Four Letters Re: Extended Care of the Chronically Ill in TEOTWAWKI

Jim,
One more suggestion (maybe it has been made already and I missed it) is that everybody should get up to date on their tetanus shots right now. If things get difficult, it would not be hard to imagine getting cut/puncture wounds in all sorts of ways, from all sorts of things in all sorts of circumstances. And these shots are good for 10 years, so you’re covered for a while. – Mike in Seattle

 

Jim,
Pfizer announced that they will no longer make Exubera, the inhaled insulin powder due to massive marketing failures. Its a good product but cost didn’t justify its marketing cost, and slow acceptance in the market. It does have a better shelf life than regular injectable insulin, i.e. no refrigerator needed. Those diabetics may want to grab up the existing supply to have at least a month of two available in a short term crunch to get by. What is out there is still available in the pipeline, but no further will be made, for now. I’m sure another company will reintroduce the idea some time in the future.
Here is a very interesting article that was produced by the military in 2002, titled “Antibiotics in tactical combat casualty care, 2002”. It discusses use of antibiotics in prophylaxis in trauma care. In 2002 they selected travofloxacin, unfortunately it was pulled from the market, but moxifloacin would make a good alternative. Brand name is Avelox. Bayer, the manufacturer, has free coupons for a 10 day supply available at your doctor’s office until the end of the year. – Mike MD in Missouri

 

Hi Jim –
I’m a new reader and excited I might be able to contribute to the discussion on your board. I work for a large health organization and in regards to dialysis and the need for renal failure patients to get dialysis, there is a new option.
One of the semi-new things going on is the evolution of “Dialysis at Home”. This is in-home dialysis treatment with smaller, table-top machines about the size of a large microwave. Some are totally portable i.e. can be rolled around in a special suitcase. It’s not exactly “new”. We’ve been training people to do it for over 30 years in our largest metropolitan Los Angeles hospital but it’s not really widespread among other organizations (I think). Many organizations are not able to spare the medical staff or don’t have the in-house expertise or don’t have the capital to develop this function or don’t have the buy-in of the medical staff or they just plain don’t know about it. It’s semi-cutting edge but I don’t think that should be a deterrent for someone wanting to drive toward this – it’s very straight forward to perform. Perhaps an investigation and switch in health insurance towards one that provides this benefit / equipment / training might be warranted for some SurvivalBlog readers with renal issues? I wouldn’t be surprised if this is more widespread. Bottom-line this is more cost-effective for a organization than using a contracted Frenius dialysis center or an in-network hospital and provides better patient outcomes. Dialysis performed more frequently for shorter intervals (i.e. 5x/week) more emulates the true function of the kidney than traditional prolonged 3x/week treatment. It’s win-win for everyone.

Here’s one company whose machines we are currently using to train our patients with. Anyway, in a nutshell, the person with renal failure (and their care-givers/helpers) get trained on this device and once physicians are sure patients can perform procedures safely, -i.e. self-insertion of the needle, operation of the machine, etc., they are sent home with their new machine. Getting ramped up is a lengthy process however; our training program is a four week program where patients are seen by nephrologists, nurses and pharmacists every step of the way so it’s not like you can just buy this machine, mothball it and ‘learn-it’ after the SHTF. Also, some minor re-work of the home’s plumbing is required to hookup most devices but nothing major; the most exciting thing is that the newest machines coming out can supposedly run on plain tap water but I don’t have experience with them.
I think anyone can see the survival utility in dialysis that is man-portable, uses tap-water, provides a better “quality of life”, and is user controlled.
Best Regards – Special K in Los Angeles

 

Dear Jim:
With reference to the letter from Simple Country Doctor, a good source of medical knowledge is The Hesperian Foundation, where several “must have” TEOTWAWKI books (“Where There Is No Doctor”, “Where There Is No Dentist”, “A Book For Midwives”) plus several other titles can be either be purchased or downloaded for free.
There is also a web site, mostly for medical professionals, that specializes in remote, austere, wilderness and third world medicine.

A good place for training is Chuck Fenwick’s Medical Corps.

My personal opinion (born out over the course of raising six children) is that 80% of family medicine can be practiced by paramedics and LVNs, 90% can be practiced by RNs and PAs, and the last 10% is where folks need an MD. This opinion will undoubtedly not sit well with “Simple Country Doctor”, but in a true TEOTWAWKI situation, folks are going to have to deal with what they’ve got.
I’ve always wondered about “First Aid Kits” that include instruction booklets. I have this macabre mental picture of someone bleeding out on the floor while the first aid provider frantically thumbs through the instruction book. I guess my point here is that it’s not enough to download the books. You have to read and re-read, and reread them, especially if you don’t have a professional medical background.
I hope this information is of some help to you. J.P., EMT-A

JWR Replies: I concur on your recommendation for taking training from Medical Corps. I have heard from a half dozen SurvivalBlog readers that have attended, and they all reported that the training was top notch, and that it brought them to a considerably higher plateau of training–even those that were already fully qualified as EMTs!