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RE: How are you staying cold free? bug free? - 1/21/2011 2:12:46 PM

RapierFugue

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quote:

ORIGINAL: calamitysandra

However, I do not agree that antibiotics should not be prescribed by an GP, or only after a culture.
If I need to go to the ER in the middle of the night with a child screaming in pain because of a bad case of otitis media (yes, onset can be so fast, and pain can be so strong and resistant to home use painkillers for children that an ER visit is necessary), I want the doctors to be able to prescribe antibiotics right then an there.

If they haven't done a culture they may well (indeed often do) do more harm than good.

That's the problem with the sheer number of resistant and semi-resistant strains that are around ATM.

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RE: How are you staying cold free? bug free? - 1/21/2011 2:32:10 PM

calamitysandra

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Depends upon the infection. With some you can be very reasonably sure which antibiotic to use.

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RE: How are you staying cold free? bug free? - 1/21/2011 2:39:11 PM

RapierFugue

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ORIGINAL: calamitysandra
Depends upon the infection. With some you can be very reasonably sure which antibiotic to use.

With some, yes. But worryingly, the band of broad-specs that work effectively has diminished alarmingly in the last few years.

I agree they don't always have time - some infections are so virulent that they just have to take a punt, and gamble. But we're still way overusing antibiotics. And phage therapy research is way behind where it should be.

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RE: How are you staying cold free? bug free? - 1/21/2011 2:44:34 PM

angelikaJ

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quote:

ORIGINAL: RapierFugue

quote:

ORIGINAL: came4U

quote:

That would be my guess too.

Too many kids start out with ear infections, eye infections (likely caught at the hospitals or clinics they visit for vaccinations anyways uhhg) and end up on all this amoxicillin crapola. Many by age 9 have had 20 occasions of antibiotic treatments. In most cases the briefness of the dosage (parents disregard the prescipt and stop giving the drug as soon as symptoms disappear) is the cause of the delay or irregularity of immunity to the antibiotics later given.

Antibiotics are massively over-prescribed. I know this because I suffered a succession of colds & chest infections in my early teens, and had course after course. My mum wasn’t to know that what the doctors were doing was compromising my immune system in the long-term in order to effect a short-term “cure”, and it became a very vicious cycle.

Eventually I had my tonsils removed, and that seemed to help enough that I no longer needed as many antibiotics. Then I left home and, because of my essential laziness when ill (“can’t be arsed to go see a doctor”) I didn't see a doctor for another 10 years (bad bike accident), during which time my immune system became, if not bulletproof, then pretty damn resistant.

Personally, I don't think GPs should be allowed to prescribe antibiotics themselves; if they think you need a course then you should be sent for a swab & culture, so they can at least target the infection properly. The problem is that most people don't realise that antibiotics are only any good when targeted, and only ever any good against infections anyway – they're of no value whatsoever in virally-based cases (unless there's secondary infection, and then not often). But doctors come under such pressure from patients to prescribe something to “make them better” (and many don't think a GP is doing their job correctly unless they emerge with a prescription), so the over-prescribing continues, and all the while ever more virulent, antibiotic-resistant, strains of bacteria are multiplying in hospitals. MRSA is the tip of an iceberg.

There are other thigns that you may not be considering: the tonsillectomy could very well have made a big difference.
When I had mine removed while they did not look bad on the surface, they were horribly infected underneath.
And don't forget that quite often when you are young and at the Dr's there are other people who are also ill at the doctors. It is not uncommon for children whose immune systems are not well developed to pick something up while there.
It often happened with me when I went for a well child check up, that I would come down with something soon after.

You got older and moved out.
There are a lot of factors just within that that may have had a great deal to do with your increased wellbeing.

Having said that, of course in many cases antibiotics are over prescribed or at least were. Things have shifted a great deal in regards to that especially over the last several years.
We have been our own worse enemy though in terms of perpetuating resistant strains: by not taking them as directed until the course is finished.

However, I can say with reasonable certainty that I am glad for a doctor who prescribes them when I go to see her.
See, I know the difference within myself between a viral infection and a bacterial one.

