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Old 02-23-2006, 12:33 PM   #1 (permalink)
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Is it possible to never get well?

I don't normally frequent this area of TFP, but I'm in my mid-twenties and I've just had my first experience with an aging body which brings me here with questions for the more health-aware...

I've always been the type who tries to avoid anti-biotics and other unnecessary prescriptions at all costs, and I recently got an upper-respiratory infection. In the past, my body has always been able to cope with these sorts of things within 3 - 5 days, and I've never seen a reason to build up an unnecessary immunity to anti-biotics when the immune system is perfectly capable of correcting the problem with rest, plenty of fluids, etc.

This story is different though, after being about as ill as I've ever been for over a week I broke down and filled the prescription my doctor gave me, and I'm happy to report I'm nearly out of the woods. This experience brought up a lot of questions for me, however, about health and the aging process and whatnot. Obviously, the older I get, the less capable my immune system is of dealing with these routine infections... but it got me wondering...

If one absolutely refuses to take medications for these common non-lethal health problems, is it possible that said person will never get well? Just be perpetually ill indefinitely? Or will the immune system always eventually deal with it, it just takes longer and longer the older we get?

In other words, now that I have caved in and taken anti-biotics to deal with this infection (yes, I feel somewhat ashamed and weak), am I now forever doomed to be medication dependent every time I get sick? And will the illnesses continue to be this much worse than I remember them being? (I haven't been sick for 3 years or so....).

Thanks for your time, everyone.
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Old 02-23-2006, 12:59 PM   #2 (permalink)
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a friend of mine didn't think her cough meant anything...even though it was hacking and lasted over a year.

Turns out she had two broken ribs and walking pnuemonia.

Dependancy or wise use of a resource to improve your health? I dunno...but i don't understand the resistance to medicine as a concept.
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Old 02-23-2006, 02:01 PM   #3 (permalink)
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Wow, this post could have been written by me 10 years ago. Back in the day, I was absolutely convinced that my immune system could beat just about any bug out there given the time, rest and nutrients that it needed. It helped that I was stressing my system every day by running 8-14 miles, so a day of rest meant extre recuperation.

When I was 27 I ran into a sinus infection that I just couldn't shake. It lasted for 2 weeks before I went to the doctor and it was another week before I broke down and took the medicine he prescribed. I was well in 4 days.

Here's what I've learned about immune systems since then from my doctor friends - taking antibiotics doesn't build up unnecessary immunity in your body. They can potentially help diseases build immunities to the drugs if taken incorrectly, but they won't hurt your body when you take them or in the future. You're not doomed to taking antibiotics every time you get sick because diseases are constantly reinventing themselves (unless the intelligent design folks are right :-) ) and ever time you successfully fight off a disease, you tend to be resistant to it several years afterwards since your body sees the need to produce those antibodies that successfully fought it off.

To get back to the actual question - yes, it is possible that you'll never get well from the common cold. It could eventually kill you if your body can't fight it off. That's not likely, but different people react differently to the same strain of disease. If it catches your immune system off guard, or your system is fighting something else off (i.e. allergy or another cold), the new one could infect a large area that isn't ready to fight it off. Or your immune system could be compromised by something else. Your body is a lot smarter than you give it credit for.
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Old 02-23-2006, 02:13 PM   #4 (permalink)
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Echoing the above, you won't build up an immunity. You may be lumping the building up of a "tolerance" to alcohol, drugs, etc., with immunity. They're very different things.

Not taking the complete antibiotic regimen, or stopping before the bug is dead will allow the surviving bugs to reproduce, and they'll inherit the resistance to that class of antibiotics. Induced resistance. People often do it by stopping their meds as soon as they feel better. It's a bad thing.

Don't be hard on yourself. You're young. Some bugs are tough. Witness the rash of 18yo athletes dying the last few years from staph infections.
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Old 02-23-2006, 10:29 PM   #5 (permalink)
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My mom is 82. Maybe ten years ago she got a bad case of pneumonia; she'd had it before, but this one went on for a very long time. Finally, they got it under control; but she has to stay on antibiotics for the rest of her life. Whatever bug was involved apparently has a little home it made in her lungs, and they can't knock it out of there. If she goes off the antibiotic for a couple of weeks, the pneumonia starts to come back.

So yes, it's possible if your immune system is weak and/or the bug is strong. Moreover, viral infections like the flu often lead to secondary infections caused by a combination of low resistance and respiratory blockages; sinus infections are the most common. That's why sometimes you get the flu, get better, and then get worse again. The "relapse" is actually a secondary bacterial infection of some kind. I once got the flu and was sick for a solid month; I started to get better twice, and then relapsed. I didn't think antibiotics would work on the flu, but somebody finally explained secondary infections to me and I got a prescription. Two days later I felt normal. God knows how long the cycle would have gone on without the pills.
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Old 02-23-2006, 11:04 PM   #6 (permalink)
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Before antibiotics came into use during the second world war people were dying of bacterial infections much more often than today. The first person they tested antibiotics on had scratched his face on a rose in his garden. His condition had deteriorated and he was expected to die. The penicillin did wonders and it looked like he was going to recover. Unfortunatley they ran out and he ended up dying.
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Old 02-24-2006, 08:56 AM   #7 (permalink)
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Hmm... interesting. I was absolutely convinced that this antibiotics resistance thing was a given... wasn't even part of my question... but I got answers to questions I didn't even know I had! Thanks everyone.

