Paradise in Sickness

Body & Spirit Body & Spirit

Just a few weeks ago, a family friend ended her own life.

She was young, vivacious, attractive and very talented.

She had some health problems which were manageable and she would probably have made a full recovery.

She had apparently spoken about suicide several times, although no one thought that she would actually do it.

Suicide is more common that you might think. Most people that you speak to know someone who has lost a friend or a relative to suicide. Suicide is the leading cause of death for

Australians aged between 15 and 44, with around 3,000 people dying by suicide every year. That’s an average of eight people every day.

In Indonesia, in particular Bali, suicide rates are relatively high, at approximately 150 deaths per year on the Island - although these figures are likely drastically less than the true figures, due to under reporting and the fact that suicide is a taboo subject amongst the local people.

For every suicide, there are tragic ripple effects for friends, families, colleagues and the broader community.

“When people kill themselves, they think they’re ending the pain, but all they’re doing is passing it on to those they leave behind.”

If someone you know seems to be struggling, reach out and connect with them. Showing that you care could make a huge difference in their life. If you are struggling yourself, you might feel better if you reach out for support, get treatment and start taking steps towards recovery.

Common warning signs

Someone who is thinking about suicide will usually give some clues or signs to people around them, though these may be subtle. Suicide prevention starts with recognising the warning signs and taking them seriously

Suicide warning signs

• A sense of hopelessness or no hope for the future. • Isolation or feeling alone - “No one understands me”. • Aggressiveness and irritability - “Leave me alone”. • Possessing lethal means - medication, weapons. • Negative view of self - “I am worthless”. • Drastic changes in mood and behaviour. • Frequently talking about death - “If I died would you miss me?”. • Self-harming behaviours like cutting. • Engaging in ‘risky’ behaviours - “I’ll try anything, I’m not afraid to die”. • Making funeral arrangements. • Giving things away (clothes, expensive gifts) - “When I am gone, I want you to have this”. • Substance abuse. • Feeling like a burden to others - “You would be better off without me”. • Making suicide threats - “Sometimes I feel like I just want to die”.

Responding to warning signs

Fortunately most threats of suicide are not genuine. It is usually a desperate cry for help. However, no suicide threat should be taken lightly. Suicidal intent can be very subtle, and even those whom you may think have every reason to live, can be very serious about taking their own life. Who would have thought that a man like Robin Williams would even dream of it? Talking to someone about suicidal thoughts can be challenging but if you are unsure whether someone is suicidal, the best way to find out is to ask.

ARE YOU SUICIDAL? Talking to someone about your suicidal feelings

Having suicidal thoughts can be scary. You may have never had them before, or perhaps the thoughts have been there for a while and you are not sure what to do. You may be

SUICIDE.....The Big “WHY??” ashamed to talk about it or worry that people will judge you or not take you seriously and just tell you to “Get over it”.

At this point in time we are popping more vitamins, herbs and other supplements than ever before. The supplement industry is the new Big-Farma. Australians alone are now spending over 8 million dollars a year on supplements that are questionably necessary.

It’s true, if you take a vitamin supplement as well as supplemented food such as orange juice, or fortified milk which comes with calcium and vitamin D. Energy bars, meal-replacement drinks, protein shakes, cereal bars, cereal itself - which claim lots of vitamins and minerals, up to 100% of the recommended daily allowance (RDA), you could end up getting up to 500% of the RDA, maybe more, in one day - up to five times what your body needs. But are we toting up toxic levels of vitamins? And throwing our money away?

The Fat Soluble Vitamins A,D, E & K

Fat soluble vitamins are stored in the body for longer than water soluble ones are, which generally poses a greater risk for toxicity that water soluble vitamins. The upper tolerable limit for adults is 10,000 IU for vitamin A. You get it from animal foods, fish, and dairy products. Also, beta-carotene (from orange and yellow veggies) gets converted to vitamin A in the body. If you’re taking a multivitamin that contains 5,000 IU, plus getting A-fortified foods in your diet, plus eating foods that contain vitamin A, you’re OK, but it’s the super-A supplements we worry about. It’s easy to overdo it with pills which is of particular concern for pregnant women. Vitamin D is tricky because we need some, and as we get older we need more. Too much can actually cause calcium to leach out of your bones, causing weak bones as well as high levels of calcium in the blood which will cause another set of serious problems. Vitamin D is found in some calcium supplements, and multi vitamins. If you do drink dairy, as well as take calcium with D, AND a multi you could be getting close to the limit. There is focus on vitamin E to prevent Alzheimer’s, heart disease, macular degeneration, cancer etc. The upper tolerable level is 1,000 milligrams (1,500 IU); the RDA is 30 IU, and even higher doses seem to be well tolerated. In an Alzheimer’s study, people took 2,000 IU for four years and did’t have any adverse effects. In another study, people took 800 IU for six years, with no adverse effects.

The Water Soluble Vitamin C & B’s

Most people think it’s fine to take as much Vit C as they want, I know people who take 10,000 mg a day. However, the upper tolerable limit is 2,000 mg a day. The risk for kidney stones can increase with very high doses and other people may get diarrhea. The B’s are generally well tolerated, however very high doses of B3 & B6 can have serious side effects.B supplements may be beneficial for pregnant women, the over 50, those that suffer from anxiety or depression, or people with certain medical conditions that prevent B absorption.

The Minerals

Like calcium, overloading on potassium supplements is potentially problematic for your ticker. This mineral has a function in regulating your heartbeat, and taking too much of it can cause heart problems. iron and zinc can both easily accumulate in your body and cause various issues, Digestive issues are typically the first sign that something is off, but people can also experience nausea, vomiting, seizures, or a rapid heartbeat.

