I've heard many monikers for the current young generation (generation Z, millenials). How about the ZPackers. Let me explain. The current generation is marked by a desire to push a button and get action. If you make them wait, they move on. Have a problem, then lets get a solution. Here's the problem, and now please fix it. It'd be nice if illness worked that way.
Now let's talk about the most common malady that we in primary care see in our offices-upper respiratory infections. Lets not call them "colds" (seems to unimpressive), so how about upper respiratory tract infections, or URI's for short. That is any combination of runny nose, nasal congestion, scratchy throat, loss of voice, cough, and malaise. Pick any two, and you likely have a URI. Those are nasty illnesses caused by viruses that take anywhere from 7-14 days to kick, regardless of what you do. Enter the Zpack generation. And alot of nifty marketing by Pfizer. ZPack-just roles right off the tongue, doesn't it?
What happens is about 3-4 days into one of these illnesses I see a patient who says they have a "sinus infection" (that puts the correct amount of emphasis and importance on their malady). You know, yellow snot, stuffy head, can't breath thru their nose, and perhaps now "coughing things up". Usually these folks know what they need ( a ZPack), and just dropped in to get one. Sure enough, once they start their Z pack, they are better in 3-4 more days (total illness 7-14 days). Now they are convinced that the ZPack cured them, and we have now created a huge public health problem. Not good for them personally, either.
Don'tjust take my word. Look at the science. The scientific literature is full of large studies that should lay any doubts to rest that URIs are not caused from bacteria, but from a variety of viruses (germs that are not killed by antibiotics, and must just run their course). That same literature also concludes that antibiotics have no effect on URI. In fact we are now seeing some pretty serious health consequences to overuse of antibiotics-the most dire is antibiotic resistance from certain commonly seen, and previously non life-threatening, bateria. The biggest and baddest maneater is called MRSA (MRSA= methacillin resistant Staph Aureus). I can't prove that overuse of antibiotics has caused this trend, but I and many doctors more expert than me believe it is at least one of the contributing factors. And not just a public health issue-on a personal level it takes up to year for your colon bacteria to fix itself once you have ingested an antibiotic. Nobody knows the consequences of that,either. But they likely aren't good.
Here's the probem. Go to most doctors tomorrow, tell them yellow snot. "sinus infection", you get them all the time, Zpacks always work, now coughing up phlegm, yada yada. Hey, we doctors want to please,so here you go, here's the ZPack. On to the next patient. Not me-I'll tell you truth if I'm not too exhausted from the previous patient (s) with the same request.
Commonly used tactics: " I go on vacation in two weeks and don't want to be sick". No. How about "I know when I get it in my head it will always go into my lungs". Nope again. Now desperate "My roomate says all I need is a ZPack". For goodness sake, stop it!
What's the right way to go about this? Doc, I fell bad, REAL bad. Cough, congested, blowing my nose all day. Can't sleep. So ask him, "do you think I need an antibiotic"? That's right, give him permission to tell you the truth. Perhaps he'll do the right thing and give you options. Yes, collaberate, bargain, lets try this or that, and if 14 days roll around and you are NO BETTER, then perhaps we'll give an antibiotic a try. Call me, or better yet email me. Won't cost you anything extra. And perhaps we won't use azithrmycin AKA ZPack. Just too strong, and we want it to really work well when we really need it like if you ever get pneumonia. Perhaps we'll try one of the other really good ones that won't kill your colon bacteria or let your Staph get drug resistant. Yep, that would be a better way to go. Your doctor will think you're smart!
So, wash you hands frequently, keep your fingers out of your nose and eyes during cold and flu season, get extra sleep that time of year. Stay away from sick people as best you can. That's the way to do it.
Now there is a second opinion!
