The greater majority of us have absolutely no health care education, training or experience. The best we can do is take some Red Cross First Aid and CPR courses or maybe even a wilderness backpacker first aid course. Beyond that we are all neophytes.
So how do we prepare for a situation where the normal infrastructures of public safety, including emergency health care are unavailable?
With much research and thought that’s how! Plus we have to remember some key concepts too:
- Prevention is key. Stay as fit and healthy as you can NOW. Keep all key vaccinations, etc. current.
- Reality is very different from perception, someone in your household is bound to get sick or injured.
- You can’t believe everything on the internet or from any other source.
- You have to be able to quantify any report and or study (for example just seeing a picture of a footprint and being told it is over 24 inches in length is pointless unless there is a ruler next to the footprint in the photo).
- You have to be very honest with yourself, your household and or group, of just what you know and don’t know and what you can do and cannot do.
Any mainstream medical professional, site, book, report, etc will stress science and education to a fault. They are just about trained to do this from the time they start their education and or research. They tend to downplay or discredit any traditional form of treatment. The reverse is also true: many of the ‘alternative’ medical ‘experts’ will also do the same against mainstream medicine.
Reality is that somewhere in between these two extremes is the truth.
So we have to be able to quantify what any of these so called experts say with true scientific research and studies that we have read ourselves.
This means the study or research must have all the parts to a scientific experiment or research project. Which will include how often each result was duplicated; what controls were used; what variables occurred, etc. Think in terms of a result along the lines of “once per 100,000” or similar.
Let’s take medication stability or shelf life as an example:
- What format is the medication? Pill, powder, liquid, gel, cream
- What fillers and binders are used?
- What active ingredients are there?
- What was the manufacture process?
- What is the packaging and shipping process?
- What environments were all the individual ingredients shipped and stored in prior to and after manufacture? (Including our own homes)
Each of these questions will affect the stability or shelf-life of that particular medication; ie: its potency and safety.
Now if we don’t have any mainstream, traditional or alternative medical experts available when we are injured or sick, we have to be able to rely on our own accumulated knowledge and resources that we have on hand at that time. This is where most of us will fall short.
Not only will most of us be unable to distinguish various symptoms with their corresponding illnesses, we haven’t the foggiest idea how to go about treating these illnesses. Yet alone how or have the equipment to test blood, etc to be sure this is indeed the illness we are thinking we need to treat.
Case in point: A severe sinus infection. These can be caused by bacteria or a virus. Without a culture or test, we cannot be sure which the root cause of the infection is. So if our infection is viral, treating with an antibiotic will not work and will in the process give what bacteria that may be present, a resistance factor to the antibiotic we take.
So, we may know that antibiotics will work against a bacterial infection and not a viral infection. However we lack the knowledge and training to know which antibiotic in what dosage will best treat the infection.
We may also know that most antibiotics need to be taken for 10 full days (240 hours) to eradicate most bacterial infections, but we don’t have the testing equipment to validate the duration or dose of the treatment to be sure we have indeed killed the infection and not created a bacteria that will become resistant to the antibiotic we used.
This poses a major dilemma for those of us that have some kind of major, long duration crisis that we are preparing for. I cannot stress enough this particular fact!!
Obviously the best way to prepare for this situation is prevention and secondly, to learn as much as we can on the various common infections, illnesses and injuries that may occur.
- At the very least we should take a Basic First Aid and CPR course. I would also recommend taking an Advanced First Aid or EMT course.
- Another thing we can do is to accumulate hard copy books on tried and true home treatments for colds, flu, infections and injuries – then reading them and even practicing the treatments.
- Keep a healthy house, yard and lifestyle
This means we have to be as physically fit as possible and we need to stay as current as possible with all our immunizations too.
Look, I understand that staying physically fit is time consuming and to me rather boring, however there are some cheap and easy ways to accomplish this and the payoffs are priceless.
- Instead of sitting down after a meal take a walk around your block or office building.
- Do calisthenics if aerobic exercise is outside your capability. This will at least keep your muscles in shape.
- Take the stairs instead of the elevator, at least for a floor or two.
- Park away from the entrance to the store, theater or mall, so you have to walk.
- Use ankle and wrist weights when you clean house, do yard work or when walking.
Besides physical fitness, we Preppers need to step things up a bit when comes to living a healthy life and utilizing health wise practices. This will include common sense house and yard practices as well as keeping our immunizations current.
- Keep your hands clean!