The Herbs

Herbs can be very dangerous, particularly for your liver. Herbal and dietary supplements are now are responsible for about 20 percent of liver injury. An “all-natural” herbal product might sound like it’s good for your health, but some common ones, like green tea extract and comfrey tea, can cause injury to your liver - the organ that breaks down medications. Because of the potential risks, it’s important to take precautions if you decide to use a herbal product. Keep these tips in mind: 1. Beware of the big liver offenders. Green tea extract, anabolic steroids, pyrrolizidine alkaloids, and flavocoxid (a herb sold to treat arthritis) are among the top substances that can cause liver injury. If you love green tea, rest assured: Drinking up to 10 cups a day is safe. It’s the high doses of green tea extract usually found in weight-loss supplements that cause damage. Certain herbs used in traditional Chinese medicine have also been found to pose some risks. Researchers have identified 28 traditional Chinese medicine herbs and herbal mixtures that have been reported to cause liver toxicity. Meanwhile, comfrey - which is sold as a tea, powder, and capsule - contains several pyrrolizidine alkaloids that may cause liver injury. Chaparral, kava, and skullcap can also damage your liver. 2. Know what’s in it. Some herbal products, such as milk thistle, are known to be safe. But others contain additional ingredients: Green tea extract, for example, is added to many herbal products. And in some cases, supplements don’t list the ingredients at all but make claims that they will flush your liver

PARADISE...

IN SICKNESS & IN HEALTH

SUPPLEMENTS How many is too many? WHO has warned that the over prescription of antibiot- 3. Check the LiverTox website. The LiverTox website ics will lead to a global resistance to pathogenic contains valuable information on hundreds of drugs that microbes (infection causing bacteria & viruses). While have been found to damage the liver, including herbal many developed countries have strict guidelines on products.

the prescription of antibiotics, third world countries

are much more relaxed on the issue, often considering 4. Don’t always trust the label. To make matters worse, the profits, incentives and commissions to be made labels of herbal medications can’t always be trusted. Black rather than the wellbeing of the patient and the global cohosh, which is often taken for menopause symptoms, is community at large. considered safe. But products labelled as black cohosh have been linked to more than 50 cases of liver injury. In For example, women that give birth in Indonesia are all several cases, scientists found herbs from the Chinese given a course of Amoxicillin after birth “just in case” infection actaea species in the supplement rather than black develops. With many doctors in Asia on low incomes, cohosh. Heavy metals, pesticides, and bacteria have also commissions from drug sales are often where they make their been found in supplements.money. Self medication is also a huge problem in this society. Antibiotics (or any “prescription” drugs for that matter) are easily purchased at most pharmacies without any prescription at all. Even more shocking is that some backstreet “warungs” also stock a supply of antibiotics, usually selling to the “gentlemen” who have visited the local whorehouses. “Antimicrobial resistance (AMR) causes an estimated 700,000 deaths annually worldwide, and every country is potentially affected. If not properly addressed, the number could grow to 10 million per year by 2050”.

What are antibiotics?

Antibiotics, through various actions, destroy or inhibit the growth of bacteria. The antibiotic may be specific, and targeted at a small group of bacteria, or it may be a broad-spectrum antibiotic, which means it will be effective against a large group of organisms. Most antibiotics are absorbed well through the gut, and are sold as tablets or syrups, but some do have to be injected.

Do antibiotics cure all infections?

No they do not. Antibiotics have no effect at all on infections caused by viruses, or fungi. Viruses cause all types of flu and colds, and most coughs and sore throats. Recovery from viral infections will happen in the same number of days with or without antibiotics. In some cases antibiotics will be prescribed for someone suffering a heavy viral infection to prevent bacterial overgrowth. Antibiotics will aggravate the condition of someone suffering a fungal infection. Many “healthy bacteria” that normally live around our bodies actually assist us in our wellbeing. These friendly bacteria are killed when broad-spectrum antibiotics are prescribed. This then leaves an open arena for pathogens like certain fungi (e.g. Candida), to take over. Interestingly enough, recovery from some bacterial infections will happen in the same number of days with or without antibiotics. Our bodies do have the ability to heal themselves in most circumstances.

What is “Antibiotic Resistance”?

When antibiotics are used to kill a certain group of bacteria, some of those bacteria may adapt, grow and multiply with a new found strength that is able to resist the antibiotic that was once effective in killing it. Each time an antibiotic is used, the chance of resistance increases. The resistance to any antibiotic is not limited to one person but affects the entire community in general. For example if Fred takes antibiotics (eg Amoxicillin) for every minor infection that he has, the bacteria will soon become resistant to that antibiotic. If John is then infected by a bacteria that has been passed on to him by Fred, it will be of no use for John to take Amoxicillin. The bacteria is already resistant. This has been proven in communities worldwide. Penicillin, the very first antibiotic to be marketed, is now useless against most infections. Certain strains of antibiotic resistant Staphylococcus (Golden Staph.) have colonized in hospitals all over the globe. Malaria is resistant to Chloroquine in almost all high-risk Malaria regions (although strictly speaking Malaria is not a bacteria, but the same principle applies).

Five Strains of Bacteria that are Now Resistant

Antibiotic resistance risks returning us to an age where even simple cuts and scrapes can become deadly. For a glimpse of what could be commonplace in our future, here are five of the scariest antibiotic resistant bacteria from the last five years.

