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Managing Pain in a Pinch

Pills in woman hands.

by Cynthia J. Koelker, MD

Excerpt from Armageddon Medicine, How to Be Your Own Doctor in 2012 and Beyond

The daily queue of suffering seems endless. Toothache, stomachache, headache, earache, back pain, leg pain, joint pain, neck pain, sore throat, sore feet, sore muscles, sore eyes. People come to you seeking relief – relief from their pain, and relief from fear. Are you up to the task of helping others, or ready to run away? Becoming a healer is not for the faint of heart.

If and when the medical community collapses, those left to carry on will need an armamentarium of tools to deal with pain. Even if it’s only your own problems and those of your family that you’ll be facing, learning how to relieve pain now, before you’re in the midst of crisis, will spare you needless worry. Pain is the #1 symptom that drives patients to physicians today. Pain will remain a fearsome opponent tomorrow, no matter what catastrophe brings the world to its knees.

Pain and fear go hand in hand, two sides of the same coin. Fear is pain’s best friend, its evil ally. Relieve one and the other may subside, at least to tolerable levels. I know what it is to fear pain. Every time I visit the dentist my childhood dread of drilling on a nerve rears its ugly head. It’s not a rational process. My childhood dentist didn’t believe in novocain. I’ll never get over it.

People can often tolerate an amazing degree of pain if given hope that the condition is only temporary. Labor pain is every bit as bad as any other sort of pain, yet how many women suffer through hour after hour of gut-wrenching torture without requesting so much as an aspirin? People will also endure an incredible amount of pain if they believe good will come of it – such as a new baby, or saving another’s life.

As a healer, you’ll need to dispense more than a dose of narcotics. Having enough medical knowledge to understand a disease process will help you foresee the course of the disease and offer hope of recovery. Even if you cannot relieve the pain, you can relieve fear – both fear of unending pain, and fear of being alone. If you lack the tools to deaden the pain, don’t think you’re doing no good. Like a child who wants his boo-boo kissed, adults, too, want to know that someone cares.

In this regard, doctors are not necessarily the best healers. Physicians are aloof by training and sometimes by nature. Once you try helping others, you’ll learn that part of the patient’s suffering becomes your own. Taking on the pain of the world is a crushing burden. Doctors cannot function when they are overwhelmed by too heavy a load, and so often limit their emotional involvement. But emotional involvement is a powerful salve. An infant with an earache may be comforted in its mother’s arms. “Hold me” may be a laboring wife’s request of her husband, knowing he cannot take the pain away.

I emphasize the non-medicinal treatments of pain because: 1) sooner or later they may be all you have; 2) stretching your supply of pain relievers will help you treat more patients; and 3) many people are intolerant of or allergic to pain medications.

The best way to relieve pain is to eliminate the underlying cause. Deliver the baby, lance the abscess, pass the kidney stone. Pain is your friend when it comes to diagnosis, but sometimes you’ll just have to treat it regardless of cause.

The English language has many words for various kinds of pain: aching, stabbing, burning, stinging, piercing, numbing, cramping, throbbing, tingling, smarting, lancinating, agonizing, and nagging, to mention the most common. The type of pain will clue you as to both cause and severity. The fluent or bodily-aware patient will be able to describe their discomfort in some detail. Others will simply say they hurt.

Beyond what a patient may say, their body language will alert you to the intensity of their distress. A smiling teenager flirting with her beaux does not need narcotics, even though she says she’s dying of pain. A silent man curled up in the fetal position has something serious going on.

The art of medicine includes deciphering both what a patient wants and needs. Some patients request no medicine, if they can only be permitted a day off work. Others prefer to pop a pill and keep going. In America, we overmedicate because we rest too little. Sleep is a powerful analgesic. If pain medication is not available, simply getting a person to rest and/or sleep may be the ticket to relief.

Doctors use many classes of drugs to alleviate or prevent pain: anti-inflammatories, steroids, narcotics, antidepressants, anti-anxiety drugs, anti-seizure drugs, beta-blockers, calcium channel blockers, triptans, muscle relaxers, sedating antihistamines, caffeine, nitroglycerin, antacids, oxygen, anesthetics, and even alcohol. We don’t always know how these drugs work. A patient does not have to be depressed for an anti-depressant to relieve pain. Thinking beyond traditional pain medications will broaden your ability to offer relief.

On treating pain-

Whereas patients focus on pain abatement, doctors often focus on functional improvement. Generally speaking, physicians do not necessarily aim for complete relief of pain, but rather sufficient improvement to permit adequate functioning. Relieving all pain can actually make a situation worse, allowing the patient to injure himself. A truck driver with chronic back pain may say he’s feeling no better, but now is able to unload his cargo. A migraine patient may report her headaches are as bad as usual, but hasn’t missed a day of work in a year. It is difficult to measure how much a patient hurts. It’s much easier to measure how well a patient functions.

Despite current medical thinking, I’m not much of a believer in patient-reported pain scales, though others find them useful. Among my patients, they seem to make little difference in clinical treatment, at least with chronic pain. Patients have difficulty remembering how much they were hurting last week or last month compared to now.

The one situation where a pain scale may be useful is where short-term observation (hours to days) of a hurting patient is possible. Asking the patient to report pain on a scale of 0 to 10 may yield a measure of improvement, or lack thereof. In the current medical environment, pain scales are often more a matter of documentation than a meaningful addition to medical care. It makes little sense to collect the information if it is not going to be used as a basis for treatment. Patients must understand the scale well to offer significant feedback. Many patients will report their pain as 8 or 9 out of 10 when it is obvious from their behavior that it is not this intense. If you are going to use a pain scale, take the time to explain it thoroughly. It also helps to use words or pictures to demonstrate the degree of pain, as in the list* below. Check online if you want an example with pictures.

