First Aid/Medical Category

Sunday, April 20, 2014

Dear Reader,

As a person who has been blessed with not needing reading glasses, I am usually happy to read lists on prepping that tell the readers to make sure that they have extra prescription glasses in case they break their everyday glasses and cannot get new ones due to unforeseen circumstances. It's one more place I can save a few dollars. That's great, but is it really that simple? Many times I have glossed this fact in my mind. I wear sunglasses everyday. They are cheap and available everywhere, which is a good thing because I am a little rough on them. Between the odd time when I sit on them or toss them onto a parts-strewn surface and scratch the daylights out of them, mine have a relatively short lifespan. I used to hang them on my head. Unfortunately, the cover crop is thinning out too much and cannot hold them there any longer. After the second smashed pair that fell off backwards, I start hanging them on my shirt. Now most of my t-shirts have a slight 'V' in the collar that my wife hates. If I do not hang them, they get forgotten and, therefore, bent, broken, or lost. As a professional driver they are an important part of my everyday carry. Of course I never thought of it as such. You do not want to drive far without a pair when driving into the sunrise or sunset or when facing a horrible glare off equally horrible city buildings, traffic, or in the winter on the Prairies when everything is white for miles. I drove a week once with a plastic Snoopy pair because I needed them and could only find one set in my size at a gift shop. Beggars cannot be choosers, and I was begging. The last thing I grab when I leave the house is a pair. I also snatch a pair when going to the garden or to work on equipment. I like the slight amber lens because while driving it helps me to notice animals. These same glasses help with the green brown contrast and go straight from my work truck to my hunting truck. The UV protection and anti-glare contrast are very helpful. Coming from a hunter, it may sound strange, but I would rather see and slow down for an animal than hit it. I do not feel that unnecessary death is something that I can live with as a cost of doing business. Additionally, these plastic trucks seem to disintegrate on impact with June bugs. As much as I use my sunglasses I had never before thought, “What if this was the last pair that I could ever buy? Have I even considered how I can protect my eyes from everyday things that happen? If the SHTF, how many things am I going to be doing that can be less than healthy for my eyes? Do I have extra sunglasses for when the lenses become crazed with scratches or milky? What about when they fall apart?”

I had a pair of sunglasses once that I left in the car in winter. When I hopped in and put them on, my body heat caused the lens to crack in half. You do not go very long without finding yourself with a new pair. Right now I have the option of buying new tools (safety glasses are tools) to use. What about down the road when they start breaking or wearing out? I know that my safety glasses have saved my sight while using the grinder. I have thrown out many a pair that had too many burns in the line of sight. Also, while using old wire wheels, I have picked lots of loose wires out of my clothes. One time I thought I was stung on my face but really had one lonely wire sticking straight out of my upper lip. Sure you say, that is a power tool, and after the SHTF we will be using hand tools. Well, then, I suppose you have never broken a drill bit. Even hand tension can send pieces of high carbon steel flying like it was shot from a slingshot. Additionally, since most people will be doing things that they have never done before, I am certain that there will be quite a few improperly used hand drills, not to mention that casehardened mild steel punch and chisel set that can be bought cheaply from an import tool store. They may be a cheap way to fill your Armageddon survival fantasy toolbox, but the first time your strike sparks, you will realize that those little pieces flying around you are dangerous. For the more adventurous prepper you may get into torches and welding. Cheap safety glasses will save you the first time you are soldering a pipe and manage to leave a couple drops of water in the line. Believe me, molten lead can sputter. (This also applies when casting bullets.) I have several shirts that are only used now for plumbing, because of the lead melted into them. The little mixed gas brazing tanks can be bought cheap and used when there is no power. Their goggles are handy, and you can pop out the dark lens and just go with the clear ones as an expedient dust goggle. If you plan on welding, well, you have more money than me. If the power stays on, my wife has the best auto darkening helmet I could find. It is good for stick welding, mig/tig, torch, and if you leave it off you have a great grinding shield. Yes, she is the welder in my family. It is simple common sense. She is great at it and wants to weld. Stick your pride on the shelf in the shed, and let those who can do. In many of those weird movies that have post-apocalyptic themes, the people many years into the future are wearing some kind of welding goggles. Why? They are industrial use. Fairly cheap safety glasses and replacement lenses are available now. You should buy some. For the cost of the one pair of ultra cool Oakley's, you can have dozens of clear, smoked, amber, or mirror safety glasses and replacement lenses. Buy some for the whole family. Ever since I first saw that ad that everyone has seen with the sunglasses that have stopped a bullet, I have thought about what it would be like to have that kind of protection. Of course, if everyone who was nasty enough to shoot at you would be kind enough to only use .22 short at the range of 50 feet or more, that would be great. Realistically, just like the military, I have come to the conclusion that the simplest form of danger to your eyes is the best one to protect for. I am talking about dust, wind, little bits of stuff blasted into your face, and of course simple bad luck. Think bad luck is not important? How about the last time you walked into a tree branch that was perfectly level with your head and scratched up your face? What about those psychotic little flies whose only purpose in life is to commit suicide by dive bombing your exposed eyeball, while you are busy doing something outside? Think that cannot happen at an inopportune moment? In the SHTF time, you will be outdoors alot more often than you are used to– possibly up to 24 hours per day. When I first thought of this, I went down to the local Salvation Army store and found three pairs of skiing goggles. I paid $3 for two pair and $3 for the third pair. This beat the pants off the surplus ones for $20. Considering that I plan to use sunglasses most of the time, it was still nice to find a cheap backup. I also use them when shooting. Sure I learned without them, but the little things have taught me better. I first started when I learned black powder. The guy who showed me, (yes, I had an enthusiast teacher) said that you never know 100% of the time what is going to happen. Sure, things are very well made, but a firearm is a controlled explosion. He put a cap on an empty chamber and fired it. That thing was mangled. He said that he had never been hit in the face with a fragment of brass, but he was never going to take the chance. I took that lesson to heart. Now, all shooting is done with glasses. I stopped shooting one brand that was made by a drunken gintaster in an un-named factory, because I noticed too many flattened primers and too many burnt casings, suggesting breach blowby potential. If that had happened, it may not destroy the firearm, but it can send oil droplets and dust (even rust flakes or carbon cakes, for those who do not clean their weapon properly), at high velocity into your face. This can seriously affect your health and well-being if that second shot is a must. As well, when reloading ALL steps can be dangerous. I have a quarter inch scar on my left index finger from trying to catch a dropped shotgun hull before it hit the ground. The primer burst with my hand beside it. Sometimes it is best to step back and let things fall. Things happen. Yes, I was wearing safety glasses. The reloading manuals all say that you should wear them at any time you handle propellants and primers. Left to my own devices, I did not know any form of commonsense as a child. I had many days without eyebrows. Looking back I am absolutely amazed that I did not take an eye out. I did have instruction about this though. My grandfather (may God rest his soul) was blinded in one eye during WW2. He would never even allow me to use a lawn mower without first putting on safety glasses or, at the very least, sun glasses. If you refused, you could not work at his farm. Grandfather had a tough life finding work, as a man with no depth perception. He always had a job, but he also had lost several in his life because the company would not allow a one-eyed man to work machinery. He used a glass eye, but eventually he was found out. It is not the same now, but back then that was life. I understand now why he was so upset when us, grandchildren, took unnecessary risks. He was trying to protect us from his life. He taught me to use my first gas power tools. When I got old enough to finally use a chainsaw, I automatically put on the glasses. I do not use just glasses anymore, because as anyone who has used a chainsaw knows pieces of wood fly everywhere. I worked in forestry for a while, and it was required that we use full face shields whenever we started up our saws. I found that the wire mesh one worked best, because in the summer it allowed a breeze to cool your face and did not fog with your sweat or breath. If you are buying your saw, go to a proper dealer. They will have these great helmets that have the shield and ear muff attachments. I may not work with a saw professionally, but I still keep this stuff for when I cut firewood. Now, even when fully blind one can be a productive member of society, and these changes are good. Making full use of people, instead of giving them pity or ignoring them, gives them good value and self determination. Discrimination is wrong, but what about after SHTF? If you loose an eye, are you going to be able to bag the wild game that your family needs to eat? If it is your shooting eye,can you protect yourself properly with one-half of your vision being a blind spot? What if you lose both eyes from some accident and suddenly have no way to properly support yourself or your family? Blindness will most likely be a death sentence for those after a SHTF situation. Those born that way will at least have the advantage of always being that way. You will have a learning curve that most likely will be insurmountable, unless you already have a large community or family that will be willing to take care of you and yours while you adjust. If your community has certain standards, they may only assist in a finite number of charity cases. Also, the government could use your situation as negative, in regards to who is useful versus who is not. I am sure that there are charts and triage requirements that say a one-eyed person has less value. It would be a shame to have to be separated from loved ones because they meet a certain criteria and you no longer do. Going back to eighteenth century medicine is not going to be easy. When you are on your own and cannot get a doctor to check out your pinkeye that you got because something got in there and infected it, you may loose your sight. Right now you buy your milk at the market. If the time comes that you must get it yourself, you will find very quickly that cows love to wrap their tails around your head while milking. Those tails, covered in dust and sometimes excrement, can put foreign matter into your eyes. This can very quickly turns out bad. Flushing them with warm milk does sometimes help clear up that infection, ironically. Several years ago my wife got metal splinters in her eye while at work. She was driven to the emergency room and got fixed up proper. It was an accident. This same accident, in a SHTF world, would have left me trying to use her eyebrow tweasers, while she screamed and flinched at every move I made. When you have no way to fix the problem, the best thing to do is try to prevent it the best way that you can before it can become a problem. Having some safety glasses or even sun glasses around, plus extras, can keep you in the habit of using them too. Just because it is a pain to go get them or that you lost them are no excuse, when it comes to protecting your eyes. I had an uncle who also lost an eye, but it was because he was too impatient to walk across his shop and get a pair of safety glasses.

Keeping yourself with vision (not visually impaired) in the future could require nothing more than simply spending a few dollars on a few items now that most of us never think about until it's time that we need them.

Saturday, March 29, 2014


A.C. wrote a very good article on asthma, but left one important care plan out– immunotherapy. Immunotherapy, also known as allergy shots, helps a person's body become tolerant of the things they are allergic to. After allergy testing, the allergist can prescribe allergy injections for what a person is specifically allergic to. A person can receive weekly allergy injections starting at a small concentration and dose of these allergens and working up, to build up a tolerance for their allergies and possible asthma triggers. This can take three to five years, so I'm not sure if there is time before the SHTF or not. This doesn't work for all asthma, as not all asthma is triggered by allergies, but it is another way to help control your asthma that you may want to consider. - C.D.

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Just wanted to add this tip. The asthmanefrin medicine can be used in an ordinary nebulizer. You don't have to use the atomizer that comes with it. Also, albuterol can be used in an atomizer, which can be useful because it is more portable than most nebulizers. It also operates on batteries, which is important if the grid goes down temporarily or you are away from home. I recommend getting an atomizer kit to carry in your vehicle. I also recommend getting several refills to use in your nebulizer, in case you run out of albuterol and can't get emergency medical help for some reason. - R.G.

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As a reminder to people out there, Albuterol is available in TABLET form and works only slightly slower than inhalers (minutes at most), but the shelf life, if stored properly, can be many years. The 4 mg immediate-release tablet is equivalent to two puffs of an inhaler. Talk to your doctor about the possibility of trying some tablets, and then you could possibly have a more stable shelf supply in an emergency that was long term. - Dr. Bob

Hugh Adds: Dont for get to add our very own Doc Cindy to the list of helpful tips: Seven Ways to Stretch Your Medicine Safely - and - A New Twist on a Live-Saving Medicine.

Economics and Investing:

The Real Reason the U.S. Dollar Has Value.

Thursday, March 27, 2014

HJL Notes: There are quite a few links in this article. Some are to procedures performed on YouTube. The reader should be warned that while SurvivalBlog made a “best-effort” to verify every link for the medical information, some also contained references to homeopathic and eastern medicine with some eastern religious gestures honoring a false god.

When I was about 14, my younger brother, who was 10 at the time, became seriously ill with pneumonia. It started out as a "chest cold", but after a couple of weeks developed into a deep, body wracking cough along with a high fever. He went to the doctor, was diagnosed with a lower respiratory infection, and was administered antibiotics. He was told to stay in bed, drink lots of fluids, and take acetaminophen to control his fever, like anyone with pneumonia. Everyone expected that the medications would take effect and that he would bounce back. Instead, a few days later, he ended up in the hospital with a collapsed lung and a chest tube. He almost died. Over the next few months, he was plagued with lung infection after lung infection, as well as breathing problems, and he landed in the hospital several times for breathing treatments and oxygen. One of my earliest memories of this time was of visiting him in the hospital when he was lying face down with the lower half of his body propped up while the nurse was giving him a "percussion" treatment . (Percussion is a technique that helps loosen mucus and other secretions so they can be coughed up. It is usually used for pneumonia or cystic fibrosis.) The pneumonia and subsequent lung infections had taken their toll on his lungs, and ever since he has had to deal with asthma.

Fast forward to 1993. My son was born completely normal– normal weight, normal apgar, normal everything. Like all babies, my son usually would get fussy and want to eat when he woke up in the morning. However, one morning, when he was about two months old, I got up to check on him because he hadn't made any noise. I found him with his eyes bulging, struggling to breathe. His breaths were so labored that I could see all of his ribs when he took a breath. (These are called retractions.) I grabbed him up, rushed him to the emergency room where he was diagnosed with RSV (Respiratory Syncytial Virus, and put in an oxygen tent because his O2 level was so low. He stayed in the tent for over a week. When he was finally able to emerge from the tent, he was put on nebulizer treatments of albuterol (a bronchodilator) three times daily and a steroid inhalant to control his lung inflammation, plus weekly evaluations by a pulmonologist. He remained on these nebulizer treatments until he was old enough to use an inhaler. He was also diagnosed with severe environmental allergies. Since then, he also has had asthma. -

Today, both my brother and my son lead healthy, active lives. Both use a metered dose combination steroid and bronchodilator inhaler, and both take allergy medications on a daily basis. Neither have had a serious asthma attacks in years. They are able to exercise and participate in the same activities as other "normal" people, provided they use their respective inhalers morning and night to prevent lung inflammation and provided they avoid the allergens that trigger their asthma attacks. Both are allergic to cats, dogs, and birds. Both are allergic to dust and molds and have hay fever. Both also have other things that they are sensitive to, such as perfumes and certain chemical odors. Both have to take additional allergy medication to control their body's reaction to allergens in the environment. However, in a situation where they couldn't obtain their medications, they would quickly have allergic reactions, develop lung inflammations, which would lead to asthma attacks, and they would likely both die.

Even though I have lifelong experience with asthma as well as medical training, this article is written as information only. It does not constitute medical advice. You should always have a discussion with your medical practitioner and educate yourself about your personal health problems. Finding a medical practitioner who has a preparedness mindset is not always easy, but there are many out there. With the knowledge you accumulate by learning about your or your loved one's health problem, you will more easily be able to have an intelligent and productive conversation about what you need to do to prepare.

Asthma is a lung disease where the lungs become inflamed and the air passages narrow, making it difficult to breathe. Since 2011, one in 12 people are diagnosed with asthma. This adds up to more than 25,000,000 people in the U.S. that suffer from the disease. Internationally, about 300,000,000 people have asthma, and many more don't even know they have it. Of these people, about 3,500 people in the U.S. die from asthma every year, and 250,000 die internationally every year. Many deaths are due to people's mismanagement of their disease, due to lack of medication or lack of medical care. However, in the U.S., once medications to control allergies and asthma run out, in a SHTF situation, people with asthma will not be able to survive.

There are a number of different categories of breathing problems. Most of them can fit into the following four categories:

  • Inflammation lung diseases which include asthma, cystic fibrosis, emphysema, chronic obstructive pulmonary disease (COPD), and acute respiratory distress syndrome (ARDS),
  • Obstructive lung diseases, which include COPD and asthma,
  • Restrictive lung diseases, which include pulmonary fibrosis and infant respiratory distress syndrome (IRDS), and
  • Lung infections (both bacterial and viral), such as the common cold, bronchitis, and pneumonia.

Note that asthma fits into both inflammation and obstructive categories. . For the purposes of this article, I will focus only on asthma, which is usually a long-term, manageable problem. If you have other breathing problems, you will want to make sure you have a conversation with your medical professional about how to prepare for emergencies and extend their recommendations to cover you for longer lengths of time. Some of what this article covers will apply to all people who have breathing problems, but every individual is different with different needs. Make sure that a thorough conversation is had with your medical practitioner about your particular illness, and then do what you can to plan.

A note on infections: Most upper respiratory infections and about half of all lower respiratory infections (bronchitis and pneumonia) are caused by viruses. (The rest are caused by bacteria, and in the case of lower respiratory infections, you can add fungi and parasites as possible causes.) The treatment for these is usually bed rest, lots of liquids, an over-the-counter decongestant, acetaminophen or ibuprofen to control fever, time, and/or allergy medication. In a healthy adult with a healthy immune system, the illness is usually resolved within a couple of weeks. On occasion, especially if the patient becomes dehydrated, they are hospitalized. However, there is no "medication" that is effective against viral infections. (Occasionally, if the pneumonia is caused by a flu virus, an antiviral may be prescribed, but they only work against flu and not all viruses.) Using an antibiotic every time people have a cough (along with the routine antibiotic dosing of animals used for food) is what has led to some antibiotic resistant infections. Of course antibiotics have their place, and we should prepare for bacterial infections, including respiratory infections, by acquiring them; however, they are not a cure-all. The often-prescribed Amoxicillin does not treat all infections, and simply dosing oneself with an antibiotic every time an illness occurs will not necessarily treat that disease. Learning how to diagnose disease, when to use antibiotics, and which antibiotics are used to treat specific bacterial infections is something that takes years of study. There are books that can be purchased that can help recognize certain symptoms, but often similar symptoms can indicate either a viral or bacterial infection. Antibiotics can also cause other serious problems if misused. Make a concerted effort to include a medical professional in your preparedness group, and always consult with them before taking antibiotics, if at all possible. Additionally, do not self-treat with antibiotics unless it is a true SHTF situation, and you know what the illness is and what antibiotic to take for the illness. There are serious side effects that can occur with improper use of antibiotics, never mind allergies to antibiotics (which would open a brand new can of worms). Do your research and make a list of what antibiotics to use and what infections they will treat. Antibiotics are a crucial part of SHTF preparedness, however, it is also imperative that you know how and when to use them.

Diagnosing asthma is not always easy. Most doctors will take a medical history and listen for several key factors, such as a family history of asthma and whether the patient has had breathing problems in the past. They will also listen to the lungs, have the person blow into a peak flow meter, have the patient breathe into a spirometer, obtain an arterial blood gas (ABG), and/or put a pulse-oximeter on one of the patients fingers to measure oxygen in their blood . They may also take a chest X-ray to see what might be visible in the lungs. They might also run a battery of allergy tests which include pricking or scratching the skin and inserting typical allergens into the wound. If there is a reaction, it means the patient is allergic, and that particular allergen could be an asthma trigger for them.

There are also telltale physical signs of asthma that the doctor will also look for:

  • chronic cough (usually worse at night and in the morning),
  • wheezing,
  • chest tightness,
  • shortness of breath, and
  • breathing difficulties, brought on by a variety of things.

In a SHTF, a medical practitioner would not have access to X-rays, however, a preparedness group should purchase several pulse-oximeters and several peak flow meters. These are inexpensive and can help with diagnosis. Related to why there are more and more asthma diagnoses every year, some medical professionals have suggested that it is our ultra-clean living that is preventing our bodies from developing strong immune systems. Some have posited that there was less asthma when most people lived on farms and raised animals, thereby coming into contact with bacteria and developing resistance to infection. ; . In a SHTF situation, there likely would be more outdoor work, which might reduce the incidence of new cases of asthma. It wouldn't be prudent, however, to assume so.

No one really knows why some people get asthma and others don't. However, once a person has asthma, it usually is life long and has no cure, although some seem to think they can "grow out" of it. Most often asthma is associated with environmental allergies, and there is also evidence that it could be genetic. . Asthma usually starts in childhood, and it is often preceded by a lung infection or allergies. Once the damage occurs, the person will have asthma for the rest of their life. Managing the disease with medication makes it possible for the person with asthma to live a normal life.

Asthma causes chest tightness and wheezing when the person has trouble moving air in and out of their lungs. People with asthma often tend to be sensitive to dust and pollen, and they also tend to have allergies that trigger asthma symptoms. Asthma triggers can be a variety of things from dust to mites, smoke to illnesses, and even cold or exercise. . When the person with asthma encounters a trigger, the lungs react by becoming inflamed and producing mucus. Mucus production often occurs simultaneously with swelling and lung muscle tightening. Airways in the lungs are surrounded by small muscles, which become constricted and narrow the airway when a trigger is encountered. These three cause extreme breathing difficulties for the person suffering with asthma. Wheezing can be heard as whistling– the air gets blocked by swelling and mucus in the small airways. Symptoms of an asthma attack are wheezing, shortness of breath, coughing and chest tightness.

All people with asthma should have an asthma care plan that they set up with their doctor. This would include steps to prevent worsening of symptoms during an asthma attack. Most asthma care plans have three components:

  1. Measure the person's peak flow rate. This is measured by a peak flow meter, which has a mouthpiece the person with asthma blows into to raise a movable indicator of air flowing out of a person's lungs. For information about using a peak flow meter, visit the following website: The person with asthma should periodically measure their peak flow rate, so they can know what their average is and then compare that to their measurement when they are having an asthma attack.
  2. Identify the person's asthma triggers. Learn how to avoid or manage these triggers.
  3. Treat the asthma. This treatment will be something the patient and his or her doctor will set up, based on the symptoms and the peak flow meter measurement.

Often, there are early warning signs to an asthma attack. Maybe the person came into contact with a known allergen. Maybe an environmental trigger was present. Regardless of the cause, the person with asthma should recognize differences in their breathing to gauge whether the trigger is affecting them and whether they need to use an inhaler to prevent worsening of symptoms. Additionally, many asthma sufferers will begin to panic once they start experiencing shortness of breath, which itself can worsen symptoms. Imagine suffocation caused by one's own body. Keep in mind that asthma (and all breathing problems) can be fatal, if not treated. The warning and danger signs are described here:

There are several treatments for asthma, which are outlined here:

Anti-inflammatory drugs are usually in the form of inhaled steroids. The person with asthma inhales the drug morning and night (or based on a treatment plan set up by a doctor) to help to control the inflammation in their lungs. With the inflammation under control, the person with asthma is less likely to react to asthma triggers. Injectable and pill form corticosteroids are also used and should be discussed with your doctor.

Bronchodilators are medications that "open the airway". There are long-term bronchodilators that keep lung muscles from contracting, thereby keeping the airway open. There are also short-term bronchodilators, which react quickly to help contracted muscles in the lungs relax to open the airway. These are used for asthma attacks. Combination medications are combination anti-inflammatory drugs and bronchodilators.

An asthma attack should not be confused with anaphylactic shock, which is usually a result of coming in contact with a potent allergen. Some people with asthma do have allergies that will cause anaphylaxis. Anaphylaxis is usually treated with epinephrine, usually in the form of an epi-pen. If you have allergies that are this severe, it is a twofold issue: treating the life threatening allergy and treating the asthma attack that the allergy may cause. Ensure that you discuss allergies with your healthcare practitioner and that you have a treatment plan that you can administer yourself. . Untreated anaphylactic shock can cause death. Make sure that you discuss your particular needs with your preparedness group and stock up on anything you need to both prevent and treat your allergies.

Accumulating medications for people with asthma is a priority when preparing for a SHTF event. Explore all avenues to obtain the medication necessary. Make sure you keep in mind that you should have several backups in case of equipment malfunction. Additionally, keeping medication dry, dark, and cool is best for obtaining the longest shelf life. Alternative medications and herbs could also be explored, but they usually can't be substituted for actual medication. The medications and equipment I would recommend to store are the following:

  1. Obtain several peak flow meters and record the measurements.
  2. Purchase several pulse-oximeters and batteries for those meters. This will help you to monitor the amount of O2 that is in your or your loved one's blood.
  3. Purchase several nebulizers and nebulizer medications, particularly those that are "rescue medications" for asthma attacks. Combivent is one example of a short acting rescue medication that can be administered with a nebulizer. Talk to your doctor about which one is best for you.
  4. Purchase oxygen concentrators and masks or cannulas for emergency treatment. You can often buy these used.
  5. Obtain enough of your beta2 adrenergic agonist medication to last for the SHTF event you are planning for. These are the medications that will help relax the muscles in your lungs, thereby opening your airway. An example of this is albuterol; however, there are a number of other medications. There is always a concern about expiration dates. However, my son has used expired albuterol inhalers, and they have worked fine. Often, people with asthma have several inhalers lying around and will grab one within reach if they start wheezing. My son has said that "old ones" (presumably out of date) work fine, but they "taste skunky". I would hazard a guess that if inhalers are kept cool and vacuum packed they will be fresher than those that are found under the bed and out of date.
  6. Obtain enough corticosteroid medication. This is the medication that reduces inflammation in the airways. There are a number of these medications, but an example of this is Flovent. . Again, keep your stockpiled medication cool, dry, and dark for maximum shelf life.
  7. Talk to your doctor about obtaining anticholinergic combination medications, as either an inhaler or nebulizer medication. These are usually reserved as rescue medication in severe asthma attacks, and for asthma are combined with another medication, such as albuterol (a Beta2 agonist). An example of an anticholinergic is ipratropium.
  8. If you use a combination medication, such as Advair, obtain enough medication to last for a SHTF event. Again, read the article about using expired medications and use your judgment,
  9. Purchase several inhaler spacers. A spacer helps to "hold" the medication longer, which makes it easier to breathe more of it into your lungs. This is especially helpful for children.
  10. Obtain enough steroids in tablet form and/or in injectable form. Make sure you talk to your doctor about which options are best for you. These could be as emergency backup or used for asthma that needs supplemental corticosteroids. Tablet form steroids, particularly if you vacuum pack them, likely could last much longer than inhaled or injectable corticosteroids.
  11. Obtain enough allergy medications and antihistamines that you use consistently or frequently. Obtain prescription medications, but also their over-the-counter counterparts. Often it's just a matter of strength. You can always double up, if it's the exact same medication. (Check with your doctor.) Also, talk to your doctor about other medication options. If one can't be obtained, what others could be used? Again in regards to storage, vacuum packing and keeping medication dark, dry, and cool is the key for preserving potency.
  12. Obtain several epi-pens in the case of severe allergy. There has been a study done about the effectiveness of epinephrine used past its expiration date. The conclusion is that as long as there is no precipitate (floaty stuff or cloudiness) in the liquid, it can be used. However, try to ensure you consistently obtain epi-pens, and keep them in date by rotating them. Don't throw out the ones that are out of date though, and make sure you refill your prescriptions, even if you don't use them so you have a stockpile. Check that the liquid is clear, and keep the pens cool. Always store epi pens in their carrier tubes. Just make sure you check them frequently.
  13. Ensure that everyone in your preparedness group is trained in CPR. On occasion, an asthma attack can worsen and the person with asthma can stop breathing.
  14. Obtain additional emergency equipment, such as blood pressure monitors (or sphygmomanometer and stethoscope), IV fluids, and sets, as well as emergency breathing equipment and the training to administer them. (There are some serious risks with using these things inappropriately.) There are a number of medical preparedness trainers around the country, as well as community colleges that can give you medical training. If you or your loved one has a medical condition that might require specialized knowledge, now is the time to get it.
  15. I recommend Asthmanefrin, with reservations. It is a bronchodilator that helps to open the airway. It is fast, acting in five minutes or less, so it can be helpful in an asthma attack, but is not recommended for long-term use. It is actually not the drug of choice for asthma. If there is nothing else available, having this "inhaler" might be better than nothing, but it is quite expensive, and the plastic parts have had a tendency to break. There have also been other serious medical issues associated with this product. . If you decide to stock up on this drug, educate yourself on when and how it should be used.

Make sure you are familiar with the side effects that asthma medications can have, as well as medications to avoid when you are using asthma medications. Side effects of some asthma medications can include rapid heartbeat, shakiness, nervousness, dizziness, headaches (in the case of bronchodilators, and bone density issues, weight gain, thrush, and others with corticosteroids . There are also some over-the-counter medications that are not recommended for people with asthma. My brother and son have not had any problems with their medications, but they have been told to avoid aspirin and ibuprofen. Just remember that not all medications affect all people the same way. Make sure you talk to your doctor about any side affects you may experience now or in a SHTF situation, and know how to deal with them. You should also talk to your doctor about how to deal with a serious side effect, if normal medical services are interrupted. Bring up weather issues such as Katrina and Sandy as well as the flooding in Colorado to help start the conversation about what to do if you can't get to a medical facility.

Alternative asthma treatments are often sought by asthma sufferers. The thought of having to take lifelong medications, some that cause side effects, is not appealing to many. In a SHTF situation, alternative medication could be something that compliments and possibly extends prescription medications. . My brother swears by yoga and meditation, which help him relax. He also says that drinking strong coffee has helped lessen his symptoms, especially if he wakes up wheezing. He fixes himself a pot of strong brewed coffee and says that by the time he is done drinking two cups, his wheezing is nearly gone. My son prefers caffeinated sodas, though I prefer him to not have the sugar and chemicals. Some people have looked at herbal remedies such as ephedra as well as special diets. Page three of this article offers some solutions from the kitchen cupboard, refrigerator, drawer, and spice rack: Also, there are some herbal/homeopathic solutions offered here, but physician or herbalist supervision is recommended: . Do your own research and work with a medical practitioner while trying them. You or your loved one may be sensitive to some of the treatments and may need allopathic care, if you have an asthma attack. There are also some over-the-counter as well as alternative medications that some people with asthma are sensitive to and, therefore, should never use. Keep in mind that some medications will affect some people, yet not affect others. Make sure you recognize the ones that you or your family members are sensitive to and talk to your doctor about what over-the-counter medications are safe for you to use.

In a SHTF situation, an asthma attack would be life threatening. If the person with asthma recognizes the symptoms and treats them with his or her quick-acting inhaler and they are still experiencing worsening breathing difficulties, the usual procedure is to call an ambulance and be transported to the nearest emergency room. There are things the hospital can do to that are not available at home:

So, what if emergency services are not available? Having emergency treatment equipment, such as O2 concentrators and nebulizers with a fast-acting combination medication as well as additional medication and equipment, might make the difference between life and death in a SHTF situation. Sometimes, a person suffering from an asthma attack might need additional breathing support. Speak with your medical practitioner about potential emergencies. Talk to them about what you could do at home, if there was a weather situation that prevented you from getting to a hospital in the event of an asthma attack. If you approach your doctor this way, even if they don't have a preparedness mindset, they won't think you are a whack job. Be calm and logical with your concerns. Using weather events and their after effects as a starting point to obtain additional medication will usually make a difference with how your doctor perceives your concerns. Concrete facts about overwhelmed hospitals and clinics after Katrina and Sandy or impassible roads during snowstorms or floods should be how you begin the conversation. Talk to them about how you can effectively treat a full-blown asthma attack during these times, particularly because these times will be extremely stressful, which could bring on an asthma attack in itself. You might also consider talking to your doctor about obtaining additional supplies saying that you are going to take a trip overseas. You could also ask what you can do if you are not able to obtain emergency treatment in a foreign country without adequate medical facilities. Their answers could help you start developing your own emergency plan for SHTF situations. If you talk to them about a short-term emergency situation, you can take their advice and extend it for a longer period of time to plan for longer events.

Equipment, such as oxygen concentrators, pulse oximeters, and nebulizers, can easily be purchased online. The medications needed for a nebulizer would need to be prescribed by a medical practitioner, but using the above suggestions to have the conversation about at home emergency treatment would be a good way to talk to them about obtaining additional supplies. Looking at ways of producing electricity to run this equipment will also be vital in a grid down situation. An easy way is to purchase a generator and store fuel for it, but alternative means of generating electricity should also be explored, such as purchasing a solar array.

It is also extremely important that a person with asthma take charge of their condition and prepare for long-term SHTF issues. Staying as healthy as possible– eating a proper diet, developing an exercise program, and building their general health– should be a priority for asthma sufferers. Ultimately though, if the person has not taken stock of their health, in a long-term SHTF situation the outcome is dire. Do what you can to prepare, and stockpile all the medication you or your loved ones need to lead as healthy of a life as possible.

Thursday, March 20, 2014

The area of prepping has grown enormously in the past few years, with a diversity not seen in other current mindsets. Some people prep for economic reasons, others for biblical reasons, others for political reasons, while some seem to have no reason at all or a combination of each. I am sure the list of reasons could extended many times over. Each person also has their areas of focus in which the majority of their prepping focuses. Many people are consumed with water storage and/or water purification. Water is the most important supply when dealing with long-term, off-grid survival. Water should be the largest, by volume, of your supplies, but there is so much more that we must give ample attention to.

Many preppers are stuck on ammunition and firearms. Security and safety should be in the top five of your preparedness priorities list. It won't do you much good to have 500 gallons of water, if someone can come and take it from you with little resistance. On the other hand, having five thousand rounds for your AR will not do you much good if you only have enough water for 10 days. Then there are those who gear for this ridiculous zombie apocalypse. I immediately turn these people off when they begin to talk because they are obviously misinformed, misguided, and heavily influenced by video games.

Whichever of the top five preparedness items you begin with, each one must be addressed in order for you to have a realistic chance at survival in any situation. Yet there is still more to consider than just supplies. My mindset on prepping may be a little different than most. The majority of preparations are made for a life-altering event. I look at it as trying to become more self-sufficient now, so the life-altering event won't be so dramatic for me and my family.

My wife and I have recently been researching and attempting to approach the issue of medicine. There have been several good articles posted in the recent past that gave great advice on procuring medicine in advance of a collapse scenario. There was one article that dealt with ordering medicines in powder form that are produced for exotic fish, in bulk and without prescription. I know of doctors who are aware of the dangers that we face in society today that will write prescriptions for antibiotics and such with an extra refill for their patients to put back. If you are one of these people that think this is unethical and illegal, you just go ahead and sign up for Obamacare, wait on the government, and believe everything will be okay.

The encouraging thing that we face in looking into medicines is that everyone in my family is healthy and not required to take any medication on a regular basis, praise the Lord!! Those that rely on medicines to regulate blood pressure, blood sugar, and so forth have to deal with a different set of circumstances, yet there are alternatives for that as well. We do not visit the doctor when we have a sniffle, infection, or tummy ache either. In fact I cannot remember the last time any of us had a regular doctor visit. We are not anti-doctor, but we do not see the wisdom in running to the doctor and getting multiple pills to take when we get sick. It reminds me of the woman with the issue of blood in Luke 8:43, who had spent all her living upon physicians and could not be healed by any.

We began this journey when our children were toddlers, and we grew weary of the pediatrician always wanting to prescribe antibiotics for whatever he/she felt was ailing them. What most people fail to realize is the basis for most drugs is a natural plant. The natural remedies that mankind has used for millenia have obviously worked as we are still here. Modern scientists have taken those plants, herbs, or whatever and tried to copy and enhance the nutrients produced naturally. It doesn't take a scientist to realize that nutrients occurring naturally are a lot healthier than nutrients produced in a laboratory. When reading the side effects of these new drugs, it makes me think that one would be better off with the ailment they are trying to treat. With our distrust of the pharmaceutical companies, we began giving our children vitamins and changing the foods that they ate. We later expanded into homemade syrups for coughs and immune boosters. We also began consuming natural foods– non-GMO, organic, non-pesticide, et cetera. Local honey and raw garlic were incorporated into various tortures. We began drinking raw milk and eating only grass-feed meat, using kefir in smoothies, and many other concoctions that I didn't always find very delicious.

The next step was herbs, whether cooking with herbs, drinking them in an herbal tea, infusing oil and herbs into a salve, and the latest trial is herbal tinctures. There are various methods for making tinctures. The main difference is the base. The most common bases are vegetable glycerin, vinegar, and alcohol. The vegetable glycerin tincture has to be cooked in a crockpot for several days. The cooking process can lessen the healing properties with certain herbs. The other two bases have to be mixed and placed in a dark cool place for 3-6 weeks. While the vinegar base has to be kept refrigerated and doesn't last very long, the alcohol base doesn't require refrigeration and will last longer. The alcohol will also draw more of the nutrients from certain herbs. We chose to do the alcohol base for the aforementioned reasons, but let me first state my stance on alcohol. I believe the Bible addresses the various uses of alcohol. While the Bible does not teach total abstinence, it does teach the evils of drunkenness and the effect that alcohol has on the body, the mind, and the home when it is abused. I am not one who believes and advocates that someone can drink socially or daily for the "medicinal benefits". Every person I have known who uses this logic to justify their actions ends up overindulging, which leads to greater sins. The Bible gives the example of using wine for problems with the stomach in I Tim 5:23. Proverbs 31:6 says, "Give strong drink unto him that is ready to perish, and wine unto those that be of heavy hearts." Again, advocating the use of alcohol as a medicine in situations but not an everyday use. So the decision we made to use the alcohol-based tincture was made with prayer and contemplation. There are various methods to remove the alcohol from the tincture, if your conscience will not allow you to use it, but please realize the amount is miniscule when taking the tincture properly.

Our first tincture was a winter tincture for colds and flu. It was a mixture of leaves and roots of Olive, Echinacea, Garlic, Elderberries, Yarrow, Astragalus, and others. We used 100 proof Vodka as the base. I am not aware if the brand of alcohol will affect the tincture, so the brand was insignificant to us. It was timely because all four of us had a mild variation of the bug that was going around at the beginning of the year. We each took a teaspoon of the tincture twice a day along with some other immune boosting remedies, and we actually survived. I give my wife a hard time with many of her homemade remedies by calling them Voodoo and complaining that they do not work and taste like high school cafeteria food. It didn't taste good by any stretch of the imagination, but then again it isn't supposed to. I have always been difficult and am just trying to stay consistent, but I would much rather take the natural remedies than go to the store and buy something not really knowing what is in it. The misconception people have about all medicines is that they are supposed to work instantly. Pharmaceuticals will address the symptoms and make one feel like they are no longer sick, while the body is still actively fighting the virus, illness, or infection. Natural medicines work differently in that they provide the body the nutrients needed to fight the sickness, while not really addressing the symptoms. God created our bodies to heal themselves, and they will do just that in most cases. God also created the plants that we are supposed to consume to provide our bodies with the necessary ingredients to aid in the healing process.

We next made a tincture that can be taken as a preventative or to aid in recovery during a battle with sickness. It has herbs such as Nettle, Peppermint, Echinacea, Elderberries, Eleuthero, and Rosehips. No, I do not know what most of these herbs are, nor could I spot them in the wild or in the health food store for that matter. That is the next step in my ongoing lessons. In the meantime, these herbs can be purchased premixed from most health food stores and bulk supply stores and just need to be added to the base of your choice. You can also find recipes online for various remedies.

With my mindset of self-sufficiency before a collapse, these tinctures are right up our alley. By using these natural remedies now we are allowing our immune systems to work as they are supposed to and build up strength instead of pumping man-made chemicals into our bodies and nullifying our immune systems. Most people will argue that they have to take a pill for this, another pill for that, and probably a pill to offset the first two pills. Remember that most man-made medicines are copied from a naturally occurring medicine. There are plenty of natural remedies for blood pressure, blood sugar, hyper tension, heart problems, gout, migraines, high cholesterol, et cetera. Why not try to get off some the prescribed drugs now before you are forced to? Even if nothing happens, which is highly unlikely, you will be healthier and happier.

Tuesday, March 18, 2014

Dear Sir,

I have been a daily reader of this site from the very beginning and have found it to be a very valuable resource for my information and awareness needs. Mr. Rawles has always been a straight forward, no nonsense fount to which the prepper/survivalist community relies upon, a mecca as it where. Mr. HJL specifically, (I don't know how to formally address a pseudonym, my apologies), you have started off in your editing of Mr. Rawles' sight with great enthusiasm, and I respect that. This site has large shoes to fill. I think you are off to a great start. That being said, I feel I must write to you and make a request. Regarding the article "Where There Is Smoke", in my opinion, you have gotten away from the concrete and no-nonsense tone of this blog to the fringe elements of your audience. The "reptilian eyes" sentiment just seems a bit off the edge for the flavor of what I thought this site should be. I am not judging the veracity of these claims, but this seems not the place to expound on this line of thought. The net is full of conspiracy sites, and that serves to confound many and leads them off on a tangent that does not contribute to the basic and bare-bones truth of what may become of our future. I ask you in all humbleness to please refrain from proceeding down this path. What I believe is needed is a home of enlightenment and wisdom that this landmark venue was originally destined for.

HJL Replies: I guess you missed my comment under "Notes from HJL" that prefaced the article.

"Today's entry in the writing contest deals with a subject that many of us would just rather pretend doesn't exist- mental illness. This subject has long been a difficult issue to deal with in our society, and being diagnosed as mentally ill (whether correctly or incorrectly) has long lasting consequences. Because the issue is so complicated, it is often terribly abused by those in authority, leaving no recourse for those who are victimized. It is also an area that we need to prepare for, because it is not going away. During a TEOTWAWKI event, it will only get worse. The causes of real mental illness are many, and the length of duration is as varied. However, once diagnosed as mentally ill, you always have, at a minimum, the stigma and legal consequences for the rest of your life (unconstitutionally, I believe). As a reader of this blog, you are probably already outside of what is considered "normal". It wouldn't take much for someone to use that against you."

Mental illness is an issue that we will have to deal with for a long time to come. There is no sense in pretending that it doesn't exists and that it doesn't affect us. I, myself, have been in a situation where a doctor wanted me to sign an agreement that I admitted I had a particular mental illness in order to save his license. (It's a long story involving doctor's misconduct in a messy situation.) I held to my principles,and the doctor was eventually disciplined, though it took years for the process to work.

I published this piece because I wanted our readers to hear from someone on the inside of "mental illness". What is logical to you or me just doesn't make sense to them at times, and we can't just turn our backs on them. We have a moral obligation to help.

An example of the repercussions would be the right to protect yourself. The 2nd amendment doesn't give you the right to defend yourself. It simply outlines a God-given right that is pre-existing in all humans. If we incarcerate a person (or commit them to a mental institution), we take away that right to self defense. That only works because the state guarantees their safety while interned, but what happens when you release them back into society? Since they are no longer under the control of the state, the state cannot guarantee their safety any longer. Yet we do not allow them the ability to protect themselves in the best manner possible. This is a huge issue that stands just under the radar because no one wants to deal with the realities of it. Yet in a TEOTWAWKI situation, it WILL rear up. Dealing with mental illness needs to be part of our preps, both as a defense against those who would do us harm and for those loved ones of ours who are subject to the illness.

o o o

Recently my husband went to our family physician for a routine physical. The first question out of the nurse's mouth was, "Do you own any guns?" After saying this, she became silent and shook her head, "No". It caught my husband off guard, and he said "Yes" without thinking about the implications of her question. Later, the doctor came in and the first thing he said to my husband was, "Do you own any guns? He answered the same as before, "Yes".

Later, at home, we were discussing this. My husband has a diagnosis of BIPOLAR DISORDER. The next time he is asked that question he plans on saying, "I do not think that question is pertinent to our situation."

Why did they ask those questions? Is this yet another big brother thing with the government? Sadly, I'm concerned that my husband is now on a list somewhere, possibly with the police. I told him to say "No", the next time. I think we also may need to hide our guns. My husband's mental illness is very stable. He does not pose a threat to anyone. Even his psychiatrist said that he was the most stable bipolar patient that she has.

Just thought you might want to warn folks of this question that your physician may ask the next time your physical is due. - M.V.

HJL Replies: While I understand why medical care facilities may want to ask those questions, I do not think it is safe to answer them. They started asking those questions because mass statistics show that there are certain behaviors, illnesses, and injuries that often proceed life-threatening suicides or homicides. However, with the advent of governmental interference in medical records, and the potential violations of liberty that will occur, it is readily apparent that you cannot answer those types of questions without repercussions, especially since the answer, once given, will be part of a permanent medical record that the politicians and the IRS have access to.

Monday, March 17, 2014

When the availability of medications becomes severely limited, what's a person to do if they suffer from diabetes, or pneumonia, or chronic pain, hypertension, asthma, or any serious condition?

Underlying this simple question are several more. Without sufficient medication:

  • Will a diabetic's blood sugar soar out of control?
  • Does a hypertensive patient run a serious risk of stroke?
  • Will a person on antidepressant or anxiety medications suffer withdrawal?
  • Will infection recur, possibly worse than ever, without a full course of antibiotics?

Now is the time to consider a future when medications are worth their weight in gold. The following are time-tested tips, which you can use when drugs are in short supply.

  1. Remove disease-causing factors from your environment. If you're asthmatic, you may thrive without an inhaler once you stop sleeping with your cat. Animals anywhere in the house account for a large proportion of medication-dependence in patients with asthma, allergies, or COPD. If all COPD patients quit smoking today, the number of hospital admissions for COPD should easily be cut in half. Infections from animal bites would be rare, if pets and strays were treated with greater respect.
  2. Prevent serious withdrawal symptoms via tapering. Withdrawal from almost any potentially-addicting medication can be prevented via a tapering scale. The most common prescription drugs to consider are benzodiazepines (such as Xanax, Ativan, or Valium) and narcotics (such as Vicodin, Percocet, or Codeine). When withdrawal is a concern, tapering by 10-25% every three to seven days is quite safe (and in truth, many people can succeed cold turkey). The two main concerns regarding tapering are anxiety, due to fear, and re-emergence of underlying symptoms. An alternative to tapering the dosage is to extend the time between doseanti-inflammatoriess. Such medications are (temporarily) put on hold, with the option of administering a dose if symptoms become truly unbearable, gradually stretching the interval between doses. (A word here regarding antidepressants, particularly Effexor: Although stopping these drugs does not cause withdrawal, a discontinuation syndrome is common, and one of the above approaches is often needed when stopping these medications.) In general, narcotics and anxiety medications should be reserved for pain or anxiety so severe that activities of daily living are impossible without treatment.
  3. Minimize your effective dose. This applies to nearly all medical conditions. Rather than simply popping a pill when your arthritis flares or your back acts up, try half a dose of your pain reliever and wait a few hours for results. If you take Prilosec or Prevacid twice daily for heartburn, perhaps once daily will suffice. One inhalation of Albuterol may work as well as two. You can measure the effectiveness yourself using a peak flow meter, available inexpensively at your pharmacy over the counter (OTC). Precious narcotics may be stretched by using only if Tylenol or OTC anti-inflammatories, such as Ibuprofen or Naproxen are ineffective.
  4. Understand when to treat symptoms rather than infection. The goal of antibiotic therapy is to minimize bacterial growth until your own immune system can take over. This does not necessarily mean taking an antibiotic until all symptoms are resolved. For example, for sinusitis, three days of Trimethoprim-sulfamethoxazole is as effective in the long run as a 10-day course. The natural history of many illnesses includes a period of post-infection inflammation. You may still experience nasal congestion for several days after a sinus infection is gone, but this does not mean you necessarily need an antibiotic that long. This is also true of bronchitis, where a cough may linger for weeks. Five days of antibiotic therapy is enough in most cases, where an antibiotic is actually required; in fact, most cases of acute bronchitis are viral and require no antibiotic at all. If "everybody has it," a bronchial cough is likely viral. (For chronically recurrent bronchitis due to smoking, antibiotics are often helpful and may prevent pneumonia if COPD is significant; so, quit smoking now!) Symptomatic treatment should be directed primarily at improved function rather than improved feeling. If you can breathe okay at rest, consider skipping a dose of Albuterol so you'll have plenty left when it's time to chop wood. For bladder infections, 1-3 days of an antibiotic is often sufficient, rather than the 5-10 days typically prescribed. Some bladder infections can be resolved without antibiotics by simply increasing fluids (aim for a gallon of water a day).
  5. Supplement or replace prescribed medications with herbal or OTC alternatives. Chronic conditions, such as diabetes, hypertension, and asthma can be treated, at least in-part, with over-the-counter preparations. Consider trying corn silk tea for hypertension or cinnamon for diabetes, or ibuprofen or willow bark tea for gout, or caffeinated beverages for asthma. Though these medications are not as strong as prescription drugs, they may help you stretch your medication when times are slim.
  6. Alter your diet to improve your health. If we all ate a third less, we'd all be a third (or more) healthier. In times of plenty, a calorie-restricted diet improves the health of patients with diabetes, high blood pressure, heart disease, arthritis, and gout, just to mention a few. In times of scarcity, we may have no choice. A diet high in potassium and low in sodium improves blood pressure. Heartburn or reflux can almost always be improved by avoiding known irritants such as alcohol, fatty food, acid foods (citrus, tomatoes), excess food, and spicy foods (as my patient who was eating 40 green onions a day discovered). Diabetes can often be cured with carbohydrate restriction. Then stockpile the medicine you don't need now for a rainy day later.
  7. Find alternative answers now, while you can. Here are examples from my own practice: A good friend not only feels better, but learned to treat hypothyroidism herself with an over-the-counter desiccated thyroid product. An overweight patient lost 100 pounds and was able to discontinue insulin. Another found glucosamine-chondroitin allows her to function better than prescription medication. Another changed his diet and eliminated gout. Yet another was able to control her cholesterol with herbs rather than medication. Now is the time to explore your options, while labs and testing can confirm their degree of effectiveness.

Based on thirty years of medical experience, the above are the most common and effective ways to minimize your dependence on medication. However, there is more to health than the physical, and depending on our Creator God rather than medications alone is often, I believe, the ultimate answer.`

Cynthia J Koelker, MD is SurvivalBlog's Medical Editor. For further information on the above topics and many more, visit her web site at, where you can also register for upcoming Survival Medicine Workshops.

Sunday, March 9, 2014


Transmission, Prevention, and Treatment of the Flu Virus was an excellent article by JJE. Research has suggested that a Vitamin D deficiency *may* make people more susceptible to respiratory illness. "…Ultraviolet radiation (either from artificial sources or from sunlight) reduces the incidence of viral respiratory infections, as does cod liver oil (which contains vitamin D)…" With regard to Vitamin D supplementation: "…it may be prudent to maintain wintertime 25(OH)D at concentrations achieved in nature by summertime sun exposure (50 ng/ml)…the dosage will depend upon age, latitude, season, skin type, body weight, sun exposure, and pre-existing 25(OH)D levels… Administration of 4000 IU/day of vitamin D for more than 6 months…resulted in average 25(OH)D levels of 44 ng/ml and produced no side-effects other than an improved mood…" but that "…supplementation with 5000 IU/day during winter but less, or none, during the summer to obtain 25(OH)D levels of 50 ng/ml…" may be required. The research also demonstrates that "…These studies indicate short-term administration of pharmacological doses of vitamin D is safe…" and that "…pharmacological doses (1000-2000 IU/kg per day for several days) may be useful in the treatment of those viral respiratory infections that peak in wintertime…" For a 175 pound person (~79 Kg), that dose would be 79,000 to 159,000 IU/day! If you obtain health care at Kaiser Permanente, they will test for a Vitamin D deficiency upon request. I was deficient and have been taking 4000 IU/day (I avoid the sun even in the summer) for years and no longer get the winter crud.

Wednesday, February 26, 2014

The author of “Setting Up a Sickroom” provided much valuable information. One tip, however, is not supported by the last 30 years of medical evidence. Side rails on a bed are known to double the incidence of falls in health care facilities, and these falls result in greater injury. The evidence is so compelling that hospital accreditation agencies will ask for corrective action, if they find indiscriminate use of bed side rails. Delirious or demented people who are intent on exiting the bed unassisted will do so, and they have more to trip them up, turn them upside down, and farther to fall with side rails. One of the most common reasons for sick people to try to get up on their own is a full bladder. Offering a means of toileting every couple of hours reduces more falls than side rails on the bed.

I am a geriatric physician (either way you interpret the term), who has studied this issue and participated in countless root-cause analyses of hospital fall incidents. Regards, - Kris

Hugh Replies: It's important to remember that much of the research that we see regarding this kind of thing is targeted towards institutions and the problems they tend to have with staffing. Side rails can be critical in keeping a patient from rolling out of bed. However, if you have a patient that wants out of bed and no one is there to help them, they will crawl over the side rail. That's where the accidents happen. Is the siderail really the problem? Or is it the lack of attention to the patient. Institutions, like hospitals and nursing homes, tend to run staffing on the ragged edge of what's acceptable, and they make decisions based upon lawsuits. As a firefighter, I am appalled that we are losing access to our backboards. When we suspect neck/back injury, we board the patient for extraction and transportation. Upon arrival at the ER, we transfer custody of the patient to the ER staff. I do not want to disparage the staffing at hospitals, but if the patient is receiving damage because they spend 10 hours strapped to the backboard, is that really the fault of the EMT/fire personnel? Yet, because patients have sued over such damage, we will soon lose the ability to use backboards. Yes, statistically, the backboards do damage, but it's because of misuse rather than proper use. Sometimes I wonder if the suits who make the decisions have ever seen (let alone participated in) removing a patient from the bottom of a 20 foot deep ravine.

As we set up our own emergency/medical stations, we should make decisions based upon sound practice, good medicine, and common sense rather than lawsuits. It's not enough just to set up a sickroom, but we need to have procedures in place that make sure those who must utilize those facilities receive adequate care. If your patient is receiving the care they need, there should be no need for them to climb out of bed over side rails by themselves. Likewise, if you are misusing a side rail to keep a lucid patient in bed, you really need to change your procedures.

Tuesday, February 25, 2014

Viruses are hitchhikers, and they love us. They love everything about us. We provide the perfect environment for them; we are warm, cozy, and moist, and we transport them exactly where they want to be. As my mother would say, we are the “Hostess with the Mostest”. Some viruses even like the same foods and drinks (water) that we like. They are sneaky little buggers. We hardly know they are there. However, with the right precautions and awareness, we can protect ourselves and others by preventing transmission and treating an infection properly. I would love to talk about how to treat and avoid every viral and bacterial infection to prepare you for when the SHTF, but to honor this flu season I will mainly talk about transmission and treatment of Influenza A, B, and C (also known as the flu). I am a Registered Nurse, and every other patient I currently treat has the flu. I will talk about the chain of events that lead to virus transmission, routes of transmission, how to treat viruses (such as the flu for when the "what if" happens without modern day medicine), and the use of herbal teas for SHTF medical care.

Transmission of a virus is a very simple yet vigorous cycle. To stop the transmission, you simply break a link in the chain of events. The transmission of a virus, such as the flu involves the following stages:

  1. Escape from the host or reservoir of infection,
  2. Transport to the new host,
  3. Entry to the new host, and
  4. Escape from the new host.

On a typical day, you head into work. You open the door to your building, wave at coworkers as you pass by, and make your way to your office, where you will sit and enjoy your coffee and quick breakfast before your busy day begins. Today, you will be interviewing a few new potential employees, and the first should be arriving shortly. (At this point, enough has been said. You have had no physical contact with a person yet, and no one has sneezed or coughed directly in your face. That would be way too obvious. Is the chain of events obvious yet? Let's continue.) Not much time passes before your first interviewee shows up early and prudent. You shake hands and offer them a seat.

  1. Escape from the host or reservoir of infection: The person who opened the door to your building right before you has mild cold/flu symptoms, a runny nose, and a sore throat. They will probably call in sick tomorrow.
  2. Transport to the new host: You grabbed that door handle.
  3. Entry to the new host: Without washing your hands, you ate your breakfast or maybe you simply rubbed your eyes, because you are still half asleep and let's face it, it's a Monday.
  4. Escape from the new host: You shook hands with your interviewee and gave them an offer they were not quite expecting.

A person who is infected with the flu can spread it up to six feet away. This is a significant distance. A droplet from a sneeze or cough must simply be inhaled into the lungs or land in the mouth or nose of its new host. The flu is most commonly transmitted via a droplet route (we will discuss shortly) and is less commonly transmitted via a vector (door knob).

The flu is a highly contagious disease. It can be spread when you inhale infected droplets (from an infected person sneezing or coughing) or have direct contact with an infected person's secretions (kissing, touching, sharing utensils, and cups). You can also collect the flu virus with your hands by touching smooth surfaces, such as doorknobs, handles, TV remotes, computers, phones, et cetera. When you then touch your hands to your nose, eyes, or mouth the virus is absorbed, and it gets right where it wants to be. The flu virus can live on a hard surface (such as those mentioned above) for 2-8 hours. This is a significant amount of time for a virus to live without a host! Just think of all those doorknobs and shopping carts! So, here is my number one rule: Stop touching your face and use hand sanitizer.

A common misunderstanding is that the winter weather brings on the flu. This is in fact not true. The flu season does commonly occur in the winter, but this is due to other factors and not weather related. The flu virus will survive suspended in air longer when there is less humidity. In the winter months, there tends to be less humidity to indoor air (compared to outdoor air) this gives the virus a longer opportunity to complete its mission. A simple humidifier and circulating the air in your home may help. Secondly, in the winter people spend more time indoors and have closer contact with others, therefore, increasing the likelihood of spreading a virus such as the flu.

For the sake of being thorough, I will briefly discuss what viruses cause the flu. The flu is different than a cold. A cold can be caused by hundreds of different viruses, whereas the flu is caused by Influenza A, B, or C. Influenza A and B are responsible for most of the flu epidemics, whereas influenza C is usually more mild and causes minor respiratory symptoms. The flu vaccine is created based off of Influenza A and B, while there is no vaccine for influenza C. Influenza A can be circulated between animals and humans, whereas influenza B usually circulates only among humans. You are probably thinking, “Wait, isn't there a new flu each year?” Yes, your thoughts are right. Based on the viruses' chemical structures, they are then categorized into influenza A, B, or C.

So, let's just say that you are standing in a line at the grocery store, and the person behind you is coughing and has a poor attempt to completely cover their cough. Or, maybe you are sitting on a bus, and your bus-neighbor sneezes without warning. You think that you can hold your breath or turn away, but most likely it's too late. Flu symptoms will usually appear within one to four days of infection. This is a pretty decent incubation period. By this time, you've completely forgotten about the grocery line or bus stranger, BUT most people infected with the flu are contagious one day before their symptoms even appear. Those sneaky little viruses! They have begun plotting their way into their new host before you even have a clue and means to stop them. (This is why hand and respiratory hygiene is key even when there is no sign of infection.) Now you are infected, and you are probably experiencing the classic flu symptoms:

  • A fever 100 degrees or higher or simply feeling feverish (but NOT everyone with the flu gets a fever),
  • Runny/stuffy nose,
  • Sore throat,
  • Body aches/chills/headache, and
  • Nausea/vomiting/diarrhea. (These symptoms are most common in children and not a typical symptom of the flu among adults. Keep in mind that the flu is a respiratory disease, not a stomach or intestinal bug).

If you remember anything from reading this article, remember this: Once infected with the flu virus, you are contagious for up to seven days! It is a misconception that if you are no longer running a fever, then you must not be contagious. This is not true! So, forget what your mother, grandmother, or whoever told you about that. Children can be contagious with the flu for even longer than seven days. As a matter of fact, you can be contagious and carry the flu virus without any symptoms at all, and you can still transmit the virus to other people.

Those infected with the flu generally take 1-2 weeks to recover. Some people, such as the geriatric population, will develop complication such as pneumonia as a result of the flu. This could be a life-threatening condition. Pneumonia, bronchitis, and sinus and ear infections are examples of complications from flu. The flu can make chronic health problems worse. For example, people with asthma may experience asthma attacks while they have the flu, and people with chronic congestive heart failure may experience a worsening of this condition that is triggered by the flu.

Influenza viruses can be destroyed by heat (167-212°F [75-100°C]). In addition, several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodine-based antiseptics, and alcohols are effective against influenza viruses. For example, alcohol-based hand rubs can be used in the absence of soap and water for hand washing.

According to the CDC, between the years 2009-2010, the H1N1 (swine flu) virus hit the United States. The very first case was documented on April 15, 2009. Eleven days later it was declared a public health emergency, and vaccines were being created and then shortly distributed. Thereafter in the U.S., they estimated 8,000-18,000 deaths related to the H1N1. Imagine if they hadn't created a vaccine? What if the "what if" happens, and there is no means of creating or distributing a vaccine for such a pandemic. We would be looking at a situation quite like the Spanish flu back in 1918, which was a worldwide pandemic that killed an estimated 50 million people. Our reliance on modern day medicine, vaccines, and antibiotics will be a pitfall once the SHTF and a worldwide pandemic strikes.

So how can we prevent and treat those infected with a flu virus, without hospitalization or vaccination? Simple, we resort back to the tried and true basic care-- taking proper contact and airborne precautions to minimize exposure.

  1. Keep the person with the flu in a separate room. This will help keep the other family members from getting the flu. Try to give the sick person their own room. If there are two sick people, they can share a room and share a bathroom. Do not let the sick person share cups, towels, linens, et cetera. Keep a good air flow in the room. Occasionally open the window for fresh air to circulate. Things that you should keep in the sick room and not remove are:
    1. Tissues,
    2. A trashcan with a lid and a plastic bag,
    3. Plenty of water (possibly a squeezable bottle or a cup with a straw for those too weak to sit up),
    4. Thermometer,
    5. Humidifier (the extra moisture will make it easier for the person to breathe),
    6. Facemasks (when the sick person leaves the room, they should be wearing a mask to protect others),
    7. If the "What if" happens:
      1. It is especially crucial to keep the sick person isolated and separate from your group.
      2. Protect the sick person from outside elements by placing them in a separate tent, if housing is not available. Keep them warm, dry, and off of the ground.
      3. Remove bodily waste, and bury it far away from the rest of the group.
      4. Boil any items, that the sick person has used, for at least 20 minutes.
      5. If the sick person remains in a tent, it is still important to circulate air, by occasionally opening a tent window to let fresh air in.
      6. Keep the sick person warm using hot heavy rocks placed on a fire. Place the rocks into a Dutch oven to heat the tent. Create a humidifier by pouring water over the hot rocks.
  2. Treating symptoms of the sick person:
    1. Fever: If medications are available, such as Tylenol or Ibuprofen, or if using herbal remedies, keep a medication log for when doses were given. Always treat the fever. This will make the person feel better, and they may be able to get more rest. Bringing down a fever may also avoid febrile seizures, which are most common in children. Tylenol and Ibuprofen may not always bring a fever down, but should take effect within 30-45 minutes. In addition to using medications to treat a fever, there other steps to take:
      1. Put a cool damp washcloth over their forehead,
      2. Wash their arms and body with a cool damp cloth,
      3. Put the person in a slightly warm bath,
      4. Give them herbal tea-- Lemon Balm tea and Yarrow tea promote sweating, which can break the fever,
      5. Give them Catnip and Ginger tea, which can relieve fever, and
      6. Treat chills that may be associated with a fever by:
        1. Providing the sick person with a light blanket,
        2. Bathing in warm water containing Epson salts (to sooth sore muscles),
        3. Providing willow bark, peppermint, ginger, and/or rosemary, which have pain-relieving properties,
        4. Serving Chamomile tea, which can help calm the body.
    2. A Sore throat:
      1. Tylenol or Ibuprofen for the pain,
      2. Ice chips or frozen popsicles,
      3. Salt water gargle then spit it out,
      4. Fennel tea will reduce fever and sooth a sore throat and upset stomach, and
      5. Ginger, Tilden flower, and sage teas will sooth sore throats. (Sage tea is also a natural antiseptic and antibacterial.)
    3. A cough: As a nurse I cannot stress enough that coughing will help break up mucus and congestion, and will make the sick person feel better. Encourage coughing. A dry cough (no mucus production, usually a hacking sound) will be irritating to the airway, throat, and chest. Treating a dry cough will make the person feel better, so provide the following:
      1. A humidifier,
      2. Hard candy to suck on, and
      3. Inhalation of chamomile, eucalyptus, or thyme, which will help loosen mucus and sooth the respiratory passageways.
    4. Congestion:
      1. A warm washcloth to the face for sinus pain,
      2. Peppermint tea can stimulate mucus flow,
      3. Cayenne pepper added to juices or soups can help break up mucus, and
      4. Licorice root is a natural expectorant and is also an anti-inflammatory.
    5. Upset stomach:
      1. Offer plain foods,
      2. Clear liquids,
      3. Valerian root tea and ginger tea, which will help sooth an upset stomach,
      4. Goldenseal tea, which boosts the immune system and treats diarrhea,
      5. Cinnamon tea, which may also stop vomiting and relieve nausea.
  3. Cleaning up after the sick person:
    1. If means of doing laundry in a washer and dryer are available, then wash laundry with soap on a hot setting. Remember to hold linen away from yourself and wash your hands! It is alright to wash the sick person's laundry with the laundry of other family members.
    2. Cleaning dishes: Dishes can be washed with normal soap and water. To sterilize, again you must boil for at least 20 minutes.
    3. As mentioned above, alcohol is a good disinfectant to kill the flu virus. I recommend keeping an abundant supply of rubbing alcohol for sterilizing the sick room.
  4. It is crucial that the sick person remains hydrated. The person infected with the flu will be at an increased risk for fluid loss due to vomiting, diarrhea, sweating, fever, and mucus production. The individual must "push" more fluids than usual. In the case that the person becomes dehydrated, here is a simple electrolyte solution:
    1. 1 liter potable water
    2. ½ teaspoonp salt
    3. ¼ teaspoon salt substitute (KCL)
    4. ½ teaspoon baking soda, and
    5. 2-3 Tablespoon sugar or honey.
    6. Crushed vitamins can also be added.
    7. NOTE for treating kids: Cut the additives in half.
  5. Protect yourself while caring for a person with the flu. Wear a mask and wash hands often. For immune boosting and antiviral herbs, try taking:
    1. Echinacea,
    2. Elderberry,
    3. Garlic,
    4. Asian Ginseng, and/or
    5. Wild Indigo.

Remember, the best treatment for the flu is prevention. Cut a link in the chain of transmission and show those bugs who is boss. Most of the time common colds and flus are taken lightly, especially by those healthy young individuals. In a "What if" situation, prevention could be the key between life and death of those who you love. Protect yourself and your family, and start this flu season.

Saturday, February 22, 2014


I am a former 0000-8404 (Field Corpsman), and I saw the link to the XStat Dressing on Survivalblog. I followed the link and read about it. It has a radiopaque marker in it so that it will appear on X-ray to ensure it is fully removed prior to wound closure. While this would be a force multiplier in the battle on blood loss in 'normal' times, I wouldn't recommend this to someone in times when you may not have access to modern medicine. When you have an open wound (puncture, penetration, et cetera) it is very difficult to identify what is tissue and what is a small piece of surgical sponge with thrombotic tissue stuck to it. I would recommend still using celox impregnated gauze that you feed in, so you still have a 'tail' with which you can use to begin removing it. Even with proper flushing of the wound prior to closure celox gauze would be my preference in primitive conditions. - Brad M

Tuesday, February 11, 2014

The time may come when normal medical facilities are not available for any number of reasons. If a family member were sick or injured, would you have the supplies and skills to care for them in your home? After 26 years as a registered nurse (RN) working in a hospital setting with a multitude of different types of patients, I have learned the procedures, tips, and tricks for making patient care easier. I will not attempt to teach you about specific injuries and diseases or their treatments. There are many resources for learning these skills, and I suggest that you take advantage of them while they are available. What I can teach you is how to set up a sick room in your home to care for a sick, injured, or quarantined patient. The first thing on the list of things to know is that organization-- both before and during care-- is very important in making a caregiver's job both possible and easy. If you stock the supplies that I have listed below and made a plan, then you will be able to make a challenging situation doable.

Let's discuss choosing a room in your home that can function as a sick room. A bedroom furthest from the rest of the home's rooms and occupants would be best. If it has an attached bathroom, your job will be much easier. It is always best not to have to transport contaminated body fluids (urine, feces, vomit, and blood) thru an uncontaminated area in order to dispose of them. If an attached bathroom is not available, then one as close as possible will do. I suggest removing all furniture except the bed, rolling table, shelves, or bureau, and a chair from the room in order to increase your working area and decrease the number of items that can be contaminated. It makes sense to also remove all rugs from the room for the same reason--less to contaminate. I believe that a single/twin bed is easier to work with because you can reach over it in order to move your patient without constantly having to walk around to the other side. It would also be back-saving for you to elevate the bed to a comfortable working level. There are bed raisers available or you can improvise with anything you have as long as it results in a stable bed. There are easily detachable side rails available which will protect a confused patient from falling out of bed. I am a big fan of side rails and suggest their use even with a patient who seems unlikely to fall. A rolling table will provide both a surface on which to place clean items that you are using to give care and the usual function of providing a dining surface for a patient who is taking food by mouth. A bureau or set of shelves can serve as a place to store all those things that you will need in order to care for the patient--linens, clothing, bath supplies, gloves, etc. It will be so much easier if you gather all these supplies and place them in the room in an organized manner before you try taking care of your patient. You will wear yourself out if you have to leave the room every time you need to go get something you forgot. You will also risk carrying germs to the healthy members of your family if you make frequent trips from the sickroom to the clean parts of your home. You will need a light source in the room-- electric lights, if they are still working or another light source if necessary. Windows for light and fresh air (if the patient is not under quarantine) are nice to have for both the patient and the caregiver.

All of these things will make your job possible and easier, but what else is needed if the problem is one of infectious disease? I suggest setting up a vestibule outside the sick room door. This can be a simple frame made of PVC pipe-- the height of the door and two feet wider on each side. This will give you enough room to prepare to enter the sick room or exit into your "clean" home. If you hang heavy, clear plastic sheeting on the sides, top and the front (nearest your clean hallway) you can produce an area that can hold you and supplies, which you don't wish to leave in the sick room. The entry plastic sheet can be split down the middle, from top to bottom so you can pass through it easily. If you fold up the bottom edge of all the plastic walls of the vestibule, you can place heavy washers or drapery weights in this edge in order to keep the sheet hanging down. Place heavy plastic sheeting, which can be cleaned with antibacterial solution on a regular basis to decrease possibility of tracking contaminants thru your home, on the floor of the vestibule. If you duct tape the long edges of the sides of the vestibule to the walls on either side of the sick room door you will have one more barrier to escaping contaminants. In the vestibule you should have a box of plastic garbage bags because all bagged trash, laundry, and body waste, which you have to transport for cleaning or disposal, should be bagged in a clean trash bag. Before you leave the sick room, the following sequence of actions can help reduce the chance of spreading germs: 1) gather all your plastic bagged items, 2) set them near the door, 3) remove your dirty gloves, 4) put on clean gloves, 5) open the door, 6) go into the vestibule, 7) open and place on the floor a clean plastic bag 8) place a filled plastic bag into the clean bag 9) remove your gloves and dispose of them 10) gather the top and close the clean bag that contains your contaminated items, without touching the dirty bag. Just a note to explain how to best remove dirty gloves without touching them with your clean hands--grasp your left glove near the wrist with your right thumb and forefinger and peel the left glove off, turning it inside out as you do so. Then you can slip the now bare fingers of your left hand under the cuff of the right glove and peel it off, also turning it inside out. This keeps the contaminated surface of the gloves away from your skin. You might want to consider having a large garbage can with lid and wheels outside the vestibule into which you can place bags for transport. This would be easier than juggling multiple bags. Make sure that you have gloves in any place you will need to remove contaminated items in order to clean or dump them. Try to remember that anything coming out of the contaminated sick room is a hazard to you and your family. Place as many barriers as possible between the sick and the healthy. You, as caregiver, are one of the healthy ones, so you should also protect yourself with gowns, hair covers, shoe covers, masks, and gloves as well as constant awareness of your risk. Plan all your actions beforehand and move carefully and deliberately in order to minimize those risks. Now that we have set up the sick room and all our supplies are installed and ready to use, what should we do next? Let's talk about the linens needed to make the bed and how we go about putting them to best use. I think the first thing to do is to encase the mattress in a zippered plastic mattress cover. This will protect it from being ruined by body fluids. A replacement mattress may be hard to come by in challenging times. The bed can then be made with the following layers of linens: a fitted sheet, a "draw" sheet (one folded to cover the area from the patient's upper back to thigh area for lifting the patient), a fluid-proof pad positioned in the center, a top flat sheet, and a blanket. The fluid-proof pads can be commercial disposable ones or home-made ones. I have made them from inexpensive flannel-backed plastic table cloths and a fabric topping, such as old, soft toweling or heavy flannel. If you decide to make them, cut them out in a size large enough to cover the bed from side to side and about 24 inches wide. Sew them together like a pillowcase with the toweling facing the plastic, then turn them right-side out so that the plastic is on one side (the bottom) and the toweling is on the other side (next to the patient's skin). Then sew the open end closed. These pads wash well but I would hang them to dry, as the plastic may melt in a dryer. A "draw" sheet may be made from cutting a flat twin sheet in half crossways then hemming the raw edges. This sheet is placed across the center of the bed with its ends tucked in on each side. This is a very useful piece of bed linen as it can be used to pull your patient up in bed or to roll them from side to side by untucking the ends and grasping them for the movement instead of grabbing the patient to move them. It becomes more comfortable for the patient and provides better body mechanics for the caregiver. The flat top sheet and blanket are placed on the bed next, just as you would do normally. The only thing I would suggest that you change from your usual bed-making is forgoing tucking the sheet and blanket under the end of the mattress. A tightly tucked covering is uncomfortable for the patient and can cause a problem called "foot drop" in patients who are unable to reposition their feet themselves. As far as pillows are concerned, you need lots of them and they should be encased in plastic protectors for the same reason as you protected the mattress. Multiple pillows have a lot of uses in the sick room. They can be used to raise the patient's head and upper body for easier breathing. They can be used to elevate injured extremities, placed under knees or feet, and tucked behind the patient to keep them in a side-lying position. It was a rule when I worked in the hospital that the nurse with the most pillows "won".