I am prone to asthmatic bronchitis and I know the difference between a cold and that.
Even knowing I need antibiotics (and likely steroids), I tend to wait... and sometimes get chastised for my optimism when I finally decide it's time to pay her a visit.

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RE: How are you staying cold free? bug free? - 1/21/2011 2:46:36 PM

Moonhead

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quote:

ORIGINAL: calamitysandra
I totally agree that antibiotics are overprescribed, but I am seeing a slow reversal of the trend. At least here you will no longer get antibiotics for a simple cold, and with diagnoses like bronchitis or ear infections all other remedies will be tried first.

However, I do not agree that antibiotics should not be prescribed by an GP, or only after a culture.
If I need to go to the ER in the middle of the night with a child screaming in pain because of a bad case of otitis media (yes, onset can be so fast, and pain can be so strong and resistant to home use painkillers for children that an ER visit is necessary), I want the doctors to be able to prescribe antibiotics right then an there.

You're overlooking a related problem that your second paragraph raises: some parent who knows less about the treatment and spread of disease than they imagine turns up at your surgery and refuses to leave without a scrip. You're pretty sure it's a cold, but you can't swear for sure that there isn't a throat infection or something going on as well, though you suspect not. Do you give the kid an unnescessary prescription for antibiotics that are unlikely to help any, but won't cause any harm either, or do you grit your teeth and have the parent's tantrum added to the hassle you're already getting from the child?

I'd suspect after a year or two in practice, you'll have long since stopped caring that you might be weakening hypochondriacs' immune systems by giving them antibiotics they don't need...

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RE: How are you staying cold free? bug free? - 1/21/2011 2:52:03 PM

RapierFugue

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quote:

ORIGINAL: angelikaJ
There are other thigns that you may not be considering:

The thing is, about 7 years ago, I had a bike-related injury that resulted in infection and blood poisoning and so I was given antibiotics again, for the first time in about 15 years. I didn't want them, but there was no choice, so I was hospitalised and given a broad-spec, followed by a culture-specific as soon as the labs came back (48 hours or so, if memory serves). The broad-spec was completely ineffective, BTW, which is when I started learning about resistant strains.

I recovered from the infection but, having been previously healthy in regard to colds and suchlike, I immediately began to start falling ill with them again, regularly. Bear in mind that's some 15 years after all the other factors had stabilised. It took me a further 3 years to get back to my "normal" immune response, so I'm fairly certain it must have been the antibiotics that were, if not the cause, then at least a strong factor.

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RE: How are you staying cold free? bug free? - 1/21/2011 2:54:01 PM

RapierFugue

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quote:

ORIGINAL: Moonhead
I'd suspect after a year or two in practice, you'll have long since stopped caring that you might be weakening hypochondriacs' immune systems by giving them antibiotics they don't need...

I could believe that too ... you honestly wouldn't believe the hassle GPs get from some of their patients.

I could tell you stories that’d make your eye pop out.

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RE: How are you staying cold free? bug free? - 1/21/2011 3:18:06 PM

calamitysandra

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quote:

ORIGINAL: Moonhead

You're overlooking a related problem that your second paragraph raises: some parent who knows less about the treatment and spread of disease than they imagine turns up at your surgery and refuses to leave without a scrip. You're pretty sure it's a cold, but you can't swear for sure that there isn't a throat infection or something going on as well, though you suspect not. Do you give the kid an unnescessary prescription for antibiotics that are unlikely to help any, but won't cause any harm either, or do you grit your teeth and have the parent's tantrum added to the hassle you're already getting from the child?

I'd suspect after a year or two in practice, you'll have long since stopped caring that you might be weakening hypochondriacs' immune systems by giving them antibiotics they don't need...

I did touch upon that in the part you cut.

I believe, that we need to educate patients/parents about what antibiotics can and can not do. Which risks are associated with them, not only immediately, but also due to longtime overuse, and why they are very often not the drug of first choice, or helpful at all.

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RE: How are you staying cold free? bug free? - 1/21/2011 3:28:59 PM

DesFIP

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quote:

ORIGINAL: came4U

Haven't had a cold in over 20 years, never had a flu (that I know of) in my lifetime. My youngest has never had a cold or flu (almost 20). My older ones, the rare (every 10 years) short-lived 24 hour flu.