0 – No pain

2 – Annoying

4 – Uncomfortable

6 – Dreadful

8 – Horrible

10 – Agonizing

When doctors evaluate pain, one of the immediate goals is to determine if it is life-threatening or not. Is chest pain a heart attack? Is abdominal pain appendicitis? If you think you have an emergency on your hands and have the option of referring to a hospital or physician, please do so. But the goal of this discussion is to focus on what you can offer on your own, without emergency back-up. Here are a few examples to consider:

Up to this point, we haven’t mentioned pain relievers per se. Oxygen, positioning, and nitroglycerin may not only improve the underlying problem, but also relieve the patient’s discomfort to a degree. As for direct pain treatment, you probably won’t have injectable morphine available, but oral Vicodin, Percocet, or even tramadol may offer some relief. Nausea frequently accompanies severe heart pain, and you may need to treat with OTC meclizine or a prescription anti-emetic (Phenergan, Vistaril, Compazine) to allow the patient to keep narcotics down. Also, if the patient is agitated, calming him may decrease his oxygen consumption, thereby decreasing chest pain. Valium, Xanax, or Ativan (all controlled prescription drugs) may be helpful.
Say a patient is experiencing excruciating chest pain in association with a likely heart attack. What can you do about it? First, give the patient an aspirin, to thin the blood a little, and perhaps limit further damage. This will not alleviate the pain, but may do some good in the long run. If you have oxygen available, have the patient inhale it at a rate of 2–3 liters per minute (per the machine’s gauge). The pain of a heart attack is partly due to inadequate oxygen within the heart muscle, somewhat like leg pain in a runner, and improving oxygenation may lessen the discomfort. Assuming you don’t have oxygen available, have the patient lie in the bed with his upper body propped up on several pillows. This decreases the work of breathing compared to lying flat, with less demand on the cardiac muscle. Next, give nitro. Nitroglycerin lessens heart pain by opening up the coronary circulation, thus delivering more oxygen to the heart. Nitroglycerin sublingual (dissolved under the tongue) offers very quick but short-term relief; nitroglycerin paste, patches, or delayed release capsules offer longer-term relief, but are slower to take effect.

Medically speaking, this is about all you can do – but still it’s not all you can do. Hold the patient’s hand or rub their neck, if this seems to comfort them. Offer a cool washcloth if they are sweating. Allow a calm, supportive family member to assist you. Keep disturbing or anxious relatives out of the room. Offer to pray with the patient, if this seems appropriate. Offer fluids unless the patient is vomiting. Two reasons fluids are withheld in the hospital are that the patient is getting an I.V. anyway, and that a surgical procedure may be around the corner, with associated anesthesia and risk of vomiting. Your post-Armageddon patient is not going to undergo a heart bypass or stenting, and does not need to suffer dehydration on top of a heart attack. Be careful, though, if the patient is short of breath, as excess fluids may worsen a case of congestive heart failure.

Now, whatever you’ve done with the equipment at hand, don’t blame yourself if the patient dies. We are simply not in control of everything. You did not cause the patient’s heart attack and you’ve done what you can to help.

Your next patient is a 45-year-old woman, complaining of chest pain as well, but who doesn’t appear ill. Chest pain in a person under about 50 years of age is more likely related to the lungs, ribs, or digestion than to the heart. In an asthma patient, when the lungs are tight and the patient is short of breath or wheezing, opening the airways (with an inhaler or steroids) may do more to relieve pain than any pain reliever. If the patient is breathing normally but complains of pain on inspiration, this is usually pleurisy (inflammation of the lining of the lungs) or rib-cage pain. Either way, anti-inflammatory medicine such as ibuprofen, naproxen, or even aspirin is helpful. (Remember, though, that if you’re wrong and the pain is coming from the stomach, these drugs may aggravate the problem.) In our index case, there is definite tenderness when you palpate along the rib margins. The heart and lungs cause pain, not tenderness. If rib tenderness is present, you can be fairly confident the problem is musculoskeletal, that is, not serious, and again an anti-inflammatory should help relieve the discomfort. Heat or ice (and not wearing an underwire bra) often help as well.

Next in line is your 30-year-old nephew who works hard and parties harder. His chest is hurting, too, sort of burning, and you can see he’s hung-over. Home-brew will be available even in the worst of times. Chest pain due to acid reflux (often aggravated by alcohol or anti-inflammatory medications) requires a different approach altogether. Pain medication is not the answer. Decreasing the amount of stomach acid refluxing into the esophagus will alleviate this pain. Baking soda and liquid antacids offer almost immediate relief, which is a diagnostic test in itself. Any of the OTC antacid reducers (Pepcid, Tagamet, Zantac, Axid, Prilosec, Prevacid) will afford longer-term acid suppression. Since these medications will not be available forever, avoiding heartburn triggers is only sensible (NSAIDs, alcohol, tobacco, spicy food, fried or fatty food, citrus fruits, tomato products, chocolate, caffeine – yes, avoid all the good stuff).

At first your 40-year-old cousin thought the pain was in her right lung, but now it seems focused in the upper abdomen, toward the right. She’s pretty sure it came on after eating half a jar of peanut butter. The pain is dull to sharp, mostly aching, but with cramps coming in waves, with intermittent nausea. This type of pain is typical of gut pain, probably stemming from gallbladder irritation. With gut pain, narcotics may help, but NSAIDS (anti-inflammatory drugs) should be avoided. Sleep, relaxation, a hot bath, and abstaining from eating also offer partial relief. These same measures help individuals with colitis, kidney stones, kidney infection, diverticulitis, and other intra-abdominal irritations.