Let's discuss those wonderful disposable plastic basins and "body fluid catchers" that will make your job so much easier. We all have friends and family who have been hospitalized (unfortunately) and return home with a collection of pink plastic "stuff". Don't let them throw them away. Offer to take them off their hands. A collection of rectangular bath basins, emesis basins, urinals, regular bedpans, and flat fracture bedpans will be treasures if you have to care for a sick family member. Just give them a good cleaning and disinfecting and pack them away with all your other sickroom preps. If you can't get them for free, they are available fairly reasonably in medical supply stores. What purpose do these plastic wonders serve? The rectangular basins can be filled with warm soapy water for a bath. The kidney shaped small emesis basins are easy to position under the chin of a vomiting patient. The urinal is fairly self-explanatory as it is positioned to catch the urine flow of a male patient. I would just warn you to make sure that it is tilted with the opening up slightly or you will be changing the sheets. Also be careful to place it gently between your patient's legs to avoid injuring "delicate" parts. The regular bedpan is used for bowel movements for both sexes and urination for female patients. It can be positioned in two ways. If the patient is awake and able to move, they can bend their knees and lift their bottom to allow you to place the bedpan underneath them. If you dust the top edges of the pan with talc first it will slide into place easier. Removal should be done the same way, except carefully so as not to soil the sheets. If the patient is unable to move, you can use the draw sheet to roll them onto their side and place the pan in position before rolling them onto their back again. Obviously the laws of fluid mechanics won't allow you to roll patient and pan for removal; just roll the patient while holding the pan flat. The pan can then be set aside on that handy rolling table while you clean the patient's bottom, straighten the sheets, and reposition them for comfort. Baby wipes are wonderful for the cleaning chores and diaper cream applied to the bottom will help avoid skin irritation. Diaper cream is especially important for those patients who are incontinent and unable to use bedpans or urinals. The fracture bedpan being flatter and smaller is useful with those patients who have lower extremity, back, or pelvis injuries and for whom movement causes pain. This pan can be powdered and gently worked under their bottoms with less pain than the full-size bedpan.

One of the other procedures that can seem daunting to a novice care giver but brings so much comfort to the patient is bathing. If you gather all your equipment first and proceed logically, it can be a pleasant experience for both of you. You will need to assemble: a basin with hot, lightly soapy water, wash cloths, towels, talc, lotion, diaper cream, and a light-weight flannel blanket. If you proceed from one part of the body to the next while keeping everything else covered with the thin blanket, the patient will not get too chilled. I usually start with the head, face, and neck, then the chest, abdomen, and arms. When these areas are washed, dried, and powdered, you can cover then with the blanket and do the lower front part of the body. Use a separate wash cloth for the genitals. After the front of the body is done, you can turn the patient on their side and do the back half. I like to gently rub lotion onto their back before I reposition them again. This relaxes tired muscles as well as stimulates blood flow to the skin, helping to avoid pressure issues. A reminder--every time you have access to any part of your patient's skin, you should make sure it is clean, dry, and either powdered or lotioned. Look for any signs of impending pressure sores--especially over bony areas like shoulder blades, hips, tailbone, elbows, and heels. If you see any redness or whitening of skin, as well as any blistering or skin breakdown, you need to address it immediately and frequently. Make sure the area is clean and dry. If the skin is intact you can apply cushioning pads (available in medical supply stores) and position the area to take pressure off of it. Patients who are unable to move and roll in bed on their own should be repositioned every two hours around the clock. It is much easier to prevent skin breakdown than it is to heal it.

If you plan to change the linen on the bed, it is easy to do after the patient's bath. After finishing bathing the back of the patient and while they are still lying on their side, you can loosen all the linen under the patient and roll it in a long roll toward the patient's back. Then remake that side of the bed with fresh linen--rolling the extra again into a long roll close to the patient's back. Reposition the patient onto their back (they will be lying in a long lump of old and new linen for a few seconds) and then onto their other side. Remove all soiled linen--place it in dirty linen bag--then pull the clean linen through and tuck as needed. Try not to leave folds and creases of linen under the patient; it is uncomfortable and damaging to skin.

Something I have not addressed is talking to your patient. It is a good thing to talk with and listen to your patient during the times you are providing care. They are probably frightened and need to express their fears, be reassured, and be updated on the situation outside their sickroom, especially if they have a contagious disease and have been isolated from family and friends. Being sick brings a strong sense of helplessness and you will be doing a service to your patient if you let them make choices and decisions where it is possible. Even if the patient is unconscious and unresponsive, talk to them; they just may be able to hear you.

Another item of caregiving that should be mentioned is record keeping. I am not talking about a detailed chart such as is seen in hospitals. I am referring to a simple record that lists pertinent information such as name, age, medical history, onset of illness, symptoms, treatment given, and results observed. This information will allow another caregiver to step in and take over care if you must leave the bedside. The last, and possibly least planned for, but most important part of the home sick room is taking care of the caregiver. Nursing a very ill or injured person, especially if it is a friend or family member, is physically, mentally, and emotionally draining. Make sure that you, as the caregiver, get enough food, liquid, rest, and time away from the sick room to maintain your strength and health.

This article contains the basics that you need to know in order to care for a patient in your home. It certainly is not a comprehensive nursing course. Please use the extensive online resources available to extend you knowledge in this area. I hope that this information has been useful and would welcome questions and comments.

Things to Stock For Setting Up A Home Sick Room

  • Single bed (possibly hospital bed or raised bed)
  • Plastic mattress cover
  • Pillows (6)
  • Plastic pillow covers
  • Fitted sheets, flat sheets, blankets, pillow cases, draw sheets, waterproof pads
  • Side rails
  • Towels/washcloths
  • Plastic basin, emesis basin bedpan, fracture bedpan, urinal
  • Hospital gowns
  • Rolling table
  • Chair
  • Bureau or shelves
  • Bedside commode
  • Walker, cane, crutches
  • Plastic garbage bags--large & small
  • Plastic garbage cans (2)
  • Toilet tissue and paper towels
  • Tissues
  • Baby wipes
  • Body wash, talcum powder, lotion, diaper cream, waterless
  • Cotton swabs
  • Disposable exam gloves
  • Thermometer with holder
  • Clipboard, paper, pens
  • Bleach, hand sanitizer, air freshener, surface cleaner
  • Tape


  • Several large, heavy sheets of clear plastic (for vestibule)
  • Heavy washers or drapery weights
  • Duct tape
  • Heavy duty stapler
  • PVC pipe
  • Shelves or table for vestibule
  • Disposable paper gowns, hair covers, shoe covers, masks
  • Large tub for soaking contaminated linens
  • Tarps for wrapping bodies

Tuesday, January 21, 2014

Dear Editor:
In response to the article titled: When The Schumer Hits (Literally), by Prepper EMT:

I am on board until we reach the recipe, which calls for lemon juice and lime juice. Unless you live in a citrus grove or in  a state where you can grow citrus and are lucky enough to get sick when the fruit is on the tree you are going to be in trouble here.   I suggest that [instead] each person stocks the ingredients to make a simple electrolyte solution that uses common and easily stored ingredients. There are several recipes to be found by simply doing a search on the internet.  There are also powdered mixes of electrolytes that you can stock. Sporting goods, camping stores and your local vet are all a good place to shop. One of the simplest ones (not necessarily the best) is:

6 teaspoons of sugar,
½ teaspoon of salt,
and 1 liter of water.

There are others that use "lite" salt and baking soda etc.  Do a little research and find the ones that work for you and your 'pantry'.

Sunday, January 19, 2014

Many things will change in a SHTF scenario but one of the most life altering will be the lack of 24/7 medical care.  Many people today take little to no hands-on care of their own personal health, and they are more than happy to let the doctors and nurses at their local doctor’s office or hospital take care of it for them.  Unfortunately, the day when local healthcare services will not be available could be closer then a lot of us think.  With the ObamaCare debacle in full swing, it’s high time each and every one of us begins to take an active role in the management of our health.

As has been mentioned many times on the Survival Blog, making sure you are in shape is the single best thing you can do for your long and short term health.  Everything in your body works better when you are in shape.  You will be able to work better, heal faster and avoid all sorts of health problems from heart attacks to back injuries.  Everybody should also get some sort of medical training.  I recommend that every prepper take a basic EMT course.  You can usually find them at your local fire station or at convenient locations throughout your state.  Being an EMT gives you a good all around foundation in medicine.  You will be able to control bleeding, set bones, and give basic meds.  You can also volunteer with your local fire department which is an amazing way to meet the locals and help out your community.  It also gives you a great in with the local emergency services which will come in very handy WTSHTF. 

When most people think of medical problems they might encounter in a grid down situation, they usually think of broken bones, gun shot wounds and uncontrolled bleeding.  The reality is usually much less exciting, but just as deadly.  One of the single biggest causes of death in areas without medical care, such as third world countries, is diarrhea.  According to the WHO, diarrhea causes 4% of all deaths.  There are nearly 1.7 billion cases of diarrheal disease every year. Diarrheal disease is the second leading cause of death in children under five years old.  It kills over 760,000 children every year.  The worst part is that a significant proportion of diarrheal disease can be prevented through safe drinking-water and adequate sanitation.  In a world without clean water or food refrigeration, our country could quickly degenerate into a situation not unlike third world countries.

The single biggest cause of death from diarrhea is from dehydration.  When a bad bacteria gets into the large intestine, the body tries to move things on through quickly.  The small intestine comes first and is where the body extracts most of its nutrients.  Then the food matter travels into the large intestine, which is where the body absorbs most of its liquid and electrolytes.  Since the body can tell that there’s bacteria in the large intestine it tries to keep everything moving through, so it doesn't have have time to absorb liquid.  Instead of absorbing for example, 90% of the liquid passing throughout the colon, now it only has time to absorb 10% of the liquid passing through.  This leads to acute dehydration and potentially death within several days. 

So, what can you do about diarrhea?  First, as with most things, an ounce of prevention is worth a pound of cure.  As was said above, most diarrhea is caused by infectious agents, so you need to be very careful about the food and water you consume in case they contain bacteria.   All water should be boiled and then put through a Berkey water filter.  This will both kill most bacterial/viral particles that maybe in the water as well as removing any contaminants such as pesticide residue.  It tougher to make sure food is safe to eat.  Of course mold or decomposition is a dead give away, but it's also important to take special consideration of food that's left out for any amount of time, even if there is no external sign of spoilage.  If you are unsure about the condition of the food you can drink a teaspoon of raw apple cider vinegar (Bragg's Apple Cider Vinegar is what I recommend) mixed with ½ a cup of water after each meal.  Apple cider vinegar has great anti bacterial properties and drinking a small amount after a meal has shown in some studies to help avoid food born illness.

Realistically, you will not be be able to avoid all bacteria, and eventually you or your loved ones will get diarrhea. How do you properly care for this illness?  The first issue that diarrhea causes, which is dehydration, is easy to remedy.  Give the patient lots of fluids!  The second, loss of electrolytes, is more serious.  First off, what are electrolytes and why are they a big deal?  Electrolytes are chemicals that become ions when they dissolve into a solution and become able to conduct electricity.  The proper ratio of fluid to electrolytes is critical to the proper functioning of cells and organs.  There are four main electrolytes that are important for us to consider, sodium, potassium, chloride, and bicarbonate.

Sodium is a major positive ion in the fluid outside of cells.  Sodium regulates the total amount of water in the body and so an imbalance in sodium results in either to much or too little water in your system, either of which can be fatal.  The movement of sodium in the brain, nervous system, and muscles helps in generating the electrical signals that these systems rely on for their operation and communication.  An imbalance in sodium can cause catastrophic organ failure and death.

An elevated level ratio of sodium in relation to water in the blood is called hypernatremia, this can be caused by many different factors including kidney disease and dehydration, but one of the very common causes is diarrhea.  Since the body is trying so hard to move everything in the large intestine along to help get rid of the virus, it cannot absorb enough liquid and hypernatremia results.  A decreased level of sodium in relation to water in the blood is called hyponatremia, and can be caused by many things including congestive heart failure or by drinking lots of liquid (water) without replenishing your sodium.  This is common in athletes and is why drinks such as gatorade are popular as they replenish sodium in the body.  A normal blood sodium level is 135 - 145 milliEquivalents/liter (mEq/L), but levels are hard to measure unless you get a doctor-ordered lab test. 

The next important electrolyte is potassium.  Potassium is the most important positive ion inside cells.  Potassium regulates the heart beat and muscle function, as you can imagine both critically important to the body.  Extremes in the potassium levels can effect the nervous system and increase the chances of irregular heart beats especially in older people or people with preexisting heart conditions.  Again, although hard to measure without a doctor ordered test the normal potassium blood levels are 3.5 - 5.0 milliEquivalents/liter (mEq/L).

Chloride is the major negative ion in the fluid outside cells and in the blood.  Like sodium, chloride helps the body maintain the proper balance of fluid and so extremes in the blood can have deleterious or fatal consequences. 

Last but not least is Bicarbonate.  Bicarbonate ions act as buffers to maintain normal levels of acidity in the blood and other bodily fluids.

Diarrhea causes all these electrolyte levels to get out of whack.  Sodium and Chloride levels often increase while Potassium and Bicarbonate levels frequently decrease.  The result is that many of the most important chemicals for the proper functioning of the body are not in the proper proportions, and this causes the body to begin shutting down.  Not good, especially when you are already compromised by a bacteria which is the root cause of all this. 

So, what can you do to prepare for diarrhea WTSHTF?  The most important thing you can do in the absence of medication to eradicate the infectious cause, and a lab to properly measure blood electrolyte levels, is to replenish the bodies store of fluids and electrolytes.  Preppers could store commercially available drinks such as Gatorade, especially the powder form but while such drinks are okay at replenishing liquid and electrolytes, they can be relatively expensive, and they have a lot of artificial colors and flavors which have bad long term health effects.  I recommend making a homemade electrolyte drink which is both easy to make with readily available ingredients, and will provide a good balance of electrolyte and nutrients that your sick body needs. 

The perfect recipe will have lots of water, salt, and citrus in it.  This is the recipe which I recommend, but feel free to experiment and modify it as you see fit.

Electrolyte replacement drink:

1 liter of water
1 teaspoon of salt
¼ cup of lemon juice
¼ cup of lime juice
1 tablespoon of honey
1/4 cup of dried, shredded coconut (optional)

In a survival situation there are much bigger ramifications to eating food that is tainted because the result will be a lot more severe then a quick trip to the doctor and a couple of sick days in bed.  If you or your loved one gets diarrhea, the best thing you can do is to give small doses of diluted apple cider vinegar three times a day, and keep hydrated with water and an electrolyte replacement.

Thursday, January 9, 2014

If you have finally decided to take the plunge and eliminate social networks from your life (Facebook, Twitter, etc.), the skills for maintaining interpersonal relationships should not be completely thrown by the wayside.  Over the course of the last five years our “group” has created a network of people that has proven to be very valuable.  One disclaimer that I must put forth is that the flippant nature of social networking on-line must be completely discounted as OPSEC is paramount.  I would never bring someone into my home to have contact with my family or include them in my preps if I didn’t fully trust them.  This is why most of the people in my network I have met through my church.  Developing a relationship with other families who have similar values and beliefs has been the backbone of the group that we have formed.  Although there are only a dozen active members (not including 14 children) we have developed a set of skills that crosses many areas of need come TEOTWAWKI.  Aside from having a wide range of skills the ability to work together as a team, the members of our group encourage growth “as iron sharpens iron" (Prov. 27:17).

I have isolated six areas of preparation that our group network has been most beneficial:

1. Physical Training:

This has been the greatest area of growth for our group.  Five years ago more than half of the members were overweight and only a few exercised on a daily basis.  As a challenge to all of our group members we started our road to fitness with an eight week program similar to the Get Healthy Challenge.  Group members kept in touch with each other on a daily basis to hold one another accountable.  After this eight week program we decided to focus on strength and core training through the Hundred Push-ups and Two Hundred Sit-Ups challenges.  While working on individual fitness goals group members encouraged and challenged each other with daily progress reports through e-mail, phone or text to see how the others were doing.  Doing these challenges with our wives was also an eye opener, as many of the women took the challenges more seriously than the men.  One of the wives actually won the Two Hundred Sit-up Challenge ending with 312 total reps.  Over the course of the last year the physical training has been taken to a much more intense level.  The majority of the group members participated in a Tough Mudder  Event and a GORUCK Challenge.  While not every member participated in these events due to ability, injury or pregnancy the bottom line is that all of us are in better shape today than we were five years ago.  The average member has lost 20 pounds (I have personally lost 40) and we all have a regular schedule of physical activity that maintains strength, flexibility and endurance.  The challenge, support and accountability that doing these types of activities as a group brings is immeasurable.  I doubt that most people would see the same results if done individually.  Working at the retreat property together has also been good physical training for the group.  Bucking hay, cutting and hauling wood and other chores at one of the two sites we have as retreat properties can be grueling work.  You really find out who your friends are when the hay needs to come in or several cords of wood needs to be put up.  Physically the group dynamic is tested with hard physical labor, but working together completes the task sooner and builds relationships with group members.

2. Medical Training:

This has been the weakest area for our group as we need to increase our level of training.  We do have a doctor (optometrist) and a registered nurse in our group.  Although they both have medical training, by no means are we able to fulfill needs like trauma care or even general surgery.  One of the goals is to get several of the members to take an EMT course at the local community college.  This would not solve all of our needs for medical training, but it would be a start for gaining more knowledge concerning emergency medicine.  This course will be a major undertaking, as 120 hours of classroom, observation and practicum is a commitment that will not be taken lightly by most families.  Ultimately the benefit of the knowledge of life saving skills will have to outweigh the cost of loss of time with one’s family.

3. Food Preps:

Buying in bulk is always better when done as a group.  Greater quantity means lower cost per unit and the most value for the money you invest into your preps.  We bought beef from a local slaughterhouse, grains from the local co-op and worked on preserving them as a group.  Whether it is canning, storing in Mylar with oxygen absorbers or dehydrating, it is always better to have more hands helping with the work.  While most of the food preps were done successfully we have decided as a group to not try to brew beer anymore.  After hours of labor and weeks of waiting we had a pretty nasty batch of skunk beer that was not worth the effort or resources allocated.  Pickling has been discovered as a fun way to spend time together as a group.  Many of the wives were looking for ways to put up excess garden produce, so pickling parties became the summer staple.  Developing the mindset that putting food up was important became the norm.

4. Ammo/Shooting Preps:

Again working as a group to purchase ammo in bulk has always been better than trying to find the best deal for each individual.  Utilizing common calibers as the group standard for our center fire rifle and pistol, 12 gauge shotshells and .22 LR we were able to accumulate adequate supplies of ammunition for each group member.  The greatest resource to ammo preparation as a group has been reloading.  Most of our group members did not know how to reload ammunition when we formed five years ago.  Today most have at least a working knowledge if not their own presses and dies.  We have worked together sorting range brass, going through the steps of case preparation and even pooled our resources during the recent shortage of components.  Sharing load data and ballistics has also helped with refining the accuracy of the rounds we produce through reloading.  It is always better to have someone else check your load data just to be safe when reloading.  We have also purchased several sets of reactive steel targets for our shooting sessions.  While I admit this is the area that the guys enjoy the most and pour the majority of their enthusiasm behind, the wives in our group have all taken classes (as husbands are often the worst firearms instructors for women) and are continuing to hone their skills with range time.  The area for improvement would be to take a tactical course like one at Thunder Ranch or Gunsite Academy.  We did participate in a 1,000 yard long range shooting match (which just demonstrated everyone’s then-current lack of ability beyond 400 yards) as a group, but this was more of a recreational activity, not tactical training.  A couple of the guys do IPSC or IDPA, but the majority of the group is not involved in competitive shooting.  To encourage group participation in a serious training course or a competitive shooting series is the goal for the future.  While all group members have firearm proficiency, few have had shooting experiences under pressure.

5. Communications Preps

Our group started out with FRS/GMRS radios as our primary method of communication in the field, and then we got CBs which were slightly better, now most members have Ham radios.  Studying and taking the ARRL tests together was also a good experience.  While the technician test is not hard, it did require some studying to refresh knowledge of electronics and radios.  It was also amazing all of the different FCC requirements and regulations that we needed to know.  Pooling resources together to build antennas and radios is another good function for the group.  A few members have actually joined a local club that maintains the repeater in our town.  The next step would be to have more members go for their General licenses to increase the bandwidth we can access and broaden knowledge concerning Ham radio.

6. Spiritual Prep

As I mentioned earlier, all of our group members were found through our local church.  We are not exclusive to church members (as some have left the church but are still a part of the group), however it was important to find people that all had similar values and beliefs.  The group members have been a part of a couple of small group fellowships that meet at least once a week.  There is a family Bible study, a women’s study and a men’s study that meets at different times on different days.  This has been probably the most important area of our network.  To “bear one another’s burdens (Gal.  6:2)” and not only hold each other accountable, but to support one another through trials and blessings is perhaps the greatest function of our group.  One of our group members is active duty Army and has been deployed four times overseas.  The group has rallied around his wife and children to provide support during his prolonged deployments, which to me fulfills the second greatest commandment (Matt. 22:39).  While a group may be squared away with beans, bullets and Band-Aids if they are not squared away with their Maker then all is for naught.

Tuesday, January 7, 2014

Mr Rawles,
I read Meir L.'s "Diabetics in Disaster," and I found the post very thorough and informative. I just wanted to add a few tips:
1) Cinnamon and Cranberries are a natural way to lower your blood sugar level. Additionally, there is an over the counter supplement called Cinnergen that is a mix of the two in a liquid form.
2) Remember artificial sweetener. Coffee and tea can be bitter and undrinkable without sugar. Also, growing sorghum is a great alternative to sugar, and it can be replaced after the SHTF. Read more at The Mother Earth News and WikiHow.
3) Insulin dependent families should maintain a schedule even after TEOTWAWKI, because going to long without insulin or giving too much insulin can become a disaster without a doctor or EMT around. So make sure to practice a prep before these things can happen.
4) Since diabetics have to watch carbs, a diabetic prepper's food will be different than a regular prepper's. Plan on eating more protein (beef jerky, canned meats, cheese), and less carbs (potatoes, pasta, rice). Also, many protein filled foods also have a lot of carbs (think:beans), so make sure to plan your diet.

- Michael L.

Monday, January 6, 2014

With 2014 and the enactment of Obamacare only days away, we’re all wondering what this so-called Affordable Care Act will really cost us.  Will your premiums be higher?  Or your deductible?  Will you lose employer-based coverage?  Will your doctor simply give up and retire? 

But Obamacare is not all bad.  I view it as a wake-up call.  In fact, I wouldn’t be writing this article nor teaching people survival medicine skills if not for our current president. 
People tend to blame Obamacare for all the upcoming health care woes, but many of the looming hassles (from a doctor’s point of view) were in the pipeline long before his tenure, including penalties for not using an electronic health record, the costly conversion to a new coding system, and never-ending threats of Medicare payment cuts to levels far below the cost of care. 

This article is not about finding the cheapest insurance; rather, it’s about decreasing your reliance on the system and learning how to care for yourself as far as possible.  What follows are seven practical ways you can save a trip to the doctor now and how you can help yourself if and when you’re on your own.

  • Sore throats.  Most sore throats are caused by viruses, particularly when associated with hoarseness or a cough, and thus require no antibiotics.  But what if it’s strep?  Wouldn’t you love to be able to test yourself at home?  It turns out you can.  The same Rapid Strep Kits used by doctors are available to you over-the-counter at a very reasonable price.  For as little as $35 you can purchase a box of 25 test kits online, with a listed shelf life of at least 1–2 years (and likely much longer).  The tests are really no more difficult than checking your own blood sugar.  Performed correctly, accuracy (specificity and sensitivity) is on the order of 95%. 

Another way to determine the likelihood of strep throat is by the Centor Criteria.  Each of four symptoms receives a point:  fever, pus on tonsils, tender glands in the neck, and absence of cough.  Then add a point for age <15, or subtract a point for age >44. 
The risk of strep is determined based on total points:
0–1             <10% risk            (no antibiotics indicated)
2–3            15–32% risk            (consider testing, and treat if positive)
4–5            56% risk            (treat with antibiotics)
Currently recommended antibiotics include penicillin and amoxicillin (250 –500 mg 3x daily for 10 days).  Other possible choices are erythromycin, azithromycin, cephalexin, other cephalosporins, or Augmentin. 

  • Bladder infections.  If you’re getting up three times a night to urinate, are you just drinking too much water or is it perhaps a bladder infection?  Again, wouldn’t it be nice to test yourself at home?  Yet again, it turns out you can.  The same test strips doctors use are also available online (Multistix 10 SG or generic equivalent) for $15 to $50 for a box of 100.  If leukocytes (white blood cells) and/or nitrites or blood are present in the urine, an infection is quite likely.  Treatment is directed at drinking plenty of water (aim for 8 glasses a day) and short-term treatment (usually 3 days is sufficient) with an antibiotic such as trimethoprim-sulfamethoxazole, ciprofloxacin, amoxicillin, or amoxicillin-clavulanate.  (This information applies to women only; men with urinary symptoms may have an STD, prostate infection, or a kidney stone.)
  • Ankle injuries.  Say your son twists his ankle, and you wonder if it’s broken.  Do you really need an X-ray?  Not as often as you might think.  The Ottawa Ankle Rules give an excellent estimate of whether or not a bone is likely broken.  An ankle X-ray is only needed if there is any pain in the malleolar zone (ankle bones on either side) PLUS any of the following:
  • Bone tenderness along either ankle bone (right over the bone, or up the leg 2–3 inches)
  • Inability to bear weight for 4 steps BOTH immediately after injury AND in the ER. 

If you can walk on a sprained ankle, odds are quite slim that it is broken. 

Another test is the tuning fork test.  Placing a vibrating tuning fork over a broken bone causes pain, but not so if the ankle is simply sprained. 

A presumed fractured ankle should be splinted a few days with no weight-bearing permitted, then casted after danger of additional swelling is past (total of 6 to 8 weeks).  A sprained ankle should be splinted as well, but with walking permitted as tolerated.

  • Poison ivy.  Most people still think poison ivy is contagious, but it’s not.  And it will resolve on its own by two weeks.  Treatment is only aimed at making the patient more comfortable (unless you’ve inhaled poison ivy smoke or rubbed it in your eyes).  So you don’t have to see a doctor for simple poison ivy, poison oak, or poison sumac.  Over-the-counter hydrocortisone cream can help (and many people swear by jewelweed).  Some doctors will call in a stronger steroid without an appointment.  OTC antihistamines help the itch (Benadryl, Zyrtec, Claritin, Allegra), and are as strong as prescription drugs.  Of all the patients I’ve seen with poison ivy over the years, at most 5% actually needed to see a physician.
  • Ear ache.  Most ear aches don’t require antibiotics or a trip to the doctor.  A few days of pain medication is all that is required in adults and older children with otitis media.  Physicians still prescribe antibiotics at times, but often only to please the patient.  With every rule there are exceptions:  the very ill-looking child, babies, and some children with recurrent ear infections do benefit from antibiotics.  Top antibiotic choices include amoxicillin, amoxicillin-clavulanate, trimethoprim-sulfamethoxazole, cefdinir, and azithromycin.
  • GERD.  Would you rather pay $150 for the “purple pill” or $5 for its first cousin?  It’s not really amazing that a brand-name medication for acid reflux would be so expensive, but rather that a similar generic has dropped in price so quickly.  The “purple pill” is esomeprazole, which decreases the amount of stomach acid produced.  A very similar medication, pantoprazole, does the same job, but the generic is now dirt cheap.  If you are taking prescription Nexium, Aciphex, Prilosec, Prevacid, or Dexilant for heartburn or acid reflux, you may want to switch to this money-saving generic.  Unfortunately, pantoprazole remains by prescription only.  Second-best inexpensive choices would be OTC generic Prevacid or Prilosec.  Checking these online today, I find prices as low as $10 for 60 count 20-mg omeprazole (generic Prilosec) – also a great deal.

And don’t forget that heartburn can be greatly reduced by avoiding aspirin, other anti-inflammatory drugs (ibuprofen, naproxen), tobacco, alcohol, caffeine, spicy foods, fatty, foods, acid foods, and too much food.  (If it tastes good, don’t eat it.)

  • Diabetes.   You can learn to treat diabetes (Type 2) on your own with very little danger of complications [if you closely monitor your blood sugar levels.] Of course, you should begin with a reasonable diet and exercise, but beyond that certain herbs will help a mild case (e.g. cinnamon 1 to 6 grams a day), and OTC insulin may be required for more severe disease.  Anyone can get a blood sugar monitor without a prescription, though the test strips can be costly.  You can also obtain a test kit for hemoglobin A1C for under $10/test on Amazon and elsewhere.  Simple urine strips (see above) aid in testing your urine for protein, ketones, and sugar.  There is more information available free online to anyone than I had access to as a medical student.  Check out for dozens of free articles.  Ideally you should work with your own doctor now (while you can) to establish a treatment regimen you can follow and monitor on your own when no doctor’s help is available.

When I teach my Survival Medicine classes, I tell my students that we’re aiming at the 90%, i.e. those with typical problems – not the 10% with severe or unusual conditions.  The foregoing information does not cover every situation, but it does apply to most, and I think 90% is a good place to start. 

Good morning!
Yesterday I received an order for Israeli bandages, ordered direct [from Israel], from:

I placed the order on 12/6/13 and received it 1/3/13. Not bad considering it was in international order/shipment.

The bandages are well packaged, dated, vacuum sealed. I applied my own labels to them as these packages are in Hebrew and English, and would be a little hard to quickly decipher, particularly in a stressful situation. The prices are good and shipping was only $4 (see below).
I ordered the following:

4" Israeli Bandage with Pressure Bar
1    $5.79 USD    $5.79 USD

6" Israeli Bandage with Pressure Bar
1    $5.99 USD    $5.99 USD

Burnfree 4"x4" Burn Relief Dressing
2     $4.99 USD    $9 98 USD

Personal Green IDF Dressing
2    $2.99 USD    $5.9 8 USD

Personal Green IDF Dressing - Larger
2     $3 .99 USD    $7.98 USD

Subtotal:    $35.72 USD
Shipping:    $4.03 USD
Grand Total:   $39.75 USD

Thanks, E.B.

Friday, January 3, 2014

A quick note about regular insulin (either Novolin R or Humulin R):  it is considered a fast acting insulin, which is different from a rapid acting insulin.  From - The rapid acting insulins, Humalog, Novolog and Apidra, "begin to work about 15 minutes after injection, peak in about 1 hour, and continue to work for 2 to 4 hours.  Regular (or short-acting) insulin usually reaches the bloodstream within 30 minutes after injection, peaks anywhere from 2 to 3 hours after injection, and is effective for approximately 3 to 6 hours."

This may not be a huge difference, but it is important to know that the regular insulin will peak later, and will have a glucose-lowering effect for a longer time than the rapid acting insulins.  This can change the way the insulin is administered.  

I hope this information is helpful for any other people with Type 1 Diabetes out there.  It has given me greater hope in preparing for an uncertain future. - Diabetic Nurse Practitioner

Wednesday, January 1, 2014

Mr. Rawles,
I'd ike to describe a way to flash-freeze insulin for (theoretical) long-term storage.

I have had Type 1 Diabetes for 15 years.  I was raised in a house that always had food storage, extra fuel for heating, and tried to prepare as best we could.  After I was diagnosed, I realized that I would not be able to survive long if anything happened to the insulin supply chain.  Meir L. mentioned getting pens instead of vials to get more insulin per month.  I started out by asking my diabetes care provider to write my monthly prescription for a little more insulin than I used each month (which some physicians may or may not do, depending on what they're comfortable with), and slowly built up a rotating stock of insulin.  In doing this I found I could only keep about a year’s supply on hand because I kept running into the expiration dates on the insulin vials.  I used to give away my almost expired insulin vials, however I don’t do this anymore. After 15 years of maintaining this practice, I now have a large supply of insulin.

I am now a Diabetic Nurse Practitioner (DNP) and I care for many patients with diabetes.  I know that conventional wisdom says that you can’t freeze insulin because it will change the shape of the protein molecules that make up insulin, thus rendering the insulin ineffective.  Two years ago I read the letter on your blog from November 30, 2011 entitled “7 Letters Re: Type 1 Diabetes – There Has to Be a Way to Prepare”.  With great interest I read the account of the man who found the old 1970 patent about flash freezing regular Insulin.  I read the patent from start to finish, and thought that it made sense.  If you freeze the insulin fast enough then the proteins don’t have time to change shape. 

I was excited to try this, because I wanted to see if it would work the same with new, modern insulins.  The insulin used in the 1970 patent was regular insulin, which is not used much any more.  Modern insulins are either rapid acting, long acting, or a mixture of both, and their chemical structures are slightly different from regular insulin.  I decided an experiment was in order.  Since I work in a Family Medicine clinic, I have access to liquid nitrogen that we use to freeze warts and other skin lesions.  I used the nitrogen (with my employers permission) to freeze the main brands of modern insulin.  I first froze a vial of Humalog (rapid acting) and a vial of Lantus (long acting), kept them frozen for about a month, then thawed them out and tried them on myself.  To my amazement and joy they worked just like they should.  My blood glucose reacted to these frozen-thawed insulins just like it does to new insulin.  I used up both vials completely and found that they stayed at full potency through the entire vial.  I then repeated the experiment with Novolog (rapid acting), Apidra (rapid acting) and Levemir (long acting), and each of them worked perfectly after being thawed. 

This news has expanded my ability to store insulin for the long term.  Instead of having just a 1-year supply on hand, I can now store up as much as I can save.  I should point out that I have not done a complete experiment.  My big assumption is that keeping insulin frozen will extend the expiration date.  One important note on my experiment:  I have not kept insulin frozen for 15 years, then thawed it out and tried it to see if it maintained potency.  What I have done is proven that you can flash freeze insulin and have it still function normally after being thawed.  The longest I have had a vial frozen and then used it successfully is one year.  That being said, I now freeze about half of the insulin I get, and use the other half in my rotating stock.  I no longer have to give any away.
One other option for stocking up on insulin is to buy regular insulin with cash.  It is a little known fact that regular insulin is not a prescription medication.  One can walk into any pharmacy and buy regular insulin like any OTC medication, you just have to pay cash for it.  At Wal-Mart one vial of 1000 units costs around $25.  

I hope this information is helpful for any other people with Type 1 Diabetes out there.  It has given me greater hope in preparing for an uncertain future. - Diabetic Nurse Practitioner


Diabetes is a serious health problem and can be difficult to stock up on and prepare for a SHTF situation. I have have had diabetes for 18 years and luckily have not had any major problems. I wanted to make a few comments on the article Diabetics in Disasters, by Meir L. I personally have one of the Frio packs and they work very well, these would be great for a BOB as long as you can access a water source every two days. Also for a long term power outage/bug in situation a small portable propane/AC/12VDC powered cooler such as a  Porta Gaz portable gas refrigerator Porta Gaz 61211 Silver 3-Way Portable Gas Refrigerator by Porta Gaz, would be great compared to a regular propane powered refrigerator is more expensive, plus a small one you could take with you in your bug out vehicle if need be. 

(I am not a doctor and am not offering medical advice)

I personally have used open insulin that was three years past expiration and it still work properly. (They were refrigerated the entire time). I also would like to mention one other thing. I am on a tight budget and the common insulin such as Lantus (which I used to use) and others without insurance cost $100 plus. I recently found out that Wal-Mart sells insulin over the counter for $25 for a 10ml vial which is 1000 units. They offer as fast acting insulin, Novolin R, an intermediate insulin, Novolin N, and a pre-mix, Novolin 70/30. I will say that you should ask your doctor before you start using a different kind of insulin, but in my personal opinion, this would be something to add to your medical preps for a low cost; because when the SHTF, and insulin will be better than no insulin for people with diabetes. Brad O.

Tuesday, December 31, 2013

(Disclaimer: I am not a doctor and I do not have anything to do with the medical field. This is strictly my personal experiences, and the following does not constitute medical advice.)
As an 18 year old type 1 diabetic, I am a very active person. I enjoy hiking, biking, climbing, etc. Two years ago, in September of 2011, I started going to the bathroom a lot, drinking like crazy,  becoming very fatigued, and feeling poorly much of the time. Since I am related to multiple Type 1 diabetics, I knew the signs of a developing diabetic, and I was kind of waiting for this to happen. Two days after I started showing the signs, I called my father and I told him my fears. That weekend I went to the hospital and I was diagnosed with Type 1 diabetes.

The month that I was diagnosed, many people asked me if this was “annoying” or “life changing.” Since I am related to so many diabetics (more than 5), I was exposed to diabetes since I was born, and therefore it really was not such a big deal. The only things I was really upset about was food, hiking, and the army. I really eat a lot of food and I enjoy eating. I love backpacking and hiking and I was afraid that since I became diabetic, I would not be able to do these activities. The reality is that this is not true, and if a person is responsible, it is very safe, providing that you monitor your blood sugar. Additionally, I was upset because I always envisioned joining an elite nit in the army, and because I became diabetic, they would not let me in. But I soon found out that diabetics can lead a completely normal life, and I have been doing hikes, bike rides and many adventures.

Since 1 in 16 people in America have diabetes, I think this post can help many people out. In this post I will use my adventure and day to day experiences to try to help diabetics (and diabetic’s relatives) understand how to prepare for a survival situation and general everyday life events.


A. Understanding diabetes and insulin

Any diabetic can tell you that insulin is the most important supply for living with diabetes. In a normal person's body, the pancreas performs many functions, one of which is the production of insulin. In a diabetic person’s body, the body’s immune system recognizes the insulin producing cells as a foreign microbe, and it targets them like your immune system would target a foreign bacteria. Therefore, a diabetic person’s body does not produce insulin, and he needs to provide it for himself.

B. Different Types of insulin

There are two types of insulin that I use: Long term (I use Lantus), and short term (I alternate between Humalog and Novolog - same thing). The insulin that the doctor prescribes come in 2 sizes: vials and pens. I like using vials because vials require syringes, and syringes are completely manual. Therefore there is no room for error that pumps and automatic injections have. I have a friend who was on the pump, and every few days he had to get something reconnected, parts replaced, and batteries changed. In my opinion, the less tech is involved, the less room for error there is. Insulin pens can be good for mobile, on the go situation. The biggest problem about insulin (which I will get back to), is that it can spoil due to hot weather (80-90F). If a vial spoils, it is a loss of 1000 units. If a pen spoils, it is a loss of 300 units. So with pens there is less risk. Though pens are manual also, to some degree they are automatic, and you are not completely in control of the injecting process. Many a time I will not be sure if the insulin went into me or not. So pens and vials are basically equal, and until a short time ago, I mostly used vials.

I am not going to talk about insulin pumps, since in a TEOTWAWKI situation pumps are incredibly non practical (batteries, supplies, potential for infections, etc.).

C. Ideas for stockpiling insulin           

A few months ago I realized something important. When the doctor sends in a prescription for insulin, they ask you if you want vials or pens. Then they send in to the pharmacy to give you how ever many units you need a month. The minimum amount of insulin that comes in a vial is 1000, and the minimum amount of units that come in a pen is 5 pens of 300 units each, which comes out to 1500 units. I realized that I use approximately 500-700 units a month, and if I request pens, they will give me 1,500 units a month instead of 1,000. I also think it cost the same amount of money in the co-pay. Because of this, I have over 5000 units of insulin (and counting) in my refrigerator, and every single month I add my surplus of 700-1,000 units. If you get more than 1,500 units a month, request pens, and they will give you 3,000.
Additionally, you can ask your doctor to increase your monthly prescription, although I am not so sure how legal that is.

D. Keeping insulin at a good temperature
For exact temperatures and brands, here, although I do not trust the shelf life they prescribe, since insulin actually lasts longer in my experience.

I. High temperatures
The biggest problem with insulin is refrigeration. Insulin should be stored at 36 to 46 F. The higher temperature it is stored at, the faster it will go bad. If you store sealed insulin at the recommended temperature, it can last until the specified date that is on the container, usually 3 years. Hopefully before three years, the survival situation will pass by and you can resume your supply. If you store opened insulin at the prescribed temperature, it can last more than 3 months. If you store it at room temperature, it will last approx. 1-2 months. Before going on a 3 day summer hike in Vermont, I found a great solution. There is something called Frio packs. It is some technology that if you place the container into water, it can keep the pack cold for more than two days. I also realized that based on this, you can probably store insulin in cold water (in a Ziploc bag), and as long as you change it every day, you can probably make the insulin last a long time. I have heard a good strategy is to leave it in the tank of your toilet.  If this does not work, hopefully you have a generator, and you can power a small fridge with it. Additionally, you can buy a solar powered fridge, although I am not so sure how reliable they are.

These are the different methods that diabetics can store their insulin:
1- Frio packs
2- Storage in cold water (tank of toilet)
3- Solar powered fridge
4- Propane powered fridge
5- Generator
6- 12v fridge that can be plugged into a car
7- Root cellar
8- Bury in the ground (similar to root cellar)
9- Zeer Pots (Evaporative coolers, using clay pots and sand.
10- Any other alternative energy source

II. Low Temperatures
I have written about storing insulin at high temperatures, and I will now go to storing insulin at low temperatures. Apparently (never experienced this), if you store insulin lower than 36F, it will freeze and become unusable. About 3 weeks ago I did a 3 day winter hike in the White Mountains in New Hampshire. At times, the temperature dipped below 0F.  The best way to store insulin in cold temperatures is with body heat. Put the insulin in your pocket, and it will stay warm as long as you stay alive. If for whatever reason you can't do this, you can keep the insulin in a warm room, though it is not so reliable. If you have farm animals, you can keep it by them, since a cow can generate more body heat than a human. If you have a privy, you can keep it next to the place where the excrement is kept since it can also generate a lot of heat. In the same vein, you can store it by animal dung which is the same as a human’s.

Testing Strips and Glucometer

Different machines
When I first became diabetic, the doctor gave me a OneTouch glucometer. I love gadgets, and I immediately set out looking for different glucometers. I checked out the Bayer USB, the freestyle lite, etc. I realized that the fancier the machine is, the less reliable it is. Take for example the One Touch mini and the new, advanced OneTouch Verio. Forgetting about cost (the Verio is 1.5 times the price for testing strips), the Mini’s batteries can last months, while the Verio’s battery is rechargeable, and therefore it lasts less than a week (I am being generous). The Verio has a cool color screen, gold testing strips, and it is a sleek white color. The Mini is small, compact, and reliable. It gives correct readings, has a long battery, and is not fancy at all. You are better off getting a cheaper, reliable, long lasting battery glucometer than a cool fancy one. In a survival situation, you might not have electricity to recharge your glucometer, while batteries are mostly reliable and long lasting. Maybe as a precaution you should keep one rechargeable glucometer in case of a battery problem. Since for some reason hospitals always give you an OneTouch glucometer when you are first diagnosed, it is worth it to always have one of those, since many people will have the same one and you can barter or share testing strips.
It is very important that you have more than one glucometer. I can’t say how many times I got a suspect wrong reading from one glucometer, compared it to a different glucometer which would give me a different reading, and take a third glucometer to see which one wins.

Cold Weather
When you are in cold weather, sometimes your glucometer will give you an error message (less than 32F). When I went on this winter hike, this happened to me a few times. If it is not a momentary concern, you can put it by you armpit (or somewhere warm on your body), and it will take a few minutes to work. If it is important for that moment, you can breathe on it, and it will warm up fast.

Expiration date
As far as I know, there is no expiration date on a glucometer, while there is an expiration date on testing strips. I think that the expiration date for the testing strips is bogus. My cousin has used testing strips past their expiration dates, and the readings are correct. It is most probably a company ploy to get you to buy more testing strips. If the machine gives you trouble, move the date on the machine back to accommodate the date on the testing strips.

Extra batteries
This is pretty obvious, but you need to have many batteries stocked up. As I said before, all or most of your glucometers should be battery powered.

As with insulin, you should always keep a very big stock of testing strips. Ask your doctor to write a prescription for 10 tests a day. This should give a nice amount of extra testing strips a month.

This can be a very touchy subject, but when it comes to survival, you don’t have a choice. Reuse, reuse, reuse. Even now, when everything is normal (Thank G-d), I disinfect and reuse syringes because I am thrifty. I think the reason why it is so controversial to reuse syringes is because drug addicts share syringes. Sharing syringes can be a problem since it can spread diseases. If you use a syringe that only you have used, I don’t think it should be a risk. I personally use a syringe around 5-10 times before I throw it out (only because it becomes to blunt). But I know someone who uses a syringe for a really long time before he throws it out. I think he might use it for a month or longer. He still as the same prescription from 2005. This is an extreme, but it shows how you can reuse syringes without a problem.


Definition (via ADA)
"Ketone is a chemical produced when there is a shortage of insulin in the blood and the body breaks down body fat for energy. Ketones in the urine are a sign that your body is using fat for energy instead of using glucose because not enough insulin is available to use glucose for energy."


  • Your blood glucose is more than 300 mg/dl
  • You feel nauseated, are vomiting, or have abdominal pain
  • You are sick (for example, with a cold or flu)
  • You feel tired all the time
  • You are thirsty or have a very dry mouth
  • Your skin is flushed
  • You have a hard time breathing Your breath smells "fruity"
  • You feel confused or "in a fog"

How to Test
You can get a ketone test form your local pharmacy. This can be prescribed and is usually covered by health insurance. Depending on the brand there are different instructions. Some glucometers come with a blood ketone test. Novo Nordisk Max comes is one of those.

Small or trace amounts of ketones may mean that ketone buildup is starting. You should test again in a few hours.
Moderate or large amounts are a danger sign. They upset the chemical balance of your blood and can poison the body. Never exercise when your urine checks show moderate or large amounts of ketones and your blood glucose is high. These are signs that your diabetes is out of control. At this point you are in danger zone. If no doctor is around, take the necessary steps to bring your blood sugar under control (insulin).
Drink a lot of water to flush out the ketones.

Adjusting your insulin dosage
I don’t want to advise people on this, since it is used in everyday life, and I have no medical credentials to give advice. Here is a good link that works with me:

Alternative insulin
I have researched alternatives to getting insulin from the pharmacy, and I found that there is no formula for making a “chemical” insulin readily available, although I really hope somebody gets one out there. What I did find was a primitive way to get ready made insulin from an animal. During WWII, a Jewish couple who fled to Shanghai from Czechoslovakia worked out a process for extracting insulin from Buffalo pancreas. The woman, Eva Saxl, became diabetic and though they knew nothing about insulin beforehand they worked out the process based on a medical text "Beckman's Internal Medicine". They were generously given access to a chemistry lab. Eva eventually tried the insulin and then began distributing it to other diabetics; by the end of the war she had supplied insulin to over 400 people. It was at least four years that they used that method.

Animal insulin formula (via a comment at TSLRF, I can’t vouch for his post, but there is no reason to not believe him)
“Extracting insulin from very fresh sheep or pig pancreases is fairly easy, if you have the required equipment, consumable supplies, and knowledge. I recall doing it in (I think) high school science labs - but we didn't actually use it. It is somewhat time consuming, as well.
One US patent for extraction is number 2779706; another is 2637680.
One key concept is that the very fresh pancreas needs to be kept very cold during most of the processing...if you don't have water ice to keep the process in an ice bath, you won't get good insulin. On the other hand, it has to be water ice - if the pancreas freezes the tissue is too damaged to use.”
For the exact formula go to

Problems with this method
a) You have to sacrifice an animal for the process, which you might need for other things (meat, fur etc.)
b) The insulin is not as good as what people are now used to (all of which is made by bacteria genetically modified to make pure human insulin)
c) Animal insulin isn't the same as human insulin, varying by 1-5 amino acids depending on the source animal. Even with real (made) human insulin, diabetics have problems, they had more problems with animal insulin. It was used decades ago but they stopped for a reason.
d) Using sheep or cows as sources can theoretically lead to spread of prion diseases (mad cow disease, scrappy, new variant Creutzfeldt-Jakob disease).
e) Bioanalysis so you know how much insulin you need (which will vary with each batch) is difficult to do and probably not realistically possible in an austere setting. Get a stronger than expected dose of insulin and you can die quickly, get a weaker than expected and you can still die, just not quickly.

Conserving and stretching your supply
If you need to conserve your supplies there are many ways to do it. In terms of testing strips, you can just test less per day. As I explained before, syringes can be reused. In terms of insulin, there are a few ways to conserve your insulin supply.

Exercise- Doing exercise can bring down blood sugar. I find that the more you sweat, the faster it comes down.
Eating less carbs- This is an obvious choice. As long as you keep this within reason, you can limit your carb intake, thus needing less insulin.
Give the long term less often- This is for a real survival situation. You don’t want to starve your body of insulin, but if you really need to, you can give the long term less often. The doctor told me the official time that the Lantus will last is 18 hours. Everyone waits 24 hours. There have been times when I was first diagnosed, and I wasn’t so good with remembering, I would by mistake give at 30 hours or more. Even now, when I give by bedtime, sometimes my bedtime is later than others. I have done this with no ill effect. Ask your doctor before doing this, as I am not a scientist.

Have a diabetic pack ready

Always be prepared. Besides your regular stock, have a package of an ample supply of diabetes supplies that you might need at moment’s notice. Here is what you should have in this pack:

  • Two glucometers
  • Many, many test strips
  • Insulin- long and short acting
  • Sugar, high carb foods. Also pack complex carbs
  • Lancets with extra needle pricks
  • Syringes (pen or regular)
  • Ketone test
  • Glucagon
  • Some kind of insulating cooler for insulin (I recommend Frio)

For the companion: The difference between lows and highs (and what to do about it)
There is some confusion of non- diabetics when it comes to the difference between a high and low blood sugar. Whenever I give myself insulin in front of my little brother, he always complains, “Meir has low numbers!”

High blood sugar
(otherwise known as Hyperglycemia) is when a person’s blood sugar is too high, and he needs insulin in order to lower it. Stress, carbs, and sleep can all cause one’s blood sugar to rise. Besides the long terms effects, if one’s blood sugar is too high, he can go into a coma. A high blood sugar is over 150, and it becomes short term dangerous when it goes past 400-500.

Low blood sugar
(otherwise known as Hypoglycemia) is when a person’s blood sugar is lower than 75-80. This can happen because one gives himself too much insulin, is too active with no food, and is not eating carbs. In order to raise it, one needs to eat sugar and carbs. If one’s blood sugar goes to low, he can become unresponsive or unconscious. In order to get one out of this, he needs to be injected with glucagon. I am not sure what the deal with trusting expiration dates on the glucagon pens are, and I am also not sure how to extend the life of one.

Getting insulin when you don’t have
I know that a zombie apocalypse will probably not happen, but I enjoy watching The Walking Dead. When the group needed to go to the animal hospital to get meds, it got me thinking that they also probably have insulin. One of my relatives has a bunch of cats, and one of them is diabetic. Every day she injects it with insulin. I looked online, and insulin made for humans have been used for animals. So it makes sense that it goes the other way around. I think you may have to adjust the dosage though.

You can barter for insulin. When someone is completely dependent on insulin, you need to have viable barter items if the need arises.
In an absolute worst case depopulation scenario, you could possibly scavenge in abandoned hospitals. I think empty nursing homes would have more, since there are more older people who are diabetic.

Recent Innovations
These are different innovations that can make a TEOTWAWKI situation easier.

Artificial Pancreas —This new system ties together existing technologies so that type 1 diabetics are freed from constantly monitoring their blood sugar levels. Instead, a computer handles it by combining an insulin pump worn outside the body, with an implanted continuous glucose monitor (CGM). Special software allows the two to talk and automatically regulate the person’s blood sugar. Not only does this make management easier, but it also helps avoid the sugar level highs and lows that can lead to complications.

Inhaled Insulin—Taking the place of injections, this ["dry insulin"] lets type 2 diabetics breathe in their insulin. Not only is it a more desirable delivery method, but it’s also faster-acting and has less of a risk of low blood sugar levels. While previous attempts at inhaled insulin have failed, this drug is showing fewer potential risks. (Via

A new [variety of] insulin does not require refrigeration.

I am not going to tell you how if SHTF you probably won’t survive. That is your calculations to make. Just understand that most survival situations usually won’t last long. With proper care, you can live out most TEOTWAWKI situations. Even if it is a non-recoverable TEOTWAWKI, you still have the option of getting insulin from animals.

Sunday, December 29, 2013

Many SurvivalBlog contributors have discussed storable foods, nutrition, First Aid, health care supplies, supplements, aromatherapy and herbs over the years I’ve been reading SurvivalBlog. But, what will you do if obtaining vitamins and common first-aid ointments will be difficult or extremely expensive? (Think Weimar Germany) So you may have Echinacea growing in your yard. Do you know how to prepare it for use effectively? What is a common source of vitamin C to prevent the debilitating disease of Scurvy and how do you use it? In the middle of winter it will be difficult to find Plantain leaves to put on your scratches when they are buried under 2 feet of snow and dormant in the soil. What will you use if Neosporin is unavailable? How can you stop a dangerous bout with diarrhea that may be of a parasitic nature? These are just a few conditions that if left untreated in the early stages can become life-and-death situations very quickly. The old adage: ‘An ounce of prevention is worth a pound of cure’, should be in every prepared mind.

Disease prevention is easy and very essential in desperate times. Good nutrition and cleanliness, especially in Winter, are essential to ward off most illnesses.  A small scratch or bite on the hand, or soreness in the teeth can quickly escalate to a life threatening situation that will require skills that not every person has. What’s worse is that you may not even know someone who has those needed skills and knowledge to help you or your loved one. So, this is another ‘plug’ for you to get to know your neighbors and community. Fill your brain with fresh learning. We don’t live long enough to accumulate all the knowledge there is for everything that can be encountered. Surround yourself with intelligent and industrious people who can help and support each other in times of need.
Dr. Chuck Fenwick said in the Medical Corps class that I took, “Wash every wound!” Using clean, fresh water is better than not cleaning a wound at all. Infection can start very quickly in a dirty wound. This is very important to remember.

Onward to addressing the ‘how-to’s of basic self care without a drugstore or internet clearinghouse to fulfill your needs.

The Disclaimer: The following is not to be considered “Medical Advice”. The author is NOT a “Medical Doctor” or “Health Care Professional”. Any use of this information is solely the responsibility of the Reader. [words in quotations owned by U.S. Federal Government.])

Regarding the use of Herbs: more is not better! Always use the recommended dosages and directed amounts from materials authored by qualified practitioners. These are already proven safe over many generations. Do not experiment unless you have studied herbalism.

Vitamins are a great stop-gap to slow down and turn around the effects of poor nutrition. But, they are very expensive and generally require extra resources from the body to digest- making absorption 50% or less and there are many manufacturers that use poor quality ingredients making many vitamins virtually indigestible. So, do your research and find supplements that are plant based which are what your body is designed to use. Pills are convenient, but liquids and water soluble powders are easier to digest making them about 90% absorbable.
This is where the knowledge of plants comes in. Winter is the most nutritionally stressful time of the year, so give special attention to nutrition to avoid disease.
 Next summer when you are out in the wilds, collect the following herbs for a nutritional herbal brew you can make while you are sleeping.

Herbal Nutritional Brew:

Dried Stinging Nettles (Urtica dioica); These provide minerals, proteins and amino acids essential for body functions. These must be picked before flowering and dried as the juice is very irritating. This is irritation avoided when they are dried because the irritating compounds are broken down when the water has evaporated. Use tools or gloves for picking. Rinse off any debris or dirt and dry in a dehydrator or warm dark place.
Fresh or Dried Red Clover (Trifolium pretense); These provide proteins, vitamins and balancing nutrients for proper endocrine functions. Pick while in full flower. The flowers are tastiest but the whole plant can be used. Clean off any dirt before drying.
Fresh preferred, or dried Pine needles (Pinus); provide more ‘Vitamin C’ than any citrus. This is one way Native Americans survived the winters without getting Scurvy. Pine needles grow 2-5 needles per ‘hole’ on the branches. If the needles are 1 per hole, that’s NOT Pine. This is important! “Fir” needles can cause miscarriage and cause upset stomach; they also suppress the desire for food. Know your Evergreens!
Dried or fresh Rose hips or leaves (Rosa); This is another option for Vitamin C. You can combine with Pine needles or use them separately. The hips are the fruiting bodies that turn red after First Frost, they have lots of seeds and some varieties have minimal flesh and many have a light fruity flavor. The flesh is where the Vitamin C is held and some varieties have very little. That’s why my first option is Pine needles. Much easier to find and no thorns. J
Dried or fresh Flowering Oat tops; (Avena sativa)This is for digestive strength, cooling irritated tissues in the gut and nourishing nerve tissues. You can grow a clump of these from seed or ask a local farmer if you can pick a few handfuls from the edge of his field. Don’t do roadsides, plants absorb the chemicals from motor traffic. Go down the field’s access road to pick; please don’t forget to ask the farmer first.
4 quarts water heated to a gentle boil, 4 quart canning jars with lids:
Put a Tablespoon of each herb in each jar. Pour the boiling water over the herbs. Cap them tightly and leave for several hours or overnight. In the morning pour the brew into a pan, straining out the plant material. Heat just until steamy, pour back into rinsed jars, cap tightly and allow to cool. When completely cooled, store in the refrigerator, basement or cellar.
Dosages: Adults and children 12 yrs and over- ½ to 1 Cup daily, children 5 to 12 yrs old- 1 Tablespoon to ¼ Cup Daily, Children 2 to 5 years old- 1-2 teaspoons daily.  12 months to 2 year old- ¼  to ½ teaspoon Daily. Do NOT give to infants. Safe for pregnant and nursing mothers. SEE NOTE on FIR above.
LABEL THE JARS: put the ingredients, date made and dosages. This is good for 4 weeks, unopened in the refrigerator, Once opened, use within a week.

Believe me, you WILL forget some or all of that information when you go reach for those jars. Put all of it on there so there’s no guessing
Cold and Flu support tonic:
This is used when you suspect that you are coming down with a cold or the flu. This will support the immune system without stress. I also recommend using the herbal brew for nutritional support when feeling under-the-weather.
Gather “Heal-All” herb (Prunella vulgaris)  This is an anti-viral.
 Any kind of Mint for calming the digestive system and nerves.
 Burdock (Arctium minus) seeds or dried root, This is an immune stimulant, anti-biotic, tonic and anti-inflammatory, High in minerals and vitamins. NOTE :Pregnant women should not use this plant as a tea until last trimester.
 Elder flowers (Sambucus Canadensis) This nourishes the immune system, helps circulation and oxygen flow
Oregano (Oreganum vulgaris) leaves This is an anti-fungal anti-biotic, helps lung function and digestive weakness, ( Note: Don’t use an Oregano you bought in the baking section at the local grocery. These are often a form of Marjoram because it’s cheaper and easier to grow.) NOTE: Pregnant women should this plant as a tea. It can cause contractions.
Boil 1 ½ pints water. Remove from heat and add 1 heaping Tablespoon of each herb. Stir and allow to simmer for 30 minutes with a lid on LOW HEAT. Allow to cool overnight with lid on. Gently bring to a low boil again and remove from the heat immediately. Allow to cool till luke-warm. Strain into glass jars and add honey to taste. (You may add 1 to 1 ½ teaspoon unrefined salt, such as Himalayan or Redmond’s Real salt, for assisting the body in making its fluids)
Dosage: Adults and children 12 years and over- 2 Tablespoons 1-3 times daily. Children 5 to 12 years1 to 2 teaspoons 1-3 times daily. Children 2 to 5 years old, ½ teaspoon 1-3 times daily.  Use within 1 week. Safe for nursing mothers, Pregnant mothers do not add Burdock and see NOTE on Burdock above.

Wound Ointment
for minor scratches, cuts and rashes:
Next summer pick several handfuls of the following herbs to make an all-purpose wound ointment to have all year round:
 “Common Plantain” or the Native favorite, “Long Leaf Plantain”(Plantago); This is a fabulous wound herb. It disinfects, cleanses and encourages closure of the wound. This can be used in the ointment fresh or dried.
Flowering “Yarrow”(Achillea), This has been known as ‘warriors wound wort’. It is best used dried. This helps the body nourish and close the wound. It is also anti-biotic. NOTE: Pregnant women should not use this plant as a tea until last trimester.
The ointment will be sufficient with these two herbs but I encourage you to grow some Basil for kitchen use and for medicine.
Dried or fresh Basil  ( Basilicum); This common kitchen herb is originally from southern Asia, it encourages blood circulation, is high in minerals and vitamins and is anti-fungal. NOTE: Pregnant women should not use this plant as a tea, can cause miscarriage and bleeding. But is helpful to expel a stubborn “afterbirth”.
To Prepare:
1 cup natural food oil such as-coconut, palm oil, olive oil, sunflower oil, sesame oil
-warm the oil in a double boiler or a metal bowl over a pot of steaming water and Very Low Heat
1 Tablespoon each of Plantain, Yarrow and Basil added to the warm oil
Allow to simmer in warm oil for 3-6 hours. Prepare a wide mouthed jar and lid by sterilizing it as you would for canning purposes. . (1 Tablespoon of bees wax can be added to make the ointment thicker)
When ready, pour the warm oil into the jar using a wire mesh sieve or tea strainer to remove plant material. A little plant “dust” will not affect the successful use of this ointment so don’t worry about getting out the minutia.
Label and store in a cool dark place. Use as you would any store-bought minor wound ointment. Warning: This is NOT for deep cuts which may require stitches. It will be good for one year from date of production if kept in a cool dark place.
So, what do you do with that Echinacea? A Tea is okay, but you will get the most benefit by making an alcohol extract of the roots. For those who wish to avoid alcohol, you can use edible vegetable glycerine available from the drugstore or online.
In early Spring when just beginning to grow or late Fall when the plant goes dormant but the dry stalk is still visible, dig up the roots.  Rinse in cold water to remove as much dirt as possible. (It doesn’t need to be perfectly clean, the rest will be processed out)
Remove any ugly debris from the roots, then chop into small pieces or shred with any kitchen appliance.

Echinacea Extract
: (roots of “Black Eyed Susan” a.k.a. Rudbekia can be used in the same way)
Sterilize a glass jar or bottle and lid, preferably a dark colored one (blue, green or brown)
Place the chopped root in the jar and cover completely with Vodka or Glycerine.
This is your “herbal maceration”. Seal the jar and label contents and date, put in a warm dark place for 3 weeks to 3 months (longer is better). It can be used in 3 weeks if needed. Occasionally shake the jar to stir its contents.
When the macerating time is complete, prepare a clean, dark bottle and lid by rinsing with Vodka. Using a funnel and tea strainer or coffee filter, pour the extract into the new bottle. LABEL BOTTLE with ingredients/date/dosages. Extracts have an indefinite shelf-life if tightly sealed and kept clean of contaminates.
Dosages: Adults and children 12 years and older-1/2 to 1 teaspoon 1-3 times Daily, Children 5 to 12 years old, ¼ to ½ teaspoon 1-3 times Daily. Do NOT give to children under 5 years old. Use the brews above instead. Safe for Nursing mothers. Pregnant mothers take dosage for “5-12 years old”, although some herbalists would tell you not to take it at all. Make an informed choice and do research.

Finally, a brief instruction on what is a “medicinal tea”;
these should not to be confused with common recreational tea beverages.  A medicinal tea is brewed 15 to 30 minutes. Longer is better but then the dosages change, so we will keep it simple. The herbs mentioned in the recipes above can be used as a tea too.
Herbs For Diarrhea:  Dried Nettles) (Urtica dioica, dried Mullein root (Verbascum Thapsus), dried Staghorn/Smooth Sumac root (Rhus typhina, or glabra, or integrifolia), dried Raspberry (black or red) root (Rubus), Dried Alder bark (Alnus); just to name a few. A pinch of dried/ powdered Black Walnut: Green Hulls (Juglans nigra) can be added if parasites are suspected. NOTE: Pregnant women should not use Black Walnut which can cause uterine contractions and other problems.
Boil water, use 1 heaping teaspoon herb per cup of water. Steep 15 to 30 mins and drink 1-3 times Daily until relieved.
Natural hard-wood charcoal powder can be added a pinch at a time up to 1 teaspoon when Diarrhea is very severe.

Note: When drying your herbs, store the finished products in glass or ceramic jars with tight lids. Label and date when the herb was stored. Upper parts of the plants can be kept for 6 months in a kitchen  cupboard or to 1 year in a cool dark place. Dried roots and barks can be stored 1 year in the cupboard or to 2 years in a cool dark place. When the herb no longer has a strong scent when opened, compost it and get a new batch.

This has been intended to give you natural, less costly options to enable you to begin practicing daily support for your health and nutrition; and to nurture creativity, independence and self-sufficiency. I hope you will be inspired to continue learning about the treasures of the plant kingdom that our Creator has provided for our use (Genesis 1:29).
Tamra Carlsen, a Christian herbalist from Minnesota said:, “Herbs are God’s little packets of super nutrition.”

Dr. David W. Christopher director of “The School of Natural Healing” in Utah said: "I truly believe that we need an Herbalist in every home and a Master Herbalist in every community."

Further Reading and Education:
Books with recipes:

Health Through God's Pharmacy: Advice and Proven Cures with Medicinal Herbs
by Maria Treben
Holistic Herbal 4th Edition: A Safe and Practical Guide to Making and Using Herbal Remedies by David Hoffman
Growing 101 Herbs That Heal: Gardening Techniques, Recipes, and Remedies by Tammi Hartung,
A Modern Herbal (in two volumes): The Medicinal, Culinary, Cosmetic and Economic Properties, Cultivation and Folk-Lore of Herbs, Grasses, Fungi, Shrubs & Trees with Their Modern Scientific Uses by Maude Grieve
The Complete Herbal Handbook for Farm and Stable by Juliette de Bairacli Levy
Healing Wise (Wise Woman Herbal Series) by Susun Weed

Web sites:;

Education: (The School of Natural Healing)

Herb Sources:

Saturday, December 21, 2013

Regarding the recent article "A Beginner’s Guide to Essential Oils":
I was involved in the Essential Oil industry for a while. There are very limited uses for essential oils, however, and this is important, there are so many scammers in essential oil sales. It is very difficult to tell, without actual spectroscopic and chemical testing, if the essential oils are actually pure, what their purity is, if they’ve been diluted, and what they’ve been diluted with. Most essential oil companies buy from farmers or wholesale dealers overseas, pay be wire transfer, and hope reputation will see them to a good product. I worked for one of the better companies, and they did not do any lab verification of product newly arrived from a distiller. Bottle it, ship it out. I had questions.
“Is this lighter color? Is the viscosity off? Does this smell right?”
The answer: “It’s a different batch! Don’t worry about it!”
Maybe they know best, but I’m often skeptical of blasé claims. Science exists to tell exactly these things, but the cottage industry of essential oils have no reason to do that. They insist their product is Pure and Natural. And just because a bottle of oils passed exam the first time (years back) doesn’t mean the farmer in Africa or India isn’t diluting it in later bottles, knowing you were dumb enough to buy the con the first time. Like salting a mine to get a better price. There is considerable variation and I would not be surprised at all to test a batch and find something interesting diluting it. It is unregulated, at every stage. Buyer beware.
Most of the oils are properly labeled as perfume oils or perfume supplies. They smell good, they get used in perfumes, and that’s fine. Night Blooming Jasmine can be diluted a lot into very nice perfume and has been used as a perfume oil since Babylon was the center of the arts and culture. Frankincense is a piney smell. Myrrh (Oppoponax) is a weaker pine smell, but irritating on the skin so while amusing to own a bit of Biblical History, the two aren’t actually a very nice scent, in my opinion.
Many kinds of Rose oil can be used as a perfume base, though many brands of rose oil are frequently synthetic labeled as organic by unscrupulous dealers. In international trade people don’t always tell the truth. And the buyers in that industry are often not the most discerning businessmen, trusting in relationships rather than verify the goods are pure every time before payment. Trust but verify. Or rather verify, don’t trust. And that’s the perfumes and placebos.
If you decide to stockpile perfume, essential oils deserve to be kept in a cool dark place, like a box in your wine cellar or basement. Some get better when they age. Perfumes are valuable trade goods, and history shows men do many things for the willing and enthusiastic attention of a woman. This is the good side of the Essential oil industry.
Unfortunately, some of the oils sold as “traditional medicines” are actually potent toxins. As in deadly [in sufficient concentration], though not normally considered such because: “They’re natural and that’s the same thing as good!”.
Yes, 90% of them are placebos and make the room smell nice, but the other 10% might stop your breathing, cause brain damage (which starts as a strong headache and nosebleed), and should be treated with extreme caution and possibly need an ambulance and Poison Control Center.
Holy Basil? Nosebleed and increasingly strong headache.
Sarsaparilla? Toxic, despite being used in root beer for a century and a half. Buy a certain beer manufacturer’s Root Beer (non-alcoholic) and drink three in a week. The third one should make your head ache like a persistent migraine. That’s the toxin. Not their fault. It’s the real extract, not synthetic.
Wintergreen oil? Oops! Toxic. This is a major component of Birch Oil, by the way
Clove Oil? Nerve blocking toxin, that will numb skin applied to. So it is popular in “natural” dentistry, but watch out. In higher doses it is like curare or botulin.
The secondary problem of essential oils is dosage. They are meant to be either breathed in or rubbed into the skin. The aerosol dispersal system uses sound waves to raise a mist over the thin film floating over a water bath. This mist is blown out with a fan and wafts around the room. If ventilation is good, you smell the nice or odd smell and its fine, probably. If you’re in a closed room and maybe inhale a bit too much, it gets into your bloodstream in higher concentration. If it’s a placebo, probably no issues other than saturating your clothes and furniture. If it’s a toxin or corrosive/irritant, you might get into respiratory distress or worse. Irritants trigger asthma attacks, even in low doses of passerby or hours later. Sneezing allergy is common with a number of essential oils with no proven effects otherwise.
Since practitioners of herbal medicine are not licensed doctors because Essential Oils are not FDA-approved drugs and have highly variable purity, this can be a very risky and unsafe, to say the least. Thankfully, most are placebos so people rarely die from overdosing. I make specific note of the NOT FDA APPROVED part because real doctors have sworn an oath (Hippocrates oath: “first, do no harm.”) An unlicensed herbal medicine clinic doctor may cause your accidental death using drugs with uncertain potency, on patients with unknown allergies with impure sourcing and no serious testing. Sellers of essential oils do zero allergy testing for patients because most sell in new age shops, by phone, or web site, or multi-level marketing so the one taking the blame in court isn’t the maker in many cases. This is the downside of the “wink wink, nudge nudge, say no more!” crowd. Deflecting blame if something goes wrong.
Oils meant to be rubbed on are generally used after diluting in a carrier oil like almond oil or jojoba (which is another frequent synthetic sold as natural and pure). One of the popular oils meant for sleeping is actually a strong toxin and an overdose can risk your life. Oops. I imagine people who die using that can’t complain, and since none of these are FDA approved, companies which sell it DO NOT ever refer to it as medicine, nor may they legally describe the effects. It’s all inferred to avoid FDA regulation violation fines. “Oh, this is really RESTFUL, okay! Its calming!” It’s a potent toxin which in small doses is a sedative but large ones may kill you. There are several like this and gushy sales people pretend to not tell you what its supposed to do, according to some culture’s traditions. Unfortunately, modern techniques of steam distillation and stainless steel means the oils are far purer (if the source is actually pure), than ever obtained in stone or bronze age cultures. This means the traditional guidelines aren’t right, to say the least. And you might get way more exposure than they ever used.
Some more examples of essential oil effects that aren’t directly stated but inferred with a wink. Quotes to paraphrase their indirect claims:
“Carrot Seed Oil is a natural sunscreen.” Nope. Multiple tests with multiple people and correct concentration in appropriate recommended carrier oil: result was bad sunburns all around.
“Rosemary oil repels mosquitoes.” Nope. They’re attracted to CO2 from your breath. The oil just repels other people.
“Eucalyptus oil prevents colds.” Placebo.
“Marigold oil repels insects when sprayed on plants.” Might work. Don’t get it on you though. Planting marigolds is a known and sometimes effective bug deterrent in gardens. But it doesn’t stop all bugs. Sometimes buying ladybugs and praying mantises is better, since they actively hunt pests down.
“Sunflower Essential Oil improves skin.” Placebo. Oils reduce dryness, generally improve skin anyway. Almond oil is cheap at health food stores.
“Neem oil is an antibiotic and antifungal.” Smells foul enough. The trouble with antibiotics is bacteria adapt and overcome. They’re like the Marine Corps. So it might work once but repeated use often breeds superbugs and most doctors recommend people do not use antibiotic soaps. Neem has similar issues.
Citrus oils cause severe sunburns on any contaminated skin exposed to sunlight. They’re called phototoxic. So Orange Oil in cleaning products isn’t just irritating and corrosive, it also gives you sun burn which could become skin cancer. Nice. Same with Lemon Oil, Lime Oil, and Grapefruit Oil. They smell nice though.
All in all, having the chance to be exposed to that industry and deal directly with those products, I can’t seriously recommend them. Most are Schumer, some are poisons, others might work once but harm afterwards. Few are proven tested to be what they claim to be so you’re taking a heck of a chance. That’s not a very good success ratio, particularly since they are so expensive. And there is no good reliable guarantee of purity or quality other than some person’s promise. Even if they believe it doesn’t make it true.
Focus on the Three Bs instead. And use more traditional means to care for your health. Proper nutrition and exercise. Split some firewood or till the garden or shovel off your driveway. It’s much safer. And probably a far better use of your time and money.
Sincerely, - InyoKern

Wednesday, December 18, 2013

I first got serious about prepping in 2006, when I realized the U.S. Dollar was on its way down.  I had a young son at home, and I wanted to make sure he would be safe if civil unrest occurred. I built a home on some acreage in the country in 2007 and started getting setup to be self-sufficient. I believed 2008 was going to be a bad year, and I wanted to be ready. I installed a wood stove in my home and purchased a hand pump for my well. When I moved my chickens out to the new home, I felt we were right on target to survive the coming turmoil. In this article I am going to share some of the things I have learned.

As the years have passed, I have continued to perfect my small piece of heaven into a full scale food-producing compound. I have leveraged tax advantage from my sale of all natural meat, poultry, and eggs. I have learned many things about sustainable food production. And meanwhile, my son grew up and joined the military. He is thousands of miles away, and here I am still maintaining the refuge I had envisioned would be for him. I have had some trying emotional times learning to deal with a situation where I am no longer needed by the child I was trying to protect.  And then it occurred to me that there are many young people who are barely able to put food on their table, let alone make preparations for an uncertain future.  So I continue to live the lifestyle of a prepper and believe I may be sharing my knowledge and my stuff with people who didn’t have the time and resources to be ready.

The Tax Man Cometh
I have been able to use many of the expenses for developing my little farm on my income taxes.  Fences, buildings, irrigation installation, vehicle expenses, equipment, etc.   Because my goal is to make a profit by selling the food I raise, the costs associated with its production are tax deductible. The deduction has been very useful in keeping more of my hard-earned cash so I can invest it in the development of a farm. Each time I need to make a big purchase, I strategize how it is associated with the farming production, so I can properly account for it in my income tax return.

