Meds for disaster

Hi everyone,

Been a while since I have been on this forum and can see it is very active.

I am a doctor here in Vancouver Canada. I have been watching CNN who had a seismic doc on who talked about increased risk for other areas on the pacific ring of fire, including the west coast of BC, stating that it is more likely than not that a large earthquake would hit our west coast now given Japans.

My go bag is hopelessly out of date, especially with a 2 year old here now, and I will be updating this for warmth, shelter, and water purification (considering looking to see if RO filters can convert seawater to drinkable water, not sure if this is possible).

For meds, I am thinking appropriate antibiotics for gastrointestinal infections, including parasitic, and respiratory antibiotics as well. For those with a medicine background, thinking ciprofloxacin for me and my wife, sulfa (bactrim) for me and my wife and my son (both for GI, and sulfa can cover parasitic bugs as well, safe for the son). Amoxicillin with clavulanic acid in dosing for both kids and adults.

Thinking SSKI or KI pills for radiation (highly unlikely anything from Japan would reach here).

Hydration salts (non prescription of course).

Antidiarrheals, antiemetics (nausea), pain killers.

That's all I can think of. Anything I might be missing?

Eric

Welcome back - An edc med for me is ibuprofen or similar pain killer/ anti inflammatory

teacher

Eric ... I'll get back to you here and post some general meds that we carry in our bags when we are working overseas. Basic stuff. Everyone here is welcome to look at the list.

Can I ask you a couple of questions? This might turn out to be research for you - but it would be helpful if you could report back to the forum on these issues.

PAIN MEDS: This is a big problem for people who are working overseas in remote areas, or in disaster zones. There are situations where both local people, and volunteers, could have accidents that create a lot of pain. Evacuation might be delayed and could take a long time. Probably no need to tell you that Tylenol and Aspirin are not going to do the trick for people with very high levels of pain. One option is codeine, which is legal as an over-the-counter drug in some countries (it is a controlled substance in others). Otherwise, it appears that the advanced painkillers are all derivatives of opiate drugs and are highly controlled (morphine, oxycodone etc.). If you come across any other options for pain relief, please post them.

RADIOACTIVITY: I'm hearing a lot on the press about Japan giving "iodine" to people who have some risk of exposure to radioactivity. This is a totally new area for me - I am not familiar with this treatment at all. Can you check and find out what form the iodine is actually in, and whether there are any possible complications from using it? That would be helpful to know.

thanks for your inputs,
other Pete

Hi Pete

For pain, no, I have not come across options other than opiates or codeine. Codeine is over the counter in small doses in Canada (Tylenol 1) but adequate doses for pain without too much acetaminophen from the tylenol would require a prescription. Moot point if codeine is controlled in most countries.

Radioactivity: going by memory it is potassium iodide. The iodide saturates the thyroid preventing thyroid uptake of radioactive iodide. I don't believe iodine used in water purification would work unless it was reduced to the colorless form with vitamin c, but then dosing is hard.

As for my med list, forgot to include allergies, including benadryl, prednisone (prescription), and epi pens.

Eric

I concure on KI being a no-go for water purification, it is too stable a compound.

Also, for KI to really work, it already has to be in your system and replacing the normal form of iodine in your thyroid. And you can only take it for limited duration. The real trick is getting solid numbers for both- it seems to vary, 3-4 for pretreat and 15-30 days for negative effects, in the various materials I've read. It's better than nothing, but it's really only looking after you thyroid.

Eric, short of Rx items, what are you thinking for an antihistamine?

you might try the YouTube vids by The Patriot Nurse

While a bit beyond me, there seems an extended discussion of emergency meds [and everything else first aid] here:

http://forums.equipped.org/ubbthreads.ph...true#Post217217

If you Know someone that,Visits Mexico on a Daily/Weekly basis,there is the Possibility they can obtain Meds,Of which are Not Obtainable Here in the States,Same Goes for Canada,They sell things there,That are Not sold here.This is Only a Suggestion,& I am Not Advocating Anything Illegal!YMMV!

