Combating Antibiotic Resistance

You may have heard about the White House report released this week “National Action Plan for Combating Antibiotic-Resistant Bacteria.”  It is a victory that this issue is on our national agenda.  As an infectious diseases physician, I have seen the life-saving and life-improving capabilities of appropriate antibiotic therapies many times.  I have also seen, however, the emergence of drug resistance in bacteria occurring over several decades. It has accelerated such in the past decade that we now see patients with bacteria that are resistant to all our usual antibiotic choices, and have to resort to toxic antibiotics used in the past, or sometimes no antibiotic at all.  The CDC estimates that drug-resistant bacteria cause two million illnesses and approximately 23,000 deaths each year in the US alone.  In case you haven’t read all 62 pages of the report, I am highlighting some of it here.

The goals of the National Action Plan (NAP) are:

  1. Slow the Emergence of Resistant Bacteria and Prevent the Spread of Resistant Infections
  2. Strengthen National One-Health Surveillance Efforts to Combat Resistance
  3. Advance Development and Use of Rapid and Innovative Diagnostic Tests for Identification and Characterization of Resistant Bacteria
  4. Accelerate Basic and Applied Research and Development for New Antibiotics, Other Therapeutics, and Vaccines
  5. Improve International Collaboration and Capacities for Antibiotic-resistance Prevention, Surveillance, Control, and Antibiotic Research and Development.

Our medical specialty of Infectious Diseases is thrilled to see this multi-pronged approach, and we have long advocated for judicious use of antibiotics and accelerated pathways for new antimicrobials.  As an essential oiler, I would like to focus on goals #1 and #4.

  1. Slow the Emergence of Resistant Bacteria and Prevent the Spread of Resistant Infections

While many of the multi-drug resistant pathogens we see are in the hospital, the bulk of human antibiotic prescribing in the US is done for outpatients.  It is estimated that 50% of antibiotic use may be unnecessary.  In 2010, 258 million courses of antibiotics were prescribed, or 833 prescriptions per 1000 persons.  The CDC’s campaign “Get Smart: Know When Antibiotics Work” educates the public and health providers that antibiotics aren’t always the answer.  For many common illnesses like viruses and flu, antibacterials will not help and can have harmful side effects, in addition to increasing drug-resistant bacteria.  We in the oily community are already aware that antibiotics are not always the best answer, and we use essential oils that have been shown to have some antimicrobial activity to fend off impending infection and also use oils to relieve symptoms of infection when they occur.  The NAP calls for monitoring of antibiotic use to assure appropriate use in both outpatient and inpatient settings.  In addition to this, wouldn’t it be great for providers and patients to know about the benefits of essential oils?

Surprisingly, 70% of antibiotics used in the US are given to livestock and poultry.  While the plan falls short of adopting antibiotic-free meats, the plan does recommend that more is done to decrease the use of antibiotics important to humans in growth promotion for animals.  Kudos to Chipotle, Panera, and Chik-Fil-A for deciding to buy antibiotic-free meats, and to McDonald’s for plans to stop using chicken raised with antibiotics important to humans!  This is progress.

4. Accelerate Basic and Applied Research and Development for New Antibiotics, Other Therapeutics, and Vaccines

This is where goal #4 comes in.  While there will be emphasis on developing new antibiotics, the goal also aims to identify new therapeutics.  And get this (from page 44 of NAP):

“Examples of non-traditional therapeutic strategies include:……

      • Identifying natural compounds with antibiotic activity (e.g., phytochemicals, essential oils,

organic acids, animal-derived lytic enzymes, and small interfering RNAs).”

So you see, essential oils are mentioned in the National Action Plan to combat antibiotic resistance! And why not?  There is already in vitro (laboratory) data and we know of many anecdotes.  We are just lacking clinical trials to demonstrate effectiveness in humans.  I found this mention of the oils in the National Action Plan very exciting.  We oilers are ahead of the game!

New vaccines for pathogens that become drug-resistant are also included as a therapeutic strategy and this is important.  Vaccines are one of the most significant public health developments of the 20th century and the more we can prevent infections, the less we have to use antibiotics!

So, the National Action Plan is a step in the right direction and even suggests developing alternatives such as essential oils.  While we love the benefits of our oils, it is no shame to use antibiotics when we do need them.  It is about using all the tools available to you—and using the right one at the right time!