1. Extensively drug-resistant Salmonella typhi

This highly contagious bacterium causes typhoid fever, a life-threatening infection that affects about 21 million people around the world every year. About 1% of those affected, or 223,000 people, will die. In November 2016, a strain of Salmonella typhi emerged in Pakistan. It was resistant to five antibiotics, leaving only one oral antibiotic (azithromycin) able to treat it.

2. Extensively drug-resistant Mycobacterium tuberculosis

Mycobacterium tuberculosis is the world’s leading infectious killer, causing more than 1.7 million deaths every year. It’s estimated up to 13% of all new tuberculosis cases are multidrug-resistant, with Europe, including Russia, seeing the highest number of these cases.

3. Pandrug-resistant Klebsiella pneumoniae

Klebsiella pneumoniae is a common bacterium found in the skin, intestines and soil. It causes a range of potentially deadly infections in people with compromised immune systems. As this bacterium is particularly prevalent in hospitals, it’s one of the most critical drug-resistant threats to public health. In 2013 there were 8,000 reports of multidrug-resistant Klebsiella pneumoniae in the United States alone, with a death rate of 50% for people with bloodstream infections.

4. Pandrug-resistant Pseudomonas aeruginosa

Like Klebsiella pneumoniae, Pseudomonas aeruginosa is a commonly found bacterium that causes infections in people with compromised immune systems. Like Klebsiella pneumoniae, it’s particularly prevalent in hospitals. In the past five years, 29 cases of pandrug-resistant Pseudomonas aeruginosa infection have been reported in hospitals in England.

5. Extensively drug-resistant Neisseria gonorrhoeae

There are an estimated 78 million global cases of Neisseria gonorrhea, which causes gonorrhea, a sexually transmitted infection affecting men and women. Although usually not deadly, serious and permanent health problems including infertility can result if the disease goes untreated. Around

PARADISE... IN SICKNESS & IN HEALTH Just a few weeks ago, a family friend ended her own life. She was young, vivacious, attractive and very talented. She had some health problems which were manageable

TOO MANY ANTIBIOTICS … and she would probably have made a full recovery. Over-prescription of Antibiotics a Major Problem - WHO

one-third of all Neisseria gonorrhea infections are resistant to at least one antibiotic. More worryingly, a new extensively drug-resistant “super gonorrhea”, resistant to all but one antibiotic, has been discovered.

Steps to reduce use of antibiotics

Try to avoid infections in the first place. If you do get one, use antibiotics correctly. The following steps can help: Wash your hands often • Use plain soap and water. • Wash before preparing or eating food. • Wash after using the bathroom, changing a diaper, She had apparently spoken about suicide several times, sneezing, coughing, handling garbage and coming although no one thought that she would actually do it. home from public places. • Wash before and after treating a cut or wound or being Suicide is more common that you might think. Most people near a sick person. that you speak to know someone who has lost a friend or a At home • Don’t share personal items like towels, razors, tweezers relative to suicide. Suicide is the leading cause of death for and nail clippers. Australians aged between 15 and 44, with around 3,000 • Keep kitchen and bathrooms clean. You can clean surfaces with soap and water. Try to avoid products people dying by suicide every year. That’s an average of with added anti-bacterials. eight people every day. • Don’t put purses, diaper bags, or gym bags on the kitchen table or counter. • Wash wounds with regular soap and water. Use over-the-counter antibiotic products such as In Indonesia, in particular Bali, suicide rates are relatively neomycin (Neosporin and generic) or bacitracin only for high, at approximately 150 deaths per year on the Island - cuts that look dirty. Work with your doctoralthough these figures are likely drastically less than the • Don’t push for antibiotics with your doctor. If you don’t true figures, due to under reporting and the fact that suicide have a bacterial infection, ask how to relieve symptoms. Consumer demand is one of the major factors in the is a taboo subject amongst the local people. over-use of antibiotics. • Fight it off. If symptoms are mild and complications unlikely, ask if you can delay treatment for a few days. For every suicide, there are tragic ripple effects for friends, • Maintain a healthy lifestyle & diet. families, colleagues and the broader community. • Take antibiotics as prescribed. Don’t skip doses or stop the medicine early. • Don’t use leftover antibiotics to treat an infection. “When people kill themselves, they think they’re ending the Taking the wrong medicine allows bacteria to multiply. pain, but all they’re doing is passing it on to those they If the household or personal product (cleaning solutions, leave behind.” soap, shampoo etc) says antibacterial, leave it on the shelf. Use vinegar, soap, or bicarb soda instead. If someone you know seems to be struggling, reach out Bacterial resistance cannot be stopped; it is part of evolution itself. However it’s development and spread can be and connect with them. Showing that you care could make minimized by: a huge difference in their life. If you are struggling yourself, • Only using antibiotics when absolutely necessary. • Knowing what sort of illnesses respond to antibiotics. you might feel better if you reach out for support, get • Understanding that recovery from many illnesses will treatment and start taking steps towards recovery. occur in the same time frame, with or without antibiotics.

Common warning signs

Someone who is thinking about suicide will usually give some clues or signs to people around them, though these may be subtle. Suicide prevention starts with recognising the warning signs and taking them seriously

Suicide warning signs

• A sense of hopelessness or no hope for the future. • Isolation or feeling alone - “No one understands me”. • Aggressiveness and irritability - “Leave me alone”. • Possessing lethal means - medication, weapons. • Negative view of self - “I am worthless”. • Drastic changes in mood and behaviour. • Frequently talking about death - “If I died would you miss me?”. • Self-harming behaviours like cutting. • Engaging in ‘risky’ behaviours - “I’ll try anything, I’m not afraid to die”. • Making funeral arrangements. • Giving things away (clothes, expensive gifts) - “When I am gone, I want you to have this”. • Substance abuse. • Feeling like a burden to others - “You would be better off without me”. • Making suicide threats - “Sometimes I feel like I just want to die”.

