Prepper’s Pill Box: NSAIDs.

Aspirin, Acetaminophen (also called paracetamol), Ibuprofen, and Naproxen are all available over the counter without prescription in the United States and most of the world. These Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are very mild painkillers that can help you deal with a headache or take the edge of joint and muscular/skeletal pain. Sometimes this can be the difference between being able to maintain a cheerful disposition or get decent sleep, and not being able to do those things. 

(There are many other NSAIDs, but since most of them are still prescription-only in the United States they are beyond the scope of this article.)

I am not a medical professional, and what follows here should not be taken as professional medical advice. This is simply my understanding of how four over the counter medications work, and how I consider using them as part of my resiliency preparations. Your specific medical situation should be something you control under the care of a licensed medical provider, as there is a lot of “Well, what he wrote is true, but in your case...” exceptions in the medical field.

Aspirin

This is the oldest NSAID on the list, which began as a raw willow bark treatment in ancient times to the modern pills we have today. Aspirin works by completely nullifying the cyclooxygenase-1 (COX1) enzyme, and modifying the cyclooxegenase-2 (COX2) enzyme production pathway to immediately prevent inflammation, and trigger the production of anti-inflammatory molecules called aspirin-triggered lipoxins, aspirin-triggered resolvins, and aspirin-triggered maresins. Aspirin is cleared from the bloodstream through the liver, as it tacks on a urea or gluconate molecule which tags the salicylic acid molecule for excretion through the kidneys.

What Does This Mean? 

Aspirin is a very good anti-inflammatory drug and fever reducer. However, it has one other medically relevant property as an anti-coagulant. Aspirin irreversibly stops platelets from clotting by blocking the thromboxane A2 signaling pathway, which also stops the signal to create more platelets.

In a Survival Situation
If you suspect someone has internal bleeding, from a fall, crush, or other injury, you should steer clear of aspirin, no matter how much pain they are in. However, if someone starts having chest pains and other signs of a heart attack, an aspirin here is very helpful to help prevent a blood clot from further restricting oxygen to heart muscle tissue.

Historical Note

There is some speculation that the mass deaths of the Spanish Flu can partly be explained by aspirin overdoses as doctors tried to get the fever under control. The availability of generic aspirin and the Spanish Flu coincided with each other: the US patent on Aspirin expired in 1917, and the Spanish Flu hit in 1918. Many of the accounts of death by Spanish Flu, including a fluid buildup in the lungs, is consistent with aspirin toxicity.

Acetaminophen

First brought to market in 1951 under the brand name Tylenol, acetaminophen is a pain analgesic and fever reducer. We don’t exactly know how it works, but the suspected mechanism of action is an indirect impact on COX1 and COX2. Acetaminophen is cleared from the bloodstream when the liver tacks on a gluconate or sulphate group, triggering excretion through the kidneys. 

Unlike the other drugs on this list, acetaminophen is not a significant anti-inflammatory drug, meaning that if someone is suffering from swollen/inflamed joints or muscles, this is not an optimal treatment option.

What Does This Mean? 

Acetaminophen is good for reducing pain and bringing down fever, without the blood clotting concerns of aspirin, but shouldn’t be your first choice for joint/muscle inflammation.

In a Survival Situation
Acetaminophen is a low-risk option for aches and pains as well as fever reduction. In fact, it is my go-to choice for fever reduction for my family.

Ibuprofen

First patented in the 1960s, ibuprofen was designed as a better option for the treatment of rheumatoid arthritis. Ibuprofen is a COX1 and COX2 inhibitor, but unlike Aspirin, it doesn’t impact blood clotting. 

The anti-inflammatory properties of a nonspecific COX inhibitor are very appropriate for joint pain caused by swelling. Ibuprofen is cleared from the blood by oxygenation in the liver.

What Does This Mean? 

Ibuprofen is appropriate for joint pain and fever reduction, and should not impact blood clotting ability.

In a Survival Situation

If someone is having a lot of pain due to swelling of the joints, Ibuprofen is a safer option for treatment than aspirin and a better option than acetaminophen.

Naproxen

The Food and Drug Administration approved Naproxen as an OTC medication in 1994. Unlike Aspirin, Acetaminophen, or Ibuprofen, Naproxen is a selective inhibitor of the COX enzyme, specifically COX2. This is good news for people who require long term NSAID use, as the COX1 enzyme is used for other things in the body such as controlling stomach mucus. If you’ve ever heard that too much aspirin/acetaminophen/ibuprofen can lead to ulcers, this is true as inhibiting the COX1 enzyme in the stomach lining can lead to areas unprotected by stomach mucus, creating an ulcer. 

