I Got A Poop Transplant!

It’s kind of crazy to think that this is where we are at in medicine. Thousands of years ago, the Chinese did their own poop transplants by simply drinking someone’s feces. Thank goodness we are past that lol. FMTs are on the rise because of c diff and the mortality rates associated with it rising too.

If you haven’t read my journey up to this point, go read my gut stuff story. It tells you everything up to this point. This blog post will begins on June 7th, 2021.

A Consultation With A FMT Specialist

After the 3rd bout of cdiff you can get an FMT. I had already discussed this option with my regular doctor the 2nd time I was sick, so I had a general idea that this was in my future, but they never really had the specifics – plus I was hoping that it wouldn’t have been so soon.

What Is FMT?

FMT stands for “Fecal Microbiota Transplantation,” or aka ‘stool transplantation’ or ‘fecal transplant’. Soon to be called bacteriotherapy in the future, I think. The main purpose of FMT is to transfer gut organisms from a healthy donor to a patient, according to GI.org.

FMTs can help treat Arthritis, Asthma, Autism, Bipolar Disorder, Chronic Fatigue Syndrome, Clostridium Difficile Infection, Colitis, Crohn’s Disease, Eczema, Fibromyalgia, IBS (Irritable Bowel Syndrome), Insulin Resistance, Metabolic Syndrome, Mood Disorders, Multiple Sclerosis, Obesity, Parkinson’s Disease, and Psoriasis. Learn all about fmts here.

The specialist went through my timeline, medications I took while sick through my 3 bouts of c diff & sibo, and my long list of questions. If you are currently sick or struggling with your gut healing process, I recommend that you keep notes somewhere, whether you get a gut journal or keep track of things via an app (I like the free & customizable app called Daylio). Check out my post on what and how to journal and track your gut healing.

What Questions To Ask Your Doctor

Every time you are at the doctor, you should always have questions. Some really basic ones being:

• What to expect for during your treatment (whatever medications, procedures, new item you are discussing)
• Aftercare – what to expect afterwards, things you should be on the look out for, any alterations to regular lifestyle or diet, etc.
• Risks (including possible worst case scenario – I like to be prepared for the worst)
• Things to avoid – I find doctors are notorious for being vague, so if there’s anything that you specifically need to watch out for (say you have medical marijuana card or food sensitivities, perhaps other medical conditions too)

I also asked Dr. FMT about:

• What did I do wrong?
• Can I eat myself into this mess?
• Did I do something to make myself susceptible to this?
• Can I have babies? What are those risks?
• What should I be eating? What should I avoid?
• What is the timeline for FMT?
• How do most patients react? What is that healing process?
• What happens if I get c diff again?
• What are my options right now?
• What makes me /my Cdiff so abnormal?
• What do other people do? What can I do differently?
• How do I stay safe after? How to keep others/pets safe?
• What supplements should I take/stop taking?
• How do I know if it’s been successful?
• What should the new normal look like?

Be sure to address any and all of your concerns. Make a symptom list and medication list to have on hand too. The gut journaling post can help you with this!

In my case, he couldn’t answer all of these but he did his best to. Nobody has all the answers. I did learn some new things, which I will share but I still admittedly don’t completely understand.

In many places it says that your chances of relapsing from c diff once you have had it 1 time is 20%, 2 times is 40% and so on. But he didn’t call my bouts a recurring c diff infection or even a relapse. Basically, he told me that unless you relapse within 8 weeks after your last c diff bout, it doesn’t count as a recurrence. And that once I got rid of c diff for more than 8 weeks, my chances were only 20% (but I have to say that is hard to believe cause I relapsed TWICE at only 20%? No way. Not with all the precautions I was taking. I still believe that my chances got higher with every relapse regardless of how much time was between the bouts). He said he’s seen a few cases like mine (whatever that means exactly) but ultimately said I could choose to move forward with the fmt even though I was an abnormal case. He also suggested that I was scoped and biopsied to determine if there’s other issues at hand, as well as try amtriptyline again for anxiety. He said we could move forward with all 3 of these options and so I did. If they were going to be scoping me we might as well try the fmt. He ordered the bloodwork and COVID test (prerequisites for the procedure) which was quick and we did that right after the consultation. As we were leaving the parking ramp the scheduling desk called, and before I was even on my way home, I was scheduled to have 7 biopsies, endoscopy, colonoscopy, and fmt just one week later.

