WEBVTT 00:00:07.789 --> 00:00:10.839 Thanks everyone. for joining us on another episode 00:00:10.839 --> 00:00:14.039 of our podcast, The Canadian Breakpoint. So today 00:00:14.039 --> 00:00:16.480 we're doing this new thing. I've never done this 00:00:16.480 --> 00:00:19.199 before. We're doing an AMR series and it's going 00:00:19.199 --> 00:00:22.519 to be fantastic. We're talking actually from 00:00:22.519 --> 00:00:26.059 the symposium here in Toronto and we have a lot 00:00:26.059 --> 00:00:28.480 of good speakers, a lot of different perspectives 00:00:28.480 --> 00:00:31.120 about antimicrobial resistance. And so today 00:00:31.120 --> 00:00:35.939 we have Ms. Huda. Rezek, who is here with us 00:00:35.939 --> 00:00:39.979 to talk about antimicrobial resistance and really 00:00:39.979 --> 00:00:43.500 have a focus on stewardship and more from a personal 00:00:43.500 --> 00:00:46.659 and patient perspective. So welcome, Huda, and 00:00:46.659 --> 00:00:48.439 thank you so much for joining us today. Thank 00:00:48.439 --> 00:00:50.899 you so much for having me. I'm so excited. Yeah, 00:00:50.960 --> 00:00:53.840 awesome. And so why don't you let our audience 00:00:53.840 --> 00:00:56.539 know a little bit about yourself and what brought 00:00:56.539 --> 00:00:59.759 you to the symposium today? For sure. So I do 00:00:59.759 --> 00:01:03.640 have cystic fibrosis. It's an infection, a genetic 00:01:03.640 --> 00:01:07.200 condition that causes a lot of infection and 00:01:07.200 --> 00:01:11.180 causes a lot of thick mucus. So I'm not a stranger 00:01:11.180 --> 00:01:14.150 to bacteria. Bacteria is always growing. There's 00:01:14.150 --> 00:01:17.390 always something going on. And I'm always taking 00:01:17.390 --> 00:01:20.790 antibiotics of some sort. So really not for the 00:01:20.790 --> 00:01:23.790 basis of most people where they go get antibiotics 00:01:23.790 --> 00:01:26.730 to get cured and it's over and the story ends. 00:01:26.909 --> 00:01:30.090 For me, the antibiotics is really just when I 00:01:30.090 --> 00:01:32.290 can't fight on my own anymore, when the base 00:01:32.290 --> 00:01:37.500 treatment doesn't work anymore. I do. antibiotics 00:01:37.500 --> 00:01:39.760 in the hospital to give me that little boost 00:01:39.760 --> 00:01:43.459 so that I can go back to doing what I do. So 00:01:43.459 --> 00:01:48.099 I do have this genetic disease. I'm also a dietitian. 00:01:48.099 --> 00:01:50.739 I graduated from McGill in Montreal, Quebec. 00:01:51.060 --> 00:01:58.540 And so I do dietitian as my job in Montreal. 00:01:58.700 --> 00:02:01.959 I'm based from there. And I also do a little 00:02:01.959 --> 00:02:04.120 bit of reception work that I like as well in 00:02:04.120 --> 00:02:06.790 the same clinic. And then when I'm not doing 00:02:06.790 --> 00:02:09.889 any of that, I do also drug testing. So I get 00:02:09.889 --> 00:02:13.710 to do like rapid tests for people, employees 00:02:13.710 --> 00:02:16.250 who are about to start for like drug testing 00:02:16.250 --> 00:02:20.810 or alcohol testing, hearing testing, all of that. 00:02:20.889 --> 00:02:23.330 So those are really like, I'm busy. Yeah. You're 00:02:23.330 --> 00:02:26.030 busy. Yeah. Especially with having kind of a 00:02:26.030 --> 00:02:28.729 condition like cystic fibrosis is more chronic. 