How It All Started
In the summer of 2016 at the age of 33, I contracted a debilitating condition called Chronic Bacterial Prostatitis along with Chronic Epididymitis – inflammations of the prostate gland and the epididymis, usually caused by an infection. I had never heard of these conditions, and had always assumed prostate problems to be something one deals with in old age.
It all started in May 2016 with a pulling kind of pain in the right side of my groin. Initially, I assumed it was due to a muscle pull, and that it would go away with time. Days turned into weeks, but the pain persisted. For almost 6 weeks, this was my only symptom. By end of June however, I began to get some more symptoms. I developed an unusual sensitivity to cold – sitting in an air-conditioned room started becoming uncomfortable, even though we were in the middle of summer. Along with that I also started getting a low-grade fever everyday. I would wake up each morning with a normal body temperature, but by evening, my temperature would rise to anywhere between 99.8-100 degrees Fahrenheit. This led to some weakness, and some anxiety as to why this was happening.
This was really unusual, and I started searching for my symptoms online, to get an idea of what was going on with me. That’s when I first came across the term “epididymitis” – a swelling of the epididymis tube in the testicle. My research showed that this condition can be caused by an infection, usually a bacterial infection. I got tests done for the most common pathogens that cause this and other, possibly related conditions as per my research. I received the test results in a few days, and they were all negative for these pathogens. I should have been relieved, but what I felt was a deeper sense of worry – if not this, then what was causing my persisting symptoms? I also wondered if the test results were accurate, and got the test done again, which reconfirmed the earlier result.
Doctor Visits and Antibiotics
Since my symptoms were not getting any better, I went to see a urologist in mid-July to get a diagnosis. He did a physical examination, and told me that I have “chronic bacterial prostatitis”. He explained that it was an inflammation of the prostate gland, possibly caused by a bacterial infection. I was prescribed a 10-day course of Doxycycline, an oral antibiotic. I had the medicine, and ended the course with no change in my symptoms. After 10 days, the doctor changed the antibiotic to Ofloxacin, a different oral antibiotic. This time the course was 4 weeks. He assured me that this was an effective drug, and it would clear up all my symptoms.
So I started having this antibiotic, but through the course of the medicine, I realised that my condition was not improving at all. In fact, my symptoms were only worsening. I started getting chills and shivers, and had to wear a sweater all day long, even though we were in the middle of a hot and humid Indian summer. I started getting pelvic pains. I also began to feel a persistent weakness and lack of energy all the time – where earlier I could get through the day after a hearty morning breakfast, I now needed to eat every 3-4 hours to keep my energy levels up. I started to feel the need of an afternoon nap to be able to get through the rest of the day, something I had never felt in my life till that point.
I tried to talk to the doctor about my worsening symptoms, but he could not reasonably explain why this was happening to me. His only response was to put me on another 3 weeks of Ofloxacin. This was end of August 2016. I needed to get better answers, so I went to another urologist – the head of urology at one of Delhi’s leading private hospitals, this time with a recommendation of a close family friend. This doctor understood the progression of my symptoms over the last 4 months, did a physical exam to check my prostate and confirmed that I had prostatitis and possibly epididymitis as well. He explained that because I was getting a low-grade fever everyday, my problem was most likely due to a bacterial infection. He asked me to get my urine cultured. This was the first time that I was asked to get a culture done. I was glad that the doctor was following a scientific approach to diagnosing the cause of my prostatitis. The culture result, however, did not show any infection. Because I had a persistent fever – a symptom of an infection, the doctor recommended that I take a 10-day course of an oral antibiotic called Ciprofloxacin and a 1 week course of another antibiotic, Amikacin, intravenously. He reassured me that these two together would give me relief from my symptoms, so I decided to go ahead with his advice and took both the antibiotics, hoping that this time, I would really be free from this condition which was making me so weak and unwell.
However, despite these strong antibiotics, my symptoms stubbornly refused to go away. My pelvic pains stayed exactly the same, my low-grade fever persisted, the chills and shivers I would get everyday continued, and I was becoming weaker by the day. This weakness began to pervade into all spheres of my life. My work was getting impacted now because I did not have the energy to work beyond a few hours. I couldn’t even sit beyond a few hours, as it would exacerbate my pelvic pains. I felt really frustrated at my condition.
