Letter Re: TEOTWAWKI Medicine and Minor Surgery

In general, [the recent medical articles are] great stuff to have on your web site. However, it is really best for trained and knowledgeable medical and paramedical people to get involved in medical and surgical issues rather than looking at these as Do-It-Yourself projects! With all due respect to your many readers with far greater mechanical intelligence than I have, the Almighty engineered the body and sustains it in a more complicated manner (beyond human comprehension) than the best human conceived and built retreat plan!

As soon as you finish a course of antibiotics, drink yogurt, (fermented) buttermilk, or kefir a few times a day for a few days to replenish good bacteria in your guts and prevent the likelihood of getting an antibiotic-associated diarrhea.

Please make sure a patient is not allergic to the antibiotic being considered or a related antibiotic (any Penicillin allergic patients is allergic to all the similar drugs (e.g, Augmentin, amoxicillin, ampicillin, dicloxacillin, etc). About 10% of patients with a real drug allergy to a penicillin will be cross allergic to any cephalsporin class antibiotic such as Keflex (cephalexin), cephadroxil, cefdinir, Cefzil (cefprozil), etc. I highly recommend people with serious allergies to any of these drugs print out from a Google search (or copy from a medical text) all the drugs in the class every couple of years because new ones are constantly being introduced into medicine.

Without getting too technical the penicillin and cephalosprin class drugs all share a chemical structure called a beta lactam ring. If you are allergic to any of these antibiotics, ask your doctor if you should be considered allergic to other and even all beta lactams. The beta lactam-containing antibiotics are even more broad than just penicillin-type antibiotics and cephalasporins and also include very potent and broad-spectrum activity non penicillin and non cephalosporin antibiotics such as Primaxin (imipenem) other "penems" and aztreonam (all are injection only drugs at this time).

Also use of Cleocin (clindamycin) is very significantly associated with a diarrhea that may prove fatal if the specific toxin that causes this "pseudomembranous colitis diarrhea" is not quickly neutralized with either oral vancomycin or Flagyl (metronidazole), very different types of antibiotics that kill the Clostridium difficile bacterial overgrowth germ that produces the toxin. In fact, use of any antibiotic or anticancer drug may result in this type of serious diarrhea that needs this specific treatment. But this complication is particularly associated with use of clindamycin (even short exposures) and more than 10 day courses of all other antibiotics.

It is best to treat cellulitis and indeed any minor skin infection, with warm soaks several times a day, before resorting to use of antibiotics and surgical incision to drain pus and look for a foreign body. Packing material, if needed, can also be made of any wick shaped piece of clean latex to temporarily drain pus and other fluids. As long as there is no latex (rubber) allergy, one may improvise to use a clean and rinsed of powder residue strip from a latex glove, unlubricated condom, or even a balloon. Change the packing material daily. When drainage of fluid from the wound slows, usually only takes 1-3 days, let the wound close on its own after irrigating it with warm sterile (requires vigorous boil for 10 min) water or packaged sterile saline solution.

Pharmacists are also great resources for their knowledge of drug side effects and allergy-related issues. Diabetics or people taking steroids (such as for asthma, bronchitis, lupus and other rheumatologic diseases, etc), should expect their blood sugars to go very high when they experience infections and understand that their bodies are less capable of fighting infections.

Bottom line: people with medical skills and knowledge and those with mechanical and gardening knowledge, etc. need to band together and help each other out when the situation calls for more than a few band aids, an epoxy repair, and growing a few veggies for supplemental fresh produce in the summer. – Yorrie in Pennsylvania (a retired physician)