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How Norway Fought Staph Infections 595

Posted by timothy
from the they-fired-adrian-monk dept.
eldavojohn writes "Studies are showing that Norway's dirtiest hospitals are actually cleaner than most other countries', and the reason for this is that Norwegians stopped taking antibiotics. A number of factors like paid sick leave and now restrictions on advertising for drugs make Norway an anomaly when it comes to diseases like Methicillin-resistant Staphylococcus aureus (MRSA). A Norwegian doctor explains, 'We don't throw antibiotics at every person with a fever. We tell them to hang on, wait and see, and we give them a Tylenol to feel better.' Norway is the most MRSA free country in the world. In a country like Japan, where 17,000 die from MRSA every year, 'doctors overprescribe antibiotics because they are given financial incentives to push drugs on patients.'"
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How Norway Fought Staph Infections

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  • by Ethanol-fueled (1125189) * on Sunday January 03, 2010 @03:52PM (#30634106) Homepage Journal
    The college I attended posted "OMG FLU Get VACCINATED!!!!1!" flyers everywhere and students were writing things like "bullshit" or "never got one, still alive" on them with magic markers. Glad to see years of media scaremongering and ultrapowerful pill-pushing lobbies haven't chipped away at the cynicism of youth.
  • by Sits (117492) on Sunday January 03, 2010 @03:53PM (#30634112) Homepage Journal

    I've heard a number of international folks complain that antibiotics are almost never prescribed in the UK and yet a number of UK hospitals have had MRSA outbreaks. Does anyone have a league table of the cleanliness of each country's hospitals?

  • by John Hasler (414242) on Sunday January 03, 2010 @03:57PM (#30634142) Homepage

    ...because the dogbite was infected (as they usually are)? Oh, well. Prosthetics are pretty good these days. This very nearly happened to an acquaintance of mine. Fortunately three days in the hospital on an antibiotic drip saved the arm. Twenty years ago they would have given her antibiotics in the ER as a matter of course for an animal bite.

  • by MichaelSmith (789609) on Sunday January 03, 2010 @04:04PM (#30634186) Homepage Journal

    On holiday in Malaysia my son was sick so we took him to a doctor. The doctor couldn't really do anything. My son was reacting to the climate and refusing to eat solids but he gave us a bottle of antibiotic dispensed from his surgery "just in case"

    So I queried that and he quickly said oh well don't worry about it if you don't think he needs it. It seems that everybody in Malaysia just gets antibiotics automatically when they go to the doctor. My wife grew up in Malaysia and when she gets a cough she gets it for weeks at a time.

  • MD (Score:4, Interesting)

    by Anonymous Coward on Sunday January 03, 2010 @04:07PM (#30634222)

    As a medical doctor, I can attest to a general over-prescription of antibiotics. I work in Sweden, where we generally don't use as much antibiotics as other parts of the world, but I would say that we use far too much anyway. I am a surgical resident, who is often on call and have a lot of out-patients. The demand from patients that you prescribe some kind of antibiotics is huge, absolutely huge, even for simpler infections where there is little evidence that it will actually shorten the length of illness or level of symtoms. Trying to educate a patient on the matter in a few minutes is no easy task, and other than a general sense of responsibility, nothing keeps one doing just that. Even then, I often hear of my patients going to a different doctor after one or a couple of days and then getting a prescription, even if they haven't gotten any worse. I don't think that there is any easy fix to this problem. People expect a life free of disease, and if they do get some minor illness, they expect immediate recovery. (I am speaking very generally here, of course...)

  • by Anonymous Coward on Sunday January 03, 2010 @04:08PM (#30634230)

    MRSA has absolutely zilch to do with the cleanliness of hospitals, and using a generalism such as this is just lazy, please research before you comment.

    The problem is the world press being the morons that they are have associated MRSA with a hospital being dirty, the real cause of MRSA in hospitals is letting too many darn visitors into wards without making them scrub up first. Reduce visitor numbers and impose strict rules about washing of hands/contact with patients etc and the MRSA infection rate would nose dive...

