August 2, 2026 • 33 mins
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Speaker 1 (00:00):
By the program participants. Welcome to iHeartRadio Communities, a public
affairs special focusing on the biggest issues impacting you this week.
Here's Manny Munoz. I am Manny Munoz. Thank you for
tuning in to iHeartRadio's Communities. our weekly public affairs show
where we try to bring you conversations that will help
(00:22):
you better understand important issues or maybe just some interesting topics.
Either way, I do hope you'll stick around for the
next half hour. And if you have any comments, questions,
or suggestions, please feel free to reach out on Instagram.
My handle is at IOD Manny. That's at IOD M
A N N Y. Now let's get on with the show.
(00:44):
For years, doctors have warned that antibiotic resistance is one
of the greatest public health threats to our time. Now,
if you watch television, home medical kits containing prescription antibiotics
are being more widely marketed. New questions are emerging about
Whether it's really necessary and the unintended consequences, let's bring
(01:04):
in our expertise, Dr. Peter Papadakis, professor of anesthesiology and
critical care at the University of Rochester. Dr. Papadakis, good
to talk to you again. I appreciate the time.
Speaker 2 (01:17):
Not at all, my friend.
Speaker 1 (01:19):
For people who haven't been following and might not have
even noticed that these home medical kits with antibiotics are
being sold all over television, why is it raising so
much concern for doctors?
Speaker 3 (01:31):
I think it's a misdiagnosis. These companies say that you
should go through the pamphlet, match your symptoms, and take
the antibiotics or the antivirals. So there's no chest x-ray.
Speaker 2 (01:43):
There's no labs.
Speaker 3 (01:44):
There's no determination whether or not this is a bacterial
infection or a viral infection. Obviously, viruses don't respond to antibiotics,
and specific antivirals are for specific viruses. So there's no
connection with that. So the patient is not getting proper treatment.
The other very, very important problem is we have a
(02:07):
worldwide problem throughout the world of antibiotic resistance from the unknown.
regulated giving of antibiotics to agricultural animals, chickens, what have you.
It's in our food supply, but also in many third
world countries, people take antibiotics without seeing a doctor.
Speaker 2 (02:27):
You can pick them up at the pharmacy.
Speaker 3 (02:29):
So what has been shown is that close to.
Speaker 2 (02:35):
1.2 million deaths annually.
Speaker 3 (02:37):
Are contributed to are occurring due to antibiotic-resistant organisms in
the ICU. And more than 5 million, this is a
factor that has.
Speaker 2 (02:51):
Contributed to the death of the patient.
Speaker 3 (02:55):
The World Health Organization has also stated that we're spending
over a trillion dollars treating antibiotic-resistant organisms.
Speaker 2 (03:04):
Throughout the world. So this is a major problem that these.
Speaker 3 (03:07):
Companies then lay people these antibiotics in the mail and
you kind of self-prescribe yourself, you know, am I going
to take penicillin or something else?
Speaker 2 (03:18):
So it's a major problem.
Speaker 1 (03:20):
Not only self-prescribe, self-diagnose, which I think is the bigger problem,
is it not?
Speaker 3 (03:25):
That is a big problem because obviously, you know, it's
for convenience. This is not, you know, I'm sorry, we
don't have a national catastrophe where there are no clinics
open and you can see a clinic and get an
x-ray or a lab test to tell you whether or
not what kind of infection you have. The other problem
(03:46):
is people don't know about the drug-drug interaction in terms
of allergies. If you're allergic to penicillin, you might not
be able to take some of the classes of antibiotics
that are included in the kit and you may actually
kill yourself through an allergic reaction.
Speaker 1 (04:01):
On the surface, these kits sound and the way they're marketed,
it's like it's a smart idea. So we can all
be prepared, especially in light of the pandemic. You don't
know what might be coming out there, but you're saying
they're doing people a disservice.
Speaker 3 (04:15):
Yes, I completely agree with you that they are doing
a large disservice because, again, A lay person is not
going to be able to figure out whether or not
they have a viral infection or they have a bacterial
infection or pneumonia. Pneumonia, we make the diagnosis based on
lab tests and a chest x-ray. I greatly doubt people
(04:36):
at home are going to do a chest x-ray on themselves.
Speaker 1 (04:39):
A couple more minutes here with Dr. Peter Papadakis, professor
of anesthesiology and critical care at the University of Rochester.
How much of a problem are doctors that give patients
antibiotics just to kind of get them to shut up,
even if they don't have some sort of bacterial infection?
I know there are cases of that.
Speaker 3 (05:01):
Yeah, there are cases of that. There's a lot of
especially people in private practice, you'll get a bad reputation
if the patient doesn't leave with something. What we do
at the University of Rochester and many other academic centers,
we have urgent care centers, people come in and we
actually counsel the patient.
Speaker 2 (05:20):
I think taking.
Speaker 3 (05:21):
Five minutes to explain to them that they have a
viral infection and antibiotics won't work, it's bed rest, fluids,
and chicken soup, And that's all you need because you
don't have pneumonia. The test x-ray is clear and you're
going to get sicker.
Speaker 1 (05:39):
Why is it so difficult to know whether someone has
a virus or a bacterial infection or something else? Can
you tell without some sort of testing?
Speaker 3 (05:49):
Usually you need testing and also diagnostic tests. A physician,
a nurse practitioner, and a PA, obviously, if there's a
lot of viral infections in the community, are geared towards
looking at that. Bacterial lung infections usually occur in elderly people,
(06:13):
immunosuppressed people, people with lung disease. And again, discussing that
with a licensed professional, be it a physician, a nurse practitioner,
or PA, is the way to go.
Speaker 1 (06:26):
You talked about antibiotics in agriculture earlier. Can you kind
of expound on that? Why does that matter in terms
of human antibiotic resistance?
Speaker 2 (06:38):
It gets into the food chain.
Speaker 3 (06:40):
A number of years ago, we had a lot of
data that came in. Farmers were buying antibiotics.
Speaker 2 (06:45):
You could buy.
Speaker 3 (06:48):
Through veterinary mail order houses antibiotics. So you were giving
it to your sheep. your beef cattle, your chickens, and
all those antibiotics, whether or not the animal had a
real infection, you thought this would make your animals healthy.