Dr. Frederick
Thx for this...my family and pharmacist was all, "ZPACK!" when it seemed I caught a cold (or developed a sinus infection) this week...my idea is to wait it out a bit, as long as I can get a little relief from an OTC decongestant. I know my body and if I do find that it heads south for the chest, then I'll go to my dr and take the next step...I do worry that overuse of antibiotics will prevent any future benefit from them when I really need them.
ReplyDeleteThis helped me SO much! I called cvs...zpack..zpack.....gonna stay hydrated...and wait it out..thanks!
ReplyDeleteMy son 7months old. Has lived the first 4 months in the hospital. Had a flu like symptoms. Went to the er low temp dehydration. The on call pd wanted to prescribe. I simply said we as parents don't feel comfortable with zpack. Response well we won't give him anything then. 15min later we took him home and keeping him hydrated. Do Dr s get kick backs from drug company's or are we just all high on drugs.
ReplyDeleteAt 26 I was prescribed a testosterone therapy drug. Now with more knowledge I know now it was not needed now its an 100 dollar a month bill because now my body can't produce it naturally. So I ask again are we high on drugs or just what the doc says we need.
I'm seeing an ENT in Korea and I've been on Antibiotics for three weeks and I'm still not better. They found an enlarged adinoid that I should not have at 30, but I swear Z packs in America knocked out sinus infections much quicker than whatever antibiotic they have me on here.
ReplyDeletewell my 20 yr old brother followed this advice an died after 10 days of coughing .
ReplyDeletehe got pneumonia some where around the 7th day
a zpak likely would have saved him ,
no ?
The severe scenarios are not what he's addressing with Zpack misuse. He wants you to be seen for severe symptoms which outlast the 7-day wait-it-out cycle of ENT infections.
DeleteYour brother got pneumonia, he was probably really, REALLY sick. Pneumonia is dangerous and quite tricky, especially if it's walking pneumonia. So yeah, he addressed the fact that pneumonia is a different story for antibiotics. If you read carefully, he says we shouldn't overuse antibiotics because when we get REALLY sick we need them to work, we need them to REALLY work. So taking them out of convenience for a run-of-the-mill cough is inappropriate and misuse, just another reason to be careful with what we're ingesting and for what reasons.
Lastly, I sympathize with your loss. My oldest sister died in April.
Interesting comments by this Doctor to say the least. Well here I have one for you. I have had a runny nose for oh 6-months now. At night, and throughout the day that runny nose gets plugged and I cannot breath. I have used and completely misused OTC nose sprays like a drug addict just so I can breath. Were talking 10 bottles weekly. So don't tell me to wait it out because trust me, I have waited. Now of course I had a heart attack back in 2007 so this prevents me from using many OTC drugs. Now what are you gonna tell me to call the AVON lady for some aftershave? I cant wait to hear the response for this one. I bet its a dandy.
ReplyDeleteThe severe scenarios are not what he's addressing with Zpack misuse. He wants you to be seen for severe symptoms which outlast the 7-day wait-it-out cycle of ENT (ear, nose, throat) infections.
DeleteI sympathize with the runny nose, Steve. I have severe allergies and often face remarks about how I should have lived in a bubble growing up. Severe or chronic ENT infections are usually addressed by a physician or ENT doctor and need long-term planning to figure out what really works best, what could work better, or what could be combined and trialled.
It sounds plausible you used something similar to Afrin. Afrin is your sinus's worst enemy. It may unclog the uncloggable sinus or two, but also removes all the natural nasal substance from nasal cavities. When used in excess or for prolonged periods, your body believes it's defense is being replaced and gets used to that, then you rely on it to unclog your head, which sounds like could have happened in your case. Always read directions carefully on medications. Afrin is only able to be used a couple of days. I had problems with nasacort, flonase, and all the other doctor-prescribed sprays too, so I don't take them and either suffer through or figure something else out for my runny nose.
My "figure something else out" was removal of my tonsils and adenoids in combination of daily and nightly allergy meds as well as asthma meds. You can always look into surgery as a last chance possibility, but first, SEE AN ENT! And don't give up!