Notes from JWR:

Friday’s closing prices for spot gold and spot silver might seem astounding, but just wait a few months. You will probably wish that you had bought more silver at today’s prices.

—

Today we present two more entries for Round 31 of the SurvivalBlog non-fiction writing contest. The prizes for this round will include:

First Prize: A.) A course certificate from onPoint Tactical. This certificate will be for the prize winner’s choice of three-day civilian courses. (Excluding those restricted for military or government teams.) Three day onPoint courses normally cost $795, and B.) Two cases of Mountain House freeze dried assorted entrees, in #10 cans, courtesy of Ready Made Resources. (A $392 value.) C.) A 9-Tray Excalibur Food Dehydrator from Safecastle.com (a $275 value), D.) A 500 round case of Fiocchi 9mm Parabellum (Luger ) with 124gr. Hornady XTP/HP projectiles, courtesy of Sunflower Ammo (a $249 value), and E.) An M17 medical kit from JRH Enterprises (a $179.95 value).

Second Prize: A.) A “grab bag” of preparedness gear and books from Jim’s Amazing Secret Bunker of Redundant Redundancy (JASBORR) with a retail value of at least $400, B.) A $250 gift card from Emergency Essentials, and C.) two cases of Meals, Ready to Eat (MREs), courtesy of CampingSurvival.com (a $180 value).

Third Prize: A.) A copy of my “Rawles Gets You Ready” preparedness course, from Arbogast Publishing, and B.) a Royal Berkey water filter, courtesy of Directive 21. (This filter system is a $275 value.)

Round 31 ends on November 30th, so get busy writing and e-mail us your entry. Remember that articles that relate practical “how to” skills for survival have an advantage in the judging.

The First Aid Kit as a Multi-Layered Medical Resource, by Hambone

SurvivalBlog has gone to some lengths to provide first rate information on a wide variety of subjects – including first aid kits.  I strongly encourage everyone to receive professional training  and to own at least one (or more) quality first aid manuals.  In my experience. many first aid kits seem to have been built with either a limited vision or a lack of foresight regarding their use in a disaster situation.  Worse, some contain items that if misused or improperly used can further injure/permanently cripple/kill the ‘patient’.  Hence my emphasis on professional training – it is easily as good an investment as freeze dried food. maybe more so.

I was fortunate enough to have had the opportunity to receive training from the military to provide field medical support to my (small) Airborne unit, and to work in military hospital ERs for several years.  I was a state licensed and Nationally Registered EMT for many years as well.   this field and clinical experience, I have some ideas on First Aid Kits that I would like to share with readers of SurvivalBlog. I will make some suggestions on how to build a multi-layer kit, offer some specific advice on items not normally found in First Aid Kits and the reasoning behind the suggestions.

Finally, I will give some URLs for sites designed for self-training in first aid, provide some suggestions for additional books and equipment sources.  I have no interest in any of the books, items or sources.

DISCLAIMER – I am not a doctor, and I never played one on television. 
Always seek consultation with a medical professional whenever possible. 
If you have not been trained on certain procedures, do not attempt to perform the procedure – you can harm, permanently injure or worse, cause a lifelong disability.

This information is for educational purposes and for discussion.  It will hopefully get you started on your own training program and help you to build a First Aid Kits that will support your family or group.  No first aid kit, no matter advanced, well stocked or massive is a substitute for training.

Concept
The  multilayer approach in building this resource is focused on supporting you, your family or small affiliated group in an abnormal situation, either long term or short term. It provides the means for escalating support for different types of injury and illness found in a situation with limited or no routine medical care access – such is found in disaster areas.  Each kit supports or provides items to be used with the next level kit.  Modular in nature, this allows for the medical supplies to be carried by many members of a group, should displacement occur.

Kit Limitations
Some injuries are so grievous that without surgery, drugs, specialized medical equipment and techniques, the odds of patient survival are extremely limited.  Likewise, some injuries while non-emergent, require very specialized treatment – for example, a detached retina.  Finally, some diseases require special testing in a lab setting to determine the course of treatment.  All of these fall outside of what I and many others would consider “first aid”.
 
You can, however, provide real first aid care for an injured or sick person that will allow them to recover from their injury – with or without advanced medical intervention.  You will find this the driving focus here.  Items listed are suggestions, feel free to change or add as you see fit.

Multi-layer – what does that mean?  It means you have a series of medical resources (First Aid Kits) or modules if you would, each with different levels of items and equipment to match treatment of what the patient is presenting to you, the care provider.  Simply put,  the modules are designed to support the treatment of different levels of injury.
These levels are:
Minor injury, individual
Minor trauma, individual with limited bleeding
Expansion module for minor trauma kit to deal with significant bleeding
Major trauma – as bad as it gets
Clinical or ‘sick call’’ type issues

Minor injury, individual. 
Failure to care for even a seemly minor injury can kill you.

My Grandmother was very alert to minor problems – she often told me that “The Presidents son died from an untreated blister” just before dosing me with some noxious concoction.  As it turns out – she remembered a tragic death in the Presidents family – that of Calvin Coolidge Jr in 1924 – from a infected toe blister. 

I worked with a youngster in the ER who presented advanced sepsis (blood poisoning).  His knee was swollen, with ‘angry’ or bright red lines running up the leg.  He was in pain with an elevated temperature.  We used a large bore syringe to remove over 70cc of pus and cloudy liquid from the swollen knee, then a drain was installed.  He was given IV antibiotics.  After a hospital stay, he was released and made a full recovery.
What happened?  He fell while playing, scraping his knee.  His folks washed the area but did nothing further.  Even as the child complained of pain in his knee, no further ‘first aid’ was attempted. On the morning of the second day after injury, he presented a swollen knee – again, nothing was done until late that night, when he made it into the ER.  A string of bad moves that could have easily killed this child.

A simple Individual First Aid Kit (IFAK) would have been enough to properly treat this child for what began as a minor injury.  In a multi-layer system, the IFAK is the first of 4 layers – this kit should have something to clean an injury, some antibiotic ointment and something to cover the injury.   I keep one of several IFAK at hand, work or play.  The size factor is focused on something small enough so that you always have it hand – in a pocket, purse, briefcase, or toolbag.  One per individual, extras for workspace.