- Cover your mouth and nose if you cough or sneeze.
- Take care of cuts, scratches and wounds.
- Keep your skin healthy.
- If you are sick, avoid close contact with others.
- Practice good hygiene at the gym and work.
- Keep exercise equipment clean.
- Clean and Disinfect! Particularly the kitchen and bathrooms
- Handle Food Safely.
- Don’t over-use antibiotics!
- Keep Pets Healthy.
- Stay Away From Wild Animals! Wild
- Keep the Home Dry.
- Keep the Home Clean.
- Keep the Home Pest-Free.
- Keep the Home Ventilated.
- Keep the Home Safe.
- Keep the Home Contaminant-Free.
- Internal and external home systems should be inspected regularly to ensure they are functioning properly.
- Dental/Oral Hygiene
- Physical Fitness & Health
Like just about everything in life, including medications (both over the counter and prescription) have a shelf life or where medication is concerned stability life. And as with food, the storage environment is critical to the longevity of the product. For medications we need:
- a cool, even temperature (no more than a 10 degree change in a 20 hour period) between 45 & 70 degrees
- it needs to be dry
- should be low light (sunlight is very destructive to just anything you are storing)
- the area should be as insect and rodent proof/free as possible.
When electricity is not available, you can keep things cool by utilizing two storage vessels:
- The inner vessel should be somewhat porous, preferably terra cotta or unsealed ceramic. Place the smaller vessel inside the larger one
- Fill the space in between the two with sand or absorbent soil.
- Wet the soil.
- Place what you want to keep cool inside the smaller vessel.
- Cover/seal the inner vessel and then the outer one.
- Store the vessels in as shaded and cool place as you can find, like a root cellar.
This will work for food items as well as medications. To keep things cool, add water as needed to keep the insulating soil layer moist.
RX Expiration & Use By Dates bottom line:
The date does not necessarily mean that the drug is unstable or ineffective after the expiration date; it just means that the product will, for sure, be stable and viable until the expiration date – provided it was transported and stored properly. Most drug products have an expiration date that’s 1 – 5 years from the date of production. That said, once you open the product up, all bets are off - the expiration date no longer applies and a 1 year Use By date is applied.
What about the stability of Herbal medicines?
Not much is really known about the stability of herbal products. Natural medicines often suffer physical instability due things such as the presence of impurities, reactions with the container, or growth of microorganisms on the material. Furthermore, some of the products are volatile, which means that their potency decreases with storage. For example, according to detailed descriptions from historical texts, the potency of products such as foxglove (digitalis) deteriorated after a number of months even when the preparations were kept hermetically sealed. In addition, there are the ever present ‘genetic variability’ of the plant itself that can create all sorts of variability in the product. Light, enzymatic reactions, chemical reactions, temperature and moisture also degrade plants.
And as with all items, environmental conditions, manufacturing and shipping processes, as well as storage environment can degrade different products at different rates.
Building Personal Medication Stores
The trick with any consumable in your preparedness stores is to be sure you do not acquire the full amount you want on hand - all at the same time. This is because just about everything has a shelf-life, so if you get all your medications at the same time, they will expire and become ineffective at the same time. We want to spread this out a bit to cover a longer timeframe.
It pays here to purchase items at intervals, in small quantities, to achieve the desired amount. So instead of purchasing that 500 count bottle of Ibruprofen at the warehouse store, purchase one or two of the smaller 20-50 count bottles every other week or so.
This will pay off in another way in that you will have a smaller amount of the medication exposed to the outside world at any given time – meaning less chance of contamination.
The second trick is to be sure to rotate the medications so that you are always storing the most viable amount.
So in your non-SHTF life when you need Ibruprofen, open the oldest bottle in your preparedness stores for your everyday use and then add another bottle to your shopping list to replace it in your preparedness stores.
The next trick is of course your storage environment and in some ways this is even more important for medications than it is for food. This is so important and essential that I will repeat myself here:
- Cool even temperature (between 45-70 degrees, with no more than a 10 degree change in any 20 hours)
- Low light, as sunlight degrades just about everything.
- Low humidity and moisture
- As insect and rodent free/proof as possible
Most vitamins, food supplements, medications and antibiotics can be preserved by refrigeration, as long as they are kept dry and in an air tight container. Don’t freeze them, though! That can permanently alter their chemical composition and they might not work anymore.
If traveling through extreme temperatures, these medications, especially antibiotics, should be encased in Styrofoam containers, at best and efforts should be made to avoid heat or freezing cold.
