Recently, my wife cut the end of her thumb while slicing peppers to go on pizza. I followed her into the bathroom and as she kept pressure on the cut, I retrieved the first aid tote from the linen closet. After rinsing the wound under the faucet followed by a quick examination, we had a brief discussion regarding the extent of damage and whether or not stitches would be needed. Anyone eavesdropping on our exchange would have decided we were two of the most careless people alive as we compared her bleeding thumb to the various injuries from our past that had or had not require stitching.
In the end, she decided we could double bandage the cut and she would keep it elevated to see if it would stop bleeding. A few hours later she asked for help changing out the original bandaging. When she unwrapped the gauze, some of the fabric was stuck to her cut and she stated that non-stick dressing would be used for the re-bandage. We only had 2×3 and 4×4 non-stick pads in the first aid tote and I mentioned that I needed to re-stock some smaller sizes. Without missing a beat, my bride said, “I know there are some sealed for emergency use in your closet.” I agreed but suggested we cut down one of the larger pads instead of breaking into the emergency supply.
Our emergency supply inventory began several years ago when I started intentionally building up our first aid supplies. I learned a lot in the process. To prepare my list of supplies, I relied on books such as: JWR’s How to Survive the End Of The World As We Know It, The Survival Medicine Handbook by Joe and Amy Alton, and The Handbook to Practical Disaster Preparedness For the Family by Arthur Bradley. With additional guidance from medical professionals via YouTube, I felt comfortable moving forward with purchases of bandages, antiseptics, wound care accessories and other typical items one can buy in quantity. I did not purchase nasopharyngeal airway tubes, bulk suture kits nor other widely suggested supplies for which I am untrained. It was tempting to spend money on some of these advanced items but I held back since I hoped to get training first.
With regard to over-the-counter (OTC) medications, the products that I commonly reach for, like Advil, Tylenol, Zyrtec, Sudafed, and Tums, were easy selections. After adding these five to my shopping cart though, I realized that I didn’t know what to procure next. I took time to read labels in the store, went home and looked up further guidance online and started asking friends and family what they kept in their medicine cabinets. Several times I returned to the pharmacy with intentions of adding to my OTC medications, and each time I left the store without making purchases because I couldn’t determine which products were most likely to be needed and I didn’t want to spend money on a medication our family would never use. After multiple fruitless trips to the pharmacy, it became clear that I needed help. It was time to recruit my wife.
My wife has a Ph.D. in a branch of pharmaceutics related to dosage forms and the mathematics of drug movement within the body. She has studied and taught pharmacy compounding as well as courses related to her field of pharmacy for 30 years. When I struck out selecting over-the-counter medications to add to our home medical kit, I briefed her on my intentions, explained my difficulties, and asked her to start adding items to the shopping cart anytime she went to the pharmacy. If memory serves me correctly this approach gained our stockpile one bottle of Benadryl in three years. It wasn’t that she didn’t support the idea of stockpiling medical supplies, she just never remembered to look for items that weren’t on the shopping list.
In recent years we have started a tradition of exchanging smallish gifts throughout December, i.e., our own twelve days of Christmas. Normally, the selections are heavily garden and hobby-related. We try not to ask for suggestions and rely on having paid attention to one another to identify gift ideas. In need of a replacement gift late last November my wife asked if there was something she could buy me to round out her gift selections. Without hesitation, I asked her for a few OTC medications and a list of other products we should obtain over time in the event the world spun out of control.
As a result, around the tenth day of Christmas my true love gave to me, a red duffle bag containing many of the following items as well as her reason(s) for making the individual selections. What follows are the notes I took on her explanations (thus the choppy nature of the descriptions) and I hope they help some of you as much as they helped me. This said, neither of us are medical doctors and none of the following should be construed as medical advice; it is only a summary from our personal planning and her profession-driven beliefs.
Analgesics (pain relief)
Aspirin (acetylsalicylic acid 325 mg) is in the nonsteroidal anti-inflammatory drug (NSAID) class and is used primarily for pain relief and fever reduction purposes. However, my wife believes in keeping Aspirin on hand for its benefit to someone having chest pains that may be due to a heart attack. In this potential event, call 911 and offer two aspirin. Additionally, you may very well know someone who takes a “baby” (80 mg) aspirin tablet daily as a blood thinner. Aspirin degrades quickly so do not use past its expiration date. If the bottle smells like vinegar, then discard and do not use.
