The Experts Weigh In: To Drug or Not To Drug

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BY: DAVE ERICSON, CONTRIBUTOR

One of the most remarkable breakthroughs in medicine has been the discovery of antibiotics. Their use has decreased mortality and sequelae of serious infections in significant numbers.

Unfortunately though, their use has increased in recent years due to inappropriate prescribing practices and demand from patients. Bluntly, it is far easier to write a prescription for a cold than to explain to the patient that 90% of upper respiratory infections are viral. This practice is then reinforced when the patient experiences improvement while taking the antibiotic. The patient 'learns' that the antibiotic heals them, so the next time they come in with a cold, they request an antibiotic. Ironically, the cold got better in spite of the antibiotic. Some antibiotics, such as azithromycin (Zithromax) have a very potent anti-inflammatory component, thereby improving the symptoms of a cold by reducing the inflammatory responses.

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Medical literature has continually supported the reduction of antibiotic usage. Primary care offices are constantly inundated with common upper respiratory tract, ear, sinus and bladder infections. With the patients being programmed to expect antibiotics, a refusal to prescribe by their primary care doctor may cause discord between the doctor and patient. Many precribers have complained that while they acted responsibly by treating symptoms of a virus without antibiotics, patients have gone to other clinics in search of their desired antibiotic.

Antibiotics are of immense value for treatment of bacterial infections. However, they do NOT treat viral infections! But more importantly, even when antibiotics are used correctly for the treatment of bacterial infections, they still have inherent risks that need to be considered and anticipated.

Antibiotics are effective in either killing or impairing the growth of bacteria. Unfortunately, treatment can also reduce the number of beneficial bacteria in the intestines. These bacteria are a normal part of our digestive system and aid in the digestion of food. Bacteria live in concert with various yeasts, mainly the candida species. Bacteria feed on yeast, controlling their numbers. If bacteria levels are diminished, yeasts are able to overgrow, possibly causing secondary illness.

As with any medication, antibiotics can put you at risk of allergic reactions and adverse reactions. Allergy severity can range from a simple skin rash to a full anaphylactic reaction with closure of the airway structures and collapse of the cardiovascular system.

Antibiotics can also potentiate an overgrowth of clostridium difficile in the gut. Clostridium difficile is a bacteria that is found in a small number of people normally. It can also be picked up by accidentally ingesting spores in a hospital or nursing home. These bacteria, when allowed to proliferate, can cause severe inflammation in the colon, even invading the colon wall.

Lastly, some antibiotics can actually weaken tendons, putting you at risk for future rupture of these structures.

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It is important to be cautious in your decision to use antibiotics. Typically, a cold or upper respiratory infection (because it is a viral illness) will dissipate within a week. Treating your symptoms with over the counter medications, rest and good hydration is the appropriate course of action. Also, stay home from work when you are sick! Your fellow co-workers will thank you. If your symptoms persist after one week, seek out care from your doctor. However, if you develop a high fever or develop more severe symptoms than the typical cold, seek out care immediately. It may still be viral, but let your doctor decide.

When a lucid decision is made to utilize antibiotics, it is important to supplement your diet with probiotics while taking the medication. It is recommended to take the probiotics during treatment and for 10-14 days after finishing the medication. Some foods, such as yogurt and some cheeses, provide these benefits. There are numerous over the counter probiotic supplements available for use as well.

While antibiotics have certainly improved our quality of life, indiscriminate use has caused increased strains of resistant bacteria. These developments have already decreased the benefits of antibiotics, causing more serious illnesses and deaths. Please be judicious in your use of these agents. Talk with your doctor before deciding on or accepting an antibiotic prescription.

Dave Ericson is a Physician Assistant based in Western Massachusetts. He also doubles as my uncle and personal healthcare consultant. When he's not treating patients, you can find Dave fly fishing on one of the many rivers near his home or jamming out on the guitar (an instrument he taught himself to play, and play well, I might add). He once played in a cover band in New Jersey and jokes that his band mates were young enough to be his kids. A bit of advice from a patient-healing, guitar-jamming, life-saving uncle?, "Quit worrying, particularly if there's nothing you can do. Enjoy your kids more... time flies by". Well said, Uncle Dave... well said.