Responding to warning signs

Fortunately most threats of suicide are not genuine. It is usually a desperate cry for help. However, no suicide threat should be taken lightly. Suicidal intent can be very subtle, and even those whom you may think have every reason to live, can be very serious about taking their own life. Who would have thought that a man like Robin Williams would even dream of it? Talking to someone about suicidal thoughts can be challenging but if you are unsure whether someone is suicidal, the best way to find out is to ask.

ARE YOU SUICIDAL? Talking to someone about your suicidal feelings

Having suicidal thoughts can be scary. You may have never had them before, or perhaps the thoughts have been there for a while and you are not sure what to do. You may be

SUICIDE.....The Big “WHY??” ashamed to talk about it or worry that people will judge you or not take you seriously and just tell you to “Get over it”.

At this point in time we are popping more vitamins, herbs and other supplements than ever before. The supplement industry is the new Big-Farma. Australians alone are now spending over 8 million dollars a year on supplements that are questionably necessary.

It’s true, if you take a vitamin supplement as well as supplemented food such as orange juice, or fortified milk which comes with calcium and vitamin D. Energy bars, meal-replacement drinks, protein shakes, cereal bars, cereal itself - which claim lots of vitamins and minerals, up to 100% of the recommended daily allowance (RDA), you could end up getting up to 500% of the RDA, maybe more, in one day - up to five times what your body needs. But are we toting up toxic levels of vitamins? And throwing our money away?

The Fat Soluble Vitamins A,D, E & K

Fat soluble vitamins are stored in the body for longer than water soluble ones are, which generally poses a greater risk for toxicity that water soluble vitamins. The upper tolerable limit for adults is 10,000 IU for vitamin A. You get it from animal foods, fish, and dairy products. Also, beta-carotene (from orange and yellow veggies) gets converted to vitamin A in the body. If you’re taking a multivitamin that contains 5,000 IU, plus getting A-fortified foods in your diet, plus eating foods that contain vitamin A, you’re OK, but it’s the super-A supplements we worry about. It’s easy to overdo it with pills which is of particular concern for pregnant women. Vitamin D is tricky because we need some, and as we get older we need more. Too much can actually cause calcium to leach out of your bones, causing weak bones as well as high levels of calcium in the blood which will cause another set of serious problems. Vitamin D is found in some calcium supplements, and multi vitamins. If you do drink dairy, as well as take calcium with D, AND a multi you could be getting close to the limit. There is focus on vitamin E to prevent Alzheimer’s, heart disease, macular degeneration, cancer etc. The upper tolerable level is 1,000 milligrams (1,500 IU); the RDA is 30 IU, and even higher doses seem to be well tolerated. In an Alzheimer’s study, people took 2,000 IU for four years and did’t have any adverse effects. In another study, people took 800 IU for six years, with no adverse effects.

The Water Soluble Vitamin C & B’s

Most people think it’s fine to take as much Vit C as they want, I know people who take 10,000 mg a day. However, the upper tolerable limit is 2,000 mg a day. The risk for kidney stones can increase with very high doses and other people may get diarrhea. The B’s are generally well tolerated, however very high doses of B3 & B6 can have serious side effects.B supplements may be beneficial for pregnant women, the over 50, those that suffer from anxiety or depression, or people with certain medical conditions that prevent B absorption.

The Minerals

Like calcium, overloading on potassium supplements is potentially problematic for your ticker. This mineral has a function in regulating your heartbeat, and taking too much of it can cause heart problems. iron and zinc can both easily accumulate in your body and cause various issues, Digestive issues are typically the first sign that something is off, but people can also experience nausea, vomiting, seizures, or a rapid heartbeat.

The Herbs

Herbs can be very dangerous, particularly for your liver. Herbal and dietary supplements are now are responsible for about 20 percent of liver injury. An “all-natural” herbal product might sound like it’s good for your health, but some common ones, like green tea extract and comfrey tea, can cause injury to your liver - the organ that breaks down medications. Because of the potential risks, it’s important to take precautions if you decide to use a herbal product. Keep these tips in mind: 1. Beware of the big liver offenders. Green tea extract, anabolic steroids, pyrrolizidine alkaloids, and flavocoxid (a herb sold to treat arthritis) are among the top substances that can cause liver injury. If you love green tea, rest assured: Drinking up to 10 cups a day is safe. It’s the high doses of green tea extract usually found in weight-loss supplements that cause damage. Certain herbs used in traditional Chinese medicine have also been found to pose some risks. Researchers have identified 28 traditional Chinese medicine herbs and herbal mixtures that have been reported to cause liver toxicity. Meanwhile, comfrey - which is sold as a tea, powder, and capsule - contains several pyrrolizidine alkaloids that may cause liver injury. Chaparral, kava, and skullcap can also damage your liver. 2. Know what’s in it. Some herbal products, such as milk thistle, are known to be safe. But others contain additional ingredients: Green tea extract, for example, is added to many herbal products. And in some cases, supplements don’t list the ingredients at all but make claims that they will flush your liver

PARADISE...

