CFer's w/ cepacia

anonymous

New member
My name's Jan and if you have cepacia, if we haven't 'talked' we have probably at least read each other's posts. My husband is 45, w/cepacia and on the list for a double lung tx. This is where we are at: Every antibiotic now tests resistant, including synergy tests from NY. (Except meropenem, of which they just gave him a larger dose and he had a rash so they stopped it.). They are now sending his cultures to Ottawa for triple synergy testing. Basically, they are saying (or trying actually not to tell us) they have no options, or only drastic options that they would only try if he was bad enough to be on a ventilator because of the 'risk vs. benefit.' It is as if they are going to cross their fingers and hope he coasts into the tx in time. Well, that's not good enough for me (besides txing w/cepacia has its own set of challenges).

I know they can't give us options that aren't available, but I am looking for more information and support. It seems the main way the CF community is fighting cepacia, is by relying on eliminating the contact with infected CFer's, which makes sense, obviously. But on the other hand, cepacia is prevalent in the environment (in the hospitals, in the ground, rotten onions, even in the water on the space shuttle) so this threat is not going to go away. But what I want to know is what is the CF community doing to help those already infected? I know U of MI types. I know Columbia does synergy. But who else does anything? Is there one center that specializes in cepacia? Is there some dr. heading the fight? When I surf the web it seems there really is nothing new, other than occasional updated (depressing) statistics or a study or two looking at all the strains and their differences, which is probably fundamental to any treatment, but still, not particularly promising for treatments in the near future. I am not involved with the CF Foundation, so maybe you are aware of something substantial they are doing that you can share with me. I realize that only about 4% of the CF population in US has cepacia, and that fact alone might not result in an incentive to devote time/enery/money to cepacia research. What about other countries? Canada?

Is there some cepacia support group or newsletter to keep us informed of current treatments and developments? Or are we really the ones leading the way, and they are learning from us how to help those that follow? Do we have someone representing us at the CF foundation? Would that be helpful? Is cepacia the focus of your own medical care and treatment? Do you know of other CF chat rooms or message boards or groups where others with cepacia are that do not come on this message board? If you want to email me instead of posting, reach me at standinginthegap4Greg@hotmail.com. If there is interest, maybe we can stay in touch with each other, sharing what we know and what's being done for us.

Of course, he does pulmozyme, TOBI, and colystin (nebs), and had been prescribed two iv antibiotics every flare up, which had gotten to be about every 6 - 8 weeks. We have never been ones to sit around - he's lived his life very proactive, fighting every step of the way. I am not ready to start sitting by and waiting for the inevitable. He has grown up living past all the 'median age' predictions, and I am planning on him to keep beating all the odds now. I am currently trying to get information on an article about txing with cepacia regarding the use of dextran & xylitol, but not having success at obtaining the info.

Sorry if this sounds intense or depressed or whatever. I guess I am! Thanks for all your input, and as always we wish all of you the best.
 

anonymous

New member
Thank you for your interesting post. I have Cepacia, the irony is I feel certain I contacted this through attending an adult CF conference. When I made my feelings known, I was told I should not speculate. Since then I have felt totally isolated from the CF community! I will email you with further details.
 

anonymous

New member
Hi Jan, I have an 11 year old son w/ cepacia. He acquired it at the age of 4. Until that time he never had any lung infections. He did pretty good for the next 2-3 years, but from the age of 7 to about a year ago he was hospitalized about every 3 months with pneumonia. He had normal lung functions even through all of this, his FEV1 would go from the 30's when he had pneumonia to the 90's in between infections. It was so frustrating for us because he would be doing so great and wake up one morning with a high fever and pnuemonia. We had no problem getting his lung function back, but no answer on how to stop this horrible cycle. We admire and respect our doctor, but even he would brush it off as "cepacia." It's pretty much their way of saying its a horrible bacteria so theres nothing we can do. That is very hard to accept, and frustrating that your supposed to just say, "oh well, thats cepacia for ya." What makes it even harder for me to accept is that we found out, too late for us, that the CF center that he was going to at the time had an abnormally high incident of cepacia patients. I know it can be acquired other places, but I know in my heart that he got this at such an early age because of improper sterilization procedures. So, the same place that gave him this bacteria pretty much turns their back on you when looking for answers to keeping them healthy. It makes you very angry. But I think your answer is correct, they dont know alot about it, and they are learning through us. I LOVED what you had to say about having an advocate, I am all for that. I honestly dont know most of the questions that you asked, but I agree with you that more needs to be done. If these things do not exist, I would love to help you start them.