  • by Anonymous Coward on Sunday January 03, 2010 @04:14PM (#30634278)

    At first the doctors blew it off as a normal infection even though I rarely get infections of any kind and it felt severe to me. The first few times they just perscribed regular antibiotics which knocked it back but it'd come back in two or three weeks. Finally some one though to check it out and it turned out to be MRSA so they gave me yet another antibiotic which followed the same knock it back comes back in a couple of week pattern. I was then told there was a better one for MRSA so they tried that. Same pattern but in the meantime I moved to another state and wound up with a new doctor that didn't trust her memory. She looked it up and said they were all using the wrong antibiotics and even the one she was going to perscribe was no longer recommended. Finally that series worked and I've been MRSA free for four months. Also I got a secondary infection from all the antibiotics that no one spotted inspite of complaints from me about another problem. That required medicine other than antibiotics to cure. Basically I received five different antibiotics mostly from doctor incompetence. And they wonder why antibiotics are over used? A lot of the problem too is doctors not believing patients. I rarely go to doctors but they still at first thought I was overreacting when I said I thought it was a serious infection. It was in my jaws and throat and I had trouble breathing and swallowing and even wound up going to the hospital once when my throat closed up. They still didn't take it seriously until the tests came back showing MRSA. Even then they didn't give me the right antibiotics. I also now have several scars on my face from later infections that could have been avoided if they had gotten it right the first time and not been so quick to blow me off. Medicine in the US is a train wreck. Did you know tens of thousands of patients die in hospital from neglect every year? I think the last number I heard a few years back was 80,000. That's a disgrace.

  • by geirnord (150896) on Sunday January 03, 2010 @04:21PM (#30634348)

    TFA is painting a picture about Norwegian hospitals that are easy to misinterpret. Yes, floor ar streaked and scratched, there is some dust on cabinets and blood pressure monitors.

    Howevery, there it is still not dirty and messy as can be interpreted by the article. Cleaning staff in Norway actually have a 3- year education in cleaning! Translated school information site [google.com] They learn how to spot the difference between dangerous and non-dangerous dirty surfaces. Think in your own home: The dust on the TV isn't dangerous, but the food spills on the kitchen counter can be. The cleaning staff is simply authorized and empowered to perform the important cleaning first, and leave non-dangerous dirt until they have the time to take care of it.

  • Re:Hmm... (Score:5, Interesting)

    by geirnord (150896) on Sunday January 03, 2010 @04:32PM (#30634410)

    I have a wife who have worked, and is working, in the these medical fields. According to her, we (Norway) have some of the strictest laws regarding veterinary use of antibiotics. We had some problems with overuse of antibiotics in the fish farming sector some years back. Since then things have gotten even tighter. In many other countries use of antibiotics as a preventative medication in food is the norm. This is not legal in Norway.

    The effect of this is not studied, at least to our knowledge, in any scientifically accurate way. However, I believe this is one of the reasons we do not have problems with MRSA in Norway. There are few natural places where you can be infected i nNorway, whereas in USA you can get MRSA from spending time at the beach!! Ref: http://pagingdrgupta.blogs.cnn.com/2009/02/16/mrsa-on-the-beach/ [cnn.com]

  • by yakumo.unr (833476) on Sunday January 03, 2010 @04:42PM (#30634466) Homepage
    Or was a quote altered to push a US (only?) brand?
  • by dgatwood (11270) on Sunday January 03, 2010 @04:49PM (#30634518) Journal

    While the doctors writing out scrips for antibiotics does play a role, one of the major factors should be patient education.

    Doctors prescribing antibiotics for individuals at home has likely had little impact on things like MRSA or C. diff. Those superbugs are almost nonexistent outside of hospital and nursing home environments. What this tells us is that antibiotics are overprescribed for people in hospitals and nursing homes. Why is this? Usually because people are much more likely to get a bacterial infection in those environments in the first place, people are in worse health and are thus unable to fight those infections off on their own, and thus more people legitimately need antibiotics in those environments.