Very light massage is a technique that helps gut pain by distracting the mind from the deeper pain. This is part of the basis for the efficacy of effleurage, a TENS unit (transcutaneous electrical nerve stimulation unit), and even a hot shower. Just as an Internet connection can only carry so much information at once, the human nervous system can only process so much neural input at one time. The heat of a hot shower takes at least several minutes to penetrate sore muscles, but partial relief begins the moment the skin is stimulated. Laboring women sometimes massage their own bellies to lessen the deep pain. Anyone can experiment with this superficial massage technique, which works not only for gut pain, but other deep pains as well. Light oil massage works similarly.

Deep massage is best described and taught by a professional masseuse, which I am not. But even an untrained friend can give a good backrub that relieves the tensions of the day. I’ve had many patients obtain as much relief from a professional massage as from medication or physical therapy. The relief may be short-lived, and the massage may need to be repeated in a day or two, but this natural remedy is used worldwide for pain relief. In fact, in countries where there isn’t a drugstore on every corner, touch therapy is the primary mode of pain relief.

Doing anything at all is nearly always better than doing nothing. Placebos, which have no physical basis for helping, still do so about a third of the time. Hope is a natural narcotic, and people will try a multitude of peculiar and likely ineffective therapies on the basis of hope alone. This is also how so many crackpot therapies work their way into the health care field. Anything, even a sugar pill, will help somebody. Part of the benefit is mind over matter; part is giving your body time to heal on its own. Many patients who think an antibiotic cured them overnight were simply going to be better by the next day anyway. Applying cool cabbage leaves to tender, engorged breasts is purported to relieve the discomfort, but perhaps grape leaves, lettuce leaves, or a cool wash cloth would accomplish as much. Still, applying cabbage leaves lies in the realm of “doing no harm,” plus it gives the mother something active to do. People prefer to be in charge of their own bodies.

As a physician I struggle with the need to be honest with my patients versus the desire not to deprive them of the placebo effect. Modern medicine prides itself on “truth.” But for anyone who believes in a certain therapy, even one proven by medical science to be ineffective, for that individual the relief is real. After an Armageddon event, the placebo effect may be a doctor’s strongest ally. A placebo may be a pill, a procedure, an activity, or a dressing. Whatever you do, choose your placebos wisely and first, do no harm.

Natural remedies also include biologically active chemicals such as opium and salicin (from which aspirin is derived). Through the years, the pharmaceutical industry has developed many refinements, but these two are the original basis of all narcotics and anti-inflammatory medications, including codeine, morphine, hydrocodone, oxycodone, ibuprofen, and naproxen. When supplies of pharmaceutical pain relievers run out, healers will need to resort to the original, naturally-available painkillers.

White willow bark contains the natural pain-killer salicin. For a full discussion, see the University of Maryland Medical Center (UMM) website, which includes details of dosing, drug interactions, side-effects, and recipes for willow bark preparations made from commercially available supplies.[1] Of course, stockpiles of willow bark will run out as quickly as stockpiles of aspirin, and it makes more sense to learn to recognize the tree, and either locate it within your community or plant your own. Other types of willow may also be effective.

 

Willow Bark Tea Recipe (from UMM)

 

Boil 1–2 teaspoons of (commercially-available) dried

white willow bark in 8 ounces of water

Simmer 10–15 minutes and let steep for half an hour.

Drink one cup 3–4 times daily as needed.

Narcotics are the strongest pain relievers and will be the hardest for preppers to come by. Doctors are extremely unlikely to prescribe enough to stockpile and so, aside from learning to prepare your own, are there any alternatives?

Tramadol is a prescription painkiller, nearly as strong as codeine or hydrocodone, at least in the narcotic-naïve patient. People who get a “high” on narcotics are not fond of this drug. Whereas a few years ago it was quite expensive, now the cost is on a par with ibuprofen. Because it is less likely to be addicting, doctors are happy to use it more freely for many conditions ranging from headaches and stiff necks to sciatica and broken bones. If you have a good relationship with your doctor, you may be able to obtain a small supply, which you should plan on reserving for serious pain. The normal dose is 50–100 mg every 4 to 6 hours.  (Note: This paragraph was written in 2011, before the change in approach to pain medicine nationwide.  As of 2017 it is much less likely your doctor will give you even a small supply of tramadol unless you have a current need.)

Secondly, the combination of Tylenol plus an anti-inflammatory is nearly as strong as the narcotics hydrocodone or codeine, and in many patients, works as well or even better. As long as a patient can tolerate the ingredients separately, they are well-tolerated in combination. With 500-count bottles of Tylenol, ibuprofen, and naproxen sodium readily available over the counter at minimal cost, anyone can lay in a good supply for future use.

Of course, anti-inflammatories (NSAIDs) are not tolerated by every patient. Any NSAID may cause stomach discomfort or even an ulcer with prolonged use. They should always be taken with food to minimize contact with the stomach lining. Some patients are able to tolerate an NSAID if they take an acid-lowering drug (such as Pepcid, Zantac, Prilosec, or Prevacid). Allergies to NSAIDs are not uncommon, and sensitive individuals may develop hives or wheezing.

For musculoskeletal pain (strains, sprains, fractures, injuries), the NSAIDs, narcotics, and Tylenol are useful, but again, don’t limit yourself to thinking of pills as the only way to alleviate pain. Rest, ice (or heat), splinting, wrapping, and taping are all measures that decrease pain by lessening the stress on the affected body part.

Again, the main point is to get beyond thinking that pain pills are the answer to pain. Yes, they have their place, when the pain is disabling and nothing else works. But overall, especially with the supply of narcotics severely limited, do what you can to avoid them, and save the “big guns” for situations that truly warrant their use.

