Thanks everyone. for joining us on another episode
of our podcast, The Canadian Breakpoint. So today
we're doing this new thing. I've never done this
before. We're doing an AMR series and it's going
to be fantastic. We're talking actually from
the symposium here in Toronto and we have a lot
of good speakers, a lot of different perspectives
about antimicrobial resistance. And so today
we have Ms. Huda. Rezek, who is here with us
to talk about antimicrobial resistance and really
have a focus on stewardship and more from a personal
and patient perspective. So welcome, Huda, and
thank you so much for joining us today. Thank
you so much for having me. I'm so excited. Yeah,
awesome. And so why don't you let our audience
know a little bit about yourself and what brought
you to the symposium today? For sure. So I do
have cystic fibrosis. It's an infection, a genetic
condition that causes a lot of infection and
causes a lot of thick mucus. So I'm not a stranger
to bacteria. Bacteria is always growing. There's
always something going on. And I'm always taking
antibiotics of some sort. So really not for the
basis of most people where they go get antibiotics
to get cured and it's over and the story ends.
For me, the antibiotics is really just when I
can't fight on my own anymore, when the base
treatment doesn't work anymore. I do. antibiotics
in the hospital to give me that little boost
so that I can go back to doing what I do. So
I do have this genetic disease. I'm also a dietitian.
I graduated from McGill in Montreal, Quebec.
And so I do dietitian as my job in Montreal.
I'm based from there. And I also do a little
bit of reception work that I like as well in
the same clinic. And then when I'm not doing
any of that, I do also drug testing. So I get
to do like rapid tests for people, employees
who are about to start for like drug testing
or alcohol testing, hearing testing, all of that.
So those are really like, I'm busy. Yeah. You're
busy. Yeah. Especially with having kind of a
condition like cystic fibrosis is more chronic.
Sometimes you're away from probably work for
a while. Yeah. it's tied into why I care about
this so much is that can we reduce that amount
of time that I'm there? Yeah. And that's a really
good point that you bring up because whenever
we think about antimicrobial stewardship and
resistance developing, we kind of always think
about appropriate use of antibiotics, but there's
also. Another kind of angle to it is how long
we're using these antibiotics, right? So starting
the antibiotic, which one it is, if it's the
right one. And obviously for you, I'm sure when
you look at your kind of susceptibilities come
back for the organisms that you normally grow,
you probably also worry like, am I developing
resistance and what's happening? So absolutely.
So we're a little bit beyond worry. I don't want
to make this too depressing, but. You know, I
do have only a couple of options left. I do carry
multi -drug resistant bacteria already. We're
kind of already there. Yeah. And it does have
a lot to do with why I'm here and why I'm so
passionate with this topic of antibiotic resistance
is that I don't think it's something people think
of as being so imminent. unless you're living
through it which i am yeah or you know someone
who is exactly yeah and so how do you feel like
the impact of kind of the resistance like over
the years has been for you from a quality or
you know patient perspective sample question
because um it used to be that i can go do like
go to the hospital get oral antibiotics get discharged
within like minutes from that Take it and it
works. And it's like, you move on, you go back
to school, you go back to your studies. Everything's
fine. It doesn't do anything. Right now, oral
antibiotics don't work for me anymore. They're
not strong enough because we've used them. My
bacteria is resistant to them. So that's one
thing. I can't go with an oral antibiotic anymore.
The other reality is that I can't even go with
one IV antibiotic anymore. It has to be two at
a time. And I'm kind of left with... two options.
So it becomes a lot harder that you start questioning
if I'm even going to go to the hospital. That's
where I'm at right now is asking, is it worth
to go to the hospital? Like, am I sick enough
that I need to go today, tomorrow, or the next
day? Exactly. And that it might just mean that
taking antibiotics now could potentially reduce.
my ability to use them next time. Right. Because
of resistance. Okay. And so what's the message
that you want to send to our listeners today?
If we can work on, you know, using the faster
diagnostic tools that companies have created
and it is available, if we can use to diagnose
quicker to avoid unnecessary antibiotic use when
it's, for example, viral or it's... fungal or
something else yeah from a patient perspective
also to not want that i think we tend to go to
the hospital hoping for a prescription yeah at
the end of the day right and we do have to realize
that what we're asking might end up hurting us
with resistance the more bacteria antibiotics
we use the more bacteria gets used to it and
gets resistant right that's just the reality
behind it so a little bit of quicker diagnostic
would be my my dream yeah being having that discussion
with the doctor about the risks and the use of
it right to really sit down and and talk about
that yeah to make that decision together yeah
that's a fantastic point I think it's really
important to kind of really bring out the idea
that sometimes if you do have a cold you know
that type of thing you not need antibiotics because
it's not material could be viral and and really
looking at it not how it's going to make me feel
better today but in the long run long -term outcomes
and the consequences if I continue kind of taking
those antibiotics and building that resistance.
Yes. Yeah, exactly. It's a really good, important
point. And I think even with the antimicrobial
resistance symposium that we're here today and
over the next two days, there's a lot of talks
around resistance and not only that, having some
diagnostic stewardship. what you mentioned in
terms of, you know, relying on some rapid tests.
And communicating, I think, is really important
in reducing that barrier within even hospitals
that, you know, we don't know what's available.
