Seven Secrets of Medical Prepping, by Cynthia J. Koelker, MD

Someone once commented that my book held no “secrets” to medical prepping, that everything in the book could be found elsewhere. I’d have to agree, but it would take you hundreds of hours to compile the information. My experience has taught me to be cautious of secrets. Don’t they usually just cause trouble? Nothing in medicine should be secret, anyway. In fact, the subtitle to my Survival Medicine courses is “Taking the Mystery Out of Medicine.” Still, “secrets” can be fun, and what follows are seven “secrets” you should know, if you don’t already:

  1. Out-dated drugs aren’t actually expired. Drug “expiration dates” are comparable to “best if used by” dates. Medications are tested to prove they are safe for a documented period of time, but this says nothing about safety or efficacy beyond the test date. When stored according to manufacturer directions, pills, tablets, and dry powders are likely safe and effective for years beyond their printed expiration dates. (The Shelf Life Extension Program has confirmed this for many drugs, including several antibiotics.) However, out-dated liquid medications are significantly less likely to remain stable, and therefore should be used with caution.
  2. Fish antibiotics are the same as human antibiotics. At least in many cases this is true. Keep in mind that fish antibiotics are legally sold OTC for aquarium use, not for human ingestion. However, if you’re going to go the fish antibiotic route, make sure you find a source where you can confirm the drugs are USP grade, AB-rated generics. Ideally, the seller would provide images of these medications showing their imprint numbers, which then can be double-checked against a pill-finder, several of which are available online. However, I again recommend that you develop a strong, trusting relationship with your personal physician and work with him or her to obtain an emergency supply of recommended antibiotics (which I’ve addressed in earlier articles).
  3. Laymen can learn to suture as well as professionals. Having taught suturing classes over the last few years, I have concluded that the layman can learn to suture as well as a professional, at least when it comes to straightforward lacerations, such as those seen daily in Urgent Care Centers. If you’d like to learn, perhaps a local physician, dentist, PA, nurse practitioner, or midwife would be willing to assist. There are also a handful of schools for preppers, missionaries, and crisis workers scattered across the country which you could attend.
  4. OTC drugs are as strong as prescription drugs. Why don’t people believe this? I think it’s largely because when the average person visits a physician, they want something “better” than they could have procured on their own, thus making the trip to the doctor “worthwhile.” However, readers of SurvivalBlog are above average, and should educate themselves regarding the amazing array of potent medications that have changed status in recent years from prescription to over-the-counter. Some of my favorites include: ibuprofen, naproxen, Zantac, Pepcid, Prilosec, Prevacid, Claritin, Allegra, Zyrtec, Monistat, Lotrimin, Lamisil, and most recently Nasacort. Older essential OTC drugs include insulin, aspirin, gentian violet, Primatene Mist (now replaced with Asthmanefrin), Benadryl, Bonine, and Dramamine, as well as several others. Knowing when and how to use these is the next step.
  5. Many medicines don’t work most of the time. In many situations, drugs offer little or no benefit over “tincture of time.” Many illnesses that are often treated with medicine would resolve on their own, given a little more time (than impatient Americans allow). For example, using antibiotics to treat sinus infections offers almost no benefit, even among patients with X-ray-proven sinusitis (93% chance of no benefit). The answer is similar for adults with middle ear infections (but young children do benefit). Is saline irrigation better for preventing infections in wounds than simple tap water? Maybe for one patient in 36. Do prophylactic antibiotics help prevent infection in people with animal bites but no sign of infection yet? No. Do topical antibiotics help pink eye? Maybe; about one in seven patients gets well faster. Does aspirin help prevent a first heart attack or stroke in healthy people? One in 1667 will benefit. Check out and search for your favorite problem or disease. The “number needed to treat” along with “number needed to harm” are interesting concepts introduced into medical research in the past decade or so. If a doctor gave you a drug and told you, “When I treat ten patients with this medicine, I’ll help on average only one,” would you take it? Even knowing these statistics, doctors use medicines that offer little value simply because patients want something. These numbers are not meant to depress you but rather to allow you to conserve your limited supply of drugs for serious problems.
  6. Neither drugs nor doctors actually cure anyone. The best a doctor or medicine can do is to optimize the environment to allow the God-given healing process to occur. Antibiotics don’t cure anyone directly, they just (hopefully) kill enough germs to allow your immune system to take care of the rest. AIDS patients don’t die of HIV, they die of diseases their own immune systems cannot overcome, regardless of how many antibiotics doctors prescribe. Surgeons don’t cure appendicitis; they just remove the infection to allow the body to heal itself. The closest to a cure doctors can achieve is by recommending something your body actually lacks, such as Vitamin C that can “cure” scurvy. However, this is actually just providing your body with the building blocks it needs to function, in the same sense that food “cures” starvation, at least for awhile. How can this help you? My main point is to relieve you from worry. Not that you don’t want to optimize the healing environment by eating a balanced diet, observing good hygiene, brushing your teeth, et cetera. Do what you can, and then thank the Great Physician for His healing touch.
  7. You can be better prepared than a physician to care for your own health. In truth there are no secrets of medical prepping. The information explosion has made all the health information available to doctors available to you as well. While there’s still time, educate yourself for free online, and buy an assortment of primary care textbooks. Also, whereas doctors do have a great deal of medical education and experience, very few are doing any sort of preparation for a rainy day or TEOTWAWKI. Even if you don’t have the confidence to provide medical care, you can acquire the tools, medications, and instruments for someone with training to use. Invest a few hundred dollars in common medical items to equip a small clinic (stethoscope, pen light, otoscope, syringes, suture material, plaster, OTC medications, bandages, splints, dressings, et cetera.)

So there you have it. The cat is out of the box. You know all my secrets. (Well, actually I do know a few more that I don’t put in writing, in order to protect all of us. However, if and when you meet me in person, feel free to ask.) For further information on the above topics and many more, visit my web site at, where you can also register for upcoming Survival Medicine Workshops.