• October 3, 2013 /  2 Comments

    Last year I had a bout of c.difficile, following hospitalisation for a lung infection. This is an account of how it affected me. As always, the way it manifests itself in an individual patient, the way it is treated and its effects will be different for all of us, so please only take this post as one version of how to deal with it. I have recently noticed some people searching for references to it, which is why I felt it may be useful to do a page with my take on it. I was lucky in that I had a relatively easy time of it, but c.diff can be a killer, so it needs to be taken seriously and recently a new strain has emerged. Treat all diarrhoea seriously.

    Before reading this page I suggest you read this link which has everything including complications and symptoms etc in it (UK): http://www.nhs.uk/conditions/Clostridium-difficile/Pages/Introduction.aspx 

    Also http://www.patient.co.uk/health/clostridium-difficile

    http://www.medscape.com/viewarticle/758268 on link to proton pump inhibitors.

    Background

    In spring of last year I was on Revlimid. I had done quite well in avoiding infections, but finally went down with a bad lung infection. As the cancer ward was full I was sent up to the renal ward. I did not realise that my hospital, like quite a few, had a problem with c.diff. I had a variety of antibiotics as the infection was a bit stubborn and as always I immediately got bad diarrhoea. I did do a stool sample while there. I had my own ensuite room. After maybe 5 or 6 days I was discharged with more antibiotics. Over a few days the diarrhoea seemed to get worse with very bad wind and greenish stools. I took in a stool sample and was diagnosed with c.diff. As I was allergic to the main antibiotic metronidazole, I was put on vancomycin. Within quite a short time my diarrhoea did improve and I was allowed to use Loperimide. I also used a lot of rehydration mix.

    However, what I had not realised was that it remains in your system for up to about 70 days, so you can be shedding spores all that time and it is very easy to reinfect yourself (I think about one in four people have this happen). I also hadn’t realised that if you are on Omeprazole or Lanzoprazole (proton pump inhibitors) before you have the antibiotics you are more likely to contract c.diff because of the impact of these drugs on your stomach acid. I might consider stopping the PPI if your doctor agrees when being treated with an antibiotic, but that may not be right for everyone and it may be too late by then, so seek advice.

    My view is that all patients should be warned of this and monitored both while in hospital and for maybe up to a couple of months immediately after.

    I read up on it and instituted a programme at home to make sure I didn’t reinfect myself. I was lucky in that although I felt a bit poorly, I was able to do most of the cleaning myself. Longer term I am not sure of the effect on my myeloma as I am very resistant and my relapse came at much the same time as the two infections, but I have no proof of any connection.

    This is what I did:

    If you can, confine yourself to a separate toilet and if possible, bathroom, away from the rest of the family.

    Initially wash EVERYTHING in the loo/bathroom – all surfaces including walls and floor – with a 10% bleach solution. I made this up in a spray bottle. Repeat this every few days. Also clean any other loos etc that you used before diagnosis.

    Every time you go to the loo, clean it all after with the 10% solution, which is supposed to be fresh every day, though I didn’t adhere to this as I didn’t know.

    Put the lid down before you flush. Clean flushes, taps (underneath too), soap containers etc.

    After showering, clean the whole thing with your solution. I did not bath at all, but I guess the same would apply.

    I cleaned lots of house surfaces, especially where I sat, all kitchen surfaces, door handles etc. This sounds a bit gross, but you can break wind constantly and this can blast out c.diff. spores. So doing chair surfaces is important. I also cleaned all cushions.

    I wore big panty liners as it is possible to soil yourself and it helps confine the spores when you break wind. I soiled the bed twice while asleep. I changed my bedding, nighties, clothes and towels every day for several weeks and wiped the washing machine with the bleach solution and then rinsed. You need to wash at the highest temp you can.

    I washed my handbag and rucksack. I watched out for my sleeves when cleaning myself after the loo and washed my jackets/coats.

    The cat got the runs while I was ill and I did ask the vet if she could have contracted c.diff – it may be possible. So be aware with pets.

    I tried to protect other people. I did not go out much and tried hard not to use loos while out. I tried not to sit on the seats and closed the lid to flush. I told the nurses in haem when I went in for appts. I told all visitors. I even told the library when I took my books back and they quarantined them for a couple of months!! I was extremely careful with food preparation. If you have kids or an elderly or another immune compromised person in the house you will need to take great care.

    The whole thing was very tiring, but worth spending time every day on preventing reinfection.

    Afterwards I went onto Ranitidine, but it was not very effective, so have reluctantly gone back onto Omeprazole, but this time, if hospitalised will be even more careful than normal. I was quite OCD about cleanliness anyway and yet still managed to get it. I think it is impossible to avoid completely as it is possible for, say, your food to be infected by a carrier or even the nurse making your bed to waft it into the air.

    But make sure you wash your hands very thoroughly, all the time and especially after using the loo and before eating. Anti-bacterial sprays don’t kill it. Wash your hands like the nurses do with soap and water with the full hand washing technique. http://www.wash-hands.com/the_campaign/wash_hands_quick_video_guide

    Hope this is helpful and I will add to it if I remember anything else I did.

     

     

2 Comments to Dealing with C.Difficile

  • We had to deal with C Diff at home when my mother in law came out of hospital with it. We panicked at first but then realised that healthy people who are not on strong antibiotics won’t develop any symptoms. We did carry out a similar cleaning regime to Sarah, but also found a product on the internet that was very useful. It is called Enduro and claims to kill C Diff spores. You can get hand sanitisers and wipes which are very convenient for cleaning taps, handles and surfaces.

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