Antibiotics: The Good and The Bad
5-24-18
The first antibiotic was discovered by Alexander Fleming in 1928 and it changed the world as Penicillin hit the scene and started being used in the 1940s.
What are antibiotics? There is much confusion about this in the general population. Antibiotics are medications that are used to kill or stop the growth of bacteria. They do not treat viruses or fungus. Let me repeat that….. ANTIBIOTICS DO NOT TREAT VIRUSES. This is important because most infections that we contract from each other are viral including most sinus infections, sore throat, and bronchitis. In fact, most of the time, if you have had symptoms less than 7 days, then you do not need an antibiotic because 90% of the time upper respiratory infections are viral and your body will kill the virus on its own. There are special situations where antibiotics are needed before that time so you should definitely see your physician to be evaluated. In general, bronchitis should not be treated with antibiotics unless you have a lung disease. Colds/sinus infections should not be treated with antibiotics unless you have other medical conditions that put you at risk or they last longer than a week.
Why is it important to limit your antibiotic usage?
1. Not all bacteria are bad. We have many bacteria growing throughout our bodies: on our skin, in our colon, in our urinary tract…… and guess what…… They are protective. They protect you from getting an overgrowth of bad bacteria. It is like a constant fight between good and evil. The problem is that antibiotics do not respect either one, they kill both good and bad bacteria. So after ALL the bacteria die when you take an antibiotic, it is a race to see which bacteria grow back faster, the Good or the BAD. The bacteria that normally and healthily live in and on your body are called your microbiome. I am under the belief that the microbiome shapes much of our health. In the next few years, I think there will be more studies revealing what long term health problems result from an unhealthy microbiome.
2. The World Health Organization classifies antimicrobial resistance as a serious threat. We are seeing less and less antibiotics being able to treat serious infections. That is because the bacteria are smart and the more they are exposed to antibiotics, the higher chance they have of developing a resistance to that antibiotic. So limiting how much you take antibiotics is the best way you can prevent bacteria in your body from developing resistance.
3. Your body was made to fight most infections. Many of the times you have a minor infection, your immune system will mount a response to kill off the infection. You should see a doctor to help you decide this.
So what is the take home message? ………. See a physician about infections and ask if antibiotics are necessary, and if not then try to let your body do the healing. Sometimes I tell patients that I will write them a prescription for an antibiotic for their infection, but to try to hold off 2 or 3 more days before filling the prescription to see if the infection will clear without it. This allows your good microbiome to stay healthy.
Seth Jarrell, MD
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How Do Doctors Recommend You Treat the Flu?
1-10-18
How do we treat the flu? The website below has a really good explanation. The flu vaccine is still the best option even this late. It is only working 10% of the time to prevent the flu this year but that’s a 10% better chance that you won’t get the flu at all. Antibiotics do not help because it’s a virus not a bacteria. The best treatment is the tincture of time. It jus takes a lot of time to get better. No magic medications help that much.
Some other tips:
• Gatorade G2 has a good amount of electrolytes. Drink at least 4 bottles a day while having a fever. You can become easily dehydrated.
• Tylenol 1000mg every 8 hours
• Ibuprofen can be added to it (unless you have health conditions prohibiting this)
• Tamiflu can shorten the duration of symptoms if you start it early
• Mucinex-DM helps with the cough.
• Pseudophed can help with the sinus congestion (do not use if you have heart conditions and watch for elevated blood pressure).
• Humidifiers can help with all of the above especially with our very dry air.
It can take up to a month for the cough and sinus congestion to go away and there are no magic medicines to make it go away faster unfortunately.
If after 7 days you run another fever (over 100F) or if you become short of breath, go back to your doctor because you can develop a pneumonia after having the flu and you may need antibiotics then.
Read the article, it is good:
http://www.slate.com/articles/health_and_science/medical_examiner/2018/01/how_to_handle_the_flu.html
Seth Jarrell, MD
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3rd Leading Cause of Death in America: COPD and other Lung Diseases
11/29/2017
From the CDC Website:
“Cigarette smoking is the leading cause of preventable disease and death in the United States, accounting for more than 480,000 deaths every year, or 1 of every 5 deaths. In 2015, about 15 of every 100 U.S. adults aged 18 years or older (15.1%) currently smoked cigarettes. This means an estimated 36.5 million adults in the United States currently smoke cigarettes. More than 16 million Americans live with a smoking-related disease.”
Its hard to imagine this many people smoking. I know I see it every single day in my practice and I see the many side effects of smoking. If you take a look at the CDC website (https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm) you can view the statistics by gender, race, age, region, etc. Here in the South, we have much higher rates of smoking. I bring this up because today I am presenting to you the third leading cause of death in the United States: COPD and other Lung Diseases.
