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Post by FlatCoatedLover on Feb 8, 2005 20:56:29 GMT -5
This is not only an issue with doctors but apparently with Vets too. Antibiotic resistance is a major problem in most industrialized (developed, 1st world) countries. There are two main causes of this. The first is the administration of antibiotics for conditions in condition it will not help. Unless the patient is immune compromised (non functional immune system), human or animal, there is no reason to give antibiotics to prevent them. If there are open wound a simple cleaning with soap and water or peroxide regularly will keep it form becoming infected.
It is very difficult to ensure that patients (or patients caretaker) follow thru with an entire course of antibiotics as they will usually stop taking them once they "feel better." When the course is not completed it is likely that some bacteria that survived. The ones that survived are more resistant to the drug than the ones that were killled quickly. These now multiply and we have whole new colonies of drug resistant bacteria. There are only one or two antibiotics left that can still be used to treat all types of infection and there has been little development in this vain in the last 10 years so once these last few drugs become ineffective there will likely not be any new ones to follow.
In addition to the problem with resistance, antibiotics are very hard on the body. They distroy the beneficial bacteria the exists naturally in the intestines, stomach, mouth, on the skin and genitals. This bacteria aid in digestion, produce chemicals that are vital to proper coagulation, prevent overgrowth of yeasts and other fungi and helps to maintain the proper pH.
I am a medical student and I contantly see people in the ER and the clinic who have a cold or flu who come in demanding antibiotics which we know will do nothing. But because at least 1 physician in the past gave in and gave it to them and they "got better." When in reality, viruses like those run their course in 3-7 days and it has usually been that long by the time they see a physician so the administration of the antibiotics just happen to coinside with the resolution of symptoms in the normal course of the virus.
Sorry for this rant but I had 2 patients come in today with antibiotic resistant TB, 1 with antibiotic resistant meningitis and 1 with antibiotic resistant "flesh eating bacteria." This in conjunction with all the things I have read on here about prophylactic antibiotic treatment in immune competent animals.
I would like to beg all of you to please, please, please question your vets and doctors about why they are prescribing the antibiotics and do not take, or give them to your pet or children unless you/they are immunocompromised or actually have a confirmed bacterial infection. If they are prescribed make sure that you take all of the one given and on the schedule the doc gives you. This will decrease the chances of bacteria becoming resistant and ensure that antibiotics are still useful in the future.
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Post by ixtlan on Feb 9, 2005 17:57:35 GMT -5
Thank you so much for sending this message. There are alot of alternatives to antibiotics for treating animals. Check out Dr. Pitcairns COMPLETE GUIDE TO NATURAL HEALTH CARE FOR DOGS AND CATS. There are alot of other good resources out there too. :
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Post by Nicole on Feb 9, 2005 18:17:21 GMT -5
I agree with everything that you said. I remember when I had an abscess in my leg and it was so bad that I had to go to the hospital to have it lanced, drained cleaned etc. and there was a big hole in my leg when they were done. I was shocked that the doctor would not give me antibiotics. He said the infection is cleaned out you don't need them. He was right but you could see the inside of my leg and I thought to myself does this guy know what he is doing!! As it turns out, he did.
My understanding is that if you have an infection, antibiotics will stop it from spreading to allow the body to take care of the active infection. The antibiotic itself doesn't kill the existing infection it just contains it. This is what I was told but I don't have a medical background so if I am wrong feel free to say so. So if there is no infection, it doesn't need to be contained and giving it as a precaution isn't going to do anything except contain it if one comes along. But in the meantime, because more often than not you don't need it, we develop a resistance.
Now, look at this angle. My husband Brian is a lawyer. He handles medical and dental malpractice cases. He defends doctors and hospitals, he doesn't bring the claim. The single most frequent medical claim that he handles is that a patient suffers an infection following a visit to the doctor for a cut, scrape, injury, tooth extraction, surgery etc. etc. where there is no infection at the time of the visit and the claim is that the doctor did not give prophylactic antibiotics which would have prevented the infection. What do you think about that?
I think that these lawsuits have a very chilling effect on doctors to do things the way they should. It isn't the entire problem but it is a part of the problem. Because juries are lay people like the average Joe who thinks that antibiotics are the cure to all ills and that if you gave it none of this would have happened.
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Post by FlatCoatedLover on Feb 9, 2005 20:14:54 GMT -5
nicole - it depends on the type of antibiotic. Some work by containing the bacteria but many actually work by disrupting some part of the life cycle (stopping DNA or RNA synthesis which stops replication, destoys the cell membrane causing death of the bacterial cell and many other methods)
As far a malpractice. A physician has to do what is best for the individual and in some cases has to consider what is best for society as well. In general, if a patient follows the protocols given by the physician in treating wounds and the like they will not get infections. If signs if infection do occur (redness, swelling, increased local temp, increased pain etc...) patients should go back to the physician for additional treatment. If they ignore the signs there is nothing a physician can do. Doctors can not function by contiunally second guessing themselves and worrying about being sued because this makes them ineffective physicians. They have to treat each patient to the best of their ability.
There protocols for care (devised by the American Medical Association and other professional groups) put forth guidelines for treatment for all conditions. As long as a physican follows these plans they are not negligent. A lawyer would have to prove that the physican deviated from the protocol to be coupable.
