Indonesia's Love Affair With Antibiotics and Drug Treatments...

There is little doubt that Indonesian doctors on the whole over-prescribe antibiotics. It is unfair to generalise because quite simply there are always exceptions to the rule. However, even if a doctor does not prescribe a course of antibiotics, then most people will self-prescribe and go to any one of the myriad of road-side drug vending stalls.

The overuse of antibiotics, and other drugs, is not without risks as the nasty things that make us sick also have an ability to build up immunity to the drugs designed to kill them. This means that Indonesia is without a doubt on the road towards creating a whole swathe of drug-resistant bacteria and viruses. Simply, the trend seems to be towards over-prescribing and poly-pharmacy no matter what the illness is. Generally, doctors or patients prescribe antibiotic and drug cocktails in an attempt to get well.

Interestingly, some Indonesian doctors have recognised the trend and are intent on arresting the malaise that is poor diagnosis and subsequent poor treatment options being prescribed. But, it would appear that changing the culture is an uphill battle if the data collected by the Foundation for Concerned Parents is anything to go by.

For example, in 2008 the Foundation found that antibiotics were prescribed in more than 78% of cases of respiratory or stomach illness. This is an increase on the slightly more than 54% in 2006. Perhaps more interestingly is the trend of prescribing certain brands of drugs in preference to cheaper locally produced generic medicines. The suggestion, albeit implied, seems to be that doctors might be being encouraged to prescribe certain drug regimes at every opportunity they get to do so. One would hope that doctors were getting a little more for their efforts than just the odd free pen or mouse pad.

The issue is one that the government is aware of and it is one that the government is keen to address. The World Health Organization (WHO) has also recognised that the over-prescribing of certain drug treatments in Indonesia is leaving the Republic susceptible to future outbreaks of super bugs and viruses that are resistant to all standard treatment options. Therefore, the WHO and the government have commenced a study to look at what can be done to turn back the tide.

Hmmm.

A Bucket List...

There is nothing like hearing the diagnosis from your doctor, terminal! I am sure there are plenty of things that run through one's mind in the immediate aftermath of knowing that the time frame remaining on your life is definitely much shorter than you had been figuring on. So, what to do with the time one has left?

Dave Ismay was diagnosed with terminal cirrhosis of the liver. The terminal part was three months to live.

Ismay is well-known around Britain as a comedian and because of his work at the Aston Villa Football Club. But, at 64 Ismay realised there were a stack of things that he had not done that he really would like to take a stab at before pulling up stumps and going to the big football club in the sky.

Remembering the movie with Jack Nicholson and Morgan Freeman, Ismay decided to make a "bucket list" and list all the things he needed to get done. These included buying a Mercedes and taking a trip to Australia.

Nevertheless, in between planning his demise and passage to the eternal life of the ever-after, Ismay began to wonder about how a non-drinker manages to get cirrhosis of the liver, particularly the terminal kind. Ismay's research began to suggest that even he, a one-time 60-cigarette per day smoker, was not a likely candidate for cirrhosis.

Probably the most interesting part of this story is that Ismay kicked his smoking habit with the aid of hypnosis. According to Ismay he made a trip to Florida from his home in the UK and sort an intervention of the hypnotic kind to rid him of his smoking habit. He did that when he was 40-years-old. He is now a sprightly 64-years-old.

Despite his concerns about the diagnosis, it was eight weeks before the doctors called to say "good news, you are not terminal with cirrhosis of the liver!" Ismay had a much more manageable condition known as haemochromatosis. Haemochromatosis is essentially iron overload. The body absorbs too much iron out of your dietary intake and overloads your system.

Haemochromatosis is generally not fatal. But, it does involve one parting with lots of blood in order to strip the body of the excess iron.

Well, now that Ismay knows that his death is not imminent, is he going to continue with his bucket list?

Really? Privacy?

I went to the doctor yesterday to get a check-up. The check-up was more for peace of mind rather than anything else, particularly when you have recently been blessed with the addition we have to our family in the form of Will. You tend to want to make sure everything is running smoothly and like a well-oiled machine. Anyways, the end result of the trip to the doctor was a blood test this morning.

The doctor said something about testing blood sugar levels and cholesterol, and then gave me a standard form for the lab/pathology people. I just whacked the form in my bag and headed home without reading it.

This morning after fasting for 10 hours or so, off I headed to the lab, for the inevitable test.

It was a fascinating affair to be sure. The nurse or pathology person or whatever one is known as in a pathology lab gave me a serve because my medicare had a different last digit (which represents the number of cards you have had) was different to that which the doctor had printed on the form. Smile No. one and a promise to rectify the "problem" as soon as possible. Then it was off into the little room to be stabbed and have my blood drawn.

Now, while walking to the lab I took the opportunity to have a squiz at the form and see if I could work out what the letter codes meant for what was being tested. There seemed to be a lot more letters than what I believed I was being tested for, blood sugars and cholesterol. So, in my infinite wisdom, I figured I would ask the woman drawing my blood what all the letters meant. And, this is the fun part.

"I cannot tell you because of privacy legislation". Huh? And, on she goes, "Doctors are allowed to test your blood for all manner of things before talking to the patient". Huh? They can? I was struggling to contain myself from bursting out laughing considering the needle was still in my arm. But, I could not contain the smile. As this is total and utter crap.

So, in my most nonchalant of ways I asked her whose privacy was at stake when it was my blood? And, since when could doctors take samples from their patients without the patients knowledge? Unfortunately, I had filled up the necessary vials and she hurried out, presumably to the next but yet to arrive patient.

Oh well, I guess I will just have to ask the doctor once the results are in.

A Trip To The Doctor -- Will and His Dad...

Photos taken on a mobile phone...

Parenthood -- A Scary Prospect?

The pregnancy is going well. The most recent trip to the doctor showed that everything was going in the direction that it is supposed to. The Kid is looking healthy and is a little bit bigger than he should be, apparently, by a couple of hundred grams or so.

The trip to the doctor have moved from a once a month event to once every two weeks. The closer it gets the more exciting it becomes. The thought of being responsible for a little life is at time daunting. I do not know if it is a normal part of the process or not, but I often find myself wondering what kind of an old man I am going to make. I also find myself spotting more parents with kids and notice how they discipline them in public.

You also notice how many Indonesians have hired help to make it "easier". I am in for a no assistance schedule on the child rearing front as I have been instructed there will be no nannies or anything else involved. So, I will be the prematurely old looking fella pushing the stroller around, if you happen to notice.

Back to the doctor trips. These trips have become like a big day out, a real event in and of themselves. They usually culminate in shopping. As the due date comes ever-closer, these shopping trips tend to end in having spent way too much money of things for the Kid, all necessary of course. Last week saw us become the proud owners of a crib with all the trimmings. The weekend before saw that the Kid kitted out in all the latest fashions. This included some hand-sewn cross-stitch additions.

The thought of parenthood is both a scary one and an exciting one. Maybe it is different for kid number 2. The first kid though just has so many unanswered questions.

The beauty of life!