Suggested contents: (you can have whatever you want, these are just suggestions)
Case, hard, designed for cigarettes.  Splits in half and is pretty waterproof.  The orange color is a plus.  Anything from a glasses case to a small bag or pouch  will work.
Inside are several adhesive bandages – both strip and ‘dot’
4 Providone-Iodine prep pads
2 foil packets of Betadine antibiotic ointment
2 foil packets of ‘triple antibiotic ointment’ – also sold as Neosporin
2 individual doses of eye drops in individual ‘tear-off’ dispensers
1 foil packet of lip balm (Blistex brand)
1 packet of Aspirin (2 tablets in packet)
1 2×2 sterile gauze packet
1 2×3 no-stick gauze packet
1 steel splinter tweezers
1 small LED ‘squeeze’ light
1 book of military waterproof (MRE) matches
1 card with 5 ft of duck tape wound upon the card. – one ‘stripe’ of tape is 1/2 in wide, the other 1.5 in wide.  The card itself is a old ‘credit card sized’ plastic card..
The kit also has a ‘manual pencil sharpener’ which looks. to me anyway, like a small folding barber razor. Small, it has a two inch ‘razor’ blade that folds into its handle for safety.  Just the thing for scraping off cactus needles and the like.  There is room for a flat Fresnel lens to spot splinters.  I keep one in my wallet, so not shown in this kit.

The case is secured with a large rubber band, which helps keep the case inside of a pocket and can further be used as ‘tinder’ if a fire is needed.

The next level in the multi-layer approach is a minor trauma kit.  The basis (container) for this is the well known military Individual First Aid Kit, Field (NSN 6545-01-521-8502). Minor trauma may be falls, twisted or sprained joints, cuts or minimal depth penetrating injury.  While not adequate for large lacerations, avulsions or deep penetrating injuries, it should do for the risk posed by your day to day outside activities.  One per individual, extras for the work area or GOOD/BOB bags.  Works with ‘expansion’ module listed next.

Years ago I worked for a geophysical exploration company.  In remote Montana, one of our field crew was struck just below the knee with a chainsaw in a brush cutting operation.  The saw cut deep, into the bone.  The location of the injury allowed us to treat and self-evacuate while treating. The crew person required surgery and a hospital stay but thanks to the care given in the field, was able to fully recover with no permanent  loss of mobility. The module described here would meet the needs of this type of accident.

Still small in size (4-3/4 inches high by 2-3/8 deep by 4-1/2 wide) the kit was designed to accommodate a waterproof plastic insert box which contained the components of the military Individual First Aid Kit. The first pattern (preferred) has snaps to fasten the cover flap.  The case can be attached to any belt via two ALICE clips.  This makes a good platform to build upon.  The nylon cover is larger than the ‘insert’ allowing for additional items to be added.  This container is available from multiple sources on line.

This next level is for dealing with minor trauma with limited bleeding.  Inside the nylon case we find:
8 Providone-Iodine prep pads
2 hand wash packets (commercial – to clean your hands before or after)
1 aluminized mylar ‘survival blanket’ – this to wrap the patient should shock or cold be an issue
1 gauze eye pad
1 set latex or Nitrile gloves in Ziploc bag, not sterile, but clean
1 Insert, First aid (plastic)
The plastic insert box holds:
3 Dressing, First aid, Field, Individual Troop, 4×7 inches
1 Bandage, muslin, compressed – a triangular bandage, or cravat
2 Band-Aid brand bandage 2×3 in (larger than the 1 x 2 in ones used in simple kits)
1 Band-Aid bandage, extra large
6 adhesive bandages – 4 ‘normal’, 2 small
2 foil packets, triple antibiotic
2 foil packets, burn get (Lidocaine) 
4 large safety pins – for use with the cravat
1 packet electrolyte tablets
1 eye drops in tear-off dispenser
1 book of waterproof (MRE) matches

If you will support an industrial type operation, you may wish to add a pair of tourniquets.  Keep in mind, use of a tourniquet will require you to seek advanced, professional medical care at a hospital or trauma center as soon as possible. 

The “expansion” module for the above listed kit is for more extensive trauma, with bleeding.  This should be adequate for large lacerations, avulsions or deep penetrating injuries – but not penetrating chest injuries which result in a tension pneumothorax or those resulting in evisceration.  One per two group members involved in industrial or dangerous activity with a high risk of injury minimum – one per person is better.

For me, this module is housed in a soft-sided nylon case 8 x 6 x 3 in deep.  It has a strap handle and a steel clip similar to a carabiner to hold the case, should that be required.  Color is optional, mine happens to be bright red with a First Aid logo on the exterior, but almost any waterproof container will work.

We had a call to respond to where a person had pushed their hand through a plate glass window.  The person had severe and deep lacerations to the hand, with soft tissue avulsion (‘meaty’ parts of one finger removed to the bone).  This kit would be adequate to deal with this level of injury.

This module contains:
2 sets of latex or nitrile gloves in Ziploc bag
1 package of 10 cotton applicators (Q-tips)
3 5 x 9 sterile combination dressing
2 Dressings, First Aid, Field 4 x 7 in
5 3 x 4 in non-adhering sterile gauze pads
2 tongue depressors/splits
1 bandage compress, muslin – AKA triangular bandage or cravat
1 non-stick gauze pad
1 eye patch
1 Band-Aid – extra large
1 roll 2 in self adhering bandage
1 roll 2 in bandage gauze with 2 safety pins
1 tourniquet
1 set plastic ‘splinter’ tweezers
1 set steel tweezers
1 ‘travel sized’ vial of 200mg INN (Ibuprofen)  22 tablets, OTC
1 vial of spray Neosporin
3 swabs, tincture of benzoin for use with SteriStrips
2 packages of ‘SteriStrip’ wound closure strips, butterfly bandages are a substitute
15 Providone-Iodine prep pads
30 adhesive bandages (1x 2)
I plastic hard case insert (3.5 x 4 x 1 in deep)
5 2 x 3 non-stick gauze pads
1 3.5 x 5 in moleskin patch
5 eye drop doses in ‘tear off’ dispensers
6 tabs Imodium (OTC)
4 large safety pins
1 #10 sterile scalpel blade
2 foil packets triple antibiotic ointment
2 foil packets ‘burn gel’ (lidocaine)
2 packets electrolyte tablet ( 2 tabs per packet)