    The only way to truly prevent resistant strains of antibiotics is to get people out of hospitals and nursing homes and back into individual homes where they are not at such a high risk of infection. In general, the absolute worst thing you can do for your health is go into the hospital. Between the constant lights and noises, nurses coming in every two hours when you should be sleeping to check your vitals (which are the same as they were the last time the b*****ds woke you up), the shared air handling with seriously sick people, the awful food that you don't want to eat, etc., it's a wonder anybody ever escapes hospitals alive.... :-D

  • by BoxedFlame (231097) on Sunday January 03, 2010 @04:52PM (#30634544) Homepage

    If you get staph in Norway, it's treatable. If you get it in the US it isn't. How does that not solve the problem?

  • by spineboy (22918) on Sunday January 03, 2010 @05:00PM (#30634620) Journal

    I'm a surgeon in the USA, and fell exactly that way, as do the majority of my colleagues. I also feel the same way about companies advertising for artificial hips and knees.
    Some patients will actually say.
      "I want the Jack Nickolaus artificial knee." They just have no freakin idea why they want it, or what about it makes it appropriate, or inappropriate for some people.

    I also think that the abmulance chasers should not be allowed to sue for any drug that has been approved by the FDA (unless there was some form of malice used to approve it).

    Ahhh - such is life.

  • by BoxedFlame (231097) on Sunday January 03, 2010 @05:06PM (#30634690) Homepage

    If the patient asks for antibiotics for a cold, the doctor can try to talk them out of it and if that fails he should just lie and give them a placebo and write it as such in their journal :P

  • by SirWinston (54399) on Sunday January 03, 2010 @05:29PM (#30634886)

    About 5 years ago, I had to give up my health insurance (Kaiser Permanente HMO, really) because we moved to a more rural area where they don't have local infrastructure. I didn't get regular health insurance from another company because my Kaiser coverage had been subsidized through an old employer plan, and everything else was too expensive. I worried that I'd get really sick and not have my HMO coverage, because I was used to going a few times a year for various things.

    Fast forward 5 years later, and I haven't been to a doctor or hospital at all in that time. I seem to get sick less often than I did before when I'd go to the HMO 3 or 4 times a year with minor ailments, and when I do get sick it's less serious and goes away faster. I've had no antibiotics in that time, just OTC meds (but I avoid fever-reducers unless my fever goes above 102, because fever is one of the body's natural defense mechanisms against microorganisms).

    The net result is that me and my immune system are happier, healthier, and wealthier, now that we're not over-relying on doctors and antibiotics. I also believe my household's complete lack of over-cleansing is part of the recipe for good health--people who clean obsessively and use that antibacterial cleanser are destroying harmless bacteria which usually "crowd out" the harmful strains, or at least leave them a minimal space to grow. But when your household is super-clean and a harmful bacterium arrives, it has room to grow everywhere since there's no existing bacterial ecosystem to compete with. Who knew that my stereotypical geeky tendency towards slight messiness and wearing the same clothes 2 days in a row thanks to all-night gaming/writing sessions might increase my health...

    I'm sure I'll have to visit the doctor or hospital eventually when something serious happens. Until then, I see my seemingly better health now than when I was going to the doctor several times a year as an anecdotal vindication of the hypothesis that too much cleanliness and hygiene and antibiotic use can be as bad or worse than none, because our immune systems need to develop and thrive by exposure to lesser bacteria in order to be ready to take on serious ones.

  • by martinX (672498) on Sunday January 03, 2010 @05:35PM (#30634936)
    There is a daily chaos, war and carnage in the microscopic world that we are not privy to and we have harnessed some of those weapons in our own antimicrobial war.

    Beta lactam antibiotics are derived from a naturally occurring substance. In the true spirit of evolution, an organism may produce a substance that inhibits its competitors in the ecological niche it occupies. This gives it a competitive advantage. Likewise, if an organism mutates to become resistant to this substance, it can reassert itself in that niche.

    When I first studied microbiology, conventional wisdom (shorthand for "I reckon this is true but don't really know") said that the genes that conferred beta-lactam resistance would exact too high a penalty on the Staph aureus making it unlikely to be found anywhere except in a hospital environment where it would be highly selected for. Well, community acquired MRSA turned that on its head. CA-MRSA can not only survive outside a hospital environment with no selective pressures, in some communities it thrives and becomes the dominant S. aureus infection.