The third trick is to determine what you may need. This sounds easy but I can assure you it is not.
- Consider what you have on hand in your home at any given time. You will want these items for sure.
- Consider what you have purchased in the last 5 years for those pesky ‘once in a while’ things.
- I highly recommend an ‘expedition’ type medical kit. You can find really good ones at very reasonable prices at campmor.com. These are things like a military medic kit. They are beyond a first aid kit in that they usually have sutures, splints, compresses and the like. (check out First Aid Kits-Lightweight & Basic Comprehensive Care by REI )
- Make a list of all prescription drugs used in the last 5 years and how often they were used. If you find you are utilizing some every few years or so, be sure to have that in your preparedness stores. If you use a prescription on a daily basis, well this is a given that you need this in your stores.
- Dental First Aid – get a dental first aid kit that contains emergency temporary fillings and caps or crowns. You may also want to get an Emergency Dental Treatment kit which will contain tools needed for cleaning a cavity and pulling a tooth as well as a topical numbing agent. Again, campmor.com is a good place to find these.
Most prescriptions are sold in 30-90 day supplies with a limited amount of refills before you need to see your physician again.
Some HMO’s will only allow a 30 day prescription before a new scrip is needed. To get around this you may have to purchase some at your own expense instead of utilizing the discounted HMO co-pay.
Talk to your physician. Tell him you are going to be traveling extensively (for your job or retirement, etc) and would like either a 90 day scrip; an extra ‘emergency’ scrip or some kind of script that can be filled any time in the next year. Also, tell him you want to avoid the usual ‘travel diarrhea’ and you want something like Tamiflu and Z-Packs for any potential viral infection you might acquire while traveling abroad.
Then be sure you travel to another state and fill the script without using your insurance. If the pharmacist asks for your insurance, just tell them that you have coverage where you pay up front and then send in the receipt for reimbursement and would like a second receipt so you have one for your records.
Not using your insurance and filling a script out of town or out of state, will throw off the federal digital tracking of your prescription. If you utilize the same chain pharmacy each time, your prescription will still be digitally tracked by the corporate pharmacy, even if you don’t use your insurance. So when paying out of pocket, stay away from the chain pharmacies and utilize a smaller local one in the town or state you have traveled to.
Things are a bit sticky when purchasing prescription medications without a prescription. There are currently four ways to purchase medications without first obtaining a prescription:
- Drive to Mexico or (for some meds) Canada
- Buy them online (ww2.SurvivingHealthy.com is a great website where you can purchase antibiotics securely online without using a prescription.)
- Buy them in an ethnic market
- Buy them in a pet store or via a pet web site like PetMeds
Note: If you purchase medications online from a foreign country: Most pharmacies located in a foreign country are willing to sell drugs and ship them as long as the drugs are legal to sell in the foreign country. There are a few problems with buying drugs from a foreign county such as the quality of the antibiotics, and counterfeit drugs.
- The manufacture, packaging, transportation and storage procedures and environment greatly (I stress this) affect the stability (shelf) life of the medication.
- The format the medication is in (pill, powder, cream, gel, liquid) will affect the stability life of the medication.
- Each active ingredient has its own stability or shelf life that affects the overall stability of the medication as a whole.
- Each filler or binder ingredient has its own stability or shelf life that affects the overall stability of the medication as a whole.
- Some medications require refrigeration to stay viable for any length of time.
- Some medications like Tetracycline become dangerous as they break down or pass their stability life. Never use these medications past their expiration date.
Then there are the lay usage considerations of utilizing prescriptions without the guidance of a healthcare professional:
- The lay user or dispenser must be sure they are using the correct medication for the correct illness.
- The user or dispenser must know all the appropriate and proper uses and side effects of the medication.
- Some prescription medications can mask or hinder diagnoses if taken before you go to a healthcare professional.
- Many medications can cause allergic reactions, some may be life threatening.
- Many medications cannot be taken with certain foods, beverages or other drugs (even OTC) without causing potential hazardous side effects.
That being said, if you do plan on storing these medications, have a pharmaceutical or drug guide on hand to ensure that correct medicines and dosages are given. Used copies of the reference can be purchased at college book stores at a discounted price.
Antibiotics are a biggie where a long duration crisis takes out our current healthcare infrastructure, which is why Preppers often want some antibiotics in their medicine stores. Antibiotics are also one of the trickier and rather picky common prescription medication.