The next level module is for major trauma.  Housed in a surplus M-3 Medic bag, it has supplies for dealing with major trauma, heavy bleeding, crushing injury.  At this stage any injury you treat will require professional medical care found at a hospital or trauma center.   Designed to provide pre-hospital treatment of large lacerations, avulsions or deep penetrating injuries which may result in a tension pneumothorax or those resulting in evisceration.
These kits are normally built based on the advice of a trauma physician and include items not covered in training at a level below P-EMT.  As such, I will just list some items to provide an idea of the level of care that might be provided –
4 sets latex or nitrile gloves
2 N-95 masks
1 set eye protection
1 SAM splint
2 Quick-clot gauze, large
2 Quick-clot gauze, small
20 5 x 9 sterile dressings
20 4 x 4 sterile non-stick pads
2 hot packs (hand warmers are fine)
2 cold packs
2 6 in Ace bandages
2 4 in Ace bandages
2 4 in self-adhering bandages
4 rolls 4 in Kale
2 Israeli Emergency Bandage 6 in with slider
1 Israeli Abdominal Emergency Bandage – 12″ or
1 Silver “H” Compression Bandage (optional as it is specialized)
1 set of  OTC meds (ASA/INN/antacid/Sudafed) 10 packs of tablets in OTC doses
1 headlamp – LED – stays in kit.
This is a sample – I strongly suggest you discuss the items for this module with your own medical professional and factor in your level of training, location and risk exposure.  I don’t discourage the view that having more ‘advanced’ supplies is a good thing – for use by medical professionals to treat your group members in case the pros supplies are exhausted.

Not to beat this to death – but in some States suturing, for example, is considered surgery – and requires professional licensing to perform.  If all goes well, fine.  If things go badly, you can expect trouble on many fronts.  The Good Samaritan laws I am familiar with do not cover you if you perform advanced medical procedures without the documented training and licensing required by the local authorities.  If society collapses, this is not going to be an issue, if this ‘system’ is for disaster support – it may become an issue.  You can make that decision for yourself.

Both M-3 and M17 based “Medic kits” are offered online.  The M3 bags are far smaller and easier to carry and work with in the field.
Prices range from under $30 to over $300.  You must examine the offered contents closely!  The “trauma items” offered by some vendors includes such items as a 100 ct package of Q-Tips, 100 adhesive strips (Band-Aids) and so on.  These items are quite useful, but are not normally considered in the same class as pressure dressings or FAST (Sternal Intraosseous Infusion) infusion equipment. 

Other vendors offer the “Medic kits” as surplus and may include IV setups, IV bags, and other advanced treatment items.  All of these advanced items have “use by” or expiration dates and may have issues with packaging that has not kept the items sterile.  Use common sense or ask a professional.  The medic bags may be purchased empty and filled as you deem appropriate, this is usually the best option.  Consultation with a professional can save you money – by not purchasing unnecessary or overpriced items.

The final module is for what I will term clinical treatment.  Here is where most of the ‘hardware’ resides.  For me – it is a two part setup. I use a large tackle box which provides water resistant protected storage and a means to organize the items. The other is a commercial ‘first aid’ bag that folds out presenting many pockets to hold items.  These are used to provide follow-on treatment and treat ‘sick call’ type complaints – earaches, foreign object in the eye, colds, hay fever and so on.  
Typical contents are:
1 box of latex or nitrile gloves
Surgical soap or Betadine or Hibiclens Soap for cleaning your hands and any wound areas that require cleaning.  Check with your medical professional on cleaning tips.
Eye protection and masks
5 x 9 sterile pads for wound dressing changes
Adaptic pads for draining wounds or burn dressing changes
Steri-strips for reclosure of lacerations, if needed, when changing dressings
Multiple swabs, tincture of benzoin. for use with SteriStrips 
Several oz of medical saline solution for wound cleaning, eye wash and so on.  Several 2 oz squeeze bottles of saline are better then one big container.
Commercial dental kit + several teabags.  Ask your dentist what is best for you.
Stethoscope and sphygmomanometer to monitor blood pressure in long term care, monitor for pulmonary sounds (like rales) and to check for distal pulse sounds.

Note – while the simple ‘nurse’ type stethoscope is just fine, the slightly more expensive Rappaport (two headed) type, with changeable diaphragms, offers better sensitivity.

A quality otoscope for ear examinations, important if your group include children.  Some are sold with booklets containing color photos of different conditions.

A UV or Cobalt Blue light for in use in conjunction with orange dye (fluorescein)
to detect foreign bodies in the eye or damage to the surface of the eye. 
Used with saline solution eye drops, it can be used to confirm all debris has been removed from the eye.  Ask your medical professional to demonstrate correct use before you use these items.  I suggest adding a set of ‘hobby’ headband magnifying lenses – very handy in eye examinations – and allow hand-free use.

Some kind of notebook or other means of recording treatment.  These records can be important in the long run, certainly valuable to medical professionals if you seek care after treatment.

Activated charcoal and syrup of ipecac are not included in this module. The American Academy of Pediatrics recommends that ipecac syrup not be stocked at home, the same for the charcoal.  Activated charcoal can cause ‘concretions’ in the intestines, an often fatal condition. 
You should closely examine those items your group will carry and consult with a poison control unit to determine risk and treatment if the substance is ingested, now.  Examples include water treatment tablets, prescription medicines and so on.