Speaker 2 (07:04):
And what actually it did, it.
Speaker 3 (07:07):
Started the whole cascade of antibiotic resistance because it got
into the food chain. We ate the beef, we ate
the chicken, we ate the lamb, and that was in
our food chain. So we developed resistance to large amounts
classes of bacterial infections because of such a widespread.
Speaker 2 (07:30):
Use of antibiotics.
Speaker 3 (07:31):
Remember, when antibiotics were first started, basically during World War II,
they were given to select patients for select reasons, not
widespread to, you know, every chicken on your farm or
every beef cattle on your ranch.
Speaker 2 (07:47):
Right.
Speaker 1 (07:48):
We've been hearing about antibiotic resistance or warnings about antibiotic
resistance for decades now. Have we actually seen any of
the consequences of what that would look like?
Speaker 3 (08:01):
Yes, as has been reported, we've had close to 1.2
million deaths worldwide per year.
Speaker 1 (08:09):
Because of antibiotic resistance?
Speaker 3 (08:11):
That is correct. Right.
Speaker 1 (08:14):
What would you say to somebody who buys one of
these kits and they're like, well, it's just one course
of antibiotics. It's not going to create a bigger problem unless,
you know, I take many more courses of this treatment.
Speaker 3 (08:29):
Well, what's going to happen is people are going to
have these antibiotics. So, you know, you're going to take
the antibiotic. It's going to get into your body. the
bacteria that you may be exposed to may become resistant
to it. So even one-time use of the wrong antibiotic
just increases the risk. Because when, in my practice in
(08:53):
the ICU, one in six laboratory-confirmed cultures in the U.S.
demonstrate a level of resistance to first-line therapy. So if
I continue using the same antibiotic that it's resistant to,
it becomes even more resistant. So a patient is not
(09:16):
going to know whether or not they already have.
Speaker 2 (09:17):
A resistant organism in their body.
Speaker 3 (09:20):
Right.
Speaker 1 (09:20):
A couple more minutes here with Dr. Peter Papadakis. He's
a professor of anesthesiology and critical care at the University
of Rochester. I've been to Mexico and stuff and other
countries where you could just get antibiotics and other drugs
just over the counter. That's not the case here in
the U.S. Why are these... that are being sold widely
(09:41):
marketed now on television with antibiotics even legal to be sold?
Speaker 3 (09:47):
Because they're circumventing our traditional system. And what needs to
happen is the FDA and state pharmacy associations need to
start looking at this. You know, they're under the radar
right now. I think our political base, our regulatory base
(10:09):
needs to understand that you can't get narcotics like you
used to get in the 1920s and 30s from Sears.
And we have regulations in place. We need to these regulations.
I think the regulatory agencies need to look into these
(10:29):
companies that are advertising on TV. I was amazed when
I started writing this article with my colleague, Dr. Glatter,
that the FDA hadn't done anything. You know, you would
think somebody from the FDA is watching television at night.
and noticing the nice lady trying to sell you antibiotics
(10:52):
over the TV.
Speaker 1 (10:53):
And it's not only the nice lady. There are big-name,
well-known doctors that are hawking some of these products. That's
an even bigger concern because people have grown to trust them.
Speaker 2 (11:08):
That is correct.
Speaker 3 (11:08):
Yeah, they have somebody who uses their MD credentials, but
it's kind of a nefarious thing because An MD, a PA,
or a nurse practitioner understand that that's not really proper practice.
Speaker 1 (11:25):
Fair argument that these kits are designed for someone who
might not have quick or easy access to medical care.
Maybe people live in rural areas. Do you buy that argument?
Speaker 2 (11:37):
You know what?
Speaker 3 (11:39):
I have a vacation home up in the Adirondacks, which
is basically very rural. But every town up here has
a doctor's office or a small urgent center where you
can see either a physician or a PA nurse practitioner.
So I don't buy that argument. I also don't buy
(11:59):
the cost argument of going to the doctor's office. Because
these kits are not free in the mail. They cost
hundreds of dollars.
Speaker 4 (12:07):
Sure.
Speaker 2 (12:08):
So if it's.
Speaker 3 (12:09):
A financial concern, sending this company several hundred dollars for
your own kit is not a cost saving.
Speaker 1 (12:17):
Fair enough. If somebody decided to put together their own
emergency medical kit, whether it be for a hurricane or
other natural disaster or whatever, or even for travel, what
should be in there and what shouldn't be in there?
Speaker 3 (12:31):
Going to a tropical medicine doctor or a sports medicine
doctor and saying, you know, I'm.
Speaker 2 (12:38):
Going to be hiking in Nepal.
Speaker 3 (12:43):
And needs for bacterial infections or whatever, they're going to
look up what's common in those areas that you're going to.
This is more a survivalist thing. I myself, prior to
traveling to Southeast Asia, met with one of our tropical
(13:03):
medicine doctors, and he said you should have you know
seven days of this you know you need anti-nausea medications
you know these are the infectious things that are available
or the parasites i'm going to give you a shot
for malaria you understand that's being prepared and again using
somebody who's an expert.
Speaker 1 (13:24):
And i guess that that's the bottom line right if
you can't trust your doctor who are you who are
you going to trust you are.
Speaker 3 (13:31):
A hundred percent right AI or Google is not a
replacement for an individual patient getting individualized care from a
trusted health practitioner that they've been using for years.
Speaker 1 (13:49):
The last message you'd like everyone listening to remember before
they ever take an antibiotic that isn't prescribed by a
doctor who's examined them?
Speaker 2 (13:59):
Don't take it.
Speaker 3 (14:01):
Seek out health care. I even tell patients if they
have antibiotics at home, don't give them to Aunt Bertha,
you know, if she's getting sick or your children. You know,
you may be 100 percent wrong and make things worse
if you get a fatal allergic reaction. to your eight-year-old
(14:22):
because you didn't know that they had a penicillin allergy,
I think you're going to feel bad.
Speaker 1 (14:27):
Makes perfect sense.
Speaker 4 (14:27):
Dr.
Speaker 1 (14:28):
Peter Papadakis, professor of anesthesiology and critical care at the
University of Rochester. Always appreciate a few minutes of your
time and getting my learn on. Thank you so much
for sharing it once again.
Speaker 2 (14:40):
Be well.