Checklist – items to include in your medical supplies:

Tylenol and OTC NSAIDs – ibuprofen, naproxen sodium, and aspirin
Prescription tramadol, narcotics, muscle relaxers, sleep aids, antidepressants, beta-blockers, calcium channel blockers
Oxygen tank or concentrator; extra tubing
Hot water bottle or reheatable rice bag
Athletic tape; Coban; elastic wraps; ankle, wrist, finger, and hand splints; slings
OTC Prilosec, Prevacid, Pepcid, Zantac (or generics); liquid Maalox; baking soda
Oil of clove for dental (nerve) pain
Actions to take:
Learn about using willow bark at the University of Maryland Medical Center Web site (at http://www.umm.edu/altmed/articles/willow-bark-000281.htm); also, locate a local source of willow bark or plant your own trees.
Study up on massage and effleurage techniques
Download a pain scale you find useful

[1] University of Maryland Medical Center: http://www.umm.edu/altmed/articles/willow-bark-000281.htm

*originally  written as “table below”.

Water Purification … EMP

rough stream

Thoughts on water purification as shared by one of TACDA’s advisory board members, Paul Seyfried ….

Hi,

Thanks for the heads-up.   As most of the attendees are well into their fifties, sixties, and seventies, I wonder just how far they’ll get on foot or pushing a bicycle.  Water is HEAVY, and there may be precious few (none) sources of water that are suitable for using a single or two-stage water filter.  Pollution.  Even the best “emergency” water filters cannot deal with urban chemical pollutants.

So far, most evacuees in the US in recent memory had a source of good water in the areas they evacuated to.  The EMP problem will eliminate that stop-gap.  No one, without a well and the ability to use that well without grid power, will have  safe water.

Don’t be a refugee.  Find a relative out of town that is willing to have you pre-position generous supplies there.  That will assure your support if you are able to get out, and that you won’t be a burden on the host.  Over-achieve on the food and clothing end of the list….it may last a lot longer than you think!  From casual conversations with guys like Bron Cikotas and Lowell Wood, they revealed that any species of a new grid will take between 10 and 20 years, and it may not be Americans that restore it.  The “experts” that assert a “months-to-a year” time window for restoring the power grid are just not realistic.  Also consider that among the suffering and dying population will be the very people who know now to install high voltage transformers and equipment.  IF they can get it, and IF they can pay for it with now-worthless American dollars from suppliers abroad, and IF they can transport it around the country without fuel, water, food, and security that we now enjoy at re-supply points along the way.

I know a man who is one of only a dozen or so who know how to splice high voltage cable.  I’m not talking the 12,000 volt stuff, I mean 500,000+ transmission lines.  A dozen such men are adequate for the random incidents where their skills are needed.  It’s the same demand for installing 700 ton extreme-high-voltage transformers at power plants.  Don’t need too many of those on a daily basis.  But melt down 6,000 EHV transformers, and you have a problem.  How do we contact these men (no communications)?  Which of them are willing to leave their starving and thirsty families to travel long distances in a grid-down country to work on your power plant (assuming they could get the huge list of gear to restore the plant) assuming they are alive by the time they need him?

With all of the perils and pitfalls of evacuation, it is probably the only way forward for city dwellers, because there will be nothing in the city for them.  The cities will die.

You can pass this short video of a talk by Bronius Cikotas about the consequences of a CME or EMP on the nation.  https://www.youtube.com/watch?v=ZpHjP1j70Xo    The follow-on videos about EMP are also excellent! He softened his remarks for the audience….but over a hamburger at Hires in September 2014, Bron left his line of conversation about life in Virginia to say, “They cities will die.  Get OUT.”  The way he said it, out of the blue- and then moved on, was unexpected.  I’m going somewhere with this, and it relates to a conversation I had with the water works engineer in West Jordan in the lobby of his building.  I just drove to the water works and walked in asking for someone from the engineering staff.  A kindly man in his fifties came out and addressed my questions about how, where, West Jordan gets it drinking water.  Indeed, his comments applied to the Wasatch Front, not just WJ, with the possible exceptions of their wells.

West Jordan gets 82% of its water from the reservoirs in the mountains….Jordanelle, Pine View, etc.  It is piped down through very large concrete aqueducts.  If an earthquake damages these, it may take 3 or 4 months to repair them.  “But we could keep the city alive with the wells, if the quake didn’t disrupt them…….if no one takes a shower. It would be close.”   I then asked, “What about EMP?”   I got no tap dancing, hemming or hawing.  He looked right at me and said, “The city will die.”  Almost exactly what Bron said at Hires.  It’s likely he had attended the EMP seminar Bron was presenting at the Little America Hotel on the morning of 9/11, which was adjourned by the events in New York City.  About 600 city and state officials were in attendance, those associated with law enforcement, utility management, etc.

In Lowell Wood’s 1999 testimony on EMP, he discusses the challenges of “bootstrapping” the grid.  It is bleak.  It is wise to consider the importance safe, clean water has on the priority list of our preparations.  Without the grid, municipal water will be a fond memory and the largest factor in the demise of hundreds of millions of Americans.  Those relying on emergency backpack filters will soon find themselves in serious trouble as their filters become hopelessly clogged using ditch water.  Virtually all filter manufacturers use tap water to rate their capacities.  In my experience in the high Uinta mountains,  I had to clean my Katadyn filter after only a few quarts of clear stream water.  It was frustrating and time consuming.  With cloudy, muddy water, it would be much worse.