Typically, bacteria are classified either "Gram-positive" or "Gram-negative" due to their structure and staining characteristics, which reflect their susceptibility to certain antibiotics.
The Penicillin family of antibiotics has been effective against Gram-positive infections. Alternatively, the Tetracyclines have been used successfully to combat Gram-negative agents.
Side Note: Penicillin cannot be easily made from bread mold. It is the secretion of a particular kind of mold that is penicillin. In 1928 Scottish biologist Sir Alexander Fleming noticed a halo of inhibition of bacterial growth around a contaminant blue-green mold on a Staphylococcus plate culture. He concluded that the mold was releasing a substance that was inhibiting bacterial growth. He grew a pure culture of the mold and discovered that it was Penicillium notatum. With help from a chemist, he concentrated what he later named "penicillin". During the next twelve years, he grew and distributed the original mold, unsuccessfully trying to get help from any chemist that had enough skill to make a stable form of it, for mass production.
Certain antibiotics should not be mixed with other drugs, foods or alcohol. For instance, drinking grapefruit juice with erythromycins or taking erythromycin with theophylline (a drug used for respiratory ailments) can cause fatal heart arrhythmias. There are many other interactions that doctors know about that the layperson does not.
Keep in mind that when antibiotics are used to treat an infection, the “good” bacteria in the large intestine may also be destroyed as a result. Therefore, consider investing in some probiotics to help restore the microbial balance that is disrupted by antibiotics and infections. Probiotics are usually sold in the vitamin section of most pharmacies as well as in health food stores. They can be stored along wtih your vitamins in your reserve supplies.
- Antibiotics are not a cure-all, nor the first line of defense. They are only effective to against bacterial illnesses. They are not effective against viral illnesses.
- Antibiotics are designed to combat specific ailments. For instance, penicillins (a family of drugs with names ending in "-cillin" such as penicillin, amoxicillin, ampicillin) are effective against streptococcal infections, syphilis, and Lyme disease but for community-acquired pneumonia, bacterial diarrhea, mycoplasmal infections or gonorrhea you would be better off using a quinolone (a family of drugs with names ending in "-oxacin such as levofloxacin (Levaquin) or Ciprofloxacin (Cipro).
- Antibiotics are designed to be used at a specific dosage level for each individual bacterial infection AND for over a very specific timeframe, usually 10 days.
- Safe and effective antibiotic dosages depend on accurate weights and measurements.
- Some Antibiotics may cause potentially fatal reactions (e.g., allergy, asthma, and death) or other medical issues.
- Antibiotics can prompt greater growth, development, and spread of resistant pathogens such as fungi and Mycoplasma prompting more severe or alternative infections.
- The antibiotics may not work due to being past their expiration, from improper storage, from the wrong dosage administered or from your body building up an immunity.
- Antibiotics can also exacerbate an issue by destroying the good bacteria in the body. Investing in some probiotics can help restore the good stuff though.
- Antibiotic usage can make it more difficult for physicians to diagnose life-threatening infectious illnesses. Thus, self-medication is not advised under normal circumstances of medical personnel availability.
- A doctor is an expert in knowing which antibiotic to use for specific ailments. If an untrained person uses the wrong antibiotic his condition may get worse and he may wind up in the hospital and this person may inadvertently create a secondary infection that is now resistant to the antibiotic that was used in error.
- A pharmacist explains that it is a bad idea for people to take veterinary medicines but that chemically the drugs are the same as what you would be prescribed by a doctor and purchase in a pharmacy. Amoxicillin, ampicillin, tetracycline, cephalexin, metronidazole and erthromycin are all available online to purchase without a prescription if you buy them as "fish antibiotics". (A pharmacist visited numerous pet stores and located most of those antibiotics in the stores, although they were in liquid gel drops or powders. These antibiotics were available in pill form from the chain pet store's websites.)
Side Bar: Antibiotic Resistance
The headlines in both alternative and mainstream media are all ablaze on this subject. Understand that nature is full of “Humans are NOT in Control” exceptions to just about every rule. This means that it is highly likely for a bacteria to become resistant to certain antibiotics. We saw this during all the US military wars and confrontations with Penicillin resistant STD’s.
Next keep in mind two very important facts:
- The timeframe it takes a bacterium to become resistant can be very quick, since their lifespans are quick.
- Bacteria travel from host to host very easily.
