Tag Archives: OTC

Momma Bear: Thoughts On The Flu

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My worst-case SHTF scenario: Facing a global pandemic. A pandemic that cuts all supply chains, destroys public services (electricity, water, medical, and government) and throws civilization into uncontrolled chaos.

sick w fluUnless you have had your head in the sand this past month, you are probably thinking about, and watching, this current flu epidemic. I took this as an opportunity to study up on the biggest global bout with the flu, known as the Flu of 1918 or the “Spanish Flu”. We’ve all heard how tons of people died from this flu (it killed 20 to 50 million people — 1 to 3 percent of the world’s population at that time). But there were three giant facts that surprised me:

  • This flu actually lasted two full years (1918-1920), and had three specific “waves” of infection at a time when the world population was not very mobile.
  • It killed quickly (in some instances only one day of symptoms)
  • It killed healthy people in the 20-40 age group (not the norm for flu related deaths).

We are a million times more mobile, as a population, than we were in 1918 so our transmission rates are much higher. Although we have modern medicines, we are also starting to see resistance to those medications. A pandemic is a very believable SHTF scenario.

stop the fluOur family got hit with the flu over the long holiday. Because we instituted some severe tactics, only two of us got moderately sick, one was minimally ill, and three escaped unharmed. When the first person became ill, it started quickly with chills, 102+ fevers, and a croupy, nasty cough. Initially thinking it was just a severe cold, he didn’t go to the doctor right away so he missed the two day window for Tamiflu but he did test positive for flu. The first thing we did was to isolate him to his room. When he wasn’t in his room he wore a mask, hand sanitized multiple times, did not touch any food/cupboards/fridge to serve himself, only used disposable plates and cups, and we sanitized the counter area where he ate. Medications he took, to treat the symptoms, were ibuprofen and MucinexDM (12 hour doses of guaifenesin and dextromethorphan) with moderate success (but he still felt crappy). The second person, our daughter, became ill by accidentally drinking from the first person’s cup. Like the first person, we isolated her at home and treated her with the MucinexDM. Unfortunately she got the vomit portion of the flu and she DID have to go to the emergency room for an IV to treat the dehydration migraine and vomiting. The last person to become ill only suffered from cold symptoms and chills. In all three cases, the people have suffered from a long term dry cough that has taken weeks to go completely away.

Isolation is the best method for treating a big flu outbreak. But in America that is something we just aren’t good at. We are very mobile and we insist on working, shopping and doing pretty much everything while we are sick (all the while spreading our germs as we go along). In Japan though, when we had a big flu outbreak, it was routine to close a public school down (or businesses or whatever) for a week and decontaminate it; while allowing the virus to, hopefully, work its way through the population AT HOME. What a great way to keep from infecting more people!

Medical masks are also key in reducing contamination rates in a mobile population but most people misunderstand how they work. When sneezing or coughing, germs can travel in the air up to six feet or so and remain active for hours. Masks are primarily used to keep an infected person from spraying their germs outward, NOT to prevent a person from breathing in germs. When you see pictures from Japan of people wearing masks, those are the sick people going about their lives while limiting their illness from transferring to others. This is a culture that is centered on being considerate and concerned with how their behavior affects others and it is considered rude to cough and hack in public and NOT wear a mask. Masks are available everywhere in Japan, including a big section at the dollar store where they come in all different sizes, colors and cartoon characters. But here in America you rarely see anyone cover their cough with a mask and most often that masked person is looked down on as being some sort of germaphobe. Our own cultural norms work against us when it comes to how we deal with illness.

mask & sanitizerIn a medical study testing the efficiency of masks at preventing an infected person from spraying their germs, it was found that N95 masks had the same effectiveness rate as a plain medical mask at suppressing the passing of germs into the air through coughing and sneezing. So the good news is that you can stock up on the plain and less expensive masks! You certainly can choose to wear a mask in an effort to prevent breathing in germs, though the masks are not air tight and germs can enter from the sides. You are also still susceptible to any surface contact with germs; they can live up to eigh hours on surfaces so it is important to wash your hands regularly, use hand sanitizer and clean any and all surfaces touched by an infected person. Similarly, most people are contagious with the flu for a day or two prior to experiencing symptoms. If you go out in public, mask or not, you are going to come in contact with the virus.

