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RN with relapsing cdiff



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Oct 20, 2005 01:28 PM

RN with relapsing cdiff

by RNinPGH

Despite my best handwashing efforts, gowning and gloving, I got cdiff. Three months ago. I just relapsed.

It has been a complete nightmare. I can't return to work. I can't eat. I'm in pain, I have fatigue, etc.

Now I have three more months to completely get better or I will be terminated. The hospital says that I can't prove that I contracted the c.diff there....and I'm harassed by HR to 'prove' that I'm still sick. Do they HONESTLY want me to PROVE that I have c.diff? Don't they think that I could find other things to fake other than this horrible disgusting illness?

My question is, have any ID nurses noticed an increase in your workers contracting c.diff, or a general increase in c.diff in your patients. About the time I got sick, I was on antibiotics, a very bad one in terms of c.diff. But others in my hospital have contracted it (RNs, CNAs and the like), and its seems that half of our ICU unit has it at sometime or another. Any advice would be helpful. Also, I wasn't even offered workman's comp, and I'm financially drowning....

Thank you

~Amanda


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26 Comments
No. 1
from prmenrs
Old Oct 20, 2005, 02:04 PM

Default Re: RN with relapsing cdiff
Your MD (or PCP) should be able to document that you have this disease. Also, request an ID consult (I'm assuming you still have insurance--oh, please!!) so you can speak to a specialist. It would be good if that consulting doc is affiliated w/your institution, s/he might be able to help.

Contact the Infection Control Practitioner, also the Public Health dep't may be able to help re: any outbreaks in the community. Try to remember any restaurants you went to before you became ill.

You may need the help of an attorney re: the employment/workman's comp/HR issues. Do you remember any of the pts you took care of that might have had this?

You might have to also apply for disability.

I feel terrible for you--I can just imaging dealing w/all this while your GI tract is--well, never mind. Best of luck!!!
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No. 2
from rjflyn
Old Oct 20, 2005, 02:37 PM
Updated Oct 20, 2005 at 02:41 PM by rjflyn

Default Re: RN with relapsing cdiff
Number one rule- if you become ill or hurt at work don't go it alone, contact a workers compensation lawyer. But I can;t afford a lawyer, can you not afford one, most work on a contingency ie 30% of nothing is nothing so whats one have to lose. The rules and regs are too complex to figure out by oneself. Do you think for one minute the hospital doesn't have an attorney working for them on these issues.

RJ
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No. 3
from RM23
Old Oct 20, 2005, 10:49 PM

Default Re: RN with relapsing cdiff
As a note re the post of worker's compensation attorneys. If the attorney does w/c then they are paid directly by the state, usually. It is a set fee of either 12 or 15 %, not sure. Worker's compensation attorneys can not ask for money from you as it regulated by either federal or state laws. Contact a w/c attorney, dont let the hospital ignore the problem. Hospitals do not want to take responsibility and admit there was a mistake, etc. and they certainly do not want w/c cases as their insurance rates go up. Having been in many a meeting with risk managment, insurance ppl and hospital management, I know they will not accept responsiblity. BUT, yhou can file a w/c claim,, GO FOR IT and take care of yourself.. don't listen to them.. they are not out for your best interest, unfortunately that is the name of the game.. good luck, sorry you are having such a hard time.
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No. 4
Old Oct 24, 2005, 01:51 PM
Updated Oct 24, 2005 at 02:00 PM by ladyofexcellance

Unhappy Re: RN with relapsing cdiff
Is there a cure for c-diff

How long were you ill with the disease. What medications were you on.I am at a complete loss for my friend. How can I help? Is this usuall a long drawn out rehibiliation.

Originally Posted by ladyofexcellance
Is there a cure for c-diff

How long were you ill with the disease. What medications were you on.I am at a complete loss for my friend. How can I help? Is this usuall a long drawn out rehibiliation.
I see one person wrote that weveral persons in her facility had c-diff at one time or another. Is there a cure? If the disease is so contagious and no medication is capable of toppint it, why isn't it treated like TB or Cancer.
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No. 5
from RNinPGH
Old Oct 24, 2005, 02:06 PM
Updated Oct 24, 2005 at 02:11 PM by RNinPGH

Default Re: RN with relapsing cdiff
Supposedly one round of flagyl was supposed to cure me...but 5 days into the flagyl treatment, I became violently ill and required hospitalization.

I went on vancomycin for a month, 250mg QID, test negative for cdiff x 3 stools but still had symptoms.

I was scoped to see if something else was causing symptoms, and I was found to be cdiff positive again.

So now I'm on a second round of vanco, this time at 125 mg QID, I'll be done with my second week on Friday, but I still am VERY symptomatic, can't eat, extremely fatigued, have muscle pain, etc.

Its been THREE months since I initially became ill. I can't work due to my 'cdiff positive' scourge.

