It’s hard to think of anything more out-of-the-box than the treatment that finally restored Lake Worth retiree Elizabeth Bolster to health.
In her case, it took germs to kill drug-resistant germs. Specifically, gut germs — the ones in poop. Her neighbor Margaret Gordon’s poop, to be precise.
It all started when a painful bout of diverticulitis, a bowel infection, forced Bolster’s doctor to prescribe a powerful fluoroquinolone antibiotic. The antibiotic didn’t just kill her bad bacteria, it wiped out most of the good ones, leaving behind a dangerous germ called Clostridium difficile. The C. diff took over and made her much sicker than she had been in the first place.
A person would have to be terribly, terribly ill to consider having someone else’s feces transferred into their own bowels. But Bolster, 87, was that sick.
She had dropped 30 pounds from unrelenting diarrhea over 10 months. She was trapped in her condominium most days, and forced to wear a diaper to go out. The illness left her constantly dehydrated, low in electrolytes and dejected.
“You don’t want to eat. You have accidents, and it’s very embarrassing,” Bolster said. “People can die from it. I was 10 times in the hospital.”
Each time she was hospitalized, she’d be put on a different antibiotic cocktail. Nothing worked. The C. diff was resistant to everything they threw at it. One of the antibiotics left her with permanent hearing loss.
It was during one of those hospitalizations that she heard about the experimental treatment.
“There was this wonderful hospitalist, and the first day I was there, I said, ‘What am I going to do with this? I can’t go through life like this,’” Bolster said. “He said, ‘They are working on this experimental treatment, you take someone else’s fecal material and it kills all the spores.’ I said, ‘Ew!’”
But not for long.
Several months later she called her gastroenterologist, asking for her own fecal transplant. He connected her with Dr. Andrew Zwick, a Boca Raton gastroenterologist who had started doing them at Boca Raton Regional Hospital a year earlier.
“There’s an ick factor,” Zwick acknowledged. “We don’t do this unless they have already failed antibiotic therapy or have been hospitalized twice because of their C. difficile infection, or are so acutely ill that they are at risk for organ failure and death if we don’t do it quickly.”
Bolster fit the protocols.
Zwick and his partner, Dr. Lawrence Fiedler, were very encouraging. They had astonishingly successful results, around 90 percent after transplanting 40 patients, Fiedler said.
“It’s really not experimental anymore,” Fiedler said. “It’s becoming the standard of care for difficult cases of C. difficile that don’t respond to conventional therapy.”
Bolster had to find a donor, though. Her husband was disqualified, because of his own recent antibiotic use. Her kindly neighbor Margaret Gordon, a retired nurse, often asked after her health. So she asked Margaret.
“I called her and she said, ‘Absolutely, I’d be delighted!’ I was very lucky to get a friend,” Bolster said.
Zwick and Fiedler do the transplant much like a colonoscopy. The bowel is prepped the day before transplant by having the patient drink a laxative soulution to empty everything in their system. Then, the morning of the procedure, the donor drops off their stool in a container. It’s mixed with sterile fluid, and then that fluid is released into the patient’s bowels.
“Within a week, that problem was no longer a problem,” Bolster said. “I’m just so pleased and grateful. In the end, I think it saved my life.”
She’s gaining weight again, going out to restaurants again. Her friend Margaret recently called to check on her from her home in Farmingdale, New York.
“I said, ‘Margaret, you are fine. Everything you have given me is just fine.’”