As far as my sons health right now, he is doing very well. He has not been in the hospital for over 7 months, and I credit glutathione for that. He takes inhaled and oral glutathione and it has improved his health. He no longer has that major inflammatory response to irratants that would have previously given him pneumonia.

I'm glad to hear they are sending his synergies to Ottowa. Doing triples with cepacia is pretty much the norm at our CF center. When in the hospital, my son is on Tobra/Merapenam/Ceftaz. He used to be able to use Timentan (Ticar) which worked well on him, but he developed an allergy to it and now he breaks out in a bad rash. They tried to de-sensitize him to it, but it didnt work, he still broke out all over.

Good luck to you and your husband, I hope you find the answers your looking for. If it turns out there are no advocates/representatives for the cepacia population and you are thinking of starting something you count me in to help in anyway possible.

Caren
 

anonymous

New member
I believe I caught cepacia from my local hospital, which used (still uses) communal bottles for nebs (using an eyedropper to put the solution in each patient's neb.) We now insist, of course, on my own meds, and encounter resistance from the rt's.

I also might have caught it from my cf clinic. When I cultured, I asked if there were any other cepacia patients. What I was told is that my dr. didnt' have any cepacia patients (and then in a separate, much later conversation learned that another dr. had a patient die from cepacia.) I believe there is only one other cepacia patient at my clinic. I think they were just trying to keep me from believing I could have become infected at the clinic.
 

anonymous

New member
I don't know what to say about symptoms - but most strains are virulent and become multi-resistant rather quickly. You seem to have exacerbations more frequently. Some people feel generally more run down, lower PFT's, and it's not unusual to run a low grade temperature often in the evening. In my case, its worse than any other bug. There are a number of strains (9 I think.) Type III being the most easily spread and the most damaging the quickest. It is smart (changing it's molecular structure, hiding behind other bacteria), hard to kill, strong to survive (can exist indefinitely in a drop of water, live a long time on any surface) bacteria, which is why the farmers initially were eager to use it as a biopesticide. This information is unofficial, just what I understood when I read up on it a couple of years ago. Perhaps someone has more information.
 

kybert

New member
i dont have cepacia but i feel for those who do. some people get treated like lost causes and forgotten about. just look at some transplant centres, after all these years some are still scared to even touch a cepacia patient. that is my biggest fear if i caught cepacia, being left to die. i agree that the problem wont be solved if poor hygeine in hospitals isnt addressed. everything i have caught has been from the staff or environment. simply seperating people wont do anything and it doesnt do anything to ease my mind. i feel more safer standing in an mrsa/cepacia patients room than touching a elevator button. hope your husbands ok, hang in there.
 

anonymous

New member
This post is for Caren. Where do you get the inhaled glutathione and oral? How long has your son used it? Are there any side effects? Fell free to e-mail me as I don't check the site all the time.
tybaum21@aol.com
Eric
 

anonymous

New member
Hello Everyone

I have a question , Our CF clinic has clinic on Tues for children and Thurs for adults, I have been taking my daughter to the Thurs appt. for some time now, due to my schedule at work. My question is do you guys think or suggest that maybe i should change her appt. days to Tues? My daughter does culture positive for pseudomonas and MRSA but not cepacia. Is it more likely that she would aquire this bacteria from adults more so than children??? I would appreciate any comments or suggestions as to what you think.

Kaitsmom<img src="i/expressions/rose.gif" border="0">
 

anonymous

New member
I have cepacia and at my clinic, they see CF patients on Monday for kids and Thursday for adults. I always go on Wednesdays. Seems to work ok.
 

