Infectious disease doc. To the rescue?

[Kristin]

So I FINALLY got in to see an infectious disease doc. This Friday. This is my 3rd time getting cdiff in 3 months. This is a new doctor who has only been practicing 3 years and is very young, even has a narly handlebar moustache and looks like a Boise Hipster. Haha! Should be an interesting consult on Friday. I'm hoping he can help me!! I'm currently on my 3rd round of vanco and on my 6th day of it. I feel great on vanco and then the magic number is usually 3 weeks aftee finishing it that I relapse.

What kind of information do I need to let this new doc know about and what kind of questions should I ask? I'm new to this whole infectious disease thing so I don't even know what this 1st consult will be like. Has yours really been that helpful? Did they help cure you? Any advice or experience will help! Thank you!

[OCmama]

Are you on a vanco pulse?

Three fails is generally the magic number for being considered for an FMT. I would work out a game plan with your new ID to figure out what to do should this round of vanco fail.

In my own personal opinion (not a doctor), I would ask that if this round fails, that your new ID prescribe Dificid. You may also want to discuss with him who in your area performs FMTs. Good luck!

[beth22]

I, too, would ask about a Dificid taper aND find out about FMT. Qualifying for FMT seems to be easier now and might be the way to go. I found the more meds I took, the more relapses I had and it was like an endless cycle.

[Kristin]

I'm not on a pulse or taper of any sort. I really wanted to be put on dificid instead of vanco this time around but the on call doc didn't know what she was talking about and wanted to prescribe flagyl (gross and no thanks) and so I said I've been om Vanco the last 2 times so she just put me on vanco again. Would it be wise to switch to dificid this far into vanco regimine? I'm sure this new doctor will offer good advice (I hope I hope. I'm so very tired of getting the runaround and getting inept doctors)

I have thought about fmt but I'm so concerned about how invasive it is and expensive and then I've seen so many on here how the 1st one didn't even work. Or they've had so much messed up in their body afterwords. It just makes me nervous. Especially since I dont think I had cdiff as bad this time (only had mucous in my poop 4 times a day...not watery) and then the toxin results came back as positive. Will the infectious disease doc be able to tell me how bad I had it this time around by my test results?

[amg]

i agree with you about the unknown sequelae of FMT for any individual. We just can't predict. And there's the whole prep thing which seems ugh, and of course there are risks to the procedure as well. What I did with my daughter is try a Dificid taper which our ID was optimistic would work after 4 relapses, but at the same time we set her up for a possible FMT if that turned out to be necessary. Thankfully, the FMT wasn't necessary.

Yes, you can go on Dificid after Vanco - Dr. Stu Johnson calls it a Dificid "chaser" if it's just a standard Dificid course after Vanco, or you can go on a Dificid taper after Vanco
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4281782/
Moderators note
Article removed please only provide links.


Good luck!!

[OCmama]

Similar experience to AMG, if my daughter failed her third bout of treatment the plan was to switch to Dificid. And if the Dificid failed go to FMT.

[Ril]

I am curious about why you tested again if you were not having watery stools? 4 times per day and not watery can happen during recovery....

[Kristin]

Mucousy stools was how cdiff presented itself the first time and it was positive for toxins a and b. The first relapse I had mucousy stools and then watery towards about the 15th poop in that day because I had nothing left. This time it started out mucous again and I called right away because this is how it presented itself the first time, and sure enough toxins were present again (this was 3 weeks after getting off vanco the 2nd time).

[Kristin]

And thanks other posters! If, God forbid, this round of vanco fails again than I will suggest the dificid and fmt would be my last resort. Hopefully this round clears it. I wasn't on florastor before and now I'm taking it twice a day so I have high hopes that maybe just maybe it might be eradicated this time!