A separate OTC carrier.  These may hold:
24 Aspirin, 325 mg Tablet
24 Acetaminophen, 325 mg Tablet
24 Ibuprofen, 200 mg Tablet
24 Diphenhydramine, 25 mg Capsule
24 Diamode, 2 mg Tablet
24 Diotame Tablet
24 Alamag Tablet
24 Sudafed Tablet
3 Cera Lyte 70, 50 g Packet, Lemon
24 Loperamide tablets (Commercial name – Imodium)
12 Triple Antibiotic Ointment
12 Hydrocortisone Cream 1%
Printout – of all OTC meds, showing reactions, contraindications and save dose levels (see this site for good data or consult a PDR guide)
Checking with a medical professional on your selection of OTC meds is a good idea if you have members with prescription medicines or long term health issues.
Prescription drugs and antibiotics are best discussed and obtained from your health care professional. 
In many jurisdictions possession of prescription items without the accompanying script is a felony.
Do not carry any medicines or pills in unmarked containers. 
Officer Friendly and his trusty canine companion Killer-Diller just may not understand.   Avoid that dirty boot on the neck and those cold steel bracelets – ensure all items are in the original and marked containers.

I have covered a module based approach for first aid treatment of :
Minor injury, individual
Minor trauma, individual with limited bleeding
Expansion module for minor trauma kit to deal with significant bleeding
Major trauma – as bad as it gets
Clinical or ‘sick call’’ type issues
in layers that provide for mutual support, ease of carry and distributed carry – avoiding a ‘all eggs in one basket’ for medical support.

I hope you have found this document useful and take the time to consider your specific needs rather than just purchasing an expensive kit that may or may not meet your real needs.  As before, the investment of your time and money is a really smart investment – one that will pay dividends to your family or supported group.

Links
Self training–
USAF Self-Aid and Buddy Care (SABC AFH36-2218V2 )
IS 0871, Combat Lifesaver Course self-study
REI stores often offer first aid classes with a focus on remote treatment

Books
Medicine for Mountaineering & Other Wilderness Activities,  James Wilkerson (Editor)
Combat Medic Field Reference (Spiral-bound) by United States Army.  Some parts may not be useful – how to deal with enemy POWs for example, but good overall – requires training for best use
Special Operations Forces Medical Handbook (it superceded the very out-of-date ST 31-91B). Requires training for best use
Wilderness Medicine, Beyond First Aid, 5th Edition by William Forgey – the original classic for field use
Where There Is No Doctor: A Village Health Care Handbook by David Werner
Where There Is No Dentist by Murray Dickson – when you need it, you really need it
First Aid — (American Red Cross Handbook) Responding To Emergencies
First Aid for Soldiers FM 21-11 – on line reference

 

Vendors
Zee Medical Supplies – they will build any first aid kit to your specifications.  While not the least expensive, they offer quality, well marked supplies.

REI – offers a set of kits, some of which are limited, some offer more expansive items.  They also offer small amounts of individually packaged and marked OTC items – worth a look

Chinook Medical – Sells professional items at reasonable prices

Red Flare Emergency Supplies Company – kits and refill items at good pricing.

An cigarette case kit

A Legal, Low-Cost, Readily-Available Painkiller, by Kitchen Maven

You’re stacking wood when a log suddenly twists, and the pile comes tumbling down on you, leaving your legs covered with cuts and bruises.

You walk into the kitchen, and see your toddler, who has climbed the counter to grab something in an upper cabinet, start to topple over. You lunge forward to grab her, and your body provides her with a soft landing spot as you crash over the kitchen chair and wind up on your face on the floor.

Accidents happen, and they hurt. Many posts have discussed pharmaceutical painkillers, but most people have limited access to them, and if a layperson tries to prep by storing controlled substances in quantity, difficulties with the law may result.

A client who owned a health food store introduced me to a legal, low-cost, readily-available painkiller that is incredibly effective for any type of flesh injury, as well as several other types of pain. Many readers already have it in their homes, since it is widely used for arthritis, but have no idea that they own something that can put morphine to shame. Not that you can get high on it, you can’t, but it wipes out most pain with without making you sick, sleepy, or risking addiction.

Methyl-sulphonyl-methane (MSM), is a common ingredient in joint health supplements. It is non-addictive, and has very few side effects – mainly softer skin and thicker hair. It has the same toxicity as water. If you take too much at once, you will get the runs, but that’s about it. A few people have mild negative reactions, usually an upset stomach, so take a small dose before using it extensively. (Since it is acidic, you could try taking it with milk, which is a chemical base, and see if this neutralizes stomach upset.)

MSM is a naturally occurring substance in the environment, produced by trillions of living organisms in the oceans in the form of a gas (don’t ask). It drifts in the atmosphere, and comes down on the continents when it rains. After tens of millions of years of this, the stuff is everywhere – in the water, in the soil, and in you.

MSM works by stopping the inflammatory processes of wounds, bruises, surgical incisions, and other soft tissue damage before it is transmitted by the nerves in the form of pain. It does not directly affect the nervous system in any way. Therefore, you can drive, play football, do brain surgery, play chess, or whatever else you want to without being fuzzy-brained or sleepy.

According to the book “The Miracle of MSM“, by Jacobs and Zucker, professional athletes were among the first users of MSM for pain caused by sports injuries. They had to get back on the field fast, and couldn’t use opiates during a game.

Does MSM work for all types of pain? No. It works primarily for soft flesh (not bone) injuries, and joint pain. It also works for a wide variety of medical conditions which involve pain, such as fibromyalgia, arthritis, chronic back pain, chronic headaches, tendonitis, bursitis, carpal tunnel, TMJ, and allergies. (There are details on the book). If you hurt, try it. If it works, it works, if it doesn’t, it doesn’t. For mixed injuries, such as damage to both flesh and bone, it will help the part of the pain from the flesh wounds, which makes your life that much easier.

Dosage: there is no fixed dosage for MSM for pain. Dosage is individual, depending on you, and on the type of damage. People have taken up to 50,000 mg. a day for very severe conditions. From what I have seen and read, 5,000 to 15,000 mg. seems to be enough for most problems.

The dosage must be divided, and taken every hour or two, to avoid reaching bowel tolerance and heading for the bathroom. Definitely don’t take it all at once. MSM can be mixed with sweet juice. I dump mine in a latte.