I smoke (tsk tsk), but we eat well. I take the occasional vitamin - when I remember, sigh, which even if it is right in front of me, I don't.

I do keep bedroom windows open all day and night, even in Canadian winter. Because the heat dries out the air I keep a humidifier going from Nov til March. Oh yeah, and I am a stickler for handwashing (after coming home from school/work, touching money, shopping carts yadda yadda you know the routine).

I can only guess that because none of us had any early onset illnesses that require ANY synthetic antibiotics is what keeps us clear of any cold n flu. That is about the only reasonable explanation I can find. In that our immune systems just haven't been compromised in any way or shape. Just a guess.

Some say Vit D3 can even prevent/cure cancer now. Who knows, we likely won't know for a while.

Actually, I'd put it down to keeping the windows open. Much simpler explanation. Cold kills bugs.

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RE: How are you staying cold free? bug free? - 1/21/2011 3:29:01 PM

RapierFugue

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quote:

ORIGINAL: calamitysandra
I did touch upon that in the part you cut.

I read that with the wrong inflection and thought it was a typo and you'd called him something very rude :)

I thought "blimey! She didn't strike me as the nasty sort!" :)

quote:

ORIGINAL: calamitysandra
I believe, that we need to educate patients/parents about what antibiotics can and can not do. Which risks are associated with them, not only immediately, but also due to longtime overuse, and why they are very often not the drug of first choice, or helpful at all.

Many patients wouldn't "get it" if you beat it into them with a clue-by-four :)

Previously (and I'm not saying this was necessarily or always a good thing!) people just accepted what doctors told them as gospel. Now, they question everything, and want a doctor to try and condense (say) 20 years of medical university training and clinical experience into a Janet & John summary they can comprehend. And even then, if they don't like it, many will go spare (and I mean properly spare) until they get what it was they had decided they needed (or whatever they read on the net) before they walked in, often using little Oscar or Tabatha's illness as an excuse for insulting and contradicting a highly trained person. I know of one female GP who was threatened with a fucking knife for refusing a course of medication (not antibiotics, I'll grant you, but still ...). What's that saying? "A little knowledge is a dangerous thing"?

I don't envy doctors one little bit. Even surgeons are getting it in the neck these days.

But yes, you are right. We need to try, little by little, to make people slightly less badly informed. And better mannered.

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RE: How are you staying cold free? bug free? - 1/21/2011 3:29:05 PM

Moonhead

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Mea culpa, I missed how that bit was relevant.
More education would stop some parents demanding a course of pills for little Brooklyn the second he got the sniffles, but I'm very dubious it'd have any impact at all on the people who cause the bulk of the problem, which is, those who believe that they know far more about their kid's health requirements than somebody who just happenes to have a medical doctorate.
(Which RF pointed out while I was posting. Arse.)

< Message edited by Moonhead -- 1/21/2011 3:34:21 PM >

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RE: How are you staying cold free? bug free? - 1/21/2011 3:29:16 PM

Toppingfrmbottom

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I only get sick when some inconsiderate shit is sick and brings it around to share.One time at a bdsm party sleep over this lady came out and she had somee nasty flu, I think, and she thought it was ok to come to come hang out as long as people kept their distance from her and she only stayed 10-20 minutes, well she made me and 2 other people sick. Needless to say the event host was pissed at her.

I don't get flu shots, I am not a germaphobe, I don't sanitize my hands a ton or those surfaces around me. True I rarely go out, but I still don't worry about germs at the grocery store and public toilets. I'm not running to my dr for every little thing either, I am pretty damned healthy, with regards to colds and flu;s and feeling poorly.

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RE: How are you staying cold free? bug free? - 1/21/2011 3:33:43 PM

Toppingfrmbottom

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My mom and dad get their flu shots faithfully every year, and with out fail every single year they're sick , my mom gets vomiting and upset stomach and a runny nose and congestion and aches and pains, just about the whole 9 yards, at least 2 if not more times that year, often shortly after the flu shot, I on the other hand refuse to get a flu shot or any of that stuff and I am never sick, unless Daddy is sick and he gives it to me, or as I said in another post some inconsiderate shit deems it fair to come to an event with every one else and pass their germs around.

