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A Chronic Patient's Progress

by Jim Worthey
"Island Breezes Inc." writes: "Who here knows of some real life cases who have been SUCCESSFULLY CURED by Dr. ANF or Dr. Fugazatto? Do these individuals become cured and then abandon the rest of us? < ... snip ... snip ...> What is the real deal?"
Here is one real deal. I've been posting to this group for a long time, but I have some major news.
Some will recall that I was one of the first people to compile a bunch of information from Dr. AE Feliciano and other sources and offer it to a urologist whom I had seen before. (see http://www.prostatitis.org/notebook.html ) He recognized that AEF's ideas were similar to those of some of his professors, so he agreed to to do a version of that treatment.
I was a very chronic case---at least 25 years of symptoms---with my entire prostate swollen and tender, nerves pinched to numbness, frequent urination, painful erection, you name it. I had not had much treatment at all, just the brush-off from various practitioners. At least I had not cultivated drug-resistant bacteria.
Treatment started a year ago, near the beginning of news from Manila, specifically from Dave Trissel who was cured by Dr. AEF. The main bacterium at the beginning was coagulase negative Staphylococcus. Months after the beginning, I got drug sensitivity information on this or a similar bug from Dr. Fugazzotto, and started taking Augmentin. The Augmentin indeed seemed to help, and when I tried to stop taking it once, I got really sick.
Three massages/week in the beginning, and one per week right to this day, converted me from a chronic case, with all my little ducts plugged up, to more of an acute case, with everything draining into the urethra, and the effects of various remedies quickly felt. Increasing the Augmentin dose a couple months ago caused a drop in symptoms, again confirming that it was a more-or-less appropriate drug.
It is difficult to quantify symptoms, but certain things seem clear. I sleep much better than in the beginning, and the pain is more localized, rather than spread throughout the pelvic region.
Recently, I have felt that my symptoms were 99% decreased, and yet my status remained 100% unsatisfactory. In my particular case, the remaining sore spot is sensitive to pressure on the bladder. Thus, I still often have a nasty symptom: pain associated with getting up, moving around, leaning over, and generally living my life. It's easier to sit still and type you this note.
So, I said to the doc, I'm still improving, but awfully slowly and we've got to do something to speed this up. I suggested a couple ideas and the one he grabbed onto was: anaerobic bacteria. Apparently it's hard (though not impossible) to test for "fastidious anaerobes" in EPS. The idea that fastidious anaerobes might cause prostatitis was tossed out casually at the NIH meeting in December '95 and played an important part in the basic AEF protocol as reported by Dave Trissel in early '96.
Specifically, Trissel said that at a certain time, Dr. AEF gave him a single dose of Flagyl (metronidazole) "to cover fastidious anaerobes." I got this dose way back in the beginning. On the very day that this idea came up, the doc also saw some kind of mutant trichomonas (a protozoon) in my EPS. Flagyl kills protozoa nicely as well as anaerobes. For whatever reason, anaerobes or "trich," that one big dose of 2 g of Flagyl (4 pills) made me feel better quickly. Though it was not the cure, the *Flagyl really did something.*
Later the mutant trich showed up again, and I took Flagyl at some different dosage, something like 250 mg, 4x/day. That got rid of the trich for good, but did not bring a particular improvement in symptoms.
Now, my doc's approach to really test the anaerobe theory was to give me Flagyl at 500 mg, 4x/day for 7 days. At this dose, the drug made me fairly nauseous. At the same time, it caused a sharp drop in prostate symptoms. After a couple days, I felt almost cured. It ain't that simple, though, and the symptoms have relapsed in part.
I also got headache and other general fatigue and soreness. I am guessing that these symptoms are related to the rapid die-off of bacteria, and the toxins that are released. During the first week of Flagyl, I had one crisis day when the headache and fatigue kept me home from work.
Right after taking the last pill from that bottle, I saw the doc again. Now my EPS had a few white cells, but a lot of debris from dead cells. Thus, the clinical sign was consistent with my feeling that this drug was hitting a major colony of bugs. The doc gave me another 30 pills (still 500 mg, 4 per day). During the second week, I had a much worse crisis day, presumably a second wave of bugs dying off. I missed 2 days of work. The next clinical evaluation is Wednesday the 18th, shortly after I finish the second bottle.
These nasty crises really make me feel that I had some mean germies in me and that we stomped them pretty hard.
Right at this moment, I unfortunately still have that unpleasant feeling that some remaining symptoms are not fading away. One option may be a still higher dosage of Flagyl, given intravenously.
So... if you ask whether doctor AE Feliciano's method was easy and quick, the answer is no.
If you ask whether my chronic prostatitis was bacterial, the answer is yes. Has the prostate drainage been important? You bet. Are anti-bacterial drugs an important part of my treatment? Absolutely.
Do I expect to be cured? I certainly hope to be cured because these bacteria multiply in minutes, as you know, and if we stop short of a cure, they'll spread all over again.
Could my treatment have been speeded up? Not MY treatment, specifically. The doc and I have been pretty good about trying new things and keeping our minds open. But one would think that if a doctor kept learning by doing, he could treat similar cases a little quicker.
In retrospect, I can say that I sure wish I did the high dose of Flagyl a lot sooner. The hint was there.
This note is my first report to the group about the Flagyl treatment. I will be very interested in any comments regarding anaerobes or other people's experience with Flagyl. What about treatment of suspected anaerobes in those who have gone to Manila?
Jim Worthey.

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