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Dammit, give me an antibiotic

February 18th, 2016 Leave a comment Go to comments
Louie, Full time entertainment, PRN  therapy dog

Louie, Full time entertainment, PRN therapy dog

As a healthcare consumer/patient advocate I have been involved in many different projects including the Choosing Wisely Campaign and the Statewide Healthcare Associated Infections council.  In both capacities, we have had many different conversations about antibiotic stewardship. Everybody knows that overuse and unnecessary use of antibiotics have lead us to Multi drug resistant infections, with very few new antibiotics in our future.  There is a lot of blame to go around about Antibiotic overuse, mostly from Big Pharma marketing then our food animal growers, then prescribers, Hospitals, and to a much smaller extent, patients.    During a Choosing Wisely encounter, patients are advised to ask questions. We are supposed to ask if the medicine is necessary, if there are alternatives, if there are risks, all very valid questions.  In the HAI council I have heard many comments about patients asking for unnecessary antibiotics.  My sympathies generally lie with patients, so I can understand why a Mom with a baby who has a very painful earache, wants everything she can get to ease her baby’s pain, including treating possible infection.  I have a constant nagging discomfort with the US vs THEM hidden message in some of these conversations, even though I understand the necessity of addressing overuse of antibiotics.  I’d feel more comfortable thinking we are all in this together and for a single purpose, to keep people healthy.

This morning I was prescribed not one, but two antibiotics, along with Prednisone.  I have been very ill for 5 days with high unrelenting fever, coughing and wheezing.  Always in the back of my mind is the usual mantra from the infection professionals in my State HAI group, “most of these things are viral and antibiotics will not help or cure that”.   My lungs sounded to me (without a stethescope) like a symphony orchestra, then a bee hive, then cats meowing, then  I swear there was  a foreign voice down there.  I was not hallucinating, at least I don’t think I was.  It’s too bad that little foreign voice in my lungs couldn’t holler up and say “I’m a bacteria” or “I am a virus”.    I was weak from fighting fever, wheezing and coughing, and I was suffering with stress incontinence and had to resort to using pads.  Being sick like that and struggling to breath is a nasty experience.

When I finally marched my sorry butt off to my doctors office this morning, I was going to be THAT patient if I had to be, the one my colleagues talk about in our HAI meetings.  I had used all of the home remedies I could including Advil, Tylenol, Tussin DM, steroid inhaler( from a prior wheezing experience), honey and cinnamon,  tons of water, and lots of Louie (my little dog) snuggling, and my dedicated husband had been caring for me and making me soup.   If my doctor did not recommend antibiotics I would request them.  I was a ragged sick old lady, and  a wash of sweat from my early morning fever, that had just broken, and I knew what I wanted.  I will NOT apologize for getting medicine I needed to avoid getting sicker or being hospitalized.

I think we must be very thoughtful and cautious in our discussions about Antibiotic Stewardship.  Maybe the conversation should provide better guidance for when an antibiotic IS appropriate than when it isn’t (stuffy nose and congestion for a few days, also miserable, but doesn’t respond to antibiotics).  We don’t want to ward people off from getting necessary care, and we certainly don’t  want people getting sicker when there is medicine that can cure them.  It is a very fine balance and the patient is the priority, because it is their health on the line.

This antibiotic conversation sometimes reminds me of how women use to feel like failures if they took something for pain during labor.  Was it implied by their caregivers, or their doctors  or their coaches that they weren’t  tough enough?  Who would do that to laboring women patients?   We must avoid making anyone feel guilty, unimportant or dissed in our Antibiotic Stewardship conversations and practices.


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  1. February 18th, 2016 at 20:06 | #1

    Well, sometimes, you’ve just got to do what you’ve got to do.

  2. Lori Nerbonne
    February 18th, 2016 at 22:41 | #2

    This is one of my favorite blog posts that you’ve done, Kathy. You bring this important conversation to the level that we can all understand and relate to. I like to think that the decision is a thoughtful one that is made together with our providers; that they ask probing questions about fever, how long we’ve coughed, how this feels compared to other colds, coughs, or the flu, listen carefully to our lungs and take all our vital signs. What we don’t want or benefit from, is a pil-pak that’s handed over in a ten minute visit without a thorough, thoughtful exam. We don’t want to be dismissed, and we also don’t want overkill. We want good, thoughtful, decision-making directed by both the art (intuitive experience & wisdom) and science of medicine. That’s when medicine is at its best and also when it feels so good because we leave with a sense of trust and relief. It sounds like that’s exactly what happened for you today. Feel better my friend.

  3. February 19th, 2016 at 10:31 | #3

    Kathy, thank you for clarifying the conundrum of being a patient and an advocate! The issues that we confront are serious public health and federal regulatory needs conflicting with ingrained cultural and powerful business interests. These titans clash and the results are what we confront as individuals when we are most vulnerable. As a patient, delaying treatment can expose one to even more drastic measures and higher and longer doses of ‘last line of defense’ ‘innovative’ & expensive antibiotics when simple and cost-effective penicillin would have done the trick in the recent past. I hope you are already feeling better and that Mike & Louie are enjoying their success!

  4. Jerolyn Ireland
    February 19th, 2016 at 13:51 | #4

    Kathy, As you are aware sometimes our thinking process is delayed on seeking medical help earlier when illness occurs to us. My wisdom & knowledge semi leaves my head when sick however knowing the possible negative outcomes “I give in “. You are a Power House when it comes to improving healthcare so my friend it’s your time to give yourself time for healing. Easier to Say Than Do Right? Glad You have Mike & hopefully are starting to feel better.

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