Jean's Case History
Was symptom free for appx. 50 days - then recurred.
Updated 3-26-99 at the bottom of the page
I am a 42 year old female - married with 3 children. I live in a little town in northwestern Pennsylvania. I contracted the c diff. bacteria from clindamycin HCL 150 caps which I was prescribed to take from my dentist for having 2 root canals done and the infection that is associated with root canals.
I am allergic to penicillin, ceclor, azulfidine, and z-pack. My first root canal was done on June 4, 1998 and the second one was done on June 15. I only took 21 pills of the clindamycin - The doctors still aren't sure if it was the first pill of clindamycin or the entire dosage of this RX that caused me to contract the c diff. bacteria. This antibiotic has a high rate of causing c diff. bacteria.
On July 13, 1998, the first signs of cramping started. I thought I had the flu. On July 19, 1998, I went to the ER at my local hospital with severe diarrhea and stomach and back pain. I was treated lomotil tablets and bentyl but my symptoms did not improve. The stool analysis showed nothing. On July 27, 1998, I returned to the ER and was told that I may be suffering from acute inflammatory bowel disease. I was admitted to the hospital for further treatment and evaluation. I was initially treated with Solu Medrol 60 mg q6 hours and also Asulfiding. I developed the rash on the face and due to my history of allergy to penicillin, ceclor and z-pack. Because of that the Azulfidine was discontinued. I did not sleep well and had continued abdominal pain. I required Demerol injections and marked tenderness in the right lower quadrant, diarrhea seemed to improve slightly. I had a CAT scan of the abdomen and pelvis that indicated possible pelvic inflammatory disease. Then I was treated Vibramycin 100 mg q 12 hours. My fever continued to be low grade and continued to have watery diarrhea. My white cell count increased from 14,000 to 26,200 and that afternoon I got worse with much more distended abdomen, much more pain and diarrhea many times. I started vomiting and a NG tube was inserted. Coffee ground brown drainage returned and remoccult test was negative. The Solu Medrol was discontinued after the diagnosis of PID was made. My condition was not making any progress but got much worse. I felt very weak, my white count was now up to 31,700. I was becoming dehydrated also. At this time they thought I may have been suffering from PID and maybe inflammatory bowel disease. I was then transferred to Hamot Medical Center in Erie, PA. since all of the doctors weren't sure what my condition was. All stool cultures showed negative for Salmonella, Shigella, Staph, negative for Yersinia, and C difficile!
I arrived in Erie at 1:30 AM on 7/30/98 with possible PID versus inflammatory bowel disease. A colonoscopy performed on 7/31/98 showed severe pseudomembranous colitis - consistent with C. Diff. Pelvic ultrasound performed on 7/30/98 showed free fluid of undetermined origin in the cul-de-sac and left adnexal area with moderate involvement. There was no other abnormality. At this time I was having 6 - 10 loose stools per day, which are watery with no blood. CT scan of the abdomen and pelvic showed the possibility of PID and was examined by a gynecologist. My Solu-Medrol was discontinued and I was put on Vibramycin 100 mg q 12 hours since 7/29/98. I was still very weak and had a low-grade fever and my white blood cells kept increasing. Stool sample was negative for white blood cells. Stool samples were again negative for Salmonella, Yersinia and Clostridium difficile. Pelvic sonogram was done and under the consult of the OBGYn consult was felt that there was no specific evidence for PID. C diff. toxin remained negative throughout the hospital stay. It was determined through the colonoscopy the I had pseudmembranous colitis due to taking the clyndomicin antibiotic. At this time I was seen by an infectious disease consult and begun on IV Flagyl and then switched over to P.O. Flagyl. The nausea, abdominal pain and diarrhea slowly improved. I was discharged on day #7 of P.O. Flagy. and continued on this for an additional 7 days. I was told to be on a low residue type diet. I was discharged on flagyl 500 mg. Also Pepcid AC 2 per day.
I was released on 8/7/98. I was very weak and could only walk short distances. With the help of my family I gradually came back to life. Prior to contracting c. diff. I was a normal healthy woman.
Due to increasing sensitivity with my root canals, my dentist sent me to an endodontist on 8/21/98 in the State College area. I then underwent apical surgery and part of my bone and jaw were removed near these teeth to save them. The one tooth was decaying for so long due to an injury that the infection had spread to my jaw and was eating away at my bone mass. I have been to my dentist faithfully every six month for over 20 years. I kept complaining about pain in these teeth but he stated it was nothing. When the pain got so sever I switched dentists and had the root canals done but it was already too late. Due to this dental surgery I was put on an antibiotic ceftin on 8/24/98. The symptoms started to reoccur. I was put on Flagyl for 7 days off for 7 days and then on again for 7 days. I ended up with this dosage on 9/21/98. On 10/5/98, I had 2nd reoccurrence of C. Diff. (14 days after taking medication). I was then put on Vancocin for 10 days 250 mg 4 times per day. On 10/24/98, I had the 3rd reoccurrence of C. Diff. (10 days after finishing the medication). I was then put on Vancocin for 21 days ( 125 mg X 4) and then Questron for 10 days. I finished Vancocin on November 13 and started Questron and finished this on November 23, 1998. On November 26, 1998, I had the 4th reoccurrence of C. Diff. (14 days after finishing the Vancocin). Then I was put on Vancocin for 10 days (250 mg x 4) I saw my gastro doctor in Erie on December 4, 1998. At this time he decided to put me on a tapered dose of Vancocin. It went like this on week 1. I would take 7 days of Vancocin 250 mg x 3) week 2 Vancocin 250 mg x 2. Week 3 Vancocin 250 mg x 1 per day. And week 4 - Vancocin 7 days of 250 mg every other day. On December 8, 1998, I went for a second opinion at the Cleveland Clinic with specialists in the gastro dept. and bacteria specialists. They agreed with the tapered dosages of Vancocin at this time and with the diagnosis of the C. Diff. problem. The only thing that they did not agree with was the Hyoscymine .375 mg for cramping - they felt this would help the spores to stay inside my colon. They told me that there were other regiments of taking this medication and that I would eventually get better. Just needed to be patient. They also suggested to take acidophilus and S.B.C. (Saccharomyces Boulardii Capsules). When I finish with the Vancocin I am to take 1 month of Questron.
