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Antibiotic Resistance – Your Role in Curbing This Serious health Problem

Antibiotic Resistance
A few days ago, I found it hard to push away a heavy sense of despair, upon reading about a woman dying of an infection resistant 26 different antibiotics, in the US. The feeling worsened as I went on to read that she had returned to the US after a long stay & treatment in India and was infected with New Delhi Metallo-beta-lactamase 0r NDM (a multi drug resistant bacteria)

The problem of rampant and growing antibiotic resistance is well known. Yet most of us are all guilty at some point, as patients, of not completing a prescribed antibiotic course, because we feel better just a couple of days into the 5 or 7 day course. At other times, we self-medicate ourselves antibiotics when they are not really needed.

How does this all add up to the kind of awful antibiotic resistance in the news?

First, a few basics-we all have bacteria in our bodies – throat, nose, gut etc. When we pop-in antibiotics only for a few days, we kill the ‘sensitive to antibiotic bacteria,’ and leave behind the ‘resistance prone bacteria’. In other words, we inadvertently target only the weakest bacteria and exempt the stronger ones from being tamed by the antibiotics. These bacteria now have a full playing field to grow and prosper-a sharp contrast to their fate had the course of antibiotics had been completed. In that case, the resistance prone ones would also have been killed. Each time we take antibiotics unnecessarily, we give our inherent bacteria an inoculum against the bacteria and opportunities to develop resistance to it.

This real and growing risk of antibiotic resistance means a person could get very sick, or, in extreme cases, die of an infection as common as a Urinary Tract Infection (UTI). This is because antibiotic abuse has made our own bacteria resistant, or just as bad, the illness is from catching a resistant-bacteria infection. Remember also, no new antibiotics are being developed by pharmaceutical companies. We cannot afford any resistance.

Patients are not powerless to fight this. As someone who is ill, don’t begin to demand antibiotics of your doctor and certainly don’t pop in antibiotics just because the smug boy at the pharmacy tells you that you must. Ask questions about your prescription, if antibiotics are being given – why are they being used?

Remember this one thing: antibiotics fight bacteria, not viruses. Many cases of diarrhea or colds etc. are caused by viruses and do not need antibiotics. In these cases what you need are simpler measures and most importantly, waiting for the body to get rid of the virus naturally.

In our practice (Dr Rachna Kucheria, leading GP in New Delhi) we regularly make an agreement with the patient about a watch and wait plan- where we counsel them on the when to start antibiotics and how long they can safely do without them.

The WHO & Government bodies have put together plans, one of them is the Chennai Declaration-a roadmap developed at a joint meeting of medical societies in India, in Chennai in August 2012 to curb this serious problem.

In the meantime, as citizens, we can contribute by auditing our own consumption and prescription of antibiotics. And being aware of the contribution each one of us can make so that antibiotics continue to protect us, in the way that we have known them to.

fitness saving plan

Fitness Savings Plan: Advice from a GP providing senior citizen care

Being a GP in Delhi, who often gets called to provide care for senior citizens does not make my work totally about medical prescriptions and formulations as most people imagine it. Part of my GP practice involves providing home health care, where I see my patients/clients in their homes- necessity since many of them are 80 years and older. This helps me get not just a medical history, but a rich weave of social, professional, family, and life stories. This information and the patterns that I observe in their daily routine are critical to many medical decisions I am trusted to make for them. Getting a holistic understanding of the individual I am responsible for makes for medicine as it is intended to be practiced.

Many seniors live with long time caregivers (not family, mind you) who assist them with their daily needs. In my experience, those that have the best quality of life, have continued to engage themselves both mentally and physically as the years went by.I think of 95 year old Mr. Gupta (name changed) as a great example for this. Mr. Gupta steps out for an early morning walk at his local park a 40 year old routine. In the past few years, he started taking his caregiver with him, due to an occasional instability, while walking.The rest of his morning routine includes reading the papers and staying informed about current events. In the afternoons, he goes to the club to play bridge, and enjoys a chat with fellow players. Evenings are usually dinner at home and television.

An easy retired life? It’s not as simple as it sounds. The work to achieve this level of independence in later years starts many decades earlier. I suggest, in one’s 40s. For many of us, this is the time after a busy 20s, 30s, spent building a career and or looking after children. It is the time we can turn to nurture ourselves more fully.

I’m going to list only one form of preparing investing in your future aging -exercise. Walking, yoga, gym, dancing, and swimming- all these are great options to improve your fitness. The benefits of exercise include improvement in arthritis, heart disease, diabetes and high blood pressure. You may not have any of these today, but you must prevent, or at least minimize their impact, tomorrow.

As it so happens, not all our bodies are similar. You simply cannot leap into exercise and expect it to benefit you without taking to your doctor about at least the no-nos. I suggest consulting with your doctor, before starting an exercise program or if you’re planning to increase the level of your physical activity. This is an important safety check and should not be missed.

So there you have the foundation of what I call the Fitness Saving Plan. Don’t neglect it just like it is prudent to start a financial retirement plan early in your career, so must one do a similar investment in fitness, with a goal to stay walking, well into your 90s. Nothing less is acceptable, is it?