Speaker 3 (14:40):
Thank you again, and have a nice afternoon.
Speaker 1 (14:43):
You're listening to iHeartRadio Communities, our weekly public affairs show.
I am Manny Munoz. If you have any thoughts, comments,
or questions, please feel free to reach out to me
on Instagram. My handle is at IODManny. That's at I-O-D-M-A-N-N-Y.
August is Spinal Muscular Atrophy Awareness Month. And while SMA
(15:07):
was once considered one of the most devastating genetic diseases
affecting children, the last decade has brought some remarkable breakthroughs.
We're going to talk about that in just a moment
as we're joined by Jamie Gibson, Chief Development Officer for
the Cure SMA. The website is curesma.org. Jamie, I appreciate
(15:29):
the time.
Speaker 4 (15:30):
Thank you, Manny, for having me. I appreciate it.
Speaker 1 (15:32):
Let me ask you this. What is the difference for
somebody who might not be familiar between spinal muscular atrophy
and what most people know of a certain age, at least,
muscular dystrophy?
Speaker 3 (15:46):
For sure.
Speaker 4 (15:46):
It really has to do with the motor neurons and
how those are impacted in spinal muscular atrophy. You know,
when people are born, you are developing your motor neurons,
which impact the muscles that you use to eat, to read,
to walk, to crawl, etc. And during the time from
(16:07):
birth to two years old, all of your motor neurons
are developed in your body. And by the time you're two,
you have all the motor neurons that you're ever going
to have. And so someone who has SMA is somebody
who has a, they're missing what we call the SMN2 protein.
And depending on how many copies of the SMN1 protein
(16:28):
they have will kind of determine how many motor neurons
their body actually will make in that time period. And
so it is about the development of those motor neurons
that happen during that timeframe that will impact, you know,
just how somebody moves, breathes, eats, et cetera. And so
it's really important that it's such a critical time and
(16:50):
why the new genetic therapies have made such an impact
to our community.
Speaker 1 (16:54):
For people who might be hearing about spinal muscular atrophy
for the first time. Um, how many, how many kids
does this affect every year in our country?
Speaker 4 (17:05):
So we have approximately 9,000 to 9,500 people who have SMA.
We currently see about, let's see, 200 to 250 children
who are born every single year. The great news is
that as of 2024, SMA is able to be identified
(17:30):
on the newborn screening panel. So those who get that
tiny little blood prick on their heel, it is in
that panel and we can tell right away who has SMA,
which is fantastic. Prior to that, you know, you would
have to have onset of those different types of milestones
that a child were missing in order for us to
(17:52):
tell if somebody potentially needed to be tested for it.
So today, thanks to all of our treatments, our actual
adult population now outweighs our children population with 64% of
those 9,500 people being adults these days, 18 and over. Yeah,
it's fantastic.
Speaker 2 (18:12):
Wow.
Speaker 1 (18:13):
Every state now requires newborns to be screened, right? That's
a big deal.
Speaker 4 (18:18):
Correct. It is a big deal. And now Puerto Rico
is adding it to their newborn panel. We also received
that some of the European countries are looking to add
it to what they are calling their newborn panel. And
so it is such an easy thing to add to
the panel. But every country, every state had to get
on board and be able to have the technology to
(18:39):
be able to do it. So we're really proud of
that momentum.
Speaker 1 (18:41):
Yeah, the big accomplishment there. SMA, though, is still considered
a fatal disease in its worst forms. You talked about
some of the treatments. How is everything changing because of
the new treatments that are becoming available?
Speaker 4 (18:58):
Absolutely. Thanks for asking. So we have seen the mortality
rate in the past decade. That's when the first genetic
therapy came to market has dropped by over 60%. Wow.
(19:19):
And they are tested. They are given a treatment within
days instead of months or even years that it took
before to find that diagnosis. And so, as I mentioned earlier,
those motor neurons, time is motor neurons. Every single day
that those motor neurons are not created in the body
is more time and more complications that a child can have.
(19:43):
So it's crucial that they're getting that diagnosis right away
and that their care team is identifying. it and getting
them a treatment within, you know, right now the average
is about 21 days post-birth.
Speaker 1 (19:55):
Speaking with Jamie Gibson, Chief Development Officer at Cure SMA.
The website is curesma.org. I mentioned that August is SMA
Awareness Month, Spinal Muscular Atrophy. What's so important about this
month and raising awareness? about SMA?
Speaker 4 (20:14):
Absolutely. We would love everybody who is impacted by SMA
and may not know about Cure SMA. It's becoming a
part of our community. We want to ensure that those
who are taking advantage of the therapies, that they know
that we are a family here at Cure SMA. We
are a small community. We're impacted. We want to share
(20:35):
each other's journeys. We want to be a part of
your journey. We want to continue to raise funds through
our events, through the Awareness Month. We'll be taking donations
through our year-end campaign, et cetera, to ensure that we
can continue on our three pillars of our strategic plan,
which is we want to continue to invest in research
for more therapies, to make everybody's life and journey with
(21:00):
SMA a better one so that everyone has a long,
long life. We want to ensure that advocacy efforts continue
so disability rights in schools, workplaces, communities, and in travel,
et cetera, is that work is being continued. And then
we have our community support program where newly diagnosed families
can come to us and learn and get resources. SMA
(21:22):
Awareness Month is really an ideal time for us to
share and to express our gratitude to our community and
put some highlights on how the organization has impacted so
many people across the country.
Speaker 1 (21:34):
Not only could you find out more information, but you
can also donate or see how else you can help
on the website cure sma.org and they've got the purple
donate heart uh beating there in the upper right hand
corner uh and it really is uh all about hope
right uh you talked about some of the milestones what
what kind of milestones are you seeing uh in kids
(21:57):
these days that that just weren't possible you know say
a generation ago.
Speaker 4 (22:02):
Yeah that it does such a tremendous Our community has
evolved and changed so much in the past 10 years.
We just finished conference in June, and this was my
fourth year getting to see it. And it's amazing to
watch these children who were born with SMA are running
in our races, are running around the conference center. Many
(22:25):
of them do not need to use a wheelchair anymore.
