IBD-A MOM's guide to survival
 
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We started the home FMT on June 1st.  I planned to start on a Saturday morning so that I would have plenty of time to prepare.  We all stayed up late the night before so it was a late start to begin with that Saturday.  Maddy was intent on going to the Oak Bay Tea Party (a local fair on the beach) and I was fine with that, knowing that if we waited to start the FMT when we had a "quiet day at home" it would likely be October before we got started!
I had previously gathered all my supplies, including: a dedicated "poo blender" (thank you XS Cargo!), a rubber spatula, a double wire mesh strainer, disposable cups, Saran Wrap, cleaning supplies and enema bottles.  I searched high and low for empty enema bottles and called every medical supply and drug store in the city.  Apparently, this is not something that exists.  Who knew?  I actually have to buy "Fleet" enema bottles, empty the solution and rinse the bottles before reloading them with the fecal slurry (or poo slurpie as Maddy so named it!)  This is particularly annoying since these things cost anywhere from $6-8 each!  I have convinced my pharmacist to order them in by the case and sell them to me just above cost but these things are literally about $2 in the states!  It turns out that not only do we pay more for our bottles of booze but for our enema bottles too!! Yeesh!
Once I had my trusty kit assembled, I had about a week to mentally prepare before we began.  We were waiting to see if Maddy's symptoms would continue to decrease before starting the home FMT.  The usual protocol is to continue home treatment once a week for 8 weeks but we discussed it with Dr. Mark and decided that we would wait it out and watch Maddy's symptoms like crazy.  As soon as she started to get slightly symptomatic, we started the treatment within 24 hours.  Her first symptoms were the occasional mild cramping, slightly softer stools and a mildly decreased energy level.  One of those on their own may not have been enough to start up again but all the symptoms combined were enough for me to know it was time.
This is the part where I WILL get a little graphic (without intentionally being gross) in order to be as honest as I can be about this.  This isn't pretty so if you're squeamish, DON'T keep reading.  This is my reality and the reality of many others and I don't intend to candy coat it.  This shit is gross.  And funny.  If you can't laugh about it, you'll cry about it!  I tend to do both!
That first day of treatment Maddy was very cooperative and even a little excited.  I think she is so convinced of the efficacy of this treatment, it excites her to know that she can and will feel better.  As much as I wanted her to feel better, I can't say I was excited to fire up my poo mixology lab!  As usual, Scott was very supportive and put the coffee on when I woke up Saturday and didn't have to "go."  Naturally.  Why would someone who is frighteningly regular in their bowel habits have to "go" the one time it actually counts?  Don't be silly.
After breakfast and 2.5 cups of over-sweetened coffee, it was finally "go" time.
After I clumsily wrapped my toilet seat with Saran Wrap, readjusting it several times to get that perfect dip in it, I finally got the right fit to it.  You know that perfect "poo catching" position, not too high, not too low...you know the one right?  Oh no, wait.  You don't know.  Unless you are at home doing this too, you probably don't have experience making perfect Saran Wrap "poo divets" to smoothly cradle the ingredients to powerful medicine- that just happens to come from your bowel.
This part was pretty straight forward.  Now as I removed the Saran, being careful not to drop the poop or waste any of it rolling around on the plastic wrap, I moved to transport it into my trusty new poo blender.  It was when I was standing in front of my bathroom window sill, holding the poop over the blender, that I realized my first potentially catastrophic error.  The blender I bought was a small "smoothie" blender.  You know the one.  Well, the opening on this thing was only about 4 inches wide.  Now, I don't know about you but I think I have a pretty normal amount of poop on a day to day basis.  This was clearly a quantity that wasn't going to fit easily into that opening.  Small blender opening.  Average size adult poop.  This could be tricky.  To my surprise, I expertly maneuvered that poop into that small opening without making any mess whatsoever.  I was pretty impressed with myself!  It was at this point that I added my distilled water.  Somewhere between 3-5 oz. the protocol says.  You want the consistency of house paint I was advised.  After pouring and blending several times, I felt my poo slurpie was of adequate consistency.
Now here's the part that nobody will tell you.  I'm not going to try to pretend here that my poop smells like roses but I would say it falls into a normal range.  Fairly bearable, odour disipates quickly and nobody's ever been hurt.   It turns out though, that once you put your poop in the blender, add water and blend several times...the smell of it is intensified.  By like a hundred times.  Ok, maybe not a hundred.  But a lot.  It gets a whole lot stinkier.  I can see why nobody mentioned this part.  Not a huge selling point.
Once I picked myself up off the bathroom floor and stopped dry heaving, I began the super awesome task of straining my poop through the poop strainer.  Now, I can honestly say, of the whole process THIS PART is the WORST.  Without a doubt.  It takes forever. While you are pushing your poop through a mesh strainer with a small rubber spatula into a beer cup, you have time to ask yourself: WTF am I doing?  Has this seriously become my life?  I am stirring my own poop in a strainer right now.  Am I crazy??  And then, just when I thought I had really lost it, I reminded myself of the health and vitality I had seen this provide.  For my own child.  And you carry on. 
So, it turns out that about a 5th of my poop is the fibrous material that won't make it through the mesh strainer, whether this is relevant or not, I have no idea.  I was just surprised at how much of my poop was fiber that won't make it through the strainer even after being blenderized!  Huh.  I've learned something here.  However inane and irrelevant it may be, I found it quite surprising and most interesting.  Clearly.
Once you've got your smelly little cocktail ready to go you need to get that mixture into the teeny tiny opening of the enema bottle.  Potentially catastrophic error number 2: nowhere in the protocol supplies list does anybody mention a funnel of any kind.  C'mon really?!?  Enter supportive Scottie to the rescue once again.  He braved the foul odor (that now took over not only my ensuite bathroom and bedroom but most of the second floor of our house) and fabricated a funnel in no time out of household items.  I was back in business!  Once the enema bottle was filled and the lid tightly secured, I looked around at the mess I had made and realized that the worst was yet to come!
When all was said and done, it took me about 45 minutes to prepare the damn thing and about 5 minutes to administer it to Maddy.  I massaged her belly.  She hung out and read comics and ate lunch in bed.  I washed and scrubbed and bleached my bathroom and my tool kit.  I put Eucalyptus drops under my nostrils.  I needed a drink. 
Then Maddy hopped off the bed full of energy and was off to the fair to play with her friends.  I'm glad my patient found this quick and painless!!!