Anyway, I find it interesting that not finishing the prescribed course is a big part of what causes the "induced resistance." I wonder, if people generally knew that, would the antibiotics scare would calm down a bit? Would people be more dilligent about finishing their prescribed course? By antibiotics scare I don't mean to imply that there is a large portion of people are hesitant about taking antibiotics, but I think that there is a significant minority. And I'm not saying that I still don't believe the average person takes too many medications for conditions that don't require them, but I also think there are a lot of people like me who are too wary to take medications even when they are needed, probably due to misconceptions like mine.
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Old 02-24-2006, 09:46 AM   #8 (permalink)
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The average cold or flu won't have me going to the doctor either, partly because I consider it "weak" to want/need help with that, partially because I consider it a waste of resources. The health care system is overloaded as it is (here), no need to burden it with my snivels.

However, I don't understand how it could escape anyone's notice that not finishing the prescribed antibiotic cure is bad for you and bad for humanity. The few times I've been prescribed antibiotics the doctor has told me sternly to finish the cure and the pharmacist has also told me sternly to finish the cure and they've also explained why. It's impossible to get hold of antibiotics without being subjected to this lecture!

Personally, I think the reason most people don't finish their cures like obedient citizens is because they want to save some pills for the next time they feel a bit under the weather but can't be bothered to go to the doctor for it.
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Old 02-24-2006, 09:50 AM   #9 (permalink)
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I refuse to take any medicine not absolutely necessary in order to stay living, because I know the enormous healing power of my body and its immune system. Things like Tylenol are certainly one that you don't overuse, as you WILL get an immunity, and your body will begin to produce less pain-reducing chemicals since their appears to be enough in your blood. Your body will voluntarily shut off many production centers if it sees that it isn't necessary; serotonin is a perfect example. That said, taking antibiotics is generally not a bad course of action -- because of their nature, they actually HELP your immune system develop antibodies of its' own to fight the infection. The only thing we hurt by taking antibodiotics is humanity. Its a small case, but you are causing bacteria to breed resistant to certain antibiotics. If we continue to use large doses of penicillin, bacteria immune to penicillin will (and have) begin to develop. That's the only downside. So no, your immune system is fine.

Oh, and yes.. there's definitely a way to "never get well" -- it's called dying.
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Old 02-24-2006, 10:35 AM   #10 (permalink)
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Quote:
Originally Posted by robbdn
Anyway, I find it interesting that not finishing the prescribed course is a big part of what causes the "induced resistance." I wonder, if people generally knew that, would the antibiotics scare would calm down a bit? Would people be more dilligent about finishing their prescribed course? By antibiotics scare I don't mean to imply that there is a large portion of people are hesitant about taking antibiotics, but I think that there is a significant minority. And I'm not saying that I still don't believe the average person takes too many medications for conditions that don't require them, but I also think there are a lot of people like me who are too wary to take medications even when they are needed, probably due to misconceptions like mine.
People are stupid. Ask anyone.

This has been common knowledge among doctors for years, and there's usually warnings on your antibiotics to finish it off. Unfortunately, doctors also tend to prescribe the strongest antibiotics for bugs that don't necessarily need that level of medicine to kill them off, and the ones that do end up surviving do so because they've developed a resistance to that family of drugs. Tuberculosis has become drug resistant in Russia because the prison system has treated patients in a slipshod manner. The prisoners have passed the disease out into the population at large, and there are cases that are nearly untreatable with modern drugs.
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Old 02-24-2006, 11:08 AM   #11 (permalink)
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Quote:
Originally Posted by robbdn
... And I'm not saying that I still don't believe the average person takes too many medications for conditions that don't require them, but I also think there are a lot of people like me who are too wary to take medications even when they are needed, probably due to misconceptions like mine.
There is an antibiotic crisis, but it cuts across medicine. If you need one, use it. Use it correctly.

I wish there were an infectious disease guy here to respond intelligently. My knowledge is limited.

There are a limited number of antibiotics. New ones are few and far between. As bugs develop resistance to old classes, doctors move to new. The problem is that nature is better at evolving around our discoveries than we are at discovering, and pharmaceuticals aren't ideally motivated...profit vs. risk. Hopefully alternatives will pan out. Researchers are playing with "active" treatments. There's work with animals (reptiles) that have built-in systems we may be able to borrow from. But last I heard any solutions are far in the distance. In the meantime we have a limited arsenal.

Careless patients aren't the only cause of resistance. Doctors can contribute, whether by prescribing when it isn't needed. If needed, prescribing too short, too weak, or just a bad match for the target. Their job is a dance between using something effective enough to kill the target but without nasty side-effects. The antibiotics are not perfect precision munitions. They kill more than just the intended target, and so while they're being administered it can lead to a cascade of problems depending on how far out of whack the normal bug community becomes. So doctors try to start with a minimum dose plus safety margin and hope.

