Tuesday, June 4, 2013

Meeting With Dr. Sahil Khanna (Great Doctor) Before Fecal Transplant

So today was a pretty efficient day. We left our hotel around 11:30 A.M. and ended up at Mayo a quarter before noon. The blood test on my schedule was at 9:20 A.M., however you pretty much can go whenever to get a blood test. The only requirement was the blood test was 2 hours before our appointment. My appointment was scheduled for 4:15 P.M. We had some lunch (the only thing I could have was chicken broth which Mayo has in their cafeteria (since I am having my colonoscopy/fecal transplant procedure tomorrow). Since we got to the clinic early we had a question regarding the bowel prep. Our appointment was 4:15 P.M. and sometimes you don’t start until a little bit later and we just wanted to make sure I had the bowel prep tonight. So a nurse actually paged Dr. Khanna to ask him and he said he could met with us to discuss the fecal transplant procedure.

Dr. Khanna was very nice, intelligent, and really knew his stuff. He spent about half an hour with us. Much of the time was asking me questions about c difficile and Crohn’s history.  Dificid does have a 90% response rate. Dificid has a 15% recurrence rate. However, one problem with clinical trials is that it excludes IBD.

He then showed us pictures of the facility the fecal transplant was done in and also described the process. Mayo uses a $7,000 Stomacher blender which is pretty sophisticated. Dr. Khanna had mentioned some doctors at national meetings would say they were doing fecal transplants with martini mixers.

The screening process is pretty rigorous for the fecal transplants. Screening donor and donee are both tested for HIV, hepatitis, and syphilis. The donor also can’t have any medical problems. The donor has their blood and stool tested. The actual transplant is pretty interesting. It only takes about 5 minutes more than a regular colonoscopy because they have to inject the fecal material. After the fecal transplant possible side effects include: cramping, constipation, bloating, and possible farting (I haven’t noticed any of these). Best case diarrhea will completely go away. The fecal transplant has over 2,000 probotics while the most you can get out of a probotic is 4.

Non IBD patients 3 days IBD days 5-10 days resolution give it two weeks before it fails. Gradual improvement should be seen. So far Mayo has had 10 patients with IBD and c diff 6 out of 10 had resolution of all symptoms.  One question I had was if I did get sick again should I take an antibiotic and Dr. Khanna told me I should take Florastora when I take the antibiotic. He actually had one patient who had 15 rounds of antibiotics and took Florastora with it and didn’t have a recurrence of c difficile.

Dr. Khanna was nice enough to follow up with me on the Sunday after the procedure. I told him my symptoms and that I was doing a little better. I really appreciate Dr. Khanna and the Mayo Clinic team. 

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