00:02:28.770 --> 00:02:30.889 Sometimes you're away from probably work for 00:02:30.889 --> 00:02:35.259 a while. Yeah. it's tied into why I care about 00:02:35.259 --> 00:02:38.300 this so much is that can we reduce that amount 00:02:38.300 --> 00:02:41.460 of time that I'm there? Yeah. And that's a really 00:02:41.460 --> 00:02:42.819 good point that you bring up because whenever 00:02:42.819 --> 00:02:45.319 we think about antimicrobial stewardship and 00:02:45.319 --> 00:02:47.800 resistance developing, we kind of always think 00:02:47.800 --> 00:02:50.580 about appropriate use of antibiotics, but there's 00:02:50.580 --> 00:02:54.819 also. Another kind of angle to it is how long 00:02:54.819 --> 00:02:57.319 we're using these antibiotics, right? So starting 00:02:57.319 --> 00:02:59.560 the antibiotic, which one it is, if it's the 00:02:59.560 --> 00:03:02.580 right one. And obviously for you, I'm sure when 00:03:02.580 --> 00:03:05.580 you look at your kind of susceptibilities come 00:03:05.580 --> 00:03:08.939 back for the organisms that you normally grow, 00:03:09.240 --> 00:03:11.719 you probably also worry like, am I developing 00:03:11.719 --> 00:03:14.599 resistance and what's happening? So absolutely. 00:03:14.900 --> 00:03:17.439 So we're a little bit beyond worry. I don't want 00:03:17.439 --> 00:03:20.340 to make this too depressing, but. You know, I 00:03:20.340 --> 00:03:24.039 do have only a couple of options left. I do carry 00:03:24.039 --> 00:03:27.240 multi -drug resistant bacteria already. We're 00:03:27.240 --> 00:03:30.379 kind of already there. Yeah. And it does have 00:03:30.379 --> 00:03:32.500 a lot to do with why I'm here and why I'm so 00:03:32.500 --> 00:03:35.960 passionate with this topic of antibiotic resistance 00:03:35.960 --> 00:03:38.780 is that I don't think it's something people think 00:03:38.780 --> 00:03:42.469 of as being so imminent. unless you're living 00:03:42.469 --> 00:03:45.129 through it which i am yeah or you know someone 00:03:45.129 --> 00:03:48.110 who is exactly yeah and so how do you feel like 00:03:48.110 --> 00:03:51.229 the impact of kind of the resistance like over 00:03:51.229 --> 00:03:54.129 the years has been for you from a quality or 00:03:54.129 --> 00:03:56.849 you know patient perspective sample question 00:03:56.849 --> 00:04:03.169 because um it used to be that i can go do like 00:04:03.169 --> 00:04:06.789 go to the hospital get oral antibiotics get discharged 00:04:06.789 --> 00:04:10.530 within like minutes from that Take it and it 00:04:10.530 --> 00:04:12.770 works. And it's like, you move on, you go back 00:04:12.770 --> 00:04:15.270 to school, you go back to your studies. Everything's 00:04:15.270 --> 00:04:18.629 fine. It doesn't do anything. Right now, oral 00:04:18.629 --> 00:04:20.430 antibiotics don't work for me anymore. They're 00:04:20.430 --> 00:04:23.110 not strong enough because we've used them. My 00:04:23.110 --> 00:04:25.790 bacteria is resistant to them. So that's one 00:04:25.790 --> 00:04:28.449 thing. I can't go with an oral antibiotic anymore. 00:04:29.129 --> 00:04:32.350 The other reality is that I can't even go with 00:04:32.350 --> 00:04:35.790 one IV antibiotic anymore. It has to be two at 00:04:35.790 --> 00:04:39.060 a time. And I'm kind of left with... two options. 00:04:39.199 --> 00:04:42.680 So it becomes a lot harder that you start questioning 00:04:42.680 --> 00:04:44.839 if I'm even going to go to the hospital. That's 00:04:44.839 --> 00:04:48.860 where I'm at right now is asking, is it worth 00:04:48.860 --> 00:04:51.540 to go to the hospital? Like, am I sick enough 00:04:51.540 --> 00:04:55.160 that I need to go today, tomorrow, or the next 00:04:55.160 --> 00:04:59.139 day? Exactly. And that it might just mean that 00:04:59.139 --> 00:05:02.480 taking antibiotics now could potentially reduce. 