Good Fences Make Good Neighbors
When I first moved onto my acreage, there were no fences.  My German Shepherds would wander off to the neighbors at times. The neighbors’ dogs would help themselves to my chickens. The coyotes and foxes had my place on the top of their list of great places to score a meal.  And then one day, I heard a chicken in distress and ran with my dog to find the chicken in the tall weeds.  My dog got there first.  The scoundrel attacking the chicken was a small dog belonging to a neighbor. My dog killed it.  It nearly became an International incident.  The neighbor was furious. He threatened to kill my chickens if they crossed onto his land.  It was a tense time.

That is when I invested in good fencing. My fences are 5-foot high predator-proof mesh.  They keep dogs, coyotes, foxes and other neighbors out, while the chickens and turkeys are usually more interested in staying in.  I had a gate constructed with the same mesh.  My dogs patrol the acreage and anything that manages to get in, soon decides it wasn’t such a good idea to get in.  The gate is locked so some unsuspecting “visitor” doesn’t just open the gate and come in.  My chickens and turkeys free range and we seldom have a predator incident. The dogs are quite aggressive in protecting our turf.

Garlic Cures Everything
I need to get a good garlic garden planted, because I have so many uses for the stuff that I simply haven’t been growing enough of it. I have an astute neighbor who is also a prepper.  She noticed my need for garlic and planted a bunch to barter with me when things get dicey.  I put the garlic cloves through a hand-cranked juicer. The pulp is mixed in with corn for my sheep, cows, and poultry.  It helps flush out internal parasites, keep the lice and fleas away, and builds the immune system.  I also mix garlic into my dogs’ dinners sometimes to combat internal parasites. 

Garlic is a natural antibiotic and anti-viral.  The juice is potent stuff. I keep some on hand in the refrigerator all the time. If I feel a cold coming on, I can spread some of the juice or pulp on toast with butter and the cold almost always goes away within an hour or so.
When I had triplet lambs this past spring, one apparently didn’t get her dose of colostrum. She suffered an acute onset of e-coli within the first 24 hours and was near death.  I added garlic juice to some warm water and gave it to her with a syringe. I continued to administer the water with the garlic and honey every 10 minutes or so for a couple of hours. Three hours later, she was up and nursing. I have been told even with antibiotics, that kind of recovery is pretty much unheard of.

I have a small herb-garden in my kitchen.  Recently I noticed the basil was being killed by tiny gnats.  I mixed some garlic juice with some olive oil and put it in a small spray bottle.  The gnats apparently don’t like garlic, because they are gone and my herb garden smells like an Italian dinner.

There’s A Lot of Poop
Raising produce without the help of commercial fertilizers is tricky.  I started vegetables indoor this year with an “organic” fertilizer I bought at Home Depot.  They did very poorly and many of them just keeled over dead after a while.  I bought the fertilizer because, at the time, everything was frozen solid outside, so I couldn’t collect poop to make the poop water I usually start them with.  Lesson learned.  This year I have some poop set aside in a place where it won’t freeze so I can start my plants indoors with something I know works. I have also mixed some soil that I have ready to use.

Chicken poop is not ideal for gardening, but I have been successfully using it for several years. When I clean the chicken coop in the fall, I spread the stuff over the garden area, so it can be rained into the ground over the winter.  I till more manure in with my spring tilling.  This year, I did not use enough and I experienced poor potato yields.

Food Cooked on the Woodstove Tastes Better
I installed a regular woodstove (not a kitchen stove) in my home.  It has a removable rounded top that leaves a nice flat surface for cooking.  If I need to oven-cook something, I use a Dutch Oven.  Last winter I slow cooked Salisbury steak in a Dutch Oven and it was heavenly.  I have also found that potatoes have a completely different moist flavor if I wrap them in foil and put them in an area of the stove that isn’t in flames.  There have been weeks passed in the winter where my kitchen range was never used. It conserves energy and provides a warm glow to cheer through those gray winter months.

Cute Little Children Become Teenagers
It is a fact – those sweet little munchkins we build our lives around eventually turn into teenagers.  Mine became increasingly resentful of my prepping.  I have heard it said that teenagers become so ornery because it is God’s plan for us feel better showing them to the door when they grow up.  Shortly before my son left home, he decided it fit for him to list all of my personal defects which ailed him.  At the top of his list was my “paranoid” belief system that something bad could change our lives in big ways.  He made it clear he was unhappy with that belief and that he would be carrying on his life without such worries.  So far, so good.  He is traveling abroad and living a good life. I still believe I would rather be ready and wrong than not ready and starving to death.

The Lifestyle Is Very Attractive
Many people see my lifestyle and want to come join in.  Well, not join in the work, but join in the food and the fun and all the nice resources I have.  Over and over my generosity has been stretched and taken advantage of.  I have learned there are many lazy moochers out there who talk the talk and then lay around in my house watching useless television programs while I carry on with the chores.  And they feel the food is “free” because I raised it myself, so they have no urge to contribute.  My new policy for anyone visiting my farm is that they will be asked to participate in chores.  I will work them out of their fantasy about how great it is to live like I do.

People Hate Rules
When I have had to travel for business, I have also had to rely on friends to help with the farm.  I have found that, regardless of the careful instructions, they always think they have a better idea and do it their own way.  It has cost me animals and it has cost me having to retrain my farm to the correct behavior for my ecosystem to function.  It is frustrating. But it has taught me that I will probably have this problem if we have a SHTF scenario where people will be coming to me for safety and food.  And I don’t expect they will be thankful as long as they will be trying to change my life to fit their own view of how things should be.  It is human nature. I will have to be very strict and it could lead to confrontation.  I anticipate that will probably be unavoidable.

Counting the Tables You Put Food On is Rewarding
Last year, I put meat, eggs and poultry on the tables of 14 families.  Counting those families at Thanksgiving was a very satisfying experience.  Although this year it has been fewer because I haven’t had beef ready, I still feel grateful to play a role in many family meals. I have contributed to the lives of many people I didn’t even know.  I have sold products of my farm, the income from which has enabled me to continue on my adventure.

Life Just Keeps On Going
If I had poured everything I had and taken big risks when I first started prepping, I wouldn’t be prepping today because I would have lost it all. I truly believed 2008 would be a year of disaster – and it nearly was.  But the powers that be found a way to kick the can on down the road. And they keep finding ways to kick it down the road again.  Life is amazingly easy right now in the artificially secure world we have to live in here in the USA  I am so blessed to have good employment from home in an area where people are often trying to live on minimum wage. Technology has brought about enormous opportunities, while it has also let us be monitored 24x7 by not only the government, but also large corporations like Google, who track everything you do on the Internet and keep the data indefinitely (I prefer because they claim not to track).  While I hope it all keeps hanging on, I really can’t see how it can.  We are living in an unmaintainable sphere of reality that is rapidly growing more unmaintainable.  I have chosen to continue to be “paranoid” and prepare to feed people in an uncertain future.  The difference now is that I realize I will probably be helping people I never planned to help and I have learned some good lessons on how to deal with them appropriately.

Tuesday, December 17, 2013

Mr. Rawles,
Is there any way that I can avoid enrolling in Obamacare? (I believe that abortion is sinful and there's no way I want to support it.) Thanks, - Debra L.

JWR Replies: As currently enacted, the Affordable Care Act (commonly called "Obamacare)" contains a special exemption provision for members of healthcare sharing ministries. One of the best of these is called Medi-share. A similar plan--and even less expensive per month--is available from Samaritan Ministries.

Saturday, December 14, 2013

I have recently been introduced to Essential Oils and I am by no means an expert, but I believe they definitely have a place in the prepper’s medical bag. They are a pure, all-natural alternative to many types of medications and ointments without the side effects of chemicals.
Essential oils are extracted from certain varieties of trees, shrubs, herbs, and flowers. The oil is concentrated in different parts of the plant. The most common way of extracting oil is through steam distillation. It takes thousands of rose petals to make one small bottle of rose oil! Most essential oils are not ‘oily’ like vegetable oil, but will penetrate the skin without an oily feel. Shelf life varies, but I’ve read the shelf life of citrus oils is 1-2 years, and other oils possibly up to 8 years, making them a great addition to your 1st aid kit. They should be stored in a dry, dark place. A 5 ml bottle of essential oils contains approximately 85 drops. One drop goes a long way, so I suggest getting a few glass droppers to use instead of dripping from the bottle-sometimes the oil can come out too fast and you don't want to waste a drop!
Some common words you will see when reading about essential oils and their meanings:

EOs=Essential Oils

Neat=Undiluted drops of essential oil

FCO=Fractionated Coconut Oil (regular coconut oil is solid at room temp, Fractionated Coconut Oil stays liquid),

Carrier Oils = Oils used to dilute EOs. Some common carrier oils are: Olive Oil, Grape seed Oil, Sweet Almond Oil, and FCO.

Some ways to use EOs: Smell straight from the bottle or place a few drops on tissue/handkerchief and inhale, diffuse, dilute with carrier oil or witch hazel, apply neat to skin, room sprays, roller bottles, or apply to a clay pendant necklace.

Here’s a small list of some things EOs can be used for: burns, bug spray, aches and pains, insomnia, cold and flu symptoms, toothaches, PMS, athlete’s foot, ADHD, allergies, anxiety, constipation, bed bugs, lice, cleaning solutions, animal issues and many more.
If using on infants, use 1-2 drops EOs to 1 TB carrier oil.
If using on children, use 1-2 drops EOs to 1 tsp. carrier oil.
Do not ingest unless it specifically states on bottle that it is safe to consume.
Use only pure therapeutic or pharma grade oils.
Use glass bottles when mixing up an EO ‘recipe’. The EOs will often break down plastic.
Many oils have similar properties, so if you don’t have an oil you can substitute another.

There are many sources to buy EOs from; I recently became an Affiliate with Spark Naturals. They are very affordable. If you are just starting out, I would suggest the most common oils- Lavender, Peppermint, Tea Tree (also known as Melaleuca), Lemon, and blends thereof are great for specific issues without having to buy many different oils. Spark Naturals offers oils and oil blends. (You can use Coupon Code "DISCOUNT" for 10% off your order.)
-Lavender is one of the most popular EOs, and is great for burns or scalds. Lavender has anti-biotic, anti-septic, anti-depressant, and sedative properties. Promotes healing and prevents scarring. It stimulates the immune system.
-Peppermint has analgesic, anesthetic, anti-septic, decongestant, and stimulant properties. It is great for digestive issues, respiratory, circulation, fatigue, and headaches. It can also keep fleas, ants and mice away.
-Tea Tree is anti-septic, anti-viral, anti-bacterial, and anti-fungal. It helps the immune system and helps the body fight off illness. It can be used to treat ringworm, athlete’s foot, infections, and mold. I’ve used it on blemishes-1 drop applied twice a day is very effective. It is also great for cold sores.
-Lemon is anti-bacterial, anti-microbial, anti-septic, and diuretic. Lemon can be used as a water purifier. Add a drop to a glass of water to detoxify and stimulate the lymphatic and digestive system. I’ve even read it can help with weight loss and keep wrinkles away!
-Shield is a blend based upon the legend of grave robbers in 15th century England. They developed a blend of clove, cinnamon, lemon, eucalyptus, and rosemary to protect them while robbing the plague victims. I use Shield in my diffuser during the winter or when someone in our house is getting sick. It smells great. I like the Zaq Allay Diffuser. I’ve bought cheaper ones that haven’t lasted long. (Spark Naturals is one place that sells it) Shield can also be used neat on the bottoms of the feet (feet have the largest pores and EOs get into bloodstream quickly) to protect against germs. I apply Shield (diluted with carrier oil) on my daughter’s feet before school using a roller bottle. I also make a hand sanitizer with Shield.
Other blends: Amend for sore muscles, Bliss for calming, Dream for sleep, Jeddy’s blend for ADHD and anxiety, Respire for respiratory issues, and more.
Essential oils that are good for Sinus issues: Basil, Rosemary, Lavender, Peppermint, Eucalyptus, Tea Tree, Oregano, Lemon.
Oils that can help with cramps/PMS: Basil, Clary Sage, Geranium, Cypress.
Uplifting oils: Orange, Grapefruit, Lemon, Bergamot, and Clary Sage.
Oils for stress relief/calming: Frankincense, Lavender, Roman Chamomile, Vetiver, Ylang Ylang.
Oils for energy/alertness: Lime, Lemon, Grapefruit, Orange, Rosemary, Peppermint.
Frankincense was of course one of the gifts for baby Jesus. It can be used for anxiety, asthma, and to treat bronchitis. It is a strong anti-inflammatory and has anti-tumor and anti-cancer properties.
Myrrh was another gift for Jesus. It is used in skin care, diffuse for bronchitis.
Ylang Ylang and Coriander are said to be aphrodisiacs.
White Fir is a powerful antioxidant, can be used to reduce cold and flu symptoms.

The Complete Book of Essential Oils and Aromatherapy by Valerie Ann Worwood is a good reference book to have. Another great resource is . Type in an ailment and I’m sure you can find an EO ‘recipe’! has a lot of information on oils and what it can be used for. is a great place to find roller bottles, glass droppers, small glass spray bottles, carrying cases and other accessories.
My suggestion when starting out with EOs is to start a journal, write down or print off recipes you find on the internet. Experiment and write down what works for you.

Here are some recipes I’ve found to work for common ailments, and other uses:
Allergies: Lemon, Lavender and Peppermint applied to feet morning and night.
Athlete's foot: Apply tea tree neat to affected areas twice a day.
Backache: Equal parts Lavender and Peppermint. Use with a little carrier oil if you wish-makes it easier to massage and helps it go farther. My mom suffers back pain and has become a believer after I told her to try this! My dad has diabetes and suffers neuropathy and this has helped him also.
Bleeding: Helichrysum can stop bleeding.
Bug Spray: In 2 oz. glass bottle, 10 drops Lemongrass, 10 drops Lavender, 10 drops Geranium. Top with alcohol free Witch Hazel. You can also use Citronella or Peppermint EOs.
Burns: Apply 2-3 drops neat Lavender. Helps burns heal faster and have less scarring.
Colds and Congestion: Diffuse any combination of Lemon, Oregano, Rosemary, Tea Tree, Eucalyptus, and Peppermint. Or place a drop on a tissue and inhale often.
Constipation: 1-2 drops Lavender in carrier oil, massage on abdomen every few hours.
Coughs: Apply 4-6 drops Eucalyptus on bottoms of feet. Dilute for children.
Cramps: 1 drop Rosemary, 1 drop Cypress, plus carrier oil. Apply to abdomen as needed.
Ear aches: Use carrier oil and Basil EO applied to a cotton ball; rub all around ear several times a day until symptoms are gone.
Fever: 1-2 drops each Peppermint, Lavender, Frankincense with a little carrier oil applied to bottoms of feet.
Hair growth: Add a few drops of Rosemary to your shampoo.
Hand Sanitizer: 2 oz. alcohol free witch hazel, (I like Thayer’s Aloe Vera Witch Hazel) 15 drops Shield, 10 drops Tea Tree.
Headache: 1-2 drops each Lavender and Peppermint applied to temples.
Homemade vapor rub: Melt 2 oz. coconut oil, 5 drops Rosemary, 5 drops Tea Tree, 3 drops Peppermint, 3 drops Eucalyptus. I use a small 4 oz. canning jar.
Mice (Repelling): Put peppermint oil on cotton balls and place around areas needed.
Other types of pain-joint pain, carpal tunnel, arthritis, etc.: Peppermint, Lavender, Birch and Wintergreen in carrier oil. Birch and Wintergreen are very high in methyl salicylate; which is the same component in aspirin. They should both always be diluted in carrier oil. Both are an anti-inflammatory. Birch and Wintergreen should not be used if you are allergic to aspirin or are on blood thinners. People with epilepsy and pregnant women should not use Birch.
Pets: add a few drops of tea tree or peppermint to your dog’s collar to get rid of fleas. For an ear infection, apply tea tree and carrier oil to a cotton ball and wipe inside of ears. Horses, goats, sheep and other farm animals can benefit from EOs too!
Runny nose: 1-2 drops Lemon on the sides of your nose will stop the running. Use caution when going into the sun, citrus oils can cause skin to burn easily.
Sweet Dreams Spray: Water and Lavender in small spray bottle. Shake before using. (I use this when my daughter has trouble sleeping. She gets excited about it and asks for it!)
Toothache: 2-3 drops Clove oil applied to cotton ball, apply to gums.
I am not a doctor; please do your own research!
This is just the tip of the iceberg when it comes to essential oils! I am thankful God has given us this gift and the ability to research and use them. There are so many more oils out there and so much more you can do with them. I’m excited to keep learning about them so hopefully I can be prepared for whatever comes our way. God Bless!

Sunday, December 8, 2013

Describing how teenagers can contribute to and have the right attitude for family prepping. (Written by a teenager for teenagers.)
As a teenage prepper my top priority is making sure my family and I will survive a natural or man-made disaster, and prepping is how I do that. Prepping is a family affair around my house, each of us have our items or category (medical, food, garden, hunting, etc) that we are responsible for prepping and stocking up and we carry-out that responsibility to the fullest. If one of us doesn't do our job, in an TEOTWAWKI situation, it could cost us our lives. So in this article I am going to tell you what this teenager does and give some advice of what my fellow teenagers can do to contribute to your or your family's prepping.

Note: An important phrase I will use often throughout this article is "two is one and one is none". That phrase means that whatever you have, it is best to have two, rather than one, of that item. If you run out of or break one thing, whether it be a fire starter, a baby bottle, a shovel, or a gun, you will have a back up, if you have two. If you only have one of that item and that one item breaks, then it could mean your or your family's safety. So, remember: two is one and one is none.

Though humans can go for weeks without food and still survive, I don't want to think that my family and I might go hungry, so I'll start with how my family and I prep food.

A garden is the best and cheapest thing to have to preserve your own food and though it may be a little more work, it's worth it. My mom loves to can. She would be canning all day everyday if she had the time and food. It's a lot of work for just one person, so that's where I come in. When many people think of themselves canning some may say, "Oh, I could never do something that difficult!" or "Oh, isn't that dangerous?". Everyone knows someone that has had some sort of traumatic experience with a pressure canner. Believe me, we've heard the stories. Actually it isn't all that difficult, just time consuming. And it isn't all that dangerous if you follow instructions or get someone that is experienced in canning to "show you the ropes". Canning is almost as simple as making a stew. Chop your vegetables (or meat, whatever you are canning) and put them in a jar, fill the jar with water, add a little salt, put them in the canner and "cook" them. Now, don't go in there and do exactly what I just said, there are a few more steps than just that, but that's how you do it in a nut shell. Vegetables and meat aren't the only things we can; you can put up meat, fruit, jams and jellies, pasta sauces, soups and chili, and so much more. And, whatever you can/preserve will last a long time. How awesome is that? We love to can soups and chili because that's a complete meal in just one jar. If you have 365 jars of soup then you have got yourself one meal a day for a year! In a disaster situation, one meal will be like gold!

Now if canning still makes you a bit nervous, fear not, for there are others options. Store-bought food. My mom and I are always looking for food sales and when we find them, we rack up on whatever is on sale. Whether it be green beans, juice, chicken noodle soup or ramen noodles, it's all 'prep-able', as I say. Store-bought food is ideal for stocking since it isn't easily damaged, where home-canned food jars can break. We are friends with the owners of our local Butcher's Shop. Normally, when their meat is nearing the expiration date, they will put it straight into the freezer to take home for themselves. He sells us that meat for half price. We go every so often to buy up as much as we can afford then we bring it home to can it.

Did you know you can also stock up on things such as crackers, coconut, cereal, chocolate chips and other dry foods that you might think would go stale or dry out? Yeah! We use a FoodSaver with a mason jar attachment. Just stick the food into a mason jar and put a flat on it, then put the jar sealer attachment on the jar and press down on the machine as if you were vacuum sealing a bag of food, and wa la! The jar sealer vacuums out all the air, making it last a very long time. We have eaten cereal and crackers recently that we sealed a very long time ago and it was all still as crispy and fresh as the day we bought them.

Inventory, Rotating, & Hiding
When prepping, inventory, rotating, and hiding is one of the most important things for our family. Inventory is important because you want to know how much of everything you have and what you need. My mom and I are usually the ones who inventory all our stock, and we do it every few weeks. Any time we buy something new to add or take something out, we make sure to mark it down. We have a couple folders and notebooks designated especially for our prepping inventory. To make the job easier for the next time we do inventory, once we have inventoried something, we use a marker to make a mark on the label or top of the can/box, so the next time we take inventory, if there isn't a highlighter mark, we know we missed that one. We also write the dates on all our food, then rotate them every so often. You always want the oldest food in the front, to use up first, even with your home-canned food. It's my and my brother's job to find hiding places for our stock stuff. It's crazy some of the places that you can find to store your stock. When finding a place to store/hide your home-canned stock food you want to make sure it's a cool dark place. In the basement, in the closet, under the beds, places that don't get too hot or too cold. I know from experience that if your home-canned food gets too hot, it will unseal, if it gets too cold, it will burst. When it comes to storing/hiding non-food items, it's not so difficult. Medical supplies, hygiene items, and clothes don't have to have such care. As long as they are out of the weather and sealed to keep out moth, pretty much any where is a good place. Under the bed, top of the closet, etc. Secret hiding places around your house that only you and your family know of are ideal.

Make a Food Chart
It's a great idea to make a chart of how much food your family eats in a year. Calculating how many meals of what you want to stock up on. How many seasoning packets, how many packs of crackers, how many jars of cereal, or how many jars of tomatoes you will need. Our family has a list of several of our favorite meals that we want to have in a disaster situation. Just say you are trying to store enough food for one year and you want to have the same meal once a week for that year. Start out by making a list of everything that goes into prepping that meal. Include everything down to the seasonings. Then buy 52 of those items. Our family of four (two adults and two teens) can eat one box of spaghetti with one quart jar of sauce per dinner. That means we vacuum sealed at least 52 quarts of spaghetti noodles and canned at least 52 quarts of sauce. We also have 52 packs of seasoning sauce (Save-a-Lot food store 3/$1.00). So you would do that with each meal you want to have. You get the idea.

"Two-thirds of the human body (by weight) consists of water. Humans need water for circulation, respiration, and converting food to energy. After oxygen, water is the body’s most important nutrient. Quite simply, you need water to live. Your body loses water constantly through sweat, urine, and even breathing. You must replace the water your body loses for your organs to continue to work properly. Dehydration occurs when your body doesn’t have enough water, because you’re losing more water than you’re taking in. In extreme heat, an adult can lose almost half-a-gallon of water through sweat alone. Without water, dehydration can set in within an hour in severe heat. The combination of physical overexertion and extreme heat — without water — can lead to death in as little as several hours. Surprisingly, it’s also easy to become dehydrated in very cold environments. Since cold air cannot hold much moisture, it dehydrates your body with every breath you take. Even if you aren’t sweating, you still need to replenish fluids even in cold weather. So how long can you survive without water? Humans in average shape and perfect conditions (not too hot or cold) can probably live for three to five days without any water if they’re not physically exerting themselves. Healthier people can live a day or so longer, while those who are unhealthy or exposed to particularly hot or cold weather may not survive as long. To stay healthy, you need to continually replenish your fluid supply. Experts recommend drinking approximately two quarts (64 ounces) of water each day. Of course, if you live in an extremely hot or cold area — or if you exercise a lot — you may need to drink a gallon or more of water every day. See: How Much Water Do You Need To Survive?

So as you can see from the excerpt above, we must have water! So let's talking about stocking some water. If you are like my family and don't have access to a working well then you can stock water by buying bottled water or you can even bottle your own. We use milk jugs and 2-liter bottles. Large drums are often used (you can see one in the tv show "Doomsday Castle: Water From a Rock"). A Berkey would be a wise investment if you can afford one. One reason we love the Berkey is that no matter where we have to get our water, we can always have clean and clear water to consume. GSE (Grapefruit Seed Extract) and water purification tablets are good to have to purify water that you aren't sure is safe to drink. We have both GSE and the tablets, that way if we run out of one we still have the other. Remember: two is one and one is none.

When it's time for our weekly shopping trip, it's a family affair. We all load up and head to town. We each have our list of things we are responsible for prepping so when we go into a store or stop at a yard sale, we scatter to all different directions looking for the items on our list. Some things must be bought brand new, but not all things. What do I mean by that? Things such as clothes, shoes, garden tools, sometimes even guns that have been taken care of, a good EDC bag, and so much more can be bought at places like the thrift store, yard sales or garage sales. Would you buy used guns? Yes, we have before. Most times it's elderly people or ex-military who sale them at garage sales and they have been well taken care of. Most often we can buy them for less than what you would pay for them buying it brand new, but remember: two is one and one is none.

When most people think of prepping they think physical items (i.e. water, food, clothing, guns, ammo, etc), but we have to not only prep those things, we must also prepare ourselves. In an TEOTWAWKI situation we will not have access to things like in normal days. Clothing stores, hospitals, etc. So we must learn how to do these things.

Medical Needs
In disaster days we will most likely not have access to a hospital. If you or a family member were to injure yourself you would need to know how to tend to the wound (as in the book "Patriots" by James Wesley Rawles). You would need to stock up on the material needed to tend to injuries, such as: gauze, bandages, pain medication, suture kit, etc. Sanitary napkins are a great absorbers for blood and would be perfect for serious injuries that need something to stop the blood flow. You don't have to become a nurse or doctor, but if you know someone or have a family member who is in the medical profession if would be a good idea to asked him/her to show you basic first aid, how to suture, perform CPR, how to stop bleeding, etc. My mom's brother is a doctor and we have asked him to show us many things that we would need to know. I am also training to become a midwife, so we know (and are learning) what to do with most injuries and child-birth. Most times you can't just go out and buy pain medications or antibiotics unless you have a prescription for them. So how will you stock the medicine needed? If you have medicine left over from the last time you were sick don't just leave it or throw it away, stock it! Natural medicines such as Essential Oils and Herbs are also wonderful medicines. I know from experience that most times they work just as well if not better than man-made medications. It wouldn't be bad to have both herbs and man made medicines. Remember: two is one and one is none. You can find herbs growing just about anywhere, so study up on your naturals medicines so that you know what to get when you need it.

Know How to Handle a Gun
It is very important, especially for us ladies, to know how to handle a gun. In James Wesley Rawles' novels "Patriots" and "Survivors" all the women knew how to handle a gun and if they didn't, they had to learn. We must be comfortable enough around them and know enough about them to be able to shoot them when we need to. You should learn how to handle, care for, load and shoot a gun. One day your life (or someone else's) may depend on it, whether it be for the use of self-defense, protection for your family or to protect your food. Don't be afraid of the gun, but give it the respect it needs. Once you know how to safely handle and care for a gun, you can show others how to as well.

Physically and Mentally Fit
Yes, we must be prepared with our stock items, but we must also prepare our bodies by getting fit, mentally and physically. You never know when you will have to bug-out and carry a heavy BOB or run for a while. You don't want to be caught or slow others down because you can't keep up. While our bodies must be fit we must also prepare our minds. We must have the Prepper's mind-set. Why do we prepare? Because we know something is going to happen and we want to be ready for it in every way. If the crap hits the fan and we blow our top freaking out like everyone around us, that will just get you lost or killed. You have more of a chance of survival if you keep a cool, calm, and collected head on you. Remember, you knew it was going to happen, so why freak out? When you stay calm, you can keep the others around you calm. There should always be one person who knows what to do, so why not let that person be you?

Soap and Body Care Products
So now that you have your water stocked and you can shower and wash clothes you need soap, right? Of course you can always buy soap to stock but what if that's something you forgot or you run out? So what do you do? You make your own. We absolutely love to make soaps and body-care products. Laundry soap can be made from things around your house such as bar soap, borax and baking soda (see the article in SurvivalBlog by J.D.C. in Mississippi that gives very clear instructions on how to make laundry soap. You can also make your own body soap, conditioner, shampoo, lotion, etc. They are so easy and such fun to make. All these things can be made with one person or many! There are millions of tutorials and recipes all over the internet and YouTube. All you have to do is pick one out and go make it! It can be much cheaper, a lot of fun, and it's healthier for you! We recently made another batch of soap that made 30 bars. It cost us only about $5! I don't know of anywhere you can buy homemade healthy soap at that price. Don't forget to stock up on lye. We buy ours very cheap from an Amish friend ($11/gallon).

Knitting, Crocheting, and Sewing Your Own Clothes
I love to knit, crochet and sew in my spare time. It's so easy and a lot of fun. You can find the materials needed at most any store and often at yard sales, thrift store, and sometimes people even give the stuff away. As long as you know the basic stitches and have the concept of how to do it, you can make most anything. During winter time blankets, hats, mittens, and scarves are a must. You can make all those things, you just have to have the some yarn, a crocheting hook and know how. It can sometimes be much cheaper as well. And it help pass the time away when there is nothing else to do (wink).

(Ladies) Prepping for the Monthly Cycle
I know many of us ladies including myself have, at some point in time, wondered what we will do when that monthly visitor arrives in a disaster situation. So what do you do? You stock some! When you have a little extra cash, buy an extra pack of your preferred item. But what about when you run out? You can make your own. I know what you are thinking, gross, right? Well, when the world is in a chaotic state and you run out, those homemade sanitary napkins are gonna look pretty darn good. They are much more sanitary than one might think. They are reusable and last years so you wouldn't need many. There are so many different styles, patterns, and materials out there all you have to do is pick one. I have made them before and they are very easy to make at home or you can buy them yourselves (the most popular ones you can buy are Luna-Pads). You can try out different ones now so that you will know what will work best for you when the times comes that you need them.

Hard Copy
Last, I want to mention something our family is working on full-time. There are tons of tutorials online in the form of video, pictures, or text. However, when we have no electricity none of it will be accessible. Now is the time to get all the the tutorial, instructions, recipes, etc printed out and neatly organized into a binder. Every time the family gives a "thumbs up" to a new recipe my mom or I try, two copies are printed or written in a binder that moment. No waiting. Remember: two is one and one is none. One important bit of information we have printed and filed is a conversion chart. It has everything from weights and measures to equivalents to substitutions. Although we copied this from a very old cookbook, I'm sure all of this information is online as well. Check out: Cooking Resources: Cooking Measurement Conversion, Ingredient Substitution, and More.
So there you have it, the answer to the question "How Can Teens Contribute?" Prepping can be a lot of fun especially when you get the whole family involved. When you are a prepper and have the mind-set of a prepper it will encourage others around you to get ready for whatever disaster may happen. I hope that you, my fellow teens, have learned something from this and have been encouraged.

Wednesday, November 13, 2013

Dear Editor,
I really do appreciate Kali for bring up our Dear Aunt Flow because is something I don't think a lot of women have thought about. I did want to bring up a concern I have about using tampons and menstrual cups that I don't think has been brought up yet which is the risk of toxic shock syndrome. From what I remember learning in nursing school it's basically when bacteria gets introduced into a dark moist place in the body is allowed to grow and gets into the bloodstream  through thin skin and becomes life threatening. I've heard of this happening not only with women using tampons that are too big for them but also with individuals who used a tampon to stop a nose bleed. Our OB instructor told us a few things to do to avoid toxic shock are to make sure to change tampons at least every 4 hours, don't sleep with them in, wash hands before putting them in and just avoid the super-absorbent varieties all together. I have personally know one woman who experienced toxic shock, it almost killed her and did enough internal damage to leave her with fertility problems years later. I personally wouldn't want to take the risk in a grid down situation. Even though toxic shock is rare it can require a lot medical interventions which probably won't be available in such a situation. Just as a side note, I am not an OB nurse nor do I have expertise in that area of medicine, I just vividly remember that class discussion from nursing school and thought I would share what I remembered. See the Mayo Clinic's web site more information on the subject. - Marie

Sunday, November 10, 2013

It is a reasonable assumption that most SurvivalBlog readers are already going to be in the preparedness mindset. Whether you're preparing for a natural disaster, economic collapse, zombie apocalypse, or something in between you must always have each and every family member's needs in mind. Most of us start with the 'generic' items that everyone needs such as water, food and standard medical supplies. While that is the absolute best starting place for all families, after the basics are accounted for you should then consider any unique or special needs that you may have to provide for. Many of us have groups we are planning for which often include extended family or close friends which are expected to show up if stuff starts going from bad to worse. Quite often those loved ones will arrive with little to no supplies of their own. Or perhaps you are just planning on hunkering down to ride out the 'storm' with your immediate family. Either way, if there's even one woman of or near reproductive age expected to end up in your home or retreat, it is imperative that you do not forget to prep for Aunt Flow's inevitable visit (aka a woman's menstrual cycle).

Many sites have covered the multiple uses of tampons beyond the 'traditional uses', most notably and comically the Art of Manliness' "Why yes, that is a tampon in my mouth" but not many 'prepping lists' on survival sites include them or if they do, it is a box here and there. There's even plenty of urban legends about our military personnel carrying tampons in their med/survival kids (while this seemed hard for me to believe, one military member of my extended family who is a veteran of the Vietnam War insists that he knew some service members that carried them). With households where a male member is the one purchasing the family preparations, this very important item may be overlooked or significantly understocked depending on the time frame that the family is planning to be self-sufficient for.

Before I go further, it has been suggested to me before that, 'women in the old days used an old cloth that they washed and reused'. While this is true, I would point out that toilet paper as we know it today is a relatively new invention. 'Splinter free' toilet paper was not even advertised until 1935!  Modern products are more sanitary and have their obvious advantages. As a family that has made the decision to start preparing to be self-sufficient should a crisis occur, the 'old fashioned' rag should only be considered a last resort. So if you're stocking modern conveniences like toilet paper, there really is no good reason not to stock feminine products for the women in your life.

It is expected that many if not most males likely think that all tampons or menstrual pads are the same. While the concept is obviously consistent across all brands, the shapes and sizes are not. For example, some brands of tampons are longer which contrasts with other brands that are shorter but 'flower' out to make a bowl shape when in use. A woman's body comes in different shapes and sizes thus most women will find a brand or style that works for them and stick with it. Not because of the name on the box, but because that product does the job effectively for that particular woman. There's significant peace of mind that comes with being comfortable that the product you are using will be effective and not leak. Especially if the Schumer hits the fan, we may not be able to wear a fresh set of clothes every day or have the convenience of washing our clothes often, so not leaking will be priceless to the women in your life not to mention more hygienic.

I imagine that some readers at this point may have the blank 'deer in headlights' look. So where do you start?
Ideally the females in the household are involved in family preparations or are open to discussions so you can simply ask what brands/sizes/amounts they use each month. However, some women are not comfortable discussing these things as would likely be encountered with a family that includes a teenage daughter who is more concerned with social media than the end of the world as we know it. If this is the case, you may need to resort to more covert ninja-like tactics to obtain the necessary information. Your best bet will be to tear the top off of a box of products that she currently uses and go buy that particular brand/style.

Most women use different sizes of products depending on the point in the cycle since the flow ramps up and then back down. When looking at the boxes that they use, note the larger of the products and focus on that size when stockpiling. It is always better to have too much absorption than too little regardless of the point in the cycle. The larger size will also aid with the speed at which the products are used since they will not need to be changed as often during the lighter part of the cycle.

During a quick Internet search, I found a study that said 70% of women in North America use tampons monthly and will use an average of 11,000 tampons in a lifetime. So naturally the next question should be, how many of a particular item do you need to store. If the lady is not willing to discuss this matter with you, just watch the boxes as they get used each month and you'll get an idea. Then do the math and add some padding (pun intended) to that number.

On average a woman has a 28 day menstrual cycle. She will be menstruating for 2-7 of those days and it is recommended to change the product every 4-8 hours. Again, every woman is different so just watch the usage of the products to get an idea.

If your family is on a budget and cannot afford the particular brand she uses to stock up on, then there are plenty of relatively inexpensive options at discount chain stores and also generic store brands. Any product will be better than no products when going to the store for a resupply is no longer an option. Make sure to check the big box stores and online retailers first for cost effectiveness. Like any item, watch for sales or coupons and stock up. If going the generic brand route, it would be best to have the woman test out the effectiveness of various store brands for reasons stated previously before making large purchases.

Keep in mind that while these products are paper based, their purpose is to absorb therefore they must be stored appropriately just like toilet paper or medical gauze. A cool dry place out of direct sunlight and humidity is required. If the products have become damp, it is best to just discard the products and replace.

The obvious problem with products such as menstrual pads and tampons is that they are disposable and the supply is finite. Therefore when the supply runs out, an old cloth may be the only option. There are, however, some alternatives to disposable pads/tampons.

Products exist that are reusable which are called menstrual cups. Menstrual cups are as old as modern applicator based tampons although they are not as popular. The most common menstrual cups on the market are medical grade and hypoallergenic silicone however latex cups do exist so those with sensitivity to latex should make note of the materials. These products have a suggested use-life of about 5-10 years and can hold significantly more liquid than a tampon so they do not need to be changed as often. When it is time to change them, simply boil to clean. Pretty easy. One of the most well known brands is the Diva Cup and you can buy them at most all grocery and drug stores. Menstrual cups do cost more than tampons or pads but since they are not one use/disposable they are more economical and pay for themselves after only a couple of months of usage. It needs to be noted that just like tampons, some women have good experiences with them while others find them uncomfortable. Some women even modify them by cutting off the extra 'stem'. A plan to go this route really requires that a woman would need to test out various brands for themselves to determine the comfort and preference before a SHTF event requires usage.

Further alternatives are noteworthy such as intrauterine devices (IUDs) that have time released progesterone which act as a long term (5-10 years depending on brand) birth control and has a common side effect of reducing or eliminating the monthly menstrual cycle. However these options are beyond the scope of this article and should only be considered after significant research and consultation with a medical professional as everything comes with potential negative side effects.

The best part of prepping for 'Aunt Flow' is that she will always visit the ladies in your life even if the Schumer never hits the fan so the products will not go to waste. And if you really want to score extra 'brownie points', don't forget the chocolate!

Friday, November 8, 2013

Have you been thinking about leaving the crowded city and moving to a retreat? Perhaps you are weighing many factors, finances, age, leaving friends and family, and work.  But the most important factor you should weigh, is the answer to the question, “If the SHTF, can we survive here?”  If the answer is no, then take the leap and move!  We did! 

We sold our San Diego house and finally landed in Washington state, on the west side of the Cascades.  We aimed for the Redoubt, but due to work constraints we could not make that work for us.  So, last November, we closed escrow on our new 20 acre retreat in the country with rich soil, good rainfall, and a good well. It is in a farming community. 

After jumping in with both feet, I will tell you up front that if your plan is to escape to a retreat at the last minute, I strongly urge you to reconsider.  There is a big learning curve to retreat living, mistakes to make and plans to rethink.  If there is anything you take away from this article, I want it to be that message:  you need to get established first and practice your new skills. For example, this past first year I had to learn the growing season of the area, the problems with tomato blight, how to drive a tractor without killing myself, what works for purifying our water and more.  Because TEOTWAWKI has not happened yet, I have had time to sort out and buy seeds that will actually grow in my microclimate.  And when I drove my tractor under a big limb with the roll bar up, and the limb came crashing down on my neck, I was still able go to the doctor to make sure I didn’t crack my vertebrae.  Yes, I learn some things the hard way, and I am trying to learn what I can now before there is no medical care.  Mistakes made now are salvageable for the most part.  They are not so salvageable after TEOTWAWKI.  Move to your retreat soon if you decide this is for you.  Learn your sustainability skills and practice, practice, practice!

This first year, my life activities were dictated by the seasonal changes.  Almost everything I did depended on what season it was, planting, harvesting, canning, etc.  Even my indoor activities, sewing my quilts, organizing my pantry, etc, were driven by rainy days when I didn’t need to be outside.  Please keep in mind, I lived in a city all of my life.  And where I came from, it was, “Rain?  What’s that?”  I have never had to cut my own firewood, grow my own food sustainably, raise chickens or drive the aforementioned tractor ever before.  My association with seasons had to do with what kind of holiday decorations to put up. This is a big change for my husband and me.

November and December were very rainy months when we were moving in.  My husband travels quite a bit, so I spent several of those first days alone in the new house watching the rain outside and asking myself, “What have we done?”  It takes a sense of adventure and a lot of faith to take a leap like this, and you may ask yourself the same question, but take heart, it gets better.  I met one set of neighbors fairly quickly when they dropped by to say hi, and with their help I organized a housewarming for the other neighbors.  They also introduced me to a good Bible church nearby.  I got to know pretty quickly who were going to be the reliable friends, who was knowledgeable about growing a garden and canning and who knew the most about what was going on in our valley.  We also spent the winter learning what needed to be improved for our situation.  We lacked a wood burning stove, and once we installed it we learned how much firewood we used month to month in the cold months.  This first year we had to buy firewood.  The wood burning stove does a great job keeping the house warm and I think it is more comfortable than central heat.  I spent a lot of time unpacking and organizing these two months and finding out what needed to be replaced.  I had already created a modest stockpile of food, largely in part from the LDS Cannery in Reno when we were living there temporarily. (See my previous SurvivalBlog article: Visits to a LDS Cannery.)  I inventoried our supplies and went into town to stock up on many other items.  Some of those purchases included new cooking utensils, and cast iron items like a dutch oven and griddle that would fit on top of the wood burning stove.  I cooked on it a couple of times with the dutch oven just to know I could do it if needed. Referring to my own lists, I stocked up on OTC meds, toiletries, batteries, toilet paper, extra heirloom seeds and many other items. I also used this time to start buying canning jars and lids, including some of the reusable Tattler lids.  My philosophy in buying these so early was that I didn’t know when the supply line could end, and by harvest season I would still need them.  I bought more canning jars on sale later when canning season came around in July and August. Shopping was something I could do in the winter and it helped me learn my way around.

We also looked at our water situation. Our well produces drinkable water IF you close your eyes and imagine it isn’t really orange and turbid.  So we considered a plan to purify it and again after a couple of mistakes, we went with a peroxide treatment, coupled with water softening and reverse osmosis for drinking. We decided to store extra peroxide and salt for the future.  If we run out, the water is still safe to drink and can also be filtered with our Katadyn filter if it becomes too objectionable. I will discuss our well and electricity later in this article.

In January, I contacted a local nursery and had a long conversation with their expert on orchards.  I knew the bare root planting season was approaching.  Many nurseries place their orders for the next year’s trees around November so I wanted to find out what varieties they were going to carry and what was recommended.  I ordered 55 fruit trees of several varieties, paying particular attention to what trees best pollinate each other. I ordered semi-dwarfs in five varieties of apples, two varieties each of pear, Asian pear, cherries and plums. One other reason for ordering different varieties has to do with crop lost due to freeze.  If some trees bloom slightly later or earlier and a freeze hits, you may have some blossoms spared and still get fruit.  I neatly laid out the orchard to have roughly 15 feet between trees running southeast and southwest, with about 22 feet (hypotenuse) north and south.  One of my neighbors owned a tractor with a post hole digger and volunteered to start the tree holes for us.   Simultaneously, he dug post holes for the new fence. The nursery also had organic compost which they dumped into the back of my truck.  Twice I brought home a load of compost for planting and shoveled it out of the back of the truck into the orchard.  Because these weren’t muscles I was practiced in using, I developed a repetitive motion injury on one arm.  That was the last of my shovel use for a couple of months and was glad I had medical care still.  Come February and March, my husband planted the trees and we threw in a few extra varieties from the home improvement store.  The trees from the nursery did grow in very well!  Some of the trees actually produced this year to our surprise. But the home improvement store varieties had some mortality. If I was doing it again, I would buy only nursery trees. The nursery trees appeared to be older, sturdier and more suited to our area and were worth the few extra dollars.   We also took the opportunity to plant a few walnut trees strategically to lessen the view of the house when they grow up and to provide a good source of Omega 3. 

In March, we installed a six foot tall, 7-wire electric fence around the orchard.  We chose this fence configuration due to it’s success in controlling deer and elk in numerous studies.  We installed wood posts in the corners of the orchard, and between corner posts we used non conductive fence posts.  Of the seven electrified strands on the fence, five are 12.5 gauge high tensile wire, and two are white Gallagher Turbo Poly Wire strands.  The white Poly Wire placed higher on the fence improves fence visibility, which we hope will reduce the chance of an animal trying to run through it.  All strands are charged by a Parmak Magnum 12 solar fence energizer.  The battery keeps the fence charged day and night, even after weeks of clouds and rain. We were told by a local to mix molasses and peanut butter and put it on the fence to train the deer about the electricity.   Thus far, it has been 100 percent effective, and we have been able to keep out the two legged creatures as well, though I suspect in TEOTWAWKI this would not be much of a deterrent. 

April was the month for chickens, garden and a tractor.  Let’s start with the newly purchased tractor.  When it was delivered, we were taught how to operate it and I insisted on being the first to drive it!  With the instructor there, I took off with it around the yard with the brush hog going and had a little fun with it.  It was helpful to have him there to ask questions.  My husband got his turn and the rep left.  I pretty much took it as my job to use the tractor when something needed to be done as my husband isn’t always home.  For the most part, I did pretty well with it mowing around the house and in the orchard between the trees. Then there were two incidences that put a dent in my confidence.  The first incident was with the tree limb I already mentioned.  The latest incident involved me destroying the engine of the tractor.  I was removing fence posts with the bucket and mowing along side the road where the new electric fence is going for next years cattle.  I missed pulling one of the posts and not seeing it, I ran the tractor up on that post.  It went through the radiator and the oil filter.  Although I stopped the tractor after getting it off the fence post, the sudden loss of oil and coolant quickly overheated the engine and resulted in it needing a complete engine replacement.  I am lucky we bought tractor insurance, and TEOTWAWKI has not happened and I can recover from my mistake.  But I will say again, if you are planning to go to a retreat after SHTF, then you will not have the luxury of insurance or doctors being there for you while you learn from mistakes.  If you were already at your retreat, you could be learning these lessons now, not later.  My lessons learned about tractors:  (1) put the roll bar down to drive under trees, or cut the lower branches on trees, or do not mow under trees at all. (2) Back into tall weed areas with the brush hog, don’t drive over those tall weed areas engine first in case there’s something you can’t see (3) tractor tires have better traction going forward than backwards because of the [tread] design of the tires (4) wear a hard hat and hearing protection (5) don’t drive into a steep area sideways if you don’t want to roll your tractor (6) insurance can be a wonderful thing for your tractor! Yes, I will get on the tractor again, but with some added knowledge on tractor safety.  But, if you see me driving the tractor, you still might want to stand clear!

Late April, I also picked up my first chickens.  I had placed an order with a fellow who was a specialized breeder and was starting to think he wasn’t going to come through with the order.  So, I grabbed some different varieties at a co-op we had joined.  The co-ops here typically carry chicks until the end of April and I was afraid I would lose my opportunity to get chicks this year. Ok, you can laugh, I had the chicks inside in a box in a spare bedroom.  I didn’t have my coop set up yet and had to keep them warm, too.  The home improvement store sold me a shed which was constructed on our land, but I laid vinyl and my husband insulated it and finished it off inside.  He cut a small chicken sized door to the outside, where I had built the cage part of their coop with a screen door.  As my chickens got bigger, I was happy to get them out of the house.  I moved them into the coop and placed wood chips on the floor which I change out regularly.  Then I got a call from the breeder and now he had chickens for me.  It was too many chickens, but since I like to hold up my end of the bargain, I took them. Many of them were roosters, so I learned how to butcher a chicken as they got older.   If you are not too keen on butchering a lot of roosters, you may want to buy only the chickens you need from the co-op. Usually the co-op sells pullets (the females) but most likely you will get a rooster or two in the mix.  I will not go into methods of killing chickens, I’m still a little sensitive about that experience. But, for removing feathers without messing up the skin (after they are dead, of course), dunking them about four times in hot water at about 160 degrees F seemed to work best for me.  I butchered a total of eleven roosters and now have that skill in my repertoire.  What is left is what I consider a healthy number of chickens for my setup.  I have heard that you need about 4 square feet per chicken, which proved about right for me.  I do not free range my chickens because I want to protect them from predators and know where they are laying their eggs.  I’ve set aside extra food for them now that they are on a laying feed.  I have two roosters that get along well with each other in addition to my 13 hens.  One problem I nipped in the bud pretty quickly was some periodic aggression by both roosters towards me.  Each time, I grabbed the offending rooster and held him upside down by his legs for awhile to show him who’s boss.  Neither rooster attacks me anymore.

Let’s talk about the garden:  I count it a huge success to have just started a garden this year. Early April, I had started some seeds inside for transplanting into the garden.  Another neighbor came by with a tiller and cut an area 40 by 100 feet, where I had laid out tarps in advance to presumably kill the vegetation.  This was going to be the size of my garden.  We did a second tilling at the end of April. Early May, I started putting in my garden.  I planted a few rows a day and had most of the garden planted.

Then everything came to a screeching stop.

With all the recent talk about appendicitis on SurvivalBlog, my poor 56 year-old husband came down with it!  All the while, I kept thanking God for letting it happen when it wasn’t TEOTWAWKI and he wasn’t traveling. It was a very scary experience as his appendix had become gangrenous, and after surgery he was on IV antibiotics for several days.  I was terribly scared I would lose him. He is normally a very healthy, fit man.  He recovered more slowly than we anticipated, in part to his inability to sit still and rest. It was the first time I had faced the prospect of losing my husband and it still rattles me.  It also brought me to thinking about how absolutely difficult it would be to continue the work we were doing without him especially in TEOTWAWKI.

The days sitting in the hospital and then caring for him at home, the garden weeds got further ahead of me and some of my planted vegetables disappeared underneath them. The weeds looked just like the beets and spinach that was mixed in there. I didn’t fight the weeds too hard; victory was theirs.  But, I still decided to call my garden a success.  It was a big accomplishment to start a garden and have an area dug up for future gardens. I used heirloom seeds and was able to collect some seeds from the plants at the end of the season.  I did get food out of it, including green beans, cabbage, squash, corn and potatoes.  I had enough green beans for several canning sessions, and dug enough potatoes for my back to hurt.  The potatoes have gone into root storage as I have a chilly basement. I froze plenty of corn. It wasn’t the prettiest of gardens, but yes, I am calling it a success.

So in July, August and September, I did lots of canning.  Remember the big orchard we planted?  Well, we discovered we already had several mature fruit trees on the property! Surprise!  Apples, pears and plums came in and along with the garden vegetables, I was canning a lot.  I have a friend here who has canned for years, who was also gracious enough to give me lessons and recipes.  I found two canning books helpful, the Ball Blue Book of Preserving, and Canning for a New Generation. The latter has some wonderful recipes (spiced pears!) Yes, this is my first year canning, too. I made sauerkraut from my cabbage, adding caraway seed to it when I transferred it to canning jars.   Learning to can has probably been the most valuable part of the year for me.  Why?  Not only have I learned how to preserve my harvest for the winter months, but in practicing it I have learned what my husband and I actually like to eat and store more of the extra ingredients needed for those recipes.  For instance, the spiced pear recipe we like uses whole cloves and whole cinnamon sticks, so I have stored more of those.  If you are planning to can food in TEOTWAWKI, wouldn’t you like to know what really tastes good and works for you?  Some people have a very common genetic trait called “geographic tongue” that makes them extra sensitive to acidic foods like pickles canned in vinegar.  Is someone in your family sensitive to hot, spicy or acidic foods? Practicing your canning now will help you to sort out preferences and store the right ingredients.

In June, I purchased a Dakota Alert system that would monitor four areas and placed the monitors around the property at access points.  I know when someone is approaching the house, and sometimes know when the deer are going through an access point.  I do not get too concerned at every alert right now and familiarization with the alert may have desensitized me somewhat for when it goes off.  I know the time may come when I will need to seriously heed every alert I receive.

It’s now the first of November.  Hunting season is in swing in our locale and I am looking for that extra meat to put away.  As I am still learning the area and not up to speed on how to hunt this location, it is yet another thing I have to learn.  The deer that used to wander into our yard previously seem to know I am ready for them.  A successful hunt will mark the end of our self-reliance cycle for this year.  I was fortunate to have experience in hunting and butchering before the move.

So to continue about our water and power, this is not a complete project yet.  On a vacation to a jungle lodge a few years back, we noticed they ran their generator two hours a day to do their essential tasks.  Then the remainder of the time, the batteries supplied power to lights and a water pump.  We decided we would like to run a generator on one hour a day or less. During that time, we could run a washer, charge batteries and refill our home water tank.  We are on liquid propane for some appliances (stove top and oven, dryer), but a small electric current is needed as part of the operation as well.  So, we calculated the loads for our essential items, and bought a generator that will accommodate those loads while providing a charge to a battery bank.  Obviously, we think our water supply is the most critical.  We get our water from a well, which pumps it to a 300 gallon water storage tank in our basement.  From there it is pumped to our house fixtures by a 240 volt Gould pump.  Without AC power, we have no water.  We watched the National Geographic movie “Blackout” earlier this week, and it was ironic that we lost our power only minutes after the movie ended, but only for about an hour.  During that time, there was some remaining water pressure in the lines, but not enough to take a shower or flush a toilet.  So in addition to the generator, inverter and deep cycle batteries, we ordered an RV water pump (powered by a deep cycle battery) and are installing it in parallel with our main house water pump.  It is a fairly simple installation, but it required adding a one way valve on the output of the house water pump to prevent back flow.  This should give us water 24 hours a day. Based on a fuel flow chart for our generator, at roughly a gallon an hour for a full load, in 365 days we can go almost a year on our 364 gallon diesel tank, if it is full.  We try to run through the fuel to keep it fresh and keep some Pri-D in it to help preserve it. Once we have our set up complete, it will be tested with others in our group to see how this works and how we can trim back use of the generator.  If during that one hour a day, tasks are assigned to start the washer, cook a meal, take showers, operate a power tool, etc. then that’s not too bad.  Perhaps we can trim the electric chores to 45 minutes a day, or even 30 minutes a day with some good choreography.  I have timed the washer cycles and can wash a speed load in 28 minutes.  A wood drying rack in the same room as my wood stove does an excellent job of drying garments.  Who knows?  With some adjustments, and the addition of solar panels to help charge our inverter batteries, we may be able to go 2 or more days between operating the generator and stretch a tank of diesel for two years. Practice will tell us what works and what needs fixing. Once fuel runs out, we can still hand wash clothes, filter water, etc.  Some fuel will be retained for the tractor use and we are considering a second diesel tank. We will be working on a rainwater collection system later on and buying a hand pump for the well.

A note for the women:  I spent many years in a nontraditional job hearing how “a woman can’t do this”and “a woman can’t do that”.  If you hear it enough times it becomes easier to believe and as a result, we may not try to do certain tasks.  Yes, we may not be as strong as a man overall, but we know how to work smarter, not harder.  Think about this:  if your husband dies before or during TEOTWAWKI and it is up to you and only you, do you think it would have been beneficial to try some of those “man” things while he was still alive just to learn how to do it? I took this as my challenge this year to step up and try those things my husband would typically do.  I decided this year to use the chainsaws, use the log splitter, work with the tractor, run wire for the electric fence, and build the chicken cage and other things.  Trust me, I am married to a talented man who makes those chores look easy and he could do it all. But after his appendectomy, I kept thinking, ‘What if?”  I know I did the best I could this year and I challenge you to do the same especially if you have youngsters who depend on you should their Dad pass away.  In addition, this year I made a point of also practicing my shooting.  I focused more on my pistol, and practiced drawing, double taps and quick clip changes.  I had taken a few lessons from an NRA instructor the previous year but I was rusty. Gals, it is worth the money to pay for a good shooting instructor.  Some instructors will let you try their different guns out to for you to see what you like.  If you haven’t already, find that favorite gun you want to carry and get some lessons in using it. Go talk to the guys behind the gun counter and take some notes.  I went with a H&K .40 S&W, one of the more recent ones that had a grip that could be downsized for my hands, and a Black Hawk CQC holster made of carbon composite.  The holster doesn’t have the friction that a leather one does on draw, and this worked better for me.  Find a gun and holster that works for you, then practice.  Try a few “hips and head” shots while practicing, in case you encounter a target wearing a bulletproof vest.  While there are many good men out there who can protect a woman, they can’t always be there.  Take some of that responsibility on yourself.  A gun is a great equalizer!

You already know that it’s important to stay up on medical and dental care.   Get caught up on health issues before moving to a new retreat.  In some places it takes up to two months to get set up with new dentists and doctors, and if one doesn’t seem like a good fit, it takes more time to switch doctors.  I had to play catch up after I moved to get a delayed root canal done.  Right, no one wants to get one but it sure was a relief to have it out of the way.  I should have done it back in San Diego.  As just a side thought, if you still have your appendix and you are scheduled for another abdominal surgery, you might ask your doctor if they could go ahead and pull that appendix for you.  I was able to get my doctor to do this for me a few years back.  I think they wanted the practice for their residents and you might have a better chance getting this done at a training hospital!  Another decision I made a few years back was to have a cardiac ablation versus going on pills for an otherwise unmanageable arrhythmia.  What if I couldn’t get pills anymore?  Not fun, but glad I did it.  You have to decide for yourself.

Final advice:  If you have decided to move to a retreat, do it now.  It took a year of retreat living to get the seasonal flow of country life.  These are only the first lessons of self reliance.  My new neighbors have been a wonderful resource for me.  Should you find yourself equally blessed with good neighbors that are willing to teach you useful self reliance skills, open your ears and close your mouth. There is much to learn and practice, and you will be making edits along the way.  We are still editing and still have more to do.  Once TEOTWAWKI happens, there will be no “do over’s” in planning.

We took the leap and we like it!  We certainly pay less in taxes and in some states you can get a reduction in property taxes by operating your retreat as a farm.  Though our bodies hurt here and there, our hearts are happy in this beautiful valley.  Goodbye city life!  Green Acres we are there!

Tuesday, November 5, 2013

If the nation’s infrastructure should crumble at TEOTWAWKI more than two centuries of medical advances in immunology will go down with it. The loss of the power grid in a massive solar flare or EMP will eliminate our capacity to make vaccines that protect us against serious, often fatal illnesses. The physicians who survive will face infectious diseases that they have never seen because they have been eliminated by vaccines.

Survivalblog readers are aware of the need to stock up on beans, Band-Aids and bullets but it is vital to acquire a supply of immune substances within the body. We may eventually run out of the three Bs but the protection provided by vaccines can last for years, perhaps a lifetime.

A SHTF scenario can take many forms, will probably affect various parts of the globe differently and the degree of recovery will depend on factors that are at present unpredictable. An example of how it might affect a vaccine-preventable disease occurred when the Soviet Union collapsed in 1991. Some regions of that country have always suffered from health standards that are quite low compared to most Western nations. Diphtheria, a disease that has been virtually absent in the United States since the middle of the 20th century was not unknown in the USSR. There were 839 cases of diphtheria reported there in 1989, two years before the implosion of the communist way of life. When the country fell apart so did their public health system. There were no funds for vaccines, including the one for diphtheria. The bacteria that cause diphtheria are always circulating within the population. The vaccine – the D in the DPT vaccine that children usually receive during the first 6 months of life – protects against a toxin produced by the germ and has no effect on the bacterium itself. As the unimmunized population grew so did the incidence of diphtheria. In 1994 50,000 persons developed the disease and 1,700 died. By the time a massive immunization program brought the epidemic under control more than 157,000 cases had been recorded and more than 5,000 persons died. Those numbers may not have told the whole story, since record-keeping also suffered during the years that followed the collapse.

This example explains why immunizations must continue even when the diseases that they protect us against have been nearly eliminated. Nearly is the key word. With the exception of smallpox, every other vaccine-controlled virus or bacterium lurks within every population group on the planet, suppressed but not eliminated. In order to maintain low levels of disease it is necessary to immunize 85 or 90 percent of the population. This is known as herd immunity, wherein there are so few susceptible individuals that outbreaks of disease are unlikely. At TEOTWAWKI herd immunity will diminish rapidly and the diseases that our great-grandparents feared will return in epidemic form. To put this in perspective the list below shows the average number of cases that occurred every year in the United States prior to the vaccine for that disease and the number that occurred annually within approximately five years after a vaccine’s introduction.

Pre-vaccine                             Disease                                               Post-vaccine

48,000                                       Smallpox                                                     0
175,000                                    Diphtheria                                                    2
16,000                                      Paralytic polio                                             0
500,000                                    Measles                                                     116*
150,000                                    Mumps                                                     266*
48,000                                       Rubella (German measles)                       23*
800                                            Congenital rubella                                        3*
20,000                                       Hemophilus meningitis, epiglottitis       181
150,000                                    Pertussis (Whooping cough)                    7,500

* - Many of these victims came here from countries with low immunization rates. Some belong to communities that do not immunize children based on religious beliefs. A growing number represents children of parents who refuse immunization.

A graph originally from the Centers for Disease Control and Prevention web site shows the dramatic decline in the incidence of measles that followed introduction of an effective measles vaccine. Nearly identical declines have followed for vaccines such as mumps, rubella, polio and Hemophilus.

There was a surprising surge in the incidence of measles during the period 1989-1991. Subsequent analysis revealed that nearly half of the cases were in preschool children and that vaccine coverage was low in this group. Ninety percent of victims that died had not received the measles vaccine. There was an increased susceptibility among infants below the age of one year who were born to mothers whose immunity occurred from having received the measles vaccine, not natural infection.

Infants who are born to mothers who have experienced natural measles receive protective antibody through the placenta and they are relatively immune to the disease for about one year. That’s why children do not receive the MMR (Measles-Mumps-Rubella) vaccine until they reach the age of 12 to 15 months. If the vaccine is given before maternally-derived antibody has fallen to very low levels, the vaccine will not “take.” However, women who were born before the introduction of the measles vaccine in 1963, and therefore might have had measles, are almost all beyond childbearing age. Just about all mothers who give birth today have had the measles vaccine, not the natural disease, and their infants do not have year-long immunity. If an outbreak of measles were to occur today, pediatricians are encouraged to give the MMR vaccine to children older than 9 months or even earlier. That option will not be available when the SHTF and no vaccine is available.

There are several reasons for the seemingly high number of victims of pertussis even though a vaccine is available. The responsible organism maintains a constant reservoir within the community. The illness that it causes in adults resembles bronchitis and it is not recognized as whooping cough. Infected adults can spread the disease to very young infants whose immunity is poor. That lack of immunity is partly because their mothers have never had the disease and cannot transmit protection across the placenta or via breast milk. Although immunization for pertussis begins at about 6 weeks the vaccine does not confer protection until at least two, usually three doses have been given. Unfortunately, infants under the age of one year develop the characteristic illness known as whooping cough. Although the mortality rate is low, about 1 percent, the disease is agonizingly painful and often causes seizures.  

A disaster that takes down the grid for a prolonged period will have a severe effect on vaccine production, distribution and administration. Each of these elements will be affected by loss of the cold chain when refrigeration systems are no longer operable. It is the unreliability of the cold chain that challenges immunization programs in the developing world.

Making a vaccine is impossible without refrigeration and freezer capability. Many vaccines must be held at low temperatures from the final step of manufacture throughout the delivery to destination clinics or physicians’ offices. Even recently there have been instances of vaccine failure because vaccines were stored in areas of a refrigerator such as a door shelf, where the difference of only a few degrees eliminated their potency. Vaccines that are now being stored in refrigerators and freezers of pharmaceutical warehouses and pharmacies will become worthless when the grid goes down and backup generators run out of fuel.

Nature provides the most effective vaccines but they come at a frightful price. Those who survived smallpox never had to fear the disease again but 30 percent of its victims did not survive. Smallpox was eradicated from the planet because late in the 18th century an astute physician overheard dairymaids comment that they were unafraid of contracting smallpox because they had developed cowpox in the course of their milking chores. Edward Jenner inoculated fluid from cowpox lesions into the skin of his gardener’s son. The child did not become ill upon later inoculation with fluid taken from a smallpox victim.

Sometimes nature’s vaccines are gentle. During outbreaks of paralytic polio in the first half of the 20th century physicians noted that the disease affected children of the wealthy at higher rates than children of the poorer classes. Sanitation among the latter was often marginal and allowed exposure to germs within human waste. These included viruses that were similar to the poliovirus but that caused only mild illness, if any. Infection with these sewage-borne enteroviruses stimulated the production of antibodies that could block infection with the related poliovirus.

Vaccination causes an artificial disease that is mild or without any symptoms at all but protection from subsequent exposure to the natural disease may not last for a lifetime. For various reasons the antibodies that develop after vaccination gradually decline, making it necessary to give one or more booster doses. For instance, boosters are recommended for all the disease noted in the comparison table above. (Hemophilus may be an exception but it is a relatively new vaccine. Healthy adults rarely develop meningitis or other life-threatening diseases caused by Hemophilus.)  Childhood immunization against diphtheria and tetanus can last for many decades but persons over the age of 50 should have a booster shot. As in the post-collapse Soviet Union, diphtheria may become widespread in TEOTWAWKI. Tetanus will be a greater threat when survivors return to an agrarian lifestyle. The dreaded “lockjaw” will become more common than it is today and there will be no treatment.

There is a little good news for persons who have been immunized prior to the loss of vaccines in the future. Later exposure to a wild virus during TEOTWAWKI may provide nature’s own booster effect. This phenomenon has not been studied extensively and will not apply to every microorganism. It’s another compelling reason, however, to take advantage of all the opportunities for immunization that are available. Even if a vaccine does not completely prevent disease, which occurs in about half the patients who receive the shingles (zoster) vaccine for example, the subsequent illness is milder and is much less likely to produce severe complications.

Some vaccines do provide lifelong protection. Hepatitis A is a disease that is usually food borne and that will likely increase when municipal sanitation facilities decline or fail in TEOTWAWKI. The incidence of hepatitis B is not likely to increase and may even decline when drug addicts, its common victims, no longer have access to intravenous narcotics. There is no vaccine for hepatitis C. Twinrix® is a vaccine that protects against both hepatitis A and hepatitis B but it requires three doses over a 6-month period. It has virtually no side effects and provides nearly 100 percent protection that will likely last a lifetime. TEOTWAWKI might occur at any time, so don’t delay getting this vaccine. You might not have 6 months to become fully protected.

Most vaccines have side effects but these are so inconsequential compared to the real disease that fear of some kind of reaction is not justified. All vaccines are delivered via a needle. (Oral poliovirus is no longer used in the U.S. because of the occasional occurrence of vaccine-associated paralytic poliomyelitis. The intranasal influenza virus is limited to certain age groups.) Needles obviously can hurt and when even a small amount of fluid is injected into muscle or into the tissue beneath the skin it’s likely that there will be a little pain. The good news is that needle technology has become so sophisticated that sometimes there is no sensation of needle entry at all.

One cannot discuss the subject of childhood immunizations without addressing the issue of vaccine-related autism. Autism Spectrum Disorder affects thousands of children and there is as yet no established cause. More than a dozen studies have shown that there is no connection between vaccines and autism but the fear persists. Much of this is because of Dr. Andrew Wakefield, an English physician whose research on the subject has been declared fraudulent. His published paper was retracted by the journal in which it was published and the British Medical Society has revoked his medical license. He has emigrated to the United States where he continues to promote his theory.

This article is not the proper venue to defend or deny Wakefield’s assertions but there are a couple of points about autism that should be considered.

Childhood vaccines have not contained thimerosol (ethyl mercury), the alleged cause of autism, for more than a decade but the incidence of Autism Spectrum Disorder continues to rise. When Japanese and English parents, fearful of autism, stopped vaccinating their children, diseases such as measles, mumps and pertussis skyrocketed even as the incidence of autism did not slow down but continued to rise. In 1974 there were more than 100,000 cases of pertussis in the United Kingdom. There were 13,000 cases of pertussis in Japan in 1979 and 14 children died. When TEOTWAWKI arrives these effects will be multiplied many fold.

Autism is a terrible affliction but pediatricians like me who have watched the agony of a child suffering from pertussis for a month or more, with multiple episodes of severe breathing difficulty, choking, seizures and finally dying of the disease prefer to look at the benefits of immunizations, not their relatively infrequent and rarely fatal side effects.

Notwithstanding the low incidence of serious problems associated with current vaccines there have been some devastating tragedies directly related to childhood immunization. With modern technology it’s not likely that any of these will ever happen again. I include them for historical perspective. My concern is that in the recovery from TEOTWAWKI the processes for vaccine production will not meet the standards of today, and tragedies like these might occur again.

In 1928, poor quality control resulted in contamination of a batch of diphtheria vaccine with Staphylococcus aureus bacteria and 10 children died. There were no antibiotics in the 1920s and some or all of these children might have survived with penicillin treatment. There will be few or no antibiotics in the years after the SHTF.

In 1930 in what has become known as The Lubeck Disaster a virulent strain of tuberculosis contaminated a batch of tuberculosis vaccine. Of more than 200 infants who developed tuberculosis, all less than 10 days of age, 72 died.

Sometimes administering a vaccine has a terrible outcome because the recipient unknowingly has a serious immune deficiency. When smallpox vaccination was routine, immunodeficient children sometimes died when the usually benign vaccine virus overwhelmed them.

Many older readers of SurvivalBlog will recall the Cutter incident of 1955. Cutter Laboratories, a manufacturer of Salk polio vaccine produced a quantity of virus that had not been adequately inactivated. More than 200 children developed paralytic poliomyelitis either directly or from exposure to an infected sibling or playmate. There were 10 deaths.

When a child develops a high fever, seizures, a skin rash or other complication of vaccination there is something that is overlooked. It’s possible that such a severe reaction is an indicator of susceptibility. In other words, if the child had been infected by the wild form of the germ, he or she might have been one of the unfortunate fatalities. A vaccine side effect may reveal who might have been a victim, not a survivor. Perhaps that will be some small consolation to parents who have had to watch their child experience a vaccine-related illness.

As our population ages more of us are losing the immunity that we received either from natural infection or from vaccines. As noted earlier, persons over the age of 50 should receive tetanus and diphtheria boosters. Everyone over the age of 65 should receive the pneumonia (pneumococcus) vaccine because the risk of invasive disease is high among seniors, especially those with a history of smoking or asthma. Boosters at this age will give truly lifelong protection.

The influenza virus kills tens of thousands of people, mostly the elderly, every year. The virus is peculiar in that it undergoes frequent genetic transformation. Adequate protection requires a dose of vaccine every year that is designed for the virus du jour – or perhaps de l’année if my French is correct. It’s extremely important to note that perhaps as many as half of influenza-related deaths are not due to the virus itself but to secondary infection with bacteria such as Staphylococcus aureus. That germ is particularly dangerous to victims of influenza for two reasons. It is a common cause of hospital-acquired infections and current strains are often resistant to most antibiotics. Persons who have received the influenza vaccine are very unlikely to have severe disease if they become infected. They will avoid hospitalization and thus will not be exposed to bacteria that take the lives of nearly 100,000 persons every year.

At this point some readers are thinking “The influenza vaccine gave me the flu.” That’s a common perception and it’s easy to see why, even though it’s not correct. First, the vaccine contains only killed virus, except for one live-virus vaccine that is not the most common one in use. The injection causes a little soreness and sometimes a low-grade fever but nothing else. Some older readers may recall becoming quite ill from vaccines that were used in the 1950s and 1960s. These were what I call “dirty” vaccines whose production was not as refined as today’s methods. They didn’t cause influenza but they certainly made people miserable.

Second, illnesses that are labeled influenza are often caused by other viruses. There are hundreds of candidates and many of them produce the cough, fever, chills, headache and muscle aches that occur in influenza. There are several strains of influenza virus and they produce a wide variety of symptoms, sometimes involving the gastrointestinal tract or nervous system. Only laboratory testing provides an accurate diagnosis.

Another reason for the misperception is that most people wait until an outbreak has been in progress for a few weeks before getting the vaccine. While sitting in the doctor’s waiting room among patients who really do have the flu they are inhaling the virus from the person alongside them. The incubation period of influenza is much shorter than the time the vaccine recipient needs to form protective antibody, so symptoms begin before immunity kicks in.

Bioterrorism is a prospective factor in TEOTWAWKI but it’s not as much of a threat as an EMP or worldwide financial collapse. Even sophisticated bioweapons delivery systems are likely to cause problems in relatively small regions, not globally. Anthrax incidents, though serious and sometimes fatal, are examples. Smallpox is a fearsome threat but the disease is easily identified and we have vaccines and antiviral agents that can limit the damage. Food supplies and water reservoirs are potential targets for bioterrorists but barring destruction of the grid such contamination can be identified and managed.

A worldwide pandemic of influenza or some new infectious disease is always a threat but we have learned a great deal from outbreaks of SARS, avian influenza, Ebola virus and others.

The best recommendation that we can make is to keep your vaccine status up to date. These biological materials are not cheap but it’s possible for anyone at any age to build up their immunity to the maximum possible for less than the cost of most handguns.

There will never be a perfect vaccine and some persons will be the unfortunate victims of a serious complication. To help keep things in perspective, more Americans die in a single week in motorcycle accidents, (average: 80) than die in a year from vaccines. Antivaccine groups will dispute this but history tells us otherwise.

About the author: Philip J. Goscienski, M.D. is a retired pediatric infectious diseases specialist and the author of Health Secrets of the Stone Age, Better Life Publishers, 2005. He has archived more than 425 of his weekly newspaper columns, The Stone Age Doc, at

Wednesday, October 23, 2013

Parasites effect a vast number of the world’s population, and they are seen as directly decreasing the productivity of people, and increasing the morbidity/mortality of affected persons.  I have witnessed numerous children afflicted with taeniasis (tapeworm), ascariasis (roundworm), and giardiasis while on a medical mission trip to a remote region in Peru.  The burden of parasitic infections in these children was immense and contributed to stunted growth, fatigue, and likely cognitive delays.  Though in North America we typically do not worry about parasitic diseases, this is only a recent phenomenon that has occurred in the past 60 to 80 years.  Parasites still do exist in the U.S. and they are still significant enough of a threat that the Centers for Disease Control (CDC) collects data/asks for mandatory reporting for many parasitic infections.  As such, parasitic diseases should be part of everyone’s medical threat assessment.                   

Parasitic diseases once believed to be suppressed or on the verge of eradication seem to be re-emerging over the past several decades, this is attributable in part, to increased world travel, declining living/hygiene standards, deteriorating infrastructure, increasing population densities of cities, and an increased resistance to treatment/preventative measures (i.e. malaria).  Though this article does not delve into all parasitic diseases, it does delve into the more common and some of the more potentially serious parasitic diseases.  It will specifically look at those diseases that have a higher likelihood of affecting individuals living in the U.S. This includes those parasites that are considered eradicated/have a minimal disease burden, but that may once again cause issues due to a lack of preventative measures, or a failure of the health-care system in stemming an outbreak.  Prevention, parasitic identification methods (clinical, basic microscopy), and treatment will be discussed for informational purposes only.  Any epidemiological statistics/historical information presented in this article are taken from the CDC web site and are in the public domain.  Methods on obtaining specimens and slide preparation/staining techniques are summarized from the book “Medical parasitology, a self instructional Text” by Leventhal and Cheadle.  The full reference is available at the end of this article.