My first experience of dosaging involved dropping a solid oak settee on my thumbnail. After I stopped howling and hopping up and down, taking 1,500 mg. an hour for several hours worked. It took an hour or two for the pain to fade completely, and I continued to take several a day for the next few weeks. Even though I lost the thumbnail, the only way it would hurt was if I squeezed it, which I was foolishly curious enough to do. There was no other pain at all.

My second experience of dosaging involved major surgery, complete with a six-inch incision. I took as much MSM as I could tolerate every hour or so for ten days before surgery, with the intention of completely saturating my tissues with it. (Ten days was an arbitrary length of time, as I didn’t know how long it should be taken for before surgery, and was taking no chances.)

After surgery, I was given an unlimited supply of morphine IV drip. When the nurse came in to remove it the next day, she looked shocked, and exclaimed “You only used one milliliter!” I also took one pain pill, mostly because I was afraid I was going to hurt (I have no pain tolerance). A friend sneaked some MSM into my room, and that was that. No pain; just a lot of abdominal discomfort from the usual bowel problems caused by anesthesia.

MSM also induces extremely rapid healing. The client who introduced me to it came in one day with a MSM lip balm. I thanked her, but added, “I have lots of chapsticks” (and need them). “No you don’t,” she said. “You only have this one. Try it.” I did. The next morning my rough, chapped lips were smooth, and completely healed. She was right, I only had one chapstick – I threw the others out. (MSM chapstick is made by TriMedica).

My surgery was the same. Recovery time from this form of surgery typically lasts from one to three months before people can resume normal functioning. I was driving, and back to work in ten days. The only problem occurred because there was no pain, and I was occasionally careless about continuing the MSM. After a few days of this, twinges of pain firmly reminded me to get back with the program.

While MSM reduces pain, it does not remove the condition causing the pain directly. But in the case of soft tissue flesh damage, since it speeds up healing, it does help remove the cause of the pain.

Many people use MSM pre- and post-surgery to reduce pain and stimulate rapid healing. An electrician friend had to go in for shoulder surgery, and was told he would be out of work for six months. Not good. He took it after surgery, and was back at work in a month.

On the other hand, an attorney I know found it didn’t work at all for his surgery. I asked him how many of the 1,000 mg. capsules he had taken. “One,” he replied. Too low a dose of any medication will accomplish nothing.

I have found taking one an hour for a day or two to see if it helps works well. If you don’t have any lessening of pain by that point, you probably won’t. For me, MSM did nothing for a toothache, or for a dislocation. However, I am not a medical professional, and am only sharing the results of my own experience. This is not medical advice; and you should consult your doctor, and do your own research.

The Miracle of MSM by Jacobs and Zucker is a good starting point (lousy title, sensible book). Dr. Jacobs has many years of experience with MSM, and gives thorough discussions of the various conditions in which it does or does not work. His book is professionally written, and readable. Other books with similar titles appear to be low quality knockoffs, as far as I could tell.

Some Amazon reviewers commented that they preferred the hardcover edition, but did not say why. Since I lent my copy once too often, I’m replacing it with the hardcover version.

MSM is readily available in almost any drugstore or health food store. The NOW brand works, and is inexpensive. For a seriously inexpensive source, try PureBulk.com, where you can buy it by the pound. You may want to consider stockpiling several pounds of it if you think that you may need a supply that would last for months or years, or for multiple families.

The dose for arthritis is 1,000 to 1,500 mg per day.

Could MSM be used to prevent or reduce pain during surgery? I do not know. (I was under anesthesia). However, my experience suggests that it might, at least for soft tissue surgery, since there was no significant immediate post-surgical pain. Obviously, this would be a desperation choice, where no alternative was available. Comments from medical professionals with experience of MSM would be valuable for your readers.

If you are pregnant, and decide to take MSM, you may want to dissolve it in juice (it is acid and tart), and drink it very slowly over an hour or so. I found that extremely high pre-surgery doses made my body temporarily acid, and made my eyes sting for an hour or two when I over-did it. You don’t want to pickle the baby by taking lots at once.

[JWR Adds: Readers are warned that they should approach “mega dosing” of any drug or dietary supplement with great caution. Even if a substance is deemed entirely “safe”, (such as water soluble vitamins) there are variations in pill binders, dyes, and encapsulation materials that are only significant at high dosages. Toxicity can develop in some individuals! Keep in mind that individual physiology, digestion, hydration, and metabolism vary greatly. Excretion of toxins varies, depending on water intake, liver function, kidney function, perspiration, et cetera.]

Letter Re: Post Disaster Wi-Fi Commo Networks

Sir:
One thing not mentioned in the survival groups web sites is the use of ad-hoc wireless wireless fidelity (wi-fi) networks.

When me and several others put together a group plan, we came up with the idea of using wi-fi as a short range method of communication, information sharing and news distribution.

We found several Wikipedia pages devoted to getting maximum range from a wi-fi router. Many of these methods can cover entire small towns. Enabling the password encryption features built into these devices can while far from perfect provide a super secure text and voice communication service when used in conduction with other encryption software.

Our idea was to set up a daisy chained router network that when accessed would display a web page hosted on a desktop or laptop on the network. This page would have links to other pages on the local hosted site. A entire library of public domain books from project Gutenberg, videos, e-mail and instant messaging options.

Because of how the Internet works, when you type in a web name like Google.com you are directed to a IP address that has the information like 111.23.457.99. Since there is no address book on the network, your browser would be directed to a local address on the network that is indexed on the home page, that you initially see when you log into the router that has the best signal close to you.

Routers themselves use a small amount of electricity; so one could set up a solar/and battery powered network discretely placed around town. Even if the batteries go out after a few years, the solar cells will still power the network in the daytime.

This network can also be used with many other devices like iPad, iPod Touch, wi-fi smart phones, Sony PSP, etc.

The methods to build this type of network are a bit complicated, but there are hundreds of web sites dedicated to instructions on how to set this up.

This communication method has been successfully set up in Hati after the earthquake and in Mali where the entire city of Timbuktu has been set up with wi-fi access using cheap off the shelf electronics and improvised gear. – M.B.

Letter Re: Developing Your Healthcare Networking List

Mr. Rawles,
I am a long time reader who enjoys how thought provoking your blog can be. But have a disagreement with a recent post by Josh S.

