Paradise in Sickness

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

TOO MANY ANTIBIOTICS … Over-prescription of Antibiotics a Major Problem - WHO The recent events in New Zealand, I am sure, have brought memories flooding back to many who have one-third of all Neisseria gonorrhea infections are resistant to at least one antibiotic. More worryingly, a new extensively been involved in similar mass casualty events. drug-resistant “super gonorrhea”, resistant to all but one antibiotic, has been discovered. The ongoing damage to those who are exposed to this kind of trauma, either as part of their work commitment, or Steps to reduce use of antibiotics as someone that has been thrown into an unfortunate Try to avoid infections in the first place. If you do get one, circumstance by fate, is often unseen, but the effects no use antibiotics correctly. The following steps can help: less devastating. Wash your hands often • Use plain soap and water. I recently spoke to an old friend who I remember as being • Wash before preparing or eating food. such a wonderfully positive and happy person. She was the • Wash after using the bathroom, changing a diaper, smile on a cloudy day, the life of the party. That was until sneezing, coughing, handling garbage and coming she became a 911 operator, and after 5 years of service home from public places. found herself thrown into the depths of PTSD to the point that she could not function…let alone smile. • Wash before and after treating a cut or wound or being near a sick person. At home • Don’t share personal items like towels, razors, tweezersDiagnosis of PTSD requires exposure to an event that and nail clippers.involved the actual or possible threat of death, violence or • Keep kitchen and bathrooms clean. You can clean serious injury. Your exposure can happen in one or more of surfaces with soap and water. Try to avoid products these ways: with added anti-bacterials. • You directly experienced the traumatic event • Don’t put purses, diaper bags, or gym bags on the • You witnessed, in person, the traumatic event occurring kitchen table or counter. to others • Wash wounds with regular soap and water. • You learned someone close to you experienced or was Use over-the-counter antibiotic products such as threatened by the traumatic event neomycin (Neosporin and generic) or bacitracin only for • You are repeatedly exposed to graphic details of cuts that look dirty. traumatic events (for example, if you are a first responder Work with your doctor to the scene of traumatic events) • Don’t push for antibiotics with your doctor. If you don’t You may have PTSD if the problems you experience after this exposure continue for more than a month and cause significant problems in your ability to function in social and have a bacterial infection, ask how to relieve symptoms. Consumer demand is one of the major factors in the over-use of antibiotics. • Fight it off. If symptoms are mild and complications work settings and negatively impact relationships. unlikely, ask if you can delay treatment for a few days. • Maintain a healthy lifestyle & diet. TREATMENT • Take antibiotics as prescribed. Don’t skip doses or stop the medicine early. Post-traumatic stress disorder treatment can help you regain • Don’t use leftover antibiotics to treat an infection. a sense of control over your life. The primary treatment is Taking the wrong medicine allows bacteria to multiply. psychotherapy, but can also include medication. If the household or personal product (cleaning solutions, Combining these treatments can help improve your soap, shampoo etc) says antibacterial, leave it on the shelf. symptoms by: Use vinegar, soap, or bicarb soda instead. • Teaching you skills to address your symptoms • Helping you think better about yourself, others and Bacterial resistance cannot be stopped; it is part of evolution the world • Learning ways to cope if any symptoms arise again • Treating other problems often related to traumatic itself. However it’s development and spread can be minimized by: • Only using antibiotics when absolutely necessary. • Knowing what sort of illnesses respond to antibiotics. experiences, such as depression, anxiety, or misuse of • Understanding that recovery from many illnesses will alcohol or drugs occur in the same time frame, with or without antibiotics. You don’t have to try to handle the burden of PTSD on your own.

PSYCHOTHERAPY

Several types of psychotherapy, also called talk therapy, may be used to treat children and adults with PTSD. Cognitive therapy. This type of talk therapy helps you recognize the ways of thinking (cognitive patterns) that are keeping you stuck - for example, negative beliefs about yourself and the risk of traumatic things happening again. For PTSD, cognitive therapy often is used along with exposure therapy. Exposure therapy. This behavioral therapy helps you safely face both situations and memories that you find frightening so that you can learn to cope with them effectively. Exposure therapy can be particularly helpful for flashbacks and nightmares. One approach uses virtual reality programs that allow you to re-enter the setting in which you experienced trauma.

Eye movement desensitization and reprocessing

(EMDR).EMDR combines exposure therapy with a series of guided eye movements that help you process traumatic memories and change how you react to them. You may try individual therapy, group therapy or both. Group therapy can offer a way to connect with others going through similar experiences.

MEDICATIONS

Several types of medications can help improve symptoms of PTSD: Antidepressants. These medications can help symptoms of depression and anxiety. They can also help improve sleep problems and concentration. Anti-anxiety medications. These drugs can relieve severe anxiety and related problems. You and your doctor can work together to figure out the best medication, with the fewest side effects, for your symptoms and situation.