00:05:03.019 --> 00:05:07.100 my ability to use them next time. Right. Because 00:05:07.100 --> 00:05:09.759 of resistance. Okay. And so what's the message 00:05:09.759 --> 00:05:13.120 that you want to send to our listeners today? 00:05:13.740 --> 00:05:18.279 If we can work on, you know, using the faster 00:05:18.279 --> 00:05:20.920 diagnostic tools that companies have created 00:05:20.920 --> 00:05:24.279 and it is available, if we can use to diagnose 00:05:24.279 --> 00:05:28.459 quicker to avoid unnecessary antibiotic use when 00:05:28.459 --> 00:05:31.889 it's, for example, viral or it's... fungal or 00:05:31.889 --> 00:05:34.990 something else yeah from a patient perspective 00:05:34.990 --> 00:05:39.529 also to not want that i think we tend to go to 00:05:39.529 --> 00:05:42.129 the hospital hoping for a prescription yeah at 00:05:42.129 --> 00:05:44.790 the end of the day right and we do have to realize 00:05:44.790 --> 00:05:48.550 that what we're asking might end up hurting us 00:05:48.550 --> 00:05:51.769 with resistance the more bacteria antibiotics 00:05:51.769 --> 00:05:54.470 we use the more bacteria gets used to it and 00:05:54.470 --> 00:05:56.629 gets resistant right that's just the reality 00:05:56.629 --> 00:06:00.160 behind it so a little bit of quicker diagnostic 00:06:00.160 --> 00:06:04.379 would be my my dream yeah being having that discussion 00:06:04.379 --> 00:06:07.600 with the doctor about the risks and the use of 00:06:07.600 --> 00:06:10.459 it right to really sit down and and talk about 00:06:10.459 --> 00:06:13.439 that yeah to make that decision together yeah 00:06:13.439 --> 00:06:15.779 that's a fantastic point I think it's really 00:06:15.779 --> 00:06:19.360 important to kind of really bring out the idea 00:06:19.360 --> 00:06:22.279 that sometimes if you do have a cold you know 00:06:22.279 --> 00:06:25.000 that type of thing you not need antibiotics because 00:06:25.000 --> 00:06:28.470 it's not material could be viral and and really 00:06:28.470 --> 00:06:31.389 looking at it not how it's going to make me feel 00:06:31.389 --> 00:06:34.430 better today but in the long run long -term outcomes 00:06:34.430 --> 00:06:38.420 and the consequences if I continue kind of taking 00:06:38.420 --> 00:06:40.720 those antibiotics and building that resistance. 00:06:40.879 --> 00:06:43.759 Yes. Yeah, exactly. It's a really good, important 00:06:43.759 --> 00:06:46.560 point. And I think even with the antimicrobial 00:06:46.560 --> 00:06:49.180 resistance symposium that we're here today and 00:06:49.180 --> 00:06:52.160 over the next two days, there's a lot of talks 00:06:52.160 --> 00:06:55.980 around resistance and not only that, having some 00:06:55.980 --> 00:06:59.279 diagnostic stewardship. what you mentioned in 00:06:59.279 --> 00:07:02.519 terms of, you know, relying on some rapid tests. 00:07:02.699 --> 00:07:05.579 And communicating, I think, is really important 00:07:05.579 --> 00:07:08.879 in reducing that barrier within even hospitals 00:07:08.879 --> 00:07:11.100 that, you know, we don't know what's available. 