COPD is short for Chronic Obstructive Lung Disease. Some people have heard it called emphysema or chronic bronchitis which are both subcategories of COPD. Smoking tobacco is the cause of 85-90% of COPD. Less common causes of COPD are occupational exposures (coal, chemical, etc.), environmental pollution, childhood illnesses, recurrent lung infections, genetic defects (alpha 1 antitrypsin deficiency), and chronic asthma. The first illustration below shows the cause of COPD.
The second illustration shows the main difference between chronic bronchitis and emphysema. In both cases, carbon dioxide is trapped in the lungs and unable to be expired into the atmosphere.
The moral of the story is that the longer you smoke, the more chance you will have of getting COPD due to the fact that smoking causes damage to the lungs. Once the damage has been caused, there is no reversing it, but if you stop smoking, the progressive decline in your lung function can stop as well. Stopping smoking will also decrease the amount of lung and sinus infections you get as well.
There is never a better time to quit smoking than now. We have more medication options to help you quit smoking than ever before. Welbutrin, Chantix, nicotine replacement gum, nicotine patches, or any combination. There is also some very good resources to educate yourself about the best ways to quit smoking. 1-800-QUITNOW is run by the CDC and is a terrific place to start. You can either call the number or go to the informational sheet here:
https://www.cdc.gov/tobacco/quit_smoking/cessation/pdfs/1800quitnow_faq.pdf
Another great website with resources is:
https://smokefree.gov/
Teaching and guiding patients to take the reigns of their own health is a passion of mine. So, if you or someone you care about have any questions about COPD, quitting smoking, or other lung diseases, please feel free to make an appointment and I will be happy to sit down and talk with you and them about it.
Seth Jarrell, MD
2nd Leading Cause of Death in America: Cancer
11/25/2017
The second leading cause of death in America is that nasty and dreaded C word… Cancer. Just the mention of it carries a sense of doom. It is scary, but many things have changed in the last 20 years regarding cancer. We have many ways to screen and prevent cancer now, and we have much improved treatments for many types of cancers. We will discuss that in more detail but first let’s clear up some confusion.
Benign – means not cancer
Malignant – means cancer
Metastatic – means the cancer has spread to other organs besides the primary site
The top 3 Cancers overall (Men and Women combined)
1. Skin cancer
2. Lung cancer
3. Colon cancer
The top 4 cancers in men
1. Skin cancer
2. Prostate cancer
3. Lung cancer
4. Colon cancer
The top 4 cancers in women
1. Skin cancer
2. Breast cancer
3. Lung cancer
4. Colon cancer
Now let’s talk about them individually:
Skin cancer is for the most part preventable (but not always). UV rays are one of the main risk factors for developing skin cancer. UV-A rays cause more aging issues (A for age 😋) and UV-B rays cause damage to the DNA in your skin leading to cancer. The most common types of skin cancers are basal cell and squamous cell carcinomas. These are easily treatable in my office with removal. You can schedule a full body check once a year if you like. The most ominous skin cancer is melanoma. It is much more rare but also much more aggressive. To prevent skin cancer, make sure you are wearing sunscreen when going outside and covering up with protective clothing and a hat (it will also keep you from aging as quickly 🤔). There has also been some evidence that Vitamin B3 (nicotinamide) taken orally can decrease non-melanoma skin cancers.
Lung cancer is for the most part preventable as well by simply not smoking. Some lung cancers do occur in people who do not smoke but this is rare. If you happen to be a smoker or smoked in the past, there is a newer screening tool that has been shown to detect early lung cancers. It is a low dose CT (cat scan) for smokers at age 55-80 yearly if the person has a 30 year pack history and is a current smoker or quit in last 15 years. A large problem with this is that we find many spots on the lungs with this screen that most of the time are nothing to worry about but end up requiring a biopsy. It can sometimes bring a lot of stress on the patient. The best way to prevent lung cancer is to stop smoking or never smoke at all.
Colon cancer is also very preventable in many cases. We recommend starting screening for colon cancer at age 50 (unless someone in your family had colon cancer at a young age, then we may screen earlier). The best way to screen for colon cancer is with a colonoscopy every ten years. The great thing about colonoscopy is that precancerous polyps can be completely removed. There are other options as well including Cologuard which tests your stool for cancer DNA. During your yearly wellness physical, you should discuss this with your physician and let him or her know if you have seen any blood in your stools.
Prostate cancer is a prime example of how we doctors do not always get things correct. The guidelines on screening for prostate cancer have changed multiple times in the last 20 years. If a man were to live to be 100, most men would develop prostate cancer… but most prostate cancers never cause any problems and the man would have never known he even had it. In fact, he would have likely passed away from something else like pneumonia. The tricky part is that it has been hard to determine which types of prostate cancer are those slow growing cancers that cause no troubles and which type are the aggressive cancers. Currently, I follow these screening guidelines: check a PSA (blood test) every year starting at age 55 to age 69 or older. The only time I do a digital rectal exam is if you are having symptoms with your prostate (lucky you). If your PSA is elevated, you will need further testing from a Urologist.
