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29 Comments

  1. Thank you for this article, and I look forward to reading the rest of it. Regarding the OTC section, how effective are these medicines past the “best use by” date? Would a one year supply with rotations be effective?

    Thanks everyone for the time to reply.

    1. I would follow the links that other folks tagged below.

      As for common OTC medications, I would stockpile what you think you might need in a WTSHTF situation, and then use them/resupply them in a FIFO order, hence always keeping some in fresh supply. Very few medications will become toxic with outdating, most will just become less efficacious.

      A trip to Costco or Sam’s Club could yield you all the major OTC’s you need to resupply a family unit for probably $50-100/year (using a FIFO plan above).

    2. I would follow the links that other folks tagged below.

      As for common OTC medications, I would stockpile what you think you might need in a WTSHTF situation, and then use them/resupply them in a FIFO order, hence always keeping some in fresh supply. Very few medications will become toxic with outdating, most will just become less efficacious.

      A trip to Costco or Sam’s Club could yield you all the major OTC’s you need to resupply a family unit for probably $50-100/year (using a FIFO plan above).

  2. Being a male of “a certain age,” prostate health is an important consideration. I knew someone with BPH, who had several instances where his urethra became pinched off and he couldn’t urinate. This caused very serious problems that required hospitalization. In a SHTF situation, would you, Dr. Dan, recommend having some catheters (and lube) on hand for such situations? I’ve never seen caths recommended as part of SHTF medical preps. Thank you.

    1. If you are not experienced with either self-cathing, or have someone with significant medical experience placing catheters in your prepping group, then I would discourage this. Catheter-related infections (bladder infections “UTI”, or worse, kidney infections “pyelonephritis”) can be devastating even in the best of times. They could be fatal in a WTSHTF event where you lacked the big-gun antibiotics to address these infections properly. Without proper training and sterile equipment, you will be very vulnerable to such infections.

      An alternative that I would recommend instead would involve:
      a.) See your PCP or a Urologist for evaluation. First and foremost, if you’re a male >50 you need screened regularly for prostate cancer, since it is quite often treatable with modern medical or surgical therapy. This visit might save your life!
      b.) If you are diagnosed with BPH (benign prostatic hypertrophy) as a cause of urinary issues (rather than prostate cancer), there are both medical and surgical options worth exploring. Instead of focusing on stockpiling catheters, I would recommend stockpiling either herbal or pharmaceutical remedies for BPH (such as Flomax).
      c.) If you desire a more permanent “fix” for your BPH, you may want to discuss the option of a TURP (transurethral resection of prostate) surgery with a Urologist. It is essentially a roto-rooter of the enlarged prostate, and may be an option to prevent this issue from occurring during a tenuous time.
      d.) Please remember that all of these treatments (both medical and surgical for prostate cancer or BPH) are available now while modern technology and medicine exists. These options will probably go away if a WTSHTF event occurs. I would encourage you to not delay in addressing them while we are able to take advantage of modern medicine.

      ** Please keep in mind I am an anesthesiologist, not a urologist, so I would encourage you to seek professional help from a specialist most knowledgeable on your particular condition. **

    2. If you are not experienced with either self-cathing, or have someone with significant medical experience placing catheters in your prepping group, then I would discourage this. Catheter-related infections (bladder infections “UTI”, or worse, kidney infections “pyelonephritis”) can be devastating even in the best of times. They could be fatal in a WTSHTF event where you lacked the big-gun antibiotics to address these infections properly. Without proper training and sterile equipment, you will be very vulnerable to such infections.

      An alternative that I would recommend instead would involve:
      a.) See your PCP or a Urologist for evaluation. First and foremost, if you’re a male >50 you need screened regularly for prostate cancer, since it is quite often treatable with modern medical or surgical therapy. This visit might save your life!
      b.) If you are diagnosed with BPH (benign prostatic hypertrophy) as a cause of urinary issues (rather than prostate cancer), there are both medical and surgical options worth exploring. Instead of focusing on stockpiling catheters, I would recommend stockpiling either herbal or pharmaceutical remedies for BPH (such as Flomax).
      c.) If you desire a more permanent “fix” for your BPH, you may want to discuss the option of a TURP (transurethral resection of prostate) surgery with a Urologist. It is essentially a roto-rooter of the enlarged prostate, and may be an option to prevent this issue from occurring during a tenuous time.
      d.) Please remember that all of these treatments (both medical and surgical for prostate cancer or BPH) are available now while modern technology and medicine exists. These options will probably go away if a WTSHTF event occurs. I would encourage you to not delay in addressing them while we are able to take advantage of modern medicine.