In the interest of full disclosure I am a health care provider with training in parasitology to include the basic microscopy methods and various treatment modalities mentioned in this article.  If you are experiencing any of the below mentioned symptoms, or suspect that you or another individual has a parasitic infection you should discuss any diagnostic testing and possible treatment plans with a trained and licensed medical provider.    If you are interested in the study of parasites I recommend a course at a local university that also has a laboratory/practical component where you can better learn to identify parasites and become proficient in specimen staining/slide specimen preparation techniques that are beyond the scope of this article.  I strongly encourage the use of proper personal protective equipment when dealing with suspected parasites, and certainly when dealing with bodily fluids to include gloves, gown/lab coat.  Hand hygiene should always be performed after handling specimens. 

Parasitic Intestinal Infections

Intestinal Protozoal Infections

Some of the more common parasites affecting the intestines belong to a type of organism classified as protozoa.  Protozoa are large single celled organisms with cellular machinery much like our own human cells and are unlike any type of bacteria.  The first protozoan to be discussed is Entamoeba histolytica, which causes amoebic dysentery (bloody diarrhea).  This organism has a worldwide distribution though it is more common in Central/South America, Africa, and developing portions of Asia (though I have seen it occur from drinking contaminated stream water/handling contaminated food in the U.S.).  Infections occur with the ingestion of contaminated (with fecal matter) food or water.   Symptoms may include bloody diarrhea, diarrhea without blood, weight loss, possible fever, and generalized versus right upper quadrant abdominal pain (indicating possible liver involvement).  Patients many times present with a history of diarrhea that has been ongoing for a week or longer, and have a history of traveling to areas that are known to have an increased incidence of infections, or possibly drinking untreated water while hiking.  Treatment other than rehydration therapy may be started empirically if the patient has dysentery/inflammatory diarrhea (bloody diarrhea with abdominal pain).  I would begin empirical treatment with an anti-protozoal/clostridium difficile agent such as metronidazole.  Also, if treating empirically for inflammatory diarrhea (bloody diarrhea), it would be advisable to also give ciprofloxacin to treat for any type of pathogenic e-coli strains or salmonella.  The differential diagnosis considerations are vast and beyond the scope of this article, but would include:  Diverticulitis, ulcerative colitis, other infectious diarrheal organism, and cancer.  If a compound light microscope with an oil immersion lens (up to at least 900 power) was available you would have the potential to perform an iodine stain of a stool sample and prepare a “wet mount” of fresh fecal matter to examine a patient’s feces for any evidence of a protozoal infection. 

Preparing a “wet mount” and Iodine staining procedure:

1.  Add 1 gram potassium iodine and 1.5 grams powdered iodine crystals to 100mL of distilled water and shake vigorously until dissolved in solution.  Conversely, you can also purchase Lugol’s iodine stain from a veterinary supplier. 

2.  Using an applicator stick mix a small amount of feces with a drop of saline solution on a microscope slide and apply a cover slip over it.  The specimen/fluid should not run out from under the cover-slip and should be opaque enough to see through it. 
3.  Systematically examine the slide moving from low power to a high power oil immersion lens (using mineral oil) and pay particular attention for any movement from flagellates/amoeba.  Ensure that your light source is dim enough for you to discern any movement and to not wash out your field of view as there is little contrast in an unstained/saline only slide.
4.  Prepare another slide and instead of using saline add a small drop of your prepared iodine solution.  Again systematically examine the slide moving from low power to a high power oil immersion lens .

If Entamoeba histolytica is present you may see movement on the saline slide (as with many protozoal infections).  However, if it the amoeba is present on the slide prepared with the iodine stain then you are likely not to see any movement as the iodine will kill the protozoan, but you will see larger spherical to oval shaped objects typically with greater than 3-4 nucleii readily identifiable and asymmetric in appearance (smaller/darker spheres contained within the larger spherical/oval shape).  

Another intestinal protozoan known as Giardia lamblia causes what is known as “traveler’s diarrhea” and is colloquially known as “Montezuma’s revenge.”  This parasite is one of the most common parasitic infections in North America.  It is found world-wide and is again more prevalent in developing countries.  It is spread via the fecal oral route by contaminated food/water and is endemic to numerous mammals in North America.  Hence, drinking untreated fresh water places you at risk for developing giardiasis.  Interestingly, in 2010 the CDC reported that the highest incidence of infection occurred in Vermont and not in any of the southern border states.  Generally, patients presenting with giardiasis complain of sudden onset of diarrhea that is initially watery, without any mucous/gross blood. They may describe their stools as greasy and extremely foul smelling.  The patient also commonly complains of belching (burping) a sulfuric smell, and extraordinary foul smelling flatus (farts) as well as abdominal bloating and cramping.  The patient commonly states that symptoms worsen after they eat.  Patients may also have a history of traveling to areas that are known to be higher risk, or possibly drinking untreated fresh water.   Generally the diarrhea can be quite debilitating and may require oral and even IV rehydration therapy.  Many times individuals can recover from giardiasis with oral rehydration therapy and develop subsequent resistance to this parasite.  However, if a patient presented with the above symptoms, I would recommend empiric treatment with the anti-protozoal agent metronidazole as there are risks of developing complications secondary to the infection.  Also, the risk of others becoming incapacitated with giardiasis that live in close proximity to an infected patient is very high.  Though the differential diagnoses again are numerous, in my experience giardiasis generally presents as rather clear cut.   Patients typically present nearly textbook with the above symptoms and usually have a history of traveling to a high risk area. 

A compound light microscope can again be used to help identify if Giardia lamblia is present in a patient’s stool using the procedure listed above to include performing wet mounts with both saline and iodine staining solution.  Typically, with a saline wet mount using high power (oil immersion microscope lens) the organism is easily identifiable by how it moves as it is a flagellate.  It’s movement is best described as moving like a “falling leaf” on the slide.  When viewing the specimen that is stained with iodine typically the nucleii are readily apparent and the parasite has either a tear drop shape with an appearance like that of an owl’s face (the nucleii being the eyes), or it is oval with 2 sets of nucleii (total of 4) that that are symmetrical.  In both cases the nucleii look like symmetrical pairs of eyes staring back at you. 

Intestinal Worm Infections

There are numerous types of intestinal worm infections.  However, only the most common ones/higher potential to be seen in North America will be discussed.  They include:  Taenia Solium (pork tapeworm)/Taenia Saginata (beef tapeworm), Enterobius vermicularis (pin worm), Necator americanus (Hook worm), and Ascaris lumbricoides (roundworm).   Tapeworms, namely the pork and beef tapeworm were estimated to have affected 100,000 people in N. America in the 1950’s.  In some places in the world over 50% of the population is infected.  They can grow up to 7 meters in length and have up to 100 segments with each segment producing up to 50K eggs.  Tapeworms are typically spread by the ingestion of undercooked pork or beef that contains cysts/eggs of the parasite.  They can also be spread by fecal-oral transmission.  It is noted that tapeworm eggs are sticky and tend to cling under fingernails and are easily transferred to food.   Tapeworms in humans usually affect the gut, but tapeworm larvae can migrate to muscle tissue, brain tissue, organ tissues.  Larvae migrating to tissues other than the intestines can be devastating (can be a secondary cause of epilepsy/seizures).  Most individuals with intestinal tapeworm infections are asymptomatic and have vague intestinal symptoms (such as nausea, hunger pain, a sensation of movement in their abdomen, loss of appetite, weight loss, bloating).  The most common factor leading to individuals coming in for an exam is seeing/finding worms in their stool or feeling the movement of worms in the anus.  

On presentation a patient may also have a history of traveling to areas that are known to be higher risk and/or they may live in close proximity to livestock.  They may also have a history of eating undercooked beef or pork.  If a patient is presenting with a report of finding worm segments in his/her stool one should be prepared to perform a gross examination of the patient’s feces.  The surface should be examined first for any worm segments.  The stool should be broken up to ensure no segments are present.  If any worm segments are detected treatment should be started.  A compound light microscope can again be used to help identify if Taenia saginata/solium is present in a patient’s stool using the procedure listed above to include performing wet mounts with both saline and iodine staining solution.  Tapeworm eggs are spherical and are difficult to discern as eggs at low power.  However, at higher power there is a thick outer shell that is yellowish in coloration with radial striations pointing outwards.  One may see hooklets in the center of the egg from the scolex that the tapeworm uses to attach to the intestinal lining.  Treatment for intestinal infections only is accomplished with praziquantel.  If infections are present in the liver albendazole may also be used.   Infections from larvae that have migrated outside of the GI tract will likely require additional treatment modalities not discussed here. 

Pin worm (Enterobius vermicularis) infection is one of the most common worm infections in the U.S.  Most individuals infected are largely asymptomatic, which is one reason it is so common.  The CDC recently estimated that approximately 40 million individuals are infected in the U.S. alone.  This parasites’ distribution is again worldwide and is most common in children and those living in institutional type settings.  Transmission occurs person to person via fecal-oral contamination.  It is important to note that eggs can remain dormant for several weeks once outside of the body and are also noted to easily stick under fingernails.  Symptoms, if any are present include intense itching of the area around the rectum (pathognomonic for pinworms) occurring especially at night when the worms exit the rectum to lay eggs.  Each female worm can produce up to 15K eggs.  Other symptoms may include abdominal pain and mild inflammation and redness around the rectum without any evidence of inflammation of the colon.  Occasionally pinworms may be seen with an examination when the worms exit the rectum to lay eggs, or rarely seeing pinworms in the stool itself.  Complications arising from pinworm infections are rare.  Pinworm infections are self limiting, but as auto-reinfection is so easily possible, and the risk to spreading to others is so great I would recommend treating the individual and all household contacts.  Treatment consists of mebendazole or albendazole with repeat treatment in two weeks after hygiene measures have been instituted (laundering undergarments, bedding, and trimming nails).  Diagnosis is easily performed with the use of cellophane tape, a tongue depressor, and a compound light microscope. 

Cellophane tape test performed in the morning prior to showering/having bowel movement
1.  Take a piece of cellophane tape and attach it to both sides of a wooden tongue depressor with the tape wrap around the top of the depressor.  The sticky side should face outwards.  The length of the piece of tape should allow you to apply the sticky side along the entire area of the rectal mucosa.
2.  The Buttocks should be spread outwards, and the taped end of the tongue depressor should be applied to the rectal mucosa and touching either side of the buttocks.
3.  The tape should be removed and applied sticky side down to a glass slide.  Systematically examine the slide moving from low power to higher power (an oil immersion lens is not required).   Ensure that your light source is dim enough for you to discern any worm eggs and not wash out your field of view.
Pinworm eggs can be seen with as little magnification as 100x.  They appear oblong/oval shaped, and they have a distinct line down the middle almost making the eggs appear like a hotdog bun. 

Hookworm (Necator americanus) infections were at one time almost synonymous with living in the Southern states; though infections in North America are exceedingly rare today.  That being said the civilian public health service was still building outhouses in the Southern U.S.  to help eliminate hookworm infections up to 1947.  Hookworm infections can cause intellectual and growth retardation in children, as well as anemia and fatigue.  Numerous historians credit epidemic hookworm infections in the Confederate army as aiding the Union in winning the civil war.  Many Confederate soldiers suffered from anemia due to hookworm infections as well as sores on their feet from where the parasite penetrated the skin.  Hookworm eggs are released in the feces of an infected individual and the egg hatches in 1-2 days.  After hatching the larvae penetrates the skin of humans (typically the feet) and then travels to the lungs via the blood stream where it is coughed up, swallowed, and matures in the intestine while feeding on the host’s blood.  Patients may present with complaints of itching at the site of skin penetration by the larvae.   A subsequent raised and creeping reddish/inflamed track line (typically on feet) that itches profusely may appear and is known as cutaneous larva migrans.  However, it should be noted in the U.S. today anyone presenting with cutaneous larva migrans is typically treated for a type of hookworm (affects dogs/cats) that is not pathogenic to humans (humans are not the definitive host).  Hence, the hookworm dies while attempting to travel in the cutaneous tissues.  The treatment is the same for any species of hookworm (pathogenic to humans or not).  Depending on where the infection is progressing the patient may also have a cough, wheezing, gastric pain, anemia, easy fatigability, diarrhea, and/or anorexia.  A compound light microscope can again be used to help identify if hookworm eggs are present in a patient’s stool using the procedure listed previously to include performing wet mounts with both saline and iodine staining solution.  Hookworm eggs are oval/oblong, and they have a very thin outer shell that is clearly visible without higher magnification requiring an oil immersion lens.  Eggs can contain larvae or 4-8 cell stage embryos.  Treatment consists of mebendazole or albendazole. 

Ascaris lumbricoides (roundworms) infections were once commonplace in the South Eastern U.S. and as recently at the 1980s it was reported that up to 32% of school children in certain areas in Florida were infected with this parasite.  Also, of note numerous species of roundworms exist that affect cats/dogs and are also pathogenic to humans.  Cold and dry climates are typically free of high rates of infection.  A single adult female worm has been known to produce up to 250,000 eggs per day in a host’s intestine.  The eggs are extremely robust and are even known to be resistant to formaldehyde and can remain infective in the soil for several years.  Ascariasis infections are common in the developing countries of Asia (extremely prevalent in China), Africa and Latin America.  Transmission occurs from fecal oral contact.  Once eggs that have been shed in feces are ingested they hatch in the intestine and travel to the lungs via the blood stream where the larvae are coughed up, swallowed, and mature in the intestine.  Most patients with roundworm infections are asymptomatic.  However, patients may experience respiratory symptoms (fever, cough, wheezing) as the worms migrate to the lungs.  Also, vomiting and abdominal pain, nausea, chronic diarrhea may occur after the parasite has traveled to the intestine.  In children that are infected, one may see delayed developmental milestones, evidence of iron deficiency anemia, or evidence of a protein deficiency.  The most common potential severe complication from a roundworm infection is a bowel obstruction.  There are reports of Worms (up to 1ft long) at times seen exiting the nose/mouth/rectum spontaneously.  There are also reports exist of worms exiting a host if a patient is suffering from a high fever, or he/she has been placed under general anesthesia.  A compound light microscope can again be used to help identify if roundworm eggs are present in a patient’s stool using the procedure listed previously to include performing wet mounts with both saline and iodine staining solution.  Ascaris eggs are typically spherical/to slightly oval in appearance.  In viewing the egg, they are noted to have a thin outer though very distinct coat that is not uniform in appearance circumferentially.  Also there is a clear space between the outer coat and a thick inner coat that is described as a yellow brown shell.  The eggs can be viewed without higher magnification requiring an oil immersion lens.  Treatment should be initiated if the parasite is found in feces using microscopy, or if the adult worm is seen exiting the anus/nose/mouth.  Treatment consists of either albendazole, mebendazole, or ivermectin. 

Blood Parasites (Malaria)

One of the most common parasitic infections in the world is malaria.  Malaria is caused by a group of protozoal organisms that invade red blood cells.  There are five different species that cause malaria.  The most deadly is Plasmodium falciparum, which is endemic to the tropical regions of southeast Asia, Africa, and South America.  The most widely disseminated parasite that causes malaria is Plasmodium vivax as it is found in the Americas, Eastern Europe, Asia, and North Africa.  Plasmodium vivax can and does exist in more temperate climates.  Worldwide, malaria causes approximately 500,000 deaths per year (typically children/pregnant women).  Malaria, was once common in the U.S. up until the early 20th century with a range extending throughout the Midwest, South, and the eastern seaboard up to New England.  Malaria was considered eradicated in the U.S. in the 1940s due to a concerted public health effort, and with the widespread use of the pesticide DDT.  However, it should be noted that the CDC states approximately 15,000 malaria cases were still reported in the U.S. in 1947, and even though malaria is currently considered eradicated in the U.S. up to 1,500 cases are reported annually.  These malaria cases typically occur from travelers returning from high risk areas.  As such, there is a risk that epidemic malaria can again occur in the U.S.  One only has to look at news reports about Greece to see how rapidly it can recur when the public health system stops employing preventative measures. 

Malaria transmission occurs from a person being bitten by a female mosquito (specifically of the genus Anopheles) that is infected with the parasite causing malaria.  Within 1-2 weeks after being bitten by an Anopheles mosquito the parasites have multiplied in the liver and they begin to invade red blood cells.  After invading the red blood cells the parasites replicate, and in a synchronized fashion burst open the red blood cells and invade other red blood cells.   This synchronous bursting of red blood cells causes the “cyclic” fevers that malaria is known for.  In fact one can typically state the species type based on the length of time it is from one fever to the next.  Over time Plasmodium falciprum causes fevers every 36 to 48 hrs and Plasmodium vivax causes fevers every 48 hrs.  Symptoms of a malaria infection include high fevers that become more cyclic over time (as described above),an enlarged spleen (over time), headaches, pain in the muscles and joints, and anemia.  If infected with the most virulent form of malaria (Plasmodium falciparum) one may also experience bloody urine, and seizures.  Diagnosis is based on microscopy and the use of more complex slide preparation (blood smears)/staining procedures not discussed in this article.  However, medication prophylaxis is recommended for individuals traveling to high risk areas.  Malaria prophylaxis consists of the daily use of doxycycline two days prior to travel and for up to 30 days upon return.   Also, one’s healthcare provider may consider the use of the medication primaquine as an adjunct to take along with doxycycline . 

Skin Infestations/Infections

There are numerous types of parasitic arthropod (insect) infections.  However, only three of the most common will be discussed in this article and include:  Pediculus humanus (head/body louse), Sarcoptes scabiei (scabies), and ticks (numerous species).  Pediculus Humanus (head/body louse) is epidemic in the U.S. and several million cases are reported annually.  Head/body lice are thin and approx only several millimeters in size with a head, body, thorax, and 6 legs.  Eggs are deposited at the base of hair shafts.  Transmission is from direct contact with an infected individual (most commonly direct head to head contact).  Significant complications associated with infected individuals are limited to secondary bacterial infections from itching, and the potential for contracting typhus (a potentially deadly illness).  Though typhus is not currently a concern in the U.S.  it has the potential to again re-appear.  Itching associated with lice infections is caused by the saliva and fecal excretions of the parasite irritating the skin.  Direct visualization of the parasite leads to the diagnosis as they are visible with the naked eye during a careful examination.   Treatment consists of the use of topical permethrin, or malathion.  Other treatment methods include using a fine toothed special metal lice comb and combing wet hair vigorously daily.  Also, petroleum jelly is thought to cause suffocation of the parasites and should be massaged in and left overnight.  After washing out the petroleum jelly, nit picking using a fine toothed comb aids in preventing re-infestation from already deposited eggs. 

Sarcoptes scabeiei (scabies) is a microscopic mite that burrows under the skin and spreads very rapidly.  Transmission is from direct contact with an infected individual and occurs most often in institutional environments/close crowding of individuals.  Symptoms include intense itching that seems to worsen at night/with hot showers.  Typically one will see a short red/inflamed burrow/tract that is up to several centimeters in length.  A purple/blue surgical marker can be used to color over any itchy/excoriated areas on the patient and then wiped off gently with an alcohol swab.  If a linear burrow is revealed one may conclude that a scabies infection is likely.  The parasite typically favors areas that are cooler, i.e. along the knuckles, penis.  A person’s face is typically not affected.  Potential complications include secondary bacterial infections from itching, or even prolonged itching even after treatment.  Treatment consists of either using topical permethrin (from the neck line down ) prior to sleep and washing off in the morning, or alternatively oral ivermectin.  Treatment should be afforded to close contacts even if they are not symptomatic.  Also, all bedding/clothing should be washed to prevent a possible re-infection.  Oral steroids/antihistamines should be considered if itching is severe. 

Numerous species of ticks are endemic to the U.S. that can carry bacterial, rickettsial (bacterial organism that can only grow inside other cells), viral, and protozoal organisms that may be transmitted when the tick is feeding.  Some of the more common Tick born diseases include:  Lyme disease, tularemia, Rocky Mountain spotted fever, Colorado tick fever, and anaplasmosis.  There is no scarcity of information about these organisms on the web/CDC web site, and it is beyond the scope of this article to discuss them in detail.   Ticks are present throughout the U.S. and typically larger juveniles/adults will climb up on blades of grass or leaves and seek a larger host (by heat, vibration, odor, etc.).  One should note that ticks that are searching for a host are typically found in greater numbers at the edge of clearings (where the light meets the shade) and where higher humidity is present.  Anytime one has been out in the wilderness one should perform a tick inspection (to include difficult to see areas using a mirror).  Ticks should be removed as soon as they are discovered to decrease the risk of acquiring a tick-borne illness.  For example, a tick carrying lyme disease needs to be attached for greater than 24-hrs to transmit the disease to a human host.  Removal of ticks consists of mechanically removing the tick using fine tipped tweezers/forceps and grasping as close to the skin as possible to ensure that the entire tick is removed without leaving the head in place.  Also, one must take care not to crush the tick during removal.  The area where the tick was attached should be thoroughly cleaned/disinfected after tick removal.  Great importance should be placed on personal prevention in areas that have the potential to harbor high tick populations.  Preventative measures include pre-treatment of clothing with permethrin, use of insect repellant with at least 20% DEET, proper blousing of clothing, and regular inspections for ticks on one’s body.   

Preventative Measures

Individuals as well as localities should incorporate education about parasites and discussions on what they can do as individuals/groups to better prevent parasitic infections.  Even though many preventative measures are commonsense, discussions should include abstaining from using night soil (human excrement) as fertilizer, and using proper latrines/disposing of human waste appropriately.  Also, ensuring that the water supply is filtered/treated properly is of key importance as is appropriate hand hygiene.  In malaria prone areas prophylactic medication should be taken as directed and permethrin impregnated mosquito nets should be used as well as permethrin impregnated clothing and insect repellent with at least 20% DEET.  If at all possible stagnant/sitting bodies of water should be drained in malaria prone areas to help decrease the mosquito population.  Lastly, routine health inspections should be considered in populations living in close quarters/more of an institutional type of setting. 


I hope that this article has been informative to you the reader, and that at the very least you have a greater appreciation for the risks presented by parasitic infections.  I would again urge the reader to consider a formal class in parasitology, or at the very least to review the reference materials listed below to be better armed with knowledge in understanding, preventing, identifying, and treating parasitic infections.


1.  The Centers for Disease Control (CDC) web site (viewed at ) has a wealth of knowledge relating to parasites in the U.S. and Worldwide.  This includes current and historical information about prevalence of said diseases, treatment, and preventative measures. 
-Specifically, I would recommend reading the following resources from the CDC:
2.  If you are interested in adding to your medical library regarding parasitic infections I would recommend the text “Medical parasitology.  A self instructional text” (5th Ed) by Leventhal and Cheadle.  It is a very inexpensive easy to read reference textbook.
3.  Army field manuals/publications also afford pragmatic advice, and easily readable information pertaining to prevention/sanitation.
- I would recommend reading the following resources

Friday, October 18, 2013

This article will focus on the latter half of the oft used phrase The End of the World As We Know It.  Operative portion being "As We Know It."

As an emergency room (ER) nurse, I have the perspective of seeing on a daily basis, for patients and family members of patients, the end of their world as they know it.  While the world keeps turning for everyone else, a tragic disaster unfolds for them and life will never be the same.  I offer this article from the perspective of one who has seen a wide range of traumatic events and people’s reaction to those events, with the intention of helping to make these family-scale catastrophes less traumatic and painful, and perhaps even decrease their frequency or severity.

First, a caveat, this is geared primarily for the US healthcare system.  I have lived, worked, and traveled abroad and seen some of how other countries operate and much of what follows will be applicable to those other systems, but there will be small operational differences.  Your mileage may vary.

To begin with, the hospital in general and the emergency room in particular is a hostile and foreign environment to many, and for good reason.  A large percentage of patients are there with substance abuse and mental health problems.  There are sick and injured patients, demanding family members, not enough staff, screaming, yelling, vomiting, defecating and bleeding people everywhere.  And there are drug resistant and normal everyday microbes waiting for a host.  Into the middle of this chaos comes you or your loved one.  How to get the best out come possible?

For starters, don’t come.  I know if widely followed this advice would seriously disrupt the bottom line of many hospital ERs, who make their money on the non-urgent, well insured patients who come in for minor problems, but a positive financial impact on the department does not necessarily equal a positive health impact on the patient.  Actually the idea of a positive financial impact is a bit of a misnomer; precious few community hospital emergency departments in the country that makes money (excluding for-profit hospital groups), they operate at a deficit, but that is a discussion for another day.  

So what should you consider not going to the ER for?  While this should not be construed as personal or specific medical advise, in general the following things can be served equally well, if not better, by other means:

-          Orthopedic injuries.  If it is a sprain, strain, or even many fractures, odds are you don’t need the ER.  Sure, we’ll do an X-ray, give you some pain meds, tell you to ice it, and follow up with the orthopedist in 3-5 days.  And when you do, they’ll repeat the X-ray and the exam and give you a prognosis and treatment plan.  Why not skip the middle man?  More often than not, our treatment and recommendation in the er is totally unrelated to the X-ray, we only do the X-ray because people want and expect it.  But it doesn’t change anything.  RICE is the treatment: rest, ice/ibuprofen, compression, elevation.  The reason the orthopedic doc doesn’t want to see you for 3-5 days is the swelling must begin to recede for them to do a good evaluation.  So skip the ER for your sprains and strains and go straight to the orthopod or urgent care center even if you must wait a day, UNLESS: you have numbness or reduced circulation downstream from the injury, have major gross deformity (foot is pointed the wrong direction), or pain that is  more severe than than you can handle with ice and ibuprofen or that is out of line for what you would expect for the injury. 

-          Upper respiratory infections.  You have a cough, cold, sinus pressure, drainage, and feel ill.  First option, rest, stay hydrated, take Tylenol and over the counter decongestants and cough suppressants.  Next best, go see your regular doctor in a regular office visit.  Next best, go to an urgent care or walk in clinic.  IF you have high fevers not controlled with Tylenol and ibuprofen and body aches and feel like you have been run over by a train and have neck stiffness, then come to the ER.  If not…

-          Nausea and vomiting.  Groups with with belly pain this group is the number one chief complaint in the ER anywhere in the country.  This is because so many things manifest as abdominal pain, and some of them are true emergencies.  But if all you have is nausea and vomiting and can’t keep anything down, it is likely a stomach virus, one of the zillions of varieties of Noroviruses, for which there is no cure, only meds to reduce the nausea and iv fluids to maintain hydration status.  So what can you do to avoid the ER for this?  Ask your doctor ahead of time for a prescription for anti-emetics; Zofran (ondansetron) and Phenergan (promethazine).  There are others that work well, but I am partial to these two because the Zofran comes in both a pill form and a dissolvable under the tongue form in case you are so nauseated your can’t even keep a pill down and won’t cause drowsiness like the other anti-emetics.  Phenergan also comes in pill form, as well as suppository form, for the same reason.  It can cause drowsiness, though sometimes that is a desirable feature!  Many doctors are very willing to prescribe anti-emetics for just-in-case use at home, even more so than antibiotics.  This can also be a good foot in the door, so to speak, for getting your doctor on board with prescribing meds for just in case use.
-          Children with fever.  If your kid is more than a couple months old, and has a fever with no other specific symptoms, give them alternating doses of Tylenol and ibuprofen.  If this works to keep the fever down, they are able to stay hydrated and pee normal amounts, and have no other symptoms (neck stiffness, ear pain, abdominal pain,etc) then it is likely a viral bug and will get better in a day or two.  A fever in an infant under 30 days old however is another matter and should be seen by a professional.

-          When in doubt, call you primary doctor.  Often they will tell you to go to the ER, because they can’t see you or assess you over the phone and don’t want the liability of telling you it is no big deal, even when it isn’t.  So instead, go see grandma, or your grandmother equivalent.  Seriously, elders have been around awhile and those who have reared several kids often have a good idea of that sick vs not sick assessment tool.  Chicken soup, ginger ale, Tylenol, water, saltine crackers, and rest; these things really do work!

So that addresses over half the patients I see in my ER on any given day.  What about the rest, the real emergencies that really need help?  How can you prepare for these and handle yourself and your loved ones best?  Here are some tips:   

Bring an advocate.  Someone who isn’t distracted with pain and illness, who won’t be impaired by meds, and who can ask questions, write down answers, observe that things are being done right and in a timely fashion, advocate for pain control, and generally look out for you when you can’t look out for yourself. 

Have a list of medicines you take, the doses, frequency, and what they are for.  Also a list of medical problems you have had or are being treated for, and a list of prior surgeries and any allergies you may have to medicines.  Your primary doctor’s name and phone number are also helpful.

Now what if you are the advocate, what should you bring and how can you help?

Bring: snacks, water, and reading material since you may be there a while.  Notebook and writing stick is also helpful to keep track of things.  Phone and a charger!  Many hospitals have poor signal and your phone will chew through battery faster searching for a signal.  Maybe a smart phone, tablet, or laptop, so you can research tests, meds, and diagnosis and things the docs and nurses are telling you.  

Ask questions.  In a polite and genuine manner, ask what the anticipated side effects of meds are.  Rather than simply agreeing to treatments, ask (again in a polite and respectful manner) what the options are.  Ask what the consequence would be of foregoing a particular diagnostic  test (such as CT scan).  If there is anything you don’t fully understand, ask, and then repeat back to the person who explained it to you, in your own words what you think you understand.  If you think the patient you are advocating for needs more pain meds, ask.  If you observe people not washing their hands before touching the patient, ask.  If no one has been in to see the patient and you are not clear on what you are waiting for, ask.  You may notice a theme here.  Most nurses and many doctors too like to teach and help patients and family members who are genuinely interested in learning and want to be healthy.  On the other hand, NO ONE likes to be hassled, bothered, pestered, criticized, or challenged.  Your goal as the advocate (or patient for that matter) is to be perceived as the former rather than the latter.  Be extra nice and tactful when making requests and asking for things, to avoid setting up an adversarial dynamic.  Instead, ask what you can do to help, for example getting warm blankets, repositioning the patient or boosting up in bed, getting water, etc.  Even if there is nothing for you to do, offering is nice. 

Even if it has been a long time you have been waiting, remember that is a good thing (usually).  The national average is over an hour before being seen by a provider, and over 2 hours until disposition.  In many big city ERs it is not unusual to spend 6-8 hours in the ER.  Remember, as I often tell people, you never want to be the most important person in the ER.  If you are the patient everyone is rushing into the room to see, that is usually a very bad sign.  Remember, this isn’t a clinic, this is the EMERGENCY room.  If you have the option, maybe you should have gone to an urgent care or walk in clinic; they are usually faster and much less expensive.

Understand the balance of power in the ER.  As a patient, you do have the right to refuse treatments or tests.  Some doctors may try and steam roll you, saying that if you don’t want their help, then there is nothing more that they can do for you.  This gets into tricky territory; if you are not having a dangerous or life threatening emergency and you are merely sick or in pain, then technically they are right, they don’t have to treat you further.  Better to not get into that adversarial position, instead asking questions instead of making demands.  If you can explain your concerns and illustrate your comprehension of the situation, you stand a better chance of negotiation what you want with the doctor.  Remember, in the ER most of the people we deal with are not rational or normal.  If you can demonstrate that you are a rational and sane individual, we are happy to work with you, but we do not assume that is the case, that is for you to demonstrate, because experience has demonstrated to us that patients are all crazy and mostly not that bright.  You can be the rare exception, and this will benefit your care.  By the way, you always have the power to leave when every you want.  It is called AMA, or "Against Medical Advice."  Be aware however you will still get bill for assessments and treatments performed up to that point, and insurance generally will not cover a visit if you leave AMA. 

If things are really bad, ask for or accept the help of the chaplain.  It doesn’t matter if you are religious, they won’t push prayer on you unless you ask, what they will do is be a resource for you.  They can make calls for you, ask questions for you, help coordinate arrangements, relay information, liaison with other departments and staff, relay concerns, pretty much what ever you need from a non-medical standpoint.  They are one of the few resources you have as a patient or patient advocate who probably knows the system better than you and is there with the sole job of assisting you.  Religious or not, if things get bad, take advantage of the chaplain's services, even if it is just a safe place to blow off steam or vent concerns or frustrations.

Clearly you didn’t plan for this to happen.  If I had a nickel for every time someone told me they didn’t have time to be in the ER, I’d have a nice little hedge on inflation.  But before it happens you can take steps to be a bit better prepared for disaster.

JWR Adds: Hospital Acquired infections (HAIs)--also known as nosocomial infections--are spread at alarmingly high rates, even in First World countries. These infectious diseases can include MRSA, ESBL-producing bacteria, Vancomycin-Resistant Enterococci (VRE), Pneumonia, and Psuedomonas Aeruginosa. For this and other reasons, I recommend avoiding purely elective in-hospital procedures, such as cosmetic surgery. Do you really need a smaller nose, a pointy chin, or "permanent makeup"? Probably not.

Friday, October 11, 2013

When I was very young I would sometime spend rainy days at my grand-mother's house going through sporting goods catalogs and the Sears catalog making list of items that might be needed during disasters or emergencies. I have no idea why I am wired in such a way that I give a good amount of thought to being prepared. I am no longer a young boy but now I believe making such plans are more important than ever before. The economic situation in our country can only be described as terrifying to anyone who will take the blinders off and look. It is said that there is nothing new under the sun and if one looks back at other countries and civilizations that followed a similar path you can see the possible outcome. If one prepares for a disaster that never happens he is no worse off but if unprepared when disaster strikes there is no remedy. 

Each family's needs and security situation is different so there is no cookie cutter plan for being prepared. Use available learning tools and make your own plans. The reason I am writing this letter is to share some resources I have found. I am by no means prepared for all possible events. I am working on my own plans as I am able to. If we encourage each other and help each other than if a disaster ever does occur then we will all be better prepared. I will list some resources I have found that others might find useful.

1. Water
    I believe that the first item everyone should try to plan for is a source for safe drinking water. If a well is available consider installing a solar powered well pump. Since most of us don't have a well I strongly recommend Lifesaver brand water filters. The Lifesaver jerry can filter will make 20,000 liters of safe drinking water from most any source of fresh water. The lifesaver jerry cans are available at There are other good filters but try to plan for months, not days.

2. Food
   You gotta eat! For short term food storage we should all have a supply of canned goods and basics such as rice, beans, oats, pasta, and flour. Don't worry too much about storing these foods for long term. As they age just donate them and replace them. One of the best resources for food storage is the Latter Day Saints food facilities. We are lucky to have one of these nearby in Slidell, Louisiana. The Mormons encourage their members to be prepared and set up regional facilities to pack food items for long term storage. Dry food items sealed in #10 cans can have a shelf life as long as 20 years. This facility is at this time open to people that are not associated the the LDS. The LDS web site has a great deal of information about disaster planning and food storage.
Storing food will feed you during most conceivable emergencies. We should also plan for an unconceivable emergency that doesn't last days or weeks but instead last months or years. We should all have on hand a good supply of heirloom non-hybrid seeds for gardens. Using heirloom non-hybrid seeds allows you to save seeds from your gardens for future gardens. Most hybrid or modified vegetables do not reproduce well naturally. Emergency seed packs are available at many sources. Here are a couple,, item wx2-222028. Type in emergency seeds on and you will many choices. Keep in mind that you will also need to keep fertilizer on hand. As you use the stored fertilizer replace it. You do have hand tools for gardening don't you?

3. Warmth and cooking
   We are lucky to live in an area with mild winters but we still need to plan on heat sources to keep warm. For short term generators or even simply extra blankets will suffice. For long term situations we will all end up burning wood in some form or fashion. Make sure you have hand tools such as ax, splitter, and saw. For cooking most of us have camp stoves or grills that we have used after hurricanes. But what if the fuel for these becomes unavailable or so expensive it might as well be unavailable. Buying some type of wood stove or making a jet cooker now and storing it will give you peace of mind. You can look up plans for home-made wood cookers on you-tube and on several prepper web-sites. I will list some helpful sites at the end of the letter. The Dollar Tree store sells candles that are about 8 or 9 inches tall in a glass jar that will burn for about 80 hours each. The candles cost $1 each. The stores are often out but you can order them by the case from their web site and pick the candles up at the store. You should have a at least couple of dozen of these candles.

4. Shelter
    This is a difficult topic because this is one area that everyone will have different needs and desires. Most everyone would want to stay in their present location but there are several items to consider. You must be in a secure location and be able to defend yourself at that location. Having a weapon is not enough. You need to consider what is required to set security watches and defendable perimeters. Some people might think that they will not resort to violence to defend their shelter and there supplies. When unprepared people decide to take what you and yours need to survive most people will fight. Your location must have a reliable water source. Many people will find it necessary to join with other friends or family members for support and security. These topics should be discussed with others before there is an emergency at hand. If people decide to plan on joining up together than it would be wise to preposition supplies at the planned location. It is also wise to have a back-up plan in case the planned location is not useable for some reason.

5. Medical supplies
    Most of us end up taking some type of daily meds as we get older. There is only so much of these meds that we can obtain and hold. However there are sources for other medical items that we all need from time to time. Many people that are called preppers these days have been buying antibiotics from vet supply resources. is one I have used. The antibiotics are usually labeled for use in aquariums or for animals. The antibiotics are exactly the same as the ones you receive from Wal-Mart or Medco. I have documentation from doctors that state that the meds are the same and that the shelf life if stored out of intense heat is measured in years in most cases. There is talk that the government wants to stop the internet sales of vet medicines because people are buying them for human use so I would get a supply as soon as you can. We should all have several types of antibiotics and other medical supplies. There are sites that describe which antibiotics are best used for different medical ailments. You should have basic first aid supplies for stopping blood loss from major injuries. Keep QuickClot or Celox packets to stop major bleeding. Israeli pressure bandages and tourniquets are must have items. Steri-strips and sutures are also needed. Also alcohol and Betadine needs to be on hand. Have a supply of forceps and other tools. Buy a good supply of otc medicines, especially imodium, tylenol, and ibuprofen.

6. Power
    As you can tell from this letter we are discussing long term emergencies instead of a couple of days without power after a storm. It would be prudent for us to look at solar power systems to provide some electrical power. This would not only allow you to have a couple of lights but could also power a communication device to talk to people on guard duty or could power radios for communication. We should all definitely have a good supply of rechargeable batteries and a solar recharging device. The more batteries you can obtain now the better. Remember that the day after the emergency is too late to find batteries, radios, or solar devices. If you decide to look into setting up a solar power system you will need deep cycle batteries. The better the deep cycle battery is the more expensive it is and none of them are cheap. A very good book to have on hand is The 12 Volt Bible, it is available on Amazon.

7. Transportation
    We should not only have at least one bicycle but it should be maintained. We should keep spare tires, tubes, and tire patches for the bike. It would be great to have an extra chain. Don't overlook having a hand powered pump

8. Clothing
    Buy a few pairs of jeans and other sturdy clothes and store them in a vacuum bag to protect them from moths. On there is available Guide Gear brand jeans. You can get them with or without a double layer of cloth on the front of the legs for extra durability.

9. Security
  This is too large a topic to cover in a letter. The most important thing to say is to learn and plan. There are many books available to order or borrow. Everyone learned a few months ago how quickly ammunition can disappear from store shelves. We should all have a couple of good weapons and plenty of ammunition. There is no such thing as enough ammunition. In a real long term emergency ammunition will become the preferred barter item. Ammo will become the basic currency along with pre '64 silver coins if we ever experience a real long term disruption. A couple of weapons and a good supply of ammunition are required but from there a person is only limited by his own resources. In a true long term disruption the man with a night vision device will be much more secure than those without. These devices are very expensive for good 3rd. generation models. At least get good night sights such as Trijicon brand night sites for your primary weapon. Trijicon night sights for an AR-15 cost less than $100 and will be invaluable if you ever need them. You won't be very effective if you cannot see your sights. A similar item is body armor. It seems like a complete waste of money in normal times but would be worth everything if it saves you from being shot. I will share some information from books I have read. It sounds basic but you must know the difference between cover and concealment. Concealment can prevent someone from seeing you but cover can stop rounds headed your way, don't confuse the two. In times of trouble a weapon is useless in a safe. During a real time of trouble you should be armed at all times.

Trying to be prepared is a project that never ends. All we can do is the best we can but even that will be more than the majority of people. I will list some items we should stock up on and a few books that can be helpful. I should say that these books should be acquired in paper form and not on an e-reader.
| Stock up items for your own use and for barter: bug spray, storage food, ammo, water filters, jeans, t-shirts, batteries, pre-1965 silver coins, otc medicines, skin lotion, towels, blankets, fertilizer, seeds, food grade pails with lids (find a restaurant that will give you mayo and dressing pails), hand gardening tools and wood cutting tools, toothbrushes, 1st aid supplies, candles, reading glasses, bike tires and tubes, tire patches, multi-vitamins, matches, baking soda, sugar, vinegar, propane (propane will store long term), bleach (dry pool tablets store well but must be pure bleach), bar soap, surgical mask, latex or vinyl gloves.

The Encyclopedia of Country Living by Carla Emery
How to Survive the End of the World As We Know It by James Wesley Rawles
Where There Is No Doctor: A Village Health Care Handbook by David Werner
Where There Is No Dentist by Murray Dickson
Wilderness Medicine Beyond First Aid By William W. Forgey M.D.
Emergency War Surgery (NATO Handbook:- Third United States Revision, 2004) by Dr. Martin Fackler, et al.
Back to Basics: A Complete Guide to Traditional Skills, Third Edition by Abigail R. Gehring
When There Is No Doctor: Preventative and Emergency Healthcare by Gerard S. Doyle,
Patriots: A Novel of Survival in the Coming Collapse by James Wesley Rawles (a great novel but it is full of useful information)
Ranger Handbook an Army field manual. (There are many other useful books and military field manuals).
Useful web sites:,,, night vision sales food storage wood gas stove raising fish at home raising fish at home, aquaponics Vet Supply Vet supply Centers for Disease Control Medical info First aid training Sportsman's Guide Northern Tool military surplus equipment Natchez Shooter Supply Brigade Quartermasters Armslist MS. classified firearms sales and trade. wilderness first aid ammo search tool Israeli Tactical gear ammo sales gun parts and magazines ammo sales ammo sales night sights medical supplies raising chickens prepping info general homesteading info general homesteading info pre-1965 silver coins

Friday, October 4, 2013

We've been preppers since the late 1970s when we were living in a New Jersey seaside apartment and our long term food was stored under furniture in a 400 square foot apartment.  After that a job relocation to a more rural area enabled us to buy a 35 acre fixer-upper farm where we lived for 16 years and learned how to garden, raise livestock, heat with wood, and become generally self-sufficient.  Then we bought our second rundown farm in upstate New York (we were suckers for fixing up dilapidated farmhouses) and started up a commercial sheep operation on 360 acres.  There we learned to farm on a larger scale for ten years, and became more prepared for a SHTF scenario, including the addition of draft horses to help with some of the work.  Now we're on our retirement farm in northern Vermont with the horses and a small flock of sheep, along with the dogs, cats and chickens.  We're both in our sixties and have been hoping for the best but preparing for the worst.  Now I've been diagnosed with an aggressive cancer and I'm faced with survival of another kind.  We all know we're going to eventually die, but we like to think that it's so far out into the future that we can forget about it.  Being diagnosed with a potentially terminal disease pulls that eventuality back into the present.  This can really throw a kink in your SHTF plans because the S has now HTF in your own life and makes everything else seem pretty irrelevant. 

If you see financial, commercial or social collapse as potential emancipation from the status quo, as I have, you're jolted into seeing the world from a new perspective since you may very well now need the existing infrastructure to support your ability to survive.  This includes the potential need for grid-based medical treatment or nutritional therapies that require foods not native to your geographical area.  So far I'm able to keep doing what I've been doing on the farm, but now as I get ready to battle the disease there's the strong possibility that illness and/or treatments will soon impact my ability to do strenuous work, hopefully just temporarily, but possibly for extended periods of time, and possibly until death.  Wanting to be ready for a world without luxuries and in order to better prepare ourselves for a world that might lack many of the things we now take for granted, over the years we've prepped by weaning ourselves from a lot of tools that require fuel from outside sources.  We walk and use the horses instead of owning an ATV, split wood by hand instead of a power log splitter, garden without a tractor, shovel manure by hand, you get the idea.  Much of that work is beyond my wife's physical capabilities, so my inability to do those types of work could leave us pretty helpless.  In retrospect it looks like making ourselves ready for TEOTWAWKI has left us very exposed and without the financial resources necessary to retrofit our farm to one that's more mechanized.  I write this simply as food for thought for those who may find themselves preparing in a similar manner.

From a preparedness perspective, societal collapse and a grid down scenario could spell the end of my life unless my disease results in total prolonged remission.  Actually, under those circumstances and without a healthcare infrastructure, I wouldn't even know if I was in remission.  Nature would just take its course.  Yes, I would be able to consume anti-cancer herbals and foods from storage along with whatever we grow or is available in our area.  We always read about increased die-off in this situation, but we all think it won't be us.  Unfortunately, in many cases it will be us, no matter how prepared we may be. - Northern Vermont Shepherd

JWR Replies: Cancer has touched the life of nearly every American. You will be in our prayers!

Sunday, September 15, 2013

Dear JWR:
I had an interesting conversation with a member of the CDC about decontaminating N95 face masks. The study results can be found here.

You'll notice that the test gives positive results but more research is needed. Here was the conversation I had with Edward Fisher after reading it.

Here are some snippets from our exchange:

1. Did you remove the metal nosepieces from the masks before sterilization?
2. Any updates to this study?

We did not modify any of the tested filtering facepiece respirators
before decontamination. If the masks had metal nosepieces, they were
not removed.
There are no further updates on the study. Currently my lab is
focusing on evaluating the risks associated from handling and/or
reusing previously worn masks.

OK thanks! I thought perhaps they were removed because of the metal in
a microwave. Did you have metal arcing from the metal nosepieces?

We did not experience arcing from the metal nosepieces. The key to
the microwave method is the addition of water. Without water and
steam, the microwave can melt the masks. (See Viscusi et al. Ann.
Occup. Hyg., Vol. 53, No. 8, pp. 815-827, 2009). It should be noted
that the steambags have not been evaluated using Influenza and more
research is required. Currently, decontamination of disposable FFRs
is not recommended. As mentioned previously, we are now trying to
evaluate the hazards associated with handling and reusing contaminated
masks and have moved away from decontamination testing. This
may be helpful for any information you may be seeking
in regards to respirator research and influenza.

Keep an eye on this topic. If it's effective it'll really save on N95 mask costs. I think I'll chance it if we have a pandemic and I'm wearing a mask but am not around anyone confirmed to be sick. - C.D.V.

Tuesday, September 3, 2013

(This is the conclusion to the article series that began on Friday.)

Appendix A

The following is essentially a "wish" list; however the items that are in bold are relatively important.  The tools and medical areas would be for a complement for 1-10 people.  The sundries area covers a family of six.  The food area is for one person for one year, multiply (or divide) as you see fit.  There is extra food included for charitable impulses.  Coordinate purchases among the group if you plan to congregate.  I live in Georgia, so the clothing and supplies are tailored for that area; make modifications to the list to accommodate your particular AO or preferences.  The weapons list really is a bare minimum.  The anvil included in the lists is a clue that I plan on bugging in, rather than bugging out. (Bugging out, while it may become necessary, is just a fancy way of saying "refugee.")


Shovel, round point (2)                                     Shovel, square point                                   
spade                                                                                      Hoe (2)
Entrenching tool                                                            Machete                                                
Pick                                                                                    Mattock           
Post hole digger                                                           

Axe, double bit                                                            Axe, single bit
Hatchet, framing                                                            Chainsaw,
16" bar                                                                   Chainsaw blades
Hard hat/face shield/ear muffs                        Peavey           
Log dogs (4)                                                            Froe
Steel wedges (6)                                                            Splitting maul                                               
Block and Tackle (2)                                                 Crowbar, large
Crowbar, small                                                            Pry bar, small                                   
pinch bar                                                                        Pulleys, large (6)                                   
Pulleys, medium (6)                                                Pulleys, small (6)                                   
Chain hoist                                                                        Chain, 30'                                   
12 lb sledge hammer                                                8 lb sledge hammer                                   
4 lb engineers hammer                                    4 lb cross peen hammer                       
40 oz ball peen hammer                                                40 oz straight peen hammer                       
40 oz ball peen hammer                                                32 oz cross peen hammer
24 oz framing hammer (2)                                    20 oz bricklayers hammer                       
16 oz nail hammer (4)                                                14 oz Mallet                                   
16 oz ball peen hammer                                    12 oz Warrington hammer                       
Tack hammer                                               

24" Jointing plane                                                            12" Jack plane                                               
9" Smoothing plane                                                4" block plane                                               
Compass plane                                                            Rabbet Plane                               
Radius plane                                                            Chamfer plane
Adze, large                                                                        Adze, small                                               
Broad axe                                                                        Draw knife                                               
#80 Scraper holder                                                Spoke shave (2)                                               
Scrapers (3)                                                            Wood chisels, 2"-1/4"                                   
Corner chisel, 1/2"                                                Corner chisel, 1/4"                                   
Framing Chisel, 1"                                                Framing Chisel, 2"                                   
Socket Slick, 2"                                   

10 tooth crosscut saw (2)                                    8 tooth crosscut saw                                   
5 tooth rip saw                                                            Hack saw (2)
Mini-hacksaw                                                            Dovetail saw                                               
Compass saw                                                            Keyhole saw                                               
Coping saw                                                                        Coping saw blades (50)                                   
Back saw                                                                        1-man timber saw                                   
12" Bow/hack saw                                                12" blades (20)                                                
30" bow saw (3)                                                            30" blades (20)                                               
Bow saw                                                                        Bow saw blades, Asst.
Frame saw            

Brace, large                                                             Brace, med                                               
Brace, corner                                                            Bits, 2"-1/4"                                               
Twist drill (2)                                                            Twist drills,  (2 sets)                                   
Brad point drills                                                            Screw starter bits                                   
Pencils, carpenter (40)                                    Pencils, regular (40)                                   
Chalk line            (2)                                                            Chalk, 1 gal                                               
Marking chisel                                               

Combination square                                                Compass                                               
Dividers                                                                        Framing square                                   
Speed square                                                            Plumb bob, brass (2)                       
25' tape (3)                                                            100' tape                                               
Folding rule                                                             4' level                                               
2' level                                                                        Torpedo level                                               
Line level (2)                                                            Water level                                               
Pipe clamps, 6' (8)                                                C-clamps, Asst. sizes (20)                       
Wood vise, 12" (3)                                                Hold downs (7)
Work bench                                                            Shaving Horse                                   

cat's claw                                                                        nail belt, leather
nail belt, cloth (4)                                                            Wood glue (3 gal)                                   
Wood glue, small bottle                                                glue brushes, 18
Nail sets, 4                                                                        Mason's trowel                                               
Putty knife (3)                                                            Sandpaper                                               
Sanding block                                                            Peg sizer                                               
Box knife (3)                                                            Straight blades (100)                                   
Hook blades (20)                                                            Saw set                                                           
Bicycle tire pump                                                Traps (Asst.)
Plumbing fittings, valves, pipes, etc           
20d nails (100 lbs)                                                16d nails (100 lbs)                                   
8d nails, box (100 lbs)                                                Wood screws (50 lbs)
Fence staples (50 lbs)                                                1-3/4" Roofing nails (50 lbs)                       
8d finish nails (40 lbs)                                                1 3/4" lead head roofing nails (30 lbs)           
4d finish nails (20 lbs)                                                Concrete cut nails (20 lbs)           
16d double headed nails (10 lbs)                        Wire brads (3 lb)                                   
Tool box, mechanical                                                1/2" drive socket set                                   
3/8" drive socket                                                1/4" drive socket set                                   
Screwdriver set                                                            Asst. bits for 1/4" drive handle                       
Extra #2 Phillips                                                            Extra 5/16" flat screwdriver                       
3/16"-2" box end wrench set (2)                        4mm-23mm box end wrench set                                   
Pliers, side cutting (3)                                                Pliers, slip joint                                    
Pliers, linesman                                                            Pliers, needle nose (2)
Pliers, electrical                                                            Vise grips, Asst. (6)                                   
Crescent wrench set (3)                                    Water pump pliers (3)                                   
Fence pliers (2)                                                            Scissors (2)                                               
Staple gun                                                                        T-50 staples (3000)                                   
Glass cutter (2)                                                            Sharpening stones, Asst. (6)                       
India ink (1 pt)                                   
Anvil                                                                                    Forge
Stump vise                                                                        Manual powered blower           
12V DC blower                                                            Hardies/mandrels
Mechanics vise, 8"                                                Wire brush (3)                                   
Leather work gloves                                                Leather apron
Coal, 700 lbs                                                            Files, Asst. (20)           
Solder irons (2)                                                            solder, 5 lb
Tongs (7)                                                                        Pipe wrench (2), 14"
Tin snips (3)                                                            Sheet metal flattener
Swage block                                                            Oil, 2 gal                                               
Shears                                                                        Tap and die set
Punches, chisels                                                            Grinding wheel
Hacksaw blades (50)                                                Oxy-acetylene rig
Propane torch                                                            Propane bottles (50)    


Clorox                                                                        Disposable lighters
Soap                                                                                    Salt
Pepper                                                                        Candles
Nails, 16d,                                                                        Needles/thread
Fish hooks                                                                        Coffee

WEAPONS, Long guns (minimum)


Centerfire bolt-action rifle (w/ scope)            12 or 20 Ga. pump shotgun, full stock            
.22 rifle                                                                         .177 Pellet rifle

WEAPONS, Handguns (minimum)

.357/.38 - 4" bbl                                                           



.Centerfire ammo (200)                                                12 or 20 Ga rifled slugs (50)           
12 or 20 Ga #0 buck (100)                                    12 or 20 Ga #4 (100)                                   
12 or 20 Ga #7-1/2 (100)                                    .22 LR HP high-vel (1,500)
.177 pellets (1,000)                                                .357/.38 HP (200)                                   

Other Weapons
8" knife                                                                         Survival knife (1)                                   
Swiss Army Knives (2)                                                Power pliers (1)                                               
Single recurve bow w/ arrows                        Cleaning kit, base                                   
Cleaning kit, field (2)                                                Solvent, 2 pints                                   
Oil, 4 pint                                                                        Grease, 4 med tubes
Eye goggles (2)                                                            Ear protection (5)
Bow strings (2)                                                            Holster                       
Extra magazines (where required)                        Spare parts, springs, sears, pins, etc.
Spare scope           


5' spinning outfit, med action (2)                        Tackle box, med spinning gear           
Net                                                                                    Trot line hooks, 200                                   


Cast iron Dutch Oven (2)                                    Cast iron frying pan (3)                       
Pots (4)                                                                        Cast iron griddle                                   
Bread pans (7)                                                            Coffee pot                                               
Meat grinder                                                            Grain grinder (2)                                   
Metal grate for outside oven                        Copper pads                                               
Kitchen knives (7)                                                Asst. utensils                                               
P-38 can openers (7)                                                Asst. dishes                                               
Hand water pump                                                Tripod
Bell                                                                                    20 yds Cotton cloth
Canning Supplies (300 jars w/ lids)            Wool blankets (12)                                   
4" foam pad, 84" x 60" (6)                                    Pillow ticking                                   
Pillow (6)                                                                        Sleeping bag (6)                                   
Pup tent (2)                                                            Cabin tent                                               
ALICE pack w/ frame (2)                                    Day pack (4)                                   
Large pack w/ frame                                                Compass (4)                                               
Area map (6)                                                            Binoculars (2)                                   
BIC lighters (24)                                                            Ball bearings, 50                                   
Stick matches, 30 boxes                                               
Survival Kits (6)                                   
            Swiss Army pocketknife                                   
            razor blade
            bic lighter
            magnesium starter
            button compass
            space blanket
            Water purification tabs (100)

LC-2 belt (2)                                                            LC-H suspenders (2)                       
Canteen w/ cup w/ holder (4)                                    Shotgun pouch (4)                       
LC-2 first aid kit (6)                                                LC-2 butt pack (2)                       
Compass pouch (2)                                                G-3 mag pouch (2)                       
BAJA waterproof bags (6)                                    LBE rubber bands (20)                                   
Trioxane bars (100)                                                Survival cards (2)                                   
Light sticks (48)                                                            Signal mirror (6)                                               
Sewing kit
            needles, Asst., 100
            thread, Asst., 50 spools
            buttons, Asst., 100
            pins, 500

Watch                                                                        Zip-lock bags
Kerosene Lamps (7)                                                Kerosene lantern, (3)
Funnels (3)                                                            Gas lantern
Propane lanterns (2)                                                Propane stove, 2 burner
Propane stove, 1 burner                                    Propane tanks, 5 gal, 3
Adapter kit for lantern/stove                        LP 2 Propane adapter
Candles (70)                                                            Extra wicks/globes/mantles                                                            
LED flashlight (3)                                                Red lenses (3)                                   
D cells, Ni-Cd (12)                                                AA cells, Ni-Cd (21)
12 volt battery, Storage (2)                                    Solar charger(s)                                   
Extra bulbs (6)                                                            Radio, shortwave w/ antenna
Radio, AM/FM                                                            Scanner
CB base station SSB                                                CB handhelds, 3, SSB           
Sound powered phones, 6                                    IR Detectors, 3
Phone cable, 700 ft.                                                Phone jacks
Asst. coaxial adapters                                                Hand powered DC generator
Gas powered DC generator, 12V                         12/3 Copper Romex wire  (500 ft)
Twist connectors (700)                                                16 Ga stranded wire (700 ft)
Jumper cables (3)                                                            Butane operated soldering iron
Butane canisters (7)
General purpose electronic repair items
            Switches, GP
            CB crystals
            solder wick

Soap bars (300)                                                            Soap, liquid, 3 gals                                   
Toothpaste, tubes (12)                                    Tooth brushes (12)                                   
Floss, dental (20)                                                Towels, hand (7)                                   
Towels, bath (12)                                                TP (300 rolls)           
Boots, hiking (2 pr ea)                                                Boots, Shoe-pacs w/ felt liner (1 pr ea)           
Shoes (2 pr ea)                                                            Socks (20 pr ea)                                               
Poncho w/ liner (1 ea)                                    leather gloves (3 pr ea)                       
Work gloves, (12 pr ea)                                    Mittens (1 pr ea)                                   
Underwear (12 pr ea)                                                Pants,  (4 pr ea)                                   
Shirts, (4 ea)                                                            T-shirt, (6 ea)                                   
T-shirt, (6 ea)                                                            Shorts, (4 ea)                                   
Parka            (1 ea)                                                Jacket            (1 ea)                                               
Travel vest                                                                        Hat, floppy                                               
Belts (2 ea)                                               
Paper, 8.5 x 11 (3,000 sheets)                                    Area Maps                       
Manila folders (50)                                                pencils/pens (4 ea) w/ refills                       
Gum erasers                                                            3X5 cards, 200                                               
Books (many)                                                            Bibles (10)                                   
Coffee cups (6)                                                            Guitar                                                           
Strings (3 sets)                                                            case                                                           

Wood burning Stove                                                 Leather sewing needles                                   
Tarp, 12'x16' (1)                                                            Tarps, 12'x10' (2)                                   
40 gal tub (2)                                                            Washboard                                               
Broom (2)                                                                        Mop (2)                                                                       
Bucket, metal (7)                                                Bucket, plastic (7)           
Gold pan                                                                        Figure-8 breaker bar

K1 Kerosene, 25  gal                                                Unleaded gas, 55 gal
White gas, 5 gal                                                             Gasoline can, 5 gal (10)
Water cans, 5 gal (3)                                                Sta-Bil gas stabilizer (for 55 gals)
55 gal drums, 4                                                            Gasoline pump, manual
Wire mesh                                                                         Baling wire, 1000'
Fencing, 100'x 5', 6 rolls                                    Chicken wire, 100'x 3', 6 rolls           
Hardware cloth, 1/4" (20')                                    Hardware cloth, 1/2" (100')                       
Rope, 3/4" braided nylon (200')                        Rope, 1/2" braided nylon (400')
Rope, sisal, 1/4" (1000')                                    Rope, Parachute cord (700')                       
Mason's twine (700')                                                Heavy-duty Mason's twine (700')           
Twine (2000')                                                            Waxed lacing (1000')
2" Nylon strap, 20'                                                Cement, fire clay, (100 lbs)           
Portland Cement, (2100 lbs)                                    Tin roofing, 1000 sq ft
3/4" Plywood, 3 sheets                                                1" plastic pipe, 100 ft
Solid drain pipe                                                            Diverter valve for pipe  ???
Burlap bags (100)                                                hose clamps, 25           
Stove pipe, 25'                                                            Stove pipe elbows, caps, terminations,
Sheet metal, 4'x4' (7 pcs)                                    Asst. nuts, bolts and hardware
Spray bottles, 3                                                            Hydraulic bottle jack, 12T (2)
PVC, 3/4 X 16', 24 pcs                                                PVC crossovers, 12           
PVC T's, 12                                                                        3/4" copper pipe, 100'
1" copper pipe, 20'                                                Misc copper fittings, 30
30 wt tar paper (10 rolls)                                    Plastic sheet, 10 mil, 3 rolls                       
Screen wire (100 ft roll)                                                Glass panes, 1' x 1', 20 pcs                       
Glazing putty, 2 1 pt cans                                    Cheese cloth, 1 roll

Clorox, 30 gal                                                            Ammonia, 1 gal
Lye, 3 gal                                                                        Iodine, 21 oz
Silicon sealant                                                            RIT dye, earth colors (4 pkgs)
Axle grease (3 lb)                                                            Bar oil for chain saw, 5 gal           
10W-40 Motor oil, 24 qt                                                30W Non-detergent Motor oil, 24 qt
Dextron II Automatic Tran fluid, 4 qt            Mineral spirits, 4 qt
Acetone, 4 qt                                                            Oil to mix w/ gas for saw, 2 qt           
WD-40, 2 gal                                                            Locktite
PVC glue, 3 bottles                                                Boric acid, 2 qt           
Sevin dust (100 lbs)                                                Linseed oil (3 gal)           
Turpentine (3 gal)                                                Electrical tape (12 rolls)           
Duct tape (30 rolls)                                                Dichotomous earth, 50 lbs



Hard Red Wheat, 100 lbs                                    Dent Corn, 100 lbs
Rice, 100 lbs                                                            Spelt, 30 lbs
Barley, 30 lbs                                                            Pinto beans, 60 lbs
Kidney beans, 10 lbs                                                Millet, 10, lbs
Lentils, 10 lbs                                                            Great Northern beans, 10 lbs
Pasta, 70 lbs                                                            Cheese powder, 10 lbs
Cheese, 10 lbs                                                            Flour, 10 lbs
Dried Potatoes, 5 lbs                                                Dried Onions, 10 qts
Dried fruit, 20 qts                                                Dried vegetables, 30 qts

Coffee, 20 lbs                                                            Oil/Crisco, 7 gal
Powdered milk, 30 lbs                                                Beef stock, 7 lbs
Salt, 20 lbs                                                                        Pepper, 2 lbs
Soup, 70 pkgs                                                            Canned tomatoes, 70 cans
Peanut butter, 10 lbs                                                Sugar, 20 lbs
Kool-Aid, 30 pkgs                                                Honey, 3 gal
Corn syrup, 1 gal                                                            Powdered butter, 3 lbs
Cocoa, 3 lbs                                                            Yeast, 3 lb
Baking powder, 3 cans                                    Baking soda, 7 boxes
Vinegar, 1 gal                                                            Chili powder, 3 cans
Garlic powder, 3 cans                                                Soy sauce, 1 bottles
Italian seasoning, 1 cans                                    Vanilla extract, 3 bottles
Maple Syrup, 3 bottles                                                Lemon juice, 1 gal
Ascorbic acid, 2 lbs                                                Molasses, 1 bottle

Additional canned gods can be substituted for grains above

5 gal plastic food buckets, 25                        5 gal lids, 25
1 gal metal food cans, 30           

Seed, non-hybrid
            et al

Vitamins (300)                                                            Coffee filters, 100
Rennet                                                                        Whiskey, 3 gal
MREs, 30    



Bag, main                                                            Bag, surplus
Ace bandages (7)                                                Large bandages (21)
Burn dressings, (4)                                                Butterfly sutures (40)                                   
Triangular bandage                                                Band-aids, Asst. sizes, 300                       
Wooden cotton swabs, 100                                    Adhesive tape, 1" and 2" (10 rolls)           
Alcohol wipes, 100                                                2x2 gauze pads, 200                                   
4x4 gauze pads, 100                                                Cotton balls                                               
BP cuff                                                                        Stethoscope
Otiscope                                                                        Teaspoon
Thermometers, 3                                                Flashlight, AA x 2                                    
Chemical ice pack                                                Measuring cup                                               
Snake bite kit                                                            Rubber gloves (24 pr)                                   
Soap, 3 bars                                                            prescription glasses, 2 pr           
Hypodermics (3)                                                100 proof Grain alcohol (3 qts)                       
Needles                                                                        Lidocaine                                               
Hemostats (7)                                                            Needle holders (2)                                   
Scissors (3)                                                            Scalpels (3)
Lancets                                                                        Wire cutters
Pliers                                                                        Tooth extraction pliers
Dental mirror                                                            Dental pick
Hacksaw blade                                                            Suture materials, Asst. (20 sets)           
Surgical tubing, 20 feet                                    IV sets
Catheters                                                                        Plaster of Paris
Space Blankets (3)                                                Suction device
Urine Test Kits (2)                                                Pregnancy test kits (3)
Magnifier/30X microscope                                    AA Batteries (4)
Magnet                                                                        eye patches (3)
Cotton bats, 7 boxes                                                Safety pins, pkg 100                                   
Tweezers (5)                                                            Toenail clippers                                   
Zinc oxide                                                                        Alcohol, 2 qt                                               
Iodine, 7 oz                                                            Betadine, 4 qt
Liniment, 1 qt                                                            1% hydrocortisone, 3 tubes                       
Hydrogen peroxide, 2 qt                                    Tylenol, 250                                               
Aspirin, 700                                                            Nyquil, 1 bottle                                   
Baking soda, 7 box                                                Salt, 1 box                                               
Calamine lotion, 1 bottle                                    Activated charcoal, 24 oz                       
Decongestant, 3 bottles                                    Imodium AD, 12 pkg           
Oil of cloves, 7 bottles                                                Benadryl, 3 bottles           
Benadryl cream, 1 tube                                    Alka-seltzer, 300 pkgs                                   
Pepcid AC, 100                                                            Vaseline, 1 sm jar           
Oral-jel, 3 tubes                                                            Dental filling material, 2 tubes
Lice Rx (Permethrin)                                                Rehydrating solution
Ammonia inhalant, 7                                                Epidrine pens, 3
Codeine or Demerol, 100 tabs                        Anti-biotic ointment, 21 tubes           
Anti-biotic, oral, 300 tabs                                    Anti-fungal cream, 3 tubes                       
Moisturizing cream, 3 tube                                               

Bag, personal size (2)
            Ace Bandage                       
            Band-Aids, 12
            Anti-biotic ointment, 1
            Large Bandage, 1
            Butterfly Bandage, 3
            2X2 gauze, 7
            Aspirin, 12
            Whiskey, 1/2 pt           

Saturday, August 31, 2013

(Continued from Part 1)

Level I Scenario

In these paragraphs, we will look at the areas of primary and secondary importance as they can be managed in a Level I scenario.


A person needs around two gallons per day for cooking and rudimentary cleaning.  For short term emergencies it may be possible to store up two weeks or more water, that much should be stored up anyway.  When you store water, treat it with iodine or Clorox or boil (iodine is better, boiling is best) and rotate water stores every six months, see level II instructions for disinfecting ratios.  Water can be recovered in the house from plumbing pipes, the back tank of the toilets, the hot water heater, and can be stored in water beds if the conditioner has never been used (treat and rotate).  Reserve the water bed, toilet tank and tub water for non-potable uses or distill before use.  Milk jugs don't make good long term storage devices, 2 liter coke bottles do.  Also, if you expect water shortages, clean the tubs thoroughly and fill them up.  Water has also been used from swimming pools.  If the water is shut off temporarily, you can flush the toilet by pouring a bucket of water directly into the bowl, use creek water or bath tub water.  Conserve water at every opportunity.


Keep two months worth of canned goods in your pantry.  Canned goods will last for at least a year, longer if you turn them over every couple months.  Rotate them on a last in, first out basis to keep the stash current.  Beware of canned goods that are bulging, smell bad or make a whooshing noise when you open them, if there is any doubt, feed them to the cat.  Just kidding, cat lovers  (the cat may be needed for extra protein)  Don't forget the can opener (non-electric, of course)  Have some way to cook: an outdoor grill with plenty of fuel, Sterno cans, fireplace, camp stoves with plenty of fuel; all the above; an outdoor campfire might work. 


A disaster may hit in the winter so have some way to heat your house if the power goes out for a while.  A fireplace, although grossly inefficient, will help, a kerosene heater costs about 150 dollars, or less, wood stoves are a good bet.  Never burn a charcoal fire inside.  Beware of carbon monoxide poisoning, use adequate ventilation, and don't catch the house on fire.  Make sure you have a couple of fire extinguishers rated for ABC type fires, keep the matches away from the kids.  Block off only the room you are trying to heat with blankets over openings not already covered with a door.   If you are depending on firewood, or whatever source of fuel, stock up well before the winter; firewood takes several months to dry out.  Have plenty of blankets or sleeping bags handy.  It would be advisable to install battery powered Carbon-monoxide monitors and extra smoke detectors, if you are heating or cooking indoors with open flame.

Physical Protection

Keep the doors secured at night; don't leave tools and firewood lying about in the open.  Avoid the cities if there is unrest; heighten driving awareness, lock the car doors and drive around crowds of people.

Spiritual Needs

Never miss an opportunity to get closer to God.  Pray for guidance before making decisions.  Try not to worry;  Matthew 6:34 

" not worry about tomorrow, for tomorrow will worry about itself.  Each day has enough trouble of its own."

Also, 1 Peter 5:9 

            "Cast all your anxiety on Him, because He cares for you."

Medical/Dental Needs

Keep current on medical issues.  Stock up on any medications you may require in case of any spot shortages in that area.  Build up a first aid kit, there is a fairly extensive one listed in Appendix A, of course speaking of appendix, with the kit listed below you could probably take one out.  Modify the kit downwards if you like to fit a Scenario I environment.  Don't forget a spare pair of glasses if you need them.  Wash your hands frequently to avoid sickness, purify your water religiously.

Financial/Legal Concerns

Make copies of all bank statements, insurance policies, retirement policies, IRAs, 401(k)s, anyplace you have money in an electronic format.  Keep a copy of your estimated Social Security benefits; this shows the amount of retirement benefits you are entitled to when you retire.  Talk to a financial advisor.  The stock market may take a dive but will probably recover.  It might be a wise move to have 3 or 4 weeks’ worth of cash at home, don't advertise, keep it in a well concealed fire-safe. 


Power, lighting, water, gas, and sewage.  In a Scenario I environment there might be random power outages lasting for a relatively short time, maybe a day or two, think of a good ice storm or tornado.  A generator might be in order, make sure you connect it to the system safely and isolate your house from the outside system to avoid cooking utility repairmen.  Talk to an electrician; there are several options on how to hook up a generator to your house, there's the correct way and there's the way everybody does it.  Store enough fuel for the noisy, hungry beast and use only those appliances that are necessary.  An alternative to electric lights are Kerosene lamps, use #1 or #2 Kerosene, three lamps burning 5 hours a night will go through about  2 -1/2 gallons of Kerosene in a month.  Calculate your fuel requirements accordingly.
Have some trash bags on hand in case there are temporary interruptions in trash pickup.  Water and sewage disposal were covered in the water section above.


It is nice to keep informed, as a bare minimum have an AM/FM radio with plenty of batteries.


Keep the gas tanks on your vehicles above half full at all times, (you and everybody will be lining up at the pumps so don't do it on the way to a party you’re already late for).

Level II Scenario

At this level, serious self-sufficiency plans have to be implemented.  The normal level of division of labor breaks down and purchasing everything you need at Kroger's, Home Depot and Wal-Mart might not be an option; therefore, you have to have supplies stockpiled ahead of time or have the ability to generate them yourself through home production or barter.  Nobody knows how bad it can get or how long such a situation could drag on, but it might be wise to plan for a slightly worst-case scenario and act accordingly.  A level II plan would preclude burning all your bridges, but would require some outlay of thought, money and time to prepare.  An extensive list of tools and supplies are laid out in Appendix A, more of a dream list than what one will be able to acquire, sort of like going through the Sears catalog saying "I want that... I want that..." , but it might give you some ideas.


Water is critical, of course.  Level I instructions apply in this scenario.  You can purify water by boiling it for one minute.  Also, by treating it with pure Clorox at the ratio of 8 drops per gallon if the water is clear or 16 drops per gallon if the water is cloudy, shake it up and let it sit for 30 minutes to allow time for the Clorox to kill all the microorganisms.  A 55 gallon drum would require about 1/5 cup of Clorox to purify for 6 months.  You can also purify water with 2% tincture of iodine in liquid form; add 20 drops per gallon of clear water, 40 drops per gallon for cloudy water, shake it up and let it sit for 30 minutes.  Don't accidentally drink any of the iodine straight, for example from the lip of the container, as it is a deadly poison; also, the iodine is suspended in alcohol, so if the alcohol evaporates, adjust the number of drops accordingly.  Don't use Betadine solution to purify water.  Probably the best way to purify water is to distill it using manufactured heat or solar power.  One easy way to construct a solar still is to build a 3' x 3' x (12" on one end, 18" on the other) waterproof box, paint the inside black with a non-toxic waterproof paint, or line with black plastic, and construct a roof of clear Plexiglas sloping to a trough or even a multi-faceted cover sloping to one point.  The box should be totally enclosed with no ventilation.  Pour dirty water into the box and let the sun work, collect the distilled water as it evaporates and runs down the Plexiglas cover; this method will yield about one quart per day so build accordingly.  Clean the box out occasionally.  Filters are an option, they are expensive and require filter element changes.  Filters might be manufactured from earth and/or sand products. 