And so talking to the microbiologists about that
is really important as well. And knowing what
your hospital can provide. And if they can't,
for instance, and not just in hospitals, I think
in community -centered settings too, like acute
care settings, we also do need that as well,
where we... know which tests that we have and
what's available to kind of help us distinguish
between bacterial viral fungal exactly yeah and
it's you know we've never done it from a patient
perspective so I think it's always important
to kind of see the other side right and and you're
seeing it from kind of, you know, the next antibiotic,
whether it's going to build more resistance.
And then, you know, you're worried not only are
you worried when you're going to the hospital,
am I going to have to stay here long enough?
Have I built more resistance? Right. And do I,
do I have options to treat? Right. Because the
question right now is I don't know. Yeah. And
it's very frightening, you know, look at it from,
I mean, from a physician standpoint, it's also
like frightening because you want to support
the patient and you want to help them, but living
with it and then knowing kind of which options
you have and don't have, it would be. I can't
even imagine. What's worse of it is that the
last two antibiotics I was on that were sensitive
to my bacteria, so we're all happy, yay, you
know? I ended up having a really scary experience
while on them where I had a massive lung bleed.
So my lungs were just bleeding nonstop. The nurses
couldn't stop it. It took a lot of effort. So
you come and you're thinking, these are the last
two, but... look at the risk. Look at how you
feel on them is that you're getting close to
that lung bleed. Now it's not directly because
of the antibiotics, but it's just being on those
two and feeling that really makes you wonder,
is there better options or maybe less risk? Yeah.
And you bring up a really good point. I mean,
this one probably wasn't mainly directly related
or a side effect, but there's also side effects
to antibiotics and being on antibiotics and those
types of things that I think in the moment when
people are thinking about an acute, you just
want to feel better. Exactly. But sometimes,
yeah, which is fair. And, but sometimes in the
long run, that is not going to benefit you. Right.
Unfortunately. Right. And so. So that's why I'm
here. That's why the AMR speaks so loudly for
me is because I am there. I am at the point.
I understand how imminent this is. And if there's
anything I can do to create that awareness for
anyone to realize that maybe we do need to talk
more about the use of antibiotics and faster
testing and all of that. That's really the goal.
It's not about finding options for me. It's realizing
that resistance is going to affect everyone.
If I cross with someone else who has CF, I can
give them my resistance. And all of a sudden,
they're down of options without even going on
it. So it is a little bit of a silent threat
that we don't realize. and it's it's it's very
it's actually quite alarming how this has progressed
um and like resistance has progressed over the
years. And I think we always talk about this
and, and how it's, you know, caused deaths and
diseases to become more challenging to treat.
And so thank you so much for bringing your perspective.
And I think most of us here at the AMR symposium
have a very share kind of the same passion as
you. Obviously, we're not going through the day
to day challenges that you are. So you're very
brave. So thank you so much for bringing out
your story and telling us a lot about kind of
how this affects you directly and we hope that
with this awareness today with you coming on
the podcast with us being here live today at
the AMR symposium and talking to experts and
researchers and clinicians that all of us can
kind of work together to really combat this issue.
Yes, well said. And I think not only work together,
but have that discussion together. You as a patient,
when you go to the hospital to be empowered to
know that this could be an issue and what are
my options and open that discussion. And you
can, you can as a, like, you don't have to be
a science -y person. You don't have to be a doctor.
You can just bring it up to your doctor about
what about resistance and is this the right?
thankfully right and thank you so much for bringing
that up because I think it's really important
as kind of being a patient and I recently had
you know some exposure of being kind of on the
patient side with my dad and and him going through
an illness and I can't even you know it's such
an eye -opener sometimes when you're on the patient
perspective side and how many things that you
have to think about and and sometimes you don't
know the questions you have to ask I think Thank
you for telling the audience that it's okay to
question things. It's okay to ask about your
care, to ask if you have fears about an antibiotic
that you're going to be put on. And I always
tell parents about the resistance that can develop
and all that. But I feel like it's really important
that families advocate or patients advocate for
themselves too and bring this up. And so I think
you're a key example of someone who for sure
does that. And it's fantastic. see from my perspective
as well to see that you're an inspiration to
others that have chronic conditions but also
just going in for a common cold and yes and you
know they should think do I really need this?
Exactly. Yeah. So just to bring about the conversation,
that's what I ask of everybody. Yeah, that's
great. Talking about. Yeah. And I think start
talking is probably a good approach to create
the education and awareness as well, because
then in that moment, the physician themselves
who is about to prescribe. probably also has
to think, you know, is this the right choice?
Right. Should I make this choice today to give
this patient a viral prescription or a antibiotic?
Yes. And I think there's a lot of different methods
that we've kind of brought up with stewardship
and a lot of different techniques that we've
figured out. And I think there's a lot of discussion
around this. So, yeah, I think we'll all continue
to get better. Yeah, I am hopeful these events
do bring about the hope. A hundred percent. Yeah.
And they bring about action. So that's what we're
here today for. Exactly. Awesome. Well, thank
you so much for coming on to the podcast and
supporting the podcast. And thank you so much
for having me. Of course. And we wish you all
the best. Thank you. Thanks.