Saturday 28 May 2011

Infection Initiated

So yesterday the worms arrived. There was a bit of a hassle with customs on Thursday but it did arrive late Friday afternoon. Applying the worms was very straight forward. I simply sucked the little worms out of the tube with a pipette (eyedropper), deposited it on the pad of the band aid and applied it to my skin. You can’t actually see any of the worms in the tube; just some black specks which I was told are the same density of the worms so you know approximately where they are in the solution.
 I was on the phone with Garin (hookworm provider) the whole time and he talked me through everything. He asked me to tell him when the itching started. I was so worried. What if I feel no itching? What if they all died on the way, or worst of all, what if I’m not a responder? I read somewhere that the average reaction time is 7 minutes and it took about 7 minutes and 12 seconds to feel the itching. It’s really a very unique itch, very deep and prickly. I’ve never been so happy in my life to be itchy. I had to keep the band aid on for two hours and then remove it and flush it down the toilet. I’ve attached photos of the band aid, the skin reaction after it was removed and a picture of what it looks like now, approximately 24 hours after its been applied. Garin said that you can count how many dots are on your arm after removing the band aid and that’s a rough estimation of how many worms penetrated the skin. I was also told that multiple worms can go through the same spot. Last night I was able to count around 17-23 dots, which out of 25 is pretty good! They’re all kind of meshed together so it’s difficult to make out an exact number.
So far, I have felt nothing unusual. I’m feeling pretty good actually which may be the so called “honeymoon period” or "bounce". I’m told in the next 1-8 days I should feel some heavy phlegm in the back of my chest. I should not spit it out because it’s housing all my little friends and they need a safe trip to my intestines.  In 2.5 weeks they will finish their final malt, their teeth will be nice and sharp, glands fully developed and they will be ready to feed. At that point, my immune system should be fully aware of their presence and I may feel some side effects: diarrhea, fatigue, headache and night sweats. I’m hoping since my ileum (where the hookworms attach) is in good shape these effects will be minor, but I guess we’ll see!



Band aid applied
Immediately after band aid removed

A few hours later

24 hours later

Monday 23 May 2011

The worms are being shipped!

I just got news today that the hookworms are being shipped! This means they should arrive either Thursday or Friday this week (today is Monday), unless they are held up in customs. Thursday I have clinical placement all day in the hospital so even if they come in I won't be able to inocculate myself until Friday. This is because I need to phone the clinic in Mexico so they can give me step by step instructions over the phone. It seems very straight forward but apparently live specimens have been lost before so its better to be safe then sorry! I'm looking so forward to this it seems ridiculous--considering its going to be a fairly long road to remission. Oh well, gotta start somewhere.

Sunday 22 May 2011

Pre-innoculation: Waiting for the worms

Where to start? I have never considered myself to be a writer. Certainly never thought I would blog, but here I am, a mid-twenties nursing student in Ontario, Canada, on the verge of starting helminthic treatment or worm therapy.
I was diagnosed with Crohn's Disease in 2003. I have been lucky so far in that I have not had any severe flares. I was very familiar with the disease and its symptoms, as my mother also has this wonderful disease and this helped with a prompt diagnosis. Since diagnosis, I have had moderate Crohn’s in my ileum which went into remission with treatment, and a couple years later I developed Crohn’s colitis. After about a year and a half of unsucessful treatments for  the colitis  my GI specialist put me on Remicade, then after a year added Imuran. I have been in “remission” for the past 2 years thanks to these very scary drugs. I am on a constant roller coaster. These drugs don’t cure; they’re like a temporary band aid. After my Remicade infusion, I tend to feel progressively better and then, as it wears off head right back to feeling crappy again. My dose is always being changed back and forth between 6-8 weeks and it feels like there are only small windows where I actually feel in remission. Imuran on the other hand, I don’t even notice a difference. I’ve been on it for over a year and I do not feel physically better at all. It has done nothing to reduce my Remicade infusions but my specialist recommends staying on it because with the Remicade alone my inflammation indicators are too high. In the last six months, arthritis has worsened, acne has worsened and I’m being investigated for an abscess/fistula.
My mother has a much more severe case of Crohn’s disease than myself. She has had 5 bowel resections, has short-gut syndrome because she only has five feet of small bowel left and she has never been prescribed a single medication that worked for her. She was told after her last resection she might get 4 years before she will need further intervention, which if delivered would require a permanent feeding tube. We were all very scared, no doubt.
Let me give a bit of background information here: My family and I live in Canada, however when my mother was in her twenties, she moved to Acapulco, Mexico. There she lived for about 8 years in complete remission, eating and drinking whatever she liked, out dancing and working all day with no symptoms or traces whatsoever of Mr. Crohn’s. Prior to moving down to Acapulco she had one bowel resection and thought that while she was in Mexico her bowel resection had simply cured her. When I was five years old, we moved back to Canada permanently and my family and I were tested for parasite infections. We were all infected and had been for years. We were treated and the parasites killed. Within two years my mother had to have another bowel resection and her Crohn’s was back full force. For years growing up my mother swore she was healthy in Mexico because of the parasites, though we really didn’t have any idea why and she was too scared to go around drinking unfiltered water... etc from Mexico in order to re-infect herself.
So to continue, last year my poor mother began to get progressively worse with her CD activity. We were all terrified that she would have to have another surgery and end up with a feeding tube. I was terrified alone for her mental health. I had just joined a support group on facebook: Let’s Talk Crohn’s and Other GI Issues. (Excellent support group, please check it out if you’re interested). On the wall someone had posted a link about helminthic therapy. I opened it up to read it and was struck by the research. This was what my mom had been talking about for years. I forwarded it to her and within a few months she started the treatment through a clinic in Mexico. She is an excellent responder. She was on the verge of having emergency surgery and went from being able to eat nothing but ensure for years, to eating whatever she wanted. It’s still two steps forward, one step back, but as time goes on she’s getting closer and closer to full remission. She has certainly had better results with this treatment than any other. It is because of her grand success that I am embarking on this journey.
            I have been waiting, for what I feel is a long time to start this treatment. I finally have the money saved, my blood results are sufficiently in range and I spoke just yesterday with Dr Llamas in Mexico to establish my dose, 25 hookworms!! From what I understand, it takes about a year and a half to get into remission, as long as I keep my worms alive. They can cause inflammation during the first 3 months or so and I’ve been told I may need to start Entecorte or prednisone if I don’t tolerate the worms well. I can then expect what they call rachetting, taking two steps forward and one step back as my immune system attempts to regulate and equilibrate with my new wormy friends. I’m nervous about it too. There is no guarantee this will work for me. I have school work to get done and it can be so difficult to complete school work and study when you’re not feeling well. But I have to start somewhere. I’m hoping by the time I finish my degree in December 2012, I will be in remission and can start working full time (without flaring). For now, I just have to wait until my worms are ready. No idea yet how long that will be, though I’m assured soon.