Naproxen is cleared when the liver tags on a glutonate or sulphate group for excretion through the kidneys. Naproxen is an effective anti-inflammatory drug suitable for swollen joints and inflamed muscles.

What Does This Mean? 
What does this mean to you? Naproxen is the only NSAID on this list that should be considered for someone with a history of stomach ulcers.

In a Survival Situation

Naproxen is the safest choice for someone with stomach issues for both fever reduction and pain management, but otherwise is very similar to ibuprofen.

Guidelines for NSAID Use
First and most importantly, don’t mix NSAIDs since they all seem to work on the same chemical pathways in the body, and in this case more isn’t better. If you need an NSAID to work faster, caffeine is your friend here, and a normal cup of coffee or strong tea to wash your pills down can really help clear up a headache or body ache.

All NSAIDs are associated with temporary reduction in kidney function, so anyone dealing with a kidney disease should avoid all NSAID use unless directed by a medical professional. 

Do not limit water intake when on NSAIDs. In fact, you should probably drink more. 

Never take more than the maximum dose listed on the bottle. If you need more medicine than that, you really need the guidance of a medical professional and likely a prescription for a different medicine.

Different pills have different release rates, so liquid gels and caplets will deliver the drug faster, as well as headache powders such as Goodies or BC, which are NSAID + caffeine cocktails.

Use the smallest effective amount for the shortest possible time. For people with chronic conditions the time span may be “the rest of their life,” but using the least amount that allows you to function is critical.

If NSAIDs Aren't Working...

1. If you can’t reduce fever enough with an NSAID, cold towels are a better option than more medicine. 
2. If you can’t reduce pain enough with an NSAID, rest and recuperate. 
3. If you can’t reduce swelling enough with an NSAID, remember RICE for Rest, Ice, Compression, Elevate.

In conclusion, NSAIDs are useful tools but they aren't a silver bullet. Use them wisely, but also be prepared to ditch them for other solutions if necessary. 

Guest Post: a Small OTC Pharmacy List

by George Groot

George is a member of our Facebook Group and has written for us before.

Every disaster prep list usually includes the words “30 days’ (or more) worth of medication.” If you are on medication, this is really great advice, but there are also a bunch of things you can purchase without a prescription that will provide you with treatment options  from a headache to a laceration, and those are good to have on hand for when stores aren’t open. This list isn’t all encompassing, and it’s meant to be generic so that you can decide, “Yeah, I need that, but not that” and customize it to your situation.

“For the Inside of You” List

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). These are the “fever reducing” and “general aches and pains” medications. I like generic acetaminophen and naproxen, but my wife finds that ibuprofen works very well for her. The generic bottles of 100 pills or more should be sufficient for a short term disaster, and I recommend one each acetaminophen, naproxen, aspirin, and ibuprofen. 
• Antihistamines. Due to the war on some drugs, the “good stuff” is still available without a prescription, but you’ll actually have to talk to a pharmacy tech and show your ID to make the purchase. The prices for even generics are pretty high, but pseudoephedrine is still the “king of clearing things up” (especially hives) for me when diphenhydramine doesn’t cut it.  I would say that two 24 packs of pseudoephedrine pills is a good start for a household that doesn’t have environmental allergies, and one large bottle of diphenhydramine for mild “seasonal allergies”. People with chronic allergies will need a 30 day supply of their normal medication.
• Laxatives. An interruption to your normal diet can cause a person to become constipated. There are multiple options, and if you don’t want to keep laxative pills on hand, you can make a “saline laxative” out of potable water and Epsom salts.
• The “Anti-Laxative” Loperamide (aka generic Imodium) This helps avoid dehydration when illness causes diarrhea. 
• Vitamins. A generic multi-vitamin is cheap insurance; I use Walmart’s Equate brand. You’ll want one pill per person per day times the number of days you are prepping; for a 4 person family working on a month, that’s 124 pills. Generally a short term disaster doesn’t lead to any sort of vitamin or mineral deficiency, but it is pretty cheap insurance. If someone in your house has a specific supplement they need to take regularly (iron, magnesium, etc.) add that in as well.
• Caffeine can really help with headaches/migraines, which is why caffeine is an ingredient in so many OTC headache pill and powder formulas. A bottle of generic “alertness pills” is cheap insurance in case someone needs caffeine to deal with a migraine, and for some reason don’t have caffeinated beverage handy.
• Rehydration salts. These can be individual packets of sports drink mix, medical grade salt mixes, or a mix of salts in pill form. It doesn’t matter too much which you choose, but you will want some on hand to assist anyone who needs to rehydrate. This can get spendy if you buy individual packets of name brand sports drink, but electrolyte tablets seem to be fairly affordable right now on Amazon.