I am a Emergency Medicine Physician, practicing in the Northeast US. Josh S.’s article is true in the detail of developing your medical network — it is quite easy to call up a friend or relative for some quick medical advice or help. And, furthermore, I appreciate this — I did get into medicine to help people, and I would much rather help friends and family than a vast majority of drug-seeking lowlifes that seem to frequent my Emergency Departments. While it is true that the ER is required by law to see you, there is really no “magic number” that states we have to treat you. The Visual Pain Scale, which is the 0-10 scale that we often use, is purely an estimate “in the patient’s own mind”. While Josh is correct, in that we (ER nurses, physicians, technicians, secretaries) have become astute at observing a patient for discrepancies, just because you say your pain is an 8 / 10, does not mean I am going to give you medicine, where-as at 7/10 I kick you out the door. You see, everyone’s pain is different, so my 7/10 is different than your 7/10. However, the pain scale is more appropriately used to see how an intervention or treatment changes your perception — a change from a 7/10 to a 2/10 (i.e. 5 points) is something that is quantifiable and seems to transfer between patients. I assure you that every junkie who wants percocet for their “back pain” tells me their pain is a “ten out of ten”. And, again like Josh said, we have become aware of things — if you are texting or laughing or playing video games, I am pretty comfortable in making the assessment that you are not “in the worst pain imaginable”.

In truth, if there is any advice I can offer as an Emergency Medicine physician, if people are just nice to me or my staff, usually we will bend over backwards for you. As soon as you get ugly or inappropriate, things will change. Nothing matches a woman’s scorn, except for an ER nurse who has been screamed at and called a b***h!

Emergency Room nurses are some of the best in the world, and they have saved lives and cleaned up puke, dealt with the dregs of society and come back with smiles. As Obama-care kicks in, we in the EM community realize that there will be a lot more people utilizing the ERs — hopefully, you won’t need to go. However, if you do find yourself there in dire straights, remember my words to be nice, and we’ll try to get you out ASAP.

Thanks for all you do for the prepper community, – Croaker

Economics and Investing:

Reader Michael A. suggested reading this commentary by Karl Denninger: Bernanke’s Folly: The End Game.

K.T. liked this piece by Bix Weir at The Road to Roota Letters: A Final Checklist for Everyone. The article opens with this sobering words: “My Road to Roota analysis shows that we literally days away from the breakdown of the entire fiat monetary system and I thought it a great time to go over final preparations for the coming chaos. In the grand scheme of things you can never be fully prepared for what is about to transpire because nobody on earth has been through it before…not to this scale. I guess the closest thing we can compare it to is the experience of the Germans in the early 1920s with the Weimar Republic.”

Expert: Home Prices Cosuld Fall Another 20% Due to Excess Inventory

Fed’s Bernanke `Doesn’t Understand’ Economics, Jim Rogers Says. (A hat tip to J.C.)

Items from The Economatrix:

Warning of Possible Bank Holiday

Retailers’ Modest October May Spur Holiday Deals

Applications for Jobless Aid Rise Sharply

Odds ‘n Sods:

Some good advice from Dr. K.: The Challenges of Medical Preparedness in a High-Tech Age

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Larry in Ohio flagged this: Carry a Cloaking Device for your Cell Phone anywhere you go. Decent protection from EMP, too…

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A reader mentioned the interesting Informed Citizen News videos available at YouTube.

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This definitely qualifies as an “Odd” item: Masked man nabbed on flight to B.C. from Asia. The accompanying video has some additional details.

Jim’s Quote of the Day:

"Lo que separa la civilización de la anarquía son solo siete comidas." ("Civilization and anarchy are only seven meals apart.") – Spanish proverb

Notes from JWR:

Das Ende der Welt, wie wir sie kennen! I’m pleased to report that my nonfiction book “How to Survive the End of the World as We Know It” will soon be published in German by publisher Kopp Verlag. There are now nine foreign publishing contracts in place, for editions of the book in eight languages. Please be patient, as some of these editions may take more than a year to reach production.

—

Today we present two more entries for Round 31 of the SurvivalBlog non-fiction writing contest. The prizes for this round will include:

First Prize: A.) A course certificate from onPoint Tactical. This certificate will be for the prize winner’s choice of three-day civilian courses. (Excluding those restricted for military or government teams.) Three day onPoint courses normally cost $795, and B.) Two cases of Mountain House freeze dried assorted entrees, in #10 cans, courtesy of Ready Made Resources. (A $392 value.) C.) A 9-Tray Excalibur Food Dehydrator from Safecastle.com (a $275 value), D.) A 500 round case of Fiocchi 9mm Parabellum (Luger ) with 124gr. Hornady XTP/HP projectiles, courtesy of Sunflower Ammo (a $249 value), and E.) An M17 medical kit from JRH Enterprises (a $179.95 value).

Second Prize: A.) A “grab bag” of preparedness gear and books from Jim’s Amazing Secret Bunker of Redundant Redundancy (JASBORR) with a retail value of at least $400, B.) A $250 gift card from Emergency Essentials, and C.) two cases of Meals, Ready to Eat (MREs), courtesy of CampingSurvival.com (a $180 value).

Third Prize: A.) A copy of my “Rawles Gets You Ready” preparedness course, from Arbogast Publishing, and B.) a Royal Berkey water filter, courtesy of Directive 21. (This filter system is a $275 value.)

Round 31 ends on November 30th, so get busy writing and e-mail us your entry. Remember that articles that relate practical “how to” skills for survival have an advantage in the judging.

Built-in Obsolescence, by Margaret G.

I’ve had a very frustrating three weeks. My laptop crashed and as I couldn’t get back the files, it had to go to the computer doctor.
I know that I’m not alone and that this has happened to many people but it doesn’t mean that I have to like it.
What really made me irritable though was that it is only three or four years old. I was told that three years is “old” for a computer. Pardon me?
Fortunately the computer doctor was able to recover my files, but I’ve had to buy a new laptop.
It’s not hard to tell from the above that I’m of the generation who when an item was bought, expected it to last practically forever. So I find it difficult to accept the built in obsolescence that is encouraging consumerism and debt. 

