It seems that every time I speak to someone that has recently
been to a local doctor for even a minor condition they are
given a course of steroids, usually a drug known as Dexamethasone.
I find this really concerning as although there are conditions
which steroids certainly are a great help, they should not
prescribed as freely as they are here, especially to children.
I even spoke to one lady who had been prescribed steroid tablets
for a mild cough, and then was double-dosed when she returned
to same clinic only to be prescribed the same drug under a
different name by a different doctor!
So what do steroids do?
Steroids decrease the body’s inflammatory response due
to any cause. They prevent the damaging inflammation caused
by conditions such as rheumatoid arthritis, asthma or inflammatory
bowel disease (Crohns disease). Steroids may also be used
for transplant patients when we are trying to decrease the
body’s immune response. Women in premature labor may
be given steroids to help mature the baby’s lungs before
birth. Steroids may be used in cases of severe head injury
to help lower the pressure inside the skull; in this and the
above mentioned conditions they can be life saving drugs,
but they should not be used in mild day to day illnesses.
Steroids when used over a long period will effectively lower
the immune system response, so while there are conditions
that warrant this therapy, a child for example who is given
steroids every time they have a throat “tickle”
or a cough will suffer the undesirable effects of the medication
such as lowered immune system and stunted growth. BE SURE
when you or your child are prescribed a drug, that you are
told exactly what it is, what is in it and what it is for.
I make a point of refusing little packets of unmarked powder
which are often distributed by doctors here, unless they can
list exactly what is in it as well as the dose.
Don’t use steroids if:
- you have an active peptic ulcer
- you have osteoporosis
- you have a mental illness
- you suffer from widespread fungal
infections
- special precaution is necessary
for those who suffer from chronic illness’s such as
heart failure, renal failure, increased tendency to blood
clotting, tuberculosis
- children (or adults) should NEVER
be given a live vaccine (eg polio, MMR, tuberculosis or yellow
fever vaccines) while on steroids
If you are taking steroids for more than 2 weeks you must
not stop taking them without first decreasing the dose gradually
– you doctor should advise you on this.
A word on eye drops and steroids
About 15 years ago, when I was still attempting to be a successful
contact lens wearer I developed a corneal ulcer. This can
sometimes happen to those who wear lenses, and this was the
second time that I had suffered so I was quite sure I knew
what I had. The eye doctor who checked my eyes in Denpasar
thought there may have been some viral involvement as well,
like herpes of the eye. Well it seemed that he knew what he
was doing so I walked out of his office quite happy with my
prescription gripped tightly in my hand as I tried to negotiate
my way across the street with blurred vision in only one eye!
I make a habit of cross checking any medication that is prescribed
for me (as should everyone), and in this case it probably
saved my sight. The kind doctor had prescribed steroid drops
for my eye which is ABSOLUTELY CONTRA-INIDICATED in viral
conditions of the eye. Unfortunately a friend of mine, who
had the same condition and probably saw the same doctor and
was not aware of this conraindication. She is now permanently
blind in one eye; a tragedy that should never have happened.
Should you have any doubt regarding the medicines that you
have been prescribed, please do not hesitate to contact me
at info@chcbali.com.
“Kim Patra is a qualified Registered Nurse and Midwife
that has been living and working in Bali for almost twenty
years. She now runs her own private practice and medical referral
service from her Kuta office. Kim is happy to discuss any
health concerns with you and she may be contacted via e-mail
at info@chcbali.com”.
