Tuesday, January 08, 2008

About Antibiotics

I know healthy people who say things like, “I don’t believe in taking medicine” or “I don’t like putting anything in my body besides aspirin.”

(These are frequently the same people who, when asked if they’ve ever been a hospital patient, are wont to say “Well, not since I was born,” causing me to shake my head in wonder. Who knew such people existed? And that I would one day marry one?)

My unspoken reaction is always “Good for you.” I realize how incredibly flippant that sounds, but I don’t mean it flippantly at all. It’s refreshing to be reminded that there are people out there—people in my life, even—who are healthy, who do not have any conditions that require regular medication.

I mean, who wouldn’t want aspirin to the only occasional remedy you need to live your life and get done what you need to do?

I will admit I am a bit blasé sometimes about taking medicine. I never skip a dose or anything like that, it’s just not something I think about. It’s something I just do, part of my daily routine for literally as long as I can remember. On a given day, I take no less than eight medicines (good times) and no more than fourteen (less good times). I have cut out four medicines altogether in the past few years, which pleases me.

I have tested and charted and experimented to make sure I am not taking any medications that I could do without, because just like my healthy counterparts, I really don’t like putting anything unnecessary in my body, either. I don’t like the never-ending co-pays, the refills, the side effects like a racing heart, dizziness, feeling jittery, brittle bones, enlarged organs, endocrine damage, etc.

But I dislike respiratory distress, respiratory failure and other phenomena even more.

Antibiotics are a regular part of my medical arsenal. And I do mean regular. In fact, they are indispensable. Remember that New Year’s Eve day infection? It got worse and worse, to the point where I was dizzy from not getting enough air, my peak flows barely registered, and all the nebs and chest PT in the world couldn’t cut through the infected mucus lodged in my chest. I basically didn’t leave my house for eight days.

The only reason I am even functioning at half capacity right now? I brought into rotation an antibiotic I hadn’t used in awhile. (Between the nature of what I grow and the fact I’ve been on them so long, there are only a few out there I can rely on). Even with them, I teetered on the edge of the hospital for a couple days, and without these antibiotics, I have no doubt I would be in the hospital right now.

Antibiotics are a hot-button issue. The big things I hear from my students and people I know in the trenches? They are over-prescribed, they are given to demanding patients or parents whose children have colds and viruses when they don’t need them, they are given to people who don’t complete the proper course of treatment once they start feeling better. In an age of multiple drug resistant bacteria, “super bugs” and emerging infectious disease, this is problematic, to say the least.

Believe me, I am just as worried about the misuse of antibiotics. Does that sound weird coming from someone who basically lives on them? I’m even more cognizant of it precisely because of how much I have to rely on them.

And yet because it is so normal for people like me to take them, I rarely stop and think about what I am putting into my body when I take one. It’s another part of the routine. But I should give them the respect for the formidable force they are. After all, look at this partial list of “less common” side effects for my current antibiotic:

“…Abdominal pain, abnormal dreams, abnormal or double vision, aggressiveness, agitation, anemia, angina, anxiety, asthma, back pain, blood abnormalities, blood clots, changeable emotions, chest pain, circulatory failure, colitis, coma, confusion, depression, difficulty in or obstructed breathing, difficulty concentrating, disorientation, dizziness, emotional or mental problems, exaggerated sense of well-being, fainting, fungal infection, gangrene or other infections, gas, genital infection and itching, hallucination, heart attack, heart failure, heartbeat irregularities, high or low blood pressure, high or low blood sugar, hives, impaired thinking, indigestion, intestinal bleeding, intestinal inflammation or blockage, irregular heartbeat, itching, kidney disorders, lack of muscle coordination, liver disorders, lung problems or inflammation, muscle pain weakness, pancreatitis, paralysis, pneumonia, rapid or slow heartbeat, rash, seizures, swelling of face or extremities, swollen tongue, tendon inflammation, tumor, vaginal inflammation, vertigo, vomiting, yellowing of eyes and skin…”

Yikes. A healthy fear is now officially instilled.

Along with a huge dose of gratitude that they still continue to do what I need them to do.


Anonymous said...