So what has that to do with preparedness? The more that you have to, or choose to spend on replacing items, the less you have for beans, Band-Aids and bullets and important survival items.

When the SHTF in one or more of its forms, you won’t be able to replace the gadget anyway. A ‘fixer-upper’ is and will be an excellent occupation for a handy person. Someone who can make one workable item using parts from several other items will be of great use to their community.

How many times have you had the repairman or shop assistant tell you “It’s not worth repairing; it’s cheaper to buy a new one”? If you then decide to buy a new toaster, what parts can you salvage off the old one? And that is the ideal time too, to buy a couple of the long-handled toasting forks used by campers. If you are a handy person, start saving bits and pieces now while they are still easy to come by.

Always have two or three backups and know how to use them. For convenience sake, I currently make my bread in an electric bread maker. But I know how to make bread by hand and have several different sized bread tins and other bits and pieces in the cupboard ‘just in case’. Back in the 1960s I didn’t have a clue about how to make bread so I enrolled in a night class and learned how. That was also pre-bread machine days too so I had a good grounding in ‘how to’. If you have the luxury of having an institution near by that offers night classes, take advantage of enrolling in as many practical courses as possible to expand your skills. Alternatively, ask around and find someone who can help you learn what you want/need to know. Quite often a retired person will be pleased to teach you in exchange for home-grown veggies.  

Returning to the topic of my computer (and I know it’s been said before) but make hard copies of important documents and files and store them safely. In a grid-down situation you may not have the luxury of taking the machine to the computer doctor.

The throw-away mentality often applies to clothes too. I have several pairs of pants and a couple of jackets that were once upon a time fleecy and warm. This year they have seen their last winter. I’m going to cut them up, sew the best bits together, line it with wadding, back the whole thing and it will become another layer of warmth on a bed. And no, I’m not going to worry too much about ‘style’, just warmth. A cold person won’t worry about glamour. The same thing can be done with flannelette shirts too.

I’ve just had my antique wind-up clock serviced and repaired. The first time it stopped, I took it to the local jewelers who kept it for months. When I got it home it kept stopping again so I found a watch/clockmaker in a different town who has it working like a charm. The three points I’m making here is that no matter how many batteries you have, they may not be sufficient or they may die; the importance of finding a ‘proper’ watch/clockmaker instead of a retailer and the chance for you to start a repair business and/or learn the business while there is still time and there are still people around who can teach you.

Another useful skill to have is boot/shoe repairing and making. I know many people wear sneakers these days but these can’t be re-soled like boots. I have two pairs of custom made desert boots – one for best and one for every-day use. And I certainly don’t want to end up wearing shoes made from car tires. (By the way, do you have shoe polish in your survival gear? Polish helps to preserve the leather so the boots last longer.) When the boots need repair – which is very seldom, I take them back to the people from whom I bought them and I get another couple of years wear out of them. Admittedly I don’t go on 20 mile hikes so I can get away with my two pairs. But having the equipment and skills to make and repair boots and shoes will enable you to make a living. That equipment can also be used to repair tents, backpacks and a wide range of material too tough for a darning needle and cotton thread.

Even though I started this article grumbling about built-in obsolescence, I would like you all to think about the every day things you use that may not be available in the future. Think too about the skills that our fore-fathers (and mothers) had that you still have a chance to learn I’ve only touched on a few of them; you can probably think of a lot more.
Start gathering items and skills that will enable you to make a living, support your family and be a useful member of your community – while there is still time.

Prepping for the Big One, by Jim Y.

There are obvious reasons for prepping, floods, hurricanes, tsunamis, fires, civil unrest, financial collapse, or just the event of an intruder into your home. Prepping is just basic insurance and just like insurance you hope you never have to use it but, need it in case of a severe raining day. I’ve found that most people will not listen to you when you tell them they should prep, they usually look at you like your some insane person who listens to every conspiracy theory that comes by. These same people in an event will be over at your house.

 “Oh my! They are killing people and I don’t have a gun!” I heard this statement from the mouth of an avid and vocal anti-gunner just after he was watching Reginald Denny being dragged out of his truck and beaten during the Los Angeles riots of 1992. I offered to sell this gentleman a single shot .22 caliber rifle for $1,000 and ammo for $5 per round. All sporting goods stores quit selling ammo during the riots at law enforcement request. When times get tough, eyes open, opinions change and inflation kicks in.

The big one. Two years ago out here in California the USGS had a statewide earthquake drill for a magnitude 7.8 quake nicknamed The Shakeout. I worked as a Land Surveyor for 10 years and am really good at making maps. A few years ago I came across Geographic Informational Systems (GIS) and started learning it and actually improved my map making skills. A few of the folks involved in the Shakeout knew I enjoyed GIS and enlisted me into the drill for my GIS skill set. The original data from the USGS stated that we would have 30 feet of lateral movement and 10 feet vertical movement along the San Andreas Fault line. This data was later revised by USGS but, the Engineer involved in the drill and I went to work on this data. The greatest thing about GIS is that you can look at how events (like earthquakes) will affect systems geographically.

Let’s examine the path of the San Andreas Fault line, it runs from the Salton Sea just north of the Interstate 10 (I-10) freeway along the mountain range (and is the reason that mountain range is there) in an Northwest direction all the way up to Grapevine on the 5 freeway. This feature basically cuts off everything from Palm Springs to Northridge and everything west of there to the ocean from the rest of the world. A lateral movement bifurcates anything crossing the fault line and moves it 30 feet in opposite directions. Everything we depend on for modern living in Southern California crosses San Andreas including major electric transmission lines, water aqueducts, major gas transmission lines and many major freeways that supplies cross on a daily basis.

What happens to modern living when we lose our power? Most of Southern California energy is generated outside of Southern California. Your home wireless telephones quit working, your lights go out, your central air stops, your laptop works until your battery dies, traffic lights stop working, hospitals start using their generator backups, the water pumps that pump water to the water towers will stop working, the equipment at the sewage treatment plants stop working, refrigeration stops working, gas station pumps quit working and so do the cash registers.  This is just the power, gas lines and water aqueducts cross the fault too. This really means no water, no heat, no food, no medical, no sanitation and no transportation.