When you put these two things together you have a very good, if somewhat iffy, chance of spreading a bacteria that either is already resistant or is quickly becoming resistant. This means that although you may not get horribly ill from the bacteria, your misuse of an antibiotic, is added onto the previous misuse of the antibiotic, so that the next person to get infected is at risk that one or more antibiotics will NOT work.
That said, how you decide to use antibiotics is a personal choice, yet one that can affect everyone around you. How you gamble on this fact, is up to you.
Common Usages of Antibiotics
According to the Patriot Nurse, the five most popular types of antibiotics (including their generics) are:
- Zithromax – UTIs, URIs, Sepsis (used in an IV), STDs, and ear infections.
- Ampicillin – This a more broad spectrum antibiotic that treats skin infections, STDs, Sepsis and ear infections.
- Cipro – This antibiotic has a lot of toxicity issues and should be taken sparingly. Can be used for UTIs, infectious diarrhea, bone and joint infections.
- Amoxicillin – This is a very popular antibiotic used in upper respiratory, ear, nose and throat infections, and teeth abscesses.
- Doxycycline - An effective antibiotic used for malaria, and Rocky Mountain Spotted Fever.
She also suggests Clindamyacin, Flagyl and Bactrim as some back-ups to the aforementioned.
The number of pills per bottle range from 30 to 100 pills, and they tend to be a lot cheaper than the pills designed for human consumption. Even though some of them could be counterfeit, the chances are highly unlikely since drugs made for human use are far more profitable for the counterfeiters to sell.
Although it is true that many fish antibiotics contain the same active ingredients as those formulated for humans, there are few considerations to keep in mind, such as;
- Using the correct dosage so as to not over or under medicate yourself
- The differences in human metabolism vs. the metabolism rate of a fish.
- It doesn’t contain any additional ‘treatments’ like say to make the scales shinny.
There are several kinds of fish antibiotics that you could add to your preparedness medical stores. Those listed most often are covered in detail in an article on Survival Blog, (A Doctor's Thoughts on Antibiotics, Expiration Dates, and TEOTWAWKI) the contributing author, happens to be a doctor and was able to purchase the below fish antibiotics online without any demand for medical license or prescription.
If you decide to add these to your preparedness stores you should also add a book or two that will assist in diagnosing the problem, explain what the different drugs are for, their dosages, duration and what the side effects will likely be.
Everyone needs know what we can and can’t eat while taking these medications to avoid dangerous interactions. And then, only when one is very certain that antibiotics will help, should anyone take them. Also remember to keep a close eye on the expiration dates since most lose their effectiveness with time and a few, such as tetracycline, can become dangerous past the expiration date.
I’ve already mentioned that we citizens don’t have the knowledge or skills to completely address emergency healthcare. It would be nice if each and every one of us has the knowledge, ways and means to have a good 3 bed field hospital, with a complete lab, however that is dreaming. So what considerations should we include in our preparedness plan beyond an extended first aid kit and some basic training?
Well the goods are almost unlimited, however to get a strong sense of what an extended ‘first aid’ medical kit can be, download and print The Survival Doctor’s Ultimate Emergency Medical Supplies List.
For a comprehensive checklist on emergency first aid kits see What is the Difference Between All the E-Kits and Bags & What Do I Need? and Preparedness Bags Checklist Compare, the first aid tab (Excel format).
Definitely contact your local Red Cross and take their basic and advanced First Aid and CPR courses. If you can form a neighborhood C.E.R.T. group, their first aid and Emergency Triage courses are a big plus.
Otherwise, a strong reality check and plain old common sense will serve you for most things. Remember, even the most healthy of us can have an accident or befall some other personal health related emergency that may be more life threatening in a SHTF world than the here and now, and most of us will NOT be able to do a darn thing about it.
Case in point: Recently I experienced a quick onset, severe illness. I had pneumonia, without a fever or chest pains, mostly just a cough with a general tiredness that progressed to where I couldn’t keep fluids or foods down. In a very short timeframe (under 48 hours) it went sepsis (blood poisoning) and then (probably due to my many allergies) went toxic shock. Basically if had not had extensive medical treatment when I did, I would have died in 24 hours. So I would have been SOL without equipped, knowledgeable, trained medical personnel and supplies.
Reality most often sucks, but it is just that – reality! Better to be as physically fit and healthy, with a firm understanding of SHTF limitations – NOW, than get blindsided by the consequences latter.
For detailed information, examples and resources download the full article Staying Healthy Without the Healthcare Infrastructure