A few more things to consider.

Sticking with Over the Counter (OTC) medicines limits things a lot (for us non-medical types). Most of what follows is for those without general access to prescription medicines.

With that in mind make sure you have any prescription meds you need with you, at least a week supply.

If you have severe allergies keep some fast melt Benadryl (or equivalent) on hand along with Zantac (or equivalent) and your epi-pens. The Zantac was recommended by my wife's doctor since it is a histamine blocker and works well with benadryl. If you don't have professional help handy immediately for an anaphylactic reaction these meds can buy you a fair bit of time.

Benadryl also makes most people sleepy so while it isn't a pain med it might help take the edge off if OTC pain meds aren't enough.

Aspirin has lots of uses, even if not as a primary pain med so you should have some along.

A little saline has a lot of uses (eye wash, wound wash, sinus wash etc.).

Not really a medicine but pedialite (and the generic versions) now have powder you can add to water. Very good for dealing with dehydration.

Thats what comes immediately to mind.

- Eric

Eric ... I think that my standard list of meds is on my computer at work. I'll bring it home and try to send it to you tonight.

This is a good time for me to brush up on this area anyway - I am always trying to improve what's on this list of meds. Thanks for your answers to the questions above!!

Watch for a PM from me.

other Pete

ERIC - Ok Here's my basic meds list. This list is not complete, and i might make a few additions. These are the basic team meds we carry when we are working in ghetto's and disaster zones overseas. The meds do NOT address comprehensive problems, and they are not intended to treat patients where we go. They just help our own team members to overcome common problems that arise.

Anyone who has any suggestions or improvements ... I am always open to better ideas.

-----------------------
BASIC TEAM MEDS

Wounds/First-Aid
* Clean water and mild antibacterial soap ... treatment of mild wounds
* Neosporin and hydrogen peroxide ... for mild wounds. These are kid-friendly. Hydrogen peroxide is heavy to carry!
* Shur-Clens: Used for cleaning acute wounds (we are still evaluating this item).

Cold/Flu
* Thera-flu packets work well. Individual team members typically bring their own preferred cold meds.

Eyes:
Visine for eye lubrication
*Gentamicin sulfate opthalmic solution for problems like conjunctivitis and pink eye

Diarrhea:
* Bring several clean towels! Explosive diarrhea is really messy.
* Immodium AD. Helps in mild cases.
* Both antibiotics below (esp. Cipro) help a lot when things are serious

Antibiotics:
* Ciproflaxacin: Good for skin infections, respiratory and urinary tract infections, bad diarrhea and infectious diarrhea
* Doxycycline ("doxy")": Used by our team as a daily anti-malarial preventive (works well), also effective against travelers diarrhea, some respiratory and urinary tract infections

Fever & Pain
* Aspirin, Motrin and Tylenol: Go like hotcakes. The locals always want what we don't use ourselves.
* Codeine: On our list of "want to have" meds, but depends on obtaining from appropriate sources. Not always legal.

Special Meds:
* Malarone for real malaria cases (Lariam NOT recommended, though it does work).
* Epi-pens: We sometimes have these, but have not needed one. Essential if you really do have an anaphylactic shock problem.

There are other meds, and I will post them. I also do a variety of "alternative" treatments, but I only do these on myself (as a guinea pig) and people in ghetto's. The ghetto folks are totally forgotten by their own system and have zero medical care. I do not use folklore meds, but rely upon clinically proven approaches. One example is the use of honey as an antimicrobial agent for treating mild wounds. Has worked OK for me.

all the best,
other Pete

So what is in your "meds for disaster" that would not also be in your "everyday" first aid kit?

A Contact list of People from the Otherside of the tracks!

Provodone-Iodine Swabs?
BZK Wipes??
Alcohol Prep Pads and/or bottle of isopropal?


Pseudoephedrine? Decongestant, also useful as a mild stimulant
Guaifenesin? Expectorant


Sterile Saline Solution? Available in several sizes as an eye wash, also works for flushing wounds.


