Going Against The Tide

Making the decision to begin  antibiotic therapy

Rheumatic patients who have finally begun antibiotic therapy have often accomplished a tremendous feat that needs to be commended.  They have also made what could have been one of the most difficult decisions of their life-- to begin a medical regimen that is not readily accessed by patients or embraced by the well-intentioned physicians who they have trusted and depended upon.  Onlookers might wonder what the fuss was about when one simply has obtained a prescription for an acne medication.   However, what these individuals have managed to do is really quite courageous, indeed sometimes downright astounding, considering the odds so consistently stacked against them.

Physicians may deny your request to begin an antibiotic protocol. They may dismiss the literature you have studied and which helped you to recognize how promising this treatment option could be for your return to health.  You can walk into a doctor's office feeling sure that you understand the issues you face and what you need to do to help yourself. You later emerge, stripped of your confidence and questioning the validity of the information you have amassed.  A common statement, recounted by rheumatic patients who have a disease other than rheumatoid arthritis or scleroderma for which there are clinical studies, is that "antibiotic therapy hasn't been tested on your condition." An informed patient seeking antibiotic therapy may point out that there exists an established history of drugs being offered to patients with diseases other than the one specifically studied in the clinical trials.

Perhaps your family wants you to "play it safe" and strictly follow traditional thinking regarding treatment of your disease.  Then, you read the conventional literature or visit web sites that detail the current perspectives from highly-respected institutions or "experts" The media is replete with ads that make treating your disease seem so simple. It is a seductive experience as you watch television and see images of healthy looking people, purportedly with serious arthritic conditions, enjoying pain free activities.  You begin to question your initial decision to go against the tide.

Then, one day you return to your rheumatologist and sit in the waiting room.  You look around, get into conversations, and listen to what the sick, discouraged patients are saying.  You learn that, as time goes on, many are taking progressively more toxic drugs to accomplish the same thing their last medication was supposed to do -- reduce the painful inflammatory cycle and stop the destructive course of the disease.  Some people, who you recognize from prior visits, are not looking as well as the last time you saw them.  Others are in obvious pain and appear exhausted.  You wonder if anyone in this population of desperate patients is actually becoming healthier.  You realize that sometimes there is a need for the immediate intervention provided by the newer anti-rheumatic drugs as they can be very effective.  But, you still wonder if any of the recipients of the newer therapies will benefit in the long term after many years of those drugs or suffer from unforeseen side effects in the future.  What is next if and when they fail?

You return home and a TV ad for a new anti-arthritic medication again captures your attention. However, this time you listen carefully to the caveats that are so quickly recited.  Now you believe in your heart that all these medications being advertised are not necessarily a path to real wellness and you need to explore other options.  So, you do more personal research, speak to as many patients as you can and once again you get back to that gut feeling that the standard fare for treatment being offered you needs rethinking for the long term.   You realize that the tide is not always going in the right direction -- and you must steadfastly chart your own course. If you fail to do so, the tide can carry you somewhere you have no intention of going.