Thursday, February 14, 2013

Fecal Transplants

Last summer, the kids and I visited my friend Trish-eee with her husband and two kids at her lake house up North.  It was restorative for me.  I hadn't seen her in a few years, long overdue.  We talk and text, sure, but there is nothing like face to face time.  She was one of my best friends in residency.  Her and Mellificent.  One of the funniest stories I remember (and there are many) was once when we were stealing away from a conference in San Diego for a little shopping time in the Bohemian district.  We asked a cabbie to take us there.  She's a beautiful blonde, a granola marathon runner, much like I might imagine Cheryl Strayed looked when she was taking her trip in Wild.  I had just read that book, and Trishie was training for a marathon during my visit.  She complained of blackened toenails, and I laughed thinking of Strayed's hiking trip.  I have never exercised so hard that my toenails blackened and fell off.  I guess there's still time in life.  Or maybe not.

Anyway, we took a cab to the district, I think it might have been called Hillcrest, which was funny to me since I lived at the time in the Hillcrest division of Little Rock.  In LR, it is a hippie, liberal area with lots of cool restaurants, bars, and fabulous old houses, some of them beautifully restored.  Trishie and I (Lizzie here) excitedly chatted about the fabulous Thai food we sought out and the wonderful second hand clothes stores we aimed to shop at.  I was winding down after presenting a paper, an on sale but fabulous Banana Republic suit happily hanging back in the hotel closet.  We were both exhilarated to be out of town and on a jaunt.  The cabbie had a question, which he asked with a heavy accent.

"So, we are going to Hillcrest.  You must be lesbians, no?"

We glanced at each other, shocked at the blatancy of his question.  And the fallacy.  Mutually decided that little explanation was better, but in retrospect I wish we would have replied yes, silently egging him on.  There were rainbow flags flying everywhere, and in another life, why not pretend?  So what if we were?

At the lake house this summer, Trishie took me on a long drive to see the area.  She told me she was on the fecal transplant committee at her hospital.  I did a double take.  Fecal WHAT?

"Lizzie, it's so crazy, but it works.  All the big research hospitals up North are doing it.  Some patients want fecal donors from their own families, but that's too rough on a small town hospital like ours.  We get a big normal stool sample, do all the testing in house to clear it of pathogens, and freeze it in aliquots.  You know those intractable patients with C.Diff.?  The ones who take tons and tons of meds and eat up hospital time?  You just do a tiny suppository of normal feces and voila!  They are cured."

I am the Director of Microbiology of my own hospital and I, subsequently confirming that all my co-workers (lab head, techs, etc.) as well, was not at all aware of this in Arkansas.  I had tons of questions for her, medical and otherwise.  She said, "Lizzie, it's so funny to sit on the committee.  There are all these poop jokes.  'I need to make a movement to approve this.'  'We need to make this our #2 priority.'"  I listened in awe and laughed until my face hurt.

A month or so ago there was an article on Fecal Transplants in the New York Times.  I also ran across it last week on Kevin M.D.  So despite my partner's reservations ('Are you sure she is not a practical joker, this friend of yours from residency?  I think she is surely pulling your leg' - you know who you are ha ha), I believe her.  It makes sense.  Replenish the gut with normal flora to fight disease, rather than blasting it with antibiotics - the bomb to kill the fly.  I wonder when it will come to Arkansas.  I am sure it will come to my attention as soon as it does.

Trishie called me a few weeks ago to set up another visit this summer, and I carved out a time.  I can't wait.  She and her husband are such wonderful parents to their kindergartner and toddler.  We played lots of games.  We watched the Olympics.  We taught Cecelia how to water ski, and she was so proud.  I got up on water skis for the first time in many years, and I was so proud.  I ran every day.  I swam laps around the lake, and my eyes burned from the muddy water, in a good way.  I learned about fecal transplants.  I wonder what I will learn about this year.  Surely it cannot compare.

I can't end this blog without mentioning that my friend Trishie is the daughter of a self-made multi-millionaire.  She would not reveal this to you - you might only learn about it if you knew her very well.  Many of you would recognize the name of what her dad has created, which I am withholding here out of respect for privacy.  She didn't have to work.  But she got her drive from her wonderful dad, who I met this past summer.  Her determination to carve out her own niche in this world and do something amazing trumped an easy, luxurious path in life which he certainly would have provided for her.  I am so proud of him for instilling that drive in her and her for fulfilling her own dreams.  She is an excellent physician.

Happy Fecal Valentine's Day Trishie, love you!




12 comments:

  1. When I told my husband there was a such thing as a fecal transplant, he was sure I was lying. Then when I convinced him, he wanted to draw a cartoon about it for my blog. But he just couldn't make it work. Maybe it's just TOO funny.

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    1. Tell him I would love for him to make that work. We need a fecal transplant cartoon in this world - I'd be surprised if it wasn't a first.

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  2. Large animal veterinarians have done this for decades, albeit in a crude fashion, and it does work. It's sometimes called transfaunation in the literature.

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    1. Transfaunation is so much more romantic than fecal transplant. New word for me - love it, thanks!

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  3. You could work with Meenaski and get a program started at BMC. :)

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    1. I could be the head of the transfaunation committee! In my copious spare time. We are short on staff, and growing our business. Double whammy right now. In a few months, definitely a consideration - I miss you and Meenakshi!

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  4. When I first heard about these, I assumed they fed the feces to the patients. Suppository is so much less gross! Though what I want to know is what is the definition of "normal" feces?

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    1. Ha ha you are right, Rock Star, normal stool is a bit of a misnomer. It reminds me of when they used to take all of our blood samples in med school - the ones we all drew on each other in blood draw lab (when I fainted, oh the horror) and use them for normal standards in the lab. Whose to say we med students were a good population for "normal controls?" Better than some, I guess. You would know more about that than me, research and statistics whiz. Feel free to expound on my ignorance.

      By normal I suppose I meant not someone who is suffering from Rota, or Shigella, or some other nasty GI bug, that they know of anyway. I might not pick the family member with bouts of uncontrollable diarrhea for my transfaunation, God forbid I ever need one someday. IBS or no, that might be bad Karma. Or bad Caca. Ha ha.

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  5. Trishie, the next time I go #2, I will giggle and think of you. I'm so glad you've found your path to happiness!

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    1. Ha ha I must say that is a small part of what she does. Very very small. In her town, she has to act as coroner in addition to pathologist. You should hear about some of the crime scenes she has attended on call. Wild wild!

      All us pathologists have to wade around in feces every now and again.

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  6. My favorite GI joke is I once told a colo-rectal surgeon that I was a food scientist. Without batting an eye, he said "Me too! I deal with food at the other end." He also made a lot of poop jokes. I think if you choose GI or especially colo-rectal surgery, you have to have a unending enjoyment of poop jokes.

    If I ever needed a poop transplant, I'd ask someone from my family. They already give me so much **it that I may as well get something out of it.

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    1. Ha ha bro, LOVE it. I'll give you mine any day:) Physical or psychological. You have my heart. I mean my sh**. It's all the same in our family, right?

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