    Our antibiotics may have refined MRSA, but it would certainly exist with or without us.
  • by Lord_Jeremy (1612839) on Sunday January 03, 2010 @05:38PM (#30634968)
    When I started showing signs of mental health issues and went to see a psychiatrist, their reaction was essentially throw the book at me. They put me on wave after wave of things I can't even pronounce, some of which had horrifying side effects. Eventually, I had such a bad psychological reaction to one of the meds that I had to be admitted to the emergency room. That night, my attending physician signed me over to an insanity ward and I spent three weeks there, unable to leave. Seriously, I was not allowed to leave because I was considered a "danger to myself and others". I can assure you this was not the case at all until people started messing with my head.

    My point is, these days with every small hiccup in orderly behavior, you get closer and closer to being tossed off a cliff into the pit of mental abnormality. Once you're in that pit, you're free game for doctors to control the way you think. I have friends that have gone through light bouts of depression but now will probably be on dangerous medication for the rest of their lives. I myself am on a dependancy-forming drug that alters the way I think and has a high risk of diabetes and liver failure. Years ago, there were no fancy drugs or somesuch to be prescribed for mental health conditions. For the most part, people just dealt with their issues. I would have gotten over my stress-related issues. Perhaps it would have involved a nervous breakdown, but the modern route put me through much worse.

    I suppose I'm on the business end of the whole mental health thing, so I'm bound to be biased. Even so, you do not want to get involved in this stuff. I have yet to hear of anyone that has actually been helped, or even not hurt by psychiatrists.
  • by 0100010001010011 (652467) on Sunday January 03, 2010 @05:40PM (#30634988)

    I recently went to India with friends and was the only person not to get Sick.

    Every single one of my travel companions had the GermX out and sanitized their hands after they did ANYTHING. When I separated from the group for the second half of the trip, I don't even think I washed my hands most of the time. I had a GREAT time walking out beyond the tourist traps into the 'old city' and trying stuff in the little shops. The Indians looked at me like they had never seen a white person trying 'their' food and the white people I told the story to just kept telling me "You're going to get sick. You're going to ruin your trip." (As they excused themselves to rush back to the bathroom). The water in the mountains (Sikkim) tasted... nothing short of amazing. It put all the bottled water to shame.

    I live the bachelors life and grew up in a dirty ole farmhouse. Sour cream/Jelly/AppleSauce has mold on the top? Scrape off the top and eat the rest. I've accidentally left milk out during the day and just come home, swish it around and put it back in the fridge. (As long as the taste isn't affected too much.) Unless I'm cooking for or around other people or expected to shake hands etc, I rarely wash my hands. Hell I'll go from #2 to the dinner table as long as the TP didn't break. Growing up I ate dog food, with the dogs, rolled around in the mud and put who knows what into my mouth.

    And guess what. I'm NEVER sick. No headcolds, no flus, no coughs, no phlegm. I'm not allergic to peanuts or other household items because my body is bored (it's just a theory). Compared to my college roommate, who grew up in what sounded nothing less than a clean room, who was sick when the weather changed. HAD to have the bottom bunk because of random nose bleeds in the middle of the night. Took a dozen or so pills for everything and still was always sick. Went through tissue paper at a box a week.

  • by 602 (652745) on Sunday January 03, 2010 @05:49PM (#30635058)
    I'm a primary care physician in the US. There are a number of logistical issues in the decision whether to prescribe antibiotics. They revolve around the ease of followup. It would be nice to always be able to say "You'll probably be fine. If you get sicker, come back." But if it's a Thursday or Friday, or if the patient lives an hour's drive from the clinic, or if I'm about to go on vacation, or if my schedule is overbooked for the next few days, I'm much more likely to prescribe an antibiotic. We need better access to care. Among the things that would help that would be (1) single payer insurance, so people could get care anywhere, and (2) better compensation for primary care providers (PCPs) which would result in (a) more of them, relative to specialists and (b) less need for existing PCP to overbook their schedules to make ends meet.
  • Re:Tip for USA (Score:3, Interesting)

    by Mishotaki (957104) on Sunday January 03, 2010 @05:52PM (#30635088)

    A Danish study showed you can cut sick days in kindergartens by half by forcing all children to wash their hands twice a day.