Rainwater catchment systems seem promising.  The rain from the roof is diverted into a cistern or barrels.  The literature I've seen says metal or plastic roofs are OK for potable water systems, but not roofs with asphalt shingles; however, if the water is just used for flushing toilets or watering cats, go with the asphalt shingles.  If you do need to build a potable catchment system under an asphalt roof, it might be ok if you use a filter made out of sand to filter out trash, I believe the problem is in tar products from the shingles and possibly fiberglass.  You can cheaply construct a washer system by letting the raw water from the roof run into a five-gallon bucket with a large overflow outlet near the top of the bucket and a smaller (1/4") outlet at the bottom of the bucket.  When it rains, the water rushing off the roof fills the bucket before overflowing into the cistern thereby washing the roof of pollution and dirt before going into the cistern; the smaller tube at the bottom allows the water to drain out of the bucket before the next rain.  All in all, quite an elegant low-tech solution.  The system might be as simple as cutting off a gutter downspout and directing it into a 55-gallon drum.  A cistern can be built out of chicken wire wrapped around circle of re-bar stakes, then plastered over with a 3:1 sand: Portland cement mixture.  There's a little more than that to it but you can research it if you’re interested in that technology (i.e. I'm not sure what all is involved, I've just seen them in use in South America).

A well would be a nice thing to have, they are somewhat expensive and most pumps require electricity to operate, plan accordingly.  Solar powered, wind powered or hand powered pumps are a viable option.  Water conservation would be necessary.  Save water used for cleaning to strain and re-use.   Water used to cook vegetables or meat can be added to soups for extra nutrition and liquids.


Picture a grocery store when the weatherman gets done talking about an ice picture the same store where not only the bread, milk and eggs are gone, but everything is stripped down to include even the canned artichokes and Brussels sprouts; well maybe the Brussels sprouts will still be there.  The average grocery store only holds enough food supplies for three days; they depend on a steady stream of trucks re-stocking the shelves on a regular basis.  In addition to the two months supply of canned goods stored for a level I situation and the food in your 72 hour kit, store whole grains, pasta, rice (white not brown), beans, powdered milk, oil, spices, salt, and other items you may care for.  There is a more extensive list in Appendix A.  Whole grains store infinitely better than flour and preserve their nutrients much longer, the problem with grains is that they have to be converted to flour to make bread, this means a grinder; a good grinder can be purchased for around $250, or possibly they can be found at flea markets for $30 -$60, look for a grist mill.  The larger the grinding wheel, the faster they work, the smaller ones with a 1 1/2" wheel take a long time to make flour.  You can grind flour between two rocks or pound them with a heavy iron bar in a sturdy metal can if you have to.  Grains can also be soaked and boiled, roasted, sprouted or just gnawed on for as long as your teeth last.  The optimum lo-tech way to cook is with an old-fashioned wood fired cook stove, not really an economically viable option for most of us, so figure out what is needed to cook over a fireplace, build a wood fired grill/oven out of rocks and mud, and learn to cook over a campfire.  A Dutch oven is a great way to bake bread if it is the type that has a raised lip around the lid to hold coals on top and provide an oven like area inside the pot.  It probably wouldn't be a good idea to set up your outside kitchen out front by the street unless you have plenty to share. 

Foraging for wild game and plants might be an option, but it is better not to depend on it for your main source of food for several reasons: 1.) everybody will be doing it.  2.) When you are hunting, nobody is looking after the farm  3.) Game will become scarce(r).  4.) if you kill something, you have to get it back to the house carrying the unfortunate deceased critter with one hand whilst fending off poachers with the other.  5.) Wild game does not have enough fat on it to make a straight deer/rabbit diet feasible.  On the other hand, if a deer wanders across your yard early one morning and you are ready for it...venison for supper.  Also, you can have a box trap, or two, working for you all night while you are sleeping and have roast Raccoon for lunch the next day.  Leg holds, snares and Connibears also work.  Pay attention to wild plants for food also, get a field guide.  A pellet gun can harvest rabbits and squirrels around the house and is quiet and cheap to shoot, as well as being good practice.

Canning supplies will be a good thing to have in a survival environment, jars, lots-o-lids, pots big enough to sterilize jars in.  Food can be dehydrated, pickled in salt, or smoked in a homemade smokehouse.  The enemies of stored food are heat, oxygen and bugs.  To store grains and beans, get five gallon plastic buckets with new lids, put 1-2 inches of grain in the bottom of the bucket, put in a chunk of dry ice as big as your (4-6 oz.) hand then fill the rest of the way to the top of the bucket.  Set the lid on loosely and wait for 4-5 hours until the lid stops 'burping'.  As the dry ice evaporates, it displaces the oxygen, which cause food oxidation, and also kills the bug’s larvae by starving them of their oxygen.  The CO2 is heavier than the O2 and stays in the bucket.  Next seal the lid and store in a cool place, don't put it in an attic or hot garage, this will shorten the storage life.  Grains will store for 20+ years, beans for 8+ years, dried food for 6 months, solid Crisco stores longer than liquid oils (about 6 months for the liquid), Brown rice 6 months, flour for 6 months, pasta 2 years and powdered milk 18 months.

Just about any food storage plan is a temporary stop gap measure until food production can resume, this means seeds, non-hybrid so that the seeds can be used from year to year (if it goes on that long).   Garden tools will be required.  If livestock farming is envisioned, envision a fox in your chicken house if you don't have some chicken wire stashed back.  Fencing can keep a deer out of your garden if it is about 10 feet tall (maybe higher if the deer is a good jumper).  Seeds can be picked up cheaply after the end of the summer and would also make an excellent barter item.


More of the same as level I, Have a way to heat it.  If you envision a more serious situation, such as a level II disaster, plan on having a wood fired heater, even a homemade one fabricated from a 55-gallon drum.  Have a way to cut firewood; the best option is a chainsaw, with a spare or at least a bucksaw as a backup.  Keep an extra bar, 2 chains, spark plugs, points, file, plenty of gas and bar oil.  If you don't have oil to mix with the gas for a 2-cycle engine, 30-weight non-detergent oil can be substituted.  Also, 90-wt gear oil can be used as a bar oil; bar oil will be used just about as fast as the gasoline mixture, so get plenty.  Eye and ear protection is also a good thing to have.  Don't forget the splitting wedge.  Plastic sheeting will be handy to further insulate windows, stop leaks or build a small greenhouse. 

Most likely your shelter will be your present home, so figure on what you could do that would make it habitable without any outside utilities coming in.  Don't put all your eggs in one basket; bury (cache) a large portion of your supplies underground to avoid a massive loss due to fire or other calamity.  Research ways to protect goods buried underground with regards to waterproofing, location, security and availability. 

Physical Protection

Here's where it starts to get somewhat confusing.  As a Christian, I have rules to follow that are not of this world; but I have a family to protect also.  I don't believe that God would have me not protect them with every tool possible.  I can only pray for guidance on this issue and hope I do the right thing as God would will it.  A gun is a tool that can be used for good or evil.  Wars have been fought with weapons that resulted in ultimate good; WWII is the most striking example.  If Hitler had not been stopped, by American's carrying guns, he would have done much more damage than he did.  On the other hand, firearms in the hands of criminals have taken untold numbers of innocent lives.  Another analogy might be that Solomon was able to build the Temple in Jerusalem because his father, David, had secured peace in the Middle East through the might of his armies.  Yet, David had wanted to build the Temple himself but was stopped by God because his hands had been bloodied in war.  Most perplexing.

If you do decide to get a gun or guns, start with a pump shotgun in 12 or 20 gauge, a .22 rifle, a center-fire bolt action scoped rifle and maybe a center-fire pistol, in that order.  Get plenty of ammunition, especially .22 ammo, it's cheap.  With the grace of God, you'll only have to use them to harvest wild game.

A dog is an effective early warning system (cats are worthless).  Also, tin cans filled with pebbles strung up on wire.  If there is civil unrest in the area, get together with several families in order to provide for mutual protection, watches, garden help and spiritual support.  Pay attention to the area and the people moving through; try to establish a buffer zone around your house, like a fence.  Don't tell people what is your exact situation.  Don't appear obviously better fed or provisioned than the people around you.  In spite of all this direness, help people to the best of your ability, without compromising the safety of your family.

Spiritual Needs

Hold regular church services, "pray without ceasing" as the Apostle Paul would say, set up Bible study classes, organize Christian counseling in stress relief areas, set up a food bank and widows and orphans ministry.  James 1:27

"Religion that God our Father accepts as pure and faultless is this: to look after widows and orphans in their distress..."

Observe the Sacraments.  The Methodist church observes three sacraments, the Communion, Baptism and the covered dish supper.  :-)

God's will is for you to help your neighbor.  When Jesus comes back, Matthew 25:37-40 says:

"Then the righteous will answer Him "Lord, when did we see you hungry and feed you, or needing clothes and clothe you?  When did we see you sick or in prison and go to visit you?"  The King will reply, "I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.""

Jesus is coming back someday, or we will go to Him, and we will then have to give an account of our actions on earth.  We are not saved by good works, but do have to account for our works, good and bad.

God loves you and wants only what is best for you, as it says in the book of Romans (8:28):

"And we know that in all things God works for the good of those that love Him."

If a collapse goes down this heavy, it will be somewhat scary, way out of our normal comfort zones, but if we put our hope in the Lord, we will never be disappointed.  He will take care of us to the ends of time.  Look at Psalms 118:5-6:

"In my anguish I cried to the Lord, and He answered by setting me free.  The Lord is with me, I will not be afraid."

At some point when you trust in the Lord for your well-being, you cease to be afraid because you know that no matter what happens, He will be with you to comfort and protect you.  Therefore, why be fearful.  I think it is OK to prepare for things such as famine, Joseph did, but don't put your faith in your own human preparations.  Look at Matthew 6:19-21:
            "Do not store up for yourselves treasures on earth, where moth and rust destroy, and where thieves break in and steal.  But store up for yourselves treasures in Heaven, where moth and rust do not destroy, and where thieves do not break in and steal.  For where your treasure is, there will be your heart also."

Maybe you think you don't need the Lord or He couldn't love somebody like you, well, you're wrong.  You do and He can.  Trust Him.  Listen to this, think about what it means to you.  Matthew 7:24-26:

"Therefore everyone who hears these words of mine and puts them into practice is like a wise man who built his house on the rock.  The rain came down, the streams rose, and the winds blew and beat against that house; yet it did not fall, because it had its foundation on the rock."

Build on the rock, not on the sand.  Jesus Christ is the rock; the things of the world are the sand.  Nobody is perfect; everybody has a past where he or she didn't live according to God's laws.  When you accept Jesus as your Savior, you may still be accountable to the world but as far as God is concerned, the sacrificial blood of Jesus Christ covers all your sins and in His eyes you are pure and sinless.   Psalm 103:1-22

"Praise the Lord, O my soul; in all my inmost being, Praise His Holy name.  Praise the Lord, O my soul and forget not all His benefits.

He forgives all my sins and heals all my diseases; He redeems my life from the pit and crowns me with love and compassion.

He satisfies my desires with good things, so that my youth is renewed like the eagle's.  The Lord works righteousness and justice for all the oppressed.             
He has made known His ways to Moses, His deeds to the people of Israel.  The Lord is compassionate and gracious, slow to anger, abounding in love.

He will not always accuse, nor will He harbor His anger forever; He does not treat us as our sins deserve or repay us according to our iniquities.

For as high as the heavens are above the earth, so great is His love for those who fear Him; as far as the east is from the west, so far has He removed our transgressions from us.

As a father has compassion on his children, so the Lord has compassion on those who fear Him; for He knows how we are formed, He remembers that we are dust.
As for man, his days are like grass, he flourishes like a flower in the field; the wind blows over it and it is gone, and its place remembers it no more.
But from everlasting to everlasting the Lord's love is with those who fear Him, and His righteousness with his children's children- with those who keep His covenant and remember to obey His precepts.
The Lord has established His kingdom in heaven and His kingdom rules over all.  Praise the Lord, you His angels, you mighty ones who do His bidding, who obey His word.  Praise the Lord, all His heavenly hosts, you His servants who do His will.  Praise the Lord, all His works everywhere in His dominion.             

Praise the Lord, O my soul.

The fear of the Lord is not the terror inspired by a tyrant, but the respect and awe a child holds for a beloved father, a father who has always been there, even when the child strayed and sinned, a father who has always loved the child; a child that will always love the father.

Psalm 91:2
"I will say of the Lord, "He is my refuge and my fortress, my God in whom I trust.""

Medical and Dental Concerns

The best thing you can do right now is to get physically fit by exercise and correct eating habits; this is a failing of mine.  Preventative medicine and proper hygiene will be important.  In a sustenance type environment, it is hard to stay clean, especially if water is in short supply.  You must however, purify drinking water and wash your hands to keep from getting sick.  Get two spare sets of glasses, if you need them.  As discussed earlier put together a first aid/medical kit sufficient to handle serious emergencies, 911 might not be working or paramedics might be overloaded.  Learn how to perform rudimentary medicine and gather medical, drug and nursing books now. 

Most drugs are still good after the expiration date (not Tetracycline- toss it when it expires, it cause kidney damage when old; also, aspirin when it smells like ascetic acid (sour, vinegary, smell like blue RTV sealant) is poisonous.  If a drug is far past the expiration date, you might have to up the dosage.  Understand, do not use this information in lieu of a real doctor, I'm not one and I don't play one on TV, this information is for emergency use only with no medical help available, I believe it to be correct.  Stock up on medication in advance, Aspirin, Tylenol, anti-biotic, painkillers (or alcohol), anti-diarrheal, etc etc.  See the list below. 

Financial and Legal Concerns 

Pretty much the same as Scenario I.  Perhaps more cash set aside and maybe some investments in gold and junk silver; junk silver is non-numismatic grade, pre-1964 solid silver coinage, useful for barter.  Junk silver is in small enough denominations to be reasonable when trading and also easily recognizable as what it is, a silver coin.  Keep a real low profile with the exact specifics of your preparations.  It won't be a secret from the criminal elements of our society that people are stockpiling cash and supplies.  There are those that are stockpiling only guns and ammunition.

With regards to barter, some things are easily tradable and typically in short supply during a crisis.  Clean water, coffee, batteries, candles, kerosene and lamps, lighters, candles, toilet paper, soap, stuff like that.  Keep some for trading purposes.   If somebody needs something you have set aside for trading purposes, but does not have anything to trade, give it to them anyway, don’t be a dweeb profiteer.  Don’t use societal collapse as an excuse to get rich; use barter goods to re-supply or obtain items you have not anticipated needing. 

To be continued…

Tuesday, August 27, 2013

 Many of us that have been prepping since before the Internet have welcomed all the new information, knowledge, and interaction with our fellow preppers. But for someone who is just starting out, it can all be overwhelming. So overwhelming that they don’t know where to start. The sad part is that many of them don’t start. They feel that they have to  spend so much money at one time to get all the gear that the experts say they need, that they just can’t do it. This is in large part due to shows like Doomsday Preppers. While I watch these shows regularly, and enjoy them, they are, in my opinion, a two edged sward. They have made many people aware of the need to start preparing for _______(fill in the blank), but they also go so far beyond the basics (where we all started)  that they leave the new prepper with the wrong idea of how to start.
None of us started out with everything we needed. For some of us, we had no idea what we would need. We knew we had to prepare, maybe we had a vague idea what we were preparing for, and a kernel of a plan in the back of our minds. Before the Internet came along, we had to search through stacks of books and magazines for information. If we were lucky, we found a survival school nearby. We slowly built up our supplies, made a Bug Out bag, practiced our skills, and continued the search for information, gear, and more skills.
For those that are just beginning, I am glad you found this site. It will offer you many tips and suggestions. The gear, gadgets, and most of the advice have all been tested. The advertisers have all been vetted, so if you choose to purchase their products (and I hope you do as they help keep this site up and running) you can be assured that they will deliver on their promises.
I hope that with a few tips, the new prepper will continue to become prepared and will continue to seek knowledge to help them and their families become more self reliant. The tips and suggestions I offer are based on my own experience, I do NOT consider myself an expert. In fact I learn more each and every day. I have had to replace my bag a few times, often on a very limited budget. These suggestions have helped me through the years, that is why I offer them to you. These suggestions are for a bug out kit, not a bug in kit. (although it can be used for both)
By way of introduction, I am 44 years old and I have been prepping since I was in my teens. I took my first survival course at 16 in the Sierra Nevada mountains. I am a Nurse and an EMT, I have also been a volunteer fire fighter and a storm spotter. I have been through ice storms and tornadoes in Oklahoma, and earthquakes and forest fires in California.
When you pack your bug out kit, think of the five priorities you have; Water, Food, Heat, Shelter, and Security. Everything you need in your bag falls into one of these five categories. You need to try to have at least three days worth of supplies. Of course, if you can’t have that at first, remember that something is better than nothing.

  A source of water would be your first criteria for your bug out location. (I will talk a little about this later). The recommendation is one (1) gallon of water per person, per day. So you would need 3 gallons of water for your own use. That would be about 24 pounds (8 pounds per gallon, approximately). Since most people can not carry more than 50-60 pounds for more than a short time, I suggest carrying two liters and having a way to purify or filter the rest. (search You Tube for your best choices on how to do this)Two liters should last you through most of one day’s drinking requirements. I prefer to carry mine in military style canteens, with a military style canteen holder and canteen cups. An alternate method would be using 2 one liter bottles or a two liter bottle such as a clean soda bottle.

 In my bag I usually carry three MREs, three dehydrated meals I made myself, a few food bars, a jar of peanut butter, M&Ms, and several pieces of hard candy and gum. Hard candy can provide sustained energy by keeping your blood sugar up while burning more calories than normal, but can also keep your mouth moist when exerting yourself. If you carry canned food, which is heavier but easier to come by when first packing your kit, make sure to pack a can opener. Also make sure you pack eating utensils. You would be surprised at the number of people who forget these.
Remember to check your food often for expiration dates. I do this by setting my e-mail ca lender to send me reminders a few days before I go shopping at the beginning of each month. That way I can check everything and add it to my shopping list as needed. Anything about to expire gets eaten or donated so nothing goes to waste.
 Like me, many of you have watched the various survival shows and watched while they made a fire out of whatever is handy. Building a fire this way is a great skill to have. You may need it, and if nothing else it builds your confidence. But, as my first instructor told me “It’s easier to flick a Bic than rub a stick”. That’s the reason I never leave the house without a lighter and a pocket knife. Disposable lighters are easier to dry than matches, or even a Zippo lighter, if they become wet. I carry all three of these with me in my bag or on my person. The matches are in a water proof container (available at almost any sporting goods store) along with a small piece of sand paper, since I have found that “Strike anywhere” matches actually do NOT work everywhere.  You should also pack some type of tender in your bag. I have cotton balls, dryer lint, paper (from the note book I carry) and I always have a few business cards in my wallet and in my bag (most sales people and many other businesses will be more than glad to give you one or two). There are also commercial fire starting fuels out there like Trioxane. A small saw and hatchet are also part of your heat providing gear. There are many choices out there for these items, so do your research and choose the best ones for you.

In this category would be the clothes you wear and pack. You should have a sturdy pair of shoes or boots, at least two extra pair of socks, long pants ( I always pack jeans or military style BDUs) a long sleeve shirt (I pack either a work shirt like Dickie's brand or, again, BDUs) and a cap or hat that can shade your eyes and keep your head warm.
You should also have a good sleeping bag appropriate to your climate and season, and a small water and wind proof tent. I like to have a few hand warmers as well as a good pair of insulated gloves, and a pair of work gloves for handling wood, rocks, etc. My bag also has a military surplus folding shovel and carrier that hangs on it. This is used for digging a fire pit as well as sanitation and preparing a shelter area.
A roll of duct tape is also useful, both for securing and repairing your shelter. as well as repairing almost anything else. I also have a Multi-tool so I have small wire cutters, screw drivers, etc handy to help repair anything that breaks.
If you have never built a shelter, you can start learning on YouTube or similar site online. Once you have watched it done, practice you methods of choice until you have it down pat. It is never as easy as it looks.

When most people think of security in a SHTF scenario, they think of firearms. While I believe everyone should have a few of those and the training to use them properly, they are not the only form of security.
First aid is also a vital part of your security. Being able to treat wounds or illness is vital to being and staying alive. If you have never taken a first aid course, do so. They are available almost everywhere, and they are cheap or free. Most commercial $10 first aid kits come with a small first aid handbook. Study it. Once you have chosen a first aid kit appropriate to your level of training, check it often and replace anything that is expired, just as you do your food.  Many people have written about this topic, from lay people to doctors, so I will not go into it again. Search out these articles, essays, videos, and books, then practice the skills described in them.
Hygiene is also important. Staying clean is the first step in fighting disease. Having a place away from your shelter and water source to “do your business” is very important. You should have a bottle of hand sanitizer in your kit. I would recommend having a complete hygiene kit in your bag that has anti-bacterial soap along with a wash cloth and small towel. You can also pack shampoo, and deodorant in there if you choose. Make sure you have a toothbrush, tooth paste and dental floss in your hygiene kit, as well feminine hygiene products if you need them. The one thing a lot of preppers seem to forget is toilet paper. So pack that too. If you wear glasses, then get an extra pair and keep them in your Bug Out Bag in a hard case, as well as a repair kit for them. If you wear dentures, make sure you have your cleaning and care supplies in your bag.
For me, one of the most important security items I have is a Bible. The one in my G.O.O.D. bag is the same small Gideon one I was given when I joined the army. The New testament, with Psalms and Proverbs, has given me very good sense of security all of my life.

The next step is finding the place you will be bugging out to. As I mentioned, you will want a place with a good source of water. You also want to have a place (or places) that has good security, or that you can quickly make secure. Your site should be away from whatever disaster you are getting away from. And it’s location should never be shared with anyone outside your immediate family or group. When the excrement hits the oscillating device you don’t want everyone and their brother trying to show up at your retreat.

The most important piece of gear you have in the one above your neck and between your ears. I can not stress enough how important your mental attitude is. Having the right mindset is the most important skill in surviving any situation. Whether you are preparing for total societal collapse, or the more common natural disasters, you can not survive unless you want to survive.  Mental preparation is the most important preparation you will do. Think about the two or three most likely disasters, then prepare for them. After that you can go on to preparing for any other disaster you think may happen.
By finding the SurvivalBlog site and reading the notes, articles, and essays in it, you have already taken the first step. By thinking about and following through with making a BOB, you are on your way to being able to get through almost any disaster.
I personally invest at least an hour each day to my preps. This can be anything from reading magazines, blogs, or books (which I do every day) to cutting wood, to food preservation and storage, to learning a new skill or practicing one I learned already. I practice one of my bug out plans at least once each month, and my bug in plan at least twice a year. I also try to exercise at least three times a week. Sometimes that is walking, sometimes I combine exercise with other activities, such as cutting, splitting, or stacking wood. In colder months I use a tread mill and do calisthenics inside.
I hope this has helped at least a few people to become more self reliant. Remember that you can not count on anyone but your self to come to your aid in an emergency. Good Luck, Good Prepping, and God Bless.

Thursday, August 8, 2013

In a situation that will be characterized by, among other things, gutted pharmacies and unmanned hospitals, the remaining population at TEOTWAWKI will be required to provide their own medical care and to meet their own pharmacologic needs.  While there have been numerous helpful articles outlining the importance of antibiotics in the context of TEOTWAWKI there has been very little addressing the importance of an overall pharmacologic strategy.

Some of you—especially those who take daily prescription medication—have likely considered this problem before.  But perhaps you are young and healthy, unburdened by any medical diagnosis.  There should still be a pharmacologic component to your overall survival strategy.  Even the robustly healthy occasionally encounter the minor health annoyance—a stomach bug, say, a case of diarrhea or constipation, or perhaps a urinary tract infection.  The problem, of course, is that, in the context of TEOTWAWKI, the minor health annoyance can rapidly spiral into something life-threatening.

Consider the title of this article, for example.  Constipation is, for most people, an infrequent and easily remedied problem—a couple of Sennekot and a quart of juice cures 95% of cases.  If worse comes to worse, there are suppositories—or enemas.

But suppose that you have no access to over-the-counter laxatives.  Suppose you are plagued by constipation for several days but because it ranks low on your list of immediate problems, it goes untreated.  By the time you get around to dealing with it, you’ve got a very large, rock-hard ball of stool in the lower rectum, and it isn’t going anywhere.   This what medical folks refer to as a fecal impaction.  Impactions are common among already sick, weakened individuals; the treatment is manual removal.  Without intervention, an impaction can lead to colon perforation, peritonitis, sepsis, and eventually septic shock and death.

Or perhaps, in desperation, you attempt to unimpact yourself, or have a willing family member do it.  In the process of this procedure, you inadvertently lacerate one of the delicate rectal vessels--and suffer a large hemorrhage.  Incidentally, I have encountered this exact scenario before, working as an EMT in rural Alaska.

It sounds ridiculous—that a case of constipation could lead to such dire straits.  But make no mistake.  Due to decreased fluid intake and no access to fresh fruits and vegetables, there will be hordes of constipated people at TEOTWAWKI. 

Consider another common health complaint, especially for females: the dreaded urinary tract infection.  Normally it is cured with a three-day course of nitrofurantoin, or, if you lack health insurance, a slightly longer course of ciprofloxacin, which costs ten dollars.  But suppose you have no access to antibiotics, and again, decreased fluid intake.  You have nothing with which to treat the fever that develops.  Eventually you start passing bloody urine, then clots.  The pain evolves from a mild discomfort during urination to a stabbing sensation in the flanks; by day five or six or seven it feels as though every organ in your abdomen and pelvis is on fire.  The infection has migrated from the urethra, to the bladder, up the ureters, and has now settled in the kidneys.  You have developed what is referred to by medical folks as pyelonephritis.  The fever climbs to 105. Your blood pressure bottoms out as the infection spills over into your bloodstream.  Untreated pyelonephritis leads to urosepsis.  Outcome same as above—septic shock and death.

The point is, if you have a body, eventually something will go wrong.  Eventually you will require pharmacologic intervention.



From a pharmacologic perspective, there will be four categories of people at TEOTWAWKI:  The first are those who are healthy and dependent on no medication, or very little medication, for day-to-day function.  They may have diagnoses ranging from seasonal allergies to mild asthma, psoriasis, and the like—the loss of pharmacologic treatment might be inconvenient but it would not be catastrophic. 

The second category includes those with diagnoses like hypertension and hyperlipidemia, who currently enjoy relatively good health. The loss of pharmacologic treatment will have no immediate impact on function.  But in the grand scheme of things, lack of access to drugs will permit deterioration of organ function; in the case of untreated hypertension, for example, long-term exposure to high arterial pressures will cause the heart muscle to become thickened and stiff.  A stiff, noncompliant heart does not pump efficiently: the inevitable result is heart failure and all its symptoms.  This group also includes those with type II diabetes, as long-term exposure to elevated blood glucose spares no organ system in the body.

The third category of people encompasses those who are able to maintain a normal lifestyle in the sense that may still be capable of work, of managing activities of self care—indeed they may even be fit and athletic depending on the nature of the diagnosis--but they suffer from a condition requiring daily intake of prescription medication, the loss of which would be serious or even fatal.  This category includes individuals with diagnoses like type I diabetes, some types of heart disease, and severe hypothyroidism.   It also includes patients who received a donor organ for transplant and rely on immunosuppressive drugs to prevent organ rejection. 

The last category of people are those who would be considered unhealthy, either because of a systemic disease that limits function, function that cannot be fully restored even with daily medication, or because, even though they may still have moderately good day-to-day function, they are dependent on a constant supply of medication and/or medical technology for survival.  The former suffer from severe heart disease, cancer, congenital heart disease, and degenerative neurological conditions such as Huntington’s or Parkinson’s.   The latter group includes dialysis patients, COPD patients who require constant supplemental oxygen, tracheostomy-dependent patients, or those who can only take nutrition via tube feeds.


This article is aimed at all but the last group.  Not that members of the last group have no chance of survival at TEOTWAWKI, but the preparations that would be required are outside the scope of this article.  Pharmacologic preparation of the first three groups, if undertaken with a specific strategy and numeric goals in mind, is quite feasible.


  1. Determine your daily prescription medication needs.  If you and your family are perfectly healthy then the task is simple.  See Appendix A for my recommendations of prescription drugs.  If not, the task is still relatively simple: a one year’s extra supply of necessary prescription medications, in addition to those listed in Appendix A.  You may need to estimate—in the case of an asthmatic that uses inhaled steroids, for example, or for the migraine medication that is taken on an as-needed basis.  Determine what constitutes a one-year supply of the drug.  Record the data, with the names, dosages, and schedule, in a spreadsheet.
  2. Determine your over the counter (OTC) medication needs.  See Appendix B for my recommendations for the average individual.  Gauge your needs by looking in your medicine cabinet—perhaps you use a lot of liquid acetaminophen because you have small children in the home.  Perhaps your family goes through more   
  3. Inventory what you already have.
  4. Develop a plan for obtaining the rest.  Plan to obtain the drugs listed in Appendices A and B within one year.  This will require extra visits to doctors, calling in refills on schedule, being willing to fib about international travel perhaps, or being willing to change physicians.  More on this below.
  5. Store the drug stockpile in an organized and responsible way (indoors, labeled, airtight containers, with 02 absorbers, under lock and key if any controlled substances are included).
  6. After OTC and prescription needs are met, work on a stockpile for bartering purposes.  See Appendix C for ideas.
  7. Buy pharmacology reference books.  See Appendix D for recommended titles.



Don’t discount the potency or usefulness of a drug just because you can buy it at the local drugstore.  Many drugs that used to be prescription-only are now sold OTC.  One example of that is the proton-pump inhibitor omeprazole, used to treat acid reflux disease.  To expand on this example, imagine a situation in which a person who suffers from acid reflux disease exists solely on a diet of canned chili for an extended period of time, without access to his usual proton-pump inhibiting medication.  One day he begins vomiting blood, having developed a gastric ulcer as a result of his untreated condition.  If one of his companions has a supply of omeprazole on hand, currently available at any Walgreens or CVS without a prescription, his condition could be treated in the same manner in which it would be treated at the ER—with a large dose of a proton-pump inhibiting medication. 

Another example is aspirin.  Aspirin has a multitude of uses beyond pain relief.  It is a blood thinner.  For this reason it is often the first medication someone receives when they show up at the ER exhibiting signs and symptoms of stroke.  Aspirin is a central component of the standard protocol in treating patients who are suspected of having a heart attack—the blood thinning properties of aspirin are useful when a clot has occluded a coronary artery.  Aspirin also has unique anti-inflammatory properties—its use is normally avoided in children, but in the context of certain pediatric diseases, high-dose aspirin is a critical component of treatment.   Every time I shop at Sam’s club for groceries, I purchase aspirin in bulk.  Aspirin is inexpensive and potentially useful in so many ways. 



Not long ago a friend mentioned to me that he had thrown away some expired anti-depressant medication.  I suggested that he might instead sock away such medication for the possibility of a survival situation.  His position was simple:  in a true survival situation, he would have no tolerance for psychiatric illness.  People suffering from depression and other psychiatric maladies would be a drain on resources and a liability for everyone around them. 

I considered my friend’s position on this matter for a time and concluded that he was mistaken, for several reasons.  Number one, in extreme situations like TEOTWAWKI, people will inevitably experience depression, psychosis, PTSD, and so on.   Many scientists consider the aforementioned to be adaptive evolutionary responses to trauma, disappointment, and loss (research “Behavioral Shutdown Hypothesis” and “Analytical Rumination Hypothesis” if interested in further information). These conditions affect the toughest, most seasoned soldiers in the US military, so it is folly to assume that a meticulously chosen survival companion will be immune to them.  Depending on the nature of the psychiatric illness, at the very least it will affect the morale of the group; in the worst-case scenario it may indeed adversely affect the group’s chances of survival.  Having the means to treat such a condition may ultimately determine the fate of an entire group—consider a well-prepared, well-stocked family, the head of which is then struck down by a paralyzing depression—imagine that this happens at the worst possible time, at the very height of danger. 

Second, a survival companion may (whether they have chosen to share this information or not) already be taking a medication for depression or other psychiatric illness.  As aptly noted by author West Texas Prepper in the article Letter Re: When the Anti-Depressants Run Out, ceasing certain medications cold turkey leads to a crippling withdrawal syndrome.  Having a small supply of the same medicine on hand would allow a dose taper, thereby sparing the individual of any withdrawal symptoms.  I have witnessed patients, normally fully-functioning, contributing members of society, completely bedbound with nausea, vertigo, and paresthesias after running out of their daily anti-depressant medication.  In an already tenuous survival scenario, it would be imperative to avoid such a situation.

Third, many psychiatric medications have multiple indications.  Some were developed and manufactured for the treatment of other diseases years before their usefulness in treating psychiatric illness was discovered.  Case in point, my friend had thrown away four sample packages of the drug Depakote, known generically as valproate sodium, or valproic acid.  It had been prescribed for a patient diagnosed with bipolar disorder who was experiencing a depressive phase of the illness.  But, unbeknownst to my friend, valproic acid is used to treat a multitude of other conditions, most notably seizure disorders, but also migraine headaches, and chronic pain characterized by neuropathic symptoms.



The expiration dates assigned to drugs is arbitrary and very few drugs are actually toxic past the expiration date (tetracycline and doxycycline being the exception).  Testing has demonstrated that drugs maintain their potency decades after their expiration dates.  Save drugs you are certain you will never use, or never need again, save the ones you think were prescribed in error.  It is impossible to predict what might be useful. Save them regardless of the expiration date, regardless of how few tablets might be left in the package or how little ointment left inside the tube. 

My grandmother suffered an extended illness, the cause of which was unknown for a time.  Her physicians, not knowing what they were treating, hoping to eventually hit on the right drug, prescribed countless medicines, medicines from different classes and of varying strengths.  When I helped my grandfather clean out his medicine cabinet last summer, I found a cardboard box filled with bottles of unused diuretics and anti-inflammatory meds used to treat autoimmune diseases (and also useful in treating malaria).  With my grandfather’s permission I took the unused medication, removed the pharmacy stickers from the pill bottles, and replaced them with medical tape on which I wrote the names of the drugs and the milligrams per tablet.  For those without medical training, I suggest also recording the indication and recommended dose.

Although there are laws prohibiting the stockpiling of prescription medications, there are no reports of arrests for stockpiling medication in the manner described above.  Those who fall under legal scrutiny do so because they stockpile controlled substances, with intent to supply their own habit or to profit financially from supplying the habits of others.  That being said it is best to not discuss this type of preparation with others.  Nor would I advertise on craigslist requesting unwanted prescription antibiotics.  Limit those you involve to immediate family and trusted friends.  




Your primary care physician (PCP) may or may not be a good resource.

On the one hand, he or she may be in total agreement with you, and willing to write scrips for an extra supply of your regular medications, and perhaps even some antibiotics.  On the other hand, he or she may interpret your desire to prepare for a worst-case scenario as a manifestation of mental illness, one that is potentially dangerous and requires further investigation.  If the physician knows you have weapons at home, the situation becomes further complicated.  Therefore I do not recommend that people approach their PCP and ask for prescriptions for stockpiling purposes.

If you decide to do so and are honest about the reason why, and your physician responds by asking searching questions about your psychiatric history, or says, “Now tell me, how long you have had this obsession with the apocalypse?” then abort the mission immediately and refocus all efforts on damage control.

However, there are ‘legitimate’ reasons that physicians sometimes write prescriptions for large amounts of antibiotics, and there are numerous taken as needed (PRN) drugs that physicians write prescriptions for on a daily basis.  Odansetron, the anti-nausea medication, is one that comes to mind.  Benzonatate, the cough medication known as “tesselon pearls” is another.  If you are willing to ask for such medications, citing the presence of nausea or a cough that keeps you awake at night, you can easily obtain such prescriptions.  If you ask that refills be available if needed, your doctor is likely to oblige.   Refill the drug on schedule as refills are sometimes limited to a twelve-month period.

Be a hypochondriac for a year.  Get more than one PCP.  Pay out of pocket for duplicate prescriptions. Ask for samples.  Have a lot of colds. 

Another strategy is to go to the physician with a request for prescription meds for international travel.  Present a list of recommended drugs to have on hand when traveling in that area, perhaps one printed from a reputable web site (CDC).  I don’t know of any physicians that require the patient to present their boarding pass before writing such prescriptions.



  1. Antibiotics
    1. Augmentin-600mg-60 tablets per person (three 10-day courses)
    2. Ampicillin-500mg-63 tablets per person (three 7-day courses)
    3. Amoxicillin-500mg-100 tabs per person (50 days’ worth per person; ten 5-day courses, five 10-day courses, seven 7-day courses—it can be tailored to what is being treated)
    4. TMP-SMX (Bactrim DS)-84 tablets per person (three 14-day courses)
    5. Azithromycin-500mg-15 tabs per person (three 5-day courses)
    6. Cephalexin-500mg-120 tablets per person (three 10-day courses)
    7. Clindamycin-900mg-90 tablets per person (three 10-day courses)
    8. Metronidazole-500mg-90 tablets per person (three 10-day courses)
    9. Cefdinir-300mg-60 per person (three 10-day courses)
    10. Nitrofurantoin-200mg-42 tablets per person (three 7-day courses)
    11. Gentamicin ophthalmic solution-two bottles per person
    12. Erythromycin 0.5% opthalmic ointment-three tubes per person
    13. Ciprodex Otic-ciprofloxacin 0.3%, dexamethasone 0.1% solution-two bottles per person
    14. Aurodex Otic-antipyrine/benzocaine solution-one bottle per person (this is not an anti-microbial but it is useful for attenuating symptoms of ear infection)
    15. Mupirocin 2% antibiotic ointment-two tubes per person
  2. Anti-virals
    1. Acyclovir-400mg-63 tablets per person (three 7-day courses)
    2. Oseltamivir-75mg-30 tablets per person (three 5-day courses)
  3. Anti-fungals
    1. Fluconazole-100mg or 200mg tablets-60 per person
    2. Clotrimazole topical-several per person
    3. Nystatin suspension-100mL per person
    4. Nystatin cream-two tubes per person
    5. Ketoconazole-200mg-28 per person (one four week course)
  4. Anti-parasitic (for treating intestinal worms)
    1. Mebendazole 100mg-20 tablets per person
    2. Pyrantel pamoate (Pin X)-720.5mg-10 tablets per person
    3. Thiabendazole (Mintezol) 500mg tablets-10 per person
  5. Cardiovascular Health
    1. Anti-hypertensives
      1. HCTZ-25mg-365 per person
      2. Metoprolol-100mg-200 per person
      3. Lisinopril-20mg or 40mg-365 per person
        1. An alternative is one of the –sartans (i.e. Valsartan, 320mg) but they are more expensive
      4. Clonidine-0.2mg-100 tablets per person
      5. Spironolactone-50mg-100 tablets per person
      6. Furosemide-40mg-100 tablets per person
      7. Phenoxybenzamine-10mg-25 per person
    2. Lipid Reduction Agents
      1. Simvastatin-10mg-365 per person
      2. Fenofibrate-35mg-100 per person
  6. Gastrointestinal Health
    1. Omeprazole-20mg-365 per person
    2. Ranitidine-150mg-365 per person
    3. Misoprostol-200mcg-80 per person
    4. Odansetron-4mg-100 per person
    5. Promethazine suppositories-25mg-25 per person
    6. Metaclopramide-10mg-25 per person
    7. Diphenoxylate-atropine-300mL per person
    8. Anusol HC suppositories (2.5% hydrocortisone)-10 per person
    9. Lactulose-100mL per person
  7. Urinary Tract Health
    1. Allopurinol-100mg-100 per male
    2. Finasteride-5mg-365 tablets per male
    3. Bethanechol-25mg-20 per person
    4. Oxybutynin-5mg-20 per peron
    5. Colchicine-0.5mg-100 per person
  8. Gynecological Health
    1. Ethinyl estradiol/norethindrone combination-28 day packets-12 per female (useful for a multitude of menstrual problems)
    2. Contraceptive method of choice-one year’s worth per sexually active female
    3. Estradiol gel 0.06%-several tubes per older female
    4. Estratab-0.3mg-365 tablets per post-menopausal female
  9. Pain Medications
    1. Carbamazepine-200mg-50 tablets per person
    2. Gabapentin-400mg-100 tablets per person
    3. Diclofenac-50mg-200 tablets per person
    4. Cyclobenzaprine-5mg-50 tablets per person
    5. Keterolac-30mg-50 per person
    6. Tramadol-25mg-50 per person
    7. Immediate Release Morphine tabs-5mg-25 per person
    8. Extended Release Morphine tabs-15mg-50 per person
    9. Sumatatriptan-100mg-25 per person
  10. Allergies/Asthma/Respiratory
    1. Hydroxyzine-25mg-50 per person
    2. Prednisone-10mg-200 per person
    3. Loratidine-10mg-100 tablets per person
    4. Albuterol metered dose inhaler-3 per person
    5. Steroid metered dose inhaler (Advair, etc)-3 per person
    6. Benzonatate-100mg-100 per person
    7. Hycodan syrup (each 5mL contains hydrocodone 5mg-homatotrropine 1.5mg)-150ml per person
    8. Epinephrine injection (EpiPen, EpiPenJr)-two injection pack-three per person
    9. Guafenisin-phenylephrine (Entex)-100mL per person
    10. Montelukast-10mg-100 per person
    11. Metaproterenol-20mg-30 per person
  11. Skin Conditions
    1. Mometasone furoate 0.1%-15g or 45g tube-two per person
    2. Silver sulfdiazene-45g tube-five per person
    3. Cleocin 1%-two tubes per person
    4. Permethrin (Lindane)-five bottles per person
  12.   Psychiatric/CNS Medications
    1. Lorazepam-1mg-50 per person
    2. Lorazepam suppositories-0.5mg-10 per person
    3. Alprazolam-0.5mg-30 per person
    4. Fluoxetine-20mg-60 per person
    5. Wellbutrin-150mg-30 per person
    6. Haldol-5mg-10 per person
    7. Amitryptiline-50mg-30 per person
    8. Bromocriptine-1.25mg-10 tabs per person
    9. Meclizine-25mg-50 per person
    10. Scopolamine patch-ten per person
  13. Endocrine Health
    1. Metformin-500mg-500 per person
      1. For those with a strong family history of diabetes, Hispanic background, or prediabetes, I recommend stockpiling a one year’s supply of 1000mg strength metformin.
    2. Levothyroxine-150mcg-100 per person
    3. Insulin-300units-10 bottles per family (must be kept refrigerated)

APPENDIX B: Recommended OTC Drugs

  1. Acetaminophen-500mg-1000 tablets per person
  2. Acetaminophen liquid-five bottles per person
  3. Ibuprofen-500mg-1000 tablets per person
  4. Ibuprofen liquid-five bottles per person
  5. Naproxen Sodium-500mg-1000 tablets per person
  6. Aspirin-325mg-1000 tablets per person
    1. 325mg tablets can be cut into quarters, the quarters then approximate the normal 81mg dose recommended for most people with mild coronary artery disease or hypertension
    2. Alternative you can purchase the ‘baby aspirin’ version, often in chewable form, which is 81mg per tablet, though it is not common to find this in bulk and it is more expensive.
  7. Water-based lubricant jelly (KY)-5 tubes per person
  8. Petroleum jelly 100%, 13oz containers (i.e. Vaseline)-5 per person
  9. Immodium (loperamide)-100 caplets per person
  10. Docusate sodium-100mg-500 caplets per person
    1. Simply Right Stool Softener with 400 gel caps per bottle is an inexpensive example of this.
  11. Glycerin suppositories 2gm glycerin per suppository-100 per person
    1. Consider purchasing the pediatric version, containing 1gm glycerin per suppository
  12. Diphendydramine HCl-25mg-1000 tabs per person
  13. Fleet enemas (containing monobasic and dibasic sodium phosphate)-eight per person
    1. Alternatively you can purchase empty enema bottles and make your own saline solution, 1.5 teaspoons table salt to 1000mL of water; this can be preferable to the phosphate solution in store-bought enemas as phosphate can cause cramping.
    2. You may also want to research how to make a soap suds enema, the type often used in hospitals, and store the ingredients—liquid castile soap is the standard.
  14. Hemorrhoidal cream (Preparation H or Equate Brand Hemorrhoidal cream-contains 0.25% phenylephrine to constrict vessels, glycerin 14% as a protectant, pramoxine 1% as a local anesthetic)-2oz tube-5 per person
    1. Phenylephrine is the active ingredient in some decongestant nasal sprays like Neo-Synephrine Extra Strength Nasal Spray or WalGreens Ephrine Nose Drops; moreover these sprays contain a more concentrated dose of phenylephrine (usually 1%)—I have found that a cotton ball soaked with aforementioned spray works far better than Preparation H (or its equivalent) cream for getting the patient quick, effective relief—as an alternative to stocking up on Preparation H, I recommend stocking up on extra nasal spray for the purpose of treating hemorrhoids
    2. If you want a local anesthetic component for treating hemorrhoids, any local anesthetic ointment can be used to supplant a vasoconstrictor—I recommend using lidocaine, 2% or 5%, which requires a prescription.
  15. Medicated hemorrhoidal pads, active ingredient witch’s hazel 50% (i.e. Tucks)-several boxes per person
    1. An alternative to purchasing $6 boxes of Tucks pads containing 20 pads each, is to purchase a $3 16-oz bottle of 100% witch hazel (at Wal-Mart or most drug stores) and make your own pads using cotton balls or the like; witch hazel has many other uses too.
  16. Zinc oxide ointment 40% (i.e. Desitin)-five large containers per person
  17. Medicinal foot powder-1% menthol-(Gold Bond, Walgreen’s brand)-10oz bottle-three per person
  18. Anti-fungal foot powder 2% miconazole nitrate (Tinactin, Lotrimin AF, Walgreen brand ‘Athlete’s Foot Powder)-3-4 oz containers-five per person
  19. Pepto Bismol (bismuth subsalicylate)-16oz-5 per person
  20. Triple antibiotic ointment(should contain bacitracin, neomycin, and polymixin b)-ten tubes per person
  21. Tea tree oil-2 fluid ounces-ten bottles per person. This is an expensive oil; however it has many uses—a recent study indicated that tea tree oil is more effective than prescription medication for the treatment of lice, which is the main reason I have it listed here, as the rate of parasitic infections will be increased at TEOTWAWKI
  22. Pseudoephedrine-25mg-100 caplets per person
  23. Dextromethorphan syrup, 30mg dextromethorphan per dose (Robitussin, Delsym))-5 bottles per person
  24. Isopropyl (rubbing) alcohol 16oz-ten or more bottles per person
    1. Warning-in a TEOTWAWKI situation, there will be desperate alcoholics in withdrawal, willing to drink anything with a label that indicates any percentage of alcohol within, no matter how small—isopropyl alcohol is usually not fatal if ingested and its effects resemble those of ethanol (the form of alcohol for drinking); the treatment is supportive care and to not do anything or give anything that interrupts metabolism, as the metabolite (acetone) is less poisonous than isopropyl.
    2. Drinking of isopropyl alcohol will not have the same effects as the ingestion of methanol (found in windshield wiper fluid-causes blindness, confusion, respiratory failure and death), or ethylene glycol (found in antifreeze-causes muscle spasms, heart dysrhythmias, congestive heart failure, kidney failure, death); nevertheless, for any product containing any percentage of alcohol on the label, I recommend adding a bright red sticker with the words “NOT FOR DRINKING-POISONOUS!” with skull and crossbones drawn—and if the TEOTWAWKI happens, keep these items stored in a place that is not well-frequented.
  25. Hydrogen peroxide-10-20 gallons per person
    1. There are many uses of hydrogen peroxide.
    2. See this site as an example of where inexpensive hydrogen peroxide can be purchased (Less than 10 dollars per gallon)
  26. Ben Gay Muscle Pain/Ultra Strength (30% methyl salicylate, 10% menthol, 4% camphor)-three tubes per person
    1. For those with allergy to aspirin an alternative is Tiger Balm Ultra, which contains 11% camphor and 11% menthol
  27. Mentholated topical cream, active ingredients camphor, eucalyptol, menthol (i.e. Vick’s VapoRub)-three jars per person
  28. Electrolyte replacement packets (Pedialyte makes these; a 4-pack costs about $5, Walgreens carries the equivalent; an 8-pack costs $4)-20 per adult, 40 per child
  29. Multivitamins-1000 per person (make sure and include some chewable forms for children or those who cannot swallow pills)
  30. Vitamin D-(1000-5000IU)-500 per person (also comes in liquid form)
  31. Folic Acid (400mcg-1mg)-500 per ovulating female
  32. Vitamin B12-(comes is dosages as low as 100mcg, as high as 5000mcg-recommend a variety)-500 per person
  33. Hydrocortisone cream 1% hydrocortisone, comes in 2oz tubes-10 per person
    1. Alternatively you can ask your doctor to prescribe a stronger version of the same medication, 2.5% strength hydrocortisone cream; this may be preferable if you or your loved ones suffer often from dermatitis, eczema, or other skin inflammation.
  34. Calamine lotion, contains calamine and zinc oxide, can be purchased in 6 oz bottles for about $1.50 at Wal-Mart. - Three bottles per person
  35. Sterile saline solution 0.9% concentration-1L bottles-10 per person
    1. You can make your own 0.9% saline solution but it will not be sterile; this becomes important when using it for the irrigation of wounds, etc
    2. For making your own solution, 9grams of sodium is dissolved in 991 mL of water
    3. Research and print the many uses of saline solution.
  36.  Oral liquid/gel anesthetic (20% benzocaine)-3 per person
  37. Coal tar shampoo (T Gel 2%, Denorex 2%, Psoriatrix 5%)-one per person
    1. If you or your loved ones suffer from psoriasis you may want to purchase other OTC coal tar products (bar soap, ointment, etc)
    2. For those with skin issues, three bottles per person recommended.
  38. Selenium sulfide shampoo-three per person
  39. Phenazopyridine (Urostat)-
  40. Miralax powder-17.9oz-three per person
  41. Fiber powder (Metamucil)-16oz-three per person
  42. Magnesium hydroxide suspension, 1200-2400mg per 10-30mL (Milk of Magnesia, etc)-16oz-five per person
  43. Antacid tablets, calcium carbonate 500mg per dose (Tums)-1000 per person
  44. Mineral oil (liquid petroleum)-16oz-three per person
  45. Earwax removal solution (carbamide peroxide)-three per person
  46. Nasal spray (Oxymetolazone HCl, phenylephrine)-five per person, more if you plan to use these to treat hemorrhoids too
  47. Doxylamine succinate 6.25-50mg per dose-50 doses per person
    1. This is the sedating component of NyQuil brand drugs
    2. It is a potent anticholinergic and can be used to treat a multitude of conditions (morning sickness, allergies, insomnia)
  48. Caffeine tablets-50mg-200 per person
  49. Trolamine salicylate cream 10% (Aspercreme)-5oz-five per person
  50. Tiger Balm Liniment (Menthol 16%, Oil of wintergreen 28%)-0.63oz-three per person
  51. Capsaicin products 0.05-0.1% strength-this is the natural ingredient found in hot peppers; it has been found to inhibit the actions of substance P in pain transmission; it can be used to treat the pain associated with diabetic neuropathy, tension and cluster headaches, osteoarthritis, trigeminal neuralgia, shingles, and more)
    1. Creams (Capsa Cream 8, Zostrix, Walgreens brand)
    2. Nasal sprays (Sinol, Sinus Plumber)
    3. Qutenza, a prescription pain patch that contains 8% capsaicin
  52. Povidone-iodine topical antiseptic-16oz bottle-five per person
  53. Phenol lozenges 14.5mg per lozenge/spray 1.4% in solution (Cepestat, Chloraseptic)-three per person
  54. Cinnamon supplement, 500mg-1000 capsules per person
    1. See the scientific evidence in support of cinnamon as having multiple healing properties
    2. Because I was a gestational diabetic, and because of my Latina heritage (my father emigrated from South America), and because my father, and multiple relatives on my mother’s side suffer from Type II Diabetes, I know that is where I am headed, despite a normal BMI and active life style.  Evidence suggests that cinnamon aids in glucose metabolism; studies have shown a decrease in A1C in diabetics who take cinnamon daily over a period of months.  I take cinnamon every day, in hopes of preventing or postponing Type II Diabetes.
  55.  Fish oil (Omega-3)-1000 caps per person
    1. A cardiologist I trust recommends daily fish oil even for the young and healthy.  Here is an article outlining the evidence.
  56. Baking soda-several five pound bags per individual
    1. There are many medicinal uses for baking soda, and whole books written on this subject
    2. Baking soda is also useful for cooking, cleaning, hygiene, as a fire extinguisher, biopesticide, cattle feed supplement, numerous others.
  57. Nutritional supplementation-Boost, Pediasure, etc
    1. To be used after electrolyte replacement therapy but before someone is ready to take regular foods again.
    2. A nutritional shake can make a huge difference in whether someone gets much-needed calories during a medically vulnerable period.

Appendix C: Drugs for Bartering

The two categories of medication likely to be most useful for bartering are antibiotics and pain medication.

  1. Antibiotics
    1. Amoxicillin-500mg-easy to get and inexpensive
    2. Bactrim DS-excellent for skin and wound infections
    3. Opthalmic antibiotics
  2. Pain Medications
    1. Aspirin
    2. Acetaminophen
    3. Ibuprofen
    4. Any narcotic/opioid (i.e. Vicodin, Percocet)—would be highly desirable in a situation involving serious injury
  3. Vitamins
  4. Insulin-will be a commonly needed, highly valued item since there are so many diabetics in our population.
  5. Inhalers for those with asthma/COPD
  6. Contraceptive devices—condoms, foam, other types of birth control
  7. Caffeine pills-ability to stay wired at critical times will be priceless at TEOTWAWKI
  8. Anti-diarrheals (loperamide, Pepto Bismol)


Appendix D: Pharmacology Bookshelf

  1. The Pill Book (Prescription medications)
  2. The Pill Book Guide to Over-the-counter Medications
  3. Any basic pharmacology textbook
  4. Sanford Guide to Antimicrobial Therapy
  5. Current Medical Diagnosis and Treatment 2013 (Lange)


JWR Adds: In addition to storing OTC laxatives (such as Senna tablets and plenty of Metamucil,) I also recommend stocking up on sprouting seeds and stainless steel screen mason jar lids (sold by several SurvivalBlog advertisers,) for growing sprouts at home. Be sure to regularly practice growing sprouts. Growing your own dietary roughage is the most healthy and reliable way to keep yourself regular.

Wednesday, August 7, 2013

Mr. Rawles -
I have been living with a CPAP for many years now, and am one of the persons for whom it has worked very well. I also know how bad things can be after not having my CPAP for three days when an airline lost it. After three days I was almost totally non-functional and was ready to lay out the $2,000 out of my own pocket to get a replacement machine. Fortunately my machine was found by the airline.

More recently I had 3 nights in 2 months where power outages deprived me of the use of my machine. I determined that I needed to find a way to get my CPAP off the power grid.

The first step was to measure the actual power drawn by my machine. Using a Kill A Watt monitor I learned that my machine used 27 watts of power. This of course could vary with the pressure setting, and model used.

I then found a 55 watt solar charging system on sale at Costco for $200. The system came with 3 panels, mounting frame, charge controller, and 200 watt "modified sine wave" inverter. I added a 125 A/hr deep cycle battery,
battery case, and some 10 gauge wire. Since my CPAP did not have a DC power option, I could not run it directly from the battery. The AC input, however, was a "universal" design which can accept any AC voltage from 100
to 250 VAC without switching. Such a universal power input has no problem dealing with the less than ideal power from the "modified sine wave" inverter. If my CPAP had just a conventional 120 VAC power input then the
use of a "true sine wave" inverter might have been needed.

This system worked fine to run my CPAP all spring, summer, and fall, but come winter with shorter days and more clouds, it could not keep the battery charged. I needed to supplement the solar charging system with a AC powered battery charger.

The next year I purchased another identical system, and hooked two of the panels to the [batteries for the] CPAP system. The charge controller supplied with the systems could only support 5 panels for about 91 watts of power in peak sunlight. This expanded system worked great all this last winter.

After the success of my off-grid solar electric system, I now have a separate system for my ham radios, and am building a larger system to power our refrigerator.

It is quite possible and not that expensive to build an off-grid solar electric system to power relatively small loads like a CPAP machine. Like everything else in preparedness, it is better to build and try your preps now, while we still have the support infrastructure to allow you to make mistakes and correct them. - Suburban R.

JWR Replies: Many thanks for giving us the details on how you made your system work. Having separate system provides redundancy. And keeping them separate will help prevent an accidental deep discharge of your system. (This typically happens when an appliance is accidentally left turned on.) Having separate systems also gives you some redundancy because of equipment failure. You could fairly quickly reconfigure your ham radio power system into a power source for our CPAP. Something as simple as just a broken power cord could deadline a system, so buy spares for all of the crucial parts. Remember: "Two is one, and one is none!"

From what I have read, the motors inside most CPAP machines run on DC voltages. So for someone to run a DC to AC inverter, only to feed your machine's 120 VAC input jack (or cord) which is then in turn transformed back into DC is grossly inefficient. So I recommend this to anyone who is dependent upon motorized medical equipment (such as a CPAP machine or an Oxygen Concentrator) with an AC input: Do your very best to replace them with a unit that has a 12 VDC power input. If you contract with a medical supply company, or a care facility, or there is a medical insurance company involved, then this might be more complex. DO NOT overly complicate the process by telling them all about your alternative power system (or your plans to get one.) That will just confuse the situation. Simply tell them that you need a system that is compatible with power available from a car cigarette lighter. THAT is something simple they will be able to understand!

Tuesday, August 6, 2013

Obstructive Sleep Apnea (OSA) is a breathing disorder which is caused by the narrowing or total occlusion of the airway while sleeping.  The study of sleep using electroencephalogram electrodes, chest and abdominal effort belts, breathing sensors, and blood oxygenation sensors is called polysomnography.  The advent of Continuous Positive Airway Pressure (CPAP) machines in the 1980s started the home treatment revolution of OSA.  Studies have shown that untreated OSA can cause high blood pressure, heart disease, stroke, depression, excessive daytime somnolence, fatigue, occupational accidents, and motor vehicle accidents.  More recent studies have shown that OSA is linked to adult-onset diabetes, fibromyalgia and attention deficit disorder.  OSA is just one of the disorders in the Sleep Disordered Breathing realm.  Depending on the diagnosis and appropriate treatment, a person may utilize a CPAP, Auto-PAP, BiLevel, Auto Servo Ventilation (AutoSV), or Variable Positive Airway Pressure (VPAP) machine.  For the rest of this article, I will refer only to OSA and CPAP for simplicity.

OSA is a common problem in our nation.  One study shows that about 1 in 5 men and 1 in 10 women in the United States have Obstructive Sleep Apnea (1).  While many people have been tested and treated for OSA in the past two or three decades, it is still suspected that more people have been undiagnosed than have been diagnosed.  One of the first things that will be seen without electricity is a die-off of people afflicted by many life-threatening ailments.  People sustained by ventilators will be gone in minutes after a large scale power failure.  People who require dialysis for kidney failure will be gone in a matter of days or weeks.  The vast majority of people with OSA will not expire in the short term without their CPAP machines.  However, they would likely become miserable, exhausted, and experience physical and mental breakdowns from not getting restful sleep.
I am a respiratory therapist and sleep technologist.  I also have OSA and use a CPAP machine.  I love and endorse it.  In a national crisis and utility collapse, I would miss running my CPAP on AC current.  However, here are some ways to cope.

Run your machine on DC power.

Most of the modern CPAP machines have a 12 VDC power input port.  Cords can be obtained from Home Medical Equipment (HME) providers but are not a prescription item and insurance does not cover them.  It is least expensive to find what you need on the internet.  I have a cable with a DC jack on one end and a male cigarette lighter plug on the other.  This cable alone could be used to power the machine in a vehicle from the cigarette lighter.  I have second cable which has a female cigarette lighter socket and splits into two jumper cable type battery connectors.  When connected to a fully charged deep cycle marine battery, I get at least two nights of power for my CPAP.  This is what I do when I go ice fishing in a sleeper house in the winter.  Hiking with a deep cycle marine battery is cumbersome to say the least and not practical when on the move.  A small number of CPAP machines have internal batteries but they usually only offer about 8 hours of power before being depleted.  Heated humidifiers really consume battery power.  If you use a humidifier, it is best to use the humidifier passively and just let the air pass over the water in the chamber.  You won’t get nearly as much humidification but it’s better than none at all.  Use saline to moisturize your nasal passages and drink water to stay hydrated.  The number of hours you get out of a deep cycle battery varies depending on the battery’s amp-hour rating, the ambient air temperature, and the pressure(s) that your ventilatory device operates at.  To recharge the battery, photovoltaic mat or panel can be used to trickle charge it.  I have looked into portable military grade solar mats and panels  They are expensive, running a few hundred to over $1,000.  However, they can also be used to recharge cell phones, GPS devices, and any other battery powered gear.  It may be worth it to you to invest in a good one.

[JWR Adds: Be sure to get a charge controller, to avoid over-charging your battery bank. For a typical CPAP machine, plan on a battery bank with at least 260 amp hours of capacity. Generally, this means buying four deep cycle ("marine" or "golf cart") 6 volt batteries, and cabling them in a series-parallel arrangement, to provide 12 Volts, DC. I recommend using 6 gauge cables. Your local golf cart shop should have a 6 gauge cable terminal crimping tool available, and can fabricate the cables for you, for a nominal fee. These days, the copper in the cables will probably cost you much more than the terminals and the labor charge.]

Provent nasal valves.

Provent is made by Ventus Medical Inc., Belmont, California.  These nasal devices were introduced a couple years ago.  They look like a pair of penny-size adhesive bandages.  In the center, each contains a small valve.  Provents are peeled and adhered over each nasal opening.  The valves allow air to easily be inhaled through the nostrils, but when exhaling, the valves close, leaving only a small hole to exhale through.  This creates backpressure which props the airway open much like CPAP.  A chin strap is recommended to keep the mouth closed.  Studies have shown that they are quite effective in treating OSA and are used primarily for people who fail to tolerate CPAP (2).  They are also used by people with OSA who go on extended outdoor trips where there is no electricity.  It requires a doctor’s specific prescription for Provent Therapy and cost about $60 to $70 for a month supply.  Like prescription medications, it could be difficult to stockpile large quantities that would last you many months or years with no electricity. 
See for more information.

Get fitted with an OSA dental appliance now.
This may be the best option, in my opinion.  No power needed.  These are very effective and portable.  I am not referring to the television infomercial “boil and bite” anti-snoring mouth pieces.  Those usually deteriorate within a matter of months.  There are several different styles of dental appliances used to treat OSA.  Very strong materials are used including high tech hard plastics, titanium, micro screws, and springs.  These are not cheap devices.  They can cost anywhere from $1,500 to $5,000 to have them custom molded, fitted, and tested by a dentist specializing in treating OSA with dental devices.  They advance the lower jaw, creating a mild under bite, advancing the tongue, and opening the airway.  Care must be taken to optimize the effectiveness of the appliance without causing temporal mandibular joint (TMJ) problems or pain.  If you wear dentures or have bridges, you will likely not be a candidate for a dental appliance like this. 

See for a list of dentists who specialize in this area.    

Positional sleep therapy.
When there are no other options, at least try to sleep on your side with upper body elevated.  A significant angle helps overcome gravity and prevents airway tissues and the tongue from drooping and blocking the airway.  Sleep at angle on a hillside if outdoors.  In your survival retreat, use a wedge or several pillows to significantly elevate your head.  45 to 60 degrees may be required for desired effect.  Many people note an improvement in sleep when in a reclining chair.  It can help.  However, I’ve rarely seen anyone sleep on their side in a recliner.  They are still essentially supine and still can exhibit obstructive apneas and flow-limited breathing.  Sleeping prone is no guarantee of a patent airway either.  I’ve seen many people snore and have respiratory events while sleeping on their stomach.  There are several pillows on the market which claim to treat OSA.  However, your head must stay in the correct position for it to work.  For anyone who has taken a CPR course, you know the head-tilt, chin lift method to opening the airway of an unconscious victim.  This head position would work great at treating obstructive sleep apnea, but who would ever stay in that perfect position while sleeping?  One positional method includes wearing a backpack with a soccer ball or basketball inside.  It prevents turning to supine position while sleeping.  If you are in the woods with a full backpack, wear it while you sleep to stay on your side.  There’s still the possibility of airway collapse when sleeping laterally and elevated but it’s less likely than totally supine.    

Lose weight now.

Obesity is a contributing factor in OSA.  That’s not to say that all obese people have OSA or that slender or fit people don’t have OSA.  People I see in the sleep lab come in all shapes, colors, and sizes.  One of the loudest snorers I’ve ever heard was a petite, middle-aged woman who was 5’ 4” and 125 lbs.  The longest obstructive apneas with the most severe oxygen desaturations I’ve ever seen were exhibited by a man who was 5’10” and 185 lbs.  People can be predisposed to having OSA due to the size of their tongue, tonsils, soft palate, and uvula.  They may have a small and / or recessed chin (micrognathia and retrognathia).  Their neck circumference, alcohol and tobacco use, age, and gender are all contributing risk factors.  However, weight gain is a major cause in developing OSA, especially during middle age.  In a survival situation, calories will be a commodity hard to come by and many will no longer have a choice in the matter.  Today while we still have all the modern conveniences, it’s a lot easier said than done to lose weight and keep it off.  If you are obese, significant weight loss is likely to reduce the severity or presence of OSA but is no guarantee that you will be “cured”.  Your goal should be to get your weight and Body Mass Index (BMI) into a normal range.  Refer to this National Institute of Health chart, to see where you are and where you should be.

Surgical treatments for OSA.
Surgeries are not always the best solution to treating OSA.  All too often, people arrive at the sleep lab and state, “If I have obstructive sleep apnea, I just want to have ‘the’ surgery and fix it once and for all”.  Unfortunately it’s just not that easy.  There are many different types of surgical procedures.  There are too many to go into in this article.  However, I will state that most surgical procedures focus on removing, shrinking or toning the tissues of the upper airway.  Depending on which surgeon is selling you their services and which procedures they specialize in, results vary greatly.  I see many people in the sleep lab who were diagnosed with OSA, disliked CPAP, had surgery, and still had OSA and had to continue with CPAP.  The surgeries are invasive, costly, painful, and require weeks of healing time with no guarantee of success.  The only surefire and drastic way to surgically treat OSA is with a tracheotomy, which people rarely agree to.  Proceed with caution and research the surgeon and the procedure they want to perform on you.

Use Breathe-Right nasal strips to decrease snoring. 

High nasal resistance is a contributing cause to snoring.  Narrow nasal passages, a deviated septum, history of nasal fractures, polyps, and congestion all contribute to increased nasal resistance.  Perform Cottle’s maneuver (3) by placing your index fingers on your cheekbones about an inch under your eyes.  Gently pull the skin on the cheekbones outwards toward your ears.  If you note your nasal passages open and you can move air easier, then you likely have some nasal resistance.  A Breathe-Right strip can help decrease nasal resistance and the likelihood of snoring from nasal issues.  Remember that snoring and OSA are two different things.  Often, Breathe-Right nasal strips do little to alleviate respiratory events caused by a compromised airway in OSA.  However, they are a great adjunct therapy in combination with wearing a CPAP mask or dental appliance to help a person exchange air nasally.  They are extremely small, portable, and light.  I feel that the treatment of snoring is also important as it could be a security risk.  Snoring while outdoors can give away your position, whether in the day or night.

In Summary:

In a world where there is a bed, bedroom, and electrical power, I will take my CPAP any day.  If there is no grid power or I’m out in the wilderness, my strategy would be to sleep laterally with my head elevated, using a dental appliance in conjunction with a chin strap and Breathe-Right nasal strip.  However you decide to manage your OSA in a world without electricity, it is my hope that you find a way to get some quiet, refreshing sleep, as it is imperative to your mental and physical acuities to be alert and sharp in order to survive.
God bless and keep you!

1.  Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. New England Journal of Medicine.  1993;328:1230–1235.

2.  Walsh J, Griffin K, Forst E, Ahmed H, Eisenstein R., Curry D, Hall-Porter J, Schweitzer P.  A convenient expiratory positive airway pressure nasal device for the treatment of sleep apnea in patients non-adherent with continuous positive airway pressure.  Sleep Medicine. 2011;12: 147-152.

3.  Tikanto J, Pirila T.  Effect of the Cottle’s maneuver on the nasal valve as assessed by acoustic rhinometry.  American Journal of Rhinology.  2007 Jul-Aug;21(4):456-9.

About the Author: Chris X. is a Registered Respiratory Therapist, Registered Polysomnographic Technologist, and a Registered Sleep Technologist

Sunday, July 28, 2013

This essay is a joint effort from a healthcare couple.  My wife is a hospice nurse and I work at a long-term care facility.  Together, we have witnessed numerous patients die.  The purpose of this essay is to educate you in helping to take care of a dying group member (will use the term patient for this writing).  The first time that I experienced death up-close and personal was when my best friend B. died a few years ago.  We were both in our 20s and he had cancer.  Over the course of more than a year I was with him as he went through chemo, radiation and surgery.  At that time my experience with death was limited to my elderly grandfather and a few friends of my parents.  Death seemed pretty sterile and did not happen directly in front of my own eyes.  Now in my early 30s, I’ve experienced the death of more friends, their newborns/young children, more grandparents, and numerous patients of ours of all ages.  I’ve learned a lot since then and would like to share it with you.

In a TEOTWAWKI scenario, the reality is that people are going to die.  People you cared deeply for as well as people you never met.  Depending upon the scenario, the death-rate could be high and the possibility that you may have to help with the care of a dying person is likely.   
Take for example some of the current big killers for the U.S. population:

  • Heart disease
  • Cancer
  • Stroke
  • Diabetes
  • Respiratory Diseases
  • Influenza

Now add in potential TEOTWAWKI scenarios and the list could be expanded to also include these potential deadly killers:

  • Gunshot and other puncture wounds
  • Lack of availability for life-sustaining medication
  • Influenza epidemics
  • Worldwide diseases that are relatively low here in the U.S. but may increase do to unsanitary conditions and/or lack of access to quality health care (such as AIDS, Cholera, Hepatitis, Malaria, Meningitis, Rotavirus, Tuberculosis, Typhoid, etc.)
  • Labor complication
  • Drowning
  • Burns
  • And the list could go on and on…

Whatever the case, if you are called upon to help with the care of a dying person, it is best to know a little about the subject. 
In this essay I’m not going to write about emergency room procedures or survival medicine that you can use in the field to save lives, but rather, I want to focus on when medically you can do no more for your patient.  Depending upon the preparation of your group, the threshold could vary widely for when you can do no more.  It is my hope that you have taken necessary steps to prepare and practice lifesaving techniques for you and your group. 

For hospice patients, they usually are given six months life expectancy or less.  In your case, the patient may have those few months to live, but more likely they will have much less time than that.  Know that when the body is going through the dying process, many changes are happening.  I understand that each person and situation is different, but I am going to try and cover the dying process in general terms.    

In hospice, when a patient is getting close to dying, it is referred to it as active dying.  Leading up to this active dying stage, the patient may have reduced appetite and you may notice weight loss.  Don’t force the patient to eat food.  The body is dying and has not need for the nourishments.  I’ve seen all too often family members trying to get their loved one to eat, only causing that patient to become nauseous.  In addition to the reduced appetite, the patient my sleep more and be very tired.  They may become disoriented, have delusions, or hallucinations (speaking to people who aren’t there).  This is very common and may times if the patient is talking to someone that is not there, it is highly likely that they are speaking to someone who has already died.  These hallucinations are a very interesting phenomenon to me.  I usually try not to change the subject, but rather gather information from the patient such as who they are talking with, and what they are talking about.  Don’t miss this opportunity as the patient may be trying to tell you or a loved one something.

Currently in hospice, we have many methods to use to make patients more comfortable.  For patients suffering from pain, we have a whole host of drugs available.  Many of these stronger drugs are opiates which diminish the experience of pain by the patient.  Some of the more common drugs used are Oxycodone (Oxycontin), Morphine (Roxanol), Fentanyl (patch, Actiq), Methadone (Dolophine), or Hydromorphone (Dilaudid).  In a TEOTWAWKI scenario, it will likely be difficult to obtain these drugs and you may be left with more common household drugs such as acetaminophen, ibuprofen, or aspirin to help relieve pain.

For patients suffering from breathing problems, we currently have oxygen [concentrator] machines that we can hook-up directly to the patient [typically via a nasal cannula.]  In addition, many of the opiates also help relieve breathing problems.  Without either of these two resources, you can try to reposition the patient by placing more pillows under their head or having them sit at an incline.  You can also try creating a light breeze directed at the patient’s face to see if that helps.  If the patient’s lips become dry, try using a lip balm.  If the inside of their mouth become dry and they are conscious, try giving the patient ice chips if available (if not, you can wipe the inside of the mouth with a cotton swab, cotton ball or damp washcloth.  This dryness in the mouth can cause irritation to the patient, so make sure to provide ice or dab the inside of the mouth every two hours.  For patients lying in the same position for any length of time, they may develop pressure ulcers (sores).  Try to reposition the patient if possible every few hours.
When a person is actively dying, there are some signs you can look for to know that the person is close to death:

  • The body has a difficult time regulating its temperature, so you will notice the body temperature beings to gradually lower (normal body temp is 98.6 -98.2F if taken orally) or if an infection is present, the temperature may spike
  • The pulse begins to become irregular, sometime speeding up with other times slowing down (normal pulse is 60-100 beats per minute)
  • Blood pressure begins to lower (normal pressure is 120/80)
  • The patient may begin to perspire and feel cool to the touch
  • Skin beings to change color as blood circulating within the body begins to diminish (you will usually notice it in the lips or fingertips as they begin to turn a bluish/purplish color)
  • Breathing usually becomes more difficult, sometime rapid and shallow and others time gradually slowing to just a few breaths per minute (normal is 12-20 breaths per minute)
  • While not as noticeable, it is very common to have a surge of energy for a short period of time (the patient my want to get up out of bed, may want to talk to friends/family, eat after going days without eating, etc.)

When pulse, blood pressure and respirations cease, the patient has died.  The deceased should always be handled with the utmost care and respect.  We are all going to die someday, so treat the body as you would want someone else to treat your body.  It is appropriate to do a small ceremony at the bedside with all who are present.  I typical being with a prayer and then have those gathered say something about the deceased.  Due to infection control, I would recommend that the deceased be buried immediately.  If at all possible, have everyone coming into contact with the deceased, the bed, clothes, etc., wear rubber gloves.  If possible, wrap the body in a blanket or sheet.  You may then want to wrap the body in a plastic trap, as body fluids may begin to be excreted from the body.  You will want to wash bedding in hot soapy water and then use a bleach solution to wipe down any infected areas.  If you are in a location to bury the body, dig an area away from water sources.  The typical grave is 4 feet deep, 8 feet long and 3 feet wide.  Use whatever measurements fit for the deceased.  If you are unable to bury the body, the next best solution would be to burn the body.  Make sure to have plenty of your fire source, as you want to dispose of as much of the body as possible. 

