Lee Dolson's case history

[leedolson]

As a Home Health/Hospice RN for a large HMO for 9 yrs., I’ve seen many people sent home with Clostridium Difficile after having been hospitalized for other complaints. I saw approximately 3 cases a week and since it was in the patients home or an Adult Family Home setting. Only once in 9 years can I remember being told by the Charge nurse or given a report which stated that the pt. had C. Diff. I was exposed to some not so clean environments. It was never stressed to us nurses that hand sanitizers do not kill the C. Diff spore ( they would have to be more than 60% alcohol to be any help) and it can live in the environment for up to 6 months. That means: someone can touch the bedroom doorknob, walk out to their car and grab a sandwich and become infected with C Diff. It takes as little as 3-6 spores to infect someone. Subsequently, as you may have guessed, I contracted C. Difficile and about lost my life. After taking an Abx for a sinus infection, I began having uncontrollable diarrhea. I saw my Primary Care MD approx 3 times and even was given a C. Diff test which came back negative a few weeks prior to my hospitalization. Jan 31, 2006, I went to the ER for extreme upper abdominal pain, fever of 103c, and diarrhea. I was checked for C diff. in the ER but no results were given to the MD and evidently no one read the results. It took 3 days to diagnose me with acalculus cholycystitis which is an atypical inflammation of the gall bladder and a high percentage of people who are not diagnosed within 24 hrs die, usually of gangrene and gallbladder contents leaking into the abdominal cavity from the ruptured gallbladder. This type of gall bladder problem is usually found only in very old, frail people or in diabetics. In my case, it was from severe dehydration from weeks of diarrhea. I wonder how many other C diff pts. Have lost their gallbladders. Anyway, I was sent home where I continued to decline for 11 days while I tried to recover from what I was told (I have done a lot of investigation since re: acalculus cholycystitis) was a common gallbladder surgery. On the 11th day, I returned to the ER with extreme diarrhea, abd. Pain and pain in every joint of my body. They were about to send me home when my labs came back which showed a high white blood cell count and other abnomalities. The ER MD finally looked at the old records and found I that I had been diagnosed with C diff back on Jan. 31st, 2006. I was sent home on a 2 week course of Flagyl. There were many more PMC MD appts. For the next few months and then I was put on oral Vancomycin for 2 weeks. A week after ending the vanco., I became even more ill than the 1st episode and returned to the ER on April 11, 2006. At that time, I had a colonoscopy and was diagnosed with pseudomembranous colitis which also has a rather high mortality rate. After nearly 8 months on oral vanco and a very slow “taper”, I have no longer gotten as sick as the past 3 times. I have now been diagnosed by Dr. Surawicz (a leader in the c diff field) with post infectious Irritable bowel syndrome. That means that I can have diarrhea at any time and sometimes incontinence. She has given me Levsin, a medication which controls severe cramping, but that’s about all the help I’ve been able to get besides my own regimen of Culturelle and strict non dairy, non spicy diet. At the time of getting Ill, I was a productive, energetic RN with a degree in Nursing from Seattle University who drove 60 to 100 miles a day to see my patients. Now, I’m unable to work, constantly have gut pain and IBS and am getting crabby! I’ve done a lot of scholarly research and try to educate as many people as I can reach.