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Post by Nicole on Feb 9, 2005 20:38:23 GMT -5
There protocols for care (devised by the American Medical Association and other professional groups) put forth guidelines for treatment for all conditions. As long as a physican follows these plans they are not negligent. A lawyer would have to prove that the physican deviated from the protocol to be coupable. I guess it depends on your state. According to my husband the AMA protocols are meaningless really. All the plaintiff needs is to get a doctor to say that treatment is a departure from the standards in the "community". In other words..everyone does it this way regardless of the AMA protocols and you did it differently and therefore you are negligent. It isn't fair but that is how it is here. Anyway, back to the overuse of antibiotics. ;D
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Post by FlatCoatedLover on Feb 9, 2005 22:44:16 GMT -5
That mentality is what need to be changed. When antibiotics were first developed they were touted as a cure all. This is the mentality that persist in many older physicians and they continue to over prescribe them. Also older people in general have this mentality and continue to propagate it on to younger generations. Only people who train as healthcare professionals now or those who take the time to learn how and why medications work know the dangers of contiuning this way. Just becuase something has been done one way for a long time doesn't mean that it is right. It is ignorance and the unwillingness to learn new things that continue to make the situation worse.
As far as malpractice, I think that lawyers have a played a huge role in making everything a crime. No one take responsibility for there own actions anymore, it is always someone elses fault. The doc didn't give me antibiotics on my first visit and because I didn't ever go back for a recheck when it started getting worse I lost my arm. It's not my fault for not going back, it is the doc because he didn't give me the antibiotics in the first place.
In general I think that if a physician has a good relationship and actually care and show compassion for their patients rather than simply shuffling them in and out they are unlikely to get sued unless there is gross negligence (removing the wrong kidney, misdiagnosing a life threatening condition). But it become harder and harder for physicians becuase lawyers will encourage people to sue for a hang nail and this decreases the legitimacy of the real cases of negligent practices.
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Post by ixtlan on Feb 12, 2005 12:15:26 GMT -5
Yow! Doctors seem to be stuck between the rock and the hard place. The problem isn't just in any one place. I agree with you about Lawyers. I also think pharmasutical companies push these medicines and create an economic atmosphere where dispensing these products means staying in business. Really I have never once had a vet volunteer information about side effects of the drugs they felt my dog should be taking. Had I not done some research myself I could not have made an informed decision. And there it is I think. We are responsible for the kind of health care we have. If we know nothing ourselves about how our or our companion animals health is optimized we will have to accept the omnipotance of the powers that be,( because we know nothing). Be they right or wrong. This is a problem that is not going to go away soon. Each of us though can take the time to learn about health. Know something of what the doctor knows and know something about alturnitive ideas on health and have the courage to make your own INFORMED decision. And then know that you might be wrong and be willing to change your mind in any direction. I personally have the same problems with vaccinations as antibiotics.
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Post by Nicole on Feb 12, 2005 17:59:05 GMT -5
Ixtlan, you are so right!! Imagine how it was without the internet resources we have today. You really were at the mercy of the provider. And while lawsuits have gotten out of control, they also do play apart in making sure that things are done properly. Without that threat, there would be no real checks and balances. This is most obvious in the vet community. There are very few lawyers who would ever take on a veterinary malpractice case because the recovery is so limited by law. A dead dog is worth pennies “legally” unless it is some great breeding dog. You can’t recover for mental anguish and pain (yours or the dogs) and I wonder if that makes vets a bit more callous and full of themselves. The examples you raised in your post really hit home with me because I have experienced both in the last six months. Sunny had an unexplained itching problem last summer. Without boring you with every detail of my efforts to get him help, the vet gave me 90 pills that he told me were stronger antihistamines than the Benedryl I was giving. He said to give 5 a day for four days and then five a day every other day. I said for how long. He said until they were finished. That was the end of the discussion. I started them and my dog became very, very ill. I looked up the medication and they were STEROIDS mixed with antihistamine. He prescribed a dose that was obscenely high and according to everything that I read, they should not be given without very close and frequent monitoring by a vet and you can’t just stop them. I thought, my God, this man almost killed my dog. What if I kept giving them and then stopped like he said to when they were finished. My dog would end up dead or with Cushings disease. He never told me any of that and he never once said what to look out for, or to return, or to taper the dose to the lowest amount necessary, or to wean the dog off. Fortunately, I went to another vet right away who was shocked, weaned him off and ultimately my dog recovered. In looking for a new vet, I stopped by this clinic to say hello and check it out. I said I don’t vaccinate and I give the three year rabies. The woman said we give the one year rabies. I said but dogs don’t need rabies every year. She says but we have to make sure they come in so they stay healthy. I was stunned. I said, you are making the dog unhealthy so you can make sure they are healthy. I said if you knew that I brought my dog in for yearly exams and blood tests would you give the three year. (At this point I wasn’t going there but I was curious) She said no. She almost fainted when I said I don’t give other vaccines. They want them in every year so they continue to make money. That is the bottom line. It is all very distressing to me.
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Post by ixtlan on Feb 16, 2005 15:29:46 GMT -5
Nicole, I'm glad to hear you think this. I really got personally attacked by the moderators of the last forum I was on for saying what you have said. They called me idiot and liar. I offered to share my sources for what I was saying. (I did alot of research). Not one of them would look at my research and they let the thread die. I took alot of flack and never responded personally. I am glad I can at least give my opinion here. I don't need to be agreed with( that's great but you don't learn as much) I always learn from thoughtful bebate. Two books that have helped me in times of uncertainity in dog care are, The Complete Herbal Book for the Dog, by Juliette de Bairacli Levy, and Dr Pitcarin's, Natural Health for Dogs and Cats. I work in the Natural Foods industry. So I have a bias. I am very interested in health care that gives us power and responsibility. I have nothing against the profession of doctors or vets. I just don't agree withhow they (meaning the whole profession) are practicing medicine. I think in general, proper food, exercise, rest and Love are the most health promoting things you can do for yourself and your animals. If you follow the rules of nature you and your pet are desinged for health. Just my opinion. Thank you for yours.
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