What is needed for long-term water filtration is multiple stages….starting at 20 microns, and moving down to the .3 micron level so that one filter is not overwhelmed by trying to handle the whole task.  Processes to handle viruses and chemicals need to be included.  The best filter I’ve found for the long-term water problem is the Lakewater Filter by Vitasalis (Equinox) out of Michigan.  Six processes (still not as good as the 19 to 23 stages your city uses) instead of one or two.  It requires power to use….so alternative power is also high on your list.  It will provide plenty of water for the long haul for showers, cooking, drinking, etc.

Plan and DO for the long haul. In virtually any nuclear confrontation with our very real enemies, you can count on loss of the grid and all its attendant benefits.

Paul

My disaster preparedness secret weapon: Hydrogen Peroxide

hydrogen peroxide

BY ALEX HOLLINGS

When putting together a disaster plan, it’s important to prioritize human needs in the way that you prepare.  To put together a solid short-term survival plan, you need only to address the most basic of human necessities: water, shelter, food, and security, but as short-term survival transitions into “well I guess this is what’s left of the world now,” it’s important to have a plan in place that can help you get by a bit longer than just the first few days after a disaster.

While ensuring you have adequate food and water will prevent death from hunger or dehydration, it’s important to remember that those are often the very easiest forms of death to avoid.  We worry about supply lines drying up after the collapse of our infrastructure for good reason, but humans have been surviving without grocery stores and running faucets for millennia… what tends to kill us in such situations often isn’t a lack of food, but rather a lack of hygiene.

Enter my favorite survival item: hydrogen peroxide.  Most of us are familiar with the brown bottle of bubbling goodness from our childhoods, when our mothers would pour a bit of the elixir onto our scraped knees to disinfect it before armoring the wound with a Batman band-aid and providing an emergency booboo-kiss for pain relief.  While wound care is certainly one of the things hydrogen peroxide is good to have around for, it’s far from the only thing.

In order to discuss some of the other important uses for the magic brown bottle, I’m going to have to delve into some of the health issues that may impact a person in an extended survival scenario; some of which are likely to sound gross, but it’s important to plan for potential health hazards other than gunshot wounds and zombie bites, because dying of an infection all by yourself will leave you just as dead as the sexier alternatives we see on TV.

Hydrogen Peroxide for Mouth Care

I’m not normally one to close my eyes during a rough scene in a movie – but watching Tom Hanks remove an infected tooth with an ice skate in “Cast Away” was tough for me.  I don’t like going to the dentist, let alone the idea of serving as my own using bits of trash I found on a beach, but I have to credit the movie for including an element of survival that is often ignored in movies and television: dental hygiene.

An infected tooth is a serious issue.  If left unchecked, and infection can spread throughout your body, possibly even killing you without antibiotic treatment.  Beyond that, an infected tooth can make eating an excruciating endeavor and can serve as a serious distraction when you need to keep your wits about you.  If at all possible, one should avoid having to do their own oral surgery, and hydrogen peroxide can help.

That same brown bottle you use on cuts and scrapes is also a FDA approved mouth wash.  Pouring a mix of hydrogen peroxide and water into your mouth and swishing it around once in a while may not give you the same fresh breath you’d get from a tooth-brush and a new tube of Crest Whitening, but it could keep the bacteria in your mouth from going rogue and rotting you from the inside out.  Keeping your teeth intact will keep you eating, and hydrogen peroxide can help stave off infections and even cavities.

Hydrogen Peroxide to Fight Fungus

Athlete’s foot and other fungal infections of the hands and feet can be serious trouble for the long-term survivor.  The reduction in available means of hygiene that may come after a disaster could leave you more vulnerable to this sort of ailment, and yet again, hydrogen peroxide can help kill the fungus causing itching and burning on your extremities.

Perhaps more important though, is hydrogen peroxide’s ability to combat yeast infections.  While we tend to think of such things as a uniquely female issue, and in today’s world, we even see it as more of an inconvenience than a matter of life and death, developing a yeast infection in a survival setting is bad news and must be addressed.

Hydrogen Peroxide is safe to be used as a douche for women suffering from a yeast infection after the stores have long stopped stocking Monistat, and can be used externally for men suffering from the same ailment.  Didn’t know men could get yeast infections?  They absolutely can – and the resulting itching, burning and open sores could lead to any number of further infections, or simply leave you too distracted to handle your day-to-day survival needs with the level of focus they require.  Hydrogen peroxide will not work as well as traditional anti-fungal medications, but as a multi-use tool, it’s good to know that you can keep the swamp-rot off your fingers and toes as well as out of your underoos with the same bottle you keep around for wound care and oral hygiene.  I’d just recommend cleaning the spout before switching between uses (just kidding, do not put the spout inside any part of you, use a different means of application).

Hydrogen Peroxide for Cleaning (everything)

If you wear contact lenses, hydrogen peroxide and water can be used to clean them between uses – extending the life of your contacts and possibly your ability to see if you don’t have access to your glasses.  It can also be used to clean food containers and utensils, water carriers, or even cooking surfaces to kill things like salmonella.

You can also use a mixture of hydrogen peroxide and water to clean and disinfect your clothes.  A clean pair of undies may not sound like the most important thing after the end of the world, but remember, we haven’t evolved to prefer the smell and touch of clean things for no reason.  Cleaning your clothes will help prevent skin irritations and even infections.  In fact, using hydrogen peroxide to clean your underwear could prevent you from having to using hydrogen peroxide to treat a yeast infection in the first place.

Hydrogen Peroxide for Farming

In a long-term survival situation, cultivating your own food may be a necessity, but if you weren’t blessed with a green thumb, you’ll likely need all the help you can get in order to turn your little garden into something that’ll feed your family.  Believe it or not, hydrogen peroxide can also help you start to grow your own food.