You can imagine my surprise as I had to wait over a month just to get my first appointment, it was all overwhelming for such a quick turnaround.

Risks Of Fecal Transplants

For the most part, this investigational procedure has positive reviews though it’s not FDA approved or anything. But there are risks with a FMT:

• Physical injury & intestinal perforation – scrapping, cutting, poking through the intestines are all risks during endo/colonoscopy/nasoenteric/enema
• Dysbiosis – unbalanced gut biome (odds are you’re trying to fix this with the fmt but if the donor is not healthy it could be worse)
• Parasites & pathogens – extensive screening is done on both the donor and the recipient, but dangerous bugs or viruses can be transferred
• Obesity – honestly, I am so sickly thin that would not be a bad thing to have helping me right now, lol this is super rare and odds are your donor is not obese since that is a characteristic they screen for
• Mental traits – some say anxiety, depression, and other mental health characteristics can be transferred to recipients, I think maybe peoples mental health changes due to the success/failure of the fmt and corresponds with their overall health but that’s just my strong opinion…
• Long term risks – there are no studies since this is all rather recent

Prepping For A FMT

I won’t lie, the prep was intimidating and scary as soon as I heard I needed to do an endoscopy/colonoscopy. Because I knew I would likely have some (ok a lot of) anxiety involved since this was my ever procedure like this, plus it was just scary in general to me. Also, diarrhea usually triggers my PTSD, I figured this wouldn’t be any different.

It was like having c diff. It’s a good comparison, I think.

The prep was called MoviPrep, a 64oz container with 4 lines at each 8oz mark. I would need to do the whole liter bottle twice, once in the evening and once in the morning before the procedure. The evening prep was to begin around 6pm, I mixed the giant bags of powder with warm water and nervously began chugging that nasty, disgusting drink. I gagged it down, barely, and it kicked in before I could even finish the whole bottle.

It was just liquid shooting out of me – every 5 seconds a steady stream of straight lava would force it’s way to the porcelain throne. I shivered on the toilet for hours, unable to leave the seat for more than a few minutes (for at least the first 4 hours). I got a magazine since I don’t bring my cellphone in the bathroom, I also remember being so cold that I filled the bathtub and took little breaks to warm up / help my poor raw bootyhole. I kept having to go into the early hours of dawn, but around 4am I started my second dose of prep. The directions said to start it 2 hours before my procedure (lol the drive is 2 hours and I couldn’t get off the pot for at least 4 hours the night before), but I gave myself about 5 hours before we needed to leave.

The second dose was the same as the first, straight yellow stomach bile was all that was coming out. It was like peeing out my ass! The only difference between that and c diff for me, was that the c diff poo was fluffy and floaty with bits no matter if I had eaten or drank, it could make me go every 30 minutes to an hour, this prep was just like pee with some bubbles on top and it would start to slow down after a few hours. Usually my c diff would be pretty consistent and steady.

I made the drive! I brought a extra set clothes, undies, a towel, and plenty of bleach wipes. I didn’t need them, but it was good to have. I had to go several more times while waiting. My appointment was supposed to be at 11:45, I had to wait to check in until 11:40.

FMT Procedure

When they checked me in, the lady at the desk very loudly asked if I finished all the prep and have been fasting, questions she had asked several people in front of me. I wonder how many other people are praying to not shit themselves?

My name was called and I was brought back into a room with changing stalls. A nurse gave me a gown, robe, and a plastic bag for my clothes. She told me to take a seat in the little wait area near the stalls and that there’s a toilet to use if needed. After changing, I took a seat and I waited until about 1:45pm. It was a long wait, I guess another procedure went a little late, I chatted with lots of ladies and I had to poop again (probably from nerves) and eventually the took me back to a room with machines and a bed covered in puppy pads.

My all gal team was very friendly and quick to hook me up, before I knew it the doctor doing the biopsies, scoping, and FMT briefly went over the process and I signed the consent form. A nurse put the bite bit in my mouth and that is the last thing I remember.

What To Expect After A FMT

FMT Side Effects

Some of the side effects that they warn you about are:

• Changes in stool – this is a given! I wanted a change in the look/feel/smell, which is the goal pretty much.
• Bloating, constipation, diarrhea, nausea, abdominal cramping, some discomfort, and in 1-3 days you should feel normal!
• If you experience diarrhea more than 3 times for several days you should do a stool sample to rule out Cdiff. If you do not have signs of C diff for 8 weeks, you will be considered cured. 😆

That was pretty much it. My life had to go back to normal. What the fuck is normal now? Like old normal? A new normal? What is normal anyways? Let’s just take it slow.