“For the Outside of You” List

• Sterilizing Fluids. You’ll want 90% rubbing alcohol on hand, and a bottle of povidone iodine or prep pads is also a good idea.
• Antibiotic Ointment. A generic “triple antibiotic ointment” is cheap insurance, so I recommend two tubes. 
• Super Glue. When you really, really need to hold skin together right now, this is good stuff to have on hand. It will harden in the container, so make sure you rotate in new stock every year. Of all the recommendations, super glue probably has the shortest useable shelf life.
• Calamine lotion and hydrocortisone cream. This is for treating rashes, itches, and mild allergic reactions to plants on the skin. 
• Anti-fungal cream. A significant number of Americans have an active foot fungus infection at any given time. Generally this is not a problem, but you don’t want it to spread to others during a disaster.
• Petroleum Jelly. Really useful for dry, cracking skin, and it also turns a cotton ball into a great fire starter.
• Sports Tape. This is different than medical tape, as it is designed to support joints. I use the cheap three dollar generic stuff for taping my fingers for Brazilian Jiujutsu the same way rock climbers tap their fingers for that sport. This also serves as a good blister cover, and can wrap around bandages for added protection. It doesn’t last forever, but is pretty cheap to have on hand.

“Preventive Medicine” List

In the event that “normal services are disrupted” you want to be able to keep your area as clean as possible, preventing rodents and insects from invading your space. 

• Insect repellent for your skin. Being munched on by bugs is pretty miserable, and this helps prevent insect-borne illnesses from spreading. In addition to the sprays and lotions for your skin, you can get candles/torches and electronic devices that help you keep your area temporarily free from the bloodsucking insects.
• Lice shampoo/treatment kit. Do not get an “organic/natural” kit here, get the kind that has dimethicone, which interrupts the lice water metabolism and kills them that way.
• Permethrin. This is an insect killer/repellent for your living area. You can get it highly concentrated for agricultural purposes, or in spray cans to kill bed bugs. Understand that this is a pretty serious chemical, and it needs to be handled accordingly. It can be seriously nasty stuff if you let it touch your skin, but I’ve found nothing better for treating fabrics. 
• Sunscreen. Don’t make a bad situation worse by getting sunburned. 

Storage and Stock Rotation

Like most perishable things, “store in a cool, dry place” is the best advice for your medicinal preparations, but even medicinal items stored properly still have a shelf life.  If it is a dry item, like a pill or powder, that shelf life is much longer than the “use by” date on the packaging. If the product is “wet” in any way, such as a gel, adhesive tape, cream, or spray, you’ll see a much more noticeable degradation of the product the further beyond the “use by” date on the packaging. If the product is a liquid, such as hydrogen peroxide, you’ll want to replace it regularly for the same reason you rotate your stock of laundry bleach (it breaks down and loses its oxidative properties over time).

References

If you have access to the internet you can check for drug interactions here, and if you are preparing to survive offline the “Where There Is No Doctor” series comes highly rated, and the newest editions are updated with additional medicinal information. 

While I don’t plan to start a village medical clinic, having a printed reference on hand is pretty cheap insurance for those things where I don’t have a clear idea on how to proceed.

Odds and Sods

Not actually Erin.

Picture by KJ Photography

& is used with permission.

David Blackard calls these "Buffet Posts": articles which are just collections of topics that by themselves aren't enough to warrant a full post. Throw enough of them together and what you get is something that's at least filling and hopefully tasty.

National Preparedness Month

September is, you guessed it, National Preparedness Month according to Congress and FEMA. I don't normally think to mention it, because to me and to most of our readers Emergency Preparedness is something we think about all the time, not just once a year. However, not everyone does that, which is why prepper are seen as odd sorts... at least until disaster strikes. 

The resources on the site are pretty sparse as far you or I are concerned. But it's a good source of entry-level information for family and friends who are new to prepping, especially for those who think it's paranoid to prepare for emergencies. You can point at this website and say "Look, even the government says we should be prepared!"

