Wednesday, April 30, 2008

Corn. It can cost a Kidney.

The true risks of a corn allergy hit home last week.

I awoke with the tell tale signs of a UTI. Thankfully, I recognized them and decided to get seen and tested ASAP. Urinalysis showed blood and the early stages of an infection. I was written a script, and sent on my way.

The pharmacist showed me the ingredients for the antibiotic of choice. Most of them were corn derived. The company that manufacturers is was closed for the evening. The compounding pharmacist said "We'll get back to you."

The next day, the antibiotic manufacturer didn't want to talk to me, because I'm not a doctor. No big deal, I was almost feeling better. I chugged water like crazy, rested, and waited for the compounding pharmacist.

The third day I did not feel well. The doctor called to see how I was doing. I told them, and they wanted to see me. They asked how long I'd been taking the antibiotic.

"You don't even have it yet?"
There was a sense of incredulity. Here is a simple to treat infection. One of the few that demands immediate treatment with an appropriate antibiotic. One that can be serious if left untreated. One that we have an appropriate medication for. Widely available. Well known.

And yet I, personally, could not access it.

I talked to the doctor for a long time. My options were to start the antibiotic, and ignore the corn. This would cause symptoms. The symptoms probably would not be life threatening. But, they would interfere with knowledge of whether or not the infection was responding to treatment. The medical community would not know if I was reacting to the antibiotic or the corn. I'd be dealing with 2 forms of physical stress. And it would lengthen my recovery time (the last I add in from experience. Corn causes intestinal inflammation, and I have digestive issues for weeks after accidentally ingesting it)
I could also be hospitalized for an IV infusion. This would bypass my digestive tract. It would probably avoid causing me much of a reaction, assuming they didn't use a corn based IV solution. (Yeah, I'd be checking each time. I'm sure the nurses would want to go on automatic, and be frustrated that they couldn't) It would cost a fortune. It's overkill for a run of the mill UTI.
I could wait, do nothing and lose a kidney.

We decided to start a different antibiotic, one that didn't have corn but was not specific. It would hopefully do *something* while we waited for the culture to come back with the exact strain of bacteria that had invaded my urinary tract.

By this time, my back hurt. That meant it had entered my kidney. We were frustrated that a "normal" person would have been almost through with their antibiotic course by this time, and relatively symptom free. I was getting worse, and not because I was obstinate or trying to ignore medical advice. I wanted help. They just didn't know how.

The pharmacist could not guarantee the brand, and the capsules could have corn in them though the drug itself, amoxicillin, was not adulterated. So I agreed to open the capsule, and take it in applesauce or another semi-liquid. The taste reminded me of the pink stuff I took when I was a kid, except that it didn't make my stomach clench and wasn't accompanied by a revolting bubblegum aftertaste. For future reference, antibiotics are better masked in carrot soup than applesauce.

The antibiotic worked for a few days. I woke up Monday feeling worse again, and shortly afterward the doctor's office called to say that the bacteria was resistant to amoxicillin. Then I got a hold of the compounding pharmacist, again, who apologized for taking so long and promised to get my Cipro by evening.

2 days on antibiotics, a week of frantic calls and office visits, and the only symptom still bothering me is an intermittent back pain and some nausea, which is common on antibiotics across the board. Kidney involvement is always risky, and permanent damage is a very real possibility.

All this simply because...there's corn in that. There's corn in everything, and no one knows it. Generally, I laugh. It's funny, people hear corn and they can't see the big picture. A little here, a little there. The FAAN calls it hypoallergenic. It's known by a thousand names. It has a myriad of uses, and growing. It took years to learn what I know to stay relatively safe. And yet, when I most need my knowledge, when it's necessary to turn to the medical community and work together for a solution, we're both lost. The pharmacist can't tell me what antibiotics might not have corn in them. The doctor can't find the information she needs to choose the best of a limited amount of pre-made corn free medications. And this time, my needs were simple. What happens next time?

Statistically, few people react to the excipients of drugs. I'm lucky. I'm just a statistic. One in a million. Insignificant. Unique.

But I exist. And I'd like to keep my kidneys, thank you very much.