Also baby wipes and extra underwear!


Nitazoxanide? Treatment for giardiasis and cryptosporidiosis
Also, how much are you going to carry? 500mg BID for 28 days is a lot of meds. Maybe consider Azithromycin Z-Packs or Tri-Packs for faster action/less bulk?

Note from the CDC: Agents such as trimethoprim-sulfamethoxazole and doxycycline are no longer considered effective antimicrobial agents against enteric bacterial pathogens.


Diphenhydramine? Antihistamine
Potassium Iodide? Possibly worthwhile given the recent events in Japan

Just throwing some ideas out there. Unfortunately, keeping a sufficient and fresh supply of antibiotics is problematic for me.

Mark M: I will add a few more items in the next day or two. I've had a lot of discussions with nurses and physicians about wound treatment. The general opinion is that iodine is too aggressive on wounds, and tends to damage good tissue as well as infectious bacteria. So that is why I listed the options that I did. In the old days, when I was a boy, everybody used iodine. I hated it as a kid because it really stings, but let's face it - it does work. If you had nothing better, you could use iodine on mild cuts & wounds.

Isopropyl alcohol is an excellent thing to have in your "kit" or BOB. It's good for cleaning skin around wounds, and very good as a fuel for makeshift stoves.

dweste: In situations where there are a lot of people who are displaced from their homes, two things tend to go wrong. The first is that human fecal matter winds up getting into local water sources. People have diarrhea and they can't help polluting the water sources. If this gets bad, you wind up with outbreaks of cholera. Cholera kills people fast - esp. people who are run down due to exhaustion, dehydration, and hunger. Cholera shots are only partially effective. The best way to avoid cholera is to drink ONLY pure water, and to mix some oral rehydration salts (ORS). So it would be worthwhile to have the ingredients for ORS and the formula handy.

The second problem is that other communicable diseases can spread, due to the fact that you've got a lot of people living in very close proximity (colds/flu, diseases from ticks & fleas, etc.). So you have to decide how clean your local "refugee camp" really is ... before going there.

other Pete

WB Eric, and timely topic. DW and I are currently evaluating our FAKs, but alas we don’t have medical backgrounds. DW works in the local hospital (social worker) and has access to docs and info. For the meds, we are looking at the variety of OTC meds and prescription meds we use/have in our home as a starting point. Things we are looking at include:

OTC meds
Anti-inflammatory/pain relief/fever reducer – ibuprofen tablets
Allergy Meds (Antihistamine/Decongestant) – generic benadryl or generic zyrtec and decongestant tabs (considering other alternatives as most allergy meds put DW down for the count)
Cold/Flu remedy – generic Nyquil works for me as it doesn’t make me sleepy, but others may need something like generic Dayquil – everyone has their own preference – along these lines might want to include something for coughs as well (thinking mucus relief type stuff with cough suppressant - the DM version basically)
Anti-Diarrheal – Generic Immodium or similar
Constipation (the other end of the spectrum) – generic ex-lax or possibly just a stool softener
Antacid/Acid reducer – generic Tums, generic acid reducer or similar (Considering Pink Bismuth as it could also serve as an anti-diarrheal but effectiveness is a consideration)
Aspirin – I am on a daily low dose regimen and as pointed out already it serves other uses as well
Considerations for DS as well – Childrens versions of above meds where appropriate and include dosing chart and measuring syringes
Something for Nausea – not sure how much a concern this will be but a vial of Dramamine or similar doesn’t take up much room
Assortment of creams/salves – itch relief, anti-fungal, petroleum jelly, etc
Feminine related stuff – DW is in charge of that

Prescription Meds
Blood Pressure meds for DW, stratera for DS, and insulin-dependent diabetic supplies for myself

I would like to be able to include some broad spectrum antibiotics and pain meds in our supplies but there is such a problem with people addicted to prescription pain killers in our area that they may be hard to come by. The recent events in Japan have me thinking of including some of the iodine treatment (potassium iodide is it?) as well. The hydration salts, pedialite and saline seem like a good idea as well. You are right about benadryl making most people sleepy, and you can add Dramamine to that list of taking the edge off of pain as well (use with caution and YMMV)

I'm not a doctor, and I don't play one on the Internet. With that understood, I'm told that different antibiotics work on different infections, and without a good diagnosis it's likely that an antibiotic just won't work.