On Dec. 18, 1998, I had another reoccurrence (5th) of the c. diff. I was down to taking 2 pills a day when the reoccurrence happened. He felt I should continue and start over again with the tapered medication regiment.
After being again depressed with the symptoms reoccurring I again went on-line to look for help. This is where I saw the method of pulse dosage - take Vancocin for 3 days , off for 2 days and on again for 3 days. It was the first time that I found someone who had really beaten this terrible monster. So, I decided to try it myself with my dosages of medication. I will finish this type of pulse dosage on January 20, 1998. I feel that my doctors are experimenting with the dosages and I might as well try this one and see if I get anywhere with it. I am scheduled to go back to the Cleveland Clinic on 2/2/99. During the course of the pulse dosages I have been uncomfortable and the symptoms do seem to start reoccurring on the off days. It's been a rather tough month but if it eventually kills off all the spores and I am rid of this it will all be worth it. I will write again with updates on my condition.
I was out of work from 7/20/98 until 9/25/98 at which time I tried to return to work on a 4 hr. day basis for 1 month. I tried to return to work an 8 hour day starting on 10/26/98. I didn't have enough strength or stamina to continue this so after 1 week I went back on 1/2 days of work. This continued all of November and I again tried working full days in Dec. At the moment I am working full days with the exception of 1 that the pain associated with c diff being too bad.
I have been off the vanco. for 8 days and seem to be doing better except for an occasional stomach ache and always being tired. I am still working 8 hours a day - so I seem to be hanging in there at the moment. The Dr.'s at the Cleveland Clinic felt it would be good for me to start a course of questron 3 times a day 3 - 4 hours after each meal- I am to do this for one month. I have been doing this for the 8 days and at the moment no reocurrance of the c diff. I have a co-worker whose wife had c-diff in the 70's and the only way she got better was to eat goats milk yogurt. I finally was able to get some ordered and will start this next Friday. I don't feel it can hurt anything. I am also taking additional acidophilus and bifidus, sacc. boulardi, and garlic. Along with eating reg. yogurt each day. I have moved my 2/2 appointment until the end of March since I am still on meds. and waiting to see if the pulse dosing has worked to rid myself of the c. diff.
While I was on the pulse doseages - I felt good for most of the days that I was on the vanco. but extremely ill on the off days. The symptoms on the off days were constant reminders of the c diff.- the back pain, abdominal pain on the right side and difficulty getting up from a down position. It seemed hard to straighten my back at times. The stools had been at least 4 per day and on the off days 8 or more. All with mucus.
So far I have gone 40 days without the c. diff. reocurrance. My energy level still seems to be lower that it was before I got sick with this terrible monster but I am starting to come back. My hair loss has stopped and I am getting new shafts back again. This is a welcome sight. Every now and then I start to get a stomach ache and get anxious that it is returning but then the stomach ache subsides. If I over do the walking or get too tired - I really need to recoup and get alot more rest than usual. But if the c. diff stays away I am hoping to get my energy level and strength back too.
I do feel that the pulse dosing really made the difference for me in getting rid of all the c. diff. spores. At least for now I am no longer troubled by these monsters. I currently am taking 3 acidolphius pills daily along with sacc. boulardi - 3 per day and bifidius. I have been taking many supplemental vitamins along with garlic 3 time per day. I eat at least 2 yogurts a day and at the moment one of the yogurts is a goats milk natural kind. Hope that this information is helpful to all of you. I know how hard it is to keep up your spirits. Always remember that we are in control and don't let the c. diff. bacteria get you down any more that it already has. Hang in there!! It is possible to feel better. Thank you for this wonderful web site. It has really helped me!
Some bad news... I was one of the lucky ones for 50 days. Then the symptoms started to reoccur.. visible mucus, increased bowel movements, pain, fever..... I had a stool sample taken - it showed negative. My tests have never shown the c diff. bacteria - only the colonoscopy! So my Erie gastro. drs. agreed to put me on vancocin for another month... It started to reoccur on March 13, 1999. So back to the drawing board. I felt miserable all week. The medicine seems to be taking longer to take effect. But I will not give up.
The doctor's wanted me to go on tapered doses even though I explained how the pulse doseages worked and that I was symptom free at that time with 40 days. Guess I spoke to soon and thought I had beaten it. At the moment I have been taking the vancocin 4 times a day for the first week. Then I plan to go on pulse dosing. I feel that this is the best way to get rid of the spores. The other ways always seem to make one feel better but only while on the medicine. Will let you know how it goes. I have postponed my visit to the Cleveland clinic due to being back on meds. again. And the fact that I have used over 60 days of sick leave already - none left... Any way they won't be able to do much now that I'm back on the meds. Take care. Jean
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