Comments on: Antibiotics and medical economics

By: Esther Hoff

Esther Hoff — Fri, 08 Sep 2006 18:24:54 +0000

You point about sore throats is well-taken, they are the one thing I don’t fool around with. Fortunately hubby only gets a mild one that lasts less than a day when he’s first coming down with a cold. I used to get horrible ones when I had a bad run of sinus infections, the doctor would alway swab because my throat looked so bad. It never was positive, though. Funnily enough, those infections coincided with an abcessed tooth that I had. When I had a root canal done, they went away. A year later, I started to get them again and wouldn’t you know it, that root canal was going bad. I had a pretty severe abcess in it and my jaw was actually swollen just like those old time drawings of people with toothaches. The pain was unbelievable. They wanted to re-do the root canal but by then I’d had enough and told the dentist to just pull it. Haven’t had a sinus infection since. I tell you one thing, though. I really, really wish that I had been following a LC diet back then because I’m sure that I would have never gotten that bad molar in the first place if I had. That was the first and last real dental problem that I’ve ever had and I’m hoping that my current diet keeps it that way. Given the checkups that I get these days, I think I’m on the right track.

By: Esther Hoff

Esther Hoff — Tue, 05 Sep 2006 14:35:59 +0000

Had to laugh as your post so perfectly illustrates why the following conversation pops up every year or so in our household:

Hubby: I’ve got a cold. I’m going to make an appointment to see my doctor.

Me: Why? She can’t do any thing for you when it’s a cold. It’s a virus, after all. Just stay home and rest.

Hubby: When I was growing up, Mom used to take me to our kindly old family doctor and he’d give me a penicillin shot. I always felt much better after that blah blah blah.

Me: Penicillin is an antibiotic, it won’t do squat for a virus. Your kindly old family doctor was a quack if he was giving you a shot of it for a cold.

Hubby: All I know is that I felt a lot better after I got it.

Me (muttering as I throw up hands and walk away): He could have been slipping you salt water for all you knew and you’d have felt just as good.

I didn’t fare much better growing up, only in my case, my mom was having my dad pick up penicillin without a prescription at the pharmacy across the line in Mexico and doling it out to us kids at the first sign of a sneeze. That nonsense ended for me when I developed an allergy to it.

Hi Esther–

The scenario you describe is all too common. The only real reason for going to the doctor with a cold and sore throat is to be checked for strep because untreated strep can lead to some some serious long term consequences. If the strep screen is negative, then ride it out. If positive, take the antibiotics UNTIL THEY ARE GONE. And don’t let anyone–doctor or otherwise–tell you that they can diagnose strep by just looking. I’ve read far too many papers on this one to believe that. Viral sore throats can look just as nasty as strep and strep positive sore throats can just be a little red. It must be checked with a strep screen to really know.

Best–

MRE

By: Lynn

Lynn — Mon, 04 Sep 2006 20:46:49 +0000

Conversely, my son’s very poor fiancee went to the doctor with what seemed to be classic strep. They sent her to a ear/nose/throat doctor who ordered a strep test. It was positive and they gave her a prescription. Because she had “insurance” she couldn’t get sliding scale prices, but it happened over the year change so deductibles for 2 years meant she had to pay the whole thing herself. Total–around $400!! She’s a waitress at a chain restaurant! Perhaps in this one case they could have given her the antibiotic first to see if it helped? I’m not in favor of unneeded antibiotics, but in this case it would have saved her a lot of money.

Hi Lynn–

I can’t believe that the first doctor didn’t do the strep test and treat. Strep is one of the bacteria that still respond to plain old penicillin, so it’s really easy to treat. I’ve checked for and treated countless cases of strep and never sent a patient to an ENT specialist for a sore throat. Seems a bizarre way to operate for a primary care doctor. The charges for the first doctor should have been about $15 for the strep test plus an office visit. $400 for an uncomplicated case of strep throat is an outrage.

Sorry you’re son’s fiancee had such a bad experience at the hands of the medical profession.

MRE

By: Victoria

Victoria — Sun, 03 Sep 2006 21:39:55 +0000

I can’t imagine someone seeing a doctor for a cold (though I know it happens). I just stay home and rest. If it doesn’t get better, THEN I will see a doctor. I’ve only been on antibiotics once in my life, and that was for a nasty gum infection that hadn’t responding to two attempts at “root planing.”