Adding a small bit of hydrogen peroxide to the water you pour on your plants can help fertilize the soil, prevent mold and mildew from developing, and even help an ailing plant regain its health.  Soaking seeds in water that contains a small amount of hydrogen peroxide will even make them germinate faster.  It’s important to use the correct amount of hydrogen peroxide however, otherwise it could kill your plants before they have a chance to grow.  Check out this chart to help you determine how much peroxide you should mix with water for various agricultural needs.

These handy uses for the old brown bottle in your medicine cabinet are far from all of the ways hydrogen peroxide can benefit a disaster victim attempting to transition from short-term to long-term survival.  I highly recommend doing some research and attempting to use hydrogen peroxide for things like oral hygiene once or twice before the world comes crashing down on you.

And maybe grab an extra bottle or two of the stuff the next time you go shopping.  Just in case.

ABOUT THE AUTHOR

Alex Hollings served as an active duty Marine for six and a half years before being medically retired from service. As an athlete, Hollings has raced exotic cars, played Marine Corps football and college rugby, fought in cages, and even wrestled alligators. As a scholar, he has earned a master’s degree in Communications from Southern New Hampshire University, as well as undergraduate degrees in Corporate and Organizational Communications and Business Management.

Survival Landscaping

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By Kylene and Jonathan Jones

The cold, hard fact is that it is almost impossible to store enough nutrient rich foods to survive a long term event. Yes, you might be able to stockpile 30 years-worth of wheat, rice, beans, dehydrated foods, and other foundation grains if you have enough room. However, you cannot stockpile fresh fruits and vegetables which provide optimal health, nutrition and go a long way toward improved immune function and disease suppression.

You might think that your next best bet would be to count on identifying edible plants in the wild to supplement your diet. After a taste-test tour eating wild plants, we immediately went and bought more food storage. Edible? Yes. Tasty and filling, not even close. We burned more calories finding the plants than we received by eating them.

According to Marjory Wildcraft of www.thegrownetwork.com, it is just too land intensive to realistically support a family on the hunter-gatherer system. She states: “Let’s start first off with the almost magical dream of the pure hunter/gatherer. I often hear this one from those concerned about a collapse of civilization. Just how much land does it take to support you without destroying all the wildlife and plant populations? How much area do you need in order to live sustainably as a hunter/gatherer? Since there are so few actual hunter/gathers left alive on the planet, and the few places where they do still exist tend to be jungles which look nothing like anything in North America, we will turn to anthropological data. The quick and easy answer is that traditional peoples used on average, about 10 square miles per person. Ten square miles is 6,400 acres – that is for one person.”

So what’s the answer? It just might include creating your very own self-sustaining food supply. Call it survival landscaping, permaculture, sustainable agriculture or whatever you like. The goal is to work with nature to create a truly sustainable system. A garden paradise that requires little or no human intervention once established. Due to the “natural looking” nature of this type of landscape most individuals would never suspect the amount of life-saving food growing in the tangle. Thus protecting your food supplies in plain sight.

The objective is to create an environment which requires very little human intervention once it is established.

The ideal permaculture design produces food year after year without weeding, pruning, tilling, fertilizing or using pesticides and herbicides. The system is perfectly balanced for the local climate. It is possible to accomplish permaculture landscape on a half-acre city lot as well as in a more spacious country environment. Permaculture takes many years to establish and become resilient to changing conditions.

Selection of plants is critical to take best advantage of local climate conditions, ensure natural balance and to extend the harvest throughout the entire growing season. There are a growing number of great reference books to guide you through the process. Many of the authors recommend a more “natural or wild looking” landscape which is perfect for a remote bug out location, but may not be welcomed in a gated community.

Delightful results can also be achieved by applying permaculture principles on a small urban lot that has a more trimmed and controlled appearance. Food does not have to be grown in an orchard or in neat weed-free rows. Even annual vegetables can be creatively interspersed with landscape to create a unique functional beauty. Limited space requires creative solutions. Consider vertical growing possibilities such as arbors, trellises and arches. Permaculture designs allow grapes or other vines to grow right up tree trunks. Container plants can extend your growing area to decks and patios. Use your imagination to produce a stunning, productive yard.

Strategically plant fruit and nut trees. Apple trees come in miniature dwarf, semi-dwarf and standard sizes. There is the perfect size to fit your landscape. Depending on the type and size of the tree, an apple tree can produce hundreds of pounds of apples each year to be stored, dried, or bottled as needed. A walnut tree is a wonderful large shade tree producing up to 150 pounds of nuts annually, providing needed fats, protein and calories. Fruit and nut trees are a long term investment and would supplement your diet and extend your food stores during a prolonged disaster scenario as well as enriching your diet today.

Consider what resources you currently have growing in your yard. Would it be possible to plant grape vines or berry bushes in with your current landscape? Remove a non-productive shrub and replace it with a life-saving nutritional plant? How about including some medicinal or culinary herbs? Those dried beans are going to taste a whole lot better with a few spices. If your current lifestyle does not allow time to harvest your bounty, don’t worry about it. Healthy soil is critical for a successful survival garden. Compost whatever you don’t use along with grass clippings and leaves to build your soil for a time when you might be dependent upon what you can produce on your own land for survival.

As you prepare for the challenges in our future, consider investing in living food sources in addition to your long term dry food stores. The security a full pantry and productive garden provide are worth the time and resources required to achieve them.

• Kylene and Jonathan Jones are authors of The Provident Prepper – A Common-Sense Guide to Preparing for Emergencies. Visit them at www.TheProvidentPrepper.org and www.YourFamilyArk.org.