Advice From The Experts: Pill Poppin'

Uncle Dave and Aunt Lenor (circa my choking incident)

My love for bagels is dangerous, especially since I'm a future health coach. I ate a lot of bagels growing up. Frankly, it's no surprise I moved to a city known for it's amazing bagels. My love runs deep... 

...in fact, it almost killed me.

When I was 11 months old, I almost choked to death on a bagel. As I started to turn a lovely shade of blue-grey in my highchair, my uncle Dave jumped to action and cleared my air passage! I could say it was a coincidence that my Physician Assistant uncle and nurse aunt just happened to be at the table with me, but then, who would I be kidding? Uncle Dave knew just what to do... and as a result, I'm here today to spread the good word about health (aka. stay away from bagels).

I've asked my uncle Dave to be tomorrow's guest contributor. In addition to being a pretty cool uncle (he is a classically trained pianist, played in a cover band, is an avid fly fisher and a fantastic cook), he is also very wise! Dave is a practicing Physician Assistant in Western Massachusetts and is clearly my first point of contact when I need medical advice (he probably  knows way more about me than he'd ever wish to).

Tomorrow he will be sharing his thoughts on the dangers of abusing prescription drugs. Now we're not talking Xanax, Percocet or Valium. No, we're referring to your run-of-the-mill antibiotics. The kind we are all so quick to run to the doctor for! 

Stay tuned for Dave's article tomorrow! It might make you look at your medications a bit differently!

What's The Big Deal?: Grass-Fed vs. Grain-Fed

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If anyone should say 'NO' to red meat, it's this girl. I was once chased down by a pack of angry cows in a pasture in North Georgia (no, I didn't deserve it), I'm dating a guy who hates hamburgers (I know, I know, so un-American) and I recently watched the documentary 'Forks Over Knives' (yikes!). After watching it, I actually tried to be a vegetarian, or more specifically a pescatarian, but it was just too hard! I grew up eating my dad's amazing grilled hamburgers... I now date a committed carnivore... and I live in the restaurant capitol of the world! 

Give me a break!

Although I still eat meat, I have made a conscious decision to watch my intake, choosing the fish or veggie option when I'm not having an intense craving for that beefy goodness. I also try to buy (or order) grass-fed beef, since becoming more knowledgeable about the differences between grass-fed and grain-fed. 

Here's the quick breakdown so you can understand what you're eating and buying...

In the olden days of yore when children walked to school uphill both ways, the cows were grass-fed. They were placed in a pasture, and they did what they knew best - graze. But in more recent years, farmers got hip to the idea of feeding the cows grain - usually corn, soy, and other grains with LOTS of added hormones and antibiotics (not good for you, obviously). It was all about making money and making it fast! The corn fattened up the cattle faster, which meant they sold more meat each year. It also cost much less to feed cows grain because they didn't need to purchase and care for so much land. They were able to house more cows in a smaller space; thereby, increasing their profits.

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This all sounds lovely for the farmers' wallets, but what does it mean for us?

When we eat grain-fed beef, we are losing out on nutrients AND consuming more fat. It's as simple as this... grass-fed cows are ingesting grass and clover, which is where they obtain their omega-3's. According to studies, your grass-fed beef will have double the amount of heart-healthy omega-3's than the alternative, grain-fed beef. 

In addition to nutrient-content, your grass-fed beef is more lean, meaning you are consuming less total fat and calories. This of course will change the flavor profile slightly, since most of the flavor comes from fat, but I, for one, don't think the taste is noticeably different if the beef is cooked well. Even adding more butter to flavor your grass-fed beef will put you in a better position than choosing grain-fed because most of that butter won't cling to the meat. It will still add less saturated fat to your meal overall than if you went with the grain-fed option.

On the downside, grass-fed beef is slightly more expensive to purchase (with often a $2-3 price difference), but when you consider what you're doing for your body, in my opinion, it's worth the cost. If you consciously invest in your health then you will actively reap the rewards.

What do you think? Can you taste the difference? Are you willing to pay more? Leave a comment below!

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And... if you're in the NYC area, you can try one of my favorite grass-fed steaks at Gustorganics, the first and ONLY certified organic restaurant in New York City. They even have a USDA certified organic bar...now that's crazy talk!

GUSTORGANICS

519 6th Avenue (at 14th St.)

New York, NY 10011

212.242.5800