    Damned Danish commies! How dare they force their poor children to do something as horrible as murdering all those innocent bacterias!

  • by WegianWarrior (649800) on Sunday January 03, 2010 @06:02PM (#30635190) Journal
    Being a Norwegian married to an American, I feel I have a grasp of both sides of the issue - although I'll admidt that I don't have first hand experience of the US health care system.
    Yes, compared to their US conterparts Norwegian doctors are really stingy with antibiotics.Off course, part of what allows them to be - apart from the whole mindset - is a) that Norwegians can take up to three sick days off* without a note from their Doctor, and b) Norwegians have a single Doctor they need to relate to** so the Doctor knows the patient better and the patient knows the Doctor. In fact we - my better half and I - seldom gets away with any less than half an hour in the Doctors office; with as much time spendt catching up since last time as on the actuall medical stuff.
    Compare this to my inlaws who has to go to the Doc-in-a-box if they are feelign poorly, sit among other sickly people and wait for a Doctor - any Doctor who happen to be free - to have a look at them, give them a note and send them home (after a detour to work to hand in the note); probably with a prescription for a drug choosen not mainly on basis of what will help the most, but on what their insurance will cover. The staff isn't interested in making usre the patients gets the best care - it's all about processing them fast. So yes, I can see how easy it is to prescribe aome broad specter antibiotics if someone comes in with a fever - if it's an infection it'll knock it down, and if it's caused by something else you'll get the placebo effect. The patient is happy (and sick), the Doctor has done his job in ten minutes and my inlaws has spent half a day to get two days off work... whereas I could have picked up the phone, called my boss and told him I would stay home, rolled over and let my body handle it.
    And yes, I know I'm overgeneralising - but I'm trying to get a point across and that often work better if done with broad strokes.
    *) Part of the horror of a 'socialist healt care system'.
    **) Another part of the horrible 'socialist healt care syste' - if you don't like your Doctor you can go online to change; up to two times a year, more if you move.
  • by Anonymous Coward on Sunday January 03, 2010 @06:08PM (#30635242)

    That ain't nothing compared to Bayer + HIV.

  • by hachete (473378) on Sunday January 03, 2010 @06:21PM (#30635376) Homepage Journal

    In the UK, cleaning was almost universally outsourced, because of some management ideology about core-functions. It turns out that cleaning *is* a core function of a hospital (see a previous poster about the training of Norwegian cleaners) and should not be left to the cheapest bidder.

  • by cinnamon colbert (732724) on Sunday January 03, 2010 @06:23PM (#30635400) Journal

    I happen to be a bit of an expert in this field - no shit

    below is from memory; if people are really interested, i can pull out some references from the scientific literature that back all of this up
    MRSA stands for "methicillin resistant Staphylococcus aureus", and it was 1st detected in the UK in the (i think ) '60s

    lets backup a bit

    the human body is covered, inside and out, with bacteria, which can be harmful, neutral or beneficial - for instance, vitamin B12, a requirement for life, is made by bacteria.
    All humans carry Staphylococcus epidermidis; ~ 20% also carry S aureus, which prefers to live in moist places like the inside of the nose (anterior nares) throat, axilla, groin and rectum. Epidermidis is pretty harmless, except for people with implanted devices like catheters; since epi likes "surfaces" it tends to colonize the surface of catheters.
    Most people have either epi or aureus, but not both,and these two bugs are a small part of the total skin microflora.

    In general, having S aureus on your skin or in your nose does not seem to be harmful; however, if you have a cut, and aureus gains entry to the bloodstream, this is a very serious matter. S aureus , whoose genome is sequenced, carrys a host of "virulence factors" that make it a particularly dangerous infection in the blood; in th era before antibiotics, the mortality rate for aureus septicemia was over 50%, and perhaps 80% in some hospitals (!).

    That is, ify ou were a physcian in the most advanced medical center in the world in the 1940s, and a healthy patient got an aureus infection in the blood - perhaps due to infection of a surgical site , where the skin is open- there was a 50% chance that pateint would die. Aureus also tends to grow on the heartvalves, which is the disease known as endocarditis; i should think it obvious that having a film of bacteria on your heart valves is not a good idea.

