Sunday, April 19, 2015

Poop Pills

Usually when I tell someone "I ate crap", what I mean is I didn't quite land a jump on my snowboard. 

That is, until March 26, 2015...when I literally ate crap.

WHY EAT CRAP?
Within 6 months time I had 3 painful infections of ->C Diff,<-  which left me willing to try the unusual for a chance at being cured. Usually when a person gets a C Diff infection, it can be resolved with special hardcore antibiotics. Unfortunately sometimes 1. antibiotics stop working - 0r - 2. if a person takes immune suppressant medication (like me), the problem may return again, and again, and again. Let me remind you that C diff can be life threatening and it can't be killed. (Although the bacterial infection can be resolved, those nasty C diff spores will always reside in the intestines and flare up at random!) This destructive pattern in my life was wearing me thin. So I started to research alternative treatments for this recurring problem and learned of the mighty Poop Pill...
FMT
Fecal Microbiota Transplants have been done for years now. Essentially doctors extract bacteria from a healthy person's stool and transplant it into a person with serious gut problems. In the past, the only way to have this procedure done was through a colonoscopy (tube up the butt) or through an upper endoscopy (tube down the throat and into the stomach). As you can imagine, both were very uncomfortable procedures. The poop pill is a way less invasive route to deliver healthy microbia to the intestines. 

ONE PERSON'S CRAP IS ANOTHER PERSON'S TREASURE
Stool from a healthy donor is frozen into vegetable/gelatin based capsules. The frozen poop pills are later swallowed by a person in need. Researchers don't just take crap from anyone though; donors are screened over several weeks for any potential infectious diseases. If they pass the tests, their poo is frozen and kept in a lab until needed.  
Boston is neat, but I'm a left coast punk.
ONLY IN BOSTON
The poop pills were invented by smarty-pants researchers at Massachusetts General Hospital. Since the procedure isn't yet approved by the FDA, it can only be administered in Boston. Only certain patients are allowed access to the treatment and only under very specific circumstances. I met the criteria: multiple episodes of C diff infections, which didn't seem to be responding to antibiotics. Side note - I truly believe I developed an allergy to the antibiotics because the longer I was on them, the worse my symptoms and pain became.

BRAIN FREEZE!
30 poop pills are taken over a course of 2 days. (15 pills one day, 15 the next). In case you wondered: allow me to confirm - the pills are both tasteless and odorless. They are however, very, very COLD! The pills are frozen in liquid nitrogen, so they are frigid! These frosty pills made a brain-freeze from a 7Eleven slurpy seem like childsplay!
Bottoms up: 15 brownies into the hatch! 
EXPERIMENTAL
The poop pills have had a very high success rate of curing people with C Diff infections. Let me repeat that: this treatment can actually cure C diff. Yet the treatment is currently labeled as "experimental" because FDA approval takes many years and lots of study on effectiveness/risks. "Cure is likely, but not guaranteed." according to Massachusetts General researchers. While in Boston, I learned that I'm the first patient without a colon to be allowed to try the treatment. That labels me as an "experiment" as well, I guess! Outcome of this treatment for a person ->without a colon<- is unknown for a number of reasons. First of all, doctors weren't sure if the pills would even stay in my intestines long enough to work. (My food exits my body just 4-6 hours after I eat, compared to people with a colon who have about 24 hours.) There were also doubts that the pills would come out whole/undissolved. However, I did mostly dissolve the capsules, but - did the pills have enough time in my intestines to work??

TATER TOTS AT 3 AM
I received contact from the Boston doctor on the night before my treatment was to happen, which read, "Be sure not to eat anything tomorrow prior to treatment." They wanted me to have an empty stomach when taking the pills. In my mind, this would give the treatment a 0% success rate. Remember how I described how food exits me in 4-6 hours?? The pills would shoot straight through me if I took them on an empty stomach! After explaining my reasoning to the doctor, I was given the okay to eat a "light breakfast" BUT it had to be eaten several hours before I took the pills. Thus I woke up at 5 AM (which to my body was 3 AM because of the time zone change) and ate a boatload of tater tots. Why tots? Tater tots are the #1 food that slow my guts down. My theory was that they would give the pills a longer amount of time in my guts.
POOP PILGRIMS
My friend, Kerri, had a good description of what the poop pills are supposed to do: Imagine that the poop pills are pilgrims. They are settlers in a foreign land and their job is to recolonize. Basically the bacteria of the healthy stool is supposed to set up little "poop colonies" in the intestines. Oh, I sure hope the "poop pilgrims" survived and were able repopulate my guts. Only time will tell...

NO NEWS IS GOOD NEWS
I've been asked a number of times whether the treatment was successful or not. Answer: I don't know! To be determined! Basically, if I never get another C diff infection, then we can assume it worked! On the flip side, if I have any further occurrence of C diff infections, then we will assume that the experiment failed. Therefore, no news is good news! Researchers in Boston are monitoring me from afar. Umm, I send them a "sample" in the mail every few weeks for their lab research. Oh, and they're going to pay me for it. Benefits of being part of being a clinical study and whatnot.


Friend:  "I like your shoes, Kelsie."
Me: "Thanks, I sold my poop to buy them!" 

Can you imagine!? Hahahahaha!
Some may say that ingesting another human's feces is disgusting. Well, do you know what's even more disgusting? - DEATH! Dying in my 20's because of a stubborn infection is about the nastiest thing I can imagine. Perhaps I have more passion for life than pride for death. 

If you're interested in reading more about the Poop Pills, here's an article on the study done by Mass General in Boston. Pretty interesting science. (Keep in mind that this study was done with patients who had large intestines): http://www.npr.org/blogs/health/2014/10/11/355126926/frozen-poop-pills-fight-life-threatening-infections