00:07:11.360 --> 00:07:15.079 And so talking to the microbiologists about that 00:07:15.079 --> 00:07:17.300 is really important as well. And knowing what 00:07:17.300 --> 00:07:19.620 your hospital can provide. And if they can't, 00:07:19.620 --> 00:07:21.480 for instance, and not just in hospitals, I think 00:07:21.480 --> 00:07:23.639 in community -centered settings too, like acute 00:07:23.639 --> 00:07:26.459 care settings, we also do need that as well, 00:07:26.459 --> 00:07:29.240 where we... know which tests that we have and 00:07:29.240 --> 00:07:31.620 what's available to kind of help us distinguish 00:07:31.620 --> 00:07:36.379 between bacterial viral fungal exactly yeah and 00:07:36.379 --> 00:07:38.319 it's you know we've never done it from a patient 00:07:38.319 --> 00:07:41.500 perspective so I think it's always important 00:07:41.500 --> 00:07:45.939 to kind of see the other side right and and you're 00:07:45.939 --> 00:07:48.980 seeing it from kind of, you know, the next antibiotic, 00:07:49.259 --> 00:07:50.959 whether it's going to build more resistance. 00:07:51.240 --> 00:07:53.680 And then, you know, you're worried not only are 00:07:53.680 --> 00:07:55.379 you worried when you're going to the hospital, 00:07:55.420 --> 00:07:56.600 am I going to have to stay here long enough? 00:07:56.819 --> 00:07:59.620 Have I built more resistance? Right. And do I, 00:07:59.620 --> 00:08:03.399 do I have options to treat? Right. Because the 00:08:03.399 --> 00:08:05.970 question right now is I don't know. Yeah. And 00:08:05.970 --> 00:08:08.129 it's very frightening, you know, look at it from, 00:08:08.170 --> 00:08:10.029 I mean, from a physician standpoint, it's also 00:08:10.029 --> 00:08:12.069 like frightening because you want to support 00:08:12.069 --> 00:08:14.850 the patient and you want to help them, but living 00:08:14.850 --> 00:08:17.829 with it and then knowing kind of which options 00:08:17.829 --> 00:08:22.550 you have and don't have, it would be. I can't 00:08:22.550 --> 00:08:25.829 even imagine. What's worse of it is that the 00:08:25.829 --> 00:08:28.889 last two antibiotics I was on that were sensitive 00:08:28.889 --> 00:08:31.110 to my bacteria, so we're all happy, yay, you 00:08:31.110 --> 00:08:34.990 know? I ended up having a really scary experience 00:08:34.990 --> 00:08:38.870 while on them where I had a massive lung bleed. 00:08:39.009 --> 00:08:42.850 So my lungs were just bleeding nonstop. The nurses 00:08:42.850 --> 00:08:46.690 couldn't stop it. It took a lot of effort. So 00:08:46.690 --> 00:08:48.769 you come and you're thinking, these are the last 00:08:48.769 --> 00:08:52.720 two, but... look at the risk. Look at how you 00:08:52.720 --> 00:08:56.179 feel on them is that you're getting close to 00:08:56.179 --> 00:08:59.059 that lung bleed. Now it's not directly because 00:08:59.059 --> 00:09:02.539 of the antibiotics, but it's just being on those 00:09:02.539 --> 00:09:06.799 two and feeling that really makes you wonder, 00:09:06.919 --> 00:09:11.059 is there better options or maybe less risk? Yeah. 00:09:11.100 --> 00:09:12.539 And you bring up a really good point. I mean, 00:09:12.559 --> 00:09:14.779 this one probably wasn't mainly directly related 00:09:14.779 --> 00:09:17.379 or a side effect, but there's also side effects 00:09:17.379 --> 00:09:19.860 to antibiotics and being on antibiotics and those 00:09:19.860 --> 00:09:22.480 types of things that I think in the moment when 00:09:22.480 --> 00:09:24.179 people are thinking about an acute, you just 00:09:24.179 --> 00:09:26.820 want to feel better. Exactly. But sometimes, 00:09:27.019 --> 00:09:30.379 yeah, which is fair. And, but sometimes in the 00:09:30.379 --> 00:09:34.059 long run, that is not going to benefit you. Right. 