Mark and Chaosmagnet ... I've fought this battle over antibiotics for a long time. First, let me say that I am 100% in agreement (and respect)with the medical community on the need to avoid over-using antibiotics. A lot of people want them needlessly. That is unnecessary. Also, as you have correctly stated - the best approach is always to identify the infectious agent and then treat appropriately. That's why we have MD's, and why they go to med school.

However, there are certain situations where this does not work. If you are working in a remote area (wilderness country, or third world destination), and you don't have an MD present, then you've got an infection risk. I am unwilling to accept the possible risk of bad infections & gangrene happening for bad wounds, just because of the normal rules. I do understand that gangrene is fundamentally due to a loss of blood flow to a part of the body, but I still want the option of fighting infections as much as possible. So for these situations - and these situations alone - I try hard to find solutions that will help. The two antibiotics that I listed are a fairly good approach. They are not perfect.

My prime method for addressing the issue of wound infections is to become MUCH better at cleaning and dressing wounds in the field. In fact, I'm working on those skills right now.

Here are a few more meds that can help (some you already mentioned):

* Benadryl ... very helpful for allergies and stuffy noses
* Lotrimin ... good anti-fungal for external use
* Isopropyl alcohol .... I prefer the 91% version, but 70% is fine. Good for cleaning skin. Excellent as a fuel for makeshift stoves (e.g. coke-can stove). But bulky, and cannot be carried on airlines.


other Pete

For this reason I probably wouldn't include them at all. However, a recent illness has made me reconsider including antibiotics in a kit. It was almost a month ago now, on a Saturday, that I started feeling bad. A sniffle, a slight cough, and an overall feeling of blah (this late Saturday night after feeling well enough earlier to be dancing at a local charity event). The next morning I couldn't even get out of bed. I layed around until 7 o'clock that evening. The sniffles and slight cough had become full blown congestion, runny nose, hacking cough, etc. Monday I went to work anyway, still feeling like a train wreck. After work that evening I visited the hospital's after hours clinic. What I thought was going to be a diagnosis of a cold and bronchitis turned out to be walking pneumonia. 10 days worth of Augmentin (I am pretty sure I butchered the spelling on that one), longer for OTC meds (generic nyquil and mucus relief) finally cleared it up. On reflection, it occurred to me that had I been in an emergency situation and had that happen I would likely not be here. There is just no way I could have done anything like setting up a decent shelter or building a fire feeling as bad as I did. Of course I would not include any kind of prescription meds without consulting my physician first, but I can't help wondering if having something like a z-pack would help. Maybe not cure me, but at least buy me some time until I could reach proper medical attention. To be honest I am not really sure. As I said this thread is timely for me. Another factor I am considering here is cost. I am fairly certain that these meds will likely go unused and have to be rotated pretty often. Z-packs and prescription pain meds aren't exactly cheap. There are good arguments for and against including them in your kit.

One thing to keep in mind ... is that although an MD might not be present at your location, it could be possible to talk to a doctor over the phone, esp. if you've got a sat phone. So you can still get remote advice on how to treat a problem. But you can't perform the treatment - if you don't have the meds.

other Pete

consider adding clindamycin or metronidazole for GI infections; clinda of course can double for cellulitis. Seems infections run rampant after this stuff.

Zofran/phenergan/compazine for Nausea/vomiting.

Personal scrips, including spare glasses. Personally, if you wear contacts, have a case with some saline already in the cups, and ditch the contacts if you are in a disaster zone. Too much potential for crud to infect your eyes.