IN SICKNESS & IN HEALTH

SUPPLEMENTS How many is too many? WHO has warned that the over prescription of antibiot- 3. Check the LiverTox website. The LiverTox website ics will lead to a global resistance to pathogenic contains valuable information on hundreds of drugs that microbes (infection causing bacteria & viruses). While have been found to damage the liver, including herbal many developed countries have strict guidelines on products.

the prescription of antibiotics, third world countries

are much more relaxed on the issue, often considering 4. Don’t always trust the label. To make matters worse, the profits, incentives and commissions to be made labels of herbal medications can’t always be trusted. Black rather than the wellbeing of the patient and the global cohosh, which is often taken for menopause symptoms, is community at large. considered safe. But products labelled as black cohosh have been linked to more than 50 cases of liver injury. In For example, women that give birth in Indonesia are all several cases, scientists found herbs from the Chinese given a course of Amoxicillin after birth “just in case” infection actaea species in the supplement rather than black develops. With many doctors in Asia on low incomes, cohosh. Heavy metals, pesticides, and bacteria have also commissions from drug sales are often where they make their been found in supplements.money. Self medication is also a huge problem in this society. Antibiotics (or any “prescription” drugs for that matter) are easily purchased at most pharmacies without any prescription at all. Even more shocking is that some backstreet “warungs” also stock a supply of antibiotics, usually selling to the “gentlemen” who have visited the local whorehouses. “Antimicrobial resistance (AMR) causes an estimated 700,000 deaths annually worldwide, and every country is potentially affected. If not properly addressed, the number could grow to 10 million per year by 2050”.

What are antibiotics?

Antibiotics, through various actions, destroy or inhibit the growth of bacteria. The antibiotic may be specific, and targeted at a small group of bacteria, or it may be a broad-spectrum antibiotic, which means it will be effective against a large group of organisms. Most antibiotics are absorbed well through the gut, and are sold as tablets or syrups, but some do have to be injected.

Do antibiotics cure all infections?

No they do not. Antibiotics have no effect at all on infections caused by viruses, or fungi. Viruses cause all types of flu and colds, and most coughs and sore throats. Recovery from viral infections will happen in the same number of days with or without antibiotics. In some cases antibiotics will be prescribed for someone suffering a heavy viral infection to prevent bacterial overgrowth. Antibiotics will aggravate the condition of someone suffering a fungal infection. Many “healthy bacteria” that normally live around our bodies actually assist us in our wellbeing. These friendly bacteria are killed when broad-spectrum antibiotics are prescribed. This then leaves an open arena for pathogens like certain fungi (e.g. Candida), to take over. Interestingly enough, recovery from some bacterial infections will happen in the same number of days with or without antibiotics. Our bodies do have the ability to heal themselves in most circumstances.

What is “Antibiotic Resistance”?

When antibiotics are used to kill a certain group of bacteria, some of those bacteria may adapt, grow and multiply with a new found strength that is able to resist the antibiotic that was once effective in killing it. Each time an antibiotic is used, the chance of resistance increases. The resistance to any antibiotic is not limited to one person but affects the entire community in general. For example if Fred takes antibiotics (eg Amoxicillin) for every minor infection that he has, the bacteria will soon become resistant to that antibiotic. If John is then infected by a bacteria that has been passed on to him by Fred, it will be of no use for John to take Amoxicillin. The bacteria is already resistant. This has been proven in communities worldwide. Penicillin, the very first antibiotic to be marketed, is now useless against most infections. Certain strains of antibiotic resistant Staphylococcus (Golden Staph.) have colonized in hospitals all over the globe. Malaria is resistant to Chloroquine in almost all high-risk Malaria regions (although strictly speaking Malaria is not a bacteria, but the same principle applies).

Five Strains of Bacteria that are Now Resistant

Antibiotic resistance risks returning us to an age where even simple cuts and scrapes can become deadly. For a glimpse of what could be commonplace in our future, here are five of the scariest antibiotic resistant bacteria from the last five years.

1. Extensively drug-resistant Salmonella typhi

This highly contagious bacterium causes typhoid fever, a life-threatening infection that affects about 21 million people around the world every year. About 1% of those affected, or 223,000 people, will die. In November 2016, a strain of Salmonella typhi emerged in Pakistan. It was resistant to five antibiotics, leaving only one oral antibiotic (azithromycin) able to treat it.

2. Extensively drug-resistant Mycobacterium tuberculosis

Mycobacterium tuberculosis is the world’s leading infectious killer, causing more than 1.7 million deaths every year. It’s estimated up to 13% of all new tuberculosis cases are multidrug-resistant, with Europe, including Russia, seeing the highest number of these cases.

3. Pandrug-resistant Klebsiella pneumoniae

Klebsiella pneumoniae is a common bacterium found in the skin, intestines and soil. It causes a range of potentially deadly infections in people with compromised immune systems. As this bacterium is particularly prevalent in hospitals, it’s one of the most critical drug-resistant threats to public health. In 2013 there were 8,000 reports of multidrug-resistant Klebsiella pneumoniae in the United States alone, with a death rate of 50% for people with bloodstream infections.

4. Pandrug-resistant Pseudomonas aeruginosa

Like Klebsiella pneumoniae, Pseudomonas aeruginosa is a commonly found bacterium that causes infections in people with compromised immune systems. Like Klebsiella pneumoniae, it’s particularly prevalent in hospitals. In the past five years, 29 cases of pandrug-resistant Pseudomonas aeruginosa infection have been reported in hospitals in England.

5. Extensively drug-resistant Neisseria gonorrhoeae

There are an estimated 78 million global cases of Neisseria gonorrhea, which causes gonorrhea, a sexually transmitted infection affecting men and women. Although usually not deadly, serious and permanent health problems including infertility can result if the disease goes untreated. Around

PARADISE... IN SICKNESS & IN HEALTH There is nothing worse than flying half way across the globe only to find you are flat on your back for the fist TOO MANY ANTIBIOTICS … few days of your trip…why? They call it “Jetlag”.