00:09:34.120 --> 00:09:37.480 Unfortunately. Right. And so. So that's why I'm 00:09:37.480 --> 00:09:41.279 here. That's why the AMR speaks so loudly for 00:09:41.279 --> 00:09:43.840 me is because I am there. I am at the point. 00:09:44.350 --> 00:09:48.230 I understand how imminent this is. And if there's 00:09:48.230 --> 00:09:51.230 anything I can do to create that awareness for 00:09:51.230 --> 00:09:54.850 anyone to realize that maybe we do need to talk 00:09:54.850 --> 00:09:58.350 more about the use of antibiotics and faster 00:09:58.350 --> 00:10:01.620 testing and all of that. That's really the goal. 00:10:01.820 --> 00:10:04.500 It's not about finding options for me. It's realizing 00:10:04.500 --> 00:10:06.980 that resistance is going to affect everyone. 00:10:07.440 --> 00:10:11.620 If I cross with someone else who has CF, I can 00:10:11.620 --> 00:10:15.100 give them my resistance. And all of a sudden, 00:10:15.139 --> 00:10:17.519 they're down of options without even going on 00:10:17.519 --> 00:10:21.659 it. So it is a little bit of a silent threat 00:10:21.659 --> 00:10:26.240 that we don't realize. and it's it's it's very 00:10:26.240 --> 00:10:30.240 it's actually quite alarming how this has progressed 00:10:30.240 --> 00:10:32.860 um and like resistance has progressed over the 00:10:33.419 --> 00:10:35.820 years. And I think we always talk about this 00:10:35.820 --> 00:10:39.240 and, and how it's, you know, caused deaths and 00:10:39.240 --> 00:10:42.019 diseases to become more challenging to treat. 00:10:42.259 --> 00:10:45.460 And so thank you so much for bringing your perspective. 00:10:45.639 --> 00:10:50.000 And I think most of us here at the AMR symposium 00:10:50.000 --> 00:10:53.320 have a very share kind of the same passion as 00:10:53.320 --> 00:10:56.740 you. Obviously, we're not going through the day 00:10:56.740 --> 00:10:59.000 to day challenges that you are. So you're very 00:10:59.000 --> 00:11:01.440 brave. So thank you so much for bringing out 00:11:01.440 --> 00:11:04.669 your story and telling us a lot about kind of 00:11:04.669 --> 00:11:08.090 how this affects you directly and we hope that 00:11:08.090 --> 00:11:11.169 with this awareness today with you coming on 00:11:11.169 --> 00:11:13.850 the podcast with us being here live today at 00:11:13.850 --> 00:11:17.350 the AMR symposium and talking to experts and 00:11:17.350 --> 00:11:20.090 researchers and clinicians that all of us can 00:11:20.090 --> 00:11:22.929 kind of work together to really combat this issue. 00:11:23.569 --> 00:11:26.389 Yes, well said. And I think not only work together, 00:11:26.470 --> 00:11:30.470 but have that discussion together. You as a patient, 00:11:30.490 --> 00:11:32.470 when you go to the hospital to be empowered to 00:11:32.470 --> 00:11:35.409 know that this could be an issue and what are 00:11:35.409 --> 00:11:37.429 my options and open that discussion. And you 00:11:37.429 --> 00:11:39.610 can, you can as a, like, you don't have to be 00:11:39.610 --> 00:11:42.669 a science -y person. You don't have to be a doctor. 00:11:42.889 --> 00:11:45.769 You can just bring it up to your doctor about 00:11:45.769 --> 00:11:48.590 what about resistance and is this the right? 