    It is easy to see how penicillin, which was very effective, was viewed as a miracle drug. However, within a few years, aureus became resistant to penicillin, and hospitals were starting to see epidemics of untreatable penicillin resistant aureus.

    Luckily, the pharmaceutical compnaies and thier scientists had variations of penicillin - the first was methicillin; since then, dozens of beta lactam antibiotics, the mot advanced of which are the carbapenems and fifth generation cephalosporins (wikipedia is good here) have ben developed.
    Staph took 10-20 years to become resistant to methicillin; however, when staph do become resistant, they do so by aquisition of a virus like element (SCCmec) which often carries resistance to a whole host of other antibiotics, so that MRSA is actually a bug that is resistant to many drugs. (technically, SCCmec encodes a replacement for PBP2a, PBP2a', which has a lactam resistant transpeptidase function; but no transglycosylase). the origin of SCCmec is unkown.

    The drugs of choice for MRSA are vancomycin, daptomycin and colistin; ceftobiprole, approved in canada and switzerland , is supposed to be very effective.
    Vancomycin is very $ and nephrotoxic; the others are worse.

    If one looks at different countrys around the world, one sees that some countrys - in particular the netherlands and the scandanavian countrys - have very low rates of MRSA, that is most of the aureus is methicillin sensitive.

    However, if you look in detail - and believe me, a lot of scientists have looked very hard - it is hard to find one particular reason why these countrys have low rates of MRSA; rather, it seems to be due to a "bundle" of practices. In general, these countrys have good antibiotic stewardship - drugs are not prescribed unless you need them; they spnd a lot on controlling outbreaks, and they are very carefull to test people from outside the country, who might hve MRSA, when they enter the hospital.

    In the US, the statistics on how many people get MRSA and how many die have been compiled by several authors; the most well known is monica klevens of the CDC.
    Now it

  • by ciroknight (601098) on Sunday January 03, 2010 @07:02PM (#30635708)
    Antibiotics don't prevent organ rejection, that would be immunosuppressant drugs.

    You get an infection, your immune system goes into overdrive to beat it and will soon start attacking the transplanted organ. You will soon afterwards reject the organ. Case and point, you can't do an organ transplant without antibiotics, whether or not you consider it a proximal or distal necessity. Organ transplant patients are often drowned in antibiotics if they get so much as a fever, since their immunosuppressant drugs prevent their bodies from overreacting to infection.

    if your sore throat (throat ache, whatever) is actually strep throat you need antibiotics to prevent rheumatic fever

    No you don't. You may need antibiotics if your infection doesn't go away on its own, but most people's immune systems are active enough to beat a mild strep infection. The main reason we have rapid strep infections and copious azithromycin prescriptions is that the people who most often get strep infections are students and office workers, neither of which will take the necessary time off when they get ill, and therefore need to get over the illness as fast as possible to prevent spreading it. If the same sick people stayed at home, it's far less likely they'd spread the infection, and they'd (most likely) get over it on their own. This is precisely what Norway has implemented.

    It's the same reason everyone wants the 'cure to the common cold' and the reason flu shots are becoming much more common in school aged children. If there was a drug that effectively treated the flu, you can rest assured it'd fly off the shelves in America, and people would stay right at work, spreading the flu on to other coworkers instead of just taking a sick day or a few and getting over it on their own.

    dog bites are much cleaner than human bites and usually don't require prophylactic antibiotics

    While they're 'cleaner' than human bites, meaning that dog's mouths have more active immune systems and thusly carry less nasty, disease causing germs, the fact remains that they do carry germs, and many dogs are carriers of much nastier bacteria than the human mouth contains, for example Strep A which can cause "the flesh eating" disease necrotizing fasciitis. If you get a dog bite, you absolutely want to wash the area thoroughly and at least treat the wound with a topical antibiotic solution as a prophylactic ("neosplorin" as many people in America know it). In fact, broken skin is probably the best overall reason to use antibiotics, as even relatively simple skin infections can quickly jump to the bloodstream and cause quick onset sepsis and death, sometimes even in healthy individuals.
  • by scottv67 (731709) on Sunday January 03, 2010 @08:11PM (#30636298)
    >And guess what. I'm NEVER sick. No headcolds, no flus, no coughs, no phlegm. I'm not allergic to peanuts or other household items because my body is bored (it's just a theory).