Our bout with the flu was by no means what I would term as a severe case because in both instances the fever was reduced by medications and overall the symptoms were manageable at home. My daughter suffers from recurring migraines so we do not necessarily consider her ER visit an acute occurrence of the flu. All that said, we were prepared to treat the flu here at home for an extended period of time if necessary, but how many “average citizens” have a stock pile of food, meds, masks, and sanitizer in their closet? Keep up the good preps folks, and cover that cough!

 

What We Did This Week To Prep 5/11/12

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Today is my 100th post. On one hand that number amazes me and I can’t believe I’ve written that much, but on the other it seems like I’ve been doing this forever. I said I’d write, three times a week, for a year and see where I am at that point — I’m into the 9th month.

We went to Costco. It was a relatively light trip, actually under budget. Since we had a little extra, we again added to our stock of over-the-counter (OTC) medications. Right now OTC generic meds, like: ibuprofen, acetaminophen (Tylenol), diphenhydramine (Benadryl, for allergies), loperamide (anti-diarrheal), pseudoephedrine (Sudafed, for congestion), guaifenesin (Mucinex, a cough suppressant), hydrocortisone (topical for skin problems), loratadine (Claritin, 24-hour allergy med) and daily multi-vitamins are all cheap and readily available. If you keep them stored in a cool, dry, dark place, they’ll last a long time. There may be a time in the future they’re not as readily available, so stock up now–even if you don’t use them much on a regular basis–you’ll be glad you have them then. Remember, as with all your preps, rotate your stock and always use the oldest first.

On the medication category we also budgeted money to buy more fish antibiotics. We already have the fish version of amoxicillin, cephalexin, and metronidazole. I ordered more amoxicillin (probably the best, widest spectrum antibiotic available in the “fish market”), more cephalexin (a good antibiotic to use for cellulitis, which I believe will be a very common type of collapse infection), doxycycline, and ciprofloxacin. We’re still not quite where I want to be, but probably a good 2/3rds of the way. Again, these are only to use after a total collapse, but at that point they will be life-saving. This is another item you can buy now, easily and inexpensively and safely store for years; and it’ll be invaluable to have in your preps if the SHTF. Unlike almost everything else we store, this is not to be rotated and used on a regular basis. This is only for a collapse, and then only to be used with proper care and education, and sparingly. If things collapse, on a large-scale, it’s likely these will never be available again.

We’ve been shooting airsoft regularly and really enjoying our little airsoft pistol. Sarah, Ryan, Alison, and I have all been shooting on our small “indoor range” inside the house; now that the weather is getting nice we go outside and shoot cans and plastic bottles off the picnic table (Sarah, especially, is getting really good). Since we’re using it so much I’ve decided to upgrade to a better, more accurate airsoft pistol. I’m also considering getting a tactical-style rifle to incorporate into our training.

On a related note, security and home defense have been in the forefront of my mind this past week. I recently read Holding Their Own and looked through Holding Your Ground, both by Joe Nobody. Also a prepper friend and I have been discussing homestead security concerns and ways to address them. Then Jack, on The Survival Podcast, did a show this week on “Security During a Break Down” (TSP episode 899) which made me do even more thinking on the topic. Security isn’t something to panic about, but it definitely needs to be part of your planning. As Jack said on the show, of your five basic needs, your body tells you when you need food, water, shelter, and energy–but sometimes you don’t know you need security until it’s too late.

I hope everyone is enjoying their spring weather and shaking off the “long dark winter” cobwebs; it’s been especially nice here. If at all possible, plant a garden this summer, start it this week if you haven’t already (it’s not too late). Even if it has to be something small; start learning the skills, eating healthier food, and learning an appreciation for growing something with your own hands.

What did you do this week?

Expired, or Not Expired… Can You Store Medications Long Term?

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What medications* do we keep in our preps? We store: 1) over-the-counter (OTC) drugs: ibuprofen (Motrin), acetaminophen (Tylenol), aspirin, diphenhydramine (Benadryl), pseudoephedrine (Sudafed), loratadine (Claritin), guaifenesin (Mucinex), and 2) antibiotics (that I recently posted about): amoxicillin, cephalexin, ciprofloxacin, doxycycline, metronidazole.

How long can they be stored? They have expiration dates, does that mean they go bad?

Let’s start with what do drug expiration dates mean? Required since 1979, the expiration date is the last date that the pharmaceutical company will guarantee 100% potency (some sources state at least 90% potency). So then we ask, how long does it take a drug to lose it’s beneficial effects?

