Abx said:
…We have a mix of several loosely related scenarios being discussed simultaneously, with some resulting confusion. I certainly did not mean to imply a scenario of a random treatment for an unspecified illness…
I am writing on this topic once again…not to try and change the minds of those already solid in the belief in the practice. I definately feel easily bated by what I feel is a continuing dangerous topic with a great deal of potential for misinformation. My goal is to hopefully prevent someone lacking proper training or education from reading this thread and being inappropriately led down the wrong path.
Abx said:
It may! Absolutely, it may hurt or kill you! Even those that for one reason or another champion the notion of “just in case” carrying/stockpiling say it may and can hurt you. The fact that you or someone in your family may have been treated with antibiotics in the past without any issues does NOT mean they or any other medication (prescribed by a trained healthcare provider) is benign and without risk.
Abx said:
…There can be significant risks involved with misdiagnosing and mismedicating…
Abx said:
…16mo daughter ...a Rx for amoxicillin An hour into the drive the daughter had a reaction to the Rx.
The daughter first went on amoxicillin...doc switched her to augmentin ...
Abx said:
...The medical community - and my own current physician - say I shouldn't have access to antibiotics unless they think I need them. I prefer to decide what I should and shouldn't have...
This of course goes back to my sense of of people wanting what they want when they
perceive a need. Your healthcare provider should be trained and licensed. He/she has far more training and experience then they can impart to you. It is their license and LIABILITY when it comes to prescribing. We may all like to “have it your way” in America. However, he/she should prescribe based on what is
medically reasonable and appropriate practice. Now, the patient/camper should be able to be educated so he/she can self diagnose and treat??? I see patients arriving all the time to the hospital with resistant infections only to find out they tried to self “treat” themselves at home!
Too many healthcare providers have been pulled into the practice of giving medications because the patient “believes” he/she needs it or “believes” their child needs it. This has contributed greatly to the increasing level of resistant infections. Too often, people are prescribed Zpacks and other antibiotics for upper respiratory tract viral infections.
Abx said:
..Educate me, make me aware of the pros and cons, and then allow me to make my own decision…
I can NOT properly educate you here in this forum. You have a right to refuse treatment. However, it is not
medically reasonable and appropriate practice for you to determine what medications you are given and under what circumstance you should receive them. That is a task for someone properly trained to do so. It is their license and LIABILITY when it comes to prescribing. We (healthcare providers) can and do sometimes misdiagnose even with extensive training. It would be unethical and irresponsible to expect "educated" campers and the population as a whole to get it right without appropriate training.
Abx said:
...surely it is still worth being prepared for a very unlikely but still possible scenario?...
No. The best preparation you can or should engage in is hygiene and wound care. However, the shortest route for you to be “prepared” for diagnosing and prescribing treatment would be to go to physician assistance (PA) school and get trained and licensed. Once you are properly trained and licensed, you will likely see what I have tried to explain in this and other threads.
Abx said:
…I don't think you are looking at some of the other issues entirely reasonably…
I disagree. I am looking at this entire issue from a very well trained, professional, and reasonable perspective. I am responding to this from a very
medically reasonable and appropriate practice perspective based on an extensive foundation.
Abx said:
…Further, the greater level of exertion, exposure, etc., is likely to lead to lowered immune response for wounded people in the wilderness…
These same issues increase the risk of mistreatment and worsen the outcome if there is a adverse reaction to the medication. We are talking about a potentially dehydrated and exhausted untrained individual now reaching into their bag and choosing a medication for some diagnosis. Many of these medications do have adverse reactions under the best circumstances. They have end-organ damage issues in dehydrated patients, etc…
Abx said:
...I'm prone to ear infections and have considerable scarring. He felt I could loose my hearing in my right ear if I had an infection that went untreated for more than a week...
Given your description, you should have your ears checked by a specialist (ENT/Otolaryngologist). If he/she feels you should carry medications “just in case” then they should give you the script and correspond with your primary care provider. If he/she (ENT/Otolaryngologist) does not agree with you having these medications “just in case”, then your primary care provider (first one) likely was over zealous or the recent research/data in this area has likely changed.
Abx said:
…I do not see it as impossible, not even unlikely for serious outdoorspeople who like to be informed and prepared, that someone could carry multiple types of antibiotics, could have a strong idea of proper diagnosis and/or have a good reference, and could choose treatment appropriately…
You are of course describing the “pocket doctor”. Individuals can and do try to do this. I especially see it with those who have partial medical training (i.e. nurses) or have spent a great deal of time caring for family members (i.e. soccer moms). They often argue they have so much personal experience that they can do just fine independently. It is dangerous and inappropriate. I see their "patients" in the hospital all the time after complications from their "treatments".
Abx said:
…The medical community does not support individuals stockpiling medication for a number of reasons the least of which is the danger of self diagnosis which has merit…
I strongly believe the danger of “self diagnosis” is a major reason…not the least.
Abx said:
…Someone I know personally just died of this as they couldn’t afford to go to the DR, 22 yrs old…
That is unfortunate. However, he/she should have just gone to the ED. Our current healthcare system has financial difficulties because the poor and/or uneducated and/or undocument routinely use the ED for primary care. The US laws prevent Emergency Rooms from refusing care to
anyone because of any reason. I can not explain or understand why this 22yr old did not simply seek ED care.
I state for all reading this forum…go to the doctor. If you have no primary healthcare provider and have a medical condition, you should go to the Emergency room. If you can not arrange transportation, call 911 and an ambulance will take you…period.
Abx said:
…hey guess what; you've got them don’t you…If your Dr won't comply find another way…
…This of course is an attitude that directly reflects the issue. Individuals start thinking their own short courses of study and experience is adequate for “just in case”. Then they proceed to self treating for “only minor issues”. Some in this forum have even claimed to treat their families to avoid the bill and/or wait at emergency room or physician’s office.