And those that have wheelchairs, you know, they are so
excited about being able to interact with their peers, et cetera,
and seeing the milestones that they're making on some of
these new drugs that are in the pipeline through the
clinical trials, et cetera, seeing strength in their muscles, seeing
(22:47):
their motor neurons come back. It's fantastic.
Speaker 1 (22:51):
We read so much about gene therapies and personalized treatments online.
that are being used in so many different things, cancers
and other diseases. How close are we to actually curing
SMA rather than just treating it?
Speaker 4 (23:06):
Oh, well, I think, you know, that's a really tough,
tricky question. But these genetic therapies have made a huge impact.
As I mentioned, you know, there were children who would
be diagnosed or be born with SMA type one, which
was one of the most common, but also the most deadly.
And instead, you know, they are in there, you know,
they're walking, they're running, they're hitting their growth milestones, just
(23:31):
like every other child out there. And it's a fantastic
progress has been made. These genetic therapies, we continue to
invest in research right now. We have four that are
on the market that impact everyone. So there is a
genetic treatment out there for every single age group, which
is fantastic, which was not the situation a few years ago.
(23:53):
And then there are more drugs in the pipeline that
are in combination. So one that should be coming to
market hopefully later on this year is a muscle treatment.
So in combination with the genetic treatment, Somebody who is
in their 40s or 50s and has lost some of
that muscle, who has lost the ability to put their
makeup on, to eat by themselves, to drink by themselves,
(24:14):
they can gain some of that muscle strength back and
be able to do those things very independently, which is
what we want for our community.
Speaker 1 (24:21):
Is there a difference between treating infants or children who
were diagnosed early as opposed to adults who've lived their
whole lives with SMAs?
Speaker 4 (24:32):
Absolutely. They still have SMA despite the fact that they
have these genetic treatments. These genetic treatments are doing wonders
and building back some of that muscle strength and giving
them the opportunity to, like I said, hit their milestones.
But somebody who was not diagnosed early or on and
is on a genetic treatment has seen some great and
(24:54):
tremendous progress. But the decline in their muscles and the
fact that they continue to become weaker still happens. It'll
be critical as we go forward with these muscle treatments
that are in the pipeline and that are coming to
market here. to be used in combination so that they
can continue to either gain some of that muscle back
(25:15):
or stop losing some of that muscle strength that they've had.
It will be critical for those who are adults.
Speaker 1 (25:20):
Just a couple more minutes here with Jamie Gibson, Chief
Development Officer at Curesma.org. August, as I mentioned, is SMA
Awareness Month, Spinal Muscular Atrophy. What do you say to
the family who's just receiving an SMA treatment? diagnosis. It
can be overwhelming. You've got a young child. You don't
(25:43):
know exactly what that means.
Speaker 4 (25:46):
I would say to them is that one, we are
here for you. This is your family. I say it
at conference. I say it when I go out to
meet with donors and families all the time. Kira SMA
is an amazing organization that is here to support you
along your entire journey. So please come and talk with us,
come learn more about us and be a part of
this family. I also say that there is so much
(26:09):
going on right now in drug development and the therapies
that while it is absolutely scary, I can only imagine
as a parent getting that diagnosis, there is a lot
of hope out there. And these treatments are fantastic in
making true strides to change and evolve this community.
Speaker 1 (26:29):
Cure SMA obviously has played a big role in many
of the advancements you've been talking about during our conversation.
Is there an accomplishment you're most proud of that has
made the most significant difference for the SMA community?
Speaker 4 (26:44):
Absolutely. You know, we definitely had a part in those
treatments coming to market, and we're very proud of it.
But I think that one of our biggest, proudest accomplishments
in this decade is getting that newborn screening added to
the panel. We are the first disease to have it
come to the panel in such a short order. We
(27:04):
did it in less than five years to have all
50 states screening for SMA. And that's such a huge accomplishment.
We have people, other organizations and other communities reaching out
to us to ask us exactly how we did that.
We share our stories, we share our advocacy plan, et cetera.
It was a huge milestone for us and something that
(27:27):
we hope that other organizations are able to also mimic
and do the same.
Speaker 1 (27:32):
Last couple of questions for you. I started off asking
the difference between SMA, spinal muscular atrophy, and muscular dystrophy.
Somebody of a certain age, I remember the Jerry Lewis telethon.
What do you wish more Americans understood about SMA?
Speaker 4 (27:50):
I think that it's an inherited disease. It is a
genetic disorder that is progressive. It is something that is
not reversible. I think that is really important. I think
that a misnomer with many people in the community is
they hear genetic treatment and this could be for any
(28:11):
disease out there is that this is not a cure.
We still have a long ways to go and that
we still, well, we will see progress and we may
stop it. where it's at or slow it down. That
doesn't reverse the symptoms. That doesn't reverse the complications. And
we still need to make sure that we are supporting
this community, both, you know, in resources as a village,
(28:35):
but also in, you know, financials so that we can
ensure that the next generations perhaps don't have to see
it at all.
Speaker 1 (28:42):
If you and I spoke in five years about this,
what do you hope we would be talking about?
Speaker 4 (28:48):
I would hope that we would be talking about that.
Our adults who didn't think that they were going to
live past the age of 20 are now in their 60s, 70s,
and 80s. The children that are born today are running, walking,
and have no complications whatsoever. And that we have truly
a full functioning treatment regimen for every single person who
(29:10):
has SMA.
Speaker 1 (29:11):
Curesma.org is the website. Curesma.org. Jamie Gibson, Chief Development Officer there.
With Cure SMA has been speaking with us. Thank you
so much for the time. Best of luck this month.
And thank you so much for what you're doing.
Speaker 4 (29:28):
Thank you, Manny. I appreciate it.
Speaker 1 (29:30):
I am Manny Munoz. I appreciate you listening to iHeartRadio's
Communities this week. As always, if you have any questions, comments,
or suggestions, reach out to me on Instagram. My handle
is at IODManny. That's at I-O-D-M-A-N-N-Y. And that'll do it
for another edition of iHeartRadio's Communities. I'm Manny Munoz. Until
(29:52):
next time.
Speaker 3 (30:03):
Thank you.
Speaker 1 (32:51):
From the Money Talks investment coach, John Arnold Studios, this
is 570 WKBN Youngstown, an iHeartRadio station, guaranteed human. This
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Speaker 2 (33:04):
The following program is paid for by Rick Hughes.