 


Doorie
06/11/2013 2:39am

Couple of things that might make it easier:
- poop 'hats' are available at medical supply stores - the hat goes over the toilet, no saran wrap needed
-use nose clips like swimmers wear to avoid the smell. Scottie might appreciate a pair too

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Rebecca Kirstein
06/20/2013 9:58pm

Thanks, we were aware of poo hats but didn't know where to get them..the nose clips are awesome!! WAY better!! THANK YOU!!

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lisa
06/19/2013 4:40am

Just a few comments:
Try vicks vapor rub or mentholatum under your nose with a dust mask fron a home improvement store- you wont even smell the poo fusion!

If you are bleaching your equipment, you are likely killing the good guys in the poo fusion as bleach kills bacteria. you should start over with new equipment and NO bleach.

I hope this puts you back on track to healing your daughter. I would even restart using your poo.
I too am home transfusing...hoping for the best

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Rebecca Kirstein
06/20/2013 10:01pm

Thanks Lisa! I hope you are having great success with your fmt. Thanks for the tips. My naturopath says there is no problem with using bleach and that if its rinsed with water and air dries there is no danger of killing important bacteria. He also said its not necessary though so I only bleached it the first time! Thanks for your advice, the Vic's is a great tip! :)

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Ann
07/19/2013 2:35pm

Hi Rebecca: I just read this story and I am still wiping the laughing tears from my eyes. You've written this with such humour and I can so relate. We just started our son on home FMTs, today was the second treatment. I had contacted you before re: Communicating through Skype. Sorry, I haven't been in touch with anyone here, but I was busy preparing for the FMT treatment day etc. Now that it is here, I can only hope that it works for our son. Time will tell. Anyway, many thanks for the laughs this evening-I so needed that. Feel free to email me at typeitann@hotmail.com anytime.

Wishing your daughter healthy. Ann

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