On a final note, throughout this the dying process, don’t forget how powerful human interaction can be.  Especially for patients who are experiencing high levels of anxiety, human touch can do wonders to help calm a person.  Touch helps to convey care, solace, and comfort.  Even if the person is no longer conscious, talk to them.  Many times the patient can hear you even if they are not alert, awake and conscious.  Have people introduce themselves as they enter the room.  Have them talk directly to the patient.  Encourage visitors or those gathered to talk directly to the patient.  Lastly, take time to mourn the loss of life.  In a TEOTWAWKI scenario, you may not be able to have much time to mourn, but make it a priority when you have the time to remember all those that died.          

Saturday, July 27, 2013

Dr. Koelker presented some great information on surviving a serious burn. One significant issue that wasn't fully discussed that is potentially more serious in the short term than fluid replacement. If you were to happen upon someone who suffered a serious burn and you determined it was safe for you to proceed and get your hands on the patient, you must verify that the patient has a good airway, i.e.: Can they or are they breathing? If they are making painful noises or yelling you know they do because otherwise they wouldn't be able to use their voice. However, with burn patients, you can suddenly lose that good airway due to swelling in the mouth / throat [/bronchial tubes]/ lungs. Check the patient for burn marks, redness (or black) and swelling on the face, nose and mouth. Look for burned facial hair and eye lashes. Check the ears for the same. If indications are there, you have to be aware that swelling may close their airway. You won't know if the patient inhaled whatever it was that was burning or just very hot air. If the airway suddenly closes, you will know it because they won't be able to speak or breath. The patient will also change color. It will happen quickly.

If the patient is to survive, you have to intubate or get a nasopharyngeal airway, (NPA), aka nasal trumpet) inserted. The NPA may not work because it reaches only so far through the nasal cavity. If the swelling extends beyond the length of the NPA, then it won't work. Most people don't walk around with NPAs, intubation equipment or emergency cricotomy (aka crico-tracheotomychric) know how. Phoning 911 is your best option. Another option is to get some basic training. Not that basic training will have you doing cricotracheotomys in the street but at least you will know what's happening; what to watch for in patients and the patient scene; and you will be a better rescuer.

Remember this also: When dealing with infants, toddlers, and children, everything happens faster and they can't compensate and hang on like a mature adult. Training is available, just do an Internet search. If time and funds are an issue, buy yourself a book on trauma medicine that is meant for EMTs and paramedics. You will understand most of it. Good Luck. God Bless America. FL Pete

Mr. Rawles,
My child is sick. I need to build a Faraday cage to surround my child's bed. We are in a second floor apartment. Can I use wood and chicken wire?

To create a ground [for the cage], can I: Take an extension cord, tear out the double prong but leave the ground post, cut off the opposite end attach the wires to the wire cage. Would that work?

Thank You, - M.R.

JWR Replies: I will pray for you and your child.

Faraday cages have no positive health effects for humans unless for some very unlikely reason that you live in an area of extreme RF field strength. (Hypothetically, living directly under a 230,000 volt AC high tension power line or right next to a poorly-designed high power microwave broadcast tower with errant side lobes.) The fact is that low level RF (such as the field strengths found in a typical house or apartment residence) has no negative health effects. Because there was cancer one one side of our family, I did some fairly extensive research on this subject. There have been many very expensive and extensive studies conducted on low level RF and they have found essential NO correlation to incidents of cancer, or other diseasesNONE! A variety of home electronics such as cordless phones, cellular phones, microwave ovens, CB radios, and wireless baby monitors have all been studied by reputable scientific and medical organizations. But the study results have all been negative of inconclusive. By the way, what used to be the biggest emitters in American homes--cathode ray tube (CRT) televisions and computer monitors--are rapidly becoming extinct, as they are being replaced by relatively low-mission flat panel displays. But even CRTs were fairly safe unless you sat within a few feet of them, and it is noteworthy that the greatest risk was for someone directly behind them.

Now, if it is electronics that you want to protect with a Faraday cage: Chicken wire will stop many radio waves but has has apertures that are far too large to stop microwaves.  (Look at the size of the fine mesh built into the transparent door of a microwave oven!) EMP is very high energy and has frequency components in a very broad range. So a solid metal structure is best. Copper is ideal, but expensive. Galvanized steel will suffice. A steel trash can works fine. You can supplement the seal of the lid by placing a thin fuzz of stainless steel wool all around the lip before you clamp down the lid.)

And BTW, grounding actually hurts the ability of a Faraday cage to stop EMP, because a grounding cable can itself form an unintentional antenna. The general rule is: For lightning protection, do use a grounding cable, but for EMP protection, do not.

If your child is sick, then take him or her to see a qualified medical doctor!

Thursday, July 25, 2013

Dear Editor:
I read with interest Dr. Koelker's description of burn treatment and had two follow-up questions: why is the issue of fluid replacement at the top of the treatment list, and of such critical importance to a burn victim? What causes the fluid loss that can be fatal?A second question: is it necessary to sterilize any water used before preparing the oral rehydration solution she mentions in the article? Thanks for all you do through SurvivalBlog. Peace to you and yours. - G.R. in Texas

Doc Cindy Replies: Fluid replacement is at the top of the list for several reasons:

1.  Fluid loss is what can kill a person the quickest. 
2.  Internal fluid loss is not necessarily apparent, nor is the problem intuitively obvious.
3.  Once kidney damage occurs, it may well be irreversible. 

Other potentially fatal problems set in later.  Lacking gross wound contamination, infection generally takes days to set in.  Hypothermia could occur quickly, but is more easily preventable and is generally reversible.  Burns cause what I usually explain as “internal dehydration.” 
People understand dehydration caused by fluid loss or lack of intake, and burns can certainly cause great fluid loss due to constant seepage from the burn.  Of more danger, however, is leakage of fluid from within the blood vessels of the body.  Significant burns cause release of chemicals which cause blood vessels throughout the entire body to become semi-permeable, much like a soaker-hose.  A large amount of fluid can leak out from the blood vessels (the intravascular space) into the space between cells (the extravascular space).  This fluid remains within the body but not the blood vessels and therefore is not useful for maintaining blood flow or blood pressure.  Without sufficient blood flow, the kidneys fail.
On a mechanical note, we could compare this to a closed system that develops an internal leak of, say, lubricating oil or hydraulic pressure.  The fluid may remain within the closed system, but not within the circulating pipes.  Once the pressure drops too low, the system fails, perhaps permanently.  Both “internal” and “regular” dehydration can progress rapidly without proper fluid replacement.  Once kidney failure sets in, without dialysis it is commonly fatal. 
As for oral rehydration solution, no, this does not need to be sterile, only appropriate for drinking (potable), whether used orally or rectally.  Normally, oral rehydration solution (water + salt + sugar) would NOT be given intravenously nor via hypodermoclysis. 
Todd B., MD comments correctly that it would be difficult to replace fluids completely via hypodermoclysis.  Normally only two sites are used, though perhaps more could be used in a life-threatening emergency.  However, hypodermoclysis does pose an additional problem, that is, the fluid must be absorbed from the extravascular system into the vascular system, and as explained above, the blood vessels become increasingly leaky as time goes on.  This is an additional reason why immediate fluid replacement is so essential. 
In today’s world, we think of a single source for fluid replacement, usually intravenous.  In tomorrow’s world, we need to consider multiple potential sources of fluid replacement:  oral, intravenous, hypodermal, rectal.  A combination of methods would likely be necessary with a significant burn. 
Can a layperson learn to insert and administer an IV?  I’d say the answer is yes, with careful attention to sterile procedure.  The bigger concern, however, is how much fluid to give, and how quickly, a question I’ll address in a future article. - SurvivalBlog Medical Editor Cynthia J. Koelker, MD

Tuesday, July 23, 2013

Mr. Rawles,

I always read your site with interest, especially the medical advice that is written by Dr. Koelker and others, as this is my area of expertise.

Dr. Koelker's article regarding burn care made very brief mention of a technique called hypodermoclysis as an alternative method for intravenous infusion of fluids in the event of a severe burn. Essentially, hypodermoclysis involves using a regular IV catheter to infuse fluids into the patient's subcutaneous tissue. Unfortunately, it wouldn't be a replacement for IV fluids in the case she uses as an example. It appears that the maximum amount of fluids that can be infused over a 24-hour period is about 3,000 mL, using two sites, which would fall short of her fluid replacement calculations using the Parkland formula.

I think in combination with oral rehydration therapy in a conscious patient, hypodermoclysis would be a valid option to assist in maintaining fluid balance in a burn patient, but would not otherwise be sufficient to keep a burn patient hydrated.

Additionally, in a TEOTWAWKI situation with limited resources, knowing when to provide "comfort care" versus aggressive fluid resuscitation might be useful. Although there are newer guidelines with regards to burn survivability, they probably only apply to burn centers. Once upon a time, the age of the patient + the % area of burned skin = the patient's chance of dying. A revision adds an additional 17% chance of death if the patient's burn includes an inhalation injury.

For further reading:

  • Hypodermoclysis: An Alternative Infusion Technique. Am Fam Physician. 2001 Nov 1;64(9):1575-1579.
  • Simplified Estimates of the Probability of Death After Burn Injuries: Extending and Updating the Baux Score. J Trauma. 2010 Mar;68(3):690-7

- Todd B., MD

Monday, July 22, 2013

How large must a burn be to kill you?  How is a burn fatal anyway?  Is there anything you can do to improve your odds?
Lacking an emergency response system, you’ll be on your own if you cook yourself on a heating pad, or catch your clothes on fire, or spill hot coffee down your pants while driving.  What would now be referred to a burn unit for specialized care may require home treatment when it’s the only option.
Without skin, you die.  The danger of burns is related to the function of the skin.  Normally the skin “keeps the insides in and the outside out.”  Skin protects against invading microorganisms which may cause infection.  It helps regulate the body temperature by preventing heat loss.  Skin acts as a barrier preventing excess water loss from the body.   

Death may occur related to interruption of any of these functions.  Dehydration, hypothermia, and/or infection are all potentially lethal.     

Skin burns are the most common type of thermal injury, and the most common burn for which patients seek treatment.  (Inhalation burns will not be addressed here.)  Most first-degree burns are treated at home, and cause only discomfort and reddening of the skin, but no blisters or significant fluid loss.  Third-degree burns are fortunately uncommon.  It is the second-degree burns which pose the greatest danger.  These burns cause blistering, pain, and fluid loss as the top layers of the skin are disrupted, exposing the tender inner layers to the outside environment.  Deeper, third-degree burns destroy the nerve endings as well, and scorch the skin into an unfeeling, leathery crust.  These deep burns are often surrounded by a zone of painful blistered second-degree burns.

As with all avoidable injures, at TEOTWAWKI , prevention is essential.  Will you allow your children to play in the kitchen while you’re boiling water?  Are you crazy enough to pour gasoline on a fire?  Is it necessary to open a hot radiator while it’s still steaming?  The great majority of the burns that I’ve seen were preventable:
Don’t lean on your curling iron as you apply make-up
Don’t wear shorts riding a motorcycle with a hot exhaust
Don’t set your water heater just below boiling
Don’t fall asleep on a heating pad
Don’t smoke in bed
Don’t let your toddler turn on the hot water
Don’t drink steaming hot coffee while driving
Don’t leave the stove on unattended
Don’t wear loose clothing around an open fire
Prevention is 90% – maybe 99% – of the battle.  Put some thought into how you might live differently if no fire truck is coming – not ever. 
Regarding treatment, the first rule of burn treatment is to protect yourself then STOP THE BURNING.  Cool the burned area with lukewarm water.  Remove clothing from the burned area.  Have the patient lie down if possible, especially if dizzy or light-headed.  Once the burned area is cooled off, heat loss will begin, so warm the patient with blankets or extra clothing.

Now for saving a life
:  if adequate fluids are not given in the first 24 hours, the kidneys may shut down permanently, resulting in death.  You must estimate the extent of the burn and calculate needed fluids accordingly.  The Rule of Nines is used to estimate the total body surface area (TBSA) damaged by second- and third-degree burns.  In an adult, the body is divided as follows:
9% for the head
9% for each arm
18% for each leg
18% for front of trunk (chest plus abdomen)
18% for back of trunk
1% for genitalia
For smaller or scattered areas, the size of the patient’s palm including fingers is considered 1%. 

A burn of 10 to 15% of the body can be life-threatening.  Death occurs early on from fluid loss causing renal failure.  Normally these patients are referred to a burn center.  IF YOU DON’T REPLACE LOST FLUIDS ON DAY ONE THE PATIENT WILL DIE. 

The Parkland Formula estimates the amount of fluids required in the first 24 hours:
4 ml x patient weight in kg x % body surface area burned
(Or approximately 1.8 ml x patient weight in pounds x % body surface area burned)
Half the fluid is given in the first 8 hours immediately after the burn, and the second half given over the next 16 hours.
For example, a 150-pound man who has burned his chest and shoulders after opening a steaming radiator may well have 18% of his body surface area involved with 2nd and 3rd degree burns.  Using the above formula, he will require nearly 5 liters of fluid in the first 24 hours (1.8 ml x 150 pounds x 18% = 4,860 ml).  That’s 5 large bags of IV solution (Ringer’s Lactate is preferred). 
Normally fluids are given intravenously.  The first half of the fluids (2.5 liters, in this case) must be given in the first 8 hours after the burn, not after treatment begins.  If it’s already been 4 hours, then this amount must be given over the next 4 hours, not 8 (divided out per hour and per minute), and the second half given over the next 16 hours.  A nurse, EMT, or physician could accomplish this.  I know this is technical, but it’s only middle-school math.
What if you can’t provide an IV?  If the patient is sufficiently alert, oral fluids are the best option (Gatorade or Oral Rehydration Solution).  However burns are painful and patients often require sedation.  Then what?
If you have the IV fluids, they may be administered rectally (similar to an enema) or via hypodermoclysis (a needle placed under the skin, not in a vein – various protocols are available online). 

What if you don’t have IV fluids on hand?  If the patient cannot take fluids orally, then Oral Rehydration Solution given rectally is probably the best option.  The recipe for this is:
6 level teaspoons of sugar
½ level teaspoon of table salt
1 liter of water (5 cups)
It should be given at approximately the same rate as an IV would be given, but taking into account any fluid which leaks out.   
On subsequent days fluids should be given in the amount needed to balance that which is lost, by measuring urine output as well as by daily weights.  Enough fluid must be given to prevent weight loss and to keep urine output above 20–30 ml/hour.  That’s only a few teaspoons per hour.  Less than this and the kidneys shut down.  In an average adult, this equals at least 1.5 to 2 liters daily, and could well be more in a burn patient.

Again, don’t forget to keep the patient warm
.  Since the patient may not be able to tell you he’s cold, measure their temperature periodically.  Aim to maintain body temperature in the normal range of 98–100o F.  The likelihood of death increases as body temperature drops below approximately 90 degrees F.

The next enemy is infection
.  Thorough cleaning of the injured area is essential.  Any embedded dirt or foreign material such as scorched fabric must be removed.  Clean, soapy water is sufficient in most cases.  Vaseline may be applied gently to remove grease or tar.  A gentle water pik or baby hair brush may help. 
Systemic antibiotics (pills, shots, IVs) are not generally given unless signs of infection occur.  However, topical antibiotics such as Bacitracin and Silvadene can help prevent infection.  Topical honey has also been shown to improve burn healing and prevent infection.
Signs of infection include increasing redness, pus, fever, or overall deterioration of the patient’s condition.  Pus must not be confused with eschar, the white or yellowish-white membrane that forms to cover a burn, much like a soft scab.  In general, this soft eschar is preferable to hard eschar (like a hard scab), which may compromise circulation and impair healing. 

If infection is suspected, nowadays a culture would be taken and the bacteria identified.  Lacking that option, a broad-spectrum antibiotic should be given, such as Augmentin, cephalexin, or possibly erythromycin.  If these are ineffective after a few days of treatment, a resistant organism or gram-negative bacteria may be present, and the patient should be switched to trimethoprim-sulfamethoxazole, doxycycline, ciprofloxacin, or similar drug.  If the infection enters the blood stream, it may cause sepsis, heart valve infection, or other fatal outcome.

Aside from potentially fatal problems, pain is a major concern with serious burns, and often requires narcotics and/or sedation.  Even exposing a burn to air may increase pain, so keeping wounds covered is essential not only for preventing infection, but also for comfort.  Your supply of narcotics and sedatives could easily be consumed with a single burn patient.  Over-the-counter sedating antihistamines (diphenhydramine, doxylamine) may be useful, but alcohol should be avoided unless the situation is hopeless, in which case easing a patient’s discomfort with any means available is reasonable. 

The current treatment of burns using early debridement and skin grafting is probably not a realistic goal without a team of medical providers. 
ReCell (spray-on skin) is a new technology that appears promising even for TEOTWAWKI.  Unfortunately it is not yet available in the US.  Perhaps the concept could be applied to grid-down medicine. 

About the Author: Dr. Cynthia Koelker serves as Medical Editor for SurvivalBlog, and hosts the survival medicine web site She is the author of the book Armageddon Medicine and is the chief instructor for the Survival Medicine Workshops. Burn injuries are just one of numerous topics covered in her Survival Medicine Workshops. 

Tuesday, July 16, 2013

I would also recommend the Emergency Response Guidebook published jointly by the USDOT and Canadian and Mexican Transportation agencies. This reference (ERG) lets you identify the material being transported by pipeline, tanker truck, or railcar. As a guide for First Responders to a HazMat accident, it also lists specific hazards and evacuation distances in the event of spill or fire.

I use this book to evaluate how at risk I am to accidents involving bulk materials being transported nearby. You need to pay attention to the placard (label) information on the side of the tanker. In my community I frequently see tanker trucks and railcars placarded "2448 Molten Sulfur". Looking up Sulfur, Molten in the Emergency Response Guidebook tells me it is a flammable solid, and that I should stay upwind and evacuate at least 330 feet away from a spill. The evacuation zone increases to 1/2 mile if there is a risk of fire. My homestead is several miles from the nearest train tracks so my concern of exposure after a derailment of cars carrying molten sulfur is limited. I am, however, prepared to stay upwind and leave the proximity of a highway or rail crossing accident involving molten sulfur-carrying tankers.

A search on the internet for "MSDS + molten sulfur" provides me with the Material Safety Data Sheet for molten sulfur. Reading the Fire & Explosion Hazards section tells me that these tankers may vent the toxic gas hydrogen sulfide if exposed to heat , thus the need to stay upwind of an accident.

The NIOSH Pocket Guide to Chemical Hazards is valuable for letting you know how to protect yourself against personal health hazards when working with various chemicals, but alone doesn't address spill/fire/explosion protocols. - Carol J.

Sunday, July 14, 2013

Disclaimer: I am a retired military officer and school teacher.  I have no formal medical or first aid training.  My recommendations are made based on anecdotal personal experience.  Nothing I recommend should be undertaken without first consulting with a physician.
When there is no medicine.
Preppers have usually read and probably own copies of well-respected books having to do with post-TEOTWAWKI conditions in which medical and dental care are not available.  Most of us have accumulated some knowledge of what medicines to stockpile, their uses, and shelf-lives.  After persuading a physician to write prescriptions for the desired medicinals, some have expended precious resources acquiring some useful broad spectrum antibiotics and other controlled substances to treat injuries and illnesses in the absence of doctors and hospitals.  All of this is good.  To the stockpile of prescription drugs, most would add hand sanitizer, alcohol, betadine, OTC medicines, bandages, sutures and all manner of first aid equipment and supplies.  If you have to bug out on foot, it might be a lot to carry. 
Bug out with what you can carry. 
I can imagine a lot of bug out scenarios where 72 hours becomes a few weeks or a year if your preparedness is sufficient.  Water, food, shelter and self-defense; knowledge and abilities; and restoration of society are all important elements of any plan. None of which will come to much if a small cut becomes infected or lack of dental hygiene allows tooth decay.  Small things you say. Details.  Okay, but there are far more wounded than killed in any battle, and infections kill more soldiers than enemy action.  As a people we are probably smart enough to knock out an abscessed tooth, and we may even amputate a gangrenous limb.  But there may be a way to avoid these unpleasant and desperate remedies. There is an inexpensive all natural substance that is an antibacterial, antiviral, anti-inflammatory, antifungal liquid which can treat a wide variety of injuries and medical conditions without side effects.  It is tea tree oil.  It is available all over the internet and in some health food stores for a few bucks.  Here are just some of its uses.  There are many more.
Cuts, abrasions, burns, bee stings, acne, cold sores, ringworm, warts.  
Use it as you would triple antibiotic ointment, which is not antiviral, antifungal or anti-inflammatory. Most pain has its root cause in inflammation.  Treat the inflammation and the pain is greatly reduced or eliminated.  Bandage the wound, of course.  Check the wound and retreat, of course. I stopped using Neosporin when the lanolin-based ointment was replaced by the white petrolatum based product.  Petroleum jelly is not as readily absorbed through the skin. Tea tree oil is absorbed almost instantly. Try this: dab a single drop of tea tree oil to the outside of your cheek and see how long it takes before you taste it.  It will be instantaneous.     
Strains and sprains of the muscles, joints, ligaments and tendons.

Call me crazy, but tea tree oil works as well as acetaminophen or ibuprofen.  Dab it on with a fingertip, Q-tip or cotton ball.  Repeat every few hours.  Healing will be quicker than with NSAIDS.  Unlike most oral medicines, tea tree oil works on the inflammation at the site of the injury, not in your head. Repeated use of tea tree oil does not damage your liver. After taking some medicines, the pain is still there, you just don’t feel it. Make a patch out of a one inch square piece of cotton cloth and a few inches of medical tape.  Dab the cloth with tea tree oil and apply it to the injury site.  Change twice a day.  You will experience greatly reduced pain and inflammation.  I have had good results using a mix of 10 per cent tea tree oil and 90 per cent Bag Balm. Rub it in. You can treat your injury and soften your skin at the same time. This mix is particularly effective when rubbed on your rough heels. I know people who have experienced good results with a mix of 10 per cent tea tree oil and 90 per cent aloe vera gel. It works better than either product used alone.
Head lice, fleas, and ticks.
Add a few drops of tea tree oil to shampoo, or rinse hair with a quart of water mixed with 10 drops of tea tree oil.  For safe tick removal, dab the critter with tea tree oil.  It will back out.  Never tweeze an embedded tick at the abdomen, and don’t try to burn it with a lighter or extinguished match head.  It will deposit saliva as well as stomach contents under your skin. Tea tree oil is much gentler on the tick, which many prevent it from vomiting with its head under your skin. You want the tick to back out.  You don’t want to kill it while it is still attached. In North America, ticks can be vectors for dozens of diseases.
Blisters. Soak a needle and cotton thread in tea tree oil. Pass the needle and thread through the blister at the widest point and leave six inches of thread passing out both sides of the blister. The blister will drain by wicking the moisture out through the thread.  Dab more tea tree oil on the blister twice a day.  Pull the thread out when the water is gone and the blistered skin has re-adhered. If a blister has ripped open, swab the whole thing with tea tree oil twice a day.  Keep it clean and bandage it.
Athlete’s Foot.
Tea tree oil is an excellent antifungal and is unbeatable as a treatment for athlete’s foot.  Washing feet regularly in a solution of a few drops of tea tree oil in a gallon of warm water will prevent re-infection.  Soaking socks and sneakers in the same solution is an excellent preventative.
If you’ve got hemorrhoids, you’ve got an inflammation of some very delicate tissues. Did you bring the Preparation H in your bug out bag? If not, dab on a little tea tree oil until the condition is cured.  If bowel movements are painful, dip a finger in tea tree oil.  You will know what to do with it.  Do it before and after. 
Let’s be clear.  There is no cure for psoriasis. However, there are many reports of people achieving significant relief of the symptoms of psoriasis by treating the infected area with undiluted tea tree oil.  It may take six months of daily treatments.
Toenail fungus. 
18 per cent of people who treated their toenail fungus twice daily for six months with tea tree oil were cured.  60 per cent achieved significant improvement of appearance and reduction of symptoms.
Oral Hygiene.  
First of all, tea tree oil tastes and smells terrible.  So naturally, I use it in my mouth.  After brushing and flossing or waterpicking, I dip a GUM Bo Between interdental stimulator in tea tree oil and run it between the teeth, rinsing the device in water and redipping every third tooth.  The tea tree oil is very rapidly absorbed, so the taste doesn’t last long.  Spit, don’t swallow. The rapid absorption also allows swishing with water or mouthwash shortly after the application. Those with bleeding gums will see this condition disappear in a week of daily treatments.  After that, twice a week is often enough.  Most adult Americans have gingivitis or some periodontal disease.  In the absence of regular dental exams and cleaning, the situation will likely get worse.  Much worse.  Quickly.  A dental hygiene kit of toothbrush, floss, GUM, and an ounce of tea tree oil will greatly improve a person’s chances of lasting a year or more without toothache, tooth loss, inflammation or gum disease.  If I had to choose between toothpaste and tea tree oil, I would carry the tea tree oil for its many other uses. But I wouldn’t brush my teeth with it.
Products containing tea tree oil.
Soap, laundry detergent, toothpaste, gels, shampoo, surface cleansers and many other products with a wide variety of applications are available with tea tree oil as an active ingredient.  Products containing tea tree oil are particularly effective when sanitization or disinfection is desired as well as general cleaning. You can make your own.  Recipes are all over the internet. Each of these products has its uses in your everyday life as well as post-TEOTWAWKI.    
If you are bugging out, you have many of the same goals and use many of the same techniques as long distance hikers.  A hike of 2,600 miles requires a light pack.  You can lighten your load if everything you carry has multiple uses. Your jacket is also your pillow.  Your trekking poles are your tent poles. Your bandana is your camp towel. Tea tree oil has many uses; some are medicinal, some are merely convenient.  Tea tree oil is like WD40.  New uses are found every day, but it won’t stop wrinkles. Every bottle of tea tree oil states it is for external use only, and keep it away from children.  That means don’t drink it, and don’t let kids have it. I wouldn’t put it in my eyes or ears, although treatments for earache and pinkeye can be found.     

Rehydration can still be accomplished when a person cannot take anything by mouth. Normally he would be given an IV. In a SHTF situation, this may not be possible. Rather one can fill an enema bag with normal saline (very dilute salt water-recipe on the internet-need not be sterile) attach a rubber urinary catheter to the enema tip, Using vaseline jelly feed the rubber catheter into the rectum carefully as not to pierce the bowel and let the tepid salt water very slowly drip in. It should be able to be absorbed because it is going in very slowly and a little higher up rather than being forcefully expelled as would happen if an irritating solution was used to treat constipation. This should only be done of course when the benefits outweigh the risk. - Sharon G.

Saturday, July 13, 2013

I found an interesting free NIOSH publication concerning recommendations for protective equipment when exposed to chemicals. It is technical so this is something that you will have to read ahead to know how to use. It also gives a listing of what the DOT numbers on placards of transportation equipment mean with a reference to what personal protective equipment is needed. If you scroll to page 379 it will reference a page number which tells what the chemical is including the threat and what protective measures need to be taken. - Bill N.

Thursday, July 11, 2013

I would first like to thank you and all of the previous posters on this blog. I have been an avid reader for a few years now and I have learned immeasurably from you all.
Dehydration can be a problem for individuals in the first world today, and a massive problem for those in the third world. In a post collapse situation, life for us in America and the rest of the first world countries could look more like the latter. There are many causes for dehydration, from working outside in the heat and sweating out fluids to a serious illness causing severe nausea and vomiting. Severe dehydration could lead to death, called Terminal Dehydration.

Before I really delve into this subject, let me give a brief summary of my experience. I spent six years in the Navy as a Hospital Corpsman serving with both the Navy onboard ship and at a hospital and also serving with the Marines as a field corpsman. I was charged with the care of sailors and marines, at times on my own. It was a very large responsibility for such a young man as I was. I took my charge VERY seriously. One thing that I was continuously on the lookout for was heat injuries and signs of dehydration, especially in the desert. This carried over from my training at the fleet marine service school. It was repeated constantly throughout my military training. The military is acutely aware of the seriousness of heat injuries and the toll they take. Since I have gotten out of the navy, I have worked in the hospital setting in differing acute care areas such as emergency rooms. I have a love of medicine and a drive to learn as much as I can. Even though I am no physician, I have had providers ask me for my thoughts on certain areas that my previous experience has given me with regards to treating their own patients. I truly love working as a member of the healthcare team. I am taking college courses to become a flight nurse. Now, I am no doctor and I am only writing this for informational purposes. If it is possible, if you or a loved one shows signs of dehydration, you should seek the treatment of a physician.

Now, back to the matter at hand, dehydration in a collapse scenario. Let us first look at dehydration. It not always simply a lack of fluids that needs to be replenished. There are actually three different kinds of dehydration: 1) hypotonic or hyponatremic (referring to this as primarily a loss of electrolytes, sodium in particular), 2) hypertonic or hypernatremic (referring to this as primarily a loss of water), and 3) isotonic or isonatremic (referring to this as equal loss of water and electrolytes). The most commonly seen is isonatremic dehydration. This loss is mostly due to profuse sweating and/or vomiting and diarrhea. The loss of electrolytes, while seemingly insignificant to some, can be very serious. Sodium in particular serves many roles in the human body. Sodium helps the body maintain fluid balance in the body down to the cellular level. Sodium also helps the body regulate blood pressure, as many may already know. Sodium also helps facilitate nutrient transfers at the cellular level. These functions of sodium in the body are done primarily through the process of osmosis. Sodium is just one of the essential electrolytes required by the human body to maintain homeostasis. Both sodium and potassium help carry electrical signals from cell to cell over the entire body.

Now dehydration can have a number of causes. I cannot go over them all, but I can focus on some. One of the most common causes in the third world is unclean drinking water that causes waterborne illnesses such as Cholera, E. Coli, Typhoid, and Salmonellosis. These can be particularly fatal to children and the elderly if not treated properly. In a post collapse situation, clean drinking water will be difficult to come by for most folks once the grid goes down and illnesses such as these will become common in America once more. Another cause of dehydration in a post collapse scenario will be simply due to overexertion and sweating. Even here in the beautiful and comparatively mild climate of northwestern United States, it gets hot enough in the summer months to cause heat injuries. And in a post collapse scenario, we will all be required to do much more work outside in the heat to simply survive. The signs and symptoms of dehydration can be headaches (similar to hangovers or “caffeine headaches), thirst, dry skin, moderate to severe muscle cramping or contractions, rapid heart rate, concentrated dark urine, dizziness or fainting, decreased blood pressure, and at the extreme delirium and death. Now, there is a simple test that can be done at home, in the absence of medical laboratories and the ability to look at blood serum sodium levels and similar testing, that can help determine if a person is experiencing dehydration or not: postural/orthostatic blood pressure and pulse measurement. The procedure is simple, all one needs is a blood pressure cuff and sphygmomanometer, a stethoscope, and the ability to feel the pulse of the patient. The procedure I have used is to have the patient lie down for approximately 5 minutes and measure their pulse and blood pressure, then have the patient stand for another minute and repeat the pulse and blood pressure. What you are looking for is a drop in the measurement of the systolic (top number) of at least 20mm/Hg and/or diastolic (bottom number) of at least 10 mm/Hg, and a significant increase in the heart rate from laying to standing may also show that the heart is trying to compensate for decreased fluid levels in the blood.
If the patient is indeed dehydrated, there are treatments that can be done in a post collapse scenario that are similar to those we use in hospitals today. Now, IV fluid rehydration may be indicated but could not necessarily be available. In that case, oral rehydration therapy may be indicated as tolerated by the patient. The history of oral rehydration therapy goes back thousands of years. There is evidence of an Indian physician named Sushruta using a solution of rock salt and molasses in tepid water in the 6th century BC to treat dehydration.  If there is significant vomiting and there are not anti-emetics available such as Ondansetron, there is a delicate balance of reducing vomiting and yet helping the patient replenish fluids that needs to be struck. If the patient simply chugs down the Oral Rehydration Solution/Salts (ORS), they may proceed to vomit it back up. The key is to let them sip some every few minutes as is tolerated. Now, just throwing in a bunch of salt and some arbitrary amount of sugar into some water is not recommended. Just as the body needs to strike a balance in electrolyte levels, so must the solution we are making. There are differing recipes of ORS out there, I will be using the World Health Organization’s recipe since they are the ones who go into the third world countries and encounter such severe dehydration without the benefit of hospitals nearby. The ingredients are easily obtained at even the local grocery store and are most likely already on your list of lists to keep in stock.

The ingredients are 3/8 tsp salt (sodium chloride), ¼ tsp table salt substitute (potassium chloride), ½ tsp baking soda (sodium bicarbonate), 2 tsp-2 tbsp sugar (sucrose) to taste; add these dry ingredients to a 1 liter bottle and fill to the final volume of 1 liter. This solution is best when chilled, but is not exactly great tasting at any time. As a rule of thumb, it should taste similar to tears. It is recommended that the solution should be discarded after 24 hours. The concentrations of electrolytes in the ORS allow for quicker absorption of fluids and reducing the need for IV fluids (if your retreat has the ability to administer them post collapse). These concentrations improve the ability of the body to absorb it in the small intestine and replace vital electrolytes lost. It is recommended that with diarrhea alone, ORS is administered to adults and large children after every loose bowel movement and should at least be 3 liters a day until they are well. For children under 2, the amount should be between a quarter and a half of a cup after each movement. For older children it should be between a half and whole cup after each movement. Do not let the patient chug away at the ORS. Doing so may cause the brain to swell and possibly cause permanent injury because it tries to pull too much fluid into the cells. A simple way to tell if a dehydrated person is well is to check the color and frequency of urine, the urine should be optimally between pale yellow to clear. An average person urinates about 5 times a day. With vomiting, the patient should wait approximately 10 minutes after vomiting before they should be administered the ORS again. The body will retain some of the water and electrolytes even though vomiting is present. The ORS will not treat or stop either vomiting or diarrhea; these will have to run their course. Both are the body’s response to either an illness or poison that it has detected and is trying to flush out.  Diarrhea, for instance, usually resolves after three or five days.

As is the case in most medical conditions, and I am sure many have heard this from their physicians before, the key is prevention. Make sure that the proper precautions have been taken to prevent waterborne illness and your water has been sufficiently treated.  Keep an eye on you and your group for the signs and symptoms of dehydration, the easiest is to watch the color of urine. Again, clear or pale yellow is optimal, a dark/amber color isn’t. Dehydration can occur in both the heat and humidity of summer and the cold dead of winter. The dry cold can zap out moisture just as effectively as the heat; do not get complacent in the winter months.
God Bless and Semper Fidelis

Friday, June 28, 2013

That was an excellent article on triage of patients in a mass casualty incident (MCI), which is also known as a multiple casualty incident. I was taught in EMT school that an MCI is any event that my truck can't handle by itself, or an incident that overwhelms currently available resources because of the number of patients involved.

Slightly tangentially, in class one day we were talking about organ donors and I volunteered the information that I haven't signed up as a donor. There's no donor info on my driver's license. However, my wife and family members have been notified and understand that I do, in fact, wish to donate my organs when the time comes, and they are to notify medical staff of that fact AFTER I expire. My classmates scoffed when I explained that emergency room staff statistically don't try as hard to save someone who is a known organ donor as they would for someone who isn't an organ donor. No one wants to admit this, but it's true. I used to work in an ER X-ray department and occasionally saw similar decisions being made.

Then I got verification. On my test for the NREMT (National Registry of Emergency Medical Technicians), there was a question that I also encountered on practice tests. It's disturbing and we didn't cover it in class, except for my little speech. I don't have the incorrect answers on this multiple-choice question (since I got it right) but here's the question and the correct answer:

At the scene of a mass-casualty incident, you identify a patient as an organ donor. When triaging the other patients, you: May have to assign the donor patient a lower triage priority.

In other words, people who have made it clear on their ID or otherwise that they intend to donate their organs when they die have set themselves up potentially to receive delayed medical attention in an MCI. I assume most of my classmates missed this question if it appeared on their test, since they doubted me in class. - J.D.C. in Mississippi

Thursday, June 27, 2013

The responsibilities of a medic in times of trouble will usually be one-to-one; that is, the healthcare provider will be dealing with one ill or injured individual at a time.  If you have dedicated yourself to medical preparedness, you will have accumulated significant stores of supplies and some knowledge. Therefore, your encounter with any one person should be, with any luck, within your expertise and resources.  There may be a day, however, when you find yourself confronted with a scenario in which multiple people are injured.  This is referred to as a Mass Casualty Incident (MCI).

A mass casualty incident is any event in which your medical resources are inadequate for the number and severity of injuries incurred.  Mass Casualty Incidents can be quite variable in their presentation.  They might be:

• ·         Doomsday scenario events, such as nuclear weapon detonations
• ·         Terrorist acts, such as occurred on 9/11 or in Oklahoma City
• ·         Consequences of a storm, such as a tornado or hurricane
• ·         Consequences of civil unrest
• ·         Mass transit mishap (train derailment, plane crash, etc.)
• ·         A car accident with, say, three people significantly injured (and only one ambulance)
• ·         Many others

The effective medical management of any of the above events required rapid and accurate triage.  Triage comes from the French word “to sort” (“Trier”) and is the process by which medical personnel (like you, survival medic!) can rapidly assess and prioritize a number of injured individuals and do the most good for the most people. Note that I didn’t say: “Do the best possible care for each individual victim”.

Let’s assume that you are in a marketplace in the Middle East somewhere, or perhaps in your survival village near the border with another (hostile) group.  You hear an explosion.  You are the first one to arrive at the scene, and you are alone.  There are twenty people on the ground, some moaning in pain.  There were probably more, but only twenty are, for the most part, in one piece.  The scene is horrific.  As the first to respond to the scene, medic, you are Incident Commander until someone with more medical expertise arrives on the scene.  What do you do?

Your initial actions may determine the outcome of the emergency response in this situation.  This will involve what we refer to as the 5 S’s of evaluating a MCI scene:

·         Safety
·         Sizing up
·         Sending for help
·         Set-up of areas
·         START – Simple Triage And Rapid Treatment

1.  Safety Assessment:  Our friend Joshua Wander ( relates to us an insidious strategy on the part of terrorists in Israel:  primary and secondary bombs.  The main bomb causes the most casualties, and the second bomb is timed to go off or is triggered just as the medical/security personnel arrive.  This may not sound right to you, but your primary goal as medic is your own self-preservation, because keeping the medical personnel alive is likely to save more lives down the road.  Therefore, you do your family and community a disservice by becoming the next casualty.

As you arrive, be as certain as you can that there is no ongoing threat.  Do not rush in there until you’re sure that the damage has been done and you and your helpers are safe entering the area.  In the immediate aftermath of the Oklahoma City bombing, various medical personnel rushed in to aid the many victims.  One of them was a heroic 37 year old Licensed Practical Nurse who, as she entered the area, was struck by a falling piece of concrete.  She sustained a head injury and died five 5 days later.

2. Sizing up the Scene:  Ask yourself the following questions:

• ·         What’s the situation?   Is this a mass transit crash?  Did a building on fire collapse?  Was there a car bomb?  
• ·         How many injuries and how severe?  Are there a few victims or dozens? Are most victims dead or are there any uninjured that could assist you?
• ·         Are they all together or spread out over a wide area? 
• ·        What are possible nearby areas for treatment/transport purposes? 
• ·         Are there areas open enough for vehicles to come through to help transport victims?
3.  Sending for Help:  If modern medical care is available, call 911 and say (for example):  “I am calling to report a mass casualty incident involving a multi-vehicle auto accident at the intersection of Hollywood and Vine (location).  At least 7 people are injured and will require medical attention.  There may be people trapped in their cars and one vehicle is on fire.”

In three sentences, you have informed the authorities that a mass casualty event has occurred, what type of event it was, where it occurred, an approximate numbers of patients that may need care, and the types of care (burns) or equipment (jaws of life) that may be needed.  I’m sure you could do even better than I did above, but you want to inform the emergency medical services without much delay.

If the you-know-what has hit the fan and you are the medical resource, get your walkie-talkie or handie-talkie and notify base camp of whatever the situation is and what you’ll need in terms of personnel and supplies.  If you are not the medical resource, contact the person who is; the most experienced medical person who arrives then becomes Incident Commander.

4.  Set-Up:  Determine likely areas for various triage levels (see below) to be further evaluated and treated.  Also, determine the appropriate entry and exit points for victims that need immediate transport to medical facilities, if they exist.  If you are blessed with lots of help at the scene, determine triage, treatment, and transport team leaders.

5. S.T.A.R.T.:  Triage uses the acronym S.T.A.R.T., which stands for Simple Triage and Rapid Treatment.   The first round of triage, known as “primary triage”, should be fast (30 seconds per patient if possible) and does not involve extensive treatment of injuries.  It should be focused on identifying the triage level of each patient.  Evaluation in primary triage consists mostly of quick evaluation of respirations (or the lack thereof), perfusion (adequacy of circulation), and mental status.  Other than controlling massive bleeding and clearing airways, very little treatment is performed in  primary triage. 

Although there is no international standard for this, triage levels are usually determined by color:

Immediate (Red tag): The victim needs immediate medical care and will not survive if not treated quickly.  (for example, a major hemorrhagic wound/internal bleeding) Top priority for treatment.
Delayed (Yellow tag): The victim needs medical care within 2-4 hours. Injuries may become life-threatening if ignored, but can wait until Red tags are treated. (for example, open fracture of femur without major hemorrhage)
Minimal (Green tag): Generally stable and ambulatory (“walking wounded”) but may need some medical care. (for  example, 2 broken fingers, sprained wrist)
Expectant (Black tag): The victim is either deceased or is expected to die.  (for example, open fracture of cranium with brain damage, multiple penetrating chest wounds)

Knowledge of this system allows a patient marking system that easily allows a caregiver to understand the urgency of a patient’s situation.  It should go without saying that, in a power-down situation without modern medical care, a lot of red tags and even some yellow tags will become black tags.  It will be difficult to save someone with a major internal bleeding episode without surgical intervention.

In the next part of this series, we will go through a typical mass casualty incident with 20 victims, and show how to proceed so as to provide the most benefit for the most people.
Part 2

A mass casualty incident is any event in which your medical resources are inadequate for the number and severity of injuries incurred.  Mass Casualty Incidents (MCIs) can be quite variable in their presentation.  They might be:

• ·         Doomsday scenario events, such as nuclear weapon detonations
• ·         Terrorist acts, such as occurred on 9/11 or in Oklahoma City
• ·         Consequences of a storm, such as a tornado or hurricane
• ·         Consequences of civil unrest
• ·         Mass transit mishap (train derailment, plane crash, etc.)
• ·         A car accident with, say, three people significantly injured (and only one ambulance)
• ·         Many others
The effective medical management of any of the above events requires rapid and accurate triage.  Triage is the process of rapidly evaluating and sorting casualties by the severity of injury and the level of urgency for treatment. We will use the following categories:

Immediate (Red tag): The victim needs immediate medical care and will not survive if not treated quickly.  (for example, a major hemorrhagic wound/internal bleeding) Top priority for treatment.
Delayed (Yellow tag): The victim needs medical care within 2-4 hours. Injuries may become life-threatening if ignored, but can wait until Red tags are treated. (for example, open fracture of femur without major hemorrhage)
Minimal (Green tag): Generally stable and ambulatory (“walking wounded”) but may need some medical care. (for  example, 2 broken fingers, sprained wrist)
Expectant (Black tag): The victim is either deceased or is not expected to live.  (for example, open fracture of cranium with brain damage, multiple penetrating chest wounds)
If you don’t have triage tags, you can simply use a pen to mark the victim’s forehead with a 1 (Red), 2(Yellow), 3(Green), and 4(Black) to indicate the level of priority.
Here’s our hypothetical scenario:  you are in your village near the border with another (hostile) group.  You hear an explosion.  You are the first one to arrive at the scene, and you are alone.  There are about twenty people down, and there is blood everywhere.  What do you do?

In our last article, we discussed the 5 “S’s” of initial MCI scene evaluation.  From that, let’s say that you have already determined the SAFETY of the current situation and SIZED UP the scene.  There appears to have been a bomb that exploded.  There are no hostiles nearby, as far as you can tell, and there is no evidence of incoming ordinance.  Therefore, you believe that you and other responders are not in danger.  The injuries are significant (there are body parts) and the victims are all in an area no more than, say, 30 yards.  The incident occurred on a main thoroughfare in the village, so there are ways in and ways out. You have SENT a call for help on your handie-talkie and described the scene, and have received replies from several group members, including a former ICU nurse who is contacting everyone else with medical experience.  The area is relatively open, so you can SET UP different areas for different triage categories.  Now you can START (Simple Triage And Rapid Treatment).

You will call out as loudly as possible:  “I’m here to help, everyone who can get up and walk and needs medical attention, get up and move to ______ (pick an area). If you are uninjured and can help, follow me.”

You’re lucky, 13 of the 20, mostly from the periphery of the blast, sit up, or at least try to.  10 can stand, and 8 go to the area you designated.  These people have cuts and scrapes, and a couple are limping; one has obviously broken an arm. 2 beaten-up but sturdy individuals join you.  By communicating, you have made your job as temporary Incident Commander easier by identifying the walking wounded (Green) and getting some immediate help.  You still have 10 victims down.

You then go to the closest victim on the ground.  Start right where you are and go to the next nearest victim in turn.  In this way, you will triage faster and more effectively than trying to figure out who needs help the most from a distance or going in a haphazard pattern.

Let’s cheat just a little and say that you happen to have SMART tags in your pack.  SMART tags are handy tickets which allow you to make a particular triage level on a patient.  Once you identify a victim’s triage level, you remove a portion of the end of the tag until you reach the appropriate color and place it around the patient’s wrist.  You could, instead, use colored adhesive tape, colored markers, or numbers

(Priority 1 is immediate/red, 2 is delayed/yellow, 3 is minimal/green, 4 is dead/expectant/black; this is used in some other countries and is useful if you’re color blind).

It is important to remember that you are triaging, not treating.  The only treatments in START will be stopping massive bleeding, opening airways, and elevating the legs in case of shock. As you go from patient to patient, stay calm, identify who you are and that you’re here to help. Your goal is to identify who will need help most urgently (red tags).  You will be assessing RPMs  (Respirations, Perfusion, and Mental Status):

Respirations:  Is your patient breathing? If not, tilt the head back or, if you have them, insert an oral airway (Note: in a MCI triage situation, the rule against moving the neck of an injured person before ruling out cervical spine injury is, for the time being, suspended) If you have an open airway and no breathing, that victim is tagged black. If the victim breathes once an airway is restored or is breathing more than 30 times a minute, tag red.  If the victim is breathing normally, move to perfusion.

Perfusion:   Perfusion is an evaluation of how normal the blood flow or circulation is.  Check for a radial pulse and/or press on the nail bed (I sometimes use the pad of a finger) firmly and quickly remove.  It will go from white to pink in less than 2 seconds in a normal individual.  This is referred to as the Capillary Refill Time (CRT).  If no radial pulse or it takes longer than 2 seconds for nail bed color to return to pink, tag red.  If a pulse is present and CRT is normal, move to mental status.

Mental Status:  Can the victim follow simple commands (“open your eyes”, “what’s your name”)? If the patient is breathing and has normal perfusion but is unconscious or can’t follow your commands, tag red.  If they can follow commands, tag yellow if they can’t get up or green if they can.  Remember that, as a consequence of the explosion, some victims may not be able to hear you well. 

It might be easier to remember all this by just thinking:  30 (respirations) – 2 (CRT) – Can Do (Commands)

If there is any doubt as to the category, always tag the highest priority triage level.  Not sure between yellow and red?  Tag red.  Once you have identified someone as triage level red, tag them and move immediately to the next patient unless you have major bleeding to stop.  Any one RPM check that results in a red result tags the victim as red.  For example, if someone wasn’t breathing but began breathing once you repositioned the airway, tag red, stop further evaluation if not hemorrhaging and move to the next patient.  Elevate the legs if you suspect shock.

Finally, these are your 10 patients on the ground, in order.  Read the descriptions and decide the primary triage level; remember you have two unskilled helpers following you.  We’ll discuss how we triaged them in detail next article:

1.  Male in his 30s, complains of pain in his left leg (obviously fractured), Respirations 24, pulse strong, CRT 1 second, no excessive bleeding.
2.  Female in her 50s, bleeding from nose, ears, and mouth.  Trying to sit up but can’t, respirations 20, pulse present, CRT 1 second, not responding to your commands.
3.  Teenage girl bleeding heavily from her right thigh, respirations 32, pulse thready, CRT 2.5 seconds, follows commands
4.  Another teenage girl, small laceration on forehead, says she can’t move her legs.  Respirations 20, pulse strong, CRT 1 second.
5.  Male in his 20s, head wound, respirations absent.  Airway repositioned, still no breathing. 
6.  Male in his 40s, burns on face, chest, and arms.  Respirations 22, pulse 100, CRT 1.5 seconds, follows commands.
7.  Teenage boy, multiple cuts and abrasions but not hemorrhaging, says he can’t breathe, respirations 34, radial pulse present, CRT 2.5 seconds.
8.  Female in her 20s, burns on neck and face, respirations 22, pulse present, CRT 1 second, asks to get up and can walk, although with a limp.
9.  Elderly woman, bleeding profusely from an amputated right arm (level of forearm), respirations 36, pulse on other wrist absent, CRT 3 seconds, unresponsive.
10.  male child, multiple penetrating injuries, respirations absent.  Airway repositioned, starts breathing.  Radial pulse absent, CRT 2 seconds, unresponsive.
Next article, we’ll see how we used START to sort our victims, utilized our unskilled help, and proceeded once we completed primary triage.  We’ll also discuss how our evaluations would stand up in a SHTF scenario.
Part 3

In Part 2 we described a mass casualty incident scene with 20 victims and told you about initial considerations before beginning START (Simple Triage and Rapid Treatment).  You ended up with 10 victims on the ground, 8 walking wounded, and 2 uninjured but unskilled helpers.  You moved the walking wounded to a separate area and are now ready to quickly triage the remaining 10 victims.

To review the primary triage categories:

Immediate (Red tag): The victim needs immediate medical care and will not survive if not treated quickly.  (for example, a major hemorrhagic wound/internal bleeding) Top priority for treatment.

Delayed (Yellow tag): The victim needs medical care within 2-4 hours. Injuries may become life-threatening if ignored, but can wait until Red tags are treated. (for example, open fracture of femur without major hemorrhage)

Minimal (Green tag): Generally stable and ambulatory (“walking wounded”) but may need some medical care. (for  example, 2 broken fingers, sprained wrist)

Expectant (Black tag): The victim is either deceased or is not expected to live.  (for example, open fracture of cranium with brain damage, multiple penetrating chest wounds)

And here are your triage evaluation parameters (RPMs):

Respirations:  Is your patient breathing? If not, tilt the head back or, if you have them, insert an oral airway (Note: in a MCI triage situation, the rule against moving the neck of an injured person before ruling out cervical spine injury is, for the time being, suspended) If you have an open airway and no breathing, that victim is tagged black. If the victim breathes once an airway is restored or is breathing more than 30 times a minute, tag red.  If the victim is breathing normally, move to perfusion.

  Perfusion is an evaluation of how normal the blood flow or circulation is.  Check for a radial pulse and/or press on the nail bed (I sometimes use the pad of a finger) firmly and quickly remove.  It will go from white to pink in less than 2 seconds in a normal individual.  This is referred to as the Capillary Refill Time (CRT).  If no radial pulse or it takes longer than 2 seconds for nail bed color to return to pink, tag red.  If a pulse is present and CRT is normal, move to mental status.

Mental Status:  Can the victim follow simple commands (“open your eyes”, “what’s your name”)? If the patient is breathing and has normal perfusion but is unconscious or can’t follow your commands, tag red.  If they can follow commands, tag yellow if they can’t get up or green if they can.  Remember that, as a consequence of the explosion, some victims may not be able to hear you well.

Remember this:  30 (respirations) – 2 (CRT) – Can Do (follows commands)

Your 2 uninjured helpers are an able-bodied man and woman.  The woman knows how to take a pulse.  You have no medical equipment with you other than some oral airways and triage tags to work with.

Begin with the nearest victim (from our list in the last article):

1.  Male in his 30s, complains of pain in his left leg (obviously fractured), Respirations 24, pulse strong, CRT 1 second, no excessive bleeding.

Respirations are within acceptable range (less than 30), pulse and CRT normal.  Complains of pain, and is communicating where it hurts, so mental status probably normal.  This patient is tagged YELLOW: needs care but will not die if there is a reasonable (2-4 hour) delay.  Move on.

2.  Female in her 50s, bleeding from nose, ears, and mouth.  Trying to sit up but can’t, respirations 20, pulse present, CRT 1 second, not responding to your commands.

This victim has a significant head injury, but is stable from the standpoint of respirations and perfusion.  As her mental status is impaired, tag RED (immediate).  Move on.

3.  Teenage girl bleeding heavily from her right thigh, respirations 32, pulse thready, CRT 2.5 seconds, follows commands.

This victim is seriously hemorrhaging, one of the reasons to treat during triage.  Respirations elevated and perfusion impaired. You use your unskilled male helper to apply pressure by placing his hands on the bleeding and applying pressure, preferably using his shirt or bandanna as a “dressing”. Tag RED.  As the patient is already RED, you don’t really have to assess mental status. You and your female helper move on.

4.  Another teenage girl, small laceration on forehead, says she can’t move her legs.  Respirations 20, pulse strong, CRT 1 second.

Probable spinal injury but otherwise stable and can communicate.  Tag YELLOW.  Move on.

5.  Male in his 20s, head wound, respirations absent.  Airway repositioned, still no breathing. 

If not breathing, you will reposition his head and place an airway.  This fails to restart breathing.  This patient is deceased for all intents and purposes.  Tag BLACK, move on.

6.  Male in his 40s, burns on face, chest, and arms.  Respirations 22, pulse 100, CRT 1.5 seconds, follows commands.

This victim has significant burns on large areas, but is breathing well and has normal perfusion.  Mental status is unimpaired, so you tag YELLOW and move on.

7.  Teenage boy, multiple cuts and abrasions but not hemorrhaging, says he can’t breathe, respirations 34, radial pulse present, CRT 2.5 seconds.

This victim doesn’t look so bad but is having trouble breathing and has questionable perfusion.  Mental status is unimpaired, but he likely has other issues, perhaps internal bleeding.  You tag RED (respirations over 30, impaired perfusion) and move on.

8.  Female in her 20s, burns on neck and face, respirations 22, pulse present, CRT 1 second, asks to get up and can walk, although with a limp.

Obviously injured, this young woman is otherwise stable and communicating.  With assistance, she is able to stand up, and can walk by herself.  She becomes another of the walking wounded, tag GREEN.   Point her to the other GREEN victims and move on.

9.  Elderly woman, bleeding profusely from an amputated right arm (level of forearm), respirations 36, pulse on other wrist absent, CRT 3 seconds, unresponsive.

Obviously in dire straits, you use your shirt as a tourniquet and sacrifice your remaining helper to apply pressure on the bleeding area.  Tag Red, move on.

10.  Male child, multiple penetrating injuries, respirations absent.  Airway repositioned, starts breathing.  Radial pulse absent, CRT 2 seconds, unresponsive.
You initially think this child is deceased, but you follow protocol and reposition his airway by tilting his head back and lifting his jaw .  A Mass Casualty Incident is one of the few circumstances where you don’t worry as much about cervical spine injuries in making your assessment. He starts breathing even without an oral airway, to your surprise, so you tag him RED.  If he is bleeding heavily from his injuries, you apply pressure and wait for the additional help you requested on initial survey of the MCI to arrive.

You have just performed triage on 20 victims, including the walking wounded, in 10 minutes or less.  Help begins to arrive, including the ICU nurse that you contacted initially.  You are no longer the most experienced medical resource at the scene, and you are relieved of Incident Command.  The nurse begins the process of assigning areas for yellow, red and black areas where secondary triage and treatment can occur.

There is still much to do, but you have performed your duty to identify those victims who need the most urgent care.  In a normal situation, your modern medical facilities will already have ambulances and trained personnel with lots of equipment on the scene.  In a collapse situation, however, the prognosis for many of your victims is grave.  Go back ` over our list of victims and see who you think would survive if modern medical care was not available.  Many of the RED tags and even some of the YELLOW tags would be in serious danger of dying from their wounds.

In times of trouble, it is wise to carry some form of individual kit to deal with medical issues you may be confronted with. Nurse Amy and I constantly research, develop and tweak medical supplies to tailor them to collapse scenarios.  We are always learning and improvising, and it would serve you well to do the same.

Thursday, June 20, 2013

Given the media outcry against gun ownership, it's easy to forget the wounds that are caused by knives and other sharp instruments.  Trauma incurred from these injuries may be minor or major; penetrating trauma such as caused by a stab wound should not be discounted as a major injury; it can be life-threatening, depending on the organs and blood vessels damaged. 

Penetrating trauma is divided into perforating and non-perforating.  A perforating wound is one in which the object causing the damage goes into one side of the body and then exits through the other side.  A wound from .223 or NATO .556 would, commonly, be an example of this type of penetrating trauma. One of my first classes in medical school showed a slide of Major General Henry Barnum, who received a minie ball through the hip in the battle of Antietam.  Years later, he could still pass a thin rod from the entry wound all the way out the other side.  General Barnum's hip, incidentally, is still on display in the National Museum of Medicine, where it has been for over 100 years.

Bullets and other high-speed projectiles cause damage related to the shock wave produced as the bullet passes through the body. This is called cavitation.  Many bullets will fragment in the body as well, sometimes causing damage further from the entry wound than expected.  Luckily, low speed projectiles such as knives will not do this. Your concerns are related specifically to the area of entry and the structures located directly in the path of the offending instrument.

Stab wounds are an example of a non-perforating wound:  the projectile causing the damage enters the body and either stays there or exits where it entered.  Most knife wounds would fit in this category, as the knife doesn’t pass entirely through and out of the body.  Some sharp instruments might do this, say a crossbow bolt or a spearhead, but let’s assume that you’ll be unlikely to see these. Most knife wounds you'll see will be minor lacerations.  Blood loss and failure of damaged organs will be the major issue to deal with.

A little about blood: Blood carries oxygen to the tissues and organs and removes waste products. It is made up of several components, including:

• ·         Red blood cells: These cells carry oxygen to body tissues.
• ·         White blood cells: These cells work to, among other things, fight infection and disease.
• ·         Platelets and other clotting factors: These allow blood to coagulate and lessen blood loss.
• ·         Plasma: A yellowish liquid in which the above are suspended.

Your immediate action upon encountering a victim of a wound with a sharp instrument may save their life.  Bleeding from arteries and internal organs can be very brisk.  If you are a typical 180 lb. (about 70 kg.) adult, you have approximately 9-10 pints (about 5 liters) of blood in your body. Athletes and those living at very high altitudes may have more. You can’t afford to lose more than 40% of total blood volume without needing major resuscitative efforts.  To get an idea of how much blood this is, empty a 2 liter bottle of fruit punch or cranberry juice on the floor.  You’ll be surprised at how much fluid that represents.

Hemorrhage (bleeding) is classified by the American College of Surgeons (of which I am a Fellow) as follows:

Class I:  Hemorrhage is less or equal to 15% of blood volume (1.5 pints/3/4 liter) in an average adult male.  A person donating 1 pint of blood is giving slightly less than 0.5 liters, for example. At this level there are almost no signs or symptoms, although some may feel vaguely faint.

Class II:  Hemorrhage is 15 to 30% loss of total blood volume (2-3 pints/1-1.5 liters).  The body tries to compensate at this point with, among other things, a faster heartbeat to speed oxygen to tissues.  This patient will appear pale and skin will be cool.  They will feel weak.

Class III: Hemorrhage is 30 to 40% loss of total blood volume (3-4 pints/1.5-2 liters).  At this point, the heart will be beating very quickly and is straining to get enough oxygen to tissues and blood pressure is low. Smaller blood vessels in extremities are constricting to keep the body core circulation going. This patient will be confused, pale, and in hypovolemic (low blood volume) shock. Blood transfusion is usually necessary. 

Class IV:  Hemorrhage is more than 40% of total blood volume (greater than 4 pints/2 liters). The heart can no longer maintain blood pressure and circulation.  Without major resuscitative help at this point, organs will fail and the patient will likely be comatose and die.

In most circumstances, sharp instrument injuries will be minor.  After controlling bleeding, your goal is to clean the wound thoroughly and dress it.  Wound closure may be an option in some wilderness cases, but most backcountry stab wounds will be dirty and should be left open (subject of another article).

If you're attending to an actively bleeding wound from a sharp object, you will need a level head and quick action.  This is, sometimes, not as easy as it sounds; most people not accustomed to dealing with these issues on a daily basis will experience a type of paralysis that may waste precious time. If modern medical care is available, contact emergency services immediately.

In the meantime, follow these steps:

·        - Assess the safety of the situation.  Make sure the situation is secure; it makes no sense for you to become the next casualty.

·         -Put on gloves if possible.  Your hands are full of bacteria and you will reduce the risk of infection by doing so.  Non-latex (nitrile) gloves are superior in avoiding allergic reactions to latex, more commonly seen than you’d think. If no gloves are available, plastic bags/wrap or, at least, hand sanitizers/soap will be useful if you have to touch the wound with bare hands.    

·         -Verify the victim’s breathing and mental status.  Clear airways if obstructed and determine if they are alert enough to help you by following commands.
·         Remove clothing carefully to fully inspect the wound and identify other injuries.  Make sure that you have a bandage scissors or EMT shears in your medical pack.

·        - Elevate the feet above the level of the heart and head (the “shock position”) to increase blood flow to the brain.

·        - If the sharp instrument is still in the body, don’t remove it.  It may be providing pressure on damaged blood vessels and decreasing the bleeding.  Stabilize the wound in place with dressings or in any way you can.  If there is no chance of emergency services reaching you, such as in a backcountry trip in an underdeveloped country, you may have to remove it at one point or another.  Don’t do this unless you are where the bulk of your medical supplies are.

·         -Apply pressure with some type of dressing, even your shirt if necessary.  Most non-arterial bleeding will stop with steady pressure on the wound. If the sharp instrument is in place and help is on the way, place pressure down on either side towards the blade to prevent it from slipping out and decrease bleeding.

·         -Elevate the injured area about the heart.  Make it more difficult to pump blood out of the body.

·         -Some recommend applying additional pressure with your other hand to major arteries about the level of the wound (especially for extremities).  These areas are called “pressure points”.  For example, a major artery (the popliteal artery) is found behind the knee.  Pressure here might decrease bleeding from a lower leg wound.  There is an entire map of pressure points for most parts of the body [that can be found with a quick web search.]

·        - If this fails, consider applying a tourniquet to stop the bleeding.  Tourniquets are to be used only when absolutely necessary, as they also stop the circulation of undamaged arteries and veins.  This will cause damage or death of tissue beyond the level of the wound if left on too long.  They also, after a very short time, hurt like a son of a gun. If a tourniquet is on, you may choose to loosen it after a period of time to determine if the body's clotting mechanisms have stopped the bleeding. Unfortunately, this can sometimes cause further bleeding, so this is mostly a strategy for when help in NOT on the way. If you are transporting a patient to a modern medical facility, make sure you mark a "T" on the victim's forehead or otherwise notify emergency personnel.

·        - In certain circumstances, the use of blood clotting agents such as QuickClot or Celox may be helpful.  They are effective in stopping bleeding, although they are sometimes difficult to clean out later.  We keep these products in all our medical packs, even individual first aid kits.

·        - Once bleeding has subsided, don’t remove a dressing unless you have to.  There are clots that can be dislodged if you do, and this may restart the bleeding.  Add additional dressings on top if help is on the way. In survival situations, you will eventually have to change and clean wound dressings.

·         -Secure everything with a pressure dressing, of which there are various on the market.  The Israeli Battle Dressing, known as The Emergency Bandage in the U.S., has a hinge which can apply up to 30 pounds of pressure if used properly.

·        - Keep the victim warm: Throw a blanket or a coat over them.  If help is coming, keep them as still and calm as possible to avoid further bleeding.  Monitor breathing, pulses, and mental status.

·        - An unconscious patient should be placed in the “recovery position”.  This will, among other things, allow fluid to drain from airways and help them breathe.

All of the above may not be necessary if you practice preventative measures.  In other words, don’t run with scissors.  With some foresight, you may be able to avoid a mishap that could turn into a tragedy.

About the Authors: Amy Alton, A.R.N.P. and Joe Alton, M.D. (aka "Nurse Amy" and Dr. Bones" are the producers and hosts of the popular Doom & Bloom podcast.

Friday, June 14, 2013

Here are some insights that I gained from a recent week-long medical mission trip to Nicaragua. We treated hundreds of men, women, and children living in remote villages for general medical complaints.  I envision these conditions as being similar to what many of us would see in TEOTWAWKI.

Living conditions:
Mostly, the men in these villages are subsistence farmers, picking coffee beans, or something similar.  The women stay at home and take care of the children, grandparents, and animals – chickens and pigs.  Their average income is very low, in the 10’s of dollars per month.

Their houses are really shacks made with available materials.  They were about as big as a two-car garage, some quite a bit smaller.  Many are composed of corrugated steel sheets, plastic sheeting, and some planks.  Some have adobe walls, but few are all adobe.  With many people in a small space, they are very crowded.  One family I interviewed had 11 people in the home, probably in 3 rooms.
Their cooking is done entirely over a wood stove, many indoors without chimneys.  Smoke inhalation is a constant for everyone in the house. 
Their diet consists mostly of rice and beans to eat with coffee, soda and juice to drink.  There is literally no money left after they buy wood for cooking and their food.  There was even a sad story of how a pot of beans on the stove must be guarded against theft.

Primary medical complaints:
1)       Headaches, Dizziness – from dehydration.  They know the water has parasites, so they mostly drink coffee and sodas or juices which all dehydrate at some level.
2)       Burning eyes, sore throat, coughing – from smoke inhalation all day long
3)       Muscle aches – from lots of hard manual labor, walking everywhere, carrying children all day, plus dehydration
4)       Gastritis, Heartburn, Abdominal Pain – from intestinal parasites gotten from drinking surface water and eating beans daily, and lots of coffee.
5)       Tooth Decay, Abscesses, Rotten Teeth – from not brushing/flossing and drinking mostly sodas and coffee every day.
6)       Infections requiring antibiotics – of almost every conceivable type.

NOTE:  I’m a licensed EMT.  The below lessons are intended as educational material and do not constitute medical advice inasmuch as they may be outside of the scope of my practice or coming from instructors, experience, or reading.  The lessons are, however, within the scope of my many years of life, caring for myself and my family members.  And, in case you’re wondering, I was working under the direction of a Physician's Assistant and an Nurse Practitioner.  I also mention several brand-name OTC products below.  I only use them because most people will recognize them a lot better than the chemical name of the medicine.  Please use your own good judgment on what is best for you and yours.

Lessons taken for TEOTWAWKI scenarios
1)        Have a way to obtain pure water without fire.  Bleach or Pool Shock (calcium hypochlorite)  work well and go a very long way.  At 1 tsp to treat 10 gallons of water, a gallon of bleach can treat up to 7,680 gallons, or enough water for a family of 4 for over 5 years, at a gallon per person per day.  (This is from a government web site.  Please do your own research.) 
If I could have handed out a quart of bleach to each family, it would change their lives.  Unfortunately, they cannot afford it on their low incomes.  And they can’t afford the wood to both cook food and boil water.

2)       Drink lots of clean water.  Most of us aren’t used to heavy physical labor all day, every day.  Drink as much as you want.  While working, you may sweat more, but you’ll stay cooler. 
Most of the folks I saw were dehydrated.  In one case, I had a sickly-looking pregnant woman drink as much clean water as she wanted.  About 20 minutes later, she looked way, way better, and said she felt better too.  Wish I could have given her a 55 gallon drum to take home.

3)       Avoid smoke inhalation.  This is so obvious as to sound stupid, but the Nicaraguans didn’t even think about the problems they cause themselves.  To avoid smoke, cook with fire outside, on a wood or gas stove with chimney inside, or without fire.  Gas, of course, doesn’t create smoke when burned, so has better OPSEC, but residual carbon monoxide is even more dangerous than outright smoke.  Solar ovens and solar-powered electric stoves/ovens are good choices as well.
The only remedy I could give those folks was to recommend they get themselves and their children outside and away from the smoke as much as possible, and to open their windows and doors – if their homes even have them.

4)       Muscle aches are a given when doing the daily activities that will be required in TEOTWAWKI.  Chopping, lifting, carrying, picking, bending over and so on take a toll on muscles.  A couple more pain reducing strategies include taking stretch breaks and learning to use the other side of your body.  Switch the tools to your other, non-dominate hand.  It’s uncomfortable learning a different way to do things, but you’ll be able to work longer and more comfortably.  Start practicing now when you don’t need it to get comfortable with it when you really need it. 
I recommended this to my patients.  I can only hope they will follow through with switching hands/arms/sides every so often.  I also wish I had been able to give out tubes of Ben Gay to everyone I saw.  It’s not a cure, but it sure feels good when you’re sore.  Advil/Ibuprofen will work, but it has some fairly serious intestinal side effects – mostly upset stomach and constipation – not good for those folks.  Aspirin and Tylenol (acetaminophen) will also work, but equally isn’t great for long-term use.

5)       Get a few pairs of really comfortable, sturdy work and walking shoes.  Break them in now so you won’t suffer when you need them. 
The only people I saw with good boots were the men who worked in the fields.  Many of the women wore flipflops – because that’s the only pair of shoes they owned.  And they walked on rocky roads and paths all the time!  Not good for many reasons.

6)       Have a lot of intestinal meds available.  The list of intestinal problems is long:  Diarrhea, constipation, gas, heartburn, vomiting, etc.  The effects are pretty simple:  pain, discomfort, and disability.  And it’s difficult to work when your belly hurts.  Example meds to have on hand:  heartburn – Tums or Rolaids; diarrhea – Imodium; constipation – stool softener and enema bag; vomiting – Pepto-Bismol; gas – BeanO or Tums.  I recommend having a few treatments of each type for each person in your party.

I gave these meds out to dozens of my patients for temporary relief, along with antiparasitics as a long-term solution.  You shouldn’t need antiparasitics if you are careful about purified water.  If not, you’ll need them, plus a bunch of other meds for the diseases that also come with contaminated water:  typhoid and dysentery among others.

7)       Brush and floss your teeth every day.  Brush your tongue.  Use an antiseptic mouthwash (Listerine).  Have a dental hygienist in your group.  Do everything you can to keep your teeth, tongue and mouth clean.  This is such a simple thing, but without dental care easily available, it can get out of hand quickly and the solutions aren’t good.
Many of the people we treated needed more than a few teeth to be pulled.  Some patients as young as 12 years old.  In some cases, our dentist didn’t even pull all of the teeth he could have because of the risks to the patient with no longer-term or follow-up care. 

8)       If you’re going to get antibiotics at the pet store, get a bunch of education too.  Our pharmacy was extremely well-stocked.  We had about every antibiotic you could name:  Amoxicillin, Doxycycline, Erythromycin, Penicillin, and so on.  This was a new area to me, except from personal experience.  It's a very complex topic incorporating microbiology, pharmacology, and lots of other “ologies”.  The big thing I learned is that antibiotics are specialized also.  One antibiotic will work for one thing but not touch another.  Going to the pet store and stocking up on FishMox in the belief that it’s a cure all is false hope and could cause someone to die.

Learn as much as you can about what you’re buying/getting.  If you go down this path, you’re in deep water.  The fancy medical words are indications, contraindications, effects, side effects, route, dosage and so on.  The English words are what you take it for, when you don’t take it, what it does that you want, what it does that you might not want, how you take it, how much and so on. 
My own story is that one stepson had an infection that required three different antibiotics prescriptions before he was cured.  The first antibiotic didn’t do anything.  He got hives from the second one.  The third one finally worked.

One comment:  Antibiotics are only useful for bacterial infections like pneumonia. They do nothing for viral infections like the common cold or flu.  Unfortunately, it’s very difficult to tell the difference between the two, even for doctors.  The only reason a doctor should give out antibiotics for a cold is if there is a real risk of pneumonia.  The current superbug scare we have is due at least in part to overprescription of antibiotics.  The germs that are left are resistant, as well as having mutated, rendering the current antibiotics harmless to them.

9)       Bactine and PhisoHex are a fantastic combination for superficial wounds.  While in country, a couple of teammates came to me for small wound treatment.  I had an AHA moment with Bactine.  It’s terrific in two ways:  topical pain reliever and antiseptic.  Topical (on the skin) pain relief is rare in the OTC med world, but super useful because I wanted to scrub the wounds to get rid of any dirt.  The antiseptic property is also nice to have.  Phisohex is another wonderful thing because it’s an antiseptic soap that doesn’t sting when you wash/scrub with it.  NOTE:  this is not a pain-free solution.  It hurts less.
I simply applied Bactine, waited for a while, then scrubbed with Phisohex and a few sterile gauze pads.  Then I reapplied Bactine for more pain relief.  In two cases (a big toe and forearm) I applied a Band-Aid for protection.  The other, I didn’t (head wound).

10)    Hand Sanitizer is wonderful  in a pinch, but doesn’t replace washing.  Being raised before the current germ phobia developed, I’ve never been big on hand sanitizer.  Of course, I used it in the Ambulance and Emergency department.  But I used it regularly while I was working in Nicaragua, treating dozens of people each day.  I have no idea what they might have been carrying, but I’m sure I’m not immune to it.  It’s a quick and easy dose of insurance when you’re in a hurry.  Washing with soap and water is even better. That said, I want to point out that keeping a house spotlessly sanitized and trying to keep the family in an antiseptic bubble is not good for  long-term health.  Reason being:  Our bodies develop immunity to germs through exposure to those very germs!  If you want to have the most robust immune system, go get dirty with a bunch of people!  Yes, you might get sick, but you’ll be immune when you recover, at least for a time.  This is exactly how vaccines work – exposing you to the specific germs you want immunity to.

