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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. 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|
 University of Maryland Medical Center: http://www.umm.edu/altmed/articles/willow-bark-000281.htm
*originally written as “table below”.
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.
(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
- Yellow Fever
- Chicken Pox
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.
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.
Dr. Joan Lelach says, ragweed pollen will likely join grass pollen to create a second Pollen Vortex for allergy sufferers this summer
Allergy sufferers hoping to survive a perfect storm of elevated tree and grass pollen during the next several weeks, aka the “pollen vortex,” need to prepare for a second wave of overlapping allergens coming later this summer, according to a leading immunologist.
“Nobody’s talking about this yet, but based on the way the climate has been behaving, we’re likely to experience a second pollen vortex when the grass pollen and the ragweed pollen begin to overlap, starting late July and August,” says Dr. Joan Lehach, an integrative medicine physician specializing in allergy, asthma and clinical immunology at Montefiore Medical Center in New York. “Because ragweed pollen creates such a strong allergic reaction, many people are going to get really sick, much worse than with pollen vortex 1, when these two pollens overlap.”
Dr. Lehach offers a few suggestions on how those with pollen allergies can breathe a bit easier during the next few months and survive pollen vortex 1 and pollen vortex 2:
- If you live in a suburban area, keep your grass short and have someone else mow it. If you are going to do yard duty, wear a well-fitting allergy mask.
- Do not hang your wash to dry outside, because, pollen bonds to fabric, like your bed sheets and T-shirts, and that pollen on the fabric will have you sneezing and wheezing all day and all night.
- Pollen counts are the highest very early in the morning, between 5-and 10-a.m., so if you do outdoor activities like jogging, it is better to jog in the evening or after 10 a.m.
- Rootology, a mixture of Chinese herbs, can be used to restore free breathing and reestablish nasal-and-sinus health in less than 20 minutes. I recommend that my patients take two capsules of this fast-acting supplement whenever pollen counts rise to uncomfortable levels. Rootology can be taken along with your current allergy meds to boost their effectiveness.
- Pollen tends to stick to hair, so wash your hair more frequently during pollen season.
- Keep your car windows and your windows at home closed and put the air conditioner on. Use the ‘re-circulate’ button on your air conditioner, because, then you are not bringing pollen in from outside.
- Beware of fruit. Because the proteins are similar, your body can mistake fruit for pollen and create some mild local reactions. I tell those who are allergic to trees to avoid apples, peaches and pears. I tell those with an allergy to grass to avoid melons, celery and kiwis, because, they can trigger an itchy mouth and throat. Eating an apple is not going to kill anyone, but people will get itchy mouths and they will be constantly clearing the back of their throat.
ABOUT JOAN LEHACH, MD (www.joanlehachmd.com)
Dr. Joan Lehach has 27 years of experience treating patients in the New York City area and is currently an attending physician at Montefiore Medical Center in New York. She is an integrative medicine physician specializing in allergy, asthma and clinical immunology and has the largest solo asthma and allergy practice in the Bronx. Dr. Lehach was named one of the top physicians in New York by “US News and World Report,” has helped design asthma protocols for a number of health plans, and lectures extensively on allergy and asthma.
(Tip was shared with TACDA from Michelle Tomao – email@example.com)