    Please, please, please stop repeating that "your immune system is fragile/angry because Mommy and Daddy didn't love you enough to let you crawl on the dirty kitchen floor" BULLSHIT. Your personal health history is just one data point. Just because you lived like a pig as a child and you now have very few health problems doesn't mean that theory applies to everyone.

    I grew up exposed to plenty of mud, dirt, animals and hay. Guess what? I am allergic to nearly everything that my asthma doctor has tested me for. Trees, pollen, animal dander, etc. I also take medications every day to keep my asthma in check. Why didn't the mud and dust and the hay loft impart a Superman-like immune system to me? Because your theory is BULLSHIT. I know why I have the health problems that I have: genetics. I inherited these "features".

    Another data point for your "clean kids are sick kids" theory: While I am alllergic to just about everything and I take Advair morning and night to keep my bronchii happy, my brother has none of these issues. We grew up in the same house, exposed to the same mud, wood smoke, hay, grass, etc. Why am I allergic to a great number of things when my brother (just a few years younger than me) is allergic to nothing and had never had a problem breathing in his life? Explain that one to me... The answer is genetics, not exposure to mud.

    >Compared to my college roommate, who grew up in what sounded nothing less than a clean room, who was sick when the weather changed. HAD to have the bottom bunk because of random nose bleeds in the middle of the night.

    Your college roommate probably grew up in a "clean room" because his parents found out early in his life that he had certain health problems and made adjustments to his living conditions to minimize his symptoms. Did he grow up without carpeting in his bedroom? No stuffed animals? No pets in the house? Did he have to wash his hands after petting the neighbor's cat? Was he told to stay out of the hay loft? These are most likely reactions to his health problems and definitely not the cause of them. He lived in a "clean room" because it was one of the ways to minimize his symptoms.

    I am very glad that you have excellent health. But please stop spreading that "clean kids will have weak immune systems" myth. Thank you.
  • by fyngyrz (762201) on Sunday January 03, 2010 @08:11PM (#30636300) Homepage Journal

    Yeah. That's why everybody had a life expectancy > 100 years before antibiotics were discovered.

    You know, there's a lot of misunderstanding about that. I've got the family genealogy back to about 1575, and a lot of the adults in the family lived into their 70's or eighties and a surprising number even longer than that. But the average age of death? Still about age thirty. You know why? Infant and child mortality. Lots and lots of dead babies and very young children. But for those who made it to adulthood, they lived pretty long. They not only did that without a lot of efficacious drugs, they did in the face of a lot of quack medicine and what we would consider very bad habits.

  • by yndrd1984 (730475) on Sunday January 03, 2010 @11:37PM (#30637534)

    Vaccines and antibiotics are fundamentally different (flu shots and other vaccines are not part of the superbug problem), but the mindset remains the same.

    Actually, they're opposites - popular culture pushes people away from vaccines (the second most effective medical intervention in human history) because they "cause autism" and other such nonsense, and toward antibiotics (that generate superbugs) even for viral infections that they're totally ineffective against.

    The logical, manipulative answer is obvious - tell a bunch of uneducated celebrities that vaccines don't cause autism, but that antibiotics do cause it. :)

  • by Anonymous Coward on Monday January 04, 2010 @01:03AM (#30637880)

    "I suppose I'm on the business end of the whole mental health thing, so I'm bound to be biased. Even so, you do not want to get involved in this stuff. I have yet to hear of anyone that has actually been helped, or even not hurt by psychiatrists."

    My child was helped immensely with their problems by a psychiatrist. We employed both drug and non-drug strategies, and it made a big difference. As my child matured, they also learned strategies to deal with the condition themselves. Much of the effort was simply a matter of understanding the nature of the illness, trying to avoid the usual triggers, recognizing the development of an acute episode, and then acting appropriately to deal with it. Most importantly, before accepting the drug aspect we tried double-blind tests, and revisited the issue with a new double-blind test each year. On principle, we did not want to use drugs, and there were some mild side-effects from them. However, each time we did the double-blind test it definitely made a net positive difference, both from our perception, my child's perception, and those of third parties that were not informed that a test was in progress. It was obvious when they were on the drug versus on the placebo when we compared observations. It simply worked. It was a choice between using it or letting our child suffer through the illness, which might lead to other psychological/social problems because of the way the illness affected their interaction with other people. We were already faced with significant issues when we sought help.