The uniqueness of each patient contributes. What if, as in Rodney's Mother's case above, the pnumonia patient has scar tissue in her lungs? (Pnumonia causes scar tissue, so it's a progressive problem.) That scarred area will not receive normal circulation therefore perfusion of the antibiotic will be reduced. The duration or method of application may need to change, but they don't know that until they fail, which creates more scar tissue, etc. Each failure brings reduced lung function, and the congestion strains the heart and other systems. It just keeps getting worse. Liquid ventilation may reach impaired areas but it's exotic and hazardous in its own right. Instead the patient lives with an oral antibiotic for life and any side-effects it may bring. Better than the alternative.

Other hazards are foreign objects. Implants like pacemakers, hardware for the repair of broken bones (screws, plates, rods...), in the future it could be identity chips your parents installed, artificial eyes, whatever. If the bug has set up a colony in or on one of these "dead" areas, it can hang out until the antibiotics have passed and then spawn new infections. After each cycle the surviving bugs will be more resistant to the treatment. Doctors will ID for another treatment, but eventually they run out of choices. The complications (collateral damage) increase as the battle escalates to harsher drugs. These battles result in what you've heard described as "superbugs" for which the treatment is brutal or nonexistent. Eventually doctors begin treating the hospital. It may be better to lose a patient than force a new strain of some critter that could take out an ICU of lowered-resistance patients.

So yes, there's a crisis, and it's why doctors no longer prescribe antibiotics for runny noses, but those who need it need it. For something that's bothered you this long doctors will be better at deciding.

Edit: Need a spelling antibiotic.
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Last edited by cyrnel; 02-24-2006 at 02:10 PM..
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Old 02-24-2006, 12:08 PM   #12 (permalink)
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Old 02-24-2006, 02:01 PM   #13 (permalink)
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thanks for the humor stevie... this threat was starting to get a little bit depressing. I'm not sure it shouldn't, though.

Are we on the verge of a post-technological revolution dark-ages? Try not to infer a predicted time period for this dark-age from the question, it's meant to be as vague as it sounds. From this thread, it seems that the breakthroughs of medical science are being more rapidly accounted for by nature than we can account for in science. We're nearly out of oil, pandemics are threatening to kill millions, and more and more nations are finding it easier and easier to develop nuclear weapons... our technological advances, particularly in medicine, seemed to put an end to the debate on whether progress is real or not. Antibiotics alone saved countless millions of lives, that one single breakthrough. Were our historically recent breakthroughs in technology and science just that, mere breakthroughs that stop and end, eventually to be left in a place where we wonder if progress is real or not once again? As nature undoes antibiotics, will it also undo everything else we've accomplished, all their other miraculous demonstrations of progress we've made to each other and ourselves?

yes, it's completely off-topic, but it seems to be where the trains of thought in this thread will eventually lead. I suppose that's why they call it a thread, because it can be weaved in many intricate patterns.

I can't tell if we need more humor, to keep us from thinking these sorts of rediculous things... or if this is exactly what is happening, and we need to be seeing it clearly. In any case, I know I don't have enough information to make a judgment. I feel like that means I shouldn't worry about it, and yet, if I don't worry about it I won't seek out the information that will allow me to see things as clearly as I can... Maybe I'm just crazy, in which case, forget I ever said anything.

I rant. I do it often. Forgive me.
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Old 02-25-2006, 07:58 AM   #14 (permalink)
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If there's been any problem with advancements in medicine, like antibiotics, it's that people were too quick to say, "This is the answer! We've got it for all time!" and then stop looking for other answers.

The first answer you find to any medical or technological problem is not necessarily the permanent one, even though it "works." In medicine and technology, we've seized on a lot of solutions we wanted to think were permanent (petroleum-based energy, certain antibiotics), and gotten comfortable with them. We stopped looking for new answers. And the flaws in the solutions that we'd accepted eventually came back to bite us. All that means is, we have to start looking for new answers again -- and we never should have stopped in the first place.

To get the discussion somewhat back on topic, one way to make antibiotics _as they are_ work for you is to use them intelligently and see about changing the conditions which makes their use so necessary. Frankly, if you live your life intelligently the need for antibiotics is reduced, although never eliminated.

As I mentioned above, I found I needed antibiotics after flu because congestion in my sinuses tended to lead to secondary infections. So I started doing a couple of things during flu (and any bad bout of head congestion):

* At intervals, drinking a large glass of warm water spiked with a dozen drops of Tabasco sauce. Read this in a medical column -- it seems to dilate everything in your head and lungs that _can_ dilate, and eases congestion pretty well.

* Crush a couple of cloves of raw garlic twice and day and eat 'em. Garlic contains a natural though mild antibiotic agent which doesn't seem to have issues with resistance.

Since I started doing that, ten years ago, I've never since had a "relapse" (aka secondary sinus infection) after the flu. And so I haven't needed antibiotics.
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