Your memory is right - KI for fallout.

Otherwise, I think most of the other meds have been touched upon.

Maybe a bag or 2 of saline, in case dehydration gets the best of someone. Which of course, entails all the set-up equipment as well.

I have been wearing glasses for quite a few years now and I have come to appreciate them. I experience none of the hassles that affect contact wearers. Get safety grade hardened lenses and protect your eyes routinely.

I always carry a spare pair - otherwise I cannot drive legally (or competently).

MDinana ... thanks. Will add to my list.

other Pete

Good post on an important (and somewhat controversial) topic.

My take is if you are going to 3rd world, you bring as much as you can to cover as many scenarios as possible. Hence, the docs in my clinic have no problem writing z packs and other antibiotics to send with people going on multi-week adventures in a place where they may not have access to the meds.

Here in the states, if you want to include a course of antibiotics in your BOB or whatever, that is your choice, but the difficulty of rotation and cost become something to seriously consider vs. the benefit.

I know some persons who went to Haiti to help out, and it was really meatball stuff. Horrid, really, with bandages running out (remember, bandages need to be changed, etc.)

If you want to go to the trouble of maintaining a fresh antibiotic supply in your home kit, go for it. I don't, even though I can easily obtain them.

Interesting about the CDC note, didn't know that here in Canada. Trimethoprim-sulfa came back as one of the useful agents in a patient who had a yersinia infection recently, and can actually be really useful in chest infections/pneumonia and skin infections also.

On keeping a fresh supply, I would discuss with your doc a travel /preparedness kit and then talk to a pharmacist about expiry. I have discussed this with pharmacists and the main thing is heat and moisture that kills drugs, and thus refrigeration or a freezer might be an option, though you have to be able to access it of course in a rapid emergency.

Eric

For sure, oral rehydration salts and the know how to replace them is important. World Health Organization has some nice home made recipes also.

Eric

About epi-pens...

No one in my family appears presently to suffer from allergies that would require an epi-pen, but I've been working to build an all-around good first aid kit and several sources convinced me to get my doctor to write a scrip for an epi-pen. He did, and I have the box of two injectors sitting on my desk here.

What I didn't think about was leaving the epi-pens in the kit (which resides in my car) would kill them from heat. I leave the FAK (assembled in a Home Depot orange Homer box with tray and handle) wrapped in a blanket to moderate the heat, but it can quite quite warm in there at times. 87 degree or higher heat will kill an epi-pen, or so I'm told. On the other hand, its useless if you don't have it available when someone needs it.

Anyone with suggestions how to deal with this problem?

My kit has a box of 4x4s, tape, a County-Comm scissors, Zip-loc bag of gloves on top, my son's Type 1 diabetes test kit (except insulin), bandages, the full contents of the FAK that came with my SUV, alcohol pads, three ACE bandages, a SAM Splint, Kerlix rolls, Diabetic sugar tabs, Benedryl, Immodium, ibuprofen, a couple of light sticks, antiseptic wipes, calamine lotion, some hydroxycodone left over from a prescription, two face masks, triple ointment, ant-itch/burn cream, some moleskin, children's cold/cough tablets and a bottle of Tums. Based on the advice here I'm going to add some anti-nausea pills and some PVP wipes (non-Traid!). Still working on it.

Store them in a properly sized thermus or lunch box with a ice pack you replace daily?

In the circumstance you describe, I would think an epi-pen completely unnecessary, and, as you are finding out, rather complex. My understanding is that epi-pens are for those with allergic histories, rather than the non-allergic general population.

I have a good friend who is highly athletic - college level pole vaulter, marathon runner, highly skilled rock climber - with a known sensitivity to bee and insect stings. he carries an epi-pen at all times. On one occasion we were climbing near a bee hive and, rightly so, he kept a very low and cautious profile. it was fine with me - I got to do most of the fun stuff.

There are posters here with greater training and more recent experience with this subject than I possess.. I hope we will hear from them.

