I must be honest with you. I did not write most of this “feces as medicine” post. Instead, it was penned by a friend and fellow blogger, who ultimately came to realize that he, due to his high station, relative sobriety and stellar reputation in life, could not give justice to the topic at hand. He found himself “pulling punches” that just needed to be freed in order to take advantage of both the informational and entertainment value the story has to offer. Therefore, he desired to find someone who had already tarnished their reputation beyond repair, and would therefore have no qualms about adding childish and infantile potty humor to the work. So, while the majority of the content was written by my friend, the inserted bull-babbage is very much my own contribution. I am proud to take that banner and ascend the throne. In fact, I consider it my doody.
And so it begins. We will try to do the piece justice. Please don't judge him. And if adolescent humor regarding a basic bodily function offends you, we will remind you that the headline of the article was "The Potently Palliative Power of Poop", yet you clicked on it, and here you are. That should have been a warning. There is no one to blame but yourself.
Several years ago, I attended a workers' compensation seminar where a physician explained the risks of antibacterial soap and other products. Yes, he contended that we could become too clean. He explained that our bodies require a certain degree of "bacterial flora." It is part of who we are and how our bodies deal with the world around us.
I recalled that presentation recently when the State of Washington announced that their workers' compensation system would, in certain circumstances, pay for fecal transplants. You read that right, they take waste excreted by one person and transplant it into another person.
And you thought your health plan sucked.
Despite the disgusting sound of all this, there is some good news. The transplant of another person's fecal matter into your body is not done orally. No, for this procedure they use the service entrance around back. You just have to hope the clinicians are not Hans and Frans (We're going to pump, (CLAP!) You up!). This is obviously a treatment that could have you down in the dumps. Or up in them. Whatever.
The Washington State Department of Labor and Industries website says (italics are direct quote):
This technology was reviewed by the State Health Technology Clinical Committee (HTCC) in November 2016 and the determination was finalized on January 20, 2017. The committee's determination, based on a systematic review of the evidence of safety, efficacy and cost-effectiveness, is that FMT is a covered benefit with conditions.
According to the website, The Power of Poop, (yes, that is a real site that gives the real down and dirty about, well, the real down and dirty) our digestive systems are populated by bacteria, "the mothers of the digestive system." It says that we all "rely on a microbiome, a community of "good bacteria living in harmony with us."
This could be why I routinely hear my colon singing Kumbaya, especially after a big bowl of onion dip or cruciferous vegetable night.
These bacteria can be on our skin or in our intestine. The website says that our individual microbiome can become "unbalanced," through our use of anti-biotics or through illness. The results are troubling, including "inflammation, malnutrition and the development of auto-immune conditions." The point of the transplant is to "repopulate the intestinal microbiome."
I swear, there must be an easier way.
The The Power of Poop site says that this transplant process is "used to treat Clostridium Difficile (C. Diff.) infection. It also says that the procedure is gaining acceptance for "conditions such as Ulcerative Colitis, Crohns Disease and digestive illness of indeterminate cause."
“Digestive illness of indeterminate cause”? Now it sounds like they're just guessing, and they may be blowing smoke up our fanny. Except it's not smoke.
An Australian doctor contends that there is evidence to support the use of the procedure for "autoimmune disorders, neurological conditions, obesity, metabolic syndrome, diabetes and Parkinson's disease." I think it may also be useful in eliminating your appetite for anything. Ever again.
The people who support this are well documented, and ironically not full of crap. Clostridium difficile, according to the Mayo Clinic, is a bacterium. This infection "most commonly affects older adults in hospitals or in long-term care facilities." The Clinic says that this infection afflicts "about a half million people" each year in the United States. So, it is not a rare condition, but the description suggests it may not be a very common condition in workers' compensation systems.
The Infectious Disease Society of America (ISDA) cautions that this transplantation "should be regulated to ensure patient safety." However, no permit is required to use this transplant "to treat recurrent Clostridium Difficile infection."
Really? No pooh pumping permit is required to perform this procedure? Sounds like this could be a lucrative opportunity for someone to look into, so to speak.
The ISDA says that our individual microbiome changes as we age, and so the ideal donor would be someone "roughly the same age as the recipient." And, it recommends that the donor be "known to the recipient."
Someone like, say, your spouse. Take note, guys. It's like they've invented yet another way for your wife to give you shit.
Recognizing that a known donor may not be possible, the website says that there may be "universal donor sources," available. But before you bust a grumpy to help a bacterially challenged stranger in need, know that practitioners are advised to be careful that any such source "employs rigorous screening and testing standards", and your deuce may not have the juice.
After all, If I'm going to have someone else's poop injected into me, I want to make sure it is of the highest caliber, and is really good, well, you know….
And who volunteers to donate this crap? They must think pretty highly of themselves; almost as if their doo-doo didn't stink. And there are Pooh Donation Stations? I can accept the concept of blood and sperm donation, but can't fathom what this type of collection facility would look like. I think the turd nerds who work at these centers would have a thoroughly depressing job.
Back to Washington State's approval of this process. The state will only approve the therapy for patients with Clostridium Difficile. That is the only malady approved. Perhaps in time the other conditions suggested by the Australian physician may become more accepted. And, in Washington, the procedure will only be approved for patients "who have failed an appropriate course of antibiotic therapy." For those injured workers, who already think the carrier is handing them a load of crap, they ain't seen nothing yet.
The point of all of this is that science is marching forward, changing medicine, and wiping away problems in unconventional ways. It may not be a treatment that affects a broad population of the workers' compensation community, but it is an intriguing science nonetheless. And while it is by no means the number one procedure, it's probably safe to say that it is definitely number two.
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Robert Wilson is President & CEO of WorkersCompensation.com, and "From Bob's Cluttered Desk" comes his (often incoherent) thoughts, ramblings, observations and rants - often on workers' comp or employment issues, but occasionally not.
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