-Photo found at Google Images

Biological Hazards

iStock_handswithsoap

(Source – CDC and Ready.gov)

Biological agents are organisms or toxins that can kill or incapacitate people, livestock and crops. A biological attack is the deliberate release of germs or other biological substances that can make you sick. However, in nature there are many items that can prove to be harmful and in some cases these can be seeded by terrorists.

These include but are not limited to:

  • Various strains of Influenza
  • Cholera
  • Typhus
  • Yellow Fever
  • Measles
  • Chicken Pox
  • Ebola

Actions to Take:

  • Take vaccinations that may be offered. If you are unsure as to your status check with your doctor to ensure all required or suggested immunizations are up to date. Children and older adults are particularly vulnerable to biological agents.
  • At all times one should maintain a high level of personal hygiene. This is especially critical before, during, or following a biological attack. Wash hands frequently, shower, clean surfaces using sanitary wipes, be aware of your surroundings and distance yourself from individuals coughing, sneezing, or secreting other bodily fluids.
  • Avoid large and small animals such as mice and wildlife, insects (mosquitoes, ticks, etc.), birds, especially bats, and unknown domestic pets (cats and dogs, etc.).
  • If you believe you have been exposed to a biological agent, take off and bag your clothes and other personal items. Wash, wear a facemask, or if not available, make a mask out of two or three layers of material.
  • Most biological agents can be filtered using home HEPA (High Efficiency, Particulate Air) filters in the air intakes. These filters are capable of filtering most biological agents that are typically larger than 3 microns.
  • In a declared biological emergency or developing epidemic, there may be reason to stay away from crowds where others may be infected.
  • Since biological agents and diseases exhibit varying incubation periods, usually measured in days or even weeks, biological agent attacks are not as noticeable initially. The more serious phases of the disease will occur several days after the disease has been contracted.
  • It is important that you only seek medical attention when you are certain you are ill. It is likely that the medical care system will be overwhelmed and the “worried well” will exacerbate that problem if they seek care when they do not need it. Your local medical experts will inform you of the symptoms that indicate you may be ill. Many symptoms do overlap, so ensure you don’t seek care until you need it.

Paper, Plastic … or Cloth?

dreamstime_diapers

By Jim Rawles

We’re sharing an article from our Journal of Civil Defense a few years back – originally found on Survivalblog.com

A couple of years ago I was watching a commercial on television that showed two young men as they stood in a check-out line at a grocery store with a 6 pack of beer, a bag of chips and a package of toilet paper…when the young men found that they had only enough money for two of the three items, they chose the 6 pack of beer and the chips. When asked by checker “Paper or plastic?” the decision was unanimous, “Paper!”

This stark reality of such a simple decision led me on a journey that would involve many years and begin my search for the answer to the question of how much is enough toilet paper and where do I store it. I never really understood just how important TP was and the impact that it could have on our daily lives until that commercial was played out. Oh sure, like many deer hunters and fishermen or any outdoor type, we all have had our moment where our lack of preparedness has caused us great concern and given us an opportunity to experience the humility of mother nature without TP and all that it encompasses.

The necessity of toilet paper and the amount of storage room necessary for a one to two years supply and the quest to keep it dry, even in our homes, is sometimes a task that has caused me great concern and some sleepless nights to say the least. With a family of seven (who will most probably come home in an emergency) and no way to transport two years of their own TP supply plus their family and their gear, I had to find a way to simplify this dilemma. The one thing that I have learned in the past 28 years is that the simplest ideas most always end up being the best…with that being said, I find myself writing about one of the simplest ideas that my wife has produced for our family, and has ended my search for the perfect ending to the mystery.

Just a short piece of history, first: About five years ago, we were on a two-week camp out when a sudden and unforeseen four days of rain descended upon our group of 18 families, who were camped in a narrow canyon with restroom facilities about ½ mile from our camp. Even though we have our own toilet facilities, we decided to use the restroom facilities provided even though we knew we would have to plan our walks for the sake of nature very carefully. We found that in this situation of being away from these very useful luxuries (our portable outhouses), the trek of ½ mile in wet and cold conditions early in the morning or late at night, with a roll of TP tucked under our jackets was sometimes a daring adventure. I lost count of the times a roll of TP was dropped onto the wet ground or in a puddle of water making it completely useless, and of the nature walks that ended half way to the desired destination. And of the rolls of TP that were found early in the morning, standing silently alone atop the picnic table, dripping wet, after someone forgot that TP and rain don’t mix.

The use of toilet paper in very damp conditions led many of our group to wonder out loud about ways to solve this problem. The storage of large amounts of TP seemed to be a major concern for the whole group.  Keeping it dry usually came up as well – the room necessary to store such was vast, to say the least, when you consider a one or two year supply of this basic luxury. I know that many folks on other blogs and survival sites are stacking phone books to use, or they are storing boxes and boxes of TP and to be quite honest, a phone book or a catalog is not quite the best choice of clean wipe tissue if you have ever tried it, and as my wife discovered, the cost of baby wipes was out of the question and our tries at making our own baby wipes (with environmentally safe soap) were discouraging simply because we knew that eventually we would run out of paper towels. We needed a solution to a problem that everyone will face someday – paper, plastic, a leaf, or well … let’s just say any port in the storm, whatever it came to, we still had a choice: find a solution or suffer someday.

They say that every problem is nothing more than a solution in waiting.  Being born in the 1950s, I remembered what many of you may not – it was called the diaper pal and was as common as toothpaste for families with babies. A closed plastic container would hold about 10-15 dirty diapers and, if kept clean (which my mother and other moms demanded), would wait patiently until Saturday morning when the pal was drained into the toilet and the cotton diapers were placed in the washing machine, to be cleaned with bleach and Tide and hung on the clothes line to be sun dried and returned to the diaper basket where, once again, the cycle would continue.