According to my research (which is scant, no one wants to make new drugs or research this bacteria), 80% of those who get it do fine with one run of flagyl or vanc. Apparently they both have the same effectiveness, but vance is SOOOO expensive ($1000+ cash price for a two week course). I'm one of the 20% that looks to have 'relapsing' cdiff that can turn into a chronic condition. I can look forward to having relapsing events until I die. I will forever have to be wary of any kind of infection I get, and need to seriously talk over any kind of antibiotic treatment with my doc.

With work, I do plan on returning to my job, if I ever get rid of this bacteria, and if my job is still there when that happens. But I'm not allowed to take care of c.diff patients. So there goes half my ward.

I don't know why cdiff isn't treated more carefully as it should be. It is transmitted through the fecal oral route, which should make it hard to contract, but it is transmitted through spores which can survive in the environment for up to 40 days outside the human body. Only bleach can kill it.

Most nurses I know don't know that. And most nurses I know (including myself) didn't know about the extreme pain and muscle fatigue and anorexia associated with it. They think its just bad diarrhea. Most of our patients with it were on the stairway to heaven to begin with...so no one paid attention. Most nurses figure that they are colonized for everything anyway.

Also to note: I was on heavy antibiotics when I became ill, most nurses don't know that they are VERY suseptible to their patients illnesses when they go to work sick. I found out the VERY hard way.
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No. 6
Old Nov 07, 2005, 11:08 AM

Default Re: RN with relapsing cdiff
I've just read an article in either the Post Gazette or the Trib about the spread of Cdiff in the local hospitals. I think it was last week?

I've done a little research on Cdif for a resident that was plagued with it. There are some online and I think in person support groups. You are not alone. I work in LTC, so I've seen my share. It is a debilitating illness, esp when you are elderly, too. We have pts on Flagyl for at least 21 days, some longer. Vanco too. Also we are using Lactinex, yogart and Florastor. I've heard that macaroons (cookies) help ease the diarrhea? Do a search on this site.....I think we had info on this. Have you heard of a stool transplant?

We were just talking about this at work....Should this be a workers comp issue? Heck you got it at work.

Sorry to have to run in to a fellow Burg nurse this way.
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No. 7
from tevans95b
Old Nov 11, 2005, 09:49 PM

Default Re: RN with relapsing cdiff
Sorry to hear about your difficulties with C. Diff. I'm sure it's more miserable than it sounds. We have a doctor that has decided that after seven days of Flagyl PO the patients are cured and don't need to be isolated. Our ICP had always said six months contact isolation. Yes, we've seen an upswing of C. Dif cases. There's a study being done that hypothesizes certain antibiotics used today make a patient more prone to C. Dif. What were you on? The Vanc you were on, you took it PO? We usually treat w/PO flagyl and IV vanc, as long as it crosses the gut. Good luck!
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No. 8
from RNinPGH
Old Nov 12, 2005, 11:58 PM

Default Re: RN with relapsing cdiff
I thought it was known that IV vanc doesn't cross into the gut, thats why its primarily INEFFECTIVE against cdiff? That is what ALL the literature I have read to date has stated. The PO vanc (which I have been on intermittently since July) doesn't cross INTO the bloodstream, essentially sparing my kidneys. My first round of PO flagyl became ineffective after 5 days of treatment, I horribly relapsed and ended up as an inpatient for a couple of days. My current dose of vanc, which is now doing NOTHING for me, which is making me question a possible VRE experience, is 250mg QID PO.

I was an inpatient last week, and despite two stools coming back negative, I was still in isolation, the ID docs explaining that since I was on vanc, my tests would logically come back negative, the vanc suppressing the toxins. The same reason why you get a blood culture BEFORE you start IV antibiotics. The proper way to test, is to be off vanc (or flagyl) for two weeks. If I were any nurse on any unit anywhere and had a pt with a HISTORY of cdiff, I would gown and glove and take every precaution for my own protection. YOU DO NOT WANT THIS RUINING YOUR LIFE!!!!!

As a result of the cdiff, I have now developed fibromyalgia, which my docs say is a direct result of battling this bacteria for so long. I have lost nearly 30 pounds to date, been off work at 60% of my salary (which is a BIG loss if you add it up), and have been paying out the butt (ha ha) for meds/copays/tests/hospitalizations and the like.

BTW, I was first on Augmentin 875mg BID for 5 days, which did not touch the symptoms of severe otitis media, then Avelox 400 mg QD for 10 days before I had the first symptoms of cdiff. I really don't want to know what was growing in my ear that didn't respond to the Augmentin at that dosage.

I'm happy I don't have your doc treating me

If you want more info about what your docs SHOULD be doing, please see the cdiff support site's FAQ section: www.cdiffsupport.com
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No. 9
from jmgrn65
Old Nov 13, 2005, 03:20 PM

Default Re: RN with relapsing cdiff
our facility says that once positive the patient will remain positive for a long time, we take them out of isolation when thier stools return to normal usually two formed stools and no diarrhea for 2 days. Hope you get better soon.
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