26 November 2013

26: antibiotics

I sometimes think about whether I would be alive without modern medicine. 


I've had malaria several times (I remember how wonderful the cool cement floor felt to lie on), and there were a few rounds of lung illnesses (pneumonia, etc.) when I was in middle school, and I've had strep throat a number of times, and there was that sinus infection in Rwanda. 

That's just the little stuff. That doesn't even count the TB that I could have contracted from my friend in Liberia when I was very small, or the vaccines that prevented me from getting cholera, or the schiztosomiasis.

The last few times I really needed antibiotics - for the sinus infection in Rwanda and strep throat in law school - I remember the distinct feeling of the disease responding to the antibiotics. I took the pills (amoxicillin in Rwanda and penicillin in law school) and literally felt better by the minute until I stopped feeling better and started feeling worse again before the next dose. 

My friend B., a surgeon who trained in Ethiopia, told me that it wasn't necessary to take antibiotics for 10 days in Rwanda, because there was so much less resistance to them. 7 days would be plenty, he told me. 

I suspect this is in part because, even though antibiotics are available without a prescription, very few people are educated enough to know when and how to take them. One of the guards who watched the house/office where I lived in Rwanda once came to me and said that he needed to go to the hospital because he had a headache. 

"I can give you medicine for it," I told him, and gave him 12 or so ibuprofen.

"How do I take it?" he asked, and I wrote down: two in the morning, two at midday, two at bedtime. It was a bit of culture surprise for someone who keeps a giant size bottle of ibuprofen all the time. (Although I try not to use it much anymore.)

Dr. B. also told me that he was horrified when he read US medical literature. "I do not have infection rates like that in my hospital," he told me. "It is rare that I have an infection after surgery. I don't know what is going on in hospitals in America."

What is going on is, in part, that we have been spoiled by antibiotics. When I had that sinus infection, as I got the antibiotics, I thought to myself that I could see how people died before there were antibiotics, because I wasn't sure how long I would maintain the will to live if my head hurt that badly with no hope of relief. I probably would have pulled through just fine, of course, but there is so much less risk to a life with good antibiotics: I can travel the world. I can go visit people in hospitals. I can go visit people in jail. I can go to schools. Whatever I pick up in those places, I'll probably be fine.

I can't imagine a world without antibiotics, even though I know that in my Oma's lifetime, her younger siblings died because of a lack of them.

The scariest thing is that we may end up right back there. My (potential) kids could die because of a lack of antibiotics. 

This article scared me, badly: Imagining the Post-Antibiotics Future.

I've been avoiding anti-bacterial soap and hand sanitizer for a long time, but now not only am I promising myself to try to make it through any illness, even bacterial, without antibiotics, but I am also going to try to eat and drink only milk and meat produced without antibiotics. 

Because even scarier than the fact that we might be losing our antibiotics? The idea that it is our cheap, mass-produced food that is a huge source of the problem.

Go forth and avoid antibiotics.

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