When I went back to my doctor after finishing the course of Ciprofloxacin and Amikacin, even he was surprised to see that my condition had only worsened. He had no answers to explain this. In fact, he told me that some people just have to live with pain, and suggested that possibly my symptoms were happening because I was “thinking too much about this problem”. This made me really angry. I knew I was not just imagining my symptoms, and this encounter made me realise I needed to take my treatment into my own hands.
I decided to stop taking antibiotics altogether, and started researching for possible solutions on my own. It was difficult for me to accept that a problem that affects 8-10% of men had no solution, despite all the advances modern medicine had made. It seemed ridiculous to me that medical science could harvest whole organs from stem cells, but could not successfully treat a bacterial infection in the prostate gland! My research revealed that men from all over the world, from young college students to retirees, were afflicted by prostatitis and were looking for solutions that worked. It was depressing to find so many people suffering from this problem without a cure in sight. I began to feel a sense of hopelessness – my symptoms showed no improvements, whether I was on antibiotics or off them, and my research threw up no promising answer to this problem.
In the meanwhile, my family was also making efforts to find better doctors who might be able to help me. We met a few more urologists based on recommendations of well-wishers, but essentially, they could only provide me with antibiotics – a solution that I knew was not going to work for me. In an attempt to find a lasting cure, I tried homeopathy as well, but it made no difference to my condition.
Then, one day in September, I came across the words “bacteriophage therapy” in relation to treating bacterial infections. I had no idea what this therapy was, and searched for it online to get more information. I learned that phage therapy is a treatment that was used to cure bacterial infections since it was discovered a hundred years ago. It was simple; in the way that nature has simple answers to complex problems. Bacteriophages are naturally occurring viruses that feed on bacteria – they are the solution that nature has devised to keep bacterial overgrowth in check. This was my Eureka moment! As I researched phage therapy further, the treatment seemed promising, and the science behind it seemed solid. Had I finally hit upon a plausible answer to my problem – could phage therapy be the light at the end of the tunnel?
However, my family and I had a lot of questions about this treatment – Is there a clinic that provides this therapy? Does it actually work? Is it safe for humans? Does it have any side effects? How will the phage medicine reach the site of infection? How will the medicine be administered? These, and lots more. To get these answers, I got in touch with scientists who had worked with phages at research institutions like the Tata Institute of Fundamental Research (Mumbai). I got some answers about phage therapy, but no one seemed to have any experience with human use of phage therapy. I started searching through medical journals like The Lancet to try and find details about treatment of infections in humans using phage therapy. Slowly, I started discovering details about the use of phage therapy to treat human infections in countries like Georgia, Poland and Russia. Each study that detailed a successful use of phage therapy to treat human infection was like an additional ray of light breaking through the darkness that had engulfed me in these few months.
After 6 weeks of intensive research, I was fairly convinced that phage therapy is a credible option to help me eradicate the infection from my prostate and epididymis. Every research paper mentioned the pioneer of bacteriophage therapy – the Eliava Institute in Georgia, a 95-year-old institute that is the hub of bacteriophage research and application. I learned that medicinal preparations made by them are used as regular anti-bacterial medication in the country of Georgia, and some other European countries as well.
With great hope as well as apprehension, I got in touch with the Eliava Institute’s clinic. I explained to them my problem, and asked if they could cure this kind of infection, in a difficult-to-reach gland of the body. I asked them all the questions that I had regarding the safety and efficacy of the treatment; whether the clinic could do lab tests to identify exactly what bacteria were causing my infection; the standards of hygiene followed by the clinic; what methods of treatment they would use; the qualifications of the doctors; the length of the treatment, and many more.
They answered all my questions patiently and to my satisfaction. I was getting more convinced about phage therapy with every passing day. But my family was not so sure, and not easy to convince. I was bombarded with all kinds of statements and questions – “This is Georgia in erstwhile USSR! You know nothing about the place! Are there direct flights to Georgia? What language do people speak there? How will you even interact with the doctors? What medical standards do they follow there? Have you personally spoken to even one person who has undergone phage therapy and had a successful treatment? What if something goes wrong?”
