 250 dose for the full 6 weeks and all that happens is the bacteria stays in it's spore form and germinates when it detects the attack is over.
Hope that makes sense.

Bobbie
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Re: Help needed quick!

Postby Bobbie » Wed Oct 04, 2017 2:43 am

Momo,

Several,posters on our site used a tapering/pulsing method and it worked for them. See CDI - Pulse dosing, tapering viewtopic.php?f=4&t=659#p4770.

Best of luck.

Kalpna41
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Re: Help needed quick!

Postby Kalpna41 » Mon Nov 13, 2017 3:34 am

thanks


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