Bug Out? Sure, If you can. Did I mention the 10 foot vertical shift? This would place a 10 foot cliff along the fault line and the I-15 freeway, the 2 freeway, the I-14 freeway and the I-5 freeway all cross the fault line. These freeways are all the major corridors out of Southern California. At the I-5 freeway and the 210 freeway interchange the overpass failed in the Northridge quake of 1994 (magnitude 6.7) and the San Fernando quake of 1971 (magnitude 6.6). The freeways in Southern California are bad in rush hour or when it rains, imagine how bad it will be when everyone is trying to get out of town. I do not believe bugging out of Southern California will be possible. The transportation system will be in shambles. It would be impossible to evacuate Southern California. With the number of inhabitants and the freeway congestion on a good day this would be impossible.

Bugging In? How long can you last? Water supplies will soon stop. Human beings can live without water for three days. How much water do you have on hand? In Southern California our food is shipped in and distributed via several key distribution centers. With refrigeration out fruit, vegetables, eggs, milk, frozen dinners, etc. will not be available. With the roads out how much food will reach the grocery stores. With everyone in a panic how much food will be at the grocery store? Out of the folks who are not preppers how many will be on your doorstep? The people that live day to day with their supplies will be looking for more supplies and they will be desperate, their lives as well as yours will be on the line.

It is a pretty scary issue once you start diving into the details. Southern California will not be a pretty place to be, it will be a death trap.  Eyes need to be opened before an event not after when it is too late. Please preach to that family member or friend. Get them to do at least the bare minimum of prepping, at least to keep them off of your doorstep for a few days.

Letter Re: Our Experience with a Chimney Fire

Mr. Rawles,
Recent posts about chimney fires mention the value of having ones chimney cleaned at least once per year. Most volunteer fire companies do chimney cleaning for a nominal donation. It gives the homeowners a chance to get their chimney cleaned and make a donation towards their community’s fire service, it helps the fire company by making one more house less likely to have a chimney fire, and it benefits both parties by getting folks to interact with and perhaps join their local volunteer fire department. Best, – RMV

Letter Re: Forecasting the Weather in a Grid-Down Situation

Old Farmer wrote an excellent piece. As he noted, each area is different and has its own patterns. I have spent decades as a pilot and have learned to read the weather fairly well. A couple of tips the Farmer left out:

1. If you place your left shoulder into the wind (or the direction from which the clouds are moving) you are facing into an area of low pressure. This is useful in locating the source of bad weather. For example, if your weather generally moves in from the west and you have a wind coming in from the North-Northeast, the low has passed your location and the worst of the weather was north of you. (Quite common in Houston).

2. Cloud thickness [generally] determines precipitation:

  • If the cloud is less than about 1000 feet thick, no precipitation
  • If the cloud is between about 1,500 feet and 3,500 feet drizzle or freezing drizzle is possible
  • Between 3,500 feet and 7,500 feet intermittent precipitation
  • Between 7,500 feet and 10,000 feet moderate precipitation
  • Above 10,000 feet moderate to heavy precipitation

You can get a good estimate of the cloud thickness based on height. Depending on temperatures you can guess as to whether you’re going to see rain or frozen precipitation. (Temperature drops about 2.7 degrees F per thousand feet in humid air. The base of the cloud is located where the dew point and the temperature meets.)

Keep a notebook of weather observations using entries like Old Farmer used in his example. One of the greatest finds was that British sea captains of the 1800s recorded weather observations in their ships’ logs and those logs still exist. The data has been priceless to researchers. For the individual, if I watch the weather channel, note the weather across the US, and the forecast, and then note how the weather plays out here; I now have a really good idea of how weather is going to play out at my home for a given set of conditions. I’m usually more accurate than the weather folks.

Final Note:
Weather is a “chaotic” system in the scientific meaning of that term. Extremely small variations can make huge differences in outcome. The old saw about a butterfly flapping its wings in Norway means hurricanes in Florida the next year is close to the truth. I say this just to re-emphasize Old Farmer’s point about being prepared. It is a scientific impossibility to ever get the weather 100% accurate, even with the best computers we can imagine. Always be prepared for it to get much, much worse than expected. The folks in Florida learned this lesson the hard way from Hurricane Andrew.

Excellent posts and the caution about relying on our technology to keep us safe is very good advice. – Capt Bart

Economics and Investing:

This article by Jeff Nielson is a must read!: Quantitative Easing is Economic Suicide. (Thanks to SurvivalBlog’s Poet Laureate G.G.sfor the link.)

The latest from our favorite Switzerdudes over at The Daily Bell: How Western Powers May Have Blown It

Here is Sheepdog to rout those grievous wolves: Ron Paul Will Chair the Monetary Policy Subcommittee.

Items from The Economatrix:

Dow Hits Two-Year High as Fed Details Stimulus. How can investors think that stock gains will out-pace double digit inflation? What idiocy.

The Fed’s Big Gamble: Here’s What Could Go Wrong

US Quantitative Easing is Fracturing The Global Economy

US Home Prices Expected to Slide Another 8%

Three Charts that Prove We are in the Biggest Debt Bubble in History

Inflation Watch:

The Federal Reserve Stirs Poltergeist of Hyperinflation, Weimar Collapse

Asset Inflation/Deflation: The Fed’s QE2 Versus $15 Trillion in Losses

Fast Rising Food Prices Feed Inflation Fears

Reader “Skyrat” notes: “Just today I purchased a Famotidine (an antacid OTC medication) refill, 20 milligrams, sixty tablets for $4.00 at Wal-Mart. This replaces the (now empty) bottle I purchased 20 August 2010, for $4.00. The kicker? The new bottle held only ninety tablets. Rising cost of living, anyone?”

Corn, food and potential sticker shock

Freakanomics: A Dunkin’ Donuts Store Exhibits Penny Sanity. JWR’s Comment: I believe this trend will continue until a zero is inevitably knocked off the currency.

Food Inflation Accelerating as Cooking Oil Poised to Catch Grains.