Digimark,

This problem has precluded me from keeping a back-up supply of insulin in my own vehicles. The only solution I have been able to come up with was to make it part of my EDC ... sort of. Not in my pockets EDC, but rather in a separate case containing all my necessary supplies and testing equipment that goes with me in a bag I carry with me EDC. The bag is never usually not far from me (it is sitting beside my office chair as I type) and it goes with me everywhere - well it is supposed to anyway. It is far from perfect (if I forget the bag, my needed supplies are left behind as well, which is why I DO have a backup kit that stays in my office as well). Good thing is the bag can also carry additional gear that I might otherwise not be able to EDC (like a heat sheets bivvy). I considered a belt pouch but my work environment precludes me carrying something like that. If you are serious about carrying the epi-pens, find a way to make them part of your own EDC. One good thing about doing that will be you can probably work it out to carry some extra insulin with you as well. Good luck.

An Epipen was the first prescription medicine I ever asked a doctor to prescribe for an emergency kit.

Quick story: When I was in college, I used to work as a lifeguard / swim instructor at summer camps. One of the really fun things I got to do was to be the last canoe down the rapids on some whitewater canoe trips run by the camp.

While getting ready for one of these trips, the camp nurse pulled me aside and told me that a neighboring camp had been on a similar trip. One of the kids had an anaphylactic reaction to a minute amount of peanut butter residue on a knife he had used to cut his sandwich, and he died on a sandbar on the Delaware River with his counselors powerless to do anything about it, and all of his friends watching. She handed me an Epipen, taught me how to use it, and swore me to secrecy that I had it, unless I needed to use it. That scared the crap out of me.

To this day, when I head out into the wilderness, in an easily accessible place I keep an Epipen and liquid Benadryl (and now that i have kids, an Epipen Jr.). While neither is an absolute cure, between the two I hope I can at least give someone with an anaphylactic reaction a fighting chance.

Seems like I met a person once who told me that they injected themselves with an Epi-pen just to see what would happen. I think they were part of an EMT class, or some first-aid training. Apparently the results DO give a great RUSH to the patient :-)

Speculating here - I wonder if an Epi-pen would be one technique to get a person moving, if they became "frozen with fear" during a critical emergency?? If all else failed, just pull off the top of the epipen and STICK!! Well ... that's probaly not very nice behavior, anyway. It bet it's been contemplated, though :-)

Pete #2

Pete,

While I'm sure you were joking, I would NOT recommend this!

In EMT class they taught that the only contraindication for epinephrine in an anaphylactic person is death - in other words, they're likely to die without the medicine, so no harm in trying (you can't be anymore dead than dead!). While most healthy people will survive an un-needed dose of epinephrine, it will raise the heart rate and blood pressure among other things, and if someone already has cardiac issues, that might not be a good thing. I'm sure some of the people with higher levels of medical training than me can elaborate more.

Besides, have you seen the needle on those things? The spring and needle are strong enough to be driven through heavy denim jeans. I would imagine that hurts! An Epipen would not be my first choice if I was looking for a chemical "rush". . .

Hi,

My wife suffers from severe anaphylaxis with no known trigger, her Dr. thinks it is some form of random histamine dump. I have had to use her EpiPens on her on a couple of occasions so I thought I would share.

Key think to remember about an EpiPen is that it is only supposed to buy you some time (and not very much, depending on circumstances) to get to medical help. If you ever have to administer one (or both of them in the kit) you need to get the recipient to a hospital ASAP! (Note: call 911 and wait for the ambulance, you don't want to cope with this in the car!!). This can be difficult because the "rush" from the medicine and the symptom relief can easily convince you that everything is all better. When the medicine wears off you can quickly find yourself back in a crisis mode. Even if you are past the histamine crisis the medicine in an EpiPen is placing a lot of stress on your system.

If you carry one, please be sure you know how, and much more importantly, when to use it.

-Eric

Eric ... thanks. Good advice. And what I noticed from your comments is that two Epi-pens may be required.