00:11:49.070 --> 00:11:51.210 thankfully right and thank you so much for bringing 00:11:51.210 --> 00:11:52.950 that up because I think it's really important 00:11:52.950 --> 00:11:56.590 as kind of being a patient and I recently had 00:11:56.590 --> 00:11:59.009 you know some exposure of being kind of on the 00:11:59.009 --> 00:12:01.889 patient side with my dad and and him going through 00:12:01.889 --> 00:12:07.230 an illness and I can't even you know it's such 00:12:07.230 --> 00:12:10.149 an eye -opener sometimes when you're on the patient 00:12:10.149 --> 00:12:12.789 perspective side and how many things that you 00:12:12.789 --> 00:12:14.909 have to think about and and sometimes you don't 00:12:14.909 --> 00:12:17.009 know the questions you have to ask I think Thank 00:12:17.009 --> 00:12:19.629 you for telling the audience that it's okay to 00:12:19.629 --> 00:12:22.169 question things. It's okay to ask about your 00:12:22.169 --> 00:12:25.769 care, to ask if you have fears about an antibiotic 00:12:25.769 --> 00:12:28.470 that you're going to be put on. And I always 00:12:28.470 --> 00:12:32.649 tell parents about the resistance that can develop 00:12:32.649 --> 00:12:34.769 and all that. But I feel like it's really important 00:12:34.769 --> 00:12:38.090 that families advocate or patients advocate for 00:12:38.090 --> 00:12:41.230 themselves too and bring this up. And so I think 00:12:41.230 --> 00:12:44.309 you're a key example of someone who for sure 00:12:44.309 --> 00:12:47.769 does that. And it's fantastic. see from my perspective 00:12:47.769 --> 00:12:51.210 as well to see that you're an inspiration to 00:12:51.210 --> 00:12:54.490 others that have chronic conditions but also 00:12:54.490 --> 00:12:57.370 just going in for a common cold and yes and you 00:12:57.370 --> 00:12:59.990 know they should think do I really need this? 00:13:00.070 --> 00:13:03.789 Exactly. Yeah. So just to bring about the conversation, 00:13:04.090 --> 00:13:06.309 that's what I ask of everybody. Yeah, that's 00:13:06.309 --> 00:13:08.929 great. Talking about. Yeah. And I think start 00:13:08.929 --> 00:13:12.269 talking is probably a good approach to create 00:13:12.269 --> 00:13:14.830 the education and awareness as well, because 00:13:14.830 --> 00:13:17.230 then in that moment, the physician themselves 00:13:17.230 --> 00:13:20.279 who is about to prescribe. probably also has 00:13:20.279 --> 00:13:22.460 to think, you know, is this the right choice? 00:13:22.559 --> 00:13:24.779 Right. Should I make this choice today to give 00:13:24.779 --> 00:13:28.580 this patient a viral prescription or a antibiotic? 00:13:28.720 --> 00:13:32.059 Yes. And I think there's a lot of different methods 00:13:32.059 --> 00:13:34.320 that we've kind of brought up with stewardship 00:13:34.320 --> 00:13:37.360 and a lot of different techniques that we've 00:13:37.360 --> 00:13:39.620 figured out. And I think there's a lot of discussion 00:13:39.620 --> 00:13:42.840 around this. So, yeah, I think we'll all continue 00:13:42.840 --> 00:13:45.919 to get better. Yeah, I am hopeful these events 00:13:45.919 --> 00:13:49.629 do bring about the hope. A hundred percent. Yeah. 00:13:49.710 --> 00:13:51.669 And they bring about action. So that's what we're 00:13:51.669 --> 00:13:53.690 here today for. Exactly. Awesome. Well, thank 00:13:53.690 --> 00:13:56.029 you so much for coming on to the podcast and 00:13:56.029 --> 00:13:58.230 supporting the podcast. And thank you so much 00:13:58.230 --> 00:14:00.909 for having me. Of course. And we wish you all 00:14:00.909 --> 00:14:02.350 the best. Thank you. Thanks.