Final note for SurvivalBlog readers:  all medical training is valuable, although difficult and time-consuming.  I started down the EMT/Paramedic path when I started seriously prepping last year.  The more I learn the more interesting and useful it is.  As one EMT I talked to said, “You never know when you’ll need it.”

JWR Adds: The SODIS method for water sterilization is ideal for impoverished regions, since the plastic bottles can be obtained free at almost any dump. If you are careful handling them, the bottles can be useful for several years.

Thursday, June 13, 2013

Greetings, my fellow SurvivalBlog readers! My name is Michael, and I am seventeen years old. I live somewhere on the East Coast of the United States of America with my mother and father. To the rest of the world, I appear a normal teenage boy: Glued to my iPad, where I read SurvivalBlog each night before bed, obsessed with both new and old music, and always quoting music lyrics, movies and television shows with my friends. Yet what both the majority my friends and society do not know is for the last year I have been preparing for The End of the World as We Know It. Yes, dear reader, it affects even the youngest in our society: this fear of a “world gone mad.” Generally, optimism is my life philosophy, but I see society on a dangerous trend towards self-ruination. Realism has taken deep root in the way that I handle the world around me. My goal for this essay is to be the example to those who say that they cannot prepare because of financial, familial, social, political, or other factors. I also want to give those holed away in the mountains or in “The Unnamed Western State” a sense of peace, knowing that regular, everyday citizens of our society understand that preparing for a future that might not come to fruition is better than partying on and having to learn the hard way.

My prepping story began when I was eight years old. My parents bought me a copy of the book The Worst-Case Scenario Survival Handbook by Joshua Piven and David Borgenicht. I fell in love with the book, as it revealed how to land a plane, jump off a building (and there is a safe way!), and escape from killer bees. The book made me think of the classic cheesy Hollywood inspired “doomsday” films that seem to open each summer blockbuster season. I thought, “How would I take care of myself if something terrible happened?” Thankfully, those thoughts faded just as quickly as they came. I still have the book a full eight years after my days dreaming of the end of the world. However, prepping fell out of my thoughts for many years, as I entered an academically challenging school where my time to consider such things was severely diminished under the weight of 12 page research papers, math homework and more. Prepping, like an urge to contact a long-forgotten friend, though, did come back. One of my father’s friends is a gunsmith and a prepper who gave me a paperback of one of James Wesley Rawles’ novel Patriots. I was in tenth grade at the time. The book did not stand a chance against my voracious appetite to keep turning the pages: I finished it within a day. Going back and reviewing the elaborate ways that the Gray’s prepared The Group" for TEOTWAWKI-style living was quite a shock, and made me consider The Worst Case Scenario Survival Handbook a trifling attempt to capture some of what the fictional Grays did at their wilderness fortress.

As I thought about Patriots, I considered where I was located in the country and the world. Being on the East Coast, many nuclear power plants exist and are an open target for some form of terrorist takeover or attack. Nuclear threats from a “rogue state” like Iran or North Korea could be a threat, but many years further on. By the time that North Korea has a missile that can reach where I am and stay in one piece, I will be dead and gone, and thus I considered myself safe. Yet such events as a Coronal Mass Ejection (CME), Flu pandemic, economic collapse and innumerable more catastrophes made me reconsider my “high on the horse” mentality quickly. As I did then, I continue to want to leave the East Coast for good, as I see it leading to the destruction of the American way of life and a haven for looters and other miscreants after a TEOTWAWKI event. As it turns out my father has a job opportunity that will take him west after I graduate high school. Naturally, my mother and I will follow him out there. As Robinson Jeffers said in his poem Shine, Perishing Republic, which includes this stanza:

“But for my children, I would have them keep their distance from the thickening center;
Never has been compulsory, when the cities lie at the monster’s feet there are left the mountains.”

I believe that prepping is a task best undertaken by the community that surrounds oneself. My parents, for example, are my strongest and most dedicated supporters on this long and arduous process of collecting and storing the things necessary to continue life as we know it. My mother has kidney, sinus, back, and other health concerns that force me to stock up on such products such as antibiotics, namely Levofloxin and Avalox. As a family, we also contract many other infections, and to combat this I attempt to keep a full prescription of Amoxicillin inside of my bug-out-bag, just in case. Advil, Tylenol, Mucinex, sleeping medications, cough drops and more play as crucial a role in my bug-out-bag as a room full of ammunition or a new AR-15 would be to an otherwise “healthy” prepper, given our medical histories and other complications. Procuring these medications, especially the antibiotics, requires nothing short of an act of Congress to get, as doctors are more reticent now than ever to forking over such prescriptions for infections that do not exist. Nevertheless, my mother and father allow me to store these medications when obtainable in an effort to protect us from what may lie around the corner.

In addition, as a family, we also work as a team on buying such things as ammunition. Our gun battery is not what I would consider sufficient, yet we are making strides forward. We have a 9mm Glock Model 17 and a .22 Long Rifle Beretta handgun. Because the nature of ammo is transient on the shelves in Wal-Mart or any other dealer, just finding ammo in either of these calibers is an act of Providence! My father enlists the help of my mother to purchase ammo in the “bulk packs”, as an individual can only purchase one per day. I am the one who stores and checks all of the ammo for defects once purchased, keeping it separate from our firearms, which are in my parent’s room, locked up. Nothing like a little bit of physical distance to keep “the lock from the key”. In addition, my mother is supportive of my father and I going to a local gun range every so often and honing our skills, of which I am grateful for her trust in my fathers and my abilities.

Because I have supportive parents, they fostered my desire to form my very own bug-out-bag. My first bag was a disaster. I constructed it last year, and at the time, it was the best thing since sliced bread to me. It was a L.L. Bean backpack that I had formerly used for school, but now insisted that it needed repurposing into a “survival kit.” My father was none too pleased because I had just gotten this backpack, but my mother was yielding, buying me a new backpack to replace the one that would soon become my “survival kit.” I woefully overfilled this poor backpack, whose purpose was to carry about 15 to 20 pounds for only a brief time. I weighed it at one point and was horrified to find that it weighed 45 pounds! I could barely carry it 15 steps when relaxed and not stressed, let alone under duress. My mother had forbid me to carry it outside the house, fearing for my physical safety! Yet, as I got older and wiser, I realized that a frame bag would take a majority of the weight from the supplies and distribute it, making carrying 45 pounds similar to carrying 20 in my current bag. After finally having this stroke of genius, I went out and purchased a Kelty Redstone 60 frame backpack. I spent the big money, and it was absolutely worth every penny. Now I can pack so much more than I could have in my old bag, and not even feel a difference! I ascertained a moral out of this: Always buy the best gear that you can afford, and make sure that it is applicable to the job you want it to do.

Now that I have made my decision and have a better bug-out-bag than I did before, I can now pack my bag with more than I ever imagined I could. Now, I have 5 days worth of clothes and food in my bag at all times, ready to go. In addition, I have a Kaito Voyager radio for staying in touch with the outside world, a 3 D-cell MagLite flashlight, a small quantity of ammunition, all of my medical supplies, toiletries and more. In addition to the bag itself, however, my room can be converted into survivalist headquarters in the event of a catastrophe. A set of clothes that include a L.L. Bean rain coat, blue jeans, sweat pants, long johns, and boot socks stay perched atop my Sturm T0 sleeping bag, which I recently purchased. The bag is amazing: it can keep me warm on even cold concrete, and while I may wake up stiff, I can sleep easy knowing that I will not become ill from being chilled. I also love the Sturm because it connects perfectly to the bottom of my Kelty bug-out-bag, where I would connect it for easy carrying if an event forced an evacuation of my home. In addition, my steel-toe boots sit beside my bed at night, along with a pair of Teva sandals and flip flops, just in case. This setup is just the “Warm weather” or “hurricane season” wear; I make the change from my “Winter weather” to “Warm weather” whenever the temperature remains above 60 degrees F at night, as only then could I survive in my summer clothes outdoors. Yet when the temperature dives below 60 degrees F at night, I make a swift change to my survival supplies, bringing out the “Winter Weather” supplies. These changes include bringing out ski pants that I have in my closet to an accessible place for quick access, bringing out my LL Bean heavy winter coat, filling it with a lighter, hand and boot warmers, Clif Bars and a small flashlight. This jacket stays next to the ski pants, where they sit in preparation for whatever life may throw at them. I also replace the sandals and flip flops with a pair of Bass winter boots that sit next to my steel toe boots, ever ready to tackle the next problem.

While my parents and I think that these plans are fantastic and prudent, there are many detractors. Some questions that I seem to get a lot from both friends my age and adults: How do you plan to implement these plans? Where would you go if you could no longer stay at your home? Why are you a “prepper” anyway? I will answer these questions respectively, starting with how my family and I would implement these plans. If there was ever a catastrophe great enough to displace thousands from their homes, and this happened at least 60 miles from my house, we would make the getaway plans effective. I would grab my bug-out-bag, put on my spare clothes I keep by my bed, put on shoes or boots, grab additional clothes that are stored in my closet, grab the family ammo tin, my watches and any other sentimental items that can be transported without additional weight. My mom and dad would grab their kits and any small items they would need and we would move to either my mother or my father’s car. The decision on which car to take would be on the amount of gas in each. As for where we would end up, we have a family friend that lives “somewhere out West” that has agreed to take us in if any catastrophe ever happened, and this is where we would formulate our plans to either return home, stay put, or move further out west, depending on the situation. As for why I personally am a “prepper”. I believe in a Supreme Being that has endowed me with enough intellect to understand when times are getting rough. With many potential threats to society now becoming apparent (CME, Yellowstone Eruption, Power grid failure, economic collapse, etc), now is the hour to hear the “little voice” within us all and begin making preparations not only for ourselves, but for the next generation of Americans as well. These preparations do not have to be on a massive scale to be a benefit; rather it is the small steps that move us forward with more wisdom and guidance than those who will attempt too great a stride too late, succumbing to a TEOTWAWKI style event rather than being a survivor.

I sincerely hope that this article has inspired you all to either begin preparing for events outside our “Circles of Influence”, or to continue on a path that protects you from those events. My family and I pray daily for the SurvivalBlog readership and the aversion of devastating events. I wish you all the best. Never Surrender. Stay Strong.

Monday, June 10, 2013

Hi James,
I'm sure you've heard of this--but on the off chance you haven't, you definitely need to: The miraculous wound-healing benefits of a goop made from sugar and betadine (povidone iodine--available cheaply everywhere). You mix together and make a paste, which can be packed into deep wounds and gouges. Some people refer to it as "sugardine."

Not everyone knows that sugar alone has been used for hundreds of years as an effective gunshot wound treatment. The high osmotic gradient it promotes attracts and traps bacteria--and animal cells are better able to withstand high osmotic conditions than bacterial cells. The addition of the povidone iodine makes it even more effective.

There are countless stories of near miraculous saves of horses with bad wounds that wouldn't heal, using this paste. I've used it to great effect on myself and on my dogs--sometimes with deep canine puncture wounds.

Ideally, it should be packed in and covered, and rinsed out and replaced everyday. But any application, under any circumstances, is a lot better than nothing. Granulated (or powdered) sugar and lots of povidone iodine are very valuable additions to prepper medical stores, in my opinion.

Here are a few medical journal articles on the topic:  

And here's a very practical video on using sugardine, from a veterinarian.

Stay Prepared! - Steve N.

Thursday, June 6, 2013

Suddenly all chaos broke loose. For a second it sounded like an unknown dog had got inside the fence. I grabbed my staff and was out the door before anyone else could react.

I was briefly reassured to see the fence was holding an unknown pit bull out but my pit bull was in full war mode. They were in fact fighting, trying to fight through the fence. Given enough time they would get through it, over it or under it. The hose was called for.

Moving quickly but carefully I unwind some hose and return to see the Sheltie engaged at the fence and I saw the moment that a two way fight through the fence turned into a three -way fight as the pit bull had engaged...pretty much everything around him. Just a split second too late I turned on the hose, disengaged my dogs and chased off the unknown dog with water.

Even though I've done many emergency and security roles, I can't eliminate that pulse of terror that runs through my body when I actually see somebody get injured. It's bad enough to be called to scenes where people are injured but you have some prep time. You are usually briefed on the situation, you get to assemble your gear on route for the call and you have some time to mentally steel yourself. I can't tell you how many hours I've spent in training for emergencies but when they actually happen there's that moment. And for me words like terror, horror and revulsion kick in first. And for me this one was pretty personally horrifying.

Shelties are herders. They are designed to work with a group, to have actual situational awareness and maintain long distance communication (visual or aural). They are fast and agile and they are made basically of legs and lungs. They can run almost for ever on dainty, almost spindly legs. Legs that fit almost entirely in the mouth of a large pit bull. And pit bulls want to bite and hold, they want to bite down. A large dog can break any single bone in yours or my body with about 850 pounds of crushing force. Therefore the extra dose of horror as I realized this conflict was for real and had injured the little one. Oh no.

The little guy was hurt. He cried in pain. Bad news. Bad, bad news. But then “the elevator goes all the way to the top” and that adrenaline rush hits that us emergency types not only know how to manage, we thrive on it. Your senses suddenly turn up to 110%, mind goes into hyperdrive, all of your training descends upon you like a gown of silken armor and in a split second, bam. You are in action.

  1. Separate combatants, war dog out, Sheltie in.
  2. Lift and cradle Sheltie off injured leg, very gently place on bed. Shut and lock door to establish control of scene.
  3. Reassurance flowing to Sheltie, I am the human, I will take care of you.
  4. Begin calming dog through kind touch and breathing patterns. Eliminate fear.
  5. Begin primary survey: determine extent of injury, single bit to left foreleg, no other injuries, no blood in ears, eyes, clear, nose and mouth clear.
  6. Gently palpate entire effected leg starting with shoulder. Shoulder still inserted into rotator cuff (good). Doggie humerus intact (good). Doggie radius and ulna seem intact (good). No puncture wounds on paw or paw pads (very good).
  7. Gentle, limited range of motion tests on all joints reveal no crepitus (grinding feeling of broken bones) or screams from dog.
  8. Swelling (edema) has begun around 6 puncture wounds--the classic dog bite pattern.

Diagnosis: Deep tissue puncture with deep tissue bruising due to crushing force. Classic large dog bite injury.

First aid: same as humans mostly. Immobilize the patient in a position of comfort that maintains airway, breathing and circulation (particularly in points on the other side of the injury from the heart (distil circulation) because broken bones can block off blood flow. No massive bleeding detected. At this point some splinting and dressing is indicted for the human, probably while we transport them to a hospital or doctor. For the animal most folks would have us transport the animal to a vet.

But heck we're preppers and in my family, dogs are a luxury animal. As have been horses for several generations. There's no budget for this treatment. If this same injury happened to me (which similar has several times) there's no budget for my treatment either. Besides we're preppers so here's where we begin our own second stage care and all following stages.

Remedial care: Try to clean and evaluate. the areas. With humans this might mean shaving hair away a good inch or so around the areas and with dogs it definitely means you are shaving. Shaving also preps you for sutures so don't be afraid to open up some field to work in. A good inch all around should suffice but hey, we want a sterile field so 2 inches is better.

Fortunately this dog wasn't scared to death by the little shaver I have on this face shaver I got in the thrift store for $2.00. It has a sideburn attachment or maybe a beard hacker and it's pretty quiet and didn't totally freak him out the way Bernie The Barber's scaled down lawn mowers would. If that didn't work I have a pair of those old fashioned “balding clippers”.

Manual balding clippers are a little trick I keep in my first aid kit (which is more like a field surgery than first aid kit) that everybody should have along with disposable razors for this purpose. For depilation (hair removal) in the field when you can't plug in a buzzer. Balding clippers are these old fashioned scissor thingies you might have seen in your grandfathers water closet cabinet. Pick up a pair in good order, the blade can be sharpened up and they work pretty good when you get the hang of them. There's a trick to not snagging the patient's hair with them and making them squeak (the patient not the shears).

Balding the bitten areas on my little guy I could see he got the primary canines in the center of leg mass. There wasn't much to do but clean the skin surface with some peroxide and let him bleed for bit.

Puncture wounds like bite wounds don't bleed profusely. In a way we almost wish they did. A good puncture will go through all of your dermal layers, the fatty layer underneath, the gliding membranes that cover our muscles, the muscles themselves, tendons, nerves and right down to bone. Whatever contaminants or pathogens you got punctured with might get flushed out a bit more with blood flow. My patient was internally contaminated.

See whatever was in pit bull's mouth was now in my patient's blood stream. Dog mouths, contrary to popular wisdom are not sanitary, antibacterial environments. To science they are full of very virulent (nasty) bacteria. So the continuing steps of care remained consistent with human treatment. Having shaved a good part of the Sheltie's leg I began to try to flush out and “departiculate” the punctures. And there's really not much you can do. “Washing” a wound that goes right through the skin and into the body is basically potentially injecting more foreign agents directly into the patient. With most lacerations and abrasions you don't have a direct hole into the body cavity and we more aggressively departiculate (pull out gravel twigs, dirt, etc). In this case I opted for peroxide to try and lift any contaminants close to surface and let them ooze.

Punctures tend to kinda ooze blood and they can continue to for a long time. Days in fact. Not only do you have severed blood vessels but with bites you have all this swelling and fluid building up because of crushed tissue. We actually want this to drain. Dogs have more of a tendency to abscess, which is develop pockets of infection below your skin and this is because a  dog's skin kinda glides over their muscles. It's not as bound to their subderma the same way ours is and infection tends to develop right between those layers. Not that humans don't run the same risk but we also have hands and great flexibility to treat ourselves. For dogs, immediate sutures, steri-strips, skin glue in this case is not indicated. We don't want the skin to close with this type of puncture if we're not trying to control major bleeding. I applied triple-antibiotic to the areas and dressed them per normal to move on in treatment.

See the clock was running and each treatment phase has a window. The effected limb was now swelling and this would complicate treatment, increase risk and increase recovery time. So to reduce this, in addition to immobilization we have elevation, compression and ice.

Now with animals, immobilization, elevation, compression and ice aren't always practical, especially without tranqs but you use the options that you can. In our case, immobilization and ice worked better than anything else as we moved into phase 2 of care. We managed to calm the Sheltie enough to keep him on his side, effected limb in the air, immobilized and then we tried to get cold ice compresses on him and keep them there as long as we could. By now I had enlisted help. The “we” part was making a big positive difference as Shelties are very curious and he kept wanting to pick his head up to see what was going on. Having help to keep him reassured was very helpful. And just like a human patient he was very curious about all of the instruments and dressings and he wanted to find out what everything was by sniffing at it.

Again we come to a juncture where if you have received the same treatments at the hospital Emergency Room (ER), you would be given a course of follow up treatment and discharged on an outpatient basis. But we are the ER and we are the follow up treatment and we are the outpatient basis. And I had a problem with supply. I was out of antibiotics. And a ride to get some was not immediately at my disposal. I canvassed the neighbors and found no antibiotics. “You are who we come to for that stuff, L.J.", they said. It was true. And I had not restocked fast enough.

Garlic is a bactriostatic agent. It sometimes doesn't totally wipe out bacteria but it will keep it's growth in check. The little guy didn't like being made to swallow raw garlic but...he was a very good patient. Very tolerant. This held him to day 2 at which he was showing signs of sepsis. In dogs you will see the eyes go unclear, reddish, kinda fuzzy, nose will warm up and dry out and lethargy set in. A friend relented to my begging, and got to the pet store for fish antibiotics.

Perhaps the golden jewel in the prepper pharmacopial cabinet, pet stores have long been our exclusive source of affordable antibiotics. In this case we chose erythromycin. Intended for use in fish tanks, this comes in powdered form. A bit of research on human child dosages and a bit of guesstimation led me to about 1mg administered twice orally after an initial dose of 2 milligrams.

Lethargy diminished in 12 hours. His full energetic character resurfaced more fully in 24 hours. A save! See left untreated this dog would have suffered sepsis and died of organ failure probably within 48 hours. His immune system had already tried and failed to beat the bacteria in his blood.    It was filling his body up with deadly toxins. That bite in the wild would have been fatal. I kept him on an 8 day course of treatment.

Now for a human the story would have likely been the end of it. Send them home with some gauze and some tape and let them dab vitamin E oil on their scabs. Human instinct tells them to complain. Dog instinct tells them to lick. A dog will lick right through their skin. Licking injuries are ugly and they can lead to all kinds of problems.

To make things worse, you really don't want to wrap gauze, tape or Ace bandages around animals like dogs. There's the chance they can get snagged on something or if you are wrapping their legs, the animal might nibble, tear and then find enough to actually pull on. They might tighten the bandage and cut off their own circulation and become seriously injured if you don't detect and correct the problem immediately. But I was running low on supplies. I left the little guy with a neighbor and dashed off to Prepperfest. Luckily not only did I know the guy behind one of the best stocked prepper medic tables but he heard the situation and picked up what I needed. Gauze bandage impregnated with no-lick, a chemical that doesn't harm dogs permanently, they just hate the taste. A quick loop of that stuck in place with no threat to circulation. Now little guy's wounds have closed nicely. He's out of the woods. A dog's life was saved. Take a deep bow folks. Our methods work.

Note that dosage here is important. The troublesome acute results of over-medicating with antibiotics can be anaphylaxis which is where your body becomes allergic to an element or compound which in time will produce symptoms like the sepsis we were originally treating for. Both will manifest in “shock” in acute stages (rapid, thready pulse, shallow respirations, lack of perfusion, low to no level of consciousness and eventually death).

Now as I've indicated, this is pretty much the same course of treatment I'd apply to myself or another human without access to medical care and as usual I take the legalistic precaution of saying “don't you try this at home.” But it's a common scenario and a very real application of preps. I'm fortunate to have had the training to be able to cope with a little help from friends.

The little Sheltie is back to springing like an arrow loosed from a compound bow (they accelerate through release), blazing through open fields and it's looks like we have many more years of fun together. It certainly makes me grateful to be a prepper and to have learned from so many people.

About The Author: L. Joseph Mountain recently published Hidden Harvest: Long Term Food Storage Techniques For Rich And Poor. He keeps a web site at where "articles are sometimes archived, info is irregularly updated  and questions are occasionally answered." 

Sunday, June 2, 2013

On the morning of August 29th, 2005 we came face to face with TEOTWAWKI in the form of Hurricane Katrina.  An estimated 92% of our community in Pascagoula, Mississippi was inundated with a storm surge of 20-30 feet and 30-55 feet sea waves.  The surge waters traveled well inland, between 6-12 miles and combined with freshwater flooding from our numerous creeks, rivers, and the runoff from the Mobile, Alabama reservoir that opened its flood gates to relieve stress on the dam.  This basically cut Jackson County in half.  Fortunately the worst of the storm hit in the morning just as it was becoming daylight or our losses of 12 souls would have been much higher had it made landfall in the dark of night.  Even though, it took almost two weeks before they found and were able to claim one of the fallen, a young child, because she was under an enormous  20-30 foot high by at least 100 feet in diameter debris pile a block up from the beach.  The devastation completely destroyed all of our basic services: electricity, communications, water, natural gas, and sewage and covered most of the town with debris piled 8 feet or higher.  The storm’s impact was such that the entire state was declared a disaster zone and it knocked out the power to over 98% of the state and damaged 100% of the states power plants.

When we were finally able to walk around and assess the situation after most of the waters receded, we counted ourselves as lucky because most of the houses in the neighborhood where we rode out the storm appeared structurally sound and there weren’t that many trees down.  Even though everyone knew things were going to be tough for a while, we didn’t count on it taking at least two weeks to restore water, another 1-2 weeks after that to restore some semblance of power and telephone services to our temporary abode.  This appeared to be the norm for most parts of town that sustained “minimal” damage.  As it was, it took over three months before it was restored in our neighborhood, not that it mattered as it was uninhabitable and eventually had to be bulldozed down but that as they say is a tale for another day.

Like most storm veterans living on the Gulf Coast, we had planned and prepared but Mother Nature has an inane way of pointing out the futility of all of mankind’s best laid plans.  Yes, we might have possibly been able to evacuate but deemed it in our best interest to hunker down with some friends and ride it out.  After all, we were staying in a well built home on some of the highest ground in town and at least a mile from the beach.  Besides, reports from other family and friends were that the roads were so congested (1-2 million evacuees from 4 states will do that don’t you know) that it was taking over 12 hours just to get as far north as Hattiesburg, a mere 95 miles north and that there wasn’t any hotel rooms available all the way up to Tennessee and even if you could find one, what would we do with our combined 10 pets?  Besides, how safe would it have been to ride out the storm on some desolate stretch of highway in a vehicle, especially with all of the tornados that Katrina spun off, 51 in total in at least 5 states with 11 of those in Mississippi alone?

So, the hatches were battened down and our storm plan was initiated.  First, was securing and inventorying our combined vital medicines, foodstuffs, pet food, drinking water, batteries, candles, grill and camp stove fuels, cleaning supplies, bleach, anti-bacterial gel, clothing, important papers and computer hard drives, tools, firearms, and cash.  Previously, all of the vehicles were gassed up along with all of the gas cans and the generator was prepped and stored high.  The ice chests, freezers and fridge were stuffed with ice and the most perishable foodstuffs were ready for immediate consumption in the event of a prolonged power outage.  The television and storm radio were tuned to the appropriate channels and the bathtubs were filled to capacity to provide general use water for cleaning and flushing.  The attic access was opened and some basic essentials like: food, water, axe, rope, flashlights, etc.  Just in case.  The outdoor surroundings were checked and a few boats in the neighborhood were identified that could potentially be used in a pinch.  All told, we had enough foodstuffs to last 6 adults and 10 animals for 2-3 weeks and at least a weeks worth of fresh drinking and cooking water as long as we were frugal.  Ah, hindsight is truly bliss now isn’t it.

During the height of the storm, when it became apparent that we would be receiving flood water into the house, everyone rushed throughout the house to empty out the lower cabinets and drawers and closet floors, placing everything as high as possible and even opening up the attic and placing more essential supplies and tools up there in case we had to seek higher ground.  Once, the homeowner and I braved the elements to go outside and unlash the next door neighbor’s small boat (they smartly evacuated early on) from its trailer and re-tied it off to keep it from sinking or floating away.  While doing this, we were obliged to add another soul to our motley crew by rescuing a man from drowning out in the street.  He was delirious and starting to suffer from hypothermia so we wrapped him up into a wool blanket and laid him up on a long dresser in the foyer.  Later, it was learned that he woke up when his head bumped against the ceiling of his bedroom and that he had to dive down and swim out of his bedroom window to safety!  He had the clothes on his back, no socks or shoes and a small empty suitcase.

We tried unsuccessfully to get a passing fire truck loaded down with EMT and rescuers to take him, in case he needed additional medical care but they said we appeared to have things under control.  Besides they were headed south into the teeth of the storm to rescue people clinging to roofs along with an apparent heart attack victim.  Later, two guys in a “commandeered” boat came by headed south but, on their return, the boat was overloaded with people they had rescued.  All total, they passed by 6 or 7 times, and each time the boat was filled to the gills with rescued souls.  Later, we learned that they had rescued over 100 people before the receding waters necessitated docking the boat in their front yard.  I’m pretty sure that that tidbit of knowledge didn’t make the media airwaves.  Of the untold hundreds of similar acts of heroism conducted during and immediately after this catastrophic event by our local emergency personnel and citizenry, I felt compelled to add it because in the end, we all need to have a little hope and faith in our fellow man.

In the immediate aftermath of the storm, it became quite apparent that we needed to re-assess our predicament and adjust accordingly.  My wife and I knew that our house that sat at a much lower elevation closer to the beach would be untenable so we gladly took our friends offer to stay with them until we could assess it later.  They were extremely fortunate in that their home, where we rode the storm out, only had 2-3 feet of water go through it and that the structure was virtually unscathed from the ravages of felled trees and flying debris which meant that at least temporarily we would have a roof over our heads and a somewhat habitable place to stay providing everyone pitched in and acted quickly to mitigate the flood damage.  This consisted of removing all floor coverings down to the slab, all of the upholstered furniture, wall sheetrock from the floor to six inches above the visible flood line, and anything else that cannot be scrubbed and taking it to the side of the road.  Next was scrapping up as much of the storm water sludge off of the floors and all heavily coated horizontal and vertical surfaces possible and depositing it at the roadside too.  Some of our precious potable water stored in large 5 gallon containers with copious amounts of bleach and general purpose disinfectant soap was used to wipe down and clean one of the bathrooms, the kitchen and dining room, and a couple of bedrooms.  It took a full 2-3 days of steady cleaning by all hands to get the house sanitized for habitability.  The surge destroyed our large reserves of fresh water in the bathtubs due to the force of the flood waters backing up through the sewage system drains.

It is vital that you sanitize every surface that could have even remotely come in contact with the flood waters because they not only contain sea water and sewage, they are also full of chemicals from industrial waste and numerous other biological and toxic substances.  In our case, there was the addition of some of the foulest smelling primordial ooze from the nearby savannahs not to mention an old medical dumpsite from a former leper colony on one of the barrier islands and numerous chemical and gas refineries.  This mire coated everything in town with inches of nasty, foul smelling and toxic ooze turning the whole city into a gigantic Petri dish rife with disease and bacteria.  It was three days before I could make the first journey out of the neighborhood to inspect our property and in those 3 days, our house was filled with every color and shape of mold that you can imagine.  It literally covered the inside of the entire house from floor to ceiling so, I cannot stress enough that the first priority in such an event is to sanitize everything.

This is also a good time to remove any large appliance that was submerged along with any other furniture and belongings that will not be repaired or restored.  Just make sure to take photos and inventory all items being tossed to the road for insurance purposes and be prepared to fight the appraisers in the event the city is able to quickly remove those items.  One of our biggest fears after the storm was that of fire because the entire city looked like one giant maze with debris piles 10-20 feet high lining every street for months after the storm.  It seems as though we went at least two months before it rained again which meant we constantly had to battle the potentially deadly dust and the oppressive sweltering heat, this is South Mississippi after all!

Fortunately, we were able to salvage the mattresses on the beds because they floated on top of the box springs, all of which was set out to thoroughly dry in the sunlight the day after the storm after being wiped down with bleach water.  Everything gets washed or wiped down with bleach water and sun dried so eventually, all of your clothes become severely faded and thread bare after time.

Temporary power and transportation was next on the agenda and even though the generator was submerged after tipping over off of the raised supports that we set it on, we were able to salvage it and get a couple of box fans and table lamps going as well as powering a couple of fans and lights for one of the next door neighbors.  If we ever have to do this again, I think suspending it from rafter eyebolts on rope or cables may be in order.  In the beginning, we only ran the generator at night because of the fuel shortage.  Because fuel was basically non-existent for the first month or so, we augmented our diminishing supply by removing the gas tanks off of the three new vehicles that “died” during the storm and filtering out the water from the gas by emptying them into a large 55 gallon drum and letting the water settle to the bottom before dipping out the gas to fill our jugs.  Make sure to place this drum outside away from the living and cooking areas but still close enough to guard against looters.  We were fortunate that my venerable 1984 Ford Bronco and 1989 Ford F-150 started right up and didn’t have any water in the oil or gas tanks.  The trannys had water in them but as our friend worked for the local Ford dealership and their main repair shop was spared from the flooding and had adequate generator backup, he was able to replace the fluids within a few days so we had transportation until we were able to replace them about six months later.  We were lucky during that time because unlike so many others, neither of these vehicles burst into flames from corroded or shorted wiring.  This was probably due to the fact that they were raised higher than normal and their cabins weren’t submerged in the flood waters.  It wasn’t until months later that I discovered that the flood water had gotten into the rear ends through a rubber vent hole, needless to say, I wound up replacing the rear end on the pickup to extends it life until we could replace it so, make sure to drain, flush, and replace with new, the fluids in the rear ends and 4x4 lockers.

An important note here about transportation is to make sure you have plenty of tire repair supplies as we must have repaired at least 20 flats that first month alone and even had to acquire another tire after we found the cast aluminum head of an old fashioned meat tenderizer imbedded in the side wall after one of our forays across town seeking supplies.

Another note on “salvaging” your vehicles is the electrical system.  A lot of folks spent enormous effort and time in drying out their cars and trucks and getting them to run to no avail as many of these same vehicles later caught fire as the electrical systems shorted out.  So, if you have to resort to this please add a fire extinguisher or two to your survival kits for such emergencies.  I had to stop two cars coming down the road within the first few months because they were on fire underneath the vehicle and the occupants didn’t know it!

The mechanic had to go back to work within a few days because his services were in high demand at the dealership as it became the main repair facility for all of the emergency vehicles.  He was their only front end specialist and in high demand because the poor road conditions were reeking havoc on those vehicles.  At any given time, there were 20 -30 vehicles with license plates from all over the country there seeking maintenance or repair of some sort for months on end.  That basically left it up to me make the twice daily trips to the county fair grounds for food, water, and ice to distribute to the folks of our old neighborhood as well as our “new” neighborhood.  I cannot stress enough the fact that you never turn anything down because whether or not you need it, someone else in the neighborhood will!  Additionally, knowing the locations of facilities rendering assistance by way of beds and hopefully hot food is vital as this will aid you immensely when you come across people wondering around aimlessly due to the trauma they experienced.  One notable experience I had was with a family of four, including two small elementary age children.  I had observed them walking around for a day or two before it dawned on me that they were still carrying the same bundles of stuff.  After stopping them, their story was one of complete despair as they had been walking the streets for the better part of a week because they didn’t have anywhere to go.  A passing National Guard truck loaded with MREs gave me the location of one such center so, I loaded them all up and of to that wonderful church made famous by Ray Steven’s squirrel song we went!  A few days later while dropping off a few more unfortunates,  I was told that one of the many charity groups was helping to relocate the family.

In the beginning, water and ice are vital to your survival and as such, must be stretched to its fullest potential.  Our wives came up with a great simple process for extending the usefulness of ice.  They set up a simple linear process using the four 100 quart Igloo ice chests that we had as the basic line with two smaller Igloo ice chest to hold any excess ice we happened to acquire.  The first chest was raised up on a sturdy chair and contained all of our foodstuffs and medicine that needed to be cooled, packed in loose ice (some ice is also placed into sealed containers to thaw as a means to augment drinking and cooking water).  To the right, sitting on the ground so that the drain plug of the first chest could drain directly into it with little effort was the second chest.  This chest served as our bathing and dish washing water.  It was sanitized with bleach because an inadvertent germ or two could be in the drained water from our hands accessing the items in the first chest.  You bathed by dipping wash clothes into the bleach water and wiping yourself clean.  Bathing was augmented by squirting GermEx with Aloe Vera directly onto a damp wash cloth and wiping oneself off.  While crude, it kept you clean, provided a refreshing tingle from the alcohol in the GermEx and aided in disinfecting any minor sores or scratches you have.  After the dishes were washed, the water from the 2nd chest was transferred to the third chest sitting to its right and then the 2nd chest was sanitized with clean bleach water making it ready for the next use.  The 3rd chest was used to our wash clothes and the 4th chest sitting to its right was used to rinse the clothes prior to hanging out on makeshift clothes lines.  The water in the 4th chest was clear water that came from sundry sources, e.g. excess ice runoff from the extra storage chests, suspect bottled water that was overheated in the sun, and later on pond water from the local park once we were informed it was safe for non-food use.  Because it was suspect, it was always adequately bleached.  After the clothes were washed, the water from the 3rd chest was used for mopping the floors and wiping off non-food areas.  The water from the 4th chest was used to rinse off everything that was washed with water from the 4th chest.  All excess water from the chests was either used to refill the bathtubs for toilet flushing water or kept in buckets in case of fire and later sprinkled throughout the yard and driveway to cut down on the dust.

Our close encounter with the Post-Apocalyptic TEOTWAWKI event named Hurricane Katrina has not only left an indelible mark upon us but has made us stronger because we survived it and has taught us a few things about ourselves and mankind in general that everyone can learn from.  Here are the 10 biggest that readily come to mind:

First and foremost, in the event you are forewarned with an approaching disaster like Hurricane Katrina, do not hesitate. Evacuate.

Second, no amount of planning can cover every contingency so be prepared to improvise.

Third, 3-7 days of supplies are completely inadequate because it can take up to 2-3 weeks before regular and consistent support from outside sources becomes available.

Fourth, everyone impacted that survives is just that, a survivor so you had better be ready to get over stupid prejudices because you either survive together or perish individually.

Fifth, you are going to have to work hard so, accept your fate and “hitch up your drawers” and get at it.  The first responders are going to need your assistance so that they can provide the aid you need.  Everything that you can do initially be that clearing roadways, sharing resources, making signs to identify streets or people in dire need, assisting neighbors, scrounging, and safeguarding will only improve your lot in the aftermath.

Sixth, maintain your vital inoculations for Tetanus, hepatitis, etc.  Get your booster shots.  Thankfully for us, the nurse in our family went over and above to seek us out and administer all of those vital inoculations.

Seventh, get your pets looked at ASAP if they are subjected to flood waters, we almost lost two of ours.  Fortunately, a dear friend that worked as a Vet tech was able to bring and administer the needed antibiotics to save their lives.

Eighth, more people die or are seriously injured after the storm than during it due to accidents while cleaning up, stress, heat exposure, microscopic critters in the surge water, disease, improperly stored or cooked food, poisonous insects and snakes, exposure to the elements, etc.  If you do not have any experience with the art of using a chainsaw to fell trees or cut them off of your house then please, seek the assistance of someone who has this knowledge!  Observe each other and don’t hesitate to seek medical assistance for even the most basic of wounds, especially if you haven’t kept up on your inoculations.

Ninth, an openly well armed citizenry tends to keep the wolves and looters at bay as they are mainly cowards seeking to prey on easy targets.  Down here after a storm, everyone just assumes that everyone is “packing” so, everyone just generally seems to be much more calm and cooperative.

Tenth, thank all those “outsiders” that show up to assist with the cleanup and rebuilding because 99% of them are there to genuinely help.  Especially show your appreciation to all of those folks manning the stationary kitchens and food trucks.  Some of the best hot meals I ever had came from the church group around the corner running a kitchen and the Red Cross and Salvation Army food trucks.

Lastly, keep the faith as it will see you through to the bitter end.  Even though it’s been almost 8 years now since that fateful day, we are still recovering from Katrina, at least economically but hey, material objects are just that, stuff, easily replaced when you get the resources should you desire to do so.  Remember, not everyone will be made financially whole after such an event but hopefully you’ll still have your health not to mention the most important asset of all, your truly good friends and family.

Wednesday, May 29, 2013

I live in Tennessee where mosquitoes, chiggers, and ticks thrive.  There are two wet weather ponds near my home and if I go to my shooting range in the evening or early morning, the mosquitoes will make any quality time really miserable.  While working in the gardens and fields, one has to be constantly checking themselves for ticks.
Last year about April I read a short paragraph in Countryside Magazine from a gentleman (I believe from Maine) that has taken a Vitamin B1 tablet starting in April and takes them every day until the first killing frost in the Fall for the past 43 years.  He never gets bitten by mosquitoes, chiggers, or ticks.
I decided there was nothing to lose by trying it.  It took a couple weeks for the B1 to get through my system but from that point on through Fall I never had one mosquito bite or tick bite.  I had mosquitoes land on me (briefly), ticks crawled on me while on the range, in the woods, or in the garden, but not one bite.
I put this information out to everyone on my email list.  One of those people is a very good friend that also happens to be a doctor (M.D.).  He emailed me back to inform me that the Vitamin B1 "trick" was one of the first things that was taught in medical school.  He and I can only offer conjecture as to why this information isn't put out en mass.
I buy cheap Vitamin B1 tablets at the local big box store.  I think the price is about $4.00 for one bottle that will last one person the entire Spring/Summer insect season.  Prior to this, I was spending at least 4 times this amount of chemical sprays that were marginal at best. - Carl in Tennessee 


I prefer to anesthetize ticks with nail polish remover (acetone-type) on a cotton ball or pad for 5 minutes and just flick them off outside away from my house. Ticks absorb the acetone through their “skin” as well as breathe it. It takes patience but nothing should be regurgitated from the tick into your blood stream. You should not press hard with the cotton even though it itches. Although I hate to do it, dogs and cats need Frontline. - Stuart R.


Mr. Rawles:
A couple of notes on the recent article "Bad as a Bullet: Tick and Mosquito-Borne Diseases":

A few years ago it was discovered that Lyme disease is under debate as a possibly preventable hereditary illness! I had Lyme disease when I was about 19. Back around 1991. I honestly don't remember when it was. Unfortunately, I also discovered I'm allergic to tetracycline, which at the time was the primary treatment for the disease, so I was forced to stop treatment about halfway through the cycle. Many years later when my wife was expecting our baby, I was encouraged to be retested for the Lyme spirochetes. Lyme disease is still considered a vector-borne illness, but it apparently can be transferred to children pre-natally, from the mother, with the mother now being considered the vector [as well as a genetic tendency that can be passed from either the mother or the father.] I'm not kidding. Scary stuff. I was clean of the Lyme disease so presumably my child is okay as well, but I still (20 years after contracting Lyme disease) have rheumatoid arthritis symptoms because of having it as a teenager.

Secondly, regarding Silent Spring and Rachel Carson: I have read that while eliminating DDT (and similar insecticides) has benefited some people, more people have died from malaria and other mosquito-borne illnesses than could ever have been injured by the insecticides. Rachel Carson's primary concern was for birds' reproductive systems, but humans are also sometimes injured by DDT. In the long term, however, more people are injured than helped by the absence of that particular pesticide. Consider this article in Audubon magazine regarding DDT. If even Audubon says DDT serves a useful role, then it might be time to overrule the Stockholm Convention and put it back into use.

Best, - J.D.C. in Mississippi

Tuesday, May 28, 2013

We have SCUBA friends from Canada who do a lot of camping, and one year the wife came down with a debilitating illness that put her out of work for many months.  The medical system there did not make it easy to consult a specialist, especially one familiar with arthropod-borne diseases.  She showed all the symptoms of Lyme disease, including weakness, fever, sore joints, lethargy, headaches, and muscle aches.  Plus she had been exposed to ticks while camping.  She suffered for over a year before she slowly recovered.  Though it was never confirmed to be a tick-borne illness, odds are it was.

Another friend, a lieutenant colonel in the Marine Corps Reserves who lives in Connecticut, came down with fever and joint pain and was diagnosed with three tick-borne diseases, which put him out of work for a year and a half.  It's not unusual for a tick to carry more than one of these nasty infections at a time.

Ticks and mosquitoes can put you out of action just as easily as a bullet.  In fact, throughout history disease has caused more casualties in war than any other factor, including combat.  When you're fighting for survival in the field, your hygiene is reduced, your stress is high, and your immune system is depressed.  You may not have time to check yourself for ticks every day, but you certainly should.  If you served in Vietnam, you lost a lot of blood to mosquitoes over there, and were exposed to malaria as well.  In the Middle East its sand flies.

There are seven major species of ticks found in the continental United States that can carry disease.  It's not important to be able to tell them apart, just know what a tick looks like.  I start seeing ticks on dogs in the spring, and usually have a collection of a couple dozen by the end of May.  People bring their dogs in for a "lump," or what they think may be a skin tag.  Ticks are always on the surface of the skin, and do not burrow into or under the skin.  Just their mouthparts penetrate.

An adult tick is about 3/16 to ¼" long, oval, and has eight legs.  An engorged tick full of blood can be ½" long.  Photos of live ticks in the wild generally show the tick on a leaf or blade of grass with one or two of its front legs reaching out.  You could say they're thumbing for a ride, because when an animal or man passes by, a small hook at the end of the leg grabs onto hairs or fabric. 

Now, they don't have their leg out all the time, but just like a hitchhiker, they put it out when something stimulates them.  Carbon dioxide from your breath is the number one trigger that they sense, and it may also be the reason they move to the head area once they're on board.  There are more capillaries close to the surface of the skin on the head and neck, too, for them to access.

Vibrations in the ground as you tromp along the trail can be felt on the end of that blade of grass by the tick, and even air movement or body heat may be a factor for them to reach out and say, "Hey!"  Although a tick may feed anywhere on the body, they do tend to migrate up (on humans) or forward on animals.  We may find them attached at our waistline or armpits, but more commonly in the hairline on the neck or behind the ears.  Adult ticks are usually felt when you run your hands through your hair, but odds are you will never feel the bite.

Ticks produce a potent anesthetic in their saliva that numbs the skin where their mouthparts penetrate.  They actually grab or glue to a small fold of skin and won't let go.  When you remove a tick, it often comes away with that tiny piece of skin in its mouth.  Another ingredient of the saliva is an anticoagulant to keep the blood flowing until the female tick is filled to the max and falls off, ready to lay eggs.

Adult ticks are usually easily noticeable and readily found, but the smaller nymph stage is equally infective and can be quite small and hard to find.  The blacklegged tick (deer tick), the primary transmitter of Lyme disease, has a nymph stage that is so tiny it will fit inside the "O" in "ONE DIME" (pull out a dime and see).  It would indeed take a fine-toothed comb to find one on a dog, and could easily go unnoticed for days on a human.

We test dogs every year for heart worms (mosquito-borne), and the test we use also checks for Lyme, anaplasmosis, and ehrlichiosis from ticks.  The incidence in Ohio for Lyme is one out of 172, anaplasmosis is one out of 300, and ehrlichiosis is one out of 324.  (2012,  The study that came up with these figures is far from accurate, however, because only a fraction of dog owners have their pets checked for heartworm every year, let alone have them on heartworm preventives.  So the actual occurrence of these diseases is undoubtedly higher.  The point is, where there's ticks, there is also disease.

While the "system" is working, you can use 20% or stronger DEET (N, N-diethyl-m-toluamide) on exposed skin to repel ticks and mosquitoes.  Some clothing comes treated with permethrin that is effective tor numerous washings, or you can buy permethrin treatment kits to do your own clothes.  Eventually, you will run out of these consumables in a TEOTWAWKI situation, and you will have to fall back on daily full-body inspections for ticks, which may have additional benefits if you are checking each other.

Some sources recommend wearing light-colored clothing, which one theory states ticks don't like, or more likely because they are easier to spot crawling on light colors.  If you're wearing camo, this won't work so well.  Tuck your pant legs into your boots.  I've always preferred over-the-calf Thorlo® anti-fatigue or combat boot socks with drawstring cuff BDU pants, in-the-boot combination.  With everything tucked in, including t-shirts into underpants, it's more likely a tick that gets through the barriers will end up on the neck and head, making it easier to find.

There are several neat little devices out there to remove ticks, but plain old tweezers or forceps work well, too.  These tick tools are designed to grasp the head of the tick near the skin, so that you don't squeeze the body (and supposedly squirt juices into your skin).  Steady, gentle traction will pull the tick off your skin.  Do not jerk it or burn it with a match or cigarette.  More likely you will get burned also.  Remember, ticks do not burrow, so they'll be obviously above the skin but attached to it.

A simple tick tool you can make requires a stout plastic teaspoon and a Xacto® "razor saw."   Cut a shallow-angled "V" in the tip of the spoon bowl, about ½" deep.  Slide the bowl channel under the tick and lift upward with gentle traction, and the tick will come away.  Now you can burn it or crush it.  Wash the bite area with soap and water, betadine or alcohol, and wash your hands, too, if you handled the tick.

Mosquitoes are also bad as a bullet.  Worldwide they kill more people than anything else (malaria), yet before Rachel Carson's "Silent Spring" brought about the ban on DDT, it was on the decline.  Millions have died since the ban, and continue to drop from malaria.  More than any other product to prevent malaria (and other mosquito-borne diseases), the mosquito net stands supreme.  Costing anywhere from $5 to $100, you can get a travel-size bed canopy net or military surplus nets that are suspended above your cot or ground cover.  There are many choices.

Mosquitoes are most active at dusk and dawn, but in wooded or tropical areas they bite all day and night, and prefer the shade and humidity.  They are attracted to carbon dioxide, perspiration, body odors, and body heat.  Researchers found that mosquitoes do have clothing color preferences, too.  They seem attracted more to dark colors, and prefer blue.  Unlike the tick, you'll usually feel the initial bite of a mosquito, but then its saliva numbs the wound and you won't notice until its tank is full.

In the USA mosquitoes carry various encephalitis viruses, including Eastern, Western, and Venezuelan Equine Encephalitis Viruses and West Nile Virus.  Case fatality rates run from 0.3% to as high as 60%.  With little medical supportive care available after a collapse, more will die.  Up to 50% of survivors have continuing problems with neurologic aftereffects.  You don't want this, so take prevention seriously. 

Remove or drain all standing water containers (old tires, cans) from your habitat area.  Check roof gutters also for standing water, and if you have water catch barrels cover them with screen to keep mosquitoes from breeding in the water.  Adding goldfish to ponds helps to keep the mosquito larvae population under control.  While the federal and state governments are under control, it is illegal to use oil, soap, or other products on standing water that "suffocate" the larvae.  And in most areas you need to have a license to apply any chemical to the environment for insect control.  You don't want to poison your own environment.

Repellants are great while you have them, but keeping your skin and head covered is the best protection.  Head nets are available, and the army surplus nets with a thin metal suspension ring work well.  There are natural repellants that work fairly well, too, using essential oils, but again they will eventually run out.  Avoiding mosquito havens, like swampy and dark areas, will reduce your attacks.

The Centers for Disease Control and Prevention have a good web site for information on ticks and mosquitoes, and it's relatively easy to prevent these illnesses.  Just watch out for them and check yourself every day, as well as do what you can to repel them.

Sunday, May 26, 2013

I was contemplating writing an article for the current round of your competition, but after reading the "hunkering down with a quadriplegic" bit, I don't think I'll bother. I'd personally vote for his to win.

I have a cousin who at 17 was paralyzed from the neck down. Now, 20-odd years later, I'm an EMT and I frequently see people (whether grievously injured or not) who must be removed inert and intact from a house that is near-complete inaccessible in its normal condition. Just last night I had to deal with a situation like this -- hauling someone out of a house I could barely squeeze into even when I wasn't holding a stretcher.

Ramps, wider doors, removing carpet and other clutter: I'll easily agree with these. Firearms and wheelchairs on hand: Absolutely

However, to me the most striking part of the aforementioned article is the danger of bed sores, or pressure sores. To someone who has never dealt with them, a pressure sore might sound no more serious than a mosquito bite. And for some people, in certain situations, that analogy is apt. Some pressure sores can be dealt with by using nothing more than a Band-aid and some Neosporin. For other people (like family members of mine) mosquito bites are an invitation to MRSA--an antibiotic-resistant staph infection that can kill. In my job, I recently had to take a non-verbal, semi-conscious quadriplegic to "wound care" 50 miles away from his nursing home. The nursing home has qualified nursing staff on hand. I honestly respect them for the work they do. But they weren't equipped to deal with a somewhat serious bedsore.

We delivered this patient to wound care for more than six months, at least once per week, until finally, yesterday, he was pronounced healed. I haven't personally seen the wound this week, so I can't really comment on the prognosis.

This may be read as a comment on inadequacies in our healthcare system. That is not my intent. Rather, I'm saying that even trained healthcare providers can fail to stop an incipient killer such as MRSA or other infections. Also, treating injuries/wounds in the long-term involves much more than Neosporin and a Band-aid. If you anticipate or can imagine any serious injuries (by animal, axe or enemy), you must be willing and able to treat them aggressively both in the short-term and in the long. That means prevention, treatment and follow-through now, or debridement, further treatment, and ... well, I think you get it.

Not all wounds can be treated with one of the extremes of healthcare -- a small bandage or a blow-out kit. To be truly prepared, get ready for those wounds that don't heal as soon as you stop the bleeding. And some of those more serious wounds might be caused simply by sitting still. - J.D.C. in Mississippi

Friday, May 24, 2013

I’ve always considered myself and my family extremely blessed.  I also am a firm believer that God expects you to make the most out of what you have.  God gave me a wonderful wife and 3 healthy, strong boys.  We are a hard working family who have always had goals and planned well for the future.  We even had a bug-out plan when not many other folks even talked about such things.  Our world took a drastic turn a little over a year ago when my oldest son was injured in a high school wrestling accident.  In the blink of an eye my son became a C4C5 quadriplegic.  After about three months reality began to sit in and we had to start planning for a greatly altered future.  One night I began to think about our bug-out plan and it became obvious for a plethora of reasons that we couldn’t just grab our stuff and head out.  At this point I began to harden our existing home.  Fortunately we live in a very rural neighborhood with like-minded people around us.  There is nothing about us that calls attention to ourselves or screams prepper.  We just go about business as usual and quietly prepare.  Here is what we have done and are in the process of doing to make our house a handicapped assessable fortress.

I must preface this article by saying that we are not a wealthy family with an unlimited budget.  We are just a dual income family that has always saved for the future.  Most of what I will describe came together very quickly because we sold a property that was not handicapped assessable and opted to put that extra money in our now primary and only home.  I hope that what I’m about to share will help others who want to prepare and have a handicapped family member.  We’re not trying to reinvent the wheel.  I do realize that we are doing many things that other individuals have done and are doing, but, I will give you a unique perspective from a handicapped assessable point of view.  The first thing I learned was that you really do need to commit to live where you will hunker down.  Everything that you want or need will be with you all the time and you will never have to decide what to take and what to leave behind in an emergency situation.  I also found it easier from a financial stand point since I was putting money into one place.  So, with that being said, here is our home and retreat.  

Our house is a one level all brick home on a full basement with one step to get in the front door and a nice smooth slope with no steps down to the drive and basement.  Talk about handicapped ready before we even arrived!  Doors will be your first challenge.  They have to be widened to allow wheel chair access.  Use this opportunity to really fortify all those exterior entries.  Nobody will question you at all in this situation so here is your opportunity to go a little crazy.  I do suggest that you limit the amount of glass and beef these doors up to take a slug.  You can justify this by saying that the door may take a beating from the wheel chair and if it is a power chair it will definitely take a few good licks early in the game.  At the very least you need a very heavy wooden door with some kind of cross support.  Install a strike plate which would deflect and distribute the force of a blow along with reinforced hinges.  Go ahead and widen every single doorway inside the house.  You won’t regret it.  It will be easier for everybody to move around, I promise.  Eventually your injured family member will need access to the entire house and it is an opportunity to reinforce the interior a little as well.  Get rid of all carpet.  Wheel chairs don’t like carpet and it’s hard to keep clean.  Hard wood is an excellent choice for all rooms and no lip at any door.  Let’s talk wheelchair for a second.  Make sure you have a high quality manual push chair as a back-up if not your primary chair.  Charging a motorized chair could be an issue when there is no power to count on.  Opt for solid wheels rather than air so that you don’t have to worry about flat tires.  Air will give you a better ride though.

The next modifications made were in my son's living area which is in our finished basement.  These changes in particular are aimed at handicapped individuals but have made maintenance and livability much easier for everyone.  All carpet and tile was torn out so that we had raw concrete.  The concrete was then polished, stained, and sealed.  It’s beautiful and very easy to clean as well as super tough and durable.  Also worth mentioning is his bathroom.  We took out a wall and increased the area from existing closet space and constructed him a huge roll in shower.  The shower is now roughly a 10 foot by 10 foot area.  It’s overkill but, maneuverability is an important issue.

Surveillance was something that we put our money into soon after getting our son home.  We invested in both indoor and outdoor cameras.  We can’t be with our son at every moment, so, we can always check on him and his care person at any time and any place.  All of our cameras are tied into our alarm system and we can monitor with our phone 24/7 by video monitor at home.  These cameras will help as our son begins to gain some independence and in crunch time they may save your life by giving you a view of exactly what is going on outside without placing someone in a potentially dangerous situation.  We did opt for infrared cameras outside which give you an incredible view in the dark.

An all metal roof is nice but, you may have to put a few other changes first.  If you don’t have gutters, get them!  Rain water is your friend.  If possible, install underground tanks to catch all the rain off your roof.  I learned this trick from a Cajun that I duck hunt with.  He has a camp built on a barge that catches rain water in 2 tanks that each holds a thousand gallons.  If you treat your water with swimming pool chlorine and use your water wisely, you should have plenty of usable water at all times.  I have been shocked at how well this works at his camp.  I’m going to us a 1,000 gallon holding tank.  Putting it in will spur a few questions but, explaining that you have drainage issues and you also intend to irrigate with it should explain it all away.  It has also come to my attention that in some cities you must have a permit to catch rain water off your roof.  This is crazy, but some regulations in a few places say you are not allowed to change the natural flow of water, even if that is off your roof.  In my opinion this is government over reaching its bounds again.  If you’re worried about this it is easy to check.  We did, and all is fine.   We will pump the water with electric pumps that can also work with our back-up power system which I will discuss later in this article.  We use about 6,000 gallons of water each month and in crunch time this could be greatly reduced.  We get plenty of rain throughout the year here in the South, so we should be able to keep our tank rather full.  For now, we are picking out the most practical placement for this tank and with a little luck it will be catching water by June of this year.  Initially we will just use our tanks for watering and car washing.  This water will be perfect to use for washing and bathing as is.  It should be run through a filter system before drinking and cooking.   Another great thing about the underground tank method is that people will never realize that you have plenty of water.  We also store water in many other various containers. 

My next suggestion concerning water will be a little complicated, but this fix will hopefully make your septic system more trouble free.  An inspector will not allow you to do this but, route your black water (toilet) to the septic tank.  Re-route your waste water (gray) out to a run off to catch it for reuse.  If you plan ahead for this, when the mess hits the fan, all you will need to do is twist a few levers and you are on a black/gray system.  If you think about it, your home just became similar to a giant camper with a fresh water holding tank, black tank, and a gray tank.

Let’s talk about energy independence and some practical modifications that I have made and will be making very soon.  Solar energy is a strong and lasting option.  You will need a good supply of sunshine though.  Our house is situated so that we get full sunlight on our house from sunrise until sunset.  Did God know that we would need this place or what!!  The system that we are planning to install produces enough energy that we can meet all our needs and feed back into the power grid for credit should we so choose.  We will have a battery system for night time power and use the grid if necessary.  Batteries are not great power sources like the sun but, they can keep you a fair supply of emergency power.  Should the grid go down, we hope it won’t faze us too bad.  This does come with a strong price tag!  Depending on your choice of set-up and needs, the price can range from $15,000-$30,000.  This will be our most expensive prep.  The good news is that you can take advantage of some tax credits by going solar.  I know that is a lot of money, but, over the span of a few years the system will help pay for itself through energy savings and increasing the value and marketability of your home.  It will be worth every penny the first time you lose power for any extended period of time and when the mess hits the fan, this system will be priceless.  Don’t forget, we have a quadriplegic that has more needs to meet than for the average person.  Thank goodness he is not respirator dependent, but, that need could be met if it were ever necessary.  We are working out the logistics for a 10KW system to be installed before summer.   We also keep a 7,500 watt generator on hand with 60 gallons of stabilized gas close by. (Yes, I know that this is not enough fuel. We are making arrangements for a larger and better storage system.)   Other electrical needs are met with an abundance of rechargeable batteries and the small backpack solar chargers.  The most important modification that we made to our house was done well before we started preparing for a hunkering down situation.  We installed lightning rods on our home.  We have been hit twice over the past few years and lost television s and other electrical items.  In crunch time, this would be a devastating blow.  Get your house grounded by a professional.  Take every step to make your shelter safe and energy independent.  We are quickly moving toward energy independence.  You should be too!

Windows are a weak link in all homes.  Ours are tied into an alarm system.  In crunch time my suggestion here is to have diamond plate sheets on hand to place over certain select windows (I’m not talking about aluminum).  You can find them in many different gauges to meet your personal needs.  I do suggest that you get them in a flat black or brown color.  They can easily be bolted on in times of emergency and to be honest, in severe weather outbreaks, they are rather handy.  Can they stop a bullet?  Yes.  A heavy gauge will offer sufficient protection from almost any projectile that you will encounter.  If a tank rolls into your neighborhood, it’s not going to matter what you have up.  Is this perfect?  No.  But I guarantee you that a looter won’t crawl in a window or shoot you from the street.  This leads me right to my next change.  We will be adding a wood burning stove in our basement kitchen for heating and cooking purposes.  It will be vented out an existing window which will now be closed and sealed off.  That’s one less window to worry about.  Also, consider adding a kitchen in your basement.  We added a small kitchen to our basement when we made modifications to our home for our son.  His area is the basement and the kitchen actually makes him feel like the basement is his own place.  You never know when you may have to stay in your basement for extended periods of time due to a Biological/Chemical hazard or some other fallout.  A good underground basement offers nice protection and can be sealed fairly tight.  Also, our basement has a fully furnished and well equipped wine cellar.  Homemade wine will be an excellent trade/barter item when some stability is returned to society.  A simple hobby now could turn into a nice profession one day.  Also, the temperature of the cellar makes it easy to store other items should it ever become necessary.

Now, let’s discuss a few personal needs.  These next few comments are especially for those hunkering down with someone who has a spinal cord injury but, can be helpful to the able bodied individual as well.  You must have a rock solid plan for bowel and bladder needs.  I won’t elaborate.  You are familiar with your loved one’s needs better than anyone else.  This is priority number one.  Next is skin care, which must become second nature.  A pressure sore could easily be fatal.  Remember, there won’t be deliveries and replacements for medical supplies for a long time (if ever).You must learn to conserve and reuse as well as clean and sterilize material.  It’s defiantly tough to consider, but, you better learn how to put an indwelling foley catheter in your family member just in case something happens and intermittent catheterization is not practical.  I suggest you obtain a large amount of cranberry supplements for your injured family member.  It will help a little in the prevention of a urinary tract infection.  Many spinal cord injury patients die from urinary tract infections long after their injury, so be careful.  I should also mention that individuals with high spinal cord injuries have trouble with blood pressure and lose the ability to regulate their body temperature.  Blood pressure medicine may be hard to get or even impossible.  You should stock up with many extra pair of ted hose and abdominal binders.  These will help push the blood back toward the heart.  Familiarize yourself with the signs of dysreflexia and be prepared to treat it immediately.  This is a sudden and huge increase in blood pressure usually caused by some type of irritation or something that would be painful to the able bodied person.  You must locate this problem and correct it immediately.  Your family member can die from this if not corrected quickly.  Your doctor should have prepared you for this.  Our family is lucky.  My wife is a family nurse practitioner so she is highly qualified to care for our family.  Here are some things that we feel you must have stocked up:  Ibuprofen, Tylenol, Aspirin, Antibiotics, Vitamins, Potassium Iodide tablets, Masks, Bandages, Tape, Eye drops, Suture kit, Surgical and other instruments.  Have a very high quality blood pressure cuff on hand that you know how to use.  Keep a very large supply of Clorox, rubbing alcohol, iodine, and peroxide on hand.   KY jelly and Vaseline should also be stocked heavily.  I would also have several aloe plants on hand and keep them in good health.  Rubber gloves, paper products, and plastic bags are vital and like other medical supplies are finite in number.  The list can go on and on.  The bottom line is to stock up so that you can meet your medical needs as best possible. 

You must eat to stay healthy.  Stocking up on food is a given.  You must learn to grow, gather seed, can, and preserve your food.  When my son was still inpatient, he took an interest in gardening and landscape.  As a result of his new found interest, we constructed several raised beds in our back yard for him to plant in and help tend his garden.  We have a large, fenced in back yard where these raised beds are located.   And much to our surprise, our neighbors have done the same.  After some discussion and planning, we have decided to team up in the food production (and defense) business should the need ever arise.  You will be shocked at the quantity and quality of food that is produced in raised beds.  Our garden produces enough that we had to give away a large amount of food.  You will find that you will be able to keep something growing almost year around.  The raised beds and fence help keep the critters out.  The fact that the beds are raised will allow our son to help cultivate the crops from his wheelchair.  It is extremely important for the mental well being of your injured family member that they be able to work and contribute to the success of your home. We also have several blackberry and blueberry bushes planted with several fruit trees.  Our newest project has been establishing grape vines.  At some point, I would like to learn how to keep bees.  Do you have any idea how popular you would be in crunch time if you had honey to barter or trade with?  Bees are vital around your garden anyway!  I should probably move this up on my list especially since we live in a perfect climate for bee keeping. 

Birds are a different story.  A BB gun or nice air rifle will handle that problem and I guess that we all might need to learn to eat a little crow.  It goes without saying that you need a dehydrator and lots of salt.  You need to learn how to make jerky.  Now, how do I put meat on the table?  Of course we have plenty on hand to last several months but, sooner or later you will need to begin harvesting again.  This won’t be easy but we have a plan.  Around here everybody and their brother will head for any wooded area and try to kill anything that moves during the first few weeks of a meltdown.  I don’t think they will have much success as there are very few real hunters.  After a couple of weeks when people figure out that they can’t just go out and kill what they want, most will stop trying and resort to other methods (looting/stealing).  In a situation where everything has fallen apart, normal rules have to be thrown out so that food can be harvested.   When the time is right, I will harvest game, if we need it, in the middle of the night with the aid of a FLIR.  That is thermal imaging.  Everything alive gives off a heat signature and I plan to take full advantage of this fact.  I was completely amazed the first time I drove through our hunting club in our Ranger and took a look through my FLIR.  Wow!  There were many pairs of eyes on me!  If you have a chance, try one out and you will be very impressed.  You can purchase a nice FLIR for about $2,000 and it will be a valuable asset when it comes to food gathering and defense of your home.  The one that I use runs on rechargeable batteries and is very trouble free.  I have not had very good luck with regular night vision goggles.  Lenses tend to break easy and they have caused us more trouble than they are worth.  Camouflage won’t hide a heat signature either.    Nobody will sneak up on you.  If you can afford it, get an extra one.  Now, back to food harvesting for a second.  Given the circumstances, I doubt the game warden will be out looking for poachers.  I’m sure I can bring plenty of game right to our door with a nice salt block or a little corn. 

It is my opinion that the defense of your home is the most important part of preparing for a crisis like the one we are discussing.  I’ve already mentioned what my plans are for entry ways and windows.  After much research and study, I believe that the reinforced heavy doors and diamond plate sheets are perfect for most situations like ours.  Our back yard and garden are already fenced in with chain link and as luck would have it, our property looks out over hundreds of acres and there is a huge drop to the property below.  We are on extremely high ground and it would be difficult for someone to approach us from behind.  Therefore, in a time of civil unrest, I would probably only add barbed wire to the top of our fence and apply a layer of electric wire.  Another huge advantage that we have is how isolated our small neighborhood is and there is only one dead end road which enters and forest around that.  However, until we can agree as a neighborhood group to barricade the road, my neighbors and I will take steps to keep a crazy looter from driving through our front door.  My two neighbors on each side and I plan to erect pilings through our yards spaced so that a vehicle cannot pass between them.  Railroad ties along with existing trees are what we plan to use and we have been collecting the ties for a couple of months now.  They are easy to get here and it doesn’t hurt to have a friend who works with the railroad.  We realize that this is going to be very tough and time consuming work but, if everything falls apart you will have plenty of time on your hands and you never know what a desperate individual might try.  Each post will be placed at least 3 feet in the ground.  This should be an excellent barrier from almost any vehicle.  Speaking as someone who has operated heavy machinery in the past, I can definitely vouch that the machine could not just drive straight through.  It would require a little work which would give us time to take appropriate action to stop it. 

Thank God for the Second Amendment!   We do try to keep things simple.  Everybody has a 12 gauge shotgun.  In a rural neighborhood like ours this gun may very well be our most valuable weapon.  We’ll use number 2 or 4 shot in most cases.  We do have buckshot and some goose loads if necessary.  Everybody has a. 22 rifle with thousands of rounds and extra magazines.  Everyone has a handgun with the exception of our injured son.   These include a .44 Magnum, .45 ACP, .38 revolvers, .22s, and some extras parts.  The long guns in addition to our .22s include a .44 Mag lever action rifle ,a .22-250, a .17 HMR, .270 and an AR-15.   

All these weapons are very effective in our particular situation and everyone is very comfortable with these weapons.  I do believe our shotguns will be our most useful tool.  Now, our handicapped son will be able to take part in the defense of the home as well.  He has a very nice .270 with a first class Leupold scope.  How does he shoot it?  Thanks to Buckmasters, he has a mounting system for his chair that enables him to shoot as well as an able bodied person if not better.  He has a LCD display with joystick controls and a sip and puff trigger control.  He can really reach out and touch someone.  The whole set-up runs off a 12 volt battery.  Many thanks go out to the people at Buckmasters for giving this to my son which has enabled him to hunt again.  We even figured out how to use the LCD with the FLIR.  Of course we do keep a few other surprises locked away in our vault and our neighbors each have a very nice selection of weapons.  Our area will be very well defended! 

With that being said, let me take a moment and talk especially to those who have an injured or disabled family member.  Your family member is an easy target for criminals.  In our situation, (our son) is a target when he is in public because he can’t help or defend himself.  A thief will target a quad and take anything they want with very little problem.  Independence is important and must be approached carefully.  Due to the level of our son’s injury he still has an attendant or close friend with him if he is in public.  One step that we took to help our son become more independent was to get a service dog.  He chose a large German shepherd.  The security around our house just doubled.  That dog loves my son and would give her life protecting his and the family.  She opens and closes doors, picks up items off the floor, helps pull him when he is in his manual chair, and is a constant companion.  She has also been exposed to the sport of schutzhund.  I know that there have been other articles about the value of dogs in crunch time so I won’t spend time discussing them.  But, you should strongly consider a service animal!  Once a dog like a German shepherd bonds with you and the family they will become extremely protective of their pack.  You are now part of the pack! You should see the wide space people give my son when he is in public with his German shepherd.  Also, these animals can go any place in public that you go.  That equals independence and peace of mind.     

Another factor that I believe will play a vital role in the survival of our family is the fact that we are all very outdoor oriented people.  We’re all avid campers and know how to ruff it when necessary.  Everyone knows how to read a map and use a compass.  These are skills that are very valuable and few people understand anymore.  We all have good knives and know how to use them.  We have good radios to communicate with and listen for local news.  We also obtained a good short wave radio.  Monitoring the radios and cameras will be our injured son’s primary job.  We have a large supply of what I call my everyday useful tools.  Examples of these are rakes, shovels, hoes, picks, axes, wedges, hammers of all sizes and weights, sling blades, hatchets, machetes, saws including an old fashioned 2 man saw, various sizes of nails, bolts, screws, nuts, and washers.  You will also need a good supply of common hand tools for mechanical, plumbing, and carpenter needs.  Consider keeping a supply of various tape, caulk, glue, and oils.  Keep a good supply of replacement parts on hand and learn how to maintain what you have, especially your solar power supply and water pumps.  Don’t forget that you are now the repair man.  There is also a little pocket reference book that is written by Thomas J. Glover which I think everybody should own.  It has over 500 pages of tables/facts/formulas and other information that you will need sooner or later.  I think that it is a great tool that everyone must have.

Also, keep in mind that with a spinal cord injury you are going to have large amounts of medical waste that will need to be disposed of to avoid disease and other problems.  My suggestion is to invest in one or two 50 gallon metal drums to burn trash in.  You might be surprised how often you use it now.  Keep your old new papers.  Try to have a nice selection of books and magazines which should include plenty of how to information.  The fox fire book series is nice to have.  Cards and board games will also help pass the time.  And I guess most important would be to learn how to reload your ammunition and have plenty of supplies in that area! 

We’re lucky we don’t live in a big city, but we are a little too close for comfort.  Should something happen, we feel that the first 24 to 48 hours will be vital in the preparation and initial fortification of our home.  While everybody else is staggering around in shock, we will get everybody home and move into action.  Close up, seal up, lock up, and drop off of the radar.  Let the crazy’s kill and steal from each other and don’t do anything to catch their attention.  No smoke during the day and keep it dark at night.  With any luck all this will pass and civility will return rather soon.  If not, we and our neighbors are ready to hunker down together where are and keep each other safe for the long haul.  Hunkering down where you are may be your best plan for now.  For us, at this time in our life, we really must make the best out of what we have.  Working with your close neighbors makes this process much easier.  For those of you who can’t relocate at this time like us, don’t stress, just work to make what you have the best possible.  It can be done.  We’re living proof.  So, until such a time that we are able to relocate to the great American redoubt, we’ll be holding the line here in the South.   God Bless and good luck.

Friday, May 17, 2013

H7N9: What should I do?

As of the recent date of writing this article, the CDC does not have any new or special recommendations for the U.S. public at this time regarding H7N9. There is currently no vaccine to prevent H7N9. CDC will keep you updated. If you live outside of the U.S., search the WHO web site often. Stay informed.

Since H7N9 is not spreading easily from person to person at this time, CDC does not recommend that people delay or cancel trips to China. The World Health Organization also is watching this situation closely and does not recommend any travel restrictions.

CDC advises travelers to China to take some common sense precautions, like not touching birds or other animals and washing hands
often. Poultry and poultry products should be fully update its advice for travelers if the situation in guidance is available at Avian Flu (H7N9) in China.
cooked. CDC will China changes. This

The foregoing content is provided and maintained by the Centers for Disease Control and Prevention (CDC).
Okay, I'm on notice, but What should I be doing now to get prepared?

Here are some Helpful thoughts and actions to consider being taken now, to assist your families in being prepared for this next epidemic in the making.
In our home, we are preparing for this H7N9 virus, and getting a two month jumpstart on our normal farm and home routines schedule. One of those ramped up to today instead of waiting until July, is making my family's annual batch of Sambucus nigra Elderberry Tincture, now.
But what is that, and why use that? So glad you asked!

We use it routinely as a supplement, because consuming Elderberry Tincture made with Sambucus nigra elderberries, is an effective alternative to Western pharmaco-medicine. This supplement has shown very positive results in preventing virus's from clinging to the body's healthy cells and aiding the passage of the virus out of the body, all naturally! The commercially made product, marketed as Sambucol, blunts the haemaglutinin spikes on the outside of viruses and stops them from entering cells where they reproduce, causing the cell to explode and allows the virus to continue invading the body. Also, in vitro study, its results has also shown Sambucol to be effective in increasing the production of four inflammatory cytokines, which are effective in boasting your body's immunity, suggesting that the intake of this supplement may have an immuno-stimulatory effect and therefore be worth taking all year round to prevent flu and other viral disease.

Besides, with all this research findings to prove its effectiveness, my maternal Yugoslavian Great-Great Grandmother made Elderberry Tincture for her family and passed on these recipes for us to use and bless US Centers for others with good health for future generations. There are many clinical research trials on the product called Sambucus available on the web for you to additionally search and read more for yourself. Here are a couple: Read what the Israeli research says! 99% EFFECTIVE!

"Retroscreen Virology, a leading British medical research institute associated to Queen Mary College, University of London, announced that Sambucol was at least 99% effective against the avian flu virus, H5N1, and in cell cultures significantly neutralized the infectivity of the virus."