Over-prescription of Antibiotics a Major Problem - WHO What is jet lag? Jet lag, also called desynchronosis one-third of all Neisseria gonorrhea infections are resistant or flight fatigue, to at least one antibiotic. More worryingly, a new extensively is a temporary drug-resistant “super gonorrhea”, resistant to all but one disorder that antibiotic, has been discovered. causes fatigue, insomnia, and Steps to reduce use of antibiotics other symptoms Try to avoid infections in the first place. If you do get one, as a result of air use antibiotics correctly. The following steps can help: travel across Wash your hands often time zones. It is • Use plain soap and water. considered a circadian rhythm sleep disorder, which is a • Wash before preparing or eating food. disruption of the internal body clock. • Wash after using the bathroom, changing a diaper, sneezing, coughing, handling garbage and coming What are other symptoms of jet lag? home from public places. Besides fatigue and insomnia, a jet lag sufferer may • Wash before and after treating a cut or wound or being experience a number of physical and emotional symptoms, near a sick person. including anxiety, constipation, diarrhea, confusion, At home dehydration, headache, irritability, nausea, indigestion, • Don’t share personal items like towels, razors, tweezers difficulty concentrating, sweating, coordination problems, dizziness, daytime sleepiness, malaise (a general feeling of being unwell), and even memory loss. Some individuals report additional symptoms, such as heartbeat irregularities and increased susceptibility to illness. and nail clippers. • Keep kitchen and bathrooms clean. You can clean surfaces with soap and water. Try to avoid products with added anti-bacterials. • Don’t put purses, diaper bags, or gym bags on the kitchen table or counter. • Wash wounds with regular soap and water. Children and babies can also suffer the same jet lag Use over-the-counter antibiotic products such as symptoms as adults. neomycin (Neosporin and generic) or bacitracin only for cuts that look dirty. What increases the risk of getting jet lag? Work with your doctor The main cause of jet lag is travel across different time • Don’t push for antibiotics with your doctor. If you don’t zones. However, there are certain risk factors that may have a bacterial infection, ask how to relieve symptoms. result in symptoms being more severe or longer lasting. Consumer demand is one of the major factors in the over-use of antibiotics. • Travel across three or more time zones: Most people • Fight it off. If symptoms are mild and complications can adjust rapidly to a one or two time zone change. unlikely, ask if you can delay treatment for a few days. Three or more may cause more noticeable symptoms • Maintain a healthy lifestyle & diet. of jet lag. • Take antibiotics as prescribed. Don’t skip doses or stop • Flying east. Travel from west to east causes travelers the medicine early. to “lose” time, and this can be a more difficult adjustment. • Don’t use leftover antibiotics to treat an infection. • Age: Older adults may recover from jet lag more slowly. Taking the wrong medicine allows bacteria to multiply. • Frequent travel: Pilots, flight attendants, and frequent business travelers who are constantly in different time zones may have difficulty adjusting. • Preexisting conditions: Preexisting sleep deprivation, If the household or personal product (cleaning solutions, soap, shampoo etc) says antibacterial, leave it on the shelf. Use vinegar, soap, or bicarb soda instead. stress, and poor sleep habits prior to travel can exacerbate jet lag symptoms. • Flight conditions: The monotony of travel, immobility Bacterial resistance cannot be stopped; it is part of evolution itself. However it’s development and spread can be minimized by: and cramped seating, airline food, altitude, and cabin • Only using antibiotics when absolutely necessary. pressure • Knowing what sort of illnesses respond to antibiotics. can impact jet lag symptoms. • Understanding that recovery from many illnesses will • Alcohol use: Overconsumption of alcohol during long occur in the same time frame, with or without antibiotics. flights can also worsen the symptoms of jet lag.

IS IT POSSIBLE TO AVOID JETLAG?

There are several home remedies that can help with prevention of jet lag and easier recovery from the symptoms. The following are tips to help travelers to avoid or to minimize the effects of jet lag.

1. RESET YOUR BODY CLOCK

Jet lag occurs when your body clock is quickly thrown into a new time zone, so help it with the transition by adjusting your sleeping patterns a few days before take-off. You might not be able to match the times exactly, but even sleeping and waking an hour earlier or later can speed up the recovery time once you land.

2. SKIP MEALS ON BOARD

According to research from Harvard Medical School in the US, your body clock temporarily resets when you forgo food, so avoiding in-flight meals en route to your destination (or for 16 hours, the experts suggest) can help you adjust to the local time faster. If you can’t go without food for that long, keep your meals light and sync them to the local eating times as best you can.

3. UNPLUG IN THE AIR

We’d never suggest you shun the in-flight entertainment, but be aware that exposure to blue light can further disrupt your sleeping patterns. Take advantage of the dark cabin and doze so when you arrive you can cruise through until bedtime.

4. SOAK UP THE RAYS

When sunlight hits your eyes, it triggers a reaction in your brain that stops the production of melatonin (the chemical that makes you sleepy), so if you feel drowsy or irritable on arrival, head outdoors. Enjoy an al fresco brekkie, go for a walk, and wear a hat instead of sunglasses as they cut out sunlight’s stimulating effects.

5. SIP ON CHERRY JUICE

Scientists at Northumbria University in the UK discovered that when people drink tart cherry juice, their body’s level of sleep-inducing melatonin significantly increases. So if you’re struggling to catch a few winks after a long flight, down a glass of the red stuff to promote a more restful snooze. Having said this, most flights do not offer cherry juice as a beverage and taking your own drink is generally forbidden on flights these days. Cherry extract is a good alternative.

