It was particularly difficult a few years ago when recurrent c diff was relatively unknown. At that point, I had to find a compounding pharmacy to get the oral vanco.
When things would recur, docs who clearly did not know what to do next would recommend doing the same thing and surprise! they'd get the same recurrence when done. Idiots.
Finally, I ended digging into the literature in order to make sure that whatever infectious disease doctor we were talking to was up-to-speed. There are few who are. I worked out some population dynamics on my own, but most of the medical community is not diffeq friendly.
As the wife dropped to under a hundred pounds, we found someone who recommended Cholestyramine during the post-vanco phase. It turns out that Cholestyramine binds one of the toxins (B? iirc) which gives the rest of the intestinal flora a fighting chance as the spores germinate. Effectively, it reduces the coupling coefficient in a population dynamical system preventing the c diff population to grow and overcome other populations. Perhaps old news if you did work in this field. At least, I hope things like this are better known than back in 2005.
Anyway, it worked but her health has never been the same.
I'm very sorry to hear about your wife's condition - C. diff is a nasty and unpleasant infection at the best of times, and recurrent C. diff is downright terrible.
There's some new drugs - evidence for example that Fidaxomicin may work better than Vanco, and increasing use of fecal transplant and other techniques.
My dissertation was on the effect of routine fecal transplant in post-CDI patients to prevent recurrence, using some models based on diffeq transmission models (but stochastic rather than deterministic).
It was particularly difficult a few years ago when recurrent c diff was relatively unknown. At that point, I had to find a compounding pharmacy to get the oral vanco.
When things would recur, docs who clearly did not know what to do next would recommend doing the same thing and surprise! they'd get the same recurrence when done. Idiots.
Finally, I ended digging into the literature in order to make sure that whatever infectious disease doctor we were talking to was up-to-speed. There are few who are. I worked out some population dynamics on my own, but most of the medical community is not diffeq friendly.
As the wife dropped to under a hundred pounds, we found someone who recommended Cholestyramine during the post-vanco phase. It turns out that Cholestyramine binds one of the toxins (B? iirc) which gives the rest of the intestinal flora a fighting chance as the spores germinate. Effectively, it reduces the coupling coefficient in a population dynamical system preventing the c diff population to grow and overcome other populations. Perhaps old news if you did work in this field. At least, I hope things like this are better known than back in 2005.
Anyway, it worked but her health has never been the same.