    It's been close to a decade now and it has worked out fine. Do I worry about the possibility of long-term side effects from taking a drug for so long? Heck, yeah. But I have to weigh that against the very likely development of some other serious problems if we didn't, and my child will soon be old enough to make the decision about the drug entirely on their own. Given that they've been involved in the decisions all along, to the extent their age allowed, I doubt they will change their mind about it, but they will be free to do so.

    I'm sorry to hear about your bad experience, but, no, it doesn't always turn out that way. I suspect that it depends greatly on the individual psychiatrist and the individual case. Your advice to generally avoid medications is wise, and I share the sentiment, but sometimes drugs are necessary and genuinely effective (see above -- there was also an occasion when my cold developed into pneumonia, and antibiotics were necessary then too). The hard part is figuring out when they truly are necessary and are doing some good, or the opposite. When you are dealing with a crisis you don't always have the luxury of a double-blind test, and if your body is changing over time or you have bad side-effects, it might not be possible to do such a test properly. Mental health is one of those areas that is exceedingly difficult for medicine to deal with because the problem is so incredibly complex. It's not surprising that the results are mixed, especially when compared to other areas of medicine. This is not a reason to reject the utility of drugs entirely. It's a reason to be cautious about them. Ditto for any medical advice.

  • by Anonymous Coward on Monday January 04, 2010 @01:08AM (#30637896)
    To balance this out, let me say that my dad was diagnosed with Multiple Myeloma almost 4 years ago, and gets treated at the Mayo Clinic (in Minnesota). Also, MM is considered a blood cancer, not a bone cancer, but that's a common mistake, due to the painful lesions it causes on the bones as they dissolve, and it's often diagnosed after a weakened bone gets broken. Dad entered an experimental treatment program at Mayo (combining Dex, Revlimid, and Cytoxan). The MM drugs and their side effects can be brutal, and they usually don't work, but every once in a great while, they do. He's now been in remission for 24 months, and while we all fully expect the cancer to return at some point (there's a reason it's called incurable), if you'd told me four years ago, when I had to leave work in tears after getting the phone call with his diagnosis, that he'd not only still be alive, despite the average survival rate with MM being 3 years, but that they wouldn't be able to detect any cancer in his bloodwork, I wouldn't have believed you. I am deeply sorry for your loss of your grandmother to this horrible disease, and I know the feeling that someone was exploiting your grandmother's illness for financial gain must be unbearable, but please don't malign those doctors or that institution unfairly, they're keeping my dad alive. They've also been very candid that they really don't know the "right way" to treat this disease, it's rare, deadly, and there are a lot of new and unproven treatment options, and many of them won't work. I'd never heard a doctor ask a patient "Well, what do you think we should do?" before, after going over all the options. You are right that the drugs are insanely expensive, though they didn't give her the most expensive option, by far. One of my dad's three drugs would cost $6800/month if he didn't receive it for free as part of the trial. Stem cell transplant operations when the disease progresses can run $250K each, and a patient can have up to three of them. MM is NOT a cheap disease to fight, and unfortunately, the fight is almost always a loss. If anyone out there wants to help in the fight, consider a donation to the Multiple Myeloma Research Foundation.
  • Re:Hmm... (Score:3, Interesting)

    by jfreaksho (263517) on Monday January 04, 2010 @01:33AM (#30637996)

    The main reason for using antibiotics on cattle is because they are fed corn, which changes the pH of their stomachs enough that different types of bacteria can survive in them. If the cattle were simply fed grass for two weeks before butchering, their stomach pH would return to normal. There would be essentially no antibiotics left in their system, no bad bacteria, and the cows would be much healthier overall when they were processed for human consumption.

    Completely grass-fed cattle have significantly less need for antibiotics throughout their entire lives, as their systems are designed/have evolved to handle that, and not grain.

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