These were difficult questions to answer. And I knew these were genuine worries from people who wished me well. I tried to get as many answers as I could, but as the date of my departure drew near, I still had many unanswered questions. What made me most uncomfortable was that there was not a single person I could talk to who had undergone phage therapy. I had searched long and hard to find someone who had taken phage therapy and could share his or her personal experience, but unfortunately, I couldn’t find anyone.
The departure date arrived, and with fingers crossed I flew to Tbilisi. I arrived in Tbilisi on 14th November, on a cold and windy evening. I hoped and prayed that being here would finally give me the answer to my problems.
The next morning was my first appointment at the clinic. My first impression was that the clinic was neat, clean, and efficient. This was a big relief. I met the international patient coordinator, and was introduced to my treating doctor. Language would have been a problem in communicating with the doctor, but the patient coordinator was at hand to understand all my symptoms and explain them to the doctor in Georgian. I found the doctors at the clinic to be patient – the first consultation where I explained my symptoms and progression of my condition and they studied my ultrasounds lasted more than half an hour.
Next, the urologist tested my prostate fluid and semen for bacteria, fungus, parasites and other microbes. I had read in a few online forums that a prostate fluid culture is a must in cases of prostatitis, but this was the first time a doctor had conducted these tests on me. They found multiple bacterial strains in my samples - Staphylococcus Aureus, Staphylococcus Haemolyticus and Streptococcus Mitis in my prostate secretion, and Enterococcus Faecalis in my semen. Based on these results, the urologist started treating me using phage medications that the bacterial strains were sensitive to.
My discussions with the urologist at the centre revealed why my antibiotic treatment had failed – there were three main reasons. The first was that the prostate is a gland with very little blood flow, so minimal amounts of medicines reach it. Next, the prostate has an outer membrane that blocks many different types of antibiotics from entering the prostate – so the minimal amounts of these antibiotics that do reach the prostate are mostly blocked from entering it. And to top it off, the antibiotics that can enter the prostate, the ones I was prescribed in heavy doses during my treatment, were completely ineffective against my infection because the bacteria was resistant towards those antibiotics. It was no wonder that I suffered for so long with prostatitis. But thankfully, phages do not have the limitations of antibiotics.
The first sign of success came in 4 days, when my low-grade fever disappeared. I was elated – after having a fever for nearly 5 months, something had finally worked and gotten rid of it! The next sign of success came over the next 3 weeks as my energy levels started increasing. I started going to the hotel gym – I had the energy to start exercising again! The pains and sensitivity to cold continued to bother me, but the doctors explained that these would take time to go, because the bacteria was still there and the body was still fighting it. The pains were a part of the healing process.
My visit to Georgia lasted 4 weeks, and I came back home with my symptoms significantly improved. My phage medications continued over the next 3 months in oral and suppository forms. My symptoms continued to improve – my sensitivity to cold gradually went away and the pains started to get better. I added certain supplements to my diet like raw garlic cloves, ginger juice and a good multivitamin to help my body recover from the fight against the infection.
I have gone back to the clinic twice after my first visit - in March 2017 and then again in November - to get tested and take fresh phage medication based on the latest laboratory tests on my prostate fluid and semen. My last test results showed that 3 out of the 4 bacteria that were causing my infection have been eliminated. The last remaining bacterial pathogen - Streptococcus Mitis - was resistant to all the standard phage preparations, so the clinic got a custom phage medication made for treating it. This custom phage is fully sensitive to the Streptococcus Mitis strain that grew in the last culture done on my prostate fluid.
My treatment continues with the custom phage. It has been a long treatment since my infection was a multi-pathogen infection, and in a gland of the body that is very difficult to reach. I plan to take my phage medication until the last remaining strain of bacteria is eradicated. The road for curing prostatitis, as I have come to learn, is a long and winding one. But I finally feel at peace, knowing that I am getting better as time passes, and will recover completely one day.
Where antibiotics failed, bacteriophage therapy came to my rescue and saved me from a much longer and more agonising battle with this disease. There have been times in this journey when I have wondered – Why is it that I knew nothing of this treatment before my desperation led me to it? After all, it was the sole answer to my physical, mental and emotional hardships. What if I had not stumbled upon it, or it was too late by the time I did?
It is my endeavour, through Vitalis Phage Therapy, to ensure that no one else who is suffering from an infection ever needs to ask these questions again.
Founder, Vitalis Phage Therapy
March 31, 2018