By the program participants. Welcome to iHeartRadio Communities, a public
affairs special focusing on the biggest issues impacting you this week.
Here's Manny Munoz. I am Manny Munoz. Thank you for
tuning in to iHeartRadio's Communities. our weekly public affairs show
where we try to bring you conversations that will help
(00:22):
you better understand important issues or maybe just some interesting topics.
Either way, I do hope you'll stick around for the
next half hour. And if you have any comments, questions,
or suggestions, please feel free to reach out on Instagram.
My handle is at IOD Manny. That's at IOD M
A N N Y. Now let's get on with the show.
(00:44):
For years, doctors have warned that antibiotic resistance is one
of the greatest public health threats to our time. Now,
if you watch television, home medical kits containing prescription antibiotics
are being more widely marketed. New questions are emerging about
Whether it's really necessary and the unintended consequences, let's bring
(01:04):
in our expertise, Dr. Peter Papadakis, professor of anesthesiology and
critical care at the University of Rochester. Dr. Papadakis, good
to talk to you again. I appreciate the time.
Speaker 2 (01:17):
Not at all, my friend.
Speaker 1 (01:19):
For people who haven't been following and might not have
even noticed that these home medical kits with antibiotics are
being sold all over television, why is it raising so
much concern for doctors?
Speaker 3 (01:31):
I think it's a misdiagnosis. These companies say that you
should go through the pamphlet, match your symptoms, and take
the antibiotics or the antivirals. So there's no chest x-ray.
Speaker 2 (01:43):
There's no labs.
Speaker 3 (01:44):
There's no determination whether or not this is a bacterial
infection or a viral infection. Obviously, viruses don't respond to antibiotics,
and specific antivirals are for specific viruses. So there's no
connection with that. So the patient is not getting proper treatment.
The other very, very important problem is we have a
(02:07):
worldwide problem throughout the world of antibiotic resistance from the unknown.
regulated giving of antibiotics to agricultural animals, chickens, what have you.
It's in our food supply, but also in many third
world countries, people take antibiotics without seeing a doctor.
Speaker 2 (02:27):
You can pick them up at the pharmacy.
Speaker 3 (02:29):
So what has been shown is that close to.
Speaker 2 (02:35):
1.2 million deaths annually.
Speaker 3 (02:37):
Are contributed to are occurring due to antibiotic-resistant organisms in
the ICU. And more than 5 million, this is a
factor that has.
Speaker 2 (02:51):
Contributed to the death of the patient.
Speaker 3 (02:55):
The World Health Organization has also stated that we're spending
over a trillion dollars treating antibiotic-resistant organisms.
Speaker 2 (03:04):
Throughout the world. So this is a major problem that these.
Speaker 3 (03:07):
Companies then lay people these antibiotics in the mail and
you kind of self-prescribe yourself, you know, am I going
to take penicillin or something else?
Speaker 2 (03:18):
So it's a major problem.
Speaker 1 (03:20):
Not only self-prescribe, self-diagnose, which I think is the bigger problem,
is it not?
Speaker 3 (03:25):
That is a big problem because obviously, you know, it's
for convenience. This is not, you know, I'm sorry, we
don't have a national catastrophe where there are no clinics
open and you can see a clinic and get an
x-ray or a lab test to tell you whether or
not what kind of infection you have. The other problem
(03:46):
is people don't know about the drug-drug interaction in terms
of allergies. If you're allergic to penicillin, you might not
be able to take some of the classes of antibiotics
that are included in the kit and you may actually
kill yourself through an allergic reaction.
Speaker 1 (04:01):
On the surface, these kits sound and the way they're marketed,
it's like it's a smart idea. So we can all
be prepared, especially in light of the pandemic. You don't
know what might be coming out there, but you're saying
they're doing people a disservice.
Speaker 3 (04:15):
Yes, I completely agree with you that they are doing
a large disservice because, again, A lay person is not
going to be able to figure out whether or not
they have a viral infection or they have a bacterial
infection or pneumonia. Pneumonia, we make the diagnosis based on
lab tests and a chest x-ray. I greatly doubt people
(04:36):
at home are going to do a chest x-ray on themselves.
Speaker 1 (04:39):
A couple more minutes here with Dr. Peter Papadakis, professor
of anesthesiology and critical care at the University of Rochester.
How much of a problem are doctors that give patients
antibiotics just to kind of get them to shut up,
even if they don't have some sort of bacterial infection?
I know there are cases of that.
Speaker 3 (05:01):
Yeah, there are cases of that. There's a lot of
especially people in private practice, you'll get a bad reputation
if the patient doesn't leave with something. What we do
at the University of Rochester and many other academic centers,
we have urgent care centers, people come in and we
actually counsel the patient.
Speaker 2 (05:20):
I think taking.
Speaker 3 (05:21):
Five minutes to explain to them that they have a
viral infection and antibiotics won't work, it's bed rest, fluids,
and chicken soup, And that's all you need because you
don't have pneumonia. The test x-ray is clear and you're
going to get sicker.
Speaker 1 (05:39):
Why is it so difficult to know whether someone has
a virus or a bacterial infection or something else? Can
you tell without some sort of testing?
Speaker 3 (05:49):
Usually you need testing and also diagnostic tests. A physician,
a nurse practitioner, and a PA, obviously, if there's a
lot of viral infections in the community, are geared towards
looking at that. Bacterial lung infections usually occur in elderly people,
(06:13):
immunosuppressed people, people with lung disease. And again, discussing that
with a licensed professional, be it a physician, a nurse practitioner,
or PA, is the way to go.
Speaker 1 (06:26):
You talked about antibiotics in agriculture earlier. Can you kind
of expound on that? Why does that matter in terms
of human antibiotic resistance?
Speaker 2 (06:38):
It gets into the food chain.
Speaker 3 (06:40):
A number of years ago, we had a lot of
data that came in. Farmers were buying antibiotics.
Speaker 2 (06:45):
You could buy.
Speaker 3 (06:48):
Through veterinary mail order houses antibiotics. So you were giving
it to your sheep. your beef cattle, your chickens, and
all those antibiotics, whether or not the animal had a
real infection, you thought this would make your animals healthy.
Speaker 2 (07:04):
And what actually it did, it.
