Doug Monroe's OPENLY OLD

The Horror of C. Diff

Doug Monroe’s OPENLY OLD

The Horror of C. Diff

I got C. Diff again. This is a horrible infection of the colon with symptoms ranging from diarrhea to death.

C. Diff is short for Clostridioides difficile. It’s a bacterium that causes an infection of the colon, the longest part of the large intestine.

Each year, 150,000 to 170,000 old people (65+) get C. Diff and about 20,000 elderly folks die from it, according to the CDC. For the record, I’m 78 and still kicking.

Most of us who get it usually contract it in a hospital or a nursing-home setting.

The hospital

I was in the hospital in late November with Toxic Metabolic Encephalopathy, I think I got that from an infection – cellulitis – in my left ankle, which I tore up during 9^th-grade football. I had it surgically rebuilt in 1985.

You normally get it after taking an antibiotic and they gave me one in the hospital, after giving me the bum’s rush out of there. Once you get it and the diarrhea starts pouring out of you like the flood after a dam break, you take another antibiotic.

The first one prescribed by my gastroenterologist’s PA cost $1,000. I couldn’t afford it.

She then prescribed Vancomycin. Which took 10 days to arrive. The co-pay was $44.

Squirtin’ for Certain

In the meantime, I spent my waking hours running to the bathroom. Sometimes I shit in my Depend briefs while I was still asleep. Talk about waking up from a nightmare.

We’re talking about diarrhea so explosive that it hits the walls, ruins your carpets and your clothes, not to mention ruining your life until you can get the proper medication and clean up the mess.

The PA stressed the importance of taking the probiotic Florastor, which is yeast-based, unlike most bacteria-based probiotics. I’m also taking Imodium, the over-the-counter medication that seems to help.

But I still have diarrhea.

That’s because rumbling merrily beneath the C. Diff is the autoimmune disease Ulcerative Colitis.

Ulcerative Colitis

I was diagnosed with UC in 1996 when I was covering the Olympic Games traffic for the Atlanta Journal-Constitution in my traffic column called “Monroe Drive.”

Blood poured out of my ass. A gastroenterologist prescribed Prednisone, a steroid drug that was the standard treatment at the time. I took it for about 15 years.

Prednisone has a side effect: it melted my spine.

I have 10 compression fractures in my spine from steroid-induced osteoporosis. I am now giving myself daily injections of a drug called Tymlos to strengthen my bones.

Next week, I will go on the biologic drug Trymfya for the colitis.

I have a history with biologic drugs.

Septic Shock in Loony Town

My worst experience with all of this was in 2015, when I was teaching Media Writing at Georgia College and State University in Milledgeville, home of what was once the world’s largest insane asylum – Central State Hospital. This is why I call Milledgeville “Loony Town.”

I was hobbling with cellulitis in my left ankle. In addition to the rebuilt ankle, I have a supinated foot that kept me out of the Army when I was drafted in 1969, a time when the U.S. sent 58,000 young men to die for nothing. At my draft physical, the doctor said, “You would never make it through boot camp with that ankle.” I was classified as 1-Y then 4-F.

In Milledgeville, I went to a jackleg doctor for my infected ankle at a walk-in clinic. He prescribed an antibiotic.

Oops.

I was already being treated for ulcerative colitis, which produces diarrhea. Then I got C. Diff from the antibiotic, producing even WORSE diarrhea. And then a gastroenterologist prescribed the self-injecting biologic drug Simponi.

You are not supposed to take a biologic drug if you have an infection. The doc just assumed my UC was getting worse. But C. Diff is one of the worst infections you can get.

Oops big time.

I exploded. I went into delirium, staggering around, shitting everywhere in my rented home on the banks of Lake Sinclair. I called my doctor and said I was the sickest I’d ever been, which are the trigger words for someone slipping into Sepsis.

I drove to his office and ran off the road three times. He thought I had flu or pneumonia and called an ambulance, which took me to the nearby hospital, where they kept giving me Xrays on my lungs.

I tried to tell them that diarrhea doesn’t come from the lungs.

After a full day of this, my gastroenterologist in Atlanta ordered an ambulance to rush me to Piedmont Hospital in Atlanta. In doing so, he saved my life. I arrived with only minutes to spare.

I was in Septic Shock. Doctors plugged me into IVs and even put an IV into my neck to pour in antibiotics and steroids. I had to sign a form acknowledging that I might get a blood clot. I got one later -- a long stringy blood clot from my shoulder to my elbow that put me back in the hospital. I always thought blood clots were like little peas.

Septic shock is described as “a life-threatening condition in which a severe infection causes the blood pressure to drop dangerously low and leads to failure of one or more organs.”

Piedmont saved my life. And my doctor prescribed Florastor. My sister, Trisha, drove me back to Milledgeville after I picked up my Vancomycin.

My son, Matty, the Philadelphia lawyer, came down, and bless his heart, put on a pair of gloves and a mask and cleaned up the remains of the watery shit. He tried to get a murder clean-up crew, but they were too expensive.

Can you even imagine? Thank you, Matty!

After I moved to Athens, the gastroenterologist’s PA put me on the biologic drug Rinvoq. Side effect: Shingles. I had a horrible case of shingles and now have Post-Herpetic Neuralgia, a constant pain in the nerves that circle my left rib cage, from spine to navel. I’ve had two nerve blocks that didn’t work.

I’m going to a Reiki healer next week.

What Doesn’t Kill You

I came across a brilliant book -- “What Doesn’t Kill You: A Life with Chronic Illness – Lessons from a Body in Revolt” -- by Tessa Miller, a Brooklyn-based science and health journalist.

I recommend this book to anyone with a chronic illness.

Ms. Miller went through many misdiagnoses until her chronic illness was identified as Crohn’s Disease, which is quite similar to ulcerative colitis. They are both Inflammatory Bowel Diseases but with Crohn’s, the inflammation runs from mouth to anus. The whole pipeline.

She first heard about the disease in the fourth grade, when her older sister had a friend diagnosed with Crohn’s and explained it as, “Crohn’s disease is where you poop … until you die.”

Fifteen years later, Ms. Miller experienced blood pouring out of her ass. Doctors asked her if she was sure it wasn’t menstrual blood. She was quite sure. She had her first rectal exam, which she wasn’t ready for, and said, “This was the beginning of relinquishing my body to health professionals, a dehumanization that I’m used to now but will never be okay with.”

Like me, her immune system was depressed. At one point, in a clinic, she caught chicken pox, which was a nightmare.

Ms. Miller got relief when she began taking the immune suppressant biologic drug Infliximab.

She experienced the same depression and fatigue that I still have.

One of the ideas in her book that resonated most with me was “Medical PTSD.”

At times, Ms. Miller and I have encountered some medical professionals who were blitheringly incompetent. Some doctors are very good. Some aren’t. Some are robotic and lack empathy.

As I mentioned, I felt the hospital rushed me out and sent me home too soon after my experience with Encephalopathy. I already had concerns about my primary care physician, who interfered with my psychiatric medication and refused to test me for low testosterone. I now have a different doctor.

Thank you for this book, Ms. Miller.

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