Jesselp ... yes I was mostly joking with my earlier comments. But if you've ever been in a situation where you need to get people moving quickly, and they just aren't responding because of high levels of personal fear (or mental exhaustion), then you might sympathize with the scenario. :-)

Pete #2

With regards to epi-pens, I'd recommend that people with a history requiring one look into a holster option such as this* to keep it with them at all times, that way it can't get lost.

Pertaining to wilderness use, where rescue might take a while during an anaphylactic crisis and the initial dose wears off, the knowledge of this information* may prove useful - how to get several more doses out of a used epi-pen. Of course doing so is not medically recommended, some guesswork is involved in the dosing and you re-use a dirty needle, so it's a last resort only option.

Also, just a reminder as you compile your lists that allergies can occur with practically any drug, so having a backup option is wise. I'm severely allergic to diphenhydramine, which the active ingredient in Benadryl. I hadn't thought it was possible to be allergic to an antihistamine and so I kept taking it, despite my reactions, until a particularly bad situation that left no room for doubt (I had taken a prophylactic dose). With Benadryl out of the picture and multiple allergies it was a big, "now what?". Thankfully there are other antihistamines out there; Benadryl is popular because it's so good, but having an alternative plan is even better in my book.

Back on the first page someone brought up the potential need for strong pain meds in situations when nothing OTC would come anywhere close. There is a legal option that I feel obligated to mention but cannot in good conscience recommend: poppy seed tea. Sufficed to say people have died of morphine overdose from drinking it. Further details are easily found with a bit of research; again these are with normal poppy seeds completely legal and easily purchased. Not something I personally want anything to do with but a good thing to be aware of.

Also nice to know that eating something containing poppy seeds can cause you to fail a drug test...

*No affiliation

Thanks Ann! I've got a kid in my group with a severe allergy to back and yellow flyers. His parents are too worried to let him go camping with us. The more I know about his allergy and treating it, the more confidence they'll have. It took a while for them to let him hike with us, and this year he hikes without them so there may be hope.

This info is very helpful. Thanks!

My understanding is that the typical adult prescription is for two epi-pens with the instructions basically being, use the first one and if there is not a rapid reduction in the symptoms, give the second. Call for help immediately after the first pen.

My wife's doctor also recommended fast melt benadryl (diphenhydramine) and Zantac. The first is an anti-histimine and the second is a histamine blocker. Not being a Dr. or biochemist all I can tell you is they work differently in the body to help reduce the reaction. If my wife detects the early symptoms we can avoid using the epi-pens by rapidly giving her a full adult dose of the Benadryl and at least one Zantac 75. Her symptoms usually stabilize within 30 minutes of taking these over the counter medicines but I usually end up watching her for several hours after while she sleeps off the benadryl.

To abuse a great line - "Darnit! I'm an Engineer, not a doctor".

Seek professional advice and guidance if this is a concern for you or yours.

-Eric

Interesting info re: reusing the epi pen.

Zantac is just another type of antihistamine drug. It's works selectively on different receptors. If you had to carry one, benadryl is a good standby, but concievably claritin,zyrtec or allegra could work.

Re: glasses - I'm currently overseas. The military saw fit to outfit me with 3 different pairs of glasses, and 2 inserts for goggles (which are crap and kind of 'off'). Because of that, I bought my own safety/goggles, one tinted and one untinted. Yup, I'm rolling with 7 different lenses. I have one sunglass and one regular daily w/ me, the rest in my barrack.

Any thoughts with regard to meds that are usually stored refrigerated, when it comes to a disaster situation? I'm particularly interested in storage of insulin for treatment of Type 1 diabetes.

Thanks!

Mike,

I am a type I, insulin dependent diabetic. While it may not be recommended, I successfully keep a backup kit (needles, alcohol prep pads, and 1 vial of insulin) in my desk drawer at the office. In general, though, my excess insulin stays in the fridge at home.