Speaker 3 (07:07):
Started the whole cascade of antibiotic resistance because it got
into the food chain. We ate the beef, we ate
the chicken, we ate the lamb, and that was in
our food chain. So we developed resistance to large amounts
classes of bacterial infections because of such a widespread.
Speaker 2 (07:30):
Use of antibiotics.
Speaker 3 (07:31):
Remember, when antibiotics were first started, basically during World War II,
they were given to select patients for select reasons, not
widespread to, you know, every chicken on your farm or
every beef cattle on your ranch.
Speaker 2 (07:47):
Right.
Speaker 1 (07:48):
We've been hearing about antibiotic resistance or warnings about antibiotic
resistance for decades now. Have we actually seen any of
the consequences of what that would look like?
Speaker 3 (08:01):
Yes, as has been reported, we've had close to 1.2
million deaths worldwide per year.
Speaker 1 (08:09):
Because of antibiotic resistance?
Speaker 3 (08:11):
That is correct. Right.
Speaker 1 (08:14):
What would you say to somebody who buys one of
these kits and they're like, well, it's just one course
of antibiotics. It's not going to create a bigger problem unless,
you know, I take many more courses of this treatment.
Speaker 3 (08:29):
Well, what's going to happen is people are going to
have these antibiotics. So, you know, you're going to take
the antibiotic. It's going to get into your body. the
bacteria that you may be exposed to may become resistant
to it. So even one-time use of the wrong antibiotic
just increases the risk. Because when, in my practice in
(08:53):
the ICU, one in six laboratory-confirmed cultures in the U.S.
demonstrate a level of resistance to first-line therapy. So if
I continue using the same antibiotic that it's resistant to,
it becomes even more resistant. So a patient is not
(09:16):
going to know whether or not they already have.
Speaker 2 (09:17):
A resistant organism in their body.
Speaker 3 (09:20):
Right.
Speaker 1 (09:20):
A couple more minutes here with Dr. Peter Papadakis. He's
a professor of anesthesiology and critical care at the University
of Rochester. I've been to Mexico and stuff and other
countries where you could just get antibiotics and other drugs
just over the counter. That's not the case here in
the U.S. Why are these... that are being sold widely
(09:41):
marketed now on television with antibiotics even legal to be sold?
Speaker 3 (09:47):
Because they're circumventing our traditional system. And what needs to
happen is the FDA and state pharmacy associations need to
start looking at this. You know, they're under the radar
right now. I think our political base, our regulatory base
(10:09):
needs to understand that you can't get narcotics like you
used to get in the 1920s and 30s from Sears.
And we have regulations in place. We need to these regulations.
I think the regulatory agencies need to look into these
(10:29):
companies that are advertising on TV. I was amazed when
I started writing this article with my colleague, Dr. Glatter,
that the FDA hadn't done anything. You know, you would
think somebody from the FDA is watching television at night.
and noticing the nice lady trying to sell you antibiotics
(10:52):
over the TV.
Speaker 1 (10:53):
And it's not only the nice lady. There are big-name,
well-known doctors that are hawking some of these products. That's
an even bigger concern because people have grown to trust them.
Speaker 2 (11:08):
That is correct.
Speaker 3 (11:08):
Yeah, they have somebody who uses their MD credentials, but
it's kind of a nefarious thing because An MD, a PA,
or a nurse practitioner understand that that's not really proper practice.
Speaker 1 (11:25):
Fair argument that these kits are designed for someone who
might not have quick or easy access to medical care.
Maybe people live in rural areas. Do you buy that argument?
Speaker 2 (11:37):
You know what?
Speaker 3 (11:39):
I have a vacation home up in the Adirondacks, which
is basically very rural. But every town up here has
a doctor's office or a small urgent center where you
can see either a physician or a PA nurse practitioner.
So I don't buy that argument. I also don't buy
(11:59):
the cost argument of going to the doctor's office. Because
these kits are not free in the mail. They cost
hundreds of dollars.
Speaker 4 (12:07):
Sure.
Speaker 2 (12:08):
So if it's.
Speaker 3 (12:09):
A financial concern, sending this company several hundred dollars for
your own kit is not a cost saving.
Speaker 1 (12:17):
Fair enough. If somebody decided to put together their own
emergency medical kit, whether it be for a hurricane or
other natural disaster or whatever, or even for travel, what
should be in there and what shouldn't be in there?
Speaker 3 (12:31):
Going to a tropical medicine doctor or a sports medicine
doctor and saying, you know, I'm.
Speaker 2 (12:38):
Going to be hiking in Nepal.
Speaker 3 (12:43):
And needs for bacterial infections or whatever, they're going to
look up what's common in those areas that you're going to.
This is more a survivalist thing. I myself, prior to
traveling to Southeast Asia, met with one of our tropical
(13:03):
medicine doctors, and he said you should have you know
seven days of this you know you need anti-nausea medications
you know these are the infectious things that are available
or the parasites i'm going to give you a shot
for malaria you understand that's being prepared and again using
somebody who's an expert.
Speaker 1 (13:24):
And i guess that that's the bottom line right if
you can't trust your doctor who are you who are
you going to trust you are.
Speaker 3 (13:31):
A hundred percent right AI or Google is not a
replacement for an individual patient getting individualized care from a
trusted health practitioner that they've been using for years.
Speaker 1 (13:49):
The last message you'd like everyone listening to remember before
they ever take an antibiotic that isn't prescribed by a
doctor who's examined them?
Speaker 2 (13:59):
Don't take it.
Speaker 3 (14:01):
Seek out health care. I even tell patients if they
have antibiotics at home, don't give them to Aunt Bertha,
you know, if she's getting sick or your children. You know,
you may be 100 percent wrong and make things worse
if you get a fatal allergic reaction. to your eight-year-old
(14:22):
because you didn't know that they had a penicillin allergy,
I think you're going to feel bad.
Speaker 1 (14:27):
Makes perfect sense.
Speaker 4 (14:27):
Dr.
Speaker 1 (14:28):
Peter Papadakis, professor of anesthesiology and critical care at the
University of Rochester. Always appreciate a few minutes of your
time and getting my learn on. Thank you so much
for sharing it once again.
Speaker 2 (14:40):
Be well.
Speaker 3 (14:40):
Thank you again, and have a nice afternoon.