The antibiotics, incidentally, killed EVERYTHING, good and bad, and I developed a yeast infection when it killed the good bacteria.

Hi Victoria–

That’s one of the problems with antibiotics: they kill both the bad and the good.

MRE

By: LarryAJ

LarryAJ — Sat, 02 Sep 2006 20:55:03 +0000

When I read in the various low carb forums about people’s benefits from going low carb, often they will say that they have NOT been sick, or only once or twice sick, since they started low carbing. I thought that was strange but I did some looking and found an article that talked about the suppression of some part (don’t remember which) of the immune system immediately after a rise in blood glucose from a high carb meal.

Being a “Senior citizen” I cannot say for sure, but I don’t think I have been sick more than once in the past four years that I have been following PPLP. And that was after I had driven two days (1000 miles) to visit my son. My “lunch” when traveling back then was still a large blueberry malt. Often I would have two during the day, so I was getting a big slug of sugar from each. And probably was exposed to some “bug” during the trip since I got sick soon after arriving at my son’s.

I just went out and back and did it malt free!
Prevention is the best thing, by far!! Thanks!

Hi Larry–

Thanks for the comment. It’s a common one from folks who adopt a serious low-carb lifestyle.

Cheers–

MRE

By: Karen J

Karen J — Sat, 02 Sep 2006 17:33:10 +0000

At long last, I can finally add a valuable(?) comment.

Baytril, NuFlor, or Azactam, using an intra muscular or intraperitoneal injection can be used on a Cod. Needle size (22-24 gauge) depends on the size of the fish and the type of antibiotic used. Aeromonas and Pseudomonas bacteria are the most common offenders, and cause ulcer disease in the fish. But unfortunately, resistance is becoming a big problem. Many strains of Aeromonas bacteria are resistant to tetracycline, and now some are becoming resistant to Azactam and Baytril.

Hi Karen–

See, even Cod that are over antibioticed (is that a word?) are adding to the problem.

Cheers–

MRE

By: R. Francis Smith

R. Francis Smith — Sat, 02 Sep 2006 14:44:30 +0000

What do you think about the use of antibacterial soaps and the like? I used to avoid them, but diabetes caused me to get very prone to skin infections and so I have resorted to antibacterial body washes. (Hopefully that susceptibility will go away now that I have my blood glucose thoroughly normalized, which, by the way, I’ve managed in the last week or so with the guidance of Protein Power — in 30 or more readings I haven’t seen one over 115 mg/dL, so thank you VERY MUCH for that!)

Hi Francis–

I’m happy to hear that your blood sugars are doing so well. Keep after it.

I think that antibacterial soaps are a problem. Many people who don’t need them use them adding to the antibiotic runoff, which, in time, can breed bacterial resistance. My recommendation is that for people like you, who needed such soaps at one point, to use them. All others who don’t need them, should avoid them.

Best–

MRE

By: Mark Levin

Mark Levin — Sat, 02 Sep 2006 00:20:38 +0000

This may be a little picky, but I would never used an antibiotic on a COD, but I might use one on a COLD. Nuff said, except I’ll take that proofreaders job.

Hi Mark–

MD just read the blog and pointed the same thing out to me. It’s true. I would never use an antibiotic on a Cod, even if I knew what kind to use.

It’s all changed now. Thanks for the heads up.

MRE

By: Sheilah

Sheilah — Fri, 01 Sep 2006 23:23:26 +0000

There could be other options here: for example, a placebo prescription for those who are prescription reliant. (After all, isn’t the antibiotic a placebo when used this way for colds?) And what about vitamin C – or other immune support?

However, is it really a prescription that patients want, or is it some sympathetic listening (even 2 minutes of undivided attention could be meaningful) – something doctors who immediately reach for their prescription pads don’t give.

I would be interested to know what percentage of patients would be satisfied with practical medical advice together with encouragement to undertake self-care – as compared to being given a prescription. Even being given permission to rest in the face of job deadlines and hectic family demands. After all – if a doctor says you must rest it does something vital … it removes the guilt factor.

Hi Sheilah–

I thought exactly as you do when I first got out of my medical training. (in fact, virtually every new doctor feels the same way) I thought patients wanted to be talked to, to be reassured, and that they would understand. It took a while for the reality of the situation to set in. Patients want to get well. They want medicine–that’s why they go to the doctor. That’s why I switched from primary care to nutritional medicine. I wanted to feel like I was actually doing something for people besides giving them the drug du jour.

Best–

MRE