Diet After FMT

This was an area I couldn’t find a lot of info in, they pretty much say you can eat whatever, but suggest the following:

• Plain Foods – hi there old friends rice, chicken, broth…
• High Fiber – fruits and veggies, but also whole grains, etc. Items that may cause issues still
• Water – every doctor/dietitian/nutritionist will tell you to drink more water and less caffeine, alcohol

It’s sad when the closest thing you can find to help in this area is an article like this.

Post-FMT Experience

I woke up pretty abruptly, I usually wake up to stomach cramps and the urge to shit, so this was no different. They told me since I am young I should try to hold it in for as long as I could, which turned out to only be 15 minutes or so. LOL. The room I was in had about 8 other people also waking up from colonoscopies & FMTs. I asked to go to the bathroom where I think mostly anxiety came out, which means I kept some of the donors stool in.

After the bathroom break, one of the other people in the walk up room sounded like they were sick, so I hightailed it out of there. I grabbed the plastic bag with my clothes in it from under my bed, pulled the 6 stickers off my chest, the nurse disconnected the iv, and I walked out to my ride.

They didn’t put me all the way under, they pretty much give you Rohypnol and there is a chance you could wake up during it, but if I did, I gladly don’t recall anything else.

The two hour drive home was fine. But as soon as I attempted to eat a tiny bit of turkey, I had to poop again.it was not the colon prep type of poops, still quite loose, but it was more fluffy and brown in color rather than yellow. Again, the donors stool. I might have more still inside! I showered and long at last, went to bed.

Day 1: Post FMT

I woke up the same way as I usually do, having to poop. It didn’t really seem as urgent as usual, it was still mushy brown donor stool. There was less tenderness in the abdominal area to the physical touch, there was still some gurgling, cramping, bloating, and not a huge appetite – then I had an afternoon poop which was hard little rabbit turds. I was also a bit gassy, which could have just been the fact I could fart without pooping myself at this point.

Day 2: Post FMT

I felt discouraged slightly, as I was able to see bits and pieces of my meal from the previous day in my #5 on the Bristol scale stool. Shit, I still can’t break down my foods completely. Give it some more time. Also I got my period this day, so it could be part of that a little…

Day 3: Post FMT

By my third morning, my poop seemed to be back to my old “normal” as it was floaty, #3-5 on the Bristol but with some urgency (less though) and gurgling cramps. My bowels just seemed all over the place to be honest.

Day 7: One Week Post FMT

On this specific Monday, I had hardly any cramping or pain. The mushy blobs floated, they smelled like before the fmt as well. My diet had more fiber, not a whole lot of sugars, but also not super different.. honestly the weirdest thing was not taking probiotics.

Day 14: Two Weeks Post FMT

The poops are pretty consistent, they range from #4-6 on the Bristol scale but like every poop is all three. It seems a little odd to sort of see what foods or meals are coming through in that aspect, otherwise my condition seems to be purely a type of post infectious ibs, when it acts up it’s usually in reaction to anxiety or stress, or bad food.

3 Months Post Fecal Transplant

I’ve been getting asked a lot how my transplant is holding up and whether I think it worked or not…

To be honest, I’m not sure but here’s what I can tell you, well I’ll try to explain anyways. The first time I had c diff it took about a year and a half to start feeling “more like normal again” and that’s when I got sick for the second time. Now, after the 2nd bout of c diff, I had a goal to be at a certain weight for a big day, that took me about a year. This 3rd bout, it’s still taking time to heal. It’s definitely still taking forever to gain weight and the plateau rut is still a bitch. I’m currently struggling just as before with my depression and anxiety, after all it’s all absorbed through the gut and if my gut can’t even absorb foods, it for sure ain’t working in favor for me. But it’s been 3 months vs. a year to eat at restaurants again, to take trips & travel, to work from a cafe sometimes. It’s hard in a post pandemic world to even act like this is a big deal, but to us – such isolation is what I feel like I need or deserve sometimes. Like I need to be weary of being around people because they might get me sick or I may be sick and get them sick (you see the spiral)…but hey! Small victories, please keep celebrating the little things. 🎉 life is too short.