Speaker 1 (14:43):
You're listening to iHeartRadio Communities, our weekly public affairs show.
I am Manny Munoz. If you have any thoughts, comments,
or questions, please feel free to reach out to me
on Instagram. My handle is at IODManny. That's at I-O-D-M-A-N-N-Y.
August is Spinal Muscular Atrophy Awareness Month. And while SMA
(15:07):
was once considered one of the most devastating genetic diseases
affecting children, the last decade has brought some remarkable breakthroughs.
We're going to talk about that in just a moment
as we're joined by Jamie Gibson, Chief Development Officer for
the Cure SMA. The website is curesma.org. Jamie, I appreciate
(15:29):
the time.
Speaker 4 (15:30):
Thank you, Manny, for having me. I appreciate it.
Speaker 1 (15:32):
Let me ask you this. What is the difference for
somebody who might not be familiar between spinal muscular atrophy
and what most people know of a certain age, at least,
muscular dystrophy?
Speaker 3 (15:46):
For sure.
Speaker 4 (15:46):
It really has to do with the motor neurons and
how those are impacted in spinal muscular atrophy. You know,
when people are born, you are developing your motor neurons,
which impact the muscles that you use to eat, to read,
to walk, to crawl, etc. And during the time from
(16:07):
birth to two years old, all of your motor neurons
are developed in your body. And by the time you're two,
you have all the motor neurons that you're ever going
to have. And so someone who has SMA is somebody
who has a, they're missing what we call the SMN2 protein.
And depending on how many copies of the SMN1 protein
(16:28):
they have will kind of determine how many motor neurons
their body actually will make in that time period. And
so it is about the development of those motor neurons
that happen during that timeframe that will impact, you know,
just how somebody moves, breathes, eats, et cetera. And so
it's really important that it's such a critical time and
(16:50):
why the new genetic therapies have made such an impact
to our community.
Speaker 1 (16:54):
For people who might be hearing about spinal muscular atrophy
for the first time. Um, how many, how many kids
does this affect every year in our country?
Speaker 4 (17:05):
So we have approximately 9,000 to 9,500 people who have SMA.
We currently see about, let's see, 200 to 250 children
who are born every single year. The great news is
that as of 2024, SMA is able to be identified
(17:30):
on the newborn screening panel. So those who get that
tiny little blood prick on their heel, it is in
that panel and we can tell right away who has SMA,
which is fantastic. Prior to that, you know, you would
have to have onset of those different types of milestones
that a child were missing in order for us to
(17:52):
tell if somebody potentially needed to be tested for it.
So today, thanks to all of our treatments, our actual
adult population now outweighs our children population with 64% of
those 9,500 people being adults these days, 18 and over. Yeah,
it's fantastic.
Speaker 2 (18:12):
Wow.
Speaker 1 (18:13):
Every state now requires newborns to be screened, right? That's
a big deal.
Speaker 4 (18:18):
Correct. It is a big deal. And now Puerto Rico
is adding it to their newborn panel. We also received
that some of the European countries are looking to add
it to what they are calling their newborn panel. And
so it is such an easy thing to add to
the panel. But every country, every state had to get
on board and be able to have the technology to
(18:39):
be able to do it. So we're really proud of
that momentum.
Speaker 1 (18:41):
Yeah, the big accomplishment there. SMA, though, is still considered
a fatal disease in its worst forms. You talked about
some of the treatments. How is everything changing because of
the new treatments that are becoming available?
Speaker 4 (18:58):
Absolutely. Thanks for asking. So we have seen the mortality
rate in the past decade. That's when the first genetic
therapy came to market has dropped by over 60%. Wow.
(19:19):
And they are tested. They are given a treatment within
days instead of months or even years that it took
before to find that diagnosis. And so, as I mentioned earlier,
those motor neurons, time is motor neurons. Every single day
that those motor neurons are not created in the body
is more time and more complications that a child can have.
(19:43):
So it's crucial that they're getting that diagnosis right away
and that their care team is identifying. it and getting
them a treatment within, you know, right now the average
is about 21 days post-birth.
Speaker 1 (19:55):
Speaking with Jamie Gibson, Chief Development Officer at Cure SMA.
The website is curesma.org. I mentioned that August is SMA
Awareness Month, Spinal Muscular Atrophy. What's so important about this
month and raising awareness? about SMA?
Speaker 4 (20:14):
Absolutely. We would love everybody who is impacted by SMA
and may not know about Cure SMA. It's becoming a
part of our community. We want to ensure that those
who are taking advantage of the therapies, that they know
that we are a family here at Cure SMA. We
are a small community. We're impacted. We want to share
(20:35):
each other's journeys. We want to be a part of
your journey. We want to continue to raise funds through
our events, through the Awareness Month. We'll be taking donations
through our year-end campaign, et cetera, to ensure that we
can continue on our three pillars of our strategic plan,
which is we want to continue to invest in research
for more therapies, to make everybody's life and journey with
(21:00):
SMA a better one so that everyone has a long,
long life. We want to ensure that advocacy efforts continue
so disability rights in schools, workplaces, communities, and in travel,
et cetera, is that work is being continued. And then
we have our community support program where newly diagnosed families
can come to us and learn and get resources. SMA
(21:22):
Awareness Month is really an ideal time for us to
share and to express our gratitude to our community and
put some highlights on how the organization has impacted so
many people across the country.
Speaker 1 (21:34):
Not only could you find out more information, but you
can also donate or see how else you can help
on the website cure sma.org and they've got the purple
donate heart uh beating there in the upper right hand
corner uh and it really is uh all about hope
right uh you talked about some of the milestones what
what kind of milestones are you seeing uh in kids
(21:57):
these days that that just weren't possible you know say
a generation ago.
Speaker 4 (22:02):
Yeah that it does such a tremendous Our community has
evolved and changed so much in the past 10 years.
We just finished conference in June, and this was my
fourth year getting to see it. And it's amazing to
watch these children who were born with SMA are running
in our races, are running around the conference center. Many
(22:25):
of them do not need to use a wheelchair anymore.
And those that have wheelchairs, you know, they are so
excited about being able to interact with their peers, et cetera,
and seeing the milestones that they're making on some of
these new drugs that are in the pipeline through the
clinical trials, et cetera, seeing strength in their muscles, seeing
(22:47):
their motor neurons come back. It's fantastic.