Advil (ibuprofen 200 mg) and Aleve (naproxen 220 mg) are NSAID pain relievers and fever reducers, similar to aspirin. NSAID’s have anti-inflammatory properties and in addition to pain relief and fever reduction, are effective at relieving joint swelling and menstrual cramps. With NSAIDS, always start with the lowest recommended dose and work your way up. Ibuprofen should be taken on an eight-hour schedule starting with a single tablet. If a larger dose is needed to obtain relief, then take the second tablet. Naproxen can be taken twice per day. Extended use of either can cause GI ulcers and kidney damage so don’t exceed recommended daily dose. Ibuprofen and naproxen will not afford the same benefit during a heart attack, so cannot be substituted for aspirin in an emergency and in fact, will interfere with aspirin’s effectiveness as a blood thinner. People with high blood pressure are often advised not to take NSAIDs.
Tylenol (acetaminophen) both regular 325 mg and 650 mg extended-release options. The slower release from the extended-release product is better for your liver. Used for pain relief and fever reduction. Extended or overuse can cause liver damage. A 500 mg version is also available. Tylenol is not an NSAID and, although effective for pain relief and fever reduction, will not work for joint swelling or menstrual cramps.
Alternating ibuprofen with acetaminophen is extremely effective for pain relief. This does not mean taking both at the same time, allow the recommended time to pass between doses and switch between the two. Do not exceed recommended daily allowance of either. We also keep Advil Dual Action which combines 125mg of ibuprofen with 250mg of acetaminophen in a single caplet. This works the same as the alternating doses method described above using half-strength doses. Be wary of taking NSAIDS on a regular schedule other than the 80 mg dose of aspirin for blood thinner purposes. If you do overuse NSAIDS, you may end up with a splitting headache referred to as a rebound headache! Rapid-release varieties are available for Tylenol and Advil but in the case of Tylenol, the load on your liver is a risk.
CBD (cannabidiols from hemp extract). We began keeping CBD oil in oral solution for pain relief, sleep aid and calming several years ago. CBD oil “tincture” comes in concentrations ranging from 500-3,000 mg of various flavors including citrus, mint, and cinnamon. We have also received benefit from CBD in ointment, lotion, and roll-on topical solution for pain relief. We have found the topical solution works fastest but lasts for the shortest time whereas the ointment has a longer onset time but also has a longer duration of action.
I was originally very skeptical of using these products because off the stigma of hemp being a “cousin” of marijuana and my own skepticism towards a natural product’s effectiveness. After my wife researched and explained the difference between THC and CBD to me and provided the professional literature documenting the effectiveness and non-addictive nature of CBD, I softened my objections. I’m glad I did because we have each used these products and benefited from them to the point that we started telling others about the effectiveness and became re-sellers for a local hemp farmer’s CBD product line.
Icy Hot (lidocaine) pain relief cream. This is a topical used for fast targeted relief such as joint or muscle ache. The cream version provides good absorption, is less greasy, is easy to wash off, rubs in cleanly and will not stain clothes as the ointment version is prone to. The gel version of Lidocaine would also be a good selection.
Gastrointestinal (GI) Products
Tums antacid (calcium carbonate) works directly at site of action to neutralize stomach acid, thus its speed at reducing discomfort. For occasional use only.
Acid Reducers – Pepcid (famotidine 20 mg) and Prilosec (omeprazole 20 mg). These differ from antacid in affect by systemically reducing the acid secreted into the GI tract. These are for short-term treatment of acid reflux. These have a two-week window for self-treatment. Symptoms that last longer should be attended by a physician.
Gas-X soft-gels (simethicone 125 mg) anti gas, works by “popping” the bubbles of gas in your stomach and intestines. This is essentially the adult version of Mylicon Drops given to infants for gas.
Pepto Bismol chewable (bismuth subsalicylate 262 mg) for general stomach upset or diarrhea. Chewable version selected for greater shelf life.
Fleet brand suppository (glycerin 2 g). This is a gentle laxative to deal with constipation.
Dramamine Less Drowsy Formula (meclizine hydrochloride 25 mg). This version was chosen over the original formula containing dimenhydrinate because it is more effective and has fewer side effects. Although best known as a motion sickness preventative, it works for prevention and treatment of nausea, dizziness and vomiting.
As we finished talking about the GI OTCs she selected, I asked my bride why she chose not to stock Imodium. Essentially every YouTube video covering the medical supplies carried by a long-distance hiker or in a bug-out-bag mentions it. She said that Imodium’s active ingredient, loperamide, is known to slow movement of the GI tract and over-usage has serious side effects such as fainting, irregular heart rhyth, and unresponsiveness. In her opinion, the risks do not outweigh the benefits and to back her beliefs, she recalled from memory an FDA safety black box report from 2019 outlining the concerns.
(To be concluded tomorrow, in Part 2.)