      ** Please keep in mind I am an anesthesiologist, not a urologist, so I would encourage you to seek professional help from a specialist most knowledgeable on your particular condition. **

  3. Insurers are unlikely to pay for “extra” prescriptions, so people must be prepared to pay cash. Most pharmacies are willing to work with customers to find ways to lower the cost of prescriptions (manufacturer coupons, rebates, generics, etc). You may also search online pharmacies.

    1. I recommend purchasing what you can from some retailers who have significant discounts on common prescriptions. For instance, Walmart has a $4/$10 Rx plan on a host of medications…price depends on the drug and the quantity (and 30 vs 90 day supply). Target, Meijer, and other retailers offer this as well in some form or another, mostly on generic/common Rx’s. It’s worth investigating.

      My wife practices emergency medicine, and they commonly refer patients to this, and will attempt to prescribe medications that fall on the discount lists. Many practitioners may be receptive to this request when they are Rx your BP, cholesterol, diabetes Rx if you take them a list from the retailers, so they can customize the Rx to this criteria.

    1. Tetanus vaccinations should be kept current for sure. The risk vs. reward ratio indicates this would be a sensible action to take. Ordinarily I don’t like the idea of big pharm vaccinations but in a SHTF situation there is likely to be much more contact with the outdoors, with dirt and rusty metal. We won’t always have the luxury of taking the time to be extra careful and injuries are sure to increase.

    2. If we were going anywhere unusual, the Navy used to vaccinate us for Typhoid and Yellow Fever. I have heard that Typhoid is making a comeback in some US cities so maybe it would be a good one. Have not heard much about yellow fever.

      Here is some information on the Typhoid vaccine. https://www.passporthealthusa.com/vaccinations/typhoid/

      Here is some information on the Yellow Fever vaccine.https://www.passporthealthusa.com/vaccinations/yellow-fever/

      I don’t remember which one of these it was, but one of them was not pleasant. Lots of us were moderately miserable after getting it.

    3. I am not in the pocket of Big Pharma, but I do think prevention is a lot better than trying to cure a potentially fatal disease, especially after a WTSHTF event occurs. The treatments for these diseases (if a cure even exists) is often much more toxic than any vaccine.

      I would look over this list to see if you’d wish any of these diseases on your child…which is much more likely to happen if they aren’t vaccinated:

      https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html

      And I don’t know about you, but I would prefer to avoid these conditions as well:

      https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html

      I’m unsure why vaccines are so controversial. Statistically they overwhelmingly save far more lives than they potentially adversely impact. In terms of a prepping plan, protection from transmissible communicable diseases is paramount to survival. Disease will be rampant without modern sanitation and medical treatments, regardless if the initial cause is pandemic or economic collapse.

    4. I am not in the pocket of Big Pharma, but I do think prevention is a lot better than trying to cure a potentially fatal disease, especially after a WTSHTF event occurs. The treatments for these diseases (if a cure even exists) is often much more toxic than any vaccine.

      I would look over this list to see if you’d wish any of these diseases on your child…which is much more likely to happen if they aren’t vaccinated:

      https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html

      And I don’t know about you, but I would prefer to avoid these conditions as well:

      https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html

      I’m unsure why vaccines are so controversial. Statistically they overwhelmingly save far more lives than they potentially adversely impact. In terms of a prepping plan, protection from transmissible communicable diseases is paramount to survival. Disease will be rampant without modern sanitation and medical treatments, regardless if the initial cause is pandemic or economic collapse.