Breast cancer screening has become highly publicized in the media over the last 20 years which has led to a much higher awareness amongst women to be screened. Unfortunately, there is a lot of false information on the internet and TV. There is also debate amongst physicians and societies on what age and how often a woman should be screened for breast cancer. The main part of this debate stems from the fact that the earlier we screen a woman in her life and the more often a woman is screened leads to more abnormalities on the screens/images. Those abnormalities most of the time are absolutely nothing to worry about. In the medical field, we call those false positives. Those false positives lead to more images being performed, more biopsies, and more surgeries that likely were never needed. That can be quite stressful and anxiety laden for a woman. This is the main reason many societies have recommended waiting until a later age to screen women. The guidelines I follow for breast cancer screening are as follows: Mammograms starting at age 50 then every 2 years. Stop at age 75 if your life expectancy is less than 10 years. If you have a high risk of breast cancer or a family history of breast cancer then I start screening at age 40 every year with a mammogram. This should be addressed at your yearly wellness physical as well.
There are many other forms of cancer. The main ways to prevent most cancers are to eat a healthy diet of many fruits and vegetables, stay within a normal weight range (obesity is a big risk factor for cancer), exercise regularly, wear sunscreen, do not smoke, keep alcohol intake low, and discuss your screening tests yearly with your physician. If you need your yearly physical, give us a call to schedule it now. Happy Thanksgiving weekend to everyone!
Seth Jarrell, MD
Heart Disease – #1 Cause of Death in The US 11/12/2017
After yesterday‘s very close win by Alabama over Mississippi State, I thought it would be very prudent to discuss the number one cause of death in the United States which is heart disease. I am sure many of you had some close calls with all the stress that mounted in this state last night. There are many forms of heart disease including:
1. Coronary artery disease: plaque that develops inside of the arteries that run to the heart. Think of this like plumbing. As a pipe develops build up, less fluid is able to travel through the pipe. As coronary arteries develop plaque, less blood is able to travel to the heart. When those plaques become unstable, they break off and cause a clot to form which is known as a heart attack.
2. Congestive heart failure: weakening of the heart in which it is no longer able to pump blood to the organs effectively. Think of this like a water pump or motor. As the motor becomes weaker, it is unable to pump the water as quickly or effectively as it used to. Therefore, as a person‘s heart but comes weak, it is unable to supply the blood to the lungs and muscles, therefore a person becomes tired and short of breath much quicker. This is also why a person with congestive heart failure swells in the legs is because the heart is no longer able to pump the blood from the legs back up to the heart efficiently.
3. Valvular heart disease: one or more of the four valves of the heart is malfunctioning. Stiff valves lead to more pressure in the heart, and leaky valves cause the heart to function less efficient.
4. Arrhythmias: the regular rhythm of the heart is either no longer regular or is not being transmitted from where it should be. Examples are atrial fibrillation or ventricular tachycardia.
5. Many others that are much more rare.
Many of these causes our genetic but many of them are also a result of how we live our lives.
Some of the best ways to prevent heart disease are:
Blood pressure control
Diabetes control
Cholesterol control
Stopping smoking
Decreasing alcohol intake
Cardiovascular exercise
Weight loss to a normal weight
Healthy eating
Stress control
If you would like to discuss this in more detail, please feel free to make an appointment and we can make an individualized plan to keep you at the lowest risk for developing heart disease. I encourage everyone to have at least yearly appointment with a physician to keep your risk for heart disease at a minimum.
Seth Jarrell, MD
———————————————————————————————————————————————————————————–Top 10 Causes of Death in the US11/4/2017
Have you ever wondered what things people most commonly pass away from in the United States? Over the next few weeks to months, I am going to discuss each one. Here is a list from the CDC for the top causes of death overall. The picture linked breaks it down by age group.
1. Heart Disease2. Cancer3. COPD and other chronic lung diseases4. Accidental Injury5. Strokes6. Alzheimer’s Disease7. Diabetes8. Flu and Pneumonia9. Kidney Disease10. Suicide Many of these causes of death are preventable or the risk can be decreased significantly. If you or someone you know does not have a primary physician you are seeing at least yearly for checkups, please give our office a call and we can put you on the path toward preventing disease.
Being overweight can be a huge struggle. It can be very hard to lose weight, and it is much harder for some people than others. The reason it is harder is not simple. It has to do with genetics, gut bacteria, upbringing, and how active you are. Regardless, obesity has become an epidemic and needs to be addressed as obesity can lead to many medical problems.
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