RN working at SNF Diagnosed Jul 18

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RNBSNCDIFF
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Joined: Sun Aug 10, 2014 10:02 am

RN working at SNF Diagnosed Jul 18

Postby RNBSNCDIFF » Sun Aug 10, 2014 1:12 pm

Here is my story :
29 y/o healthy f other than a couple of UTI's treated with Cipro and Bactrim. I work at a SNF (Skilled Nursing Facility) for 4 years now. Everything started because I was having some episodes of nausea that progressed to lactose-intolerance like symptoms (about 3-4 months ago). I just dealt with the symptoms and just tried to cut out lactose. Well as things began to get worse despite having absolutely no dairy I knew something else was going on. I began losing weight (which I have plenty to lose) and was unable to eat due to the fear of developing symptoms and persistent N/D and belching. Plus I had 2 episodes of really bad upper abdominal pain which lasted from 2-8 hours and had me doubled over in bed until the pain passed. So finally I decided it was time to go see the Dr. So after some testing and an abdominal ultrasound I came to find out that I had H. Pylori and gallstones. So on June 23rd I started on Amoxicillin, Clarithromycin, and Prilosec for 2 weeks. My symptoms began to greatly improve and I could actually eat again. Then towards the end of the antibiotic course I got a sore throat that quickly progressed into probable strep throat. The rapid strep test came back negative and they failed to get the appropriate throat cultures so they empirically treated me with a shot of Rocephin and Azithromax . So I had 4 antibiotics in my system at once. Well despite the antibiotics my throat infection got worse so I went back to the Dr. and prescribed a longer does of Azithromycyin. Fortunately I had finished my medication regimen for the H. Pylori and was on only one antibiotic and then come. Then finally July 13th I was antibiotic free! I was so happy and thought finally things can get back to normal. But no I started having N & D again. So back to the Dr. Got diagnoses with CDiff on July 18th. I almost didnt drop off my stool sample because it wasn't loose but it was definitely mucoid with foul odor. So the Dr. started me on Flagyl for 2 weeks. I continued to have N & D and abdominal cramps for the first couple of days and then I started to feel better. But I was kind of convinced that it never went away since sometimes I still had D and mucus in my stool. I was so ecstatic to finish the Flagyl as it was horrid tasting, left a bad taste in my mouth and made me nauseous. Once again on August 1st I was antibiotic free. Then the N & D started up again with some extremely painful abdominal cramps. I called the Dr. who told me I had to wait for 7-10 days after I finished the Flagyl to be retested. So I tried to suck it up but things continued to get worse. So August 7th I called the Dr. and spoke to a nurse practitioner who said that since I had the antigen for CDiff it wouldnt make sense to retest for CDiff. She ordered another round of Flagyl and Cholestyramine (Which she said will bind to the toxins and should help with the stomach cramps). I finally got ahold of my Dr. who suggested I go to urgent care because I most likely had a Flagyl resistant strain of CDiff. So I went into urgent care with a low-grade fever 100.6, increased heart rate 106, bouts of severe abdominal cramping and pain plus 10+ stools a day. The Dr. said well lets restart that Flagyl and Ill give you some Zofran for the N and something called Levsin for the abdominal cramping since Immodium and Narcotic medications are not recommended for CDiff because they could cause megacolon. So I have been back on Flagyl for 2 days now and I have to admit I am feeling alot better. Still having moderate abdominal cramping and some D but overall much better. Even had some solid food yesterday. So I guess we will see if things are better the second time around. Im still waiting on stool cultures to come back. But one issue I have is I have not told my work that I have CDiff. I don't know if I should tell them as I do not have alot of sick or vacation days and I am a single mother of 3 and can't afford to not work. Ive asked my Dr. about how long I am contagious for and I know the usual consensus is usually while you are having the active diarrhea. But she had said 48 hours after I start the antibiotics. I have very good hand-washing and hygiene practices. I used gloves with all my patients as well. I do not believe I acquired the CDiff from work but I guess its always a possibly considering I have had many CDiff patients. If you have read my whole story thank you. I wanted to post somewhere else as people are not allowed to reply on case histories but I couldn't figure out how to post.
Thank you for reading
Nurse in distress

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