Monday 23 October 2017

Dr Ciara Kelly on her post-op complications: 'I felt like there was a hot poker searing through my middle'

As bugs evolve, the drugs don't work any more

Operation Transformation's GP Dr Ciara Kelly. Photo: Gerry Mooney
Operation Transformation's GP Dr Ciara Kelly. Photo: Gerry Mooney
We need to stop using antibiotics for anything that won't kill you
Ciara Kelly

This week's column is yet again about me - when is it ever not, I hear you ask. Hmm, if I'm hearing you talking back, I must be in trouble! But back to the business at hand - it's once more, sort of, about my rather slow road to recovery.

Three weeks on from surgery, I was back at the hospital and unable to climb the single flight of stairs to my surgeon's office. Nor could I carry my own (admittedly oversized) handbag. The reason for this massive setback was that I had developed a wound infection.

I knew I had, it was pretty obvious - I'll spare you the details. So I had self-started an antibiotic to try and treat it. When that didn't work, I changed to a second one.

When that didn't work and my whole abdomen was so tight that I couldn't stand up straight and I felt like there was a hot poker searing through my middle, I decided to call the cavalry - and picked up the phone to my fantastic surgeon, Donal Maguire.

He saw me straight away, despite it being the weekend, started me on two industrial-strength antibiotics and let me crawl home.

And slowly as I write this from my bed in my PJs, I am turning the corner. I no longer walk stooped over like a T-Rex.

I no longer wince at the smallest movement. And the burning numbness in my abdominal wall is ebbing away.

What prompted me to write about it - apart from self-pity and looking for sympathy, obviously - was the fact that I was actually getting into real trouble post-op.

My wound was infected but that infection was spreading beyond it.

I was becoming septic.

I was losing the battle against these bugs. And if it wasn't for the wonders of antibiotics there is every chance that I could have gone on and died from this.

Antibiotics are very possibly the most important drugs in the world. We have little concept now of the fact that people used to die from cat scratches, grazed knees and sore throats. But they did.

We completely take for granted the fact that we can fight off most bacterial infections, despite how nasty they are - simply by popping a pill. But that is changing.

Antibiotics are slowly losing their effectiveness against bacteria.

The bacteria are mutating and evolving and becoming resistant to our drugs and unfortunately we haven't kept pace with that.

We haven't developed a new antibiotic since 1987 and little by little, the bugs are winning - and regaining their ability to kill.

At least 23,000 people died in the US last year from antibiotic-resistant infections.

This resistance is caused by a variety of factors but one of the main ones is certainly the over-use of antibiotics.

They're used liberally for both viral infections, where they are utterly useless, and also for self-limiting bacterial infections where there is really no need to step in with medication at all.

The LA Times recently called it "a slow catastrophe unfolding". As we genuinely stare into the abyss of being unable to treat minor ailments or indeed undergo routine surgeries safely, there will be no safety net.

We are going to start having to look at the possibility of us only ever using antibiotics in cases of severe debilitating infections - saving them, as it were, for when they are really, really needed. And we need to stop using them altogether for anything minor, anything that probably won't kill you.

We are also going to have to look at the possibility of incentivising or forcing, drug companies to develop new antibiotics or we will once again be at the mercy of the bugs.

In the meantime, I'll just shuffle about in my PJs - it looks like I've dodged the bullet this time.

To paraphrase Tolstoy: "Though doctors treated me, let my blood and gave me medicine to drink - I nevertheless survived."

@ciarakellydoc

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