6. HIT THE GROUND RUNNING

A study in the journal Mental Health and Physical Activity found that exercise can help make you more alert during the day, so boost your concentration with a run around your new surrounds or do sprints on the hotel treadmill to tire yourself out.

7. PUSH THROUGH

To realign the systems that help you sleep, go to bed when the clock says, not when your body says. If it’s 10am when you arrive at your destination, for example, avoid the urge to nap until at least 6pm as this will only exacerbate your jet lag. If there’s no way you’ll survive without a little shut-eye, save your naps for after lunch and limit them to an hour. Food is also important in establishing sleep rhythms, so eat during wakefulness and try as best as you can to live like the locals.

8. WEAR COMFORTABLE CLOTHES

On a long trip, how you feel is more important than how you look. Wear comfortable clothes and shoes. Avoid items that pinch, restrict, or chafe. When selecting your trip outfit, keep in mind the climate in your destination time zone. Dress for your destination.

9. BREAK UP YOUR TRIP

On long flights traveling across eight, 10, or even 12 time zones, break up your trip, if feasible, with a stay in a city about halfway to your destination. For example, if you are traveling from New York to Bombay, India, schedule a

OUTSMARTING JETLAG

stopover of a few days in Dublin or Paris. (At noon in New York, it is 5 p.m. in Dublin, 6 p.m. in Paris, and 10:30 p.m. in Bombay.)

10. OIL UP YOUR FEET

The strangest tip I’ve ever received for preventing jet lag is to rub a bit of sesame oil onto the soles of your feet and wear a pair of socks to help it absorb while you’re on the plane. Surprisingly, it works!

11. CAFFEINE

Caffeine works for you & it works against you. Don’t drink it if you are trying to get some shut-eye, do drink it if you need a pick-me-up when you get to your destination.

WHAT CAN YOU DO FOR JETLAG?

The best way to treat jet lag is to take measures to prevent it. But you may still feel jet lagged when traveling across many time zones, even with some preventative measures. There are no specific medications for jet lag, only medications that may help you get to sleep more easily when you reach your destination, or that remedy some symptoms of jet lag. Melatonin is a hormone that plays a key role in body rhythms and jet lag. After the sun sets, the eyes perceive darkness and alert the hypothalamus to begin releasing melatonin, which promotes sleep. Conversely, when the eyes perceive sunlight, they tell the hypothalamus to withhold melatonin production. However, the hypothalamus cannot readjust its schedule instantly; it takes several days. A dose of melatonin that is between 0.3 mg-5 mg may be taken on the first day you travel at the time you go to sleep at your destination, and for a few days, if needed. Melatonin seems to be most effective when crossing five or more time zones, or traveling east. Melatonin should only be taken by adults. Do not drink alcohol when taking melatonin. Consult a doctor if you plan on taking melatonin. Prescription or over-the-counter (OTC) sleeping pills may help you reset your body clock to the time at your destination. Try not to use them if possible, but if your doctor has prescribed sleep medication, it may be taken if needed for up to two or three nights. Try not to take it for longer, as these medications can be habit-forming. Happy Travels ☺