Diane

New member
Hi Jan,
I know your frustration. I have had b.cepacia for about 8 years now and i have often thought the same things you said about how it seems like no-one seems to be looking to help the ones with cepacia . They only seem interested in making sure we dont infect anyone else. WHY WASNT SOMEONE LOOKING OUT FOR ME THEN? I dont even remember ever being told there even was something called b.cepacia. Had someone mentioned it and how bad it can be,i certainly would have been less willing to have my sinus surgery or maybe i could have taken precautions while i did have the surgery. I was in great health till i had my sinus surgery, the day after the urgery i started coughing and feeling very weak and figured it had to be from the anesthesia from the surgery. Only problem was, that feeling never seemed to go away. About a yearlater after more symptoms started to arrive and not want to go away i found out i had cepacia. It seems to me that you hit the nail on th head, WE ( with cepacia) are the ones teaching about cepacia. It seems like kind of a "hit or miss" thing with how they treat it. I notice there are a LOT of trials for all kinds of things for cf, but people with cf and b.cepacia are always left out of these. Where are the trials for people with cf and b.cepacia ?????? It seems like all the new treatments are aimed towards those who have no lung damage yet, what about those of us that do? Dont we count? I started using oral glutathione about 2 year ago and noticed a dramatic difference in my energy level as well as in my general health. Right now i am sick, and on an iv and wish there were something else on the horizon with the promise of good results for those of us with cepacia. Count me in on anything you need to help with starting something for cepacia research or whatever........... Jinxnick @ aol.com
ps. i said a prayer for your husband...................
 

anonymous

New member
Hello Jan, I too, found your letter of personal interest as I was diagnosed with Burkholderia Cepacia four years ago. Like the second poster, I had also attended a Conference a week prior to been hospitalised with my worst chest infection. I was told speculation was not healthy and I could have 'picked it up' from anywhere in the environment..... realising the consequences of this new diagnosis I did ask many questions. After all I had been in this environment for 48 years, growing up on a farm, I hadn't just arrived on that shuttle from Mars<img src="i/expressions/face-icon-small-wink.gif" border="0"> I recall shedding many tears of frustration. Nobody seemed to hear what I was saying.......

You asked a very pertinent question, What is the CF Foundation doing to help those inflicted sufferers with this bacteria that once colonised can never be erradicated from our lungs?? After leaving Hospital and a lengthy recovery period, I did endeavour to seek answers from my local CF Assoc., I believe my barrage of questions was my way of dealing with the likelihood of my then mild CF, becoming progressively worse.
However our CF Assoc., went the extra mile to support me with much reading material and their added assurance, others would be educated on this 'nasty invader'. I believe they have done their best and will keep me informed with any updates in this area. I live in a small country, New Zealand, and am one of a small minority of Cepacia victims.........

The second poster stated that he/she has felt isolation from the CF Community, that is surely sad, but I can to a degree understand how that can happen. I have probably isolated myself from the CF community [in recent years], more because I am truly aware of the dangers of cross-infection to susceptible persons. I am happy, leading my life in relative peace.


You sound like you are giving Greg alot of strength and support Jan, I hope and pray his tranplant is not far away. Do hope you find a measure of comfort knowing that from this forum there are alot of us experiencing similar life-styles.

I would be interested too, to learn of any channels we can seek to help our cause.
If you would like to email me please feel free to do so: iswag1@xtra.co.nz

All the very best to you both.
Eileen<img src="i/expressions/sun.gif" border="0">
 

anonymous

New member
Eric,
I order glutathione from Theranaturals, their phone number is 801-224-8893 and website is www.theranaturals.com. The recommended dosage correlates with your weight. Jordan is 11 and weights 98 lbs., we started him on a low dose and worked him up to the optimal dose for his weight. He takes 2 oral (1 GSH CAP) and 2 inhaled treatments (4 L-glutathione plus sodium bicarbonate pills with 8 ml. of sterile water) per day. We try to put 4 hours in between each. As an example he does the inhaled in the morning, takes the oral at lunch, does the inhaled after school around 4p, and the inhaled again before bed. For the inhaled, it is recommended that you use 2-2 1/2 ml. of sterile water per pill.