Great! So Can I make my own? and, if so, How do I make my own? Again, glad you asked! YES!

How to make Homemade Sambucus nigra, Elderberry Tincture

Note: Not recommended for administration to Children or alcoholics, due to the high alcohol content.
Materials and Ingredients needed:
6 pint mason jars with lids and ring bands 1 1/2 lbs. of Sambucus nigra, Elderberries 2 fifth bottles of any inexpensive brand, unflavored 80 proof vodka
Order or buy the dried elderberries from a reliable health food store, or from an online source. is an inexpensive
source to consider. also has several suppliers available.

Fill a large stainless steel stock pot 1/2 full of potable water, and bring the water to a boil. Carefully submerge all 6 pint sized mason jars, lids, and ring bands, and one stainless steel serving spoon in the boiling water, and set your timer to boil for 15 minutes. Turn off your heat source. Carefully remove the jars with clean tongs, pour off any water in them and lightly shake off
the lids and band rings of water, and allow these to cool to room temperature on a fresh clean towel, with all flat surfaces facing up, to dry.

Using the sterilized spoon, scoop straight into the mylar bag they are packaged in and fill each of the cooled sterilized jars with elderberries up to the 1/3rd full mark. Set the berry filled jars aside.
Now pour the 80 proof vodka into the jars to fill up the jars remaining 2/3rd space, to near totally full. Leave a sparse 1/8th inch head space at the top of the jar unfilled.
Then seal up the jars, by placing on the clean lids and apply the band rings snugly. Place them gently in a cabinet or, on a shelf that is out of any source of direct light and also away from any heat source. They will stay here for 14 days. You can keep the berries in the jars for longer, but 14 days will be the minimum adequate time for the berries to finish soaking in the vodka. Take the jars in hand and once a day shake up the jars contents very well. During this osmotic process that is taking place over the 14 days, the elderberries will be taking up the alcohol and successively extracting off the berries medicinal anti-viral properties into the liquid, to give you a quality finished product of tincture of the berries.

After 14 or more days, (but never longer than 21 days), use a sieve strainer to separate the berries from the juice caught into a clean bowl. Press down on the berries in the sieve strainer with your spoon, to get all of the juice from them into the bowl of tincture.

Finally, pour your filtered elderberry tincture back into the jars and place the rinsed clean lids back on and tighten the ring bands well. Label the jars with contents and date. There is no need to heat or pressure seal the jars like you would in canning. In fact, a heating process used on this tincture would kill the anti-viral properties of it. Your tincture should keep for storage and use for a few years, as long as it is stored in a cool, dry location. The vodka is also the long term preservative medium in this recipe. You now have your own homemade Elderberry tincture to begin using.
Okay, now while that recipe is being turned into usable tincture, you may want to also create this temporary use syrup, which has a "no wait time", to consume it for some protection of boasting your immunity with a ready-made homemade supplement. It will get you through an unexpected "viral flu attack" season, or again, through the period of time while waiting for the more anti-viral potent tincture to age for use.

Homemade Elderberry Syrup
Note: can be considered for use of children over 24 months of age. Raw Honey should never be administered to children under the age of 2 years.

2 cups dried Sambucus nigra elderberries 1 quart of boiling water 1/4 cup raw honey 1/4 lemon juice
Put the elderberries in a non-reactive metal or glass saucepan, add the boiling water and cover the pan and leave it out on the stove or counter to soak overnight. The next day, low simmer the berries for 30 minutes, set aside to cool a little, then put the mixture in a food processor or blend them.
Once blended well, add the honey and lemon juice. Cool, then pour into a clean mason jar or dark glass bottle. Store this in the refrigerator and use the syrup daily.
Here, I offer other important considerations to take to help boost and prepare the human body's immune system in protecting it from viruses, and other physical and logistical preparations to make and consider for your family to do now, don't dawdle!

1. Adults, and teens, start taking 2000 UI per day (one pill) of Vitamin D3, and extra Vit C. consumption.
Note: The Fat soluble vitamins, which are vitamins A,D,E & K can be toxic to your body organs if you take dosages past the recommended daily allowances.

2. Begin to increase that dosage US, to 4000 UI per day (two pills) of Vitamin D3, only for the duration of the epidemic.

3. Also start taking one tablespoon of Elderberry Tincture, per day and continue to do so, or make the Elderberry syrup and begin using it now, and until the viral epidemic is cleared by the CDC or becomes non-life threatening in the your region.

4. Note: There is a non-alcoholic version of Sambcus available for small children, Nature's Answer Sambucus nigra Black Elder Berry Extract Kids Formula, just look for Sambucus nigra at your local health store, or order some online now. Don't wait until the virus is reported in the US, because it will become scarce or totally unavailable when the virus starts spreading to our country's geographical direction.

5. Prepare to not leave your home once the virus has entered into your geographical region. Consider enforcing a rule in your own homes, of no outside human contact, other than with those staying quarantined inside of your own household or property gate. Consider options for your work outside of the home. Consider having any normal prescheduled farm or home need deliveries of animal feed, fuel, hay, or supplies done now, instead of later.
A self imposed protective quarantine or closing off your property to others is strongly advised if this virus becomes epidemic and deadly. Bookmark and Check your state dept. of health and the CDC web sites daily to see where the virus is being transmitted from and moving to, so you will know to effectuate this protective quarantine of your family.

6. Do not handle mail or packages delivered by the mail carriers or from delivery carriers during this self imposed quarantine.

7. Dehydration is caused due to loss of body fluids by high fever and sweating, in loss of respiratory secretions associated with respiratory infections, with nausea, which causes vomiting and with diarrhea, which are all showing to be significant symptoms of this virus, that can quickly become life threatening if you are not prepared to immediately counter their effects of the body and actively treat them. Children and infants have much less body mass, and if they develop any of these symptoms and continue having them excessively for prolonged periods, over 4 hours, you should seek emergent medical help.

For the whole family's use, have extra potable water stored for use, store Pedialyte, Extra Formula, Gatorade powders, Tylenol,(acetaminophen), Aspirin and otc anti-diarrheals and remember to get on hand extra of any medications you are already prescribed to take if the Virus jumps from Asia to the routinely. Procure and store several boxes of disposable nitrile gloves, kleenex tissues, extra toilet paper, disposable towels, disposable eating utensils and plates and large garbage type plastic bags for trash disposal use.

8. Stay Home and away from crowds of people. If you must absolutely go out into the general public due to emergency needs which cannot be met at home during this epidemic, you will need to wear N95 masks and gloves at all times, with long sleeves and long pants, cover your body up as much as possible, as this flu is transmitted by human contact on any surface contact made by carriers of this virus. Don't hug, kiss, or shake hands. Disrobe immediately upon returning to your home from the outside world, disrobe in the garage or carport, and then bag up your soiled clothes. Discard the disposable mask and then take off and dispose of the gloves, into a bag lined lidded bucket placed outside of your home. Wash your clothing separately from others in your household, in hot soapy water and wash your face and hands, better yet, go take a hot shower, wash your hair, and add the towels you use to the washing machine with your dirty clothing. Don't forget to disinfect your car wheel, and mobile phone, and seats and floor board and mats.

Again, make sure you have ample supplies that you will need to use, on hand in your home, your vehicles, at your work place, as well as ample food stocks and water set aside in every number of the locations you may decide you need to move from or go to.

9. Make provisions for bagging up or burning your household trash. Do not handle your curb-side waste containers that have been handled by contracted disposal companies.

10. Take special precautions to wash your hands often during the day with soap and water, before and after going shopping for your food at the grocery, wipe off cans and packaging before you bring them into your home from your vehicle. Wash up after handling any produce or food imported from other outside countries, and after handling any food preparation tools. Especially be cautious after touching any live animals. Do not let your pets have free run outside of your property gates. Use meticulous washing after using public restrooms. Use a paper towel to touch a public restroom door to exit it. Wash surface areas with diluted bleach water mixed at a 10:1 ratio in a spray bottle. Don't forget to wipe down your phone receiver often and computer mouse and keyboard.

I am a holistic medicine-practicing RN, and wife to a MD. I have No affiliations with any companies mentioned in this article other than purchasing some of their quality products for our home use, nor have I merited by any free products or compensation for the recommendations of their products. Also, you are responsible for what you consume into your own body, thus I am not advocating intake of any substance to which you have not thoroughly researched for yourself. As with any human consumption, allergies to substances need to be heeded and avoided in the ingredients noted in any of these recipes, if you are known to have allergic food reactions. Dosages of alternative products made yourself need to be titrated individually and according to the
products used and to your body weight and age.

I pray that this information will be fruitful to you and will assist you and your family, in being prepared for the next coming epidemic.
GodSpeed to your Health Preparations and May HE Bless you and Shelter your family with Protections from this Deadly Disease!

Monday, May 13, 2013

A thoughtful EMT wrote me to ask:

Dr. Koelker:
What effect could you have on blood sugar for a diabetic (type 1) through blood transfusions? I am a paramedic, and our field treatment for high blood sugar is IV fluids until the hospital can give them insulin to lower the blood sugar. In a SHTF scenario, there is no hospital. The thought process got me thinking though....My questions are these:

1) What, if any effect could you have on lowering blood sugar through transfusions? i.e., basically finding a non-diabetic donor match, and swapping a couple pints of blood...the non-diabetic can process any sugar, and the diabetic gets blood sugar lowered by dilution.

2) Could you time a high sugar meal for the non-diabetic to manipulate the blood you were donating? Could you get enough glucose and insulin transfused to affect the diabetic’s intracellular glucose?

3) If the science and idea are valid, would it be able to have any appreciable effects or would you be re-arranging deck chairs on the Titanic?

The idea intrigues me, because blood transfusion gear can store a lot longer than insulin.

Thank you- Eli
Here is my reply:
Excellent questions, Eli.  I’ve pondered the possibility myself and will offer my preliminary conclusions.
First, theoretically, the answer is yes, it could work. 
For example, in a scenario where, say, identical twins would essentially share the same pancreas, IV lines could be connected in a continuous system, allowing the diabetic’s blood to enter the non-diabetic’s system, with the “treated” blood being returned in equal amounts from the non-diabetic to the diabetic. 
This is not quite the same as swapping a couple pints of blood, as I’ll address below.
Eli’s preliminary questions raise several more:
1.      Who is a suitably-matched donor?
2.      Would a non-diabetic be the best donor? 
3.      How much blood would need to be transfused?
4.      How long would this arrangement work?
5.      Should the non-diabetic receive blood back in return?
6.      Should serum be used instead of blood?
7.      Could the blood be administered via a different route?
8.      Could non-human blood be used?
9.      Could God have left us a simpler answer for treating diabetes Type 1 than we’ve discovered to date?
To begin with the end, I believe #9 above could well be true.  Though science has investigated pancreatic transplantation, islet cell transplants, stem cell manipulation, and other high-tech options, no simple solutions have been found, but they yet may be out there.
And so, at TEOTWAWKI, what to do? 

(Before I go on, let me say don’t miss the March 13, 2013 SurvivalBlog article by AERC regarding Insulin Dependent Diabetics.  The author offers many excellent suggestions along with personal experience as a diabetic.)

But the question remains: what to do if no insulin is available?  Would transfusion work?
A few calculations will help explain:  In the non-diabetic, serum insulin levels average <30 microUnits/ml (that’s 0.000030 Units/ml), or 0.003 Units per liter of blood or serum.  (In a type 2 diabetic with insulin resistance, the serum insulin level may actually be higher than normal.)  If a type 1 diabetic requires 24 units of insulin/per day, that’s 1 unit/hour, or 0.0427 Units per minute, if my number-crunching is correct (and let me know if it’s not).    The calculations are actually quite complex, in part due to the half-life of insulin, along with multiple other factors. 
To simplify the computation enormously, if it takes a serum insulin level of around 10 microU/ml to metabolize a serum glucose level of 100 mg/dL, it would take about 5 times that much insulin (or non-diabetic blood) to regulate a serum glucose level of 500.  To treat a diabetic’s blood sugar of 1000 could require all the insulin within a non-diabetic’s circulatory system – and clearly you can’t donate all your blood multiple times a day (except in the shared-pancreas arrangement described above).
If a diabetic’s blood glucose level of 900 were suddenly diluted 50:50 with a non-diabetic’s blood (which isn’t really possible), this would decrease the level to around 400 mg/dL to start, then perhaps 50 points further due to transfused insulin . . . but only for a very short time, on the order of hours at best.  And in order to administer this much blood, an equal amount would have to be removed via blood-letting.

Given an unlimited blood supply and ICU-level nursing, perhaps this could be accomplished, but considering factors likely to be present at TEOTWAWKI, the challenges appear to be insurmountable.

Additionally, to answer a few more of my own questions above:
1.      In the identical twins shared-pancreas scenario, with blood going in and out of each person, blood typing is not a problem.  However, for others to share blood back and forth, both the diabetic and non-diabetic would need to be compatible to both donate and receive blood.  Simple ABO/Rh typing does not prevent all transfusion reactions, and of course even correct typing does not eliminate the possibility of infection or fluid overload.  Still, in a life-or-death situation, with a supply of insulin expected to be available shortly, it could be considered.  (Make sure to obtain a blood donation compatibility chart if you would consider transfusion for any reason.  You’ll either need to know everyone’s blood type ahead of time, or learn how to crossmatch it yourself.)
2.      Theoretically a normal weight or an overweight person, even a mild Type 2 diabetic with insulin resistance, could serve as the donor.
3.      Serum alone is not likely to work because transfusion alone is not really feasible.  The only way I see transfusion working is the shared-pancreas scenario already described. 
Next, what about non-human blood?
Animal-to-human blood transfusions have been tried hundreds of years ago, but were often fatal, and assuredly would be fatal using large volumes of blood.
But could the insulin within, say, a gallon of cow blood be put to use some other way?  
Theoretically, maybe so.  The blood would need to be centrifuged promptly to remove the cells, since the blood cells themselves remain metabolically active until they begin to break down.  The serum could be further concentrated by evaporation at room temperatures (with careful attention to sterile technique).  The resulting insulin-containing liquid should not be given intravenously but might be effective via a rectal infusion, high in the anus (see Oral Insulin (Swallowed) and Rectal Insulin Suppository for Diabetics by T.R. Shantha, MD, PhD, FACA).
Although insulin does not degrade when given rectally as it does when given orally, absorption is a potential problem.  Although some insulin is absorbed rectally, I can find no answer to whether bovine insulin would be – but it might work.

Another possibility would be an enema of blenderized bovine (cow) pancreas, though the pancreatic enzymes might irritate or even perforate the colon – perhaps a reader would like to try this experiment on rats or rabbits before trying it on themselves.  Allergic reactions are also a concern.

The earliest treatment of hypothyroid patients involved implanting (not transplanting) sheep thyroid tissue into a patient.  Surprisingly, it worked.  So could the same idea work with insulin-dependent diabetes?  Again, I don’t know, and again the pancreatic enzymes could be a problem.  But it might work, to a degree.  Perhaps a curious reader would be interested in trying this experiment on their diabetic pet.  Answers simply cannot be obtained without experiments (some of which end badly for the subject). 

Transdermal insulin use has also been studied, but requires ultrasound or iontophoresis for transport through the skin.  Could a slurry of pancreas be used on the skin?  We just don’t know – I doubt it’s been tried.  The pancreatic enzymes may irritate the skin.  Alternatively, the same enzymes may aid insulin absorption.  Insulin itself has some deleterious effects when applied topically.  But if the choice is death or experimentation, necessity becomes the mother of invention. 

In summary, the analogy of re-arranging deck chairs on the Titanic is probably valid regarding using transfusion to lower blood sugar, but if I had a child with Type 1 diabetes, I’d be motivated enough to start experimenting, maybe even learn how to follow Banting’s recipe for insulin.  And I’d do some hard praying about stem cells – the answer to a new pancreas lies within our bodies; how to unleash it is the only question. 

About the Author: Dr. Cynthia Koelker is SurvivalBlog's Medical Editor. her web site is

Tuesday, May 7, 2013

In One Second After, William Forstchen describes a cataclysmic scenario, a widespread EMP effect that is only slightly less devastating than nuclear near-annihilation. The protagonists in JWR's novel Patriots fare better temporarily because the physical infrastructure remains relatively intact for a few weeks after the nation’s economic collapse. In either scenario the five epidemics that are already under way in the United States give new relevance to TEOTWAWKI.

Epidemic (from the Greek: among the people): prevalent and spreading rapidly among many individuals within a community at the same time; widespread.

The five epidemics:
            Type 2 diabetes
            End-stage renal disease (kidney failure)

Although it is the leading cause of death in the United States, heart disease resulting from coronary atherosclerosis is not an epidemic according to the above definition. It is not spreading rapidly but is well established and mortality
is actually decreasing slightly because of modern treatment.

Epidemic #1: Obesity
Obesity is the linchpin for the other four epidemics.
From 2000 to 2010 obesity increased by 80 percent or more in 39 states. The Centers for Disease Control and Prevention estimate that by 2030 42 percent of Americans will be obese, nearly half again as many as currently bear that burden. A study from Duke University indicates that morbid obesity, a weight 80 pounds or more above standard weight, will affect 11 percent of the U.S. population. Obesity is clearly “prevalent and spreading rapidly among many individuals” as defined above.

Inactivity is a major factor in the obesity epidemic. A century ago only about 5 percent of Americans were obese but labor-saving devices and automobiles have reduced the need for physical activity for the average person by nearly 75 percent. The typical American adult or child spends 8.5 hours a day watching television and using a computer or similar devices.
Diet is the other major factor that leads to obesity. Over the past 4 or 5 generations we have replaced whole-grain products with those made from refined flour and we have increased our consumption of sugar several-fold. The average American consumes 40 pounds of sugar in soft drinks alone in a single year. When the SHTF, whatever the cause, our food supply will be severely compromised.            

One might think that the one-third of our population that is obese will be able to live off stored energy and will survive longer but they will not. The reason is that very few of them are free of medical problems. Obesity is simply not compatible with good health. There are no exceptions. To think otherwise is delusion.

Epidemic #2: Type 2 diabetes
Type 2 diabetes is the fastest-growing chronic disease in the world. It affects more than 25 million Americans and 57 million more have prediabetes (defined as a fasting blood sugar between 100 and 125), half of whom are not yet aware of their condition. The CDC projects that one-third of the population will have type 2 diabetes by 2050. Among Hispanic females that number will reach 53 percent.

Type 1, early onset or juvenile diabetes, is a disease in which an autoimmune process completely destroys the insulin-producing cells of the pancreas. A severe reduction in carbohydrate intake will postpone the inevitable in some persons with type 1 diabetes but not for long. They need insulin daily in order to survive. Reduced supplies of all forms of insulin and the lack of effective refrigeration mean that their days are numbered, as described so tragically in One Second After.

Type 2 diabetes was once known as adult-onset diabetes but it has become common in adolescence and it occurs with some frequency among pre-adolescent children. Persistently high levels of blood sugar cause cells to be come unresponsive to the action of insulin. After a period of such insulin resistance the cells that produce this hormone eventually fail.

A lifetime of moderately intense physical activity almost eliminates the risk of developing type 2 diabetes. Experts refer to it as an exercise-deficiency disease. Sometimes it results from a genetic disorder or from prescription medications but these are in the minority. In reality, more than 90 percent of persons with type 2 diabetes are inactive and overweight or obese. Among those who appear to be of normal weight, some fall into the category of normal-weight obese, persons who have gained fat but lost muscle. Although their weight is normal, their waist size reveals the truth because a pound of fat takes up more space than a pound of muscle.

Diabetes is a disease of blood vessels. That’s why its worst complications, heart disease, stroke, kidney failure, blindness and limb amputation are so common. These complications appear faster and earlier among children because those growing bodies are constantly forming and re-forming new blood vessels as they increase in size.

When the SHTF death rates will rise dramatically among those with both types of diabetes. Type 2 diabetics who have mild disease will fare better but most of them have
complications that will worsen without prescription drugs. Lifestyle changes can postpone the need for insulin but when metformin and other drugs become unavailable, complications of the disease and mortality will rise rapidly. 

Survivalists with type 2 diabetes should double down on their efforts to lose weight and to become physically fit. Those who can afford to stock up on medications should do so. Pharmacies will be depleted of stock as rapidly as grocery stores when the SHTF.

Epidemic #3: Osteoporosis
The incidence of this bone-thinning disorder will reach epidemic proportions by mid-century. Like type 2 diabetes, osteoporosis is an exercise-deficiency disease. It is not due to an inadequate calcium intake. Lack of calcium makes bones soft, not brittle. Two examples are childhood rickets and adult osteomalacia. The first is due to a lack of vitamin D that inhibits the absorption of calcium; the second has several causes, including chronic kidney disease. These calcium-deficient bones do not break; they bend, causing extreme bowlegs, for example.

There is a bone-building window between the ages of about 5 and 25 years during which the body completes the formation of almost all of its bone mass. Once closed, that window never reopens. The process requires two elements: moderately intense physical activity and proper nutrition. Today’s young people fail on both counts and will face an epidemic of broken hips and collapsed vertebrae when they are eligible for Medicare (if it still exists then).

Only a couple of generations ago most kids walked a lot, rode bikes, climbed trees, participated in pick-up games of various sports, frolicked on monkey bars and roughhoused. Safety concerns, urbanization, organization of sports, cancellation of Physical Education classes in school and other factors limit those activities now. Computer games and television occupy about half of their waking hours today.

Calcium is important during these bone-building years but children now drink twice as much soft drinks as milk. In the 1970s it was just the opposite. Other nutrients for making strong bones include several vitamins, magnesium and omega-3 fats but children who don’t get many vegetables but eat plenty of junk food get few of them. Nearly half of today’s adolescents are deficient in vitamin D because they spend so much time indoors.

Few people, including those in the medical field, are aware that pregnancy factors will affect the skeleton of the fetus when that infant reaches middle age. A pregnant young woman who exercises little, smokes and has poor nutrition will herself have an inadequate bone mass. Her baby will too, the evidence of that being that the rate of forearm fractures among school-age children has doubled since the 1970s.

Most adults lose bone mass year by year because of their sedentary lifestyle. Without regular, moderately intense physical activity bones become less dense and break easily in a fall. Exercise, especially resistance training, helps to restore some of the bone mass that has been lost during years of inadequate physical activity.

Why is osteoporosis a problem in TEOTWAWKI? A hip fracture almost always requires hospitalization, perhaps surgery. Even with modern medical care about 25 percent of persons with a hip fracture die within a year. Picture the scenario when the SHTF.

Epidemic #4: Dementia.

Dementia consists of two different conditions, Alzheimer’s disease and vascular dementia. Alzheimer’s disease is a disorder whose cause is uncertain. Genetic factors play a major role in about half of its victims. As our population ages it is estimated that Alzheimer’s disease will affect about 25 percent of the population by the age of 85.

Vascular dementia is the result of narrowing of the blood vessels of the brain. Diminished blood flow prevents brain cells from being properly nourished and removing waste products. The result is poor mental function, memory loss and shrinkage of brain tissue. Type 2 diabetes has become the most important cause of vascular dementia.

Persons with dementia require attentive personal care for their nourishment and hygiene requirements. I cannot predict what will happen to them in a TEOTWAWKI scenario but many of them have one or more chronic illnesses that require prescription medications that are likely to be in short supply. In a worst-case scenario they will have a low priority for treatment.

Epidemic #5: Kidney failure (End-Stage Renal Disease)

The kidney is little more than a collection of tiny blood vessels in close contact with equally tiny tubular structures, the combination forming a filtering system that removes waste products in the form of urine. When normal blood vessels within the kidney are replaced by those that have become deformed and scarred because of diabetes or other disease, toxic by-products accumulate within the body. A dialysis machine – what some persons still refer to as an artificial kidney – cleanses the blood in 3 or 4 treatments per week.

When the nation’s power grids fail because of an EMP or a devastating cyber attack it will take the lives of hundreds of thousands of dialysis patients with it. In 1972 there were 10,000 persons on dialysis; in 2010 that number reached 350,000, even as dialysis centers were struggling to keep up with the demand. If the CDC’s projection for type 2 diabetes, the primary cause of kidney failure, is correct that number could soar to more than a million in a couple more decades. The yearly cost of dialysis ranges from $15,000 to $50,000 per year and it will make kidney failure one of our most expensive epidemics.

There is no alternative treatment for kidney failure. Kidney transplantation, which may require a year or two on a waiting list, is not an option for millions of diabetics and it certainly will not be at TEOTWAWKI.

Dialysis units will stop working when the lights go out. Patients with end-stage renal disease will be among the grid failure’s first casualties.

Finding solutions: Genes load the gun; lifestyle pulls the trigger.

All these chronic conditions are lifestyle-related and are not due to genetics or to aging. They were either rare or nonexistent barely a century ago and not because people are living longer and have more time to acquire these diseases. Centenarians in places as diverse as Okinawa and Sardinia are slender and fit and can name their great-grandchildren. They have almost no heart disease and type 2 diabetes is virtually non-existent. Elderly hunter-gatherers don’t develop these diseases either – until they become civilized.

To be sure, if the pharmaceutical industry were to collapse in a SHTF scenario we would again face new threats from old infectious diseases but the thin and the fit would fare best. Obesity and diabetes weaken the immune system but exercise strengthens it.

Scores of posts on SurvivalBlog urge us to maintain a high level of fitness and to keep our weight, i.e., body fat, at normal levels. No one is too old to exercise and eating sensibly (quantity and quality) is not rocket science. It’s not too late to begin a healthy lifestyle. It may be the key that will help you to survive in TEOTWAWKI.

About The Author: Philip J. Goscienski, M.D. is a retired pediatric infectious diseases specialist, CPR instructor, columnist and author. His book, Health Secrets of the Stone Age, Second Edition, Better Life Publishers, 2005 has won three book awards. He has archived more than 400 weekly newspaper columns at

Monday, April 22, 2013

Dear Editor,
I am an emergency physician practicing in Southern Californistan. I share TXNurse's concern about influenza in general, and especially new variants of Avian Influenza, like H7N9.   Her information is current and valuable.  I would urge standard OPSEC on this information if you are a nurse or physician or other health worker.

Many of my colleagues pooh-pooh my concerns about Influenza.  They just don't believe it.  And these are educated physicians!  Given many of them are liberal and believe FEMA will protect them and all that, but even so you would expect a nod from other physicians about the threat, given the history of the Great Pandemic of 1916-1918.   

Our family knows the value of OPSEC.  We just don't discuss our preparations, especially as to Influenza.  My wife, a Nurse by the way, and I already monitor world influenza cases, and have email alerts regarding influenza.  

One thing we have done that others may find helpful is to have pre-determined sentinel events for keeping our children home from school and implementing quarantine.  Our quarantine triggers involve cases in adjoining states, a pattern of progressive number of cases, and so on.  Our triggers may not fit yours, so research the data as to your local situation and prayerfully make a decision.

One more note regarding OPSEC.  Two months ago our doorbell rang about 9PM.  Odd.  While I went to the door, our son stood by at the ready.  It was a previous ER patient who wanted me to loan him money for rent.  I expressed my concern, but told him I couldn't loan him money and suggested some alternatives.  I don't know how he made my address, but nowadays your address is all over the Web.   This rattled me, and I told one of my few Prepper ER doc friends about it.  He reminded me to drive home by different routes when I get off shift.  

FWIW, I am not an epidemiologist.  I'm just an ER Doc.  - Doc C.J.

Friday, April 19, 2013

Influenza A viruses originate from various avian species, and almost exclusively begin in China. Influenza A viruses have always infected many different species of birds. Often initially seen in one species, they frequently cross over and cause illness in another species, this is called mixing, mutation or antigenic drift. This is how new subtypes of viruses are created. Eventually these viruses progress until they mutate enough to become infective to mammalian hosts (us). These viruses can be highly infective, easily transmissible and very lethal in humans. Most of us have probably heard of the H1N1 virus that took a substantial toll on the world’s population in 2009, and continues to be a threat during flu season. Many still may be familiar with H5N1. This subtype appeared around 1997 in China and has made slow progress to become more adaptable with human to human transmission (H2H). In the last 10 days China has made announcements (almost daily) of cases of severe influenza that has been subtyped as H7N9. This particular strain has been known to infect birds, but up until this point not humans. The number of cases daily, including deaths has been alarming. The World Health Organization (WHO) and the Centers for Disease Control (CDC) are taking this new development very seriously. What the 3 subtypes mentioned above have in common is that when they first appeared they are what scientists and virologists call Novel subtypes (meaning new to humans). Depending on the way they have mutated and adapted to become infective to humans has a lot to do with how lethal they are to us. The unique genetic sequences of these viruses also give virologists insight into how lethal they may be, and what their “case fatality rate” (CFR), may be on the general population.

My intent on writing this article is to make it as easy as possible for everyone to understand the importance of how serious a novel pandemic can be to us without getting bogged down with the scientific terms, and how important it is for us as prepared individuals to know how to handle and stockpile for a pandemic with a high CFR. My background is in critical care. For the past 24 years I’ve worked in an Intensive Care Unit, and have taken care of numerous influenza patients. We had quite a few patients on ventilators in 2009, and we lost some young people with serious pneumonias and multi organ failure. I have always been interested in epidemiology and in the mid-1990s began researching influenzas extensively. What has me particularly worried about H7N9 is the rapid development of this novel subtype, and the possibility that there is already human to human transmission. As of 4/12/13 China has reported 49 cases, 11 deaths, many remaining critical and only two recoveries. This may not sound worrisome to most people, but if you knew how difficult it is to get accurate information and numbers out of China, it is quite astounding that they are admitting to these cases so quickly! This leads me to believe that there are many more still unreported. We do not have a complete picture yet, with possible “mild” cases factored into the numbers, but the numbers we do have show an extremely high CFR (probably greater than 50%). In comparison the last great pandemic in our recent history was the Spanish Flu of 1918, it had a CFR of 2% and it killed approximately 50 – 100 million people world wide. The World Heath Organization, CDC, and much of the scientific community believe it is only a matter of time before another novel pandemic virus hits the world again. Normally in each century the world has approximately three flu pandemics, this was the case in the last century, we had two mild pandemics in 1957 and 1968, which increased the overall mortality rates throughout the world, but not significantly, and still had the elderly and infirm as its primary victims. The Spanish Flu in 1918 was quite different in the fact that its primary victims were young and healthy people in their prime. Scientists believe this was primarily due to something called a “cytokine storm”, which occurs most frequently in the young healthy population, allowing a person’s own immune system to over react and attack vital organs, especially the lungs. This is also what we saw to some extent with the H1N1 virus in 2009. Currently with H7N9 victims the reports have stated that most became very hypoxic (short of breath) fairly soon, and most progressed rapidly to multi organ failure.

Effects of Past Pandemics on the United States
Pandemic    Estimated U.S. Deaths      Influenza A Strain     Populations at Greatest Risk

1918-1919       500,000                            H1N1                      young, healthy adults
1957-1958         70,000                            H2N2                      infants, elderly
1968-1969         34,000                            H3N2                      infants, elderly
2009-2010         18,300                            H1N1 (swine)         young, healthy adults

Please note that all these recent pandemics had a CFR of 2% or less. World wide the current CFR for the slow adapting H5N1 virus is greater than 60%, which means that every 6 out of 10 people who have caught the H5N1 virus have died! I shutter to think what the CFR will be for the H7N9 virus that appears to be adapting to humans at a much faster pace.

Seasonal Flu vs. Pandemic Flu what is the difference?

The seasonal flu is the normal flu we see arrive every year usually starting sometime in the fall and lasting until sometime in the spring. Each year we see slightly different variations of influenza virus subtypes that have been around for awhile, and most of us have some antibodies and immunity to some of these subtypes. So when it comes time to look at making the next season’s flu vaccine our influenza specialists usually look at the three most prevalent subtypes we just had and begin to culture these viruses in fertilized eggs (scientists are working on cell based vaccines now for faster deployment of vaccines, soon to be common place I hope) and then combine them to come up with our new vaccine for the coming flu season (this is the simple version). The process to make a new vaccine usually takes about 6 months. The seasonal flu can target 5 – 30% of the population, and usually makes you feel horrible for about a week or so. Complications arise in people with compromised immune systems and in the very young and elderly. Deaths occur usually from a secondary pneumonia infection. Getting your flu vaccine every year greatly reduces your chances of getting the flu. The experts who just made the new vaccine are hoping the new subtype out for the season will at least be partly covered by the vaccine. I’ve heard many people say they “got the flu” from the shot. That really is not possible as the vaccine is made from a “killed” virus, your arm may hurt and some people may have a slight fever, with minimal other discomforts, but I believe you are better off being vaccinated.

A pandemic flu occurs when we have an avian species coming up with a new subtype that we have no antibodies or immunity to. The virus goes through several stages until it mixes and mutates to become easily transmissible to humans. This novel strain can possibly be very lethal. “Pandemic” simply means it will become a global problem (because of the newness). A global pandemic flu will likely target greater than 50% of the world’s population due to the fact that none of us has any immunity.

Consequences of a Global Flu Pandemic

In a typical disaster which usually happens to a localized area or country, resources are mobilized to help with the recovery. In a global flu pandemic there are no resources from unaffected regions to mobilize, it will be every region, every country, every family fending for themselves. In a global pandemic the disaster is unrelenting (up to 12 – 18 months), which will thwart any effort to recover. Hospitals will be overwhelmed in days to 1 – 2 weeks. Because of our “just in time delivery systems” that every corporation now uses, medical supplies will become nonexistent in days. The hospital I work in usually has a pharmacy delivery twice a day. As an example of the systemic system weakness people will walk off their jobs and go home due to the fear of catching the flu and bringing it home to their loved ones. This will greatly affect our supply chains for all our resources; groceries, medicines, fuel, etc. Hospitals are not just made up of Doctors and nurses, we have ancillary departments that are fundamental in the care and operation of our hospitals. Suppose just one department, like Nutritional Services is affected first, either by fear of coming to work, or by people who have caught the flu, how do our patients get fed? Within days many departments in the hospital will be depleted of personnel, again either by not coming into work, or becoming victims of the flu. Emergency Room departments will be completely over run very quickly, and unfortunately in most cases there is not a whole lot we can do medically for people with a viral infection. Flu usually has to run its course, and if we do not have IV fluids for hydration and any antivirals left, how do we care for these people? People requiring a ventilator for lung support will be out of luck, as this number could be in the thousands, or worse, millions. Our hospital has 5 ventilators at any given time, in times of extra need we can rent maybe 1 or 2 more in our area. It is my firm belief that if we had a global pandemic occur with a high CFR we will be taking care of our own sick, at home. The smartest way is to prepare ahead of time with supplies at home, and be prepared to quarantine your family during the event.

What are the Symptoms of the Flu?

Pretty much what we are already familiar with: sore throat, cold, fever, chills, nausea, vomiting and muscle aches. Warning signs for an immediate Doctor or ER visit would include severe acute shortness of breath, bluish skin (fingers, lips, etc.), seizures and dehydration.

What is the incubation period for catching the flu?

The time between human exposure and onset of illness (incubation period) is usually 2 – 4 days, sometimes up to 7 days. (If I had my family in isolation/lock down for a pandemic and another family member came, I would quarantine them for up to 14 days).

How long does a Pandemic last?

Generally flu pandemics come in three waves, with the second wave usually being the worst. For a global pandemic you are usually looking at up to possibly eighteen months for the three waves to have made their rounds and begin to subside. Currently the CDC has stated that in the recent past they have tried to make a H7 vaccine “just in case” and have had difficultly with it conveying immunity. This may be a big problem for us, as it could take up to a year or more to have a vaccine available to vaccinate our total population.

How contagious is the flu?

The influenza virus can live on an inanimate surface for up to 48 hours; it can live on your clothes for up to 8 hours.

How is the flu spread?

The flu can be spread by droplet infection: coughing, sneezing, bodily fluids. It can be spread by direct contact: shaking hands, door knobs, computer keyboards, shopping carts, etc. The flu can also be airborne, and many influenza experts call for social distancing during a pandemic while out in public or at work (6-10 feet), and if you are out in public during a pandemic you should be wearing personal protective equipment  (PPEs).

What can I do to prepare my family for a pandemic?

Make sure your family members are up to date on their vaccines, such as the annual flu vaccine (this could possibly convey some immunity to a new virus, not really sure if it would or not). The pneumovax vaccine is also very important, this protects against 23 types of bacterial pneumonia. Hepatitis A is not a bad idea if our utilities are not working and we are forced to drink or eat questionable water or food. A tetanus vaccine is also important, as everyone should have one every 10 years. Be sure to contact your own Physician and discuss these maters with her/him.

The single most important thing we can do during a flu pandemic while at home, work or in public is practice good hand washing skills. This means using plenty of soap with warm to hot water and scrubbing 30 – 40 seconds, remember to get the back of your hands and in between your fingers, under your nails and up your arms. Rinse thoroughly and dry with a paper towel and then turn off the water with the paper towel, so as not to contaminate your hands on the dirty faucet handle. Using a alcohol based hand sanitizer is also recommended (not a antibacterial soap that is not alcohol based). To use this thoroughly wet your hands with the sanitizer and let air dry, do not towel dry. If you are sneezing or coughing be sure to use Kleenex, and properly dispose of them, if Kleenex is not available sneeze into the fabric of your shirt sleeve. I think sneezes have been clocked at 200 miles/hour, that can really travel some distance! Frequently clean your work surfaces at home and at work with either germicidal wipes or a weakened bleach solution (one part bleach to 4 parts water), don’t forget your telephones and computers!

Medicines and Personal Protective Equipment (PPEs)

Lets talk about antivirals first: Neuraminidase Inhibitors have been proven to be effective for some people during normal flu seasons and also with the 2009 H1N1 pandemic, and for some of the unfortunate people who contracted the H5N1 subtype, these antivirals may not prevent the flu, but they can lessen the severity and duration of the flu. Some of these antivirals are Tamiflu, and Relenza and the M2 inhibitors Amantadine and Rimantadine. If you have an understanding physician try talking to them now and see if you can get some prescriptions for these drugs. The first two listed have proven to be the most effective, but depending on the specific subtype, some of the viruses have become resistant to the antivirals. Please be sure your home is stocked with plenty of pain and fever reducers. Also be sure you have working thermometers on hand. Have a blood pressure cuff at home and learn how to use it properly; low BP can be one of the first signs of complications.

Particulate Respirator Masks – these ideally should be “fit tested” to be worn properly, you could try going by your local hospital and see if they could show you the proper way to wear the mask. If that is not possible be sure the mask fits snuggly around your face covering your nose and mouth without leak areas (guys….this means no mustaches or beards). These masks must be NIOSH approved N95 rating or higher. A surgical mask is a second (although poor) alternative if respirators are unavailable. One mask can usually be worn for approximately 8 hours, if it has not become soiled, contaminated (taking off and on), or becomes too moist. Nitrile, latex, or vinyl (if you have a latex allergy) single use exam gloves. These come in boxes of 100, you can find them cheap at Sam’s or Costco. The masks can be ordered from places like medical supply companies. You need to have a lot of these on hand, try to get appropriate sizes for your kids if you can. You also need eye protection, wear goggles or a face shield. Goggles should have the side protectors, these can be found at medical supply companies and stores like Lowe’s or Home Depot. Often I have seen pictures of people in the world wearing only masks and not goggles during a pandemic, this was especially evident during the SARS out break. With droplet infections you are contaminated by coughing and sneezes into your mucous membranes…..that includes your eyes! Don’t forget your alcohol based hand sanitizers, and germicidal wipes.

Gowns – a long sleeved cuffed disposable gown may be needed for direct care for an infected person.
 If you are caring for an infected person at home in the case of a severe pandemic and hospitals are closed or full be sure to isolate and quarantine this person to a separate part of the house if at all possible, and have only one primary care person who always wears their PPEs. Keep all materials to care for the infected also separate. Be sure to dispose of  any items that may be soiled or contain bodily fluids very carefully, and away from other family members.

Hydration of the person with flu is extremely important, especially if a hospital is not available. This can prove daunting for someone with nausea and vomiting, but it is imperative if you are the care giver to keep trying to push fluids.

Electrolyte drink
½ tsp. baking soda
½ tsp. table salt
3-4 tbsp. sugar
1 quart water
Mix well, flavor with lemon or sugar free Kool Aid.

Keep a daily record of the person who is ill, include temp, blood pressure, and respirations. Also take daily temps of other members of your family (with a separate thermometer), and be prepared to separate and isolate any additional family members who you believe may be becoming ill. Make sure the infected person is urinating regularly, and in good amounts, if they aren’t this is the first sign of dehydration, or worse, possible kidney failure.

As preppers we all strive to protect our families and loved ones as best we can, a pandemic with a severe CFR would be devastating to the world. Personally this would be one of my tipping points in calling all family members home and staying home, no one in or out for the duration. I would be praying that they come up with a vaccine within a year.

I sincerely hope none of us has to deal with a pandemic with a high CFR in our future, but if we do please prepare now with the items you may need. I will never forget watching scenes from Toronto, during the SARS epidemic, of people selling simple surgical masks on street corners for $10 each! Like with everything else we prepare for now, this is just another possibility in the crazy, crowded world we live in.

Please stay healthy and God Bless.

Disclaimer: This information is not intended to replace the advice of a doctor. The author and web site disclaim any liability for the decision you make based on this information.

Saturday, March 30, 2013

I know this blog is primarily aimed at folks preparing for a long-term crisis, but I have a unique perspective on living without electricity after a regional disaster that I thought some might find informative. I live in the hills of northwestern New Jersey, and I have lived through three sustained (my definition: 4 or more days each) power outages caused by extreme weather events during the last two years. These power outages were caused, respectively, by Hurricane Irene, 19 inches of wet, heavy snow in October before the trees had lost their leaves, and Hurricane Sandy. I have learned important lessons from each power outage that I would like to share.
A wood stove and lots of firewood are necessities. I live in a county with tens of thousands of acres of forest. Today, however, most folks are too lazy to cut and process firewood. As each generation passes, fewer and fewer know how. Fortunately, I grew up on a farm and my dad always heated our home with firewood so I learned the joy of hard work and more about trees than I could begin to write here. As the temperatures plunged in the wake of Hurricane Sandy, the inside temperature of homes in my neighborhood dropped to near freezing and those of us with woodstoves became havens of comfort each day for friends, children, the elderly and neighbors in need of warmth. I think anyone who doesn’t have a wood stove and 10 cords of split, stacked and dried firewood in the backyard by October is unprepared. It’s a low-technology essential that works on simple principles, it warms your home, cooks your food and dries your clothes. Get a wood stove. Trust me when I say your wife won’t complain about the mess that comes with one when it is warming your house. Get a bigger wood stove than you think you need, it will make it easier to load and you won’t have to work as hard cutting small pieces of firewood. The side benefit is that a wood stove will save you thousands in heating costs each winter and will pay for itself in short order.
Water. It seems so obvious, but even most country folk today are dependent on electricity to run their well to provide them with water. Having a generator is much more useful if it powers your well. For starters, this means you can flush your toilet, wash your hands and take a shower, things we take for granted when the electricity is running. I learned after our first extended power outage that I wanted to get a generator and a lot of gas cans to protect the venison in my freezer. After the second one I realized that I wanted a Reliance transfer switch to hook up my generator in a safe way to my electrical box so that I could provide power to my well pump. As a bonus, I could also run my freezers, a refrigerator, a few lights and outlets. But I needed water. For a longer-term crisis, I am looking into a hand pump such as the Simple Pump that has the capability to pump water by hand from my existing well. Because I believe in redundancy when it comes to water, I also picked up some high-quality water containers that hold 7 gallons of fresh potable water. You can use it for drinking, cooking, washing and filling up the toilet. There’s a stream about a mile from my house that I could drink from if I had to (I strongly discourage this unless it is a true survival situation because of water-borne illnesses found in most surface streams), and I would be glad to haul the water back home in a wheelbarrow each day if it came down to it.
A generator coupled with a transfer switch. I made this a separate category because I think it deserves special attention. I personally bought a 5,000 Watt generator that can surge to 6,250 Watts, made by Briggs and Stratton. There are myriad choices in this area so do your research, evaluate your budget, and get the most appropriate generator for your circumstance. It has performed admirably for over 100 hours and has only required minimal maintenance. For starters, it is recommended that you change the oil every 40 hours or so. You should also drain the gas out when you are done using it. No problem here, but if you don’t use the generator for six months you ought to run it for half an hour or so. This means you are bi-annually putting a little gas in, running the generator, and draining the fuel out. A model which lets you easily detach the fuel line to drain the leftover fuel out makes this chore much less of a hassle.
I suggest having a two-week supply of fuel on hand, because it is amazing how quick it runs out during a crisis. I never would I have believed that I would live to witness gas lines, gas rationing, people driving to other states to get fuel, etc. until I actually experienced it. It can happen. That being said, I believe that within two weeks after a regional disaster, supply chains will develop to get things moving around again. If they don’t, then we are talking about a situation that is truly dire and you’d better think about how to live without electricity from any source for the long haul. My generator burns a little less than 4 gallons of gas in twelve hours (I turn mine off each night), so 10 gas cans gets me there if I conserve a bit. I could get by on eight hours, but my wife immeasurably appreciates being able to open and close the refrigerator with four kids. If I have learned only one thing in thirteen years of marriage, it is that having an appreciative wife is invaluable.
I had a neighbor with very large whole-house generator that was burning over 10 gallons of gas a day, and he ran out of fuel within a few days. So bigger is not always better. I also learned that diesel fuel is more available than gasoline during these situations, so if I were to do it again, and money were not an issue, I would consider a diesel, natural gas or propane generator. I found out the hard way that having a can of carburetor cleaner and a small piece of wire is invaluable because carburetors get gummed up easily if a little gas sits in there for a few months. If this happens, you have to clean it (which is easy once you have done it once) or run your generator on partial choke all the time (which is less than ideal and may not work). Drain your gas completely when you put it away and this shouldn’t be a problem.
Food. This was actually the least of our worries. We had plenty of food on our shelves to last for months if necessary, and we didn’t really even plan it that way. I guess with four kids and one income we are just used to buying in bulk when sales hit at the local grocery store. There has been a lot written already on this subject, so I will defer to other essays on this topic.
Medical Supplies. Everyone has different needs here, but it is just good sense to keep a few extra of whatever you need around in case the pharmacy isn’t open (which it won’t be if the store doesn’t have a back-up generator).
Feminine hygiene products. Keep a few extra boxes around.
Lighting. Because we had plenty of firewood and a fireplace, we lit the fireplace each night and everyone in the family loved it, but it didn’t light up the bathrooms or the other rooms in the house. And when I went out in the dark each night to turn off the generator and bring it in the garage, a lantern came in really handy. LED lanterns that can run over 100 hours on one set of batteries are great, and are easily available on Get two of them because you need one in the bathroom and the rest of the family doesn’t have to sit in the dark while they wait for your return if you have two. I also purchased two old-fashioned kerosene lanterns and a gallon of kerosene after the last power outage. The more flashlights and batteries you have around the better when the power goes out. Those little LED book lights are nice luxuries as well when you want to settle down and read a book in the evening.
A hand crank radio. This is one item I used every day during lunch. We sat around and listened to the local AM radio station as people would call in with all sorts of useful information, such as which gas stations had gas to sell and a generator to power their pumps, which stores were open, where one could get potable water (some buildings have emergency generators), what roads were cleared of trees and now passable, and where the electrical crews were working. On top of this, listening to a radio lifts your spirits when you have no other contact with the outside world.
Relationships with your neighbors are vital. No one knows everything, and a plumber, electrician, farmer, mechanic, doctor, dentist, police officer, etc. each possess unique and valuable skills and knowledge. You can only access those skills and knowledge if they trust you before the crisis and are regularly communicating with you during the crisis. Build friendships now with your neighbors. Find out what their strengths are. Forgive those whom you have had past disagreements with, as those arguments will seem truly unimportant if the SHTF. One of the unexpected benefits of Hurricane Sandy was that I built several long-lasting friendships with neighbors as we spent two weeks cutting trees, dragging branches, splitting wood and stacking firewood. We worked together to get warm, make food, get gasoline and other supplies, take showers and watch children. And everyone in my area has give a lot of thought about surviving when the government and the utility companies cannot help you. I can honestly say it was, in some ways, a blessing.  
Cash. Try buying something when nobody in town has power and you find out real quick that cash is still better than a credit card or a debit card.  A few hundred bucks was more than enough for the short-term outages I have experienced, but a longer-term situation would require more. In a truly long-term disaster situation, actual goods that you could barter with would have the most value.
Intangibles. I would like to conclude by suggesting that maintaining a positive attitude in spite of adversity is of immense value. Being a person who smiles while working to meet daily challenges lifts the spirit of everyone you come into contact with, and your attitude will have a marked impact on children. My children actually think that power outages are something to be celebrated (no school and you get to pretend like you are living Little House on the Prairie)! Having faith helps us see the good that comes with difficulty, and gives us strength to forge ahead, no matter what.
Our world is becoming more like a Rube Goldberg machine every day. Our infrastructure and supply lines become more fragile as they become more dependent on new layers of technology. My advice to everyone is to build redundancy into every system you control, and pass on practical knowledge to the next generation. A co-worker who was not prepared for any of these circumstances suggested to me that preparing for them was wrong, that it amounted to cynically saving yourself at the expense of your neighbor. I replied that quite the opposite was true: those who are prepared are far more able to help their neighbors than those who are not, and my real-life observations actually back up this assertion. Thank you for taking the time to read this essay and God Bless!

Wednesday, March 27, 2013

I enjoyed the Become Your Own Herbal Doctor article very much as herbal medicine is my current interest and latest preparation.  Because I did not learn this type of information from my grandmothers or mother, I have opted to take a class to speed up the learning curve.  The author is correct; the home remedies our families knew just a hundred years ago have already been lost to most of us.  Taking this class has been a fun and educational process.  We have learned so many herbs and their uses; we’ve even crafted our first (sprain/strain) salve.  There is a lot to learn in this field, but the process has been rewarding.  The class I take is also offered as an online course for those of you like me who need some structure to make any real progress or just want a fast track to learning herbal medicine.  One day soon, I hope to begin teaching my kids these valuable skills.  For me, the choice to learn herbal medicine now makes great sense and I appreciate how the author provides information to help others get started.
The school (The Human Path) I am referring to is lead by Sam Coffman, whose medical background started as a U.S. Special Forces (a.k.a. “Green Beret”) medic.  He started becoming very interested in plant medicine while in the field as a medic on teams.  At the time his interest was based on the need for a backup if there was no pharmaceutical medicine available.  However, over the past 20+ years, Sam has devoted his time to integrating plant medicine (“herbalism”) into every day acute illness and injury care.  His goal has been to work with plant medicine as a first alternative rather than a last resort, for injuries and illnesses that people normally go to the Emergency Room for (non-surgical care).  He runs the previously mentioned school that focuses primarily on post-disaster and remote medicine using medicinal herbs both from the area as well as worldwide.  He also runs a non-profit organization (Herbal Medics) that takes students into remote areas to create off-grid solutions for health care, clean water and self-sustainable food solutions.
People located in the central Texas region ought to give this school a look, as there are many types of classes offered. These classes have been a fun way to learn skills and meet people. - Laura in Texas

Saturday, March 23, 2013

Hi James,
I was very concerned about some of the things C.C. recommended in her letter to you for a woman giving birth, post-collapse.  I am a strong believer in natural childbirth.  After my first birth at a hospital with a doctor I swore never again!  I had my next three babies with midwives, two of the births being at home.  I read every book out there over the years on natural childbirth, including several of the ones the above writer listed.  I even trained to be a doula (woman who aids a labouring and post birth woman).  Two things the writer advised are not just foolish but down right dangerous in a home-birth and post collapse situation.  

First is her suggestion that a woman should "catch"  her own baby. Anyone who has attended a number of natural births will tell you that many women who are in the last stages of birth and actually pushing go into an almost trance like state, only really noisy!   Often times they are concentrating so hard on just getting that baby out that they cant even really hear what people are saying around them.  To then expect the woman to reach down and help guide the baby out is ridiculous.  I did in fact help to "catch" my third baby, but with the midwife helping guide my hands, and only after she had checked to see that my daughter didn't have a cord wrapped around her neck and that her mouth and nose were already clear.  Also a birthing woman cannot ascertain if the baby has a cord wrapped around its neck or is in distress.  That is what a midwife, or birth attendant would do.  Not only is the labouring woman a little busy at the moment, she also is in a very bad position to see the baby clearly.  And last but not least if a woman does have the wherewithal to grab the slippery baby and pull it up to her chest she could accidentally tear the umbilical cord if it is short or wrapped around the baby causing blood loss to both mother and child.

Also most babies need to have their mouth and nose cleared and checked before the mother immediately starts nursing as the writer suggested.  There is obviously lots of fluids happening during birth and if a mother were to try nursing before the babies nose and mouth were cleared really bad things can happen.

The second suggestions of allowing the placenta to stay attached to the baby via the umbilical cord is downright dangerous to a newborn and totally unnecessary.  Those who practice it probably feel that they are being more back to nature or something.  Where they ever got that idea is beyond me.  I have had goats, rabbits, and dairy cows and watched births more times than I can count.   Every mother animal who gives birth rapidly severs the umbilical cord from the birth leftovers by urgent licking and gentle biting until it is detached.  If the mother animal doesn't eat the placenta herself then she will move her newborn(s) as far from it as possible for two reasons.  One is that the smell of the placenta draws predators, but second and most important in our case is that the placenta is the perfect place for breeding bacteria.  To keep such a thing close to a newborn with a weak or non-existent immune system is begging for infection.  And considering that post collapse we will not have access to neo-natal units, antibiotics, or doctors the risk is too great to chance.  The first and foremost goal of anyone helping a woman to give birth is to reduce the chance of infection to mother and child.  People need to remember that childbirth was the number one killer of women due to post birth infections!   The cord should be cut and clamped as soon as it stops pulsating and then when the placenta is delivered it should be checked over carefully by the birth attendant to make sure some is still not in the womb.  Then is should be disposed of as hygienically as possible. Preferably by burying it by a tree or some other large plant that could use it for good. - C.W.

JWR Replies: Thanks for those comments. I should add that one of the books that C.C. recommended, Spiritual Midwifery, while entertaining to read, has some dated information. It was written by a hippie from The Farm in the 1970s. In this book contractions are euphemistically called "rushes."

Friday, March 22, 2013

I saw J.A.N.'s letter about MSDS information for chemicals.  A comment J.A.N. made indicated the lengthiness of some MSDSs – very true with amazingly confusing info.  Another source is the international chemical safety card (ICSC) and can be located here.
These are typically only two pages in length, have standardized format, and are available in numerous other languages.  As an FYI – the “MSDS” is quickly becoming archaic as the U.S. is finally catching up with the international concept of SDSs  (no “M”)– with mandated format, international symbology, and definitive info for personal protective clothing/equipment (PPE).  Too many MSDS indicate simply to wear “gloves” as PPE – well, is that nitrile, or latex, or neoprene, or what? - Bill C.

Thursday, March 21, 2013

Common ailments can really keep you down in the best of times, but when the SHTF you won’t have the luxury of staying in bed and taking a sick day when a bad cold or diarrhea strikes.  In a TEOTWAWKI scenario, there will be no doctor to call and no over-the-counter medicines to treat your symptoms.  If that sounds at all scary to should. But fear not!

Luckily, we all have the ability to become our own doctor, as plant medicine is all around us.  But it takes more than a reference book or cursory knowledge of herbal medicine to be prepared to use it.  To be really prepared to cure yourself when TEOTWAWKI strikes, you must start now, just as you have with your other preps. 

Before we embark on the path to natural healing, let me offer this disclaimer. I am not a least, not in the sense that most people use the word. Rather, I am a self-reliant homesteader. I grow my own meat, vegetables fruits and medicinal herbs. Like many of you (hopefully), I make my own soaps/lotions/shampoos and have long sworn off chemicals and fancy pharmaceutical products. From my gardens and land, I make specialized medicines and use them to prevent or cure many family ailments, from arthritis relief to the common cold. But all of the information presented here is from my own experience and intended for informational purposes only.

With that disclaimer out of the way, let's begin our journey to self-reliant health.

The first hurdle to over come may be the toughest – to realize that you can be your own doctor.  In a way, we've all been on life support our whole lives, having been trained that the doctors are experts and that they have the magic answer to whatever problem we present.  As a result, we have lost our own intuition and confidence in our ability to heal ourselves.  While a trained doctor may be what you need for surgery or severe medical trauma, there is no reason why you can’t heal (and even prevent) your own common ailments. 

Thanks to relentless advertisements and lobbying of doctors by the pharmaceutical industry, we have also been brainwashed into believing that a little pill made in a lab is safer to take than a naturally grown herbal tea of weeds we can find in our own backyard.  Medicine from nature has become a foreign concept, one we now look at as unsanitary or potentially toxic.  In retrospect, it’s amazing to consider how quickly we allowed this to happen.  Just a few generations ago our ancestors had knowledge of basic home remedies that included things like horehound cough drops and chamomile tea.  When the doctor wasn’t so easy to get to, families took care of their own during times of fever and flu.  So the first thing you have to realize is that people have used plants for medicine far longer than they have used pharmaceuticals, and without all the side effects. The knowledge is in our history and our confidence must come from our experience.  You can start preparing now by resisting the urge to call to a doctor when you feel a twinge of illness coming on, if at all possible.  Instead, begin experimenting with being your own healer and making your own medicine. This will prepare you for a time when it may be your only option. 

The second thing to do is to change your mindset of illness and medicine.  Start by knowing that being a little bit sick is actually a good thing.  When your body encounters invading bacteria it has natural defenses to combat them.  For example, one purpose of a fever is to raise the body temperature to a point in which it is inhospitable for the bacteria to live.  A bit of a fever can be a good thing!  Our reaction however is to quickly take a fever reducer at the first sign thereby limiting our body from doing its job.  Those fast acting chemical medicines have also trained us into thinking that medicine must work quickly in order to be effective. The medicine is also so concentrated and potent that it can alleviate symptoms often with just one dose.  In addition to introducing chemicals with potentially harmful side effects to your body, you are also treating your illness with a crutch rather than allowing your immune system to strengthen and do its job.  This means that the next time you encounter the bacteria, you will need more medicine rather than relying on your immune system’s memory, which could have built up a natural resistance, had you not taken the medicine.  The only one who benefits from this approach is the shareholders of the pharma giant that hooked you on the medicine!

Using plant-based medicine helps you to realize that tolerating a little bit of sickness will just make you stronger in the long run.  It also teaches you to listen to your body and feel the instant that something is out of balance. Plant-based medicine is also far gentler. This is good on your bodily systems, but also means you often have to take it at the first signs and in low doses over the course of a few days in order to keep symptoms at bay.  Much of what herbal medicine does is to boost your immune system so that your body can defend itself.  This, paired with the natural properties of the plant, can alleviate pain, reduce swelling, or increase circulation in order to help your body function at it’s most effective level.  Changing the way you think about being sick NOW will make an easier adjustment to herbal medicine.  Also, not reaching for an over-the-counter aid at the first cough or sneeze will help you to become more in tune with your body and allow you to focus on what it’s natural reaction is.  Practice listening to and trusting what your body is telling you and find natural remedies that will complement your own defenses rather than taking over the fight.  Most of all, don’t be skeptical when one dose doesn’t bring you back to 100%. Instead, realize that fully experiencing the illness is much like exercising your muscles.  Giving your body and your immune system this workout will make you that much stronger over time. 

One of the best things that experience will teach you is what you can treat on your own and what you need expert help with.  We will most likely each draw the line at a different point, but as your confidence grows you will feel able to treat more serious conditions.  This is why starting now is so important.  You do not want to wait until the doctors and medicine are unavailable before you turn to herbal medicine.  The best way to truly be prepared for TEOTWAWKI is to make it a commonplace every day thing that you are already accustomed to. 

To ease into it and start off simply, begin with herbs and plants that you are already used to consuming.  Culinary herbs and spices are easily identified and considered safe to everyone as we use them in cooking almost every day.  What we have overlooked is that they are also medicinal.  Learning to make basic medicines from kitchen herbs is a great way to feel comfortable and build your confidence. 

Now, let’s explore some basic medicine making techniques and apply them to some common every day herbs. 

Infusions and Decoctions
Simply put, this is making tea.  Tea used for medicine is much like regular tea that you drink, but it is just a bit stronger.  Having a mesh tea ball that can hold lose herbs is handy, but you can always just strain the herbs out through a clean piece of cloth, such as a bandana or T-shirt, if necessary.  Teas can be made from either fresh or dried herbs. 

Infusions are made from softer plant material such as leaves and flowers and decoctions are made from harder plant parts like bark and roots.  For either process, begin by boiling water and gathering clean, washed herbs.  To make an infusion, simply pour boiling water over the herb and then leave it to steep for 15-20 minutes.  You will want to cover it loosely so as to not let steam escape. Rather, the aim is to direct the essential oils of the plant back into the cup for consuming.  After steeping, strain out the herbs and press them to get the last bits of medicine out, and then drink the tea.  If the herb you are using holds it’s medicinal properties in the roots or bark (or something harder), then you will make a decoction.  Just add the herb to the boiling water, cover, and simmer for 15-20 minutes.  The continued heat will help to draw the medicine out of the tougher material.  After steeping, just strain, press, and drink the tea. 

Infusions and decoctions are great ways to take medicine if you have fresh or recently dried plant material and access to boiling water.  Once you harvest a plant, the medicinal value begins to deteriorate.  Fresh plant material is the most potent.  You can dry the material and preserve much of its power, but the longer it sits the less potent it will be. Therefore, if you require a certain plant that is only available for a short time, relying on tea to consume it may not be the most effective option and you should look to other ways of preserving it. However, teas are sometimes the best ways to take medicine due to the other properties that hot tea can provide.  A cup of hot tea can warm the body, soothe a harsh throat, and the steam can loosen congestion. Children easily consume teas and teas do not require previous preparation. Rather, they can be made in just a few minutes when symptoms first appear.  They are highly perishable, though, and will not last longer than a day or two before growing mold and bacteria.  

Try a simple infusion:
Mint is an herb that is easily grown.  It tolerates neglect and will spread like crazy in just about any environment.  Although starting from seed is more difficult, buying a transplant or taking a division of a plant from a friend is an easy way to start growing your own mint.  Try peppermint to help with stomach and intestinal complaints.  In many climates, mint is available year round, but in colder areas it may die back in the winter and then re-grow when the temperatures warm up.  The leaves hold the medicine and can be harvested whenever the plant is growing and dried for later use.  When a stomachache comes with gas and bloating, make a cup of mint tea following the infusion directions above.  Drink a cup every few hours until relief is felt. 

Try a simple decoction:
Ginger is an plant that everyone is familiar with.  The root is the part that holds the most medicinal value.  You can buy ginger root from the store and then sprout it yourself by submerging half of it in a cup of water.  It will take a few weeks, but will eventually grow roots and green shoots.  Then you can plant your sprouted ginger in a pot and it will grow into a beautiful plant.  Each year it will grow offspring roots that can be harvested.  Ginger plants like warm weather and will need to be brought indoors for protection during cold periods.  Chop or grate your cleaned ginger root and dry it for future use.  Make a decoction using the directions above with a piece of ginger root to ease a nauseous stomach.  Whether it is due to motion sickness or illness, a cup of hot ginger tea will soothe and relax the stomach muscles taking away the nausea.  Try a cup every few hours until relief is felt. 

A tincture is made by soaking the plant material in a strong substance such as alcohol or vinegar over a period of time, with the aim being to draw out the medicinal qualities.  The substance you choose to use serves two purposes.  First, it will attack the plant’s cell walls and release the medicine. Second, it will preserve the extracted liquid by creating an environment that is inhospitable for bacteria and mold growth. The stronger the alcohol or acidity content of your substance, the longer the medicine will last. This means that grain alcohol will preserve your medicine the best and substances with less alcohol content such as wine or brandy will not last as long. However, some may find them more enjoyable to consume. 

When stocking your pantry with food storage, be sure to include grain alcohol in abundance not only for bartering, but also for medicine making.  Otherwise, learning to make your own alcohol and vinegar will provide you with an endless supply of ingredients with which you can preserve your herbal medicine.  Once you have your extracting substance, then you must gather clean, washed fresh or dried herbs. 

Place the plant material in a sealable container, then pour the extracting liquid over it until all material is completely submerged.  If you are using dried plant material, then you may need to top it off in a day or two as the plant matter rehydrates and absorbs some of the liquid.  As long as all material is covered, it will not mold.  Put the lid on the container and leave it in a protected area that you can easily get to, as it will need daily maintenance.  Each day you will shake the container at least once, but more often will only help and not hinder the process.  By shaking the container you are helping to break apart the plant cells and forcing the extracting liquid deeper into the plant matter to extract more medicine.  You are also making sure that all parts of the plant matter are coated with the liquid that will preserve it.  In 14 days your tincture will be finished.  Strain out the plant material and press it to push out all of the last bits of medicine.  The liquid that remains is a concentrated form of the herb’s medicine.  Storing it in an opaque glass bottle out of direct light and protecting it from temperature changes will help it to last the longest.   

Tinctures are a great way to take medicine because they are preserved so well that they can last months to years depending on the extracting liquid used and how they are stored.  They are also easy to store and transport because they are concentrated, so only a little bit is needed.  Tinctures are usually taken by dropperfuls or teaspoon sized doses.  The drawbacks of tinctures are that they usually contain alcohol and might not be the best way for some people, especially children, to take medicine.  They also do not offer any other medicinal properties the way hot tea does.

Try a simple tincture:
Garlic is well known for its antibacterial and immune boosting properties.  It is also easy to grow.  You can buy a head of garlic from the store, pull off the individual cloves without peeling them and plant them in your garden.  Garlic is planted at different times of the year depending on your zone so refer to a planting guide for your area.  Each clove that is planted will grow into a new head of garlic.  Be sure to save some cloves from your year’s harvest to plant for your next year’s garlic crop.  Make a tincture by chopping a few cloves of garlic into very small pieces and then follow the directions above.  Your garlic tincture can be used for many purposes including lowering blood pressure and cholesterol, speeding the healing process of an infection, and serving as an antiseptic.  The next time you feel a common cold coming on, reach for your garlic tincture and take 20 drops three times a day to boost your immune system and help fight off invading bacteria.  To make the medicine more palatable, mix the dosage in a cup of water to dilute the taste. 

Medicinal Oils and Salves
Medicinal oils are made in a similar way as a tincture, but in this case it is the oil that extracts the medicinal qualities of the herb. The first rule to remember is that oil and water don’t mix and if you have water in your medicinal oil, you will get mildew and mold.  Fresh plant material contains water and therefore is unsuitable for making medicinal oils. 

In order to make medicinal oil, harvest and clean your plant material and then dry it until all of the water has evaporated.  A dehydrator works fine if you have electricity or a solar one, but you can just as easily dry leafy plant material by hanging it up in your house or laying a single layer of plant material in a dry spot outside.  If drying outside, cover the plant material with a screen or cheesecloth to keep bugs and birds off of it, and do not dry it in direct sunlight.  Also, be sure to take it inside if morning dew is expected.  Leaves, stems, and flowers can be dried whole and will crumble easily once brittle, but roots and bark should be chopped before drying to speed the drying process and also because they may become too hard to break up once dried.  You will also need oil and this is a good item to stock up on in your food storage. If you do not have oil, medicinal oil can also be made from animal fat or pressed from seeds if necessary.  Learning how to harvest animal fat and render it into lard and tallow is as valuable skill as is learning to grow things like sunflowers for seed. If you do grow your own seed for oil, having a simple hand cranked oil press will be a very valuable addition to your preps.   

Once your material is dried, put it in a sealable container and cover with oil.  You may need to top it off after the plant material rehydrates and absorbs some of the oil.  Make sure that all material stays covered with oil in order to keep it preserved. Seal the container and put it in a warm location, such as a sunny window.  The heat will help the oil to penetrate the plant material.  You will also need to shake it at least once a day to force the oil deeper into the plant material and to ensure that all parts are covered.  The ideal temperature for extracting the medicinal qualities of the herb is around 100 degrees.  Too cool and it will either take a much longer time to extract the medicinal values, or else will be unable to extract the plant’s properties.  Too hot and the heat could kill some of the valuable properties of the plant’s medicine.  In a TEOTWAWKI situation where mechanically creating a constant temperature via appliances such as a crock-pot or stovetop is more difficult, the sunny window is a perfect solution.  While constant temps at exactly 100 degrees would be sufficient to extract medicine in as little as 24 hours, a sunny window is less precise and therefore leaving your jar there for around 14 days is a better idea.  After this time, strain out the plant material and press it to extract the last bit of medicine.  Your medicinal oil should be stored in an opaque airtight container out of direct sunlight and protected from extreme temperature changes. 

Medicinal oils are best used for topical applications.  While you could soak a cloth in some freshly brewed tea and apply it to the skin, this would require fresh or recently dried plant material and is highly perishable.  Also, you could apply a few drops of tincture to the skin, but this could sting if it was an open wound.  Medicinal oils work great because they are preserved for a long time and can be applied in any circumstance.  Rub them into muscles, cover wounds and bruises with them, or even apply to a cotton ball and place in the ear for ear infections. 

Medicinal oils can be messy to transport and use though.  Turning your oil into a salve is easy with just one additional ingredient.  If you have access to wax, possibly by keeping your own beehives, all you have to do is to put the oil in a pot over a heat source or water bath and grate some wax into it.  The wax will melt into the oil and, once cooled, will harden in to a solid and more easily transportable salve.  The amount of wax you add depends on how hard you want the salve to be and will take some experimentation.  For a muscle rub you may want a looser salve that easily melts into the skin.  For soothing chapped lips you may want a stiffer salve that will sit on top of the skin without being rubbed away as quickly.  Try making your salve with only a portion of your medicinal oil. That way, if the texture is not what you want initially, you can re-melt your salve and add more wax to harden it or more oil to soften it as needed.   

Try a simple medicinal oil or salve:
Thyme is a very common culinary herb used to flavor meats and salad dressings.  It is also one of the most useful and powerful medicinal herbs.  Among its many properties, thyme is highly antiseptic and can be use to disinfect anything from kitchen counters to bed linens to infected wounds.  There are many varieties of thyme so you can choose the one that is best suited to your gardening needs.  Thyme is a perennial that can withstand cold temperatures, so in most climates you can have access to thyme year round.  During an extremely harsh cold spell the most care it may need is a blanket to give some protection from a freeze. Thyme can be started from seed or you can buy a transplant or get a division from a friend.  To make oil infused with thyme simply cut a few of the small branches and lay them out to dry.  Once dried you can follow the directions above to make an oil or salve.  Immediately rub the oil or salve onto any cuts or scrapes to kill bacteria and avoid infection.  If you already have an infected cut, blister, or incision, apply the oil or salve 3-4 times a day directly to the wound.  The thyme oil will draw out the infection and kill the bacteria promoting healing. 

A poultice can be thought of as an herbal bandage.  To make a poultice, you can use either fresh or dried plant material.  Gather and wash your plant material and then use a mortar and pestle to break up the plant pieces.  If you do not have a mortar and pestle, just smash the material between two clean rocks. Even chewing it will accomplish the same goal.  Fresh material may release enough water to make a paste, but dried material will need a few drops of water or saliva to rehydrate it enough to make a paste.  By smashing the material you release the medicine, and by adding just a bit of liquid you are able to create a substance that binds together. Shape a piece of thin cloth into a pouch and wrap the mass of plant material in it.  Cheesecloth or gauze work great, but you could also use a bandana or piece of T-shirt.  You want the material thin enough that the plant juices can seep through to the skin.  To use the poultice, hold it over the affected area or tie it on in place and leave it to do its work.

Poultices are great ways to apply medicine to the skin and will be most potent if you use fresh plant material.  They are very perishable, however. Therefore, they are only useful if you have fresh or recently dried material.  They are best to use if you have an ailment that will benefit from constant medicine.  For example, if you have an infected wound, then a tincture will sting and medicinal oil may wear off, but a poultice tied on the area will apply medicine all day long.  They are also very effective if you require something to be drawn out of the skin, such as venom or splinters.  One of the best things about poultices is that they can be easily made and used on the go.  For example, if you get a bee sting while out in the woods, you can quickly grab a leaf, chew it up, and hold it on the skin to draw out the venom. 

Try a simple poultice:
Oregano is a popular herb used in many Italian style dishes.  It’s also very easy to grow either from seed, transplant, or a division of a friend’s plant.  It is a perennial in most climates, but may need cover in extremely cold areas.  Oregano also grows very well indoors in containers if you live in an area where it is too cold to survive the winter.  The medicine is held in the leaves of the oregano plant.  To make a poultice, strip the leaves off of a few stems then follow the directions above.  Oregano has strong anti-inflammatory properties.  The next time you have a bruise or swelling, try adding an oregano poultice to the area.  Leave the poultice on all day or change the poultice a couple of times a day to a fresh one if the material becomes dry. 

By starting with some common herbs and spices that you already know and probably have on hand to treat minor conditions, you can familiarize yourself with medicine making and build your confidence.  Soon you will be researching the medicinal properties of other herbs and learning to identify native plants in your area that can serve as medicine.  Also, by starting now, you will begin to build up a natural medicine cabinet of medicinal oils and tinctures that will supplement your preps of stored bandages and gauze. 

The most important benefit of becoming an herbal medicine maker before you really need it is that you can develop a garden of plants from which you can always rely.  Once you have perennial herbs all around your home or bug-out location, you will learn to save seeds and cuttings from annual herbs that will provide you with medicine from year to year, no matter what happens in the world around you. Indeed, you may become one of the most valuable members of your community, a new-age doctor with skills so valuable that others will help trade their resources/skills to ensure your survival and allow you to prosper.

Wednesday, March 20, 2013

This article isn’t designed to cover all aspects of childbirth, of course, but it is meant to reassure people who are unsure of their abilities to do prenatal care and their own or a neighbor’s birth, if the stuff hits the fan. I am a Certified Professional Midwife, and have assisted people in birth as a childbirth educator, doula, and now midwife since 1984. (My North American Registry of Midwives certification, however, is fairly recent, since I have concurrently raised three children alone, and earned a BS in Computer Information Systems.)

One of the first things to remember when the stuff hits the fan, is that most births, if not tinkered with, are straightforward.  Most women are quite capable of birthing at home just fine. I would recommend having several good books on hand, such as Spiritual Midwifery by Ina May Gaskin (the only midwife who has had a procedure named after her), Heart and Hands by Elizabeth Davis, and either Varney’s Midwifery, or Myles Midwifery. Varney’s