LIVING WELL WITH CANCER

Both my parents experienced the sudden change in life’s priorities associated with the diagnosis of inoperable cancer.  Suddenly, things that have occupied our mind, time and energy are reappraised in light of a stark reminder of life’s uncertainty and our mortality. Hope is kept alive by modern medicine’s remarkable results with conventional treatments and the fact that some individuals do much better than expected, even with serious and advanced cancer.

….FULL ARTICLE

MINDFULNESS AND GRATITUDE FOR YOUR AGING EYES

Most people say the gift of sight is their most valuable sense perception – and almost everyone experiences decline in visual function with aging. B One of the most common symptoms of aging is the decline in accommodation, the process by which the eye changes (accommodates) focus to maintain a clear image of objects at different distances. This decline often begins before age 50 years. Accommodation acts like an automatic reflex, but it can also be consciously controlled.

….FULL ARTICLE

THE MINDFUL GIFT OF LOVING KINDNESS

The holiday season is filled with emotion for most people. While this emotion is often happy, positive and loving, for many people it can be very unhappy and even depressing. Holiday music can trigger emotional associations with the absence of a loved one or unhappy memories from the past. The gap between the smiling faces of holiday ads and one’s unhappy emotional experience can actually lead to a deepening of the emotional darkness that often accompanies this season of lights.

….FULL ARTICLE

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USING ANTIBIOTICS WISELY

Is it necessary, or even safe, to take an antibiotic for your next illness?


This question is becoming a routine part of conversations between consumers and health providers. The way we answer this question has serious implications. Consumers and health care providers are both being urged to help achieve the goals of good medicine and public health: making a correct diagnosis, using antibiotics only if the diagnosis war- rants and avoiding harm to patients and the general public caused by unnecessary antibiotic use.


The overuse of antibiotics is contributing to an alarming increase in antibiotic resistance, leading to the emergence of untreatable, potentially fatal “superbugs. ” The more bacteria are exposed to antibiotics, the more they develop resistance to them. Many bacteria that were previously susceptible to antibiotics have developed resistance that makes them difficult or impossible to treat.


It is estimated that 11 million (or over half) of the prescriptions for U.S. antibiotics written each year are unnecessary, with roughly 12 percent called in over the phone without an examination. Medical and public health authorities are sounding the alarm as antibiotic-resistant infections cause 2 million illnesses and 23,000 deaths in the United States each year. Many additional deaths result from other conditions complicated by an

antibiotic-resistant infection.


Responding to calls from the medical and public health communities, President Barack Obama created in 2014 the Task Force for Combating Antibiotic-Resistant Bacteria. Highlighting this issue’s impotance, the Secretaries of Defense, Agriculture and Health and Human Services co-chair the Task Force. The Centers for Disease Control and Prevention (CDC) has designated Nov. 14-20, 2016 as Get Smart About Antibiotics Week. This annual observance raises awareness of the threat of antibiotic resistance and the importance of appropriate antibiotic prescribing. CDC director Thomas Frieden says, “We must be diligent stewards of antibiotics, protecting this precious resource in doctors’ offices, homes and farms so that they are available to help us and our children in the future.”


The global importance of antibiotic resistance is underscored by simultaneous international observances, including European Antibiotic Awareness Day, Australian Antibiotic Awareness Week and Antibiotic Awareness Week in Canada.


Most coughs, colds and upper respiratory illnesses are caused by viruses – not

bacteria. Antibiotics kill bacteria – not viruses. Therefore, it is important to use scientifically based guidelines and sound judgment to determine whether an ear, sinus, throat or chest condition is caused by bacteria or a virus. While it is not always possible to distinguish between viral and bacterial conditions, there are guidelines that help consumers, parents and clinicians make wise choices.


Health care providers often treat specific symptoms (such as fever, aches and congestion) with rest, saltwater nose drops, humidification and lots of warm liquids. There is little evidence that over-the-counter cough and cold medications help children, though they can cause side effects, including death. Even many childhood ear infections resolve without antibiotics. Therefore, health care providers may not prescribe antibiotics unless the ear infection persists or worsens.


Four out of five sore throats are caused by viruses and do not require antibiotics. An office exam can determine the likelihood of a bacterial infection (strep throat), which requires an antibiotic. The Infectious Diseases Society of America recommends antibiotic use only when a strep throat is confirmed by a throat swab.


Many “sinus infections” are not infections at all but are caused by allergies and may respond to allergy medication. When an infection is present, it is more likely to be viral rather than bacterial. However, there is no easy test to distinguish viral from bacterial sinusitis. Even the presence of colored mucus from the sinuses does not reliably predict a bacterial infection. Since 80 percent of sinus infections resolve within two weeks without treatment, current guidelines advise against using antibiotics in the first week of symptoms, unless the symptoms worsen after initial improvement.


Although coughing can be caused by many different conditions, the majority of coughs that accompany seasonal respiratory illnesses are not caused by bacteria and do not respond to antibiotics. The CDC recommends health care providers use the term “chest cold” in their efforts to explain that bronchitis is usually caused by a virus and typically resolves on its own.


Safety is a common goal of consumers and their health care providers, as we all try to avoid causing harm. Many consumers are unaware of the potential harm from antibiotics even when they are prescribed appropriately. Antibiotics are the most common cause of allergic drug reactions. These reactions can be serious and even fatal. Antibiotic-associated colitis can cause a diarrheal illness that can be life-threatening, especially in the elderly. Asthma occurs more frequently in children born to women who received antibiotics during pregnancy. Many women develop vaginal yeast infections from antibiotics, requiring another medication to treat the vaginitis, increasing overall cost and the risk of an allergic reaction to the second drug.


Health care providers and consumers have both contributed to antibiotic resistance and its alarming consequences. We are both being called upon to have frank conversations as we all strive for medical care that is safe, effective, scientific, economical, individualized, patient-centered and socially conscious.


Sources and Resources

Obama Administration Takes Actions to Combat Antibiotic- Resistant Bacteria.

Get Smart About Antibiotics. Centers for Disease Control and Prevention (CDC).

DR. JOHN PATTERSON

Dr. John Patterson is past president of the Kentucky Academy of Family Physicians and is board certified in family medicine and integrative holistic medicine. He is on the family practice faculty at the University of Kentucky College of Medicine and the University of Louisville School of Medicine, Saybrook University’s School of Mind Body Medicine (San Francisco) and the Center for Mind Body Medicine (Washington, D.C.). He operates the Mind Body Studio in Lexington, where he offers integrative medicine consultations

more articles by dr john patterson