So personally I don't believe in flu shots, and will never get one.

quote:

ORIGINAL: Tantriqu

Flu shots! Hurrah for flu shots! As all about me crumble and fall in a tower of tissues and phlegm. I never get colds anymore, either. Just like mama told you, take your shots, wash your hands and avoid sickos.

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RE: How are you staying cold free? bug free? - 1/21/2011 3:33:59 PM

RapierFugue

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ORIGINAL: DesFIP

Actually, I'd put it down to keeping the windows open. Much simpler explanation. Cold kills bugs.

And where it doesn't it slows their rate of regeneration and multiplication but yes, seriously, it's a very good point.

I think central heating (lovely as it is in the recent cold weather) is partially to blame - we heat all or most of our houses, whether we're going to be in that room for hours or not. Bugs love that. I live in a lovely old Victorian building which despite being lovely to look at is a proper pig to heat, and I don't have CH, so I heat one main room, then others as I transfer to them. I know older folk need the heat more but I honestly can't sit in my mum's place for long - I have to stand in the garden for a bit - it's like a bloody orchid house!

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RE: How are you staying cold free? bug free? - 1/21/2011 3:36:39 PM

pahunkboy

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Locally they do not over rx anti-biotics.

I had an ear infection- thing- and the rx was a topical for that.

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RE: How are you staying cold free? bug free? - 1/21/2011 3:41:26 PM

Toppingfrmbottom

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There's a lady who was given collodial silver when she was a little girl for some medical condition and it turned her grey. She's an old lady now and permenantly discolored from taking the collodial silver the dr gave her.

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ORIGINAL: abrattyprincess

I take colloidal silver whenever I feel like I'm coming down with something. There is NO pathogen known to man that this stuff can't kill. You just have to be careful with your use of it.

~Bratty

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RE: How are you staying cold free? bug free? - 1/21/2011 4:02:36 PM

calamitysandra

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I know that it is difficult, and that it will take time, because people have been conditioned to believe antibiotics are a wonderdrug for so long, but I honestly think that education all around is the key*.
The medical community, patients, parents, all need to be inundated with the information. People believe what they see on the telly or read on the net. Make it ubiquitous, repeat it often. Eventually it will catch on.
I simply can not find an other, workable, solution.

*Granted, I believe that education is the key to remedy a lot of the worlds ills, so I am biased.

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RE: How are you staying cold free? bug free? - 1/21/2011 4:04:12 PM

RapierFugue

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quote:

ORIGINAL: calamitysandra

I know that it is difficult, and that it will take time, because people have been conditioned to believe antibiotics are a wonderdrug for so long, but I honestly think that education all around is the key*.
The medical community, patients, parents, all need to be inundated with the information. People believe what they see on the telly or read on the net. Make it ubiquitous, repeat it often. Eventually it will catch on.
I simply can not find an other, workable, solution.

I find myself broadly in agreement with you. Hurrah and huzzah!

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RE: How are you staying cold free? bug free? - 1/21/2011 4:07:29 PM

DesFIP

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What are you suggesting to use for bacterial pneumonia or a staph infection or a sinus infection if not antibiotics? Pneumonia used to be highly fatal before the invention of penicillin. Today it rarely is.

Obviously it is inappropriate to use for a virus, but there are a great many bacterial infections that require them.

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RE: How are you staying cold free? bug free? - 1/21/2011 4:11:59 PM

RapierFugue

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ORIGINAL: DesFIP

What are you suggesting to use for bacterial pneumonia or a staph infection or a sinus infection if not antibiotics? Pneumonia used to be highly fatal before the invention of penicillin. Today it rarely is.

Obviously it is inappropriate to use for a virus, but there are a great many bacterial infections that require them.

Nobody suggested not using them at all. What's killing lots of people now, and will kill fuck knows how many in years to come if we don't stop it, is over-using and prescribing, because you get resistant strains, and more of them are turning up almost monthly.

It’s bad enough in the UK, but in France they prescribe seven times as much of them as we do. We have to be more specific in their use, and more targeted, through culturing where and when possible.

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