The solution to my problem was as simple as looking to the past for an answer to the future. Why not use cotton diaper material, cut into 4 x 9 inch sections, and then sown around the edges of the material with a zig-zag stitch to prevent the edges from unraveling? My wife and some of her friends chose a Saturday afternoon, had the men load their sewing machines into the truck and carted them over to a local church where an assembly line soon formed; men setting up sewing machines, women cutting material, and other women sewing the edges, after which we men would then package them in bundles of 50 – a finished product that every man and women took special care not to lose. We all enjoyed the Saturday, we have a product that we are comfortable with now, and we have no fear of it being destroyed by rain or muddy puddles, left outside in the morning dew, or blown off of a table top. We can store 5,000 reusable sheets in a medium cardboard box.

My cost in time and material was around 20 cents per sheet if we figured $10 per man-hour to complete the task. Then again this was five years ago, but the benefits have outweighed our investment ten to one! The material was purchased at a local box store but as many of our women discovered, their mothers had a lot of diaper material stored in boxes in their basements and were grateful to have it put to good use. We have found that it took a few times to get use to not depositing the wipes into the toilet facility, but with practice and a few reminders the system works.

The results of our efforts became a very useful item that we now carry in all of our backpacks or bug out packs, stored in freezer bags (but we don’t care if they get wet, as they are still usable) and stacked neatly in our portable toilet’s cabinets in plastic containers right next to our regular TP that we still use while we can.

I have been able to find diaper pails at yard sales and in some stores, and I have found some that would have really made my mom sit up and take notice; they have two-way entries and are very insect proof. We have found that this cotton TP also serves as a wound dressing when two are sown together with a famine napkin in between, as a washcloth, a sweat rag, as a feminine pad (also when sown together with a sponge material in between) in an emergency situation, and other ways that we are finding each and every trip into the wilderness and around our home. As a student of outdoor survival and family preparedness for 28 years, I have found that each and every bit of information received, is another thread of the tapestry that will assist us in the days of uncertainty that lie ahead, and that will greatly add to our chances of survival in the world in which we will soon find ourselves.

Note from TACDA:  Microfiber material may be an option to cotton.  It dries quickly, and is very absorbent.

11 Tips for a Safe 4th of July

4th flag

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

  1. Be a safe swimmer. Water sports and fireworks are two of the biggest pastimes for Fourth of July celebrations, and these are both linked to numerous deaths and injuries each year. Never swim alone, and make sure that kids’ water play is adequately supervised at all times. Many drownings occur when parents and other adults are nearby, so always have a designated chaperone for water play and don’t assume that others are watching the kids. Statistics show that most young children who drown in pools have been out of sight for less than five minutes. Related articles:
  1. If fireworks are legal in your community and are a part of your celebration, be sure to store and use them safely. Keep the kids away from the fireworks at all times, and keep spectators at a safe distance. Attending fireworks displays organized by professionals is always safer than trying to put on your own show.
  1. Use alcohol responsiblyAlcohol and fireworks can be a hazardous and dangerous combination. Also, have a designated driver to bring partygoers home from the festivities. Remember also that alcohol and swimming can be as dangerous as drinking and driving.
  1. Lakes, waterways, and seas will be crowded with boats. Review safe boating practices, and don’t drink and drive your boat. Alcohol consumption while operating boats or other motorized water vessels is illegal, and you can be arrested for a BWI (boating under the influence!). Be sure that you have an adequate number of life preservers on hand for extra guests. Become familiar with the boating laws in your area.
  1. Cover food and beverages outdoors to discourage bees and wasps from attending your party. If someone is allergic to insect stings, you should have an emergency anaphylaxis kit on hand. Wearing shoes, long sleeves, and long pants outdoors and avoiding fragranced body products, bright colors, and sugary drinks can also help prevent bee stings.
  1. Apply sunscreen both before and during an outdoor party. Ultraviolet rays from the sun can cause both premature aging and skin cancer in the long term, and a painful burn the next day. Even those with darker skin should use a sunscreen with a minimum sun protection factor (SPF) of 15, according to recommendations from the American Academy of Dermatology.
  1. Check prescription medications you are taking to assure you will not have a sun-sensitizing drug reaction to the medication.
  1. If you’ll be hiking or camping in an area where ticks are abundant, wear long-sleeved, light-colored shirts and long pants tucked into socks or boots to protect yourself from tick-borne diseases. For your skin, you can use a tick repellent with no more than 30% DEET according to the manufacturer’s instructions. Products containing DEET should not be used on children less than 2 months of age and should not be applied to the hands or face of young children. Check yourself (and your pets) for ticks at the end of the day.
  1. Spend adequate time indoors or in the shade and drink plenty of fluids to avoid heat illness in extremely hot climates. The risk of heat illness is increased when participating in strenuous activity or sports, and those with chronic medical conditions and the elderly are also at an increased risk of heat exhaustion and/or heat stroke. Alcohol consumption can also promote dehydration and increase the risk.
  1. Keep children away from campfires and grills. Gas leaks, blocked tubes, and overfilled propane tanks can be a cause of grill fires and explosions.
  1. Don’t leave the picnic spread out all day. Allowing food to sit in outdoor temperatures can invite foodborne illness. The U.S. FDA suggests never leaving food out for more than one hour when the temperature is above 90 F and not more than two hours at other times. Foods that need to be kept cold should be placed in a cooler with plenty of ice or freezing packs and held at a maximum temperature of 40 F. While mayonnaise and other egg dishes are often associated with food poisoning, any food can potentially become contaminated. Adequate hand washing and food preparation can also help prevent food poisoning.

(Article found at http://www.MedicineNet.com)