References for more information:

https://www.whitehouse.gov/sites/default/files/docs/national_action_plan_for_combating_antibotic-resistant_bacteria.pdf

Hicks LA, Taylor Jr TH. U.S. Outpatient Antibiotic Prescribing, 2010. N Engl J Med 2013;368:15

Get Smart: Know When Antibiotics Work.  http://www.cdc.gov/getsmart/community/index.html

Chao SC, Young DG, Oberg CJ. Effect of a diffused essential oil blend on bacterial bioaerosols. J Essent Oil Res 1998;10:517-23.

http://www.chipotle.com/en-US/fwi/fwi_facts/fwi_facts.aspx

http://press.chick-fil-a.com/Pressroom/LatestNews/PressDetail/abf

http://marketing.panerabread.com/liveconsciouslyeatdeliciously/#!articles/antibiotic_free_answers

http://news.mcdonalds.com/press-releases/mcdonald-s-usa-announces-new-antibiotics-policy-and-menu-sourcing-initiatives-nyse-mcd-1179405

Dad’s Dementia

My dad has the most common form of dementia, Alzheimer’s disease. More than 5 million Americans are affected and the number is growing due to the increase in the geriatric population. As with other kinds of mental illness, the person with Alzheimer’s is not the only one affected. It affects all of the family and caregivers.

At first, it was subtle. He couldn’t remember what he did with his billfold and forgot what he had been intending to do. As the disease progressed, he would forget things that happened just a few minutes ago and became irritable with caregivers that needed to help him after my mother died. Poor judgment threatened his safety, like the time he took off to get his riding mower fixed—on the riding mower on a major thoroughfare. We were finally able to get him into assisted living. His deterioration continues. He no longer remembers where we live and what we do—previous major topics of conversation. He no longer talks about his wife of 70 years. In fact when I last visited and reminded him it was her birthday, he said “Tell me about her.”

There are days when he tries to “escape.” He’s in a wheelchair now, but will try to open the doors to exit from the unit. The doors are alarmed, and he’s not really able to get through in his wheelchair, but it is very disconcerting to the staff and to us. I visited him the day after he had one of those “escape” days and reminded him he needed to stay so he would be safe and we could visit him. He responded “Well, I guess I shouldn’t try to leave, right?”

It’s hard to watch these changes in someone who was so bright, hard-working, and independent. It’s another one of those things in life that don’t make sense. Why do our loved ones have to go through this?

Essential oils help me in my everyday life, and there is accumulating data with their use in long term care and end of life care. Experience indicates there can be decreased weight loss, agitation, insomnia, and enhanced pain control with the use of essential oils in long term care patients, and essential oils can also improve clarity and effectiveness among the staff.

So, I took my dad some essential oils the other day: Peace & Calming (a blend of tangerine, orange, ylang ylang, patchouli and blue tansy) and Stress Away (a blend of copaiba, lime, cedarwood, vanilla, ocotea, lavender). Both of these have helped me calm and de-stress, so why not give it a try? My dad’s open-minded physician readily prescribed these “as needed” and the nurse commented on how wonderful they smelled. (Maybe they’ll help her too!). These oil blends, and some melatonin for sleep, seem to be helping my dad. Next I’m getting Tranquil (lavender, cedarwood, Roman chamomile) and Rutavala (ruta, valerian, lavender) for him. These are roll-ons so will be even easier for the staff, and they are blends of some of my favorite oils.

My prayers continue for my dad’s well-being.

http://www.todaysgeriatricmedicine.com/archive/0714p30.shtml

http://www.best-alzheimers-products.com/aromatherapy-for-alzheimers.html

http://www.recreativeresources.com/aromatherapy.htm

http://birchhillhappenings.com/v1522012hospital.htm

Tools:  Family, Essential Oils, Faith, Medicine

St. Patrick

To many, Saint Patrick’s Day is simply a day to wear green and drink beer. Traditionally, San Antonio dyes the river green.  There is much more to this Saint, however.shamrock

Saint Patrick lived in the 5th century and is known as the Apostle of Ireland.  He was born in Britain, but captured by Irish pirates at a young age.  During his enslavement in Ireland, he converted to Christianity. He acted on a voice telling him it was time to go home; he escaped and returned to Britain.  A few years later, he had a vision of a man carrying letters, one headed “The Voice of the Irish” and appealing him to come walk among them.  He acted on the vision and returned to Ireland as a Christian missionary, baptizing many people.  Legend says that he used the three-leafed Shamrock to talk about the Holy Trinity.  He is also credited with banishing snakes from Ireland, but naturalists say there were no snakes in Ireland at that time to banish!  March 17 recognizes the date of his death and is a religious and cultural holiday in Ireland.

