In October 2022 I was diagnosed with oesophageal cancer. At the time I was working as a Clinical Nurse Specialist in Paediatric Dermatology but had increasing problems with indigestion for a few months, then some difficulty swallowing. The diagnosis was a huge shock but I was offered a curative pathway of treatment involving Chemoradiation followed by major surgery in the April of 2023.
In the immediate post op period, I developed a pseudomonas chest infection so was on intravenous antibiotics –a chest infection being one of the relatively common post op complications. I was discharged home 16 days after surgery, but within two days started vomiting with increasing pyrexia. By five days after discharge, despite antiemetics, I couldn’t tolerate anything orally and felt so incredibly unwell I couldn’t even wait until the GP or nurse was available to give advice. At 5am my husband took me to A&E.
It was initially assumed I had a further chest infection but, because I was recovering from major surgery, everything was more complex and I required IV fluids on admission. I’d had some diarrhoea but nothing of note – the vomiting and pyrexia were my main problem. Antibiotics were restarted and increased with little effect. My temperature only settled on IV paracetamol and a septic screen showed nothing of note. I remember voicing concerns to my surgeon that the IV paracetamol was masking the pyrexia and that – what was a presumed chest infection – just wasn’t responding to the antibiotics. Four hours after the antipyretics, my temperature would immediately spike again. The IV paracetamol was withheld, the septic screen repeated again and on day ten of this second admission my surgeon had a call from microbiology with the results that C. diff had been identified. I remember it was a Sunday afternoon and she came up to tell me what had been found. At the time I was in a four bedded ward and one of the ward toilets was awaiting repair. There were no cubicles available so there was no option of isolating me. It was decided that I should be discharged home that afternoon on oral Vancomycin. My clinic appointment later in the week was changed to a telephone consultation.
At home, we made sure that the rest of my family didn’t use the bathroom I used and I remember being vigilant about disinfecting the handles, using separate hand towels and taking other measures to protect my husband and children. We also stopped my elderly parents from visiting until I was fully recovered.
I remember being surprised by the diagnosis, as it was a bacterial infection I was familiar with after 39 years of nursing. There’s normally a very distinctive smell to it that I hadn’t noticed but I found out later that C. diff after chemotherapy is harder to identify.
C. diff had made me feel so unwell at home, before re-admission, far worse even than I had felt with the chemotherapy.
Luckily, my treatment then was successful, but it surprised me how ill and weak I felt with the C. diff and feel it definitely delayed my recovery from the surgery.
I’ve needed a few courses of antibiotics since this experience and have always been apprehensive about the risk of C. diff again. I take the yoghurts and drinks with probiotics to try to protect myself – I’m not sure if it really helps but I’m pleased to say I’ve had no recurrence of C. diff symptoms since.