That is the question that the Department of Defense (DOD) asked the Food and Drug Administration (FDA) in 1985 (the military had over a billion dollars worth of medication stored). So in response, in 1986, the DOD and the FDA began the Shelf Life Extension Program (SLEP).

The SLEP program is documented in the Wall Street Journal article, Many Medicines Are Potent Years Past Expiration Dates, by Laurie P. Cohen, March 28, 2000. The military submitted, and the FDA has evaluated, over 100 drugs – prescription and OTC. The results showed that about 90% of them were safe and effective well past their expiration dates, some for 10 years or longer. Joel Davis, a former FDA expiration-date compliance chief, said that with a handful of exceptions – notably nitroglycerin, insulin and some liquid antibiotics – most expired drugs are probably effective.

In light of these results, a former [FDA] director of the testing program, Francis Flaherty, says he has concluded that expiration dates put on by manufacturers typically have no bearing on whether a drug is usable for longer.

Mr. Flaherty notes that a drug maker is required to prove only that a drug is still good on whatever expiration date the company chooses to set. The expiration date doesn’t mean, or even suggest, that the drug will stop being effective after that, nor that it will become harmful.

“Manufacturers put expiration dates on for marketing, rather than scientific, reasons,” said Mr. Flaherty, a pharmacist at the FDA until his retirement in 1999. “It’s not profitable for them to have products on a shelf for 10 years. They want turnover.”

The Harvard Medical School Family Health Guide, in Drug Expiration Dates – Do They Mean Anything?, notes that, with rare exceptions, “it’s true the effectiveness of a drug may decrease over time, but much of the original potency still remains even a decade after the expiration date”.

Where and how medications are stored is an important factor in minimizing their degradation. Storing in a cool, dry, dark place will maximize their lifespan; when possible keep sealed in their original container until ready to use. Medications stored in bathroom cabinets or shelves could have effectiveness significantly reduced. Be sure to discard any pills that become discolored, turn powdery, or smell overly strong; any liquids that appear cloudy or filmy; or any tubes of cream that are hardened or cracked.

Dr. Bones, from The Doom and Bloom Show, states in his blog post, The Truth About Expiration Dates, “I put forth to you this recommendation: Do not throw away medications that are in pill or capsule form after their expiration dates if you are stockpiling for a collapse. Even if a small amount of potency is lost after time, they will be of use when we no longer have the ability to mass-produce these medicines. I’m aware that this is against the conventional medical wisdom, but we may find ourselves in a situation one day where something is better than nothing.”

(Friday: What I Did This Week To Prep)

* The terms medications and drugs (referring to legal drugs) are used interchangeably.

Post Script: Dealing With The ‘Tetracycline Becomes Toxic’ Myth

There has long been a belief that the antibiotic tetracycline becomes toxic once it has past it’s expiration date.

In Medscape Today’s article, Do Medications Really Expire?, they discusses the original case, “A contested example of a rare exception [of expired drugs possibly becoming toxic] is a case of renal tubular damage purportedly caused by expired tetracycline (reported by G. W. Frimpter and colleagues in JAMA, 1963;184:111). This outcome (disputed by other scientists) was supposedly caused by a chemical transformation of the active ingredient.”

The case was thoroughly evaluated in the 1978 article, Tetracycline in a Renal Insufficiency: Resolution of a Therapeutic Dilemma, it states, “”Old” and degraded tetracyclines have previously been demonstrated to have direct toxic effects on the renal proximal tubule, but because of changes in manufacturing techniques this is no longer a real problem.” It also states, “It has often been stated that the tetracyclines should be avoided in patients with severe renal disease, but, as we shall see, doxycycline represents an important exception to the rule”.

In Cohen’s article on the Shelf Life Extension Program, Many Medicines Are Potent Years Past Expiration Dates, it goes on to state, “Only one report known to the medical community linked an old drug to human toxicity. A 1963 Journal of the American Medical Association article said degraded tetracycline caused kidney damage. Even this study, though, has been challenged by other scientists. Mr. Flaherty says the Shelf Life program encountered no toxicity with tetracycline”.

Dr. Bones and Nurse Amy, from The Doom and Bloom Show, when interviewed on TSP, clearly state that tetracycline past it’s expiration date is safe (episode 736, beginning at 43:45). Nurse Amy concludes the topic with “. . . if they can just get that in their heads that tetracycline isn’t going to kill you when it’s past expiration”.

Medical evidence supports that tetracycline, past it’s expiration date–especially in the form of doxycycline–is as safe as any other expired antibiotic.