  4. As a fellow physician, I think this is a nice article. Really good work.

    Just a few comments with regard to fish antibiotics, and this reflects my understanding to date. This does NOT constitute medical advice, and I am not suggesting anyone take veterinary medications. Now that we have that covered:

    It’s my understanding that fish antibiotics are in fact produced off the same manufacturing line as human antibiotics.

    It is my understanding that any medication that is intended to be distributed for the consumption of animals must by law be labeled “not for human consumption“, even if the medication is identical to that used on humans, and comes off the same line at the same time.

    It is my understanding that every prescription medication distributed in this country must have by law a UNIQUE number and letter designator on the pill. In this way, we can ensure no confusion when a patient drops their medications on the floor and mixes them up. The pharmacist can easily separate the various medications by the designator code.

    The website drugs.com has an application where you can put in the pill identifier and it will tell you exactly who made it, what it is, and what the dose is.

    I have yet to review any fish antibiotic (and I have reviewed many) that did not have the same designation as the human counterpart.

    I am not offering any conclusions, simply providing the known facts that I understand at this time. Hopefully this is helpful.

    Thanks

    1. Fish antibiotics and animal antibiotics cannot be lumped together. Fish antibiotics are made to human pharmaceutical standards. Animal antibiotics are NOT made to human standards, and should be used only if desperate.

      FishMox is a decent brand.

      To dose, I grind the contents of the capsules in a mortar and pestle (the are pretty hard and lumpy in the capsule) to a very fine, silky powder. It does not take long. I then add the appropriate amount of purified water to the contents of the mortar, and pour them into a bottle. I put a label giving the contents of the bottle, and the appropriate dosage.

      (For cats/kittens, the formula is 500 mg. Amoxycillin/Fishmox, plus 10 ml. purified water, and the dosage is .1ml per pound of body weight twice a day for ten days.)

      For human dosage, consult your doctor.

    2. Thanks Dr. Marc!

      I have found this guide to be extremely helpful for dosing many different antibiotics:
      https://bookstore.acep.org/emra-antibiotic-guide-900152

      ** Hypothetically (with the proviso this doesn’t constitute specific medical advice): one could use this book to dose fish antibiotics based on the various conditions found in the book. Some basic medical knowledge would be helpful in forming a differential diagnosis, so that appropriate therapy can be instituted. **

    3. Thanks Dr. Marc!

      I have found this guide to be extremely helpful for dosing many different antibiotics:
      https://bookstore.acep.org/emra-antibiotic-guide-900152

      ** Hypothetically (with the proviso this doesn’t constitute specific medical advice): one could use this book to dose fish antibiotics based on the various conditions found in the book. Some basic medical knowledge would be helpful in forming a differential diagnosis, so that appropriate therapy can be instituted. **

  5. Look forward to the rest of the article.
    For OTC meds we keep a good supply of Benadryl, Meclizine, Orajel, and, epinephrine.

    our ability to survive and thrive are heavily influenced by our prepredness actions. Good teeth, good blood pressure, and overall good health is a much better place to start Post-TEOTWAWKI than 100 pounds over weight, unable to walk to get the mail without resting, and your first meal of the day is a handful of pills. I think part of our medical preparedness NEEDS to include training beyond that of “Boy Scout” first aid. Knowing how to take a pulse, a BP, and a capillary refill test and be able to make some assumptions based on those signs.

  6. Do not overlook the prevention tools,safety glasses,sun glasses,mouth guards,gloves,face guards,helmets,chain saw chaps. An ounce of prevention is worth tons of cures(rehab sucks even if scars are cool)

    1. Prevention tools are a great point.

      For shooting, I recommend eyewear, ear protection, and a tourniquet (in case of an accidental GSW).

      For cutting firewood, I wear eyewear, ear protection, a helmet with face shield, leather gloves, kevlar chaps, leather boots, and carry a tourniquet in my chaps pocket “just in case” the saw bites me while I’m out in the woods.

  7. Regarding getting and staying fit. The book “The Barbell Prescription, strength training after 40” if awesome. It totally changed how I work out.

    We are all competing in the extreme sport of aging. We must have a strength training (not exercise) regime.

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