Caren
 

Diane

New member
Hi Eileen,
I am doing my iv's at home. I usually do all my iv treatments at home except when there is a real emergency like when i had to have 2 embolizations or if i am so sick i can not take care of myself. I forgot to mention that the reason i am sure i got the cepacia from when i was hospitalized with my sinus surgery is because i hadnt been in the hospital prior to that in many many years( well over 10 years), and like i said i was doing fine till then. The whole reason for the surgery was polyps and a drainage issue and the doctor didnt want my sinus's to infect my lungs with what was in them. Isnt that interesting, i went in there to protect my lungs, and wound up leaving with something whos only intent is ruining them. <img src="i/expressions/face-icon-small-sad.gif" border="0">
I do feel a bit better today and i hope that trend continues. Do look into the glutathione, as far as i have been reading on the message board it has helped just about everyone whos tried it. I only use the oral because i have problems with hemoptysis and it is not advised to inhale it if you have hemoptysis problems. I get mine from iherb.com . I take 500 mg with 500 mg vit C each dose ( to help with the uptake of the glutathione) 4 times a day. ( for a total of 2000 mg. per day) good luck<img src="i/expressions/face-icon-small-smile.gif" border="0">
 

anonymous

New member
Thank you to all with cepacia who have responded.

The only thing I have come across that's new to us is the glutathione (sorry for the spelling) and one other inhaled antibiotic - fortaz, but they said it tasted so gross it wasn't used much. Actually, I found some information, although I don't know how reliable, that other antibiotics could be inhaled. I guess I take TOBI (and now colystin) for granted, but really, I know it's cutting edge. Still, TOBI is not necessarily targeted for cepacia, but pseudonomas, right? Does anyone know how or if they test the inhaled antibiotic's (like colistyn) effectiveness on the individual patient's culture? If it doesn't work in the petry dish, would they use it as inhaled? Well, I guess they do, because no antibiotics test sensitive, and they're having him inhale two.

As far as the glutathione, we read about it a year or two ago and became interested in finding out more about it. When we asked our cf dr., she stressed we should follow the recommendations of the CF Foundation. Didn't I read something from the CF Foundation about trials or something? What exactly are the effects - less infections, less congestion? If someone would briefly refresh me, I'd appreciate it.

Also, to the person from New Zealand - what is the date of your latest cepacia information? Does it suggest new treatments/drugs? Is it from your country?

Regarding tx, I have found the article about the study of dextran and xylitol being administered just prior to tx. I am now looking for a 'hard copy' of what Dr. Egan does at UNC - something about washing out the chest cavity during surgery. If anyone knows how to get ahold of that, let me know.

I do not mean to criticize the CF Foundation, I'm just looking for some proactive treatments especially for those who have already contracted cepacia.

Thanks again and God bless, jan
 

anonymous

New member
Caren,

Thanks for the website and info. Exactly which pills do you order? Could you explain how you mix the inhaled Glutathione? Thanks again.

Eric
 

Diane

New member
Hi Jan,
Ive used the fortaz in the past quite a few times. I dont care about the taste as long as it works, and it did help some, but it also seemed to correlate with hemoptysis so i stopped using it. As for the glutathione, ( i can only speak for the oral use of it) it gave me my enegry back that i used to have before i got b.cepacia. I also get sick less often and when do get sick it is less severe. I decided not to wait till the trials are finished on the use of glutathione because if it took 5 years to get it approved, where would i be in 5 years? Would i be way worse off than i am now? I decided after having to have 2 embolizations that i didnt want to wait , i needed results now. If it was gonna work for me, i needed it now, not later. I notice results very quickly within a week. Luckily my doctor was supportive of me trying the glutathione, as long as i didnt inhale it.
 

anonymous

New member
Yes, I have been finding stuff on cepacia (most of it depressing). The largest articles are from about 2001, I think, and are chock full of info. I assume most of us have read through those at time of diagnosis, although I will share those with everyone. Newest info I found was 2/05 - distressing news about tx results. The articles from 2001 talked about how much work was being done to identify the germs, etc. Will put all this together soon. Again, fortaz and triple synergy seems only new things I've found. I'll keep in touch! It takes hours to slog through everthing everyday. Best wishes to all and thanks for all the help. -Still looking for some written info on the bathing of chest cavity during tx (Dr. Egan, UNC) jan
 
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