However, I am guessing your inquiry is in regards to keeping the excess insulin supply as cool as possible in the event of a power outage. This is a difficult question and one I have thought about off and on over the years. A few possible solutions I have considered include:

- Generator to keep the fridge going
- Keep the insulin cool in a cooler - make sure the insulin does not freeze; one of the coolers with a tray in it might be best to keep it from coming in direct contact with the ice; of course this relys on having a source for ice which may not be possible in the event of a widespread outage
- If you are close to a running stream or river, place the insulin in a waterproof case and place the case in the running river - be sure it is well anchored and easy to retrieve; the running water over the case should keep it cool enough

To be honest, though, as I mentioned before my backup supply at the office hasn't seemed to be affected by not being refrigerated (to be fair it is in at least a somewhat temperature controlled environment at the office). Likewise, the vial I use, which travels with me wherever I go, does not seem to be affected either (but it is used up fairly quickly). As long as you keep it from extremes of heat and cold, short term it should be ok from my personal experience. Longer term, there are much bigger concerns. As always, YMMV

I am flight nurse and we keep Humulin R in our main medication kit. It is subject to whole kind of temperature change. We change it every 2 weeks.

http://www.diabetesnet.com/about-diabetes/insulin/insulin-basics

Whooaa there. In the midst of normal conversation, a puzzle appears. Did someone say ... "There is a legal option that I feel obligated to mention but cannot in good conscience recommend: poppy seed tea. "

Is this actually true??

Can someone actually extract enough morphine from poppy seed tea to create a significant dose of morphine? That would be pretty amazing if it is correct. I would have thought that it would take a LOT of poppy seeds to produce any significant amount of morphine.

I am not asking because I have any interest in morphine as an illegal drug. I am asking because if the above statement is even close to being correct, then poppy seed tea could be a helpful pain reliever. But I've never head of anyone doing this - surely it would be well known if true.

Pete #2

WB Edited to specific

Hopefully this answer helps:

Why I know what I know:
At one time I was a Medic on a SAC base (Strategic Air Command - the B-52's with the big bombs). I was on the NBC (Nuclear, Biological, Chemical) warfare team and received lots of interesting training.
Later on - while a firefighter and a reserve LE Deputy I attended more CBRN (Chemical, Biological, Radiological, and Nuclear) accident/incident classes - basically re-learning what I had been taught before)

I-131 is a radioactive isotope of I (Iodine) formed during the explosion of an atomic bomb OR during a severe accident at a nuclear reactor. It has a half-life of 8 days. SO 64 days after 100 grams is formed you have 0.390625 grams left.
(
amount decays by 1/2 per half-life.
creation 100g,
8 days later 50 gram,
8 days later 25 gram,
8 days later 12.5 gram,
8 days later 6.25 gram,
8 days later 3.125 gram,
8 days later 1.5625 gram,
8 days later 0.78125 gram,
8 days later 0.390625 gram,
you get the idea.
)
I-131 is treated by the body just as if it were normal Iodine and will be absorbed into the thyroid. Get too much - your thyroid can die. Get a little bit - your thyroid is subject to a greater chance of a cancer.

To prevent I-131 uptake by the thyroid, you have to flood it with non-radioactive Iodine.

There are two types of Iodine available:
- KI (Potassium Iodide) and
- KIO3 (Potassium Iodate)
that can be used to saturate your thyroid.

<< As a FYI, SSKI drops is a super saturated solution of potassium iodide>>

There seems to be some controversy/intense discussion concerning whether KI or KIO3 is best.

We were always issued KI pills.

Concerning which is best, I have read the papers quoted and for the most part MIS-quoted.
I am satisfied that either will do the job and that both have their downsides.
Neither downsides - in my opinion - are as bad as thyroid problems.

KI4U.com is a good place to read up on it.
Also the Medical Corps website is a good place to read up on it.

As it stands right now, based on what I know and for my location, I am not worrying about saturating my thyroid. You may want to check with local authorities for your area.

If you have any questions, concerns, comments, or just want to chat more about this, please do so.

WB