The day is meaningful to me because it is the birthday of two of my loved ones—my mother and one of my sisters, Zee Ann.  I never knew Zee Ann because she died in a car accident at age 3, before the days of car safety awareness and seat belts.  I am sure my mother was delighted that her first daughter was born on her birthday, and then how tragic and bittersweet each birthday following Zee Ann’s death must have been for her.  Zee Ann was a beautiful and precious child by all accounts.  She was a loving playmate for my brother David, developmentally delayed from asphyxia at birth.zeeann oval feathered

What I remember about my mother is her sense of humor, her faith, her love for children, and her ability to make friends.  Her friends adored her, and she had a nature about her that even made store clerks want to help her in any way possible.  She died in 2011 at 93 years old and it was a release for her because she was in poor health and pain the last few months of her life.  I miss her and wish I could still pick up the phone and talk to her.  I felt her presence after the death of my son and when I was in pain from uterine cancer surgery.   I know I will see her again in heaven, and I look forward to meeting  Zee Ann, too.Mother young

Tools:  Faith, Family

Pi Day ! 3.1415926…..

Today is pi Day, 3/14, and especially monumental since it is 2015, making it 3/14/15. Our friends, Barbara and Michael, have a pi Day party and started it at 9:26am– making it 3.1415926…. There was a long table of pies of all kinds – pecan pie, quiche pie, coconut cream pie, lemon pie, chess pie, cheesecake pie, pumpkin pie,  and spaghetti pie.  There was even a pie in the shape of a pi. Fun

pi partypi

It hasn’t been easy for us to go to parties.  In the 3 years since our son, Will, died, we haven’t much felt like seeing people and many of our friends don’t feel comfortable around us even still, so we have stayed home a lot.  It felt pretty good to just go to a party where we didn’t know many people.

The sprained foot/ankle is much better. The cycle of whirlpool/oils/icing is helping a lot, as is the boot immobilizer (using all the tools!).  Did upper body strength training at the gym today.  Gotta keep moving. Especially if I’m eating PIE at 10am in the morning!

And–it was a beautiful Texas spring day.  One of the best yet.  Short sleeves, sun, light breeze, redbuds blooming, and a gorgeous sunset at the ranch tonight. Peaceful.

sunset

Tools:  Family, Fun, Friends, Oils, Medicine, Fitness

Ouch!

bootSo proud of getting through the ski trip without a hitch–

Then went to Philadelphia for a meeting and SLIPPED ON THE ICE!  Foot twisted under me and sprained ankle and foot.  Ugh.  At least its not broken.  Got the CAM boot from my orthopedic friend so I can at least walk.  4-6 weeks slow down on the fitness just when I was getting more into it.  Will see what I can do with the upper body weight training….

But the meeting in Philly was good–meaningful work.

Oh, and yes I am using my anti-inflammatories on the injury.  Iced it and took ibuprofen the first couple of days.  Now using cycle of whirlpool, oils (frankincense, YL Deep Relief) and icing.  Doing much better.

Tools:  Function, Medicine, Fitness, Essential oils

Skiing

Skiing and me have had a hate-love relationship.  I hated it before I loved/liked it.  Because I learned to ski as an adult, it took a while for this overweight and relatively clumsy middle-aged woman to get it.  I finally did, and was glad I could participate with the guys in my family who really like to ski (and who learned when they were young!).

Anyway, just completed the annual ski trip w no injuries! Very proud of that.  An accomplishment.

Oh – the left knee got a little swollen after 3 days of skiing.  Used some frankincense on it and it worked great. No pain the next am.  Hmmm why frankincense?  Well-it turns out it is an effective anti-inflammatory.  Even some clinical studies published in a review in the British Medical Journal in 2008.  Worked for osteoarthritis, rheumatoid arthritis, inflammatory bowel disease. Imagine that!  BMJ. 2008; 337: a2813.  And, it smells wonderful!

Tool:  Family, Fun, Finding a new interest, Essential Oils

Hello world!

Why write a blog?  I’ve been thinking about it for a while but I wasn’t sure anything I had to say would be interesting.  Well, there are things I want to write about and things I want to say. And maybe it could help someone. Even if it doesn’t, maybe it will help me.  A lot has happened to me (us) in the last few years.  While I can’t talk about all of it, I have been encouraged lately by the use of essential oils.  It’s an important part of my “survive and thrive” toolkit now.  I’d like to use this forum to talk about how essential oils help me and to spread information about essential oils and how they can fit into the whole picture of wellness.

It takes a whole tool kit to make it through this life.

A Foundation

  • Faith
  • Family
  • Friends

Adding Fulfillment

  • Function – Meaningful work
  • Fitness
  • Fun
  • Finding new interests

These have facilitated Healing:

  • Medicine
  • Essential oils and Herbs

And so as a bereaved parent, griever, cancer survivor, infectious diseases physician, mother, wife, sister, friend, sprint triathlete, and most recently, essential oiler, I’d like to share some of my journey with you.