Today we had our final visit with our Naturopath, Dr. Stephanie.  The goal was to go through a list of questions we had for her about our FMT process and to get the official leave of absence letter that Ashley will need for school and work.  It was an excellent visit, as always.

Here are the questions we asked and the answers we received, paraphrased of course.

Me: Antibiotics or no antibiotics?

Doc: I think this decision has to be decided carefully, based on each individual patients history.  Ashley has a history of antibiotic use that we think caused this issue.  She is already suffering from low or imbalanced flora.  I suggest we do not use antibiotics but instead just go with the low fiber diet for 2 weeks in advance.
Ashley: Does this mean I get to eat like crap?
Me: Yes.  White bread, chicken nuggets, etc.
Ashley: Yay!

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Me: Ashley struggles with yeast overgrowth.  Is this going to hinder the ability of the FMT bacteria from colonizing?

Doc:  No.  The yeast won’t play a role in how successful the FMT is, but let’s go ahead and double up on our efforts.  Let’s add Oregano Oil to her supplements.

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Me: Beyond a high fiber diet, do you have any recommendations for feeding the implanted bacteria so they can take hold?

Doc: Yes!  Pre-biotics.  Things like fructooliogosaccharides and inulin.  In fact, I think there is a supplement with both of those things and more.  Yes.  I strongly recommend Probioplex Intensive Care, 4 tablets a day.  This formula is specifically made to feed your gut flora.

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Me: How long should we continue this diet after the FMT’s are complete?

Doc:  You’ve said you don’t anticipate your daughter sticking with a really super healthy high fiber diet but she she should make an effort to continue eating fibrous foods for her lifetime.  More importantly, I’d keep her on the pre-biotics.  Keep her on those for 1 month for every year she’s been sick.  So 18 months, to be safe.

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Me: Are there foods we need to avoid, like anti-bacterial foods?

Doc: I’ve never heard of that.  No.  Since she doesn’t have any food sensitivities, you don’t need to worry about avoidance.

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Me: Fleet or tube enema?

Doc: Tube!  If you can manage the tube enema, and get it in there as high up as possible, this is the best case scenario.  If this just won’t work for Ashley, then use the fleet and have gravity help.  Have her lie on her left side with her bottom up in the air for a while, and then switch to the right.  She should be resting a lot during this process.

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Me: Enema at room temperature or body temperature?

Doc: Room temperature is good.  If you want to wrap a heating pad, on low, around the gallon jug of water for some ambient warmth that’s fine.  You don’t want it too warm or you’ll kill off the bacteria.

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Me: Water vs. Saline.  The water won’t kill the bacteria?

Doc: You can use either.  Saline is a hydrator, while water is a dehydrator.  Try both if you’d like, see which works better.  The water won’t kill the bacteria so long as you use it right away.  For the short time you’ll have it in there, it will be just fine.

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Me: Someone on the Sally Brown page is doing what she calls Mega Flushing.  She’s giving her husband enemas one right after the other with FMT fluid, like a regular enema. What do you think about mega flushing?

Doc: I think that’s a fantastic idea…do that!  Make up as much solution as you can with your fecal matter and then flush all but the last enema of it.  When you infuse the last enema, have her retain that one as long as she can.  Shoot for 4 flushes and a hold.

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Me: Is there any reason to avoid alcohol during or after the FMT’s?

Doc: Not really…I’d probably have to do some research but I can’t think of any correlations at this time.  Just to be extra cautious, I’d avoid it during the FMT process and then for a few weeks afterward.

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With all of this information under my belt, I’m ordering the pre-biotic that Dr. Stephanie recommended and planning diets for my donor hubby and patient daughter.  We will definitely be entering some new territory this week with high fiber foods we haven’t eaten before, we’ll be avoiding processed meats and generally eating super duper healthy (we’re fairly healthy eaters anyway, but we aren’t going to win any awards).  Lee is also eliminating sugar from his diet (which will be the toughest part of this for him and his sweet tooth) so that we don’t encourage that yeast that Ashley is working on eliminating.

Ashley will contently be munching all of her favorite low fiber teen foods before having to eat like a grown up beginning April 1st.   I’m off to start planning the menu.  Wish me luck!

 

COSTS TO DATE:

Note: We are self-insured with a high deductible policy ($2500). Your out of pocket costs could vary based on your insurance coverage, doctors and testing facilities as well as the region you live in.

Item	Actual Cost	Amount Paid
Doctor’s visit	$145.00	$0 (insurance covered)
Blood and Urine Tests	$1019.50	$331.24 (after insurance discounts)
Stool Testing	$454.71	$454.71 (no insurance discounts)
Supplies	$94.16	$94.16
Follow up Doctor’s Visit	$145.00	$0 (insurance covered)
Enema bottles, heating pad, Probioplex	$97.16	$97.16
Totals:	$1810.53	$977.27

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