Speaker 1 (22:51):
We read so much about gene therapies and personalized treatments online.
that are being used in so many different things, cancers
and other diseases. How close are we to actually curing
SMA rather than just treating it?
Speaker 4 (23:06):
Oh, well, I think, you know, that's a really tough,
tricky question. But these genetic therapies have made a huge impact.
As I mentioned, you know, there were children who would
be diagnosed or be born with SMA type one, which
was one of the most common, but also the most deadly.
And instead, you know, they are in there, you know,
they're walking, they're running, they're hitting their growth milestones, just
(23:31):
like every other child out there. And it's a fantastic
progress has been made. These genetic therapies, we continue to
invest in research right now. We have four that are
on the market that impact everyone. So there is a
genetic treatment out there for every single age group, which
is fantastic, which was not the situation a few years ago.
(23:53):
And then there are more drugs in the pipeline that
are in combination. So one that should be coming to
market hopefully later on this year is a muscle treatment.
So in combination with the genetic treatment, Somebody who is
in their 40s or 50s and has lost some of
that muscle, who has lost the ability to put their
makeup on, to eat by themselves, to drink by themselves,
(24:14):
they can gain some of that muscle strength back and
be able to do those things very independently, which is
what we want for our community.
Speaker 1 (24:21):
Is there a difference between treating infants or children who
were diagnosed early as opposed to adults who've lived their
whole lives with SMAs?
Speaker 4 (24:32):
Absolutely. They still have SMA despite the fact that they
have these genetic treatments. These genetic treatments are doing wonders
and building back some of that muscle strength and giving
them the opportunity to, like I said, hit their milestones.
But somebody who was not diagnosed early or on and
is on a genetic treatment has seen some great and
(24:54):
tremendous progress. But the decline in their muscles and the
fact that they continue to become weaker still happens. It'll
be critical as we go forward with these muscle treatments
that are in the pipeline and that are coming to
market here. to be used in combination so that they
can continue to either gain some of that muscle back
(25:15):
or stop losing some of that muscle strength that they've had.
It will be critical for those who are adults.
Speaker 1 (25:20):
Just a couple more minutes here with Jamie Gibson, Chief
Development Officer at Curesma.org. August, as I mentioned, is SMA
Awareness Month, Spinal Muscular Atrophy. What do you say to
the family who's just receiving an SMA treatment? diagnosis. It
can be overwhelming. You've got a young child. You don't
(25:43):
know exactly what that means.
Speaker 4 (25:46):
I would say to them is that one, we are
here for you. This is your family. I say it
at conference. I say it when I go out to
meet with donors and families all the time. Kira SMA
is an amazing organization that is here to support you
along your entire journey. So please come and talk with us,
come learn more about us and be a part of
this family. I also say that there is so much
(26:09):
going on right now in drug development and the therapies
that while it is absolutely scary, I can only imagine
as a parent getting that diagnosis, there is a lot
of hope out there. And these treatments are fantastic in
making true strides to change and evolve this community.
Speaker 1 (26:29):
Cure SMA obviously has played a big role in many
of the advancements you've been talking about during our conversation.
Is there an accomplishment you're most proud of that has
made the most significant difference for the SMA community?
Speaker 4 (26:44):
Absolutely. You know, we definitely had a part in those
treatments coming to market, and we're very proud of it.
But I think that one of our biggest, proudest accomplishments
in this decade is getting that newborn screening added to
the panel. We are the first disease to have it
come to the panel in such a short order. We
(27:04):
did it in less than five years to have all
50 states screening for SMA. And that's such a huge accomplishment.
We have people, other organizations and other communities reaching out
to us to ask us exactly how we did that.
We share our stories, we share our advocacy plan, et cetera.
It was a huge milestone for us and something that
(27:27):
we hope that other organizations are able to also mimic
and do the same.
Speaker 1 (27:32):
Last couple of questions for you. I started off asking
the difference between SMA, spinal muscular atrophy, and muscular dystrophy.
Somebody of a certain age, I remember the Jerry Lewis telethon.
What do you wish more Americans understood about SMA?
Speaker 4 (27:50):
I think that it's an inherited disease. It is a
genetic disorder that is progressive. It is something that is
not reversible. I think that is really important. I think
that a misnomer with many people in the community is
they hear genetic treatment and this could be for any
(28:11):
disease out there is that this is not a cure.
We still have a long ways to go and that
we still, well, we will see progress and we may
stop it. where it's at or slow it down. That
doesn't reverse the symptoms. That doesn't reverse the complications. And
we still need to make sure that we are supporting
this community, both, you know, in resources as a village,
(28:35):
but also in, you know, financials so that we can
ensure that the next generations perhaps don't have to see
it at all.
Speaker 1 (28:42):
If you and I spoke in five years about this,
what do you hope we would be talking about?
Speaker 4 (28:48):
I would hope that we would be talking about that.
Our adults who didn't think that they were going to
live past the age of 20 are now in their 60s, 70s,
and 80s. The children that are born today are running, walking,
and have no complications whatsoever. And that we have truly
a full functioning treatment regimen for every single person who
(29:10):
has SMA.
Speaker 1 (29:11):
Curesma.org is the website. Curesma.org. Jamie Gibson, Chief Development Officer there.
With Cure SMA has been speaking with us. Thank you
so much for the time. Best of luck this month.
And thank you so much for what you're doing.
Speaker 4 (29:28):
Thank you, Manny. I appreciate it.
Speaker 1 (29:30):
I am Manny Munoz. I appreciate you listening to iHeartRadio's
Communities this week. As always, if you have any questions, comments,
or suggestions, reach out to me on Instagram. My handle
is at IODManny. That's at I-O-D-M-A-N-N-Y. And that'll do it
for another edition of iHeartRadio's Communities. I'm Manny Munoz. Until
(29:52):
next time.
Speaker 3 (30:03):
Thank you.
Speaker 1 (32:51):
From the Money Talks investment coach, John Arnold Studios, this
is 570 WKBN Youngstown, an iHeartRadio station, guaranteed human. This
program is furnished by the program participants.
Speaker 2 (33:04):
The following program is paid for by Rick Hughes.
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