Medication Dependence and TEOTWAWKI — 10 Tips for Survival, by Cynthia J. Koelker, MD

Thyroid disease, diabetes, heart disease, back pain, asthma, COPD.
If you suffer from any of these chronic illnesses, you may be medication dependent.  What will you do when the supply of pharmaceuticals dries up?  Do you have enough medication stockpiled for the rest of your life?  What are the consequences of doing without?  Will you die or merely suffer?  Is there any way to prevent what appears to be inevitable?
And if not you, what about your parents, grandparents, and other loved ones?
Although complete answers to these questions would require hundreds of pages and perhaps years of study, here are 10 tips to help medication dependent persons survive TEOTWAWKI.

  1. Understand what your medications are actually accomplishing for your disease and the consequences of doing without. In my experience, few patients understand the physiology of their particular disease and the purpose of their medicine.  If you are on heart medicine, ask your doctor why.  Is it to control the heart rate or make the heart pump stronger?  Is it meant to limit chest pain or decrease the likelihood of a heart attack?  If a certain medicine is unavailable, is there an older (less expensive) generic?  Will you likely die without nitroglycerin? For COPD patients, will you suffocate without your inhalers? Diabetics, will you dehydrate without insulin or metformin? For thyroid patients, without Synthroid will you develop a goiter?  Or will you grow sluggish, gain weight, and end up in a coma?  (For thyroid patients, these questions are answered in detail in my new self-study course “Hypothyroidism – Answers for the End of the World” . Armed with a better understanding of your disease, you’ll be better able to evaluate your options.
  2. Understand your treatment goals.  For the atrial fibrillation patient, do you understand why you’re on Coumadin rather than aspirin?  If you’re also on a beta-blocker, do you know why?  As a heart patient, what is the purpose of your nitroglycerin patch?  Is avoiding chest pain the same as avoiding a heart attack?  For diabetics, what is your current goal of therapy?  How will this change when home blood sugar monitoring is unavailable?  Is the aim of thyroid replacement therapy to lower your TSH or make you feel better?  Are pain meds to help your back feel better or allow you to work harder? Ask your doctor the specific purpose of each medication you’re taking.  Just knowing “it’s for my heart” isn’t enough to plan your future.
  3. Research treatment options beyond pharmaceuticals and try them out now.  It amazes me when an asthmatic chooses to sleep with their cat and wheeze, rather than ban the cat and breathe.  If medication weren’t available to open the airways, would they make the same choice?  Or, if you’re allergic to the world and can’t escape, would rinsing your nose with saline work as well as medicine?  It often does.  Or, ever wonder if eating half as much would cure your diabetes?  (If you don’t find out now, you may when the food’s gone.) Can’t live without Prilosec?  GERD (acid reflux) would be markedly reduced if people would elevate the head of their bed, eat less, limit spicy, fatty, and acid foods, and avoid alcohol and tobacco.  Narcotics aren’t the only option for a bad back.  Heat, exercise, and massage can work wonders in a motivated patient.  Medicine is not the answer for everything, though it often seems simpler to pop a pill than to make lifestyle changes.
  4. Research over-the-counter alternatives to the prescription medication you’re on now.  OTC drugs can be stockpiled much more easily than prescription drugs.  Excellent OTC meds that could easily be substituted for certain prescription medications include Prilosec OTC, Prevacid, ranitidine, topical antifungals, meclizine, Azo, naproxen sodium, ibuprofen, cetirizine, diphenhydramine, bacitracin, and pseudoephedrine, among others.  Asthmatics may want to purchase Primatene Mist (which may be unavailable after 12/31/11) for emergency use in case their albuterol runs out.  Anyone taking Plavix should have a back-up supply of aspirin. Don’t forget to ask your physician if an OTC might substitute for your prescription medication.
  5. Consider substituting an older drug for a newer medication too expensive to stockpile.  Since your insurance will not cover medications beyond three months in advance, how will you afford them (assuming your doctor is willing to prescribe them)? Many of these drugs are $200 a month, which most people find unaffordable.  Though not every drug has a $4/month alternative, many of them do so, or at least a generic form that doesn’t cost an arm and a leg.
  6. Ask your doctor about vaccines that may improve your condition or prevent future problems.  Anyone with a heart, lung, or immune problem should certainly have a pneumonia vaccine and the newer TDAP vaccine, which includes a booster for pertussis (whooping cough).  Though the annual flu vaccine is aimed at the current year’s expected strain, there is also a cumulative effect, so receiving the vaccine annually may help not only in the short run, but in the long run as well.  Consider vaccines to hepatitis A and B if you haven’t yet had them. Also, make sure your family is up-to-date on their own immunizations, for their personal protection as well as your own.  Infections uncommon today will re-emerge when the number of unvaccinated individuals increases.   
  7. Seek a permanent remedy now if one is available.  Atrial fibrillation patients may want to consider radioablation.  Spinal stenosis sufferers may choose to undergo surgery now, while it is an option.  It only makes sense for every asthma and COPD patient to quit smoking immediately.  Hyperthyroid patients may want to consider surgery or radioactive iodine treatment sooner rather than later.  Physical therapy (or manipulation under anesthesia) may resolve a frozen shoulder that otherwise might plague you the rest of your life.  Allergy desensitization shots may enable you to get off allergy or asthma medications altogether. If you suffer from any chronic condition, ask your doctor if a cure exists, no matter how involved.
  8. Acquire supplies you may need in the future.  A COPD patient should consider purchasing a nebulizer.  An arthritis or back pain sufferer may be wise to find a used wheelchair or walker.  A diabetic may want to buy additional needles and lancets for future use.  Think about your environment and what accommodations you would need if electricity, heat, light, or running water were unavailable.
  9. Try a dry run.  Ask your physician if it would be safe for you to do without your medication while being monitored medically.  Do not try this on your own!  As a COPD patient, do you really need three inhalers, or would a single inhaler work as well?  If so, which one? Can you monitor yourself using a peak flow meter? As a heart patient, will you develop chest pain or become short of breath without nitroglycerin? For back pain or arthritis patients, since doctors won’t prescribe a lifetime supply of narcotics, can you get off them now or try an alternate therapy?  For thyroid patients, will your TSH climb 10 points or 100 if you discontinue your medication? Don’t try this experiment without your doctor’s approval and understanding, but do express your concerns.  The doctors I know don’t envision the world as a permanently stable environment.  Your questions may take additional time with your physician, so make the receptionist aware when you schedule.  Please don’t tack these questions on as your doctor is heading for the door.  Your doctor will feel rushed and the questions won’t receive the attention they deserve.
  10. Consult with a fellow prepper health professional, or perhaps a seasoned physician.  Treatments come and go, and newer is not always better.  Older treatments (such as Armour thyroid) do work, but may require a modified approach for optimum treatment.  Switching now, when monitoring is readily available, may be easier than later, when guesswork will replace laboratory testing. Younger doctors may have head knowledge but no practical knowledge of older treatments.  A retired physician may be a gold mine of information.