COPING & SUPPORT

If stress and other problems caused by a traumatic event affect your life, see your doctor or mental health professional. You can also take these actions as you continue with treatment for post-traumatic stress disorder: Follow your treatment plan. Although it may take a while to feel benefits from therapy or medications, treatment can be effective, and most people do recover. Remind yourself that it takes time. Learn about PTSD. This knowledge can help you understand what you’re feeling, and then you can develop coping strategies to help you respond effectively. Take care of yourself. Get enough rest, eat a healthy diet, exercise and take time to relax. Try to reduce or avoid caffeine and nicotine, which can worsen anxiety.

PARADISE...

IN SICKNESS & IN HEALTH

PTSD - Post Traumatic Stress Disorder Don’t self-medicate. Turning to alcohol or drugs to numb your feelings isn’t healthy, even though it may be a tempting way to cope. It can lead to more problems down the road, interfere with effective treatments and prevent real healing. Break the cycle. When you feel anxious, take a brisk walk or jump into a hobby to re-focus. Stay connected. Spend time with supportive and caring people - family, friends, faith leaders or others. Consider a support group. Ask your mental health professional for help finding a support group, or contact veterans’ organizations or your community’s social services system.

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 health professional. Try and think about it as any other conversation. You can describe what has happened, how you feel and what help you need. It’s best to be direct so 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 together you can find a way through it. Ask your friends/ 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 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. 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 are plentiful, so sourcing support on line from your country of origin may be the best option for some people. Support for local people can be sourced at the SURYANI Institute http://www.suryani-institute.com/ or the department of Mental Health at Sanglah Hospital.

Share how you feel with someone you trust and feel comfortable with, a family member, teacher, doctor or other health professional. Try and think about it as any other conversation. You can describe what has happened, how you feel and what help you need. It’s best to be direct so 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 WHEN SOMEONE YOU LOVE HAS PTSD together you can find a way through it. Ask your friends/ family member to help you find support in person, online, over the phone. Understand that others do care. It is 5. Tell your doctor what herbal products you’re using. 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. The person you love may seem like a different person than you knew before the trauma - angry and irritable, for example, or withdrawn and depressed. PTSD can important to have support from your friends but if you tell 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 significantly strain the emotional and mental health of loved ones and friends. 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. 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 Remember that you can’t change someone. However, you can: Learn about PTSD. This can help you understand what your loved one is going through. Recognize that avoidance and withdrawal are part of 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. 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 the disorder. If your loved one resists your help, allow space and let your loved one know that you’re available when he or she is ready to accept your help. Offer to attend medical appointments. If your loved one is willing, attending appointments can help you understand 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. and assist with treatment. Be willing to listen. Let your loved one know you’re willing 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. If you’re taking medicine that interferes with nutrient absorption, if you’re an older person whose calorie intake is to listen, but you understand if he or she doesn’t want to talk. Try not to force your loved one to talk about the trauma Support for local people can be sourced at the SURYANI Institute http://www.suryani-institute.com/ or the department of Mental Health at Sanglah Hospital. 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 would be to take a multivitamin as insurance. Take a calcium supplement, if you don’t drink much milk. 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. Rather than taking a supplement you’re not sure about, first learn all you can about it, talk with your doctor, and improve until he or she is ready. Encourage participation. Plan opportunities for activities with family and friends. Celebrate good events. Make your own health a priority. Take care of yourself by eating healthy, being physically active and getting enough rest. Take time alone or with friends, doing activities that PARADISE... 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. PARADISE... IN SICKNESS & IN HEALTH 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. help you recharge. Seek help if you need it. If you have difficulty coping, talk with your doctor. He or she may refer you to a therapist who can help you work through your stress. Stay safe. Plan a safe place for yourself and your children if your loved one becomes violent or abusive. IN SICKNESS & IN HEALTH Kim Patra is a qualified Midwife & Nurse 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 her own Private Practice & Mothers & Babies center at 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 There are now some excellent private mental health services on the Island which I would be happy to share with you via email - balikim2000@gmail.com.

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 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 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. Kim Patra is a qualified Midwife & Nurse Practioner who has 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 been living and working in Bali for over 30 years. She now runs Kim is happy to discuss any health concerns that you have and may be contacted via email at Community Health Care office in Sanur. Kim is happy to discuss any health concerns that you have and her own Private Practice & Mothers & Babies center at her Community Health Care office in Sanur. balikim2000@gmail.com, or office phone 085105-775666 or https://www.facebook.com/ CHC Bali may be contacted via email at balikim2000@gmail.com, or office phone 085105-775666 or https://www.facebook.com/CHCBali 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 her own Private Practice & Mothers & Babies center at her Community Health Care office in Sanur. 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 © 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