DangerousStatement said:
...FISH antibiotics from vet suppliers...I treat myself, my family and pets all the time with them...Iv supplies and tubing etc…(taken from another thread)
DangerousStatement said:
...As for using them, I have done so very effectively for known illnesses I can easily diagnose especially in myself. Taking proper doses and duration is not rocket science if you can read ie, merck manual among many other text in my medical reference library...(taken from another thread)
DangerousStatement said:
...I just can't be bothered to go to the emergency room and wait 8 hrs for some ...intern to say it needs cleaning and if I want stitches or glue?...There is a vet type product ...not yet approved for humans…I want to give it a try next…(taken from another thread)
Abx said:
…Sure as s%@it your Dr has meds and Tamiflu etc....stockpiled for their family…
This quote is a poor application of the high school “everyone else is doing it so why don’t you”. This is not true. I DO NOT KEEP MEDS. I know numerous physicians and they do not keep meds. When someone in my family or I get sick or believe we will need antibiotics, we see our healthcare provider. I have enough training and knowledge to use them for myself, family, friends…and enough training, knowledge, and understanding to know it is as one has said “a fool hardy venture at best”. I would say that saying a physician (trained, qualified, and licensed in the proper diagnosis and treatment of disease) keeps antibiotics at home somehow justifies a non-physician doing the same is inappropriate comparison.
Abx said:
...because of my own ignorance thinking that there could be a relationship between viral and bacterial...
That is the entire point! Individuals are ignorant. I state that not as insult but as fact. Individuals lack the proper training and knowledge, thus ignorant. There are numerous statements made in error on what those actually trained in medicine know to be the very basic principles. There is a large foundation of information. Just because you can read a PDR or Merck Manual (etc...) does not replace the need or importance of the foundation you lack.
Abx said:
...John Wiseman says in 'the sas survival book' to put antibiotics in your small survival tin,...Would he waste precious space in the survival tin if he didnt think they where important ?
There is in medicine a principal called “evidence based medicine”. We in the medical community have moved away from simply doing something because our professor did it that way. Numerous individuals have been hurt and killed over hundreds of years by practitioners that provided treatment because someone told them about it. I can not tell you why John Wiseman says or does what he does. I can say the current infectious disease literature and data does not support “just in case” antibiotics stockpiled or otherwise. You can contact John Wiseman and chat with him if you like.
Abx said:
...Fact is, a full doseage of antibiotics would take up a considerable amount of room in a small kit and taking advice to only carry a few, is in my opinion, a fool hardy venture at best…
Agreed.
longbow50 said:
...Since most bacterial infections occur from cuts and abrasions, antibacterial or antiseptic wipes would be the wisest choice here. There are a wide variety of them available...
Agreed.
Abx said:
…there are infections that can come on very quick that are not skin injury related that can be fought with a few tabs until you get back to civilization…
I don’t know what infections you are talking about but very few “come on very quick” infections will be treated by carrying some random antibiotics. I know that the CDC and travel medicine clinic do recommend carrying specific antibiotics when traveling to specific countries for treatment of specific endemic illnesses. Again, these are prescribed meds for specific situations.
Abx said:
…think stomach infections that can benefit from a few metronidazole tabs or a lung infection you develop ovenight which is very common.
I dont go anywhere without 3 days worth of Metronidazole and Keflex…
This very statement goes back to the lack of basic understanding and training. It goes back to “a mix of several loosely related scenarios being discussed simultaneously, with some resulting confusion”. It is a dangerous statement. Gastroenteritis is generally NOT a “stomach infection”. A “lung infection” (I’m guessing you mean pneumonia) would not generally be treated with either of these agents.
Final points:
1. I am not going to educate you on what to take and when to take it and how long. Not because I think I am better then you or smarter then you…I probably am not. The reason is that it would be irresponsible to try and do in a online forum what takes years of training. It is not reasonable to think we can self teach ourselves through these little chats. I wish I could become a wilderness specialist by coming to this or another forum but I can’t and neither can anyone become a trained diagnostician and treatment specialist.
2. Stockpiling just in case meds by untrained individuals is dangerous and irresponsible. There are real risks.
3. Keflex (cephalexin)/Flagyl (metronidazol) are generally NOT treatments for Pneumonia/Pneumonitis/Bronchitis/etc…
4. Dental abscess generally NOT treated with keflex/Ciprofloxin/etc…
5. Leptospirosis generally has a 7-13 day incubation period, it is not an easy diagnosis nor is it an easy treatment by the untrained. Prophylaxis is given to those working in high risk environments (i.e. talk with your primary care physician to find out if it applies to you).
6. There is no place for treating a virus with an “antibiotic”. You can treat Herpes and such with appropriate anti-virals…completely different issue.
7. People are hurt and have died from treating infectious diarrhea with immodium (Yes, I know nobody has recommended this course. However, someone may see that medication in this thread and behave innappropriately).
Again, I apologize if my back ground and training make my position unreasonable or overdramatic. Unfortunately, I do see the end product of individuals, well-meaning, self treating and treaing others. I see more and more patients arriving with resistent infections because of the high environmental load of antibiotics. I see patients arriving with disasterous intestinal infections because they self treated a "respiratory tract infection" with antibiotics....they unkowingly changed their microflora and suffered! I see patients die from over the counter medications like immodium or aspirin or ibuprofen. I have taken an oath to do no harm. I take it seriously. I think about this when I do prescribe and when I do not. Both, I think are important to consider. I believe a good healthcare provider will take this into consideration when he/she chooses to provide or not provide medications.