Let someone know

Let someone know Share how you feel with someone you trust and feel comfortable with, a family member, teacher, doctor or other Share how you feel with someone you trust and feel health professional. Try and think about it as any other comfortable with, a family member, teacher, doctor or other conversation. You can describe what has happened, how health professional. Try and think about it as any other you feel and what help you need. It’s best to be direct so conversation. You can describe what has happened, how that they understand how you feel. Be prepared for their you feel and what help you need. It’s best to be direct so reaction. that they understand how you feel. Be prepared for their reaction. Often people who learn that someone is suicidal can be quite confused and emotional at first. Just keep talking and Often people who learn that someone is suicidal can be together you can find a way through it. Ask your friends/ quite confused and emotional at first. Just keep talking and family member to help you find support in person, online, together you can find a way through it. Ask your friends/ over the phone. Understand that others do care. It is 5. Tell your doctor what herbal products you’re using. family member to help you find support in person, online, over the phone. Understand that others do care. It is important to have support from your friends but if you tell 5. Tell your doctor what herbal products you’re using. Giving your doctor a full list of what you’re taking, including herbal teas or supplements, is extremely important. important to have support from your friends but if you tell them about your suicidal thoughts you cannot expect them to keep it a secret. They want to be able to help you stay Giving your doctor a full list of what you’re taking, including herbal teas or supplements, is extremely important. 6. Look for drug contraindications. Another reason to report any supplements you’re taking to your doctor: They them about your suicidal thoughts you cannot expect them to keep it a secret. They want to be able to help you stay safe and that usually means calling in extra help. 6. Look for drug contraindications. Another reason to report any supplements you’re taking to your doctor: They could be working against your prescription medications. St. John’s wort, for example, should be avoided by anyone taking the contraceptive pills or hepatitis C medications. safe and that usually means calling in extra help. There are few if any support centres for expatriates suffering from mental health issues in Indonesia or Bali. While there could be working against your prescription medications. St. John’s wort, for example, should be avoided by anyone taking the contraceptive pills or hepatitis C medications. 7. Limit the number of herbal products you take. The ingredients could overlap, and you could end up with a higher There are few if any support centres for expatriates suffering from mental health issues in Indonesia or Bali. While there are some excellent counsellor now resident on the Island, their services are reasonably expensive. Help lines overseas 7. Limit the number of herbal products you take. The ingredients could overlap, and you could end up with a higher dose of something that’s potentially toxic. In general, the fewer drugs you take - including those derived from herbs - the better. are some excellent counsellor now resident on the Island, their services are reasonably expensive. Help lines overseas are plentiful, so sourcing support on line from your country of origin may be the best option for some people. dose of something that’s potentially toxic. In general, the fewer drugs you take - including those derived from herbs - the better. Despite our best efforts many people still aren’t getting the right vitamins, either through lack of diet variation or are plentiful, so sourcing support on line from your country Despite our best efforts many people still aren’t getting the destruction of nutrients through cooking etc. of origin may be the best option for some people. right vitamins, either through lack of diet variation or destruction of nutrients through cooking etc. Support for local people can be sourced at the SURYANI If you’re taking medicine that interferes with nutrient absorption, if you’re an older person whose calorie intake is Support for local people can be sourced at the SURYANI Institute http://www.suryani-institute.com/ or the department If you’re taking medicine that interferes with nutrient absorption, if you’re an older person whose calorie intake is low, if you’re an athlete, or if you’re pregnant my advice Institute http://www.suryani-institute.com/ or the department of Mental Health at Sanglah Hospital. low, if you’re an athlete, or if you’re pregnant my advice would be to take a multivitamin as insurance. Take a calcium supplement, if you don’t drink much milk. of Mental Health at Sanglah Hospital. would be to take a multivitamin as insurance. Take a calcium supplement, if you don’t drink much milk. Rather than taking a supplement you’re not sure about, first learn all you can about it, talk with your doctor, and improve PARADISE... IN SICKNESS & IN HEALTH Kim Patra is a qualified Midwife & Nurse Rather than taking a supplement you’re not sure about, first learn all you can about it, talk with your doctor, and improve your health by considering herbal products in a safe way. A nutritionist can evaluate your diet for deficiencies. Also, some online programs provide the same service. If you are seeing a naturopath or herbalist make sure that they are qualified and experienced. And remember, NATURAL is not necessarily SAFE. The OLEANDER flower is a natural beauty – but it will KILL you. PARADISE... IN SICKNESS & IN HEALTH Kim Patra is a qualified Midwife & Nurse Practioner who has been living and working in Bali for over 30 years. She now runs her own Private Practice & Mothers & Babies center at your health by considering herbal products in a safe way. A nutritionist can evaluate your diet for deficiencies. Also, some online programs provide the same service. If you are seeing a naturopath or herbalist make sure that they are qualified and experienced. And remember, NATURAL is not necessarily SAFE. The OLEANDER flower is a natural beauty – but it will KILL you. Kim Patra is a qualified Midwife & Nurse Practioner who has been living and working in Bali for over 30 years. She now runs Kim Patra is a qualified Midwife & Nurse Practioner who has PARADISE... IN SICKNESS & IN HEALTH Kim Patra is a qualified Midwife & Nurse Practioner who has been living and working in Practioner who has been living and working in her Community Health Care office in Sanur. her own Private Practice & Mothers & Babies center at her been living and working in Bali for over 30 years. She now runs Bali for over 30 years. She now runs her own Bali for over 30 years. She now runs her own Kim Patra is a qualified Midwife & Nurse Practioner who has Community Health Care office in Sanur. her own Private Practice & Mothers & Babies center at her Private Practice & Mothers & Babies center at Private Practice & Mothers & Babies center at been living and working in Bali for over 30 years. She now runs Kim Patra is a qualified Midwife & Nurse Practioner who has Kim is happy to discuss any health concerns that Community Health Care office in Sanur.her Community Health Care office in Sanur. her Community Health Care office in Sanur. her own Private Practice & Mothers & Babies center at her been living and working in Bali for over 30 years. She now runs you have and may be contacted via email at Kim is happy to discuss any health concerns that you have and Community Health Care office in Sanur. her own Private Practice & Mothers & Babies center at her balikim2000@gmail.com, or office phone may be contacted via email at balikim2000@gmail.com, or office Kim is happy to discuss any health concerns that you have and Kim is happy to discuss any health concerns that Kim is happy to discuss any health concerns that you have and may be contacted via email at Kim is happy to discuss any health concerns that you have and Community Health Care office in Sanur.085105-775666 or https://www.facebook.com/ CHC Bali phone 085105-775666 or https://www.facebook.com/CHCBali may be contacted via email at balikim2000@gmail.com, or office phone 085105-775666 or https://www.facebook.com/CHCBali you have and may be contacted via email at balikim2000@gmail.com, or office phone Copyright © 2017 Kim Patra You can read all past articles of Paradise...in Sickness & in Health at www.BaliAdvertiser.biz balikim2000@gmail.com, or office phone 085105-775666 or https://www.facebook.com/ CHC Bali Copyright © 2019 Kim Patra You can read all past articles of Paradise...in Sickness & in Health at www.BaliAdvertiser.biz may be contacted via email at balikim2000@gmail.com, or office phone 085105-775666 or https://www.facebook.com/CHCBali Copyright © 2019 Kim Patra You can read all past articles of Paradise...in Sickness & in Health at www.BaliAdvertiser.biz Kim is happy to discuss any health concerns that you have and may be contacted via email at balikim2000@gmail.com, or office phone 085105-775666 or https://www.facebook.com/CHCBali Copyright © 2017 Kim Patra You can read all past articles of Paradise...in Sickness & in Health at www.BaliAdvertiser.biz Copyright © 2019 Kim Patra You can read all past articles of Paradise...in Sickness & in Health at www.BaliAdvertiser.biz Copyright © 2019 Kim Patra You can read all past articles of Paradise...in Sickness & in Health at www.BaliAdvertiser.biz Copyright © 2018 Kim Patra You can read all past articles of Paradise...in Sickness & in Health at www.BaliAdvertiser.biz 085105-775666 or https://www.facebook.com/ CHC Bali