I feel about antibiotics the way I do about prednisone--I hate the side effects in my asthmatic daughter, but thank God we have these meds and she's therefore celebrating her 9th birthday next month. She doesn't use either class of meds nearly as frequently as when she was little, and I'm certainly grateful for that, too.

But I have to say--despite all the news and information about superbugs and overprescriptions--I have yet to see any real efforts from the pediatricians I know to limit antibiotic use in even healthy children.

Some of the newer research indicates antibiotics aren't always terribly helpful in sinus infections or in childhood ear infections, yet any time my other daughter--who doesn't have asthma--ends up with ear problems, they immediately want to prescribe them. No matter how mild/early the infection.

I know a lot of people like to pin the problem on pushy parents who demand meds, but plenty of parents HAVE to be pushy b/c of unsympathetic managers or HR folks when they need time off for sick children.

I think the antibiotics/superbug/overprescription problem (for people w/out chronic issues, of course) is only going to be solved with some sort of universal effort, one that involves the drs., the patients, AND the workplace.

Anonymous said...

Hello. This post is likeable, and your blog is very interesting, congratulations :-). I will add in my blogroll =). If possible gives a last there on my site, it is about the CresceNet, I hope you enjoy. The address is http://www.provedorcrescenet.com . A hug.

Terry at Counting Sheep said...

Laurie, you are one of the people who does NOT abuse antibiotics, and definitely needs them and benefits from them. May they always serve you well, and may you always have them available to you as necessary.

Aviva said...

What a great post. I love the way you write.

Two things spring to mind:

1. Despite everything I've read about how peds are not giving out antibiotics for every little thing anymore, I'm constantly surprised when we take my 3-year-old daughter to the ped to find out what's causing the middle-of-the-night screaming and get an Rx for antibiotics along with the diagnosis of an ear infection. (We're lucky, she never had one until after she turned two!) I don't look a gift horse in the mouth and I do give her the antibiotics and she does seem to respond immediately. But I wonder why. We don't go in asking for an Rx, just a Dx so we know it's not something really scary. I guess the deciding factor is that by the time we show up in the ped's office, Ellie has usually been sick for at least 10 days, even if the ear infection symptoms are new. I should probably ask ... but part of me likes getting her on meds and in theory getting her better faster. It's so awful to have a sick kid, even with these minor illnesses; I so prefer that I be the one who's sick and not her. I'm grateful every day that I'm the one who has the chronic illness & chronic pain and not her!!!

2. In the early years of dating my husband, who is disgustingly healthy, he used to say that people only got sick when they wanted to, even if it was a subconscious desire. I took great offense to that. Although I'd never been as sick as I am currently, my lifelong asthma does predispose me to turning typical colds into bronchitis and/or pneumonia on a regular basis. I swear, I think we almost broke up over this issue, which after much argument he finally insisted applied only to him and not to anyone else in the universe. :)

Anney E.J. Ryan said...

It's interesting that you mention that you never realized that there were people out there who don't get sick often... because until I started teaching, and joined SWiG, I didn't realize how many people DO get sick often. Every semester, another kid in my class has to miss a day due to biopsies, chronic kidney stones, celiac, etc. It is so easy to take health for granted, when you are healthy.

This is probably why the people who damn medication always seem to be the people who never get sick, and don't NEED medication. I.E. Tom Cruise.

Anonymous said...

Antibiotics...totally a double-edged sword. I'm glad there are still some that work for you, and based on what little I know about you I think it's safe to say you're unlikely to fall into the "abuser" class.

And the overuse is mostly doctor's faults anyway. They can always say no to prescribing something, and simply educating parents (who are some of the worst misusers) and patients about antibiotics could make a huge difference.

Anonymous said...

I was one of the people you write about. I scoffed at health, and swore never to take medicine. After all, you could damage your liver, and I needed that to process all the alcohol. I take 18 pills a day, not counting pain meds, and I don't think I would be here if I didn't have these medications. One of them is a non-absorbable anti biotic called rifaximin that helps keep the ammonia down by killing off ammonia producing gut flora. Nice blog, Laurie, good luck in the polls.

Powered by blogger. Customized by PinkDezine.