Aches and Pains

I'm at that age now where I just wake up with spontaneous pains in various muscles and joints, and from what I can tell it seems like that's only going to get worse until I die. To that end I have added the following over-the-counter remedies to my preps, including my Get Home and Bug Out Bags, and I recommend you do the same if you're over 40 or prone to similar discomfort. 

Voltaren is a topical NSAID pain reliever that until a few years ago was prescription only, and now can be bought in generic form as Diclofenac. While it can be used for most aches, I find that it works best on joints -- which is no surprise, as it was originally prescribed for arthritis pain. 

For muscle soreness, I recommend Tiger Balm. It's your typical hot-then-cold pungent ointment that penetrates deeply and lasts for a long time, and it comes in a compact little jar because a little goes a long way. Just be sure to wash your hands thoroughly, because you definitely don't want this stuff in your eyes, nose, mouth, or crotch. It's greasy (which accounts for its stickiness and staying power) so scrub well. 

Know When to Get Out

This last entry is a bit fast and loose with our "no politics" policy. I instituted that policy because I don't want this blog to be taken over by partisan shouting matches that aren't relevant to our mission. However, I feel that this rule can be skipped when talking about other countries, especially when there is a very important point to be made involving evacuation from a country that turns hostile towards you. 

The following videos were made by an American who lived in China from 2008 to 2018, and they explain his concern over the growing hatred towards foreigners and increased police interest in him during that time, culminating with him fleeing the country and then his family joining him. Politically speaking, it is anti-Chinese government (but categorically NOT anti-Chinese people), but if I'm being perfectly honest I don't think I have many pro-CCP people reading this blog anyway, and even if I did, they aren't my target audience anyway. 

This first video sets the premise for the others. I was amused at the beginning where he described everything he loved about close, crowded urban life in China, and I thought "That sounds horrible" and then he talks about visiting his parents in a small town and I thought "That sounds lovely," so there's clearly a difference in values at the start. His opinion changes towards the end, however, and it reminds me very much of people who start off thinking preppers are paranoid and then being very happy for their preparations when disaster finally strikes. 

This second video explains why he felt he needed to leave, and why it had to be immediately. I will confess that this reminded me, far too much to be comfortable, of the stories my father told me of escaping the Nazis in 1942 by fleeing Austria for the safety of America. 

It's important to note that he posted this video two years after escaping China, probably to protect those who helped him get out. 

As you would expect, the next video is how his Chinese wife and child escaped and were reunited with him.

 

This final video shows that it's a good thing he got out when he did.

I know this is close to an hour of videos to watch, but I think there's important information here. Break them up and watch a video with your morning coffee over the next four days, if you can't watch them all at once, or do what I do and listen to them while doing household chores. The important thing is that you watch them and learn from them, especially if you live abroad. 

I hope you enjoyed this "buffet" of posts; hopefully I'll have more coherent content for you next week. 

The COVID-19 Vaccine Explained

Not actually Erin.

Picture by KJ Photography

& is used with permission.

This is an informative post, not a political post. 

If you're like me, you have some questions about the COVID-19 vaccination, such as:

• How can it work? I thought viruses mutated and that's why we can't vaccinate against them. 
• What is mRNA and what does it have to do with a vaccine?
• Will this vaccine affect my DNA at all?

I am neither a doctor nor a scientist, so I cannot answer these questions for you myself. However, I know several doctors and scientists, and I am able to present to you some information about the science behind the COVID-19 vaccine that will allow you to make an informed decision about whether or not you want to take it. 

I have two ways to explain it: the short, colloquial version, and the more in-depth version which is less conversational. 

The Colloquial Explanation

These are a series of Tweets by a Canadian physician. I know that Twitter is not peer-reviewed, so I asked my Doctor of Microbiology friend to look at them and she said "Other than one typographical error it is correct."

1:

The mRNA vaccines (Pfizer and Moderna) are kind of brilliant at a science level. I’ve had a few people in my real non-Twitter life ask me to explain how it works so I’m going to try my best here in this thread while I’m waiting for a patient to show.

— WheatNOil (@WheatNOil) December 17, 2020

2: 

The first thing to know is how your immune system works. Basically, your immune cells attack anything foreign to your body. If it sees a protein or a virus or a bacteria or anything that it doesn’t recognize, it launches an attack.

— WheatNOil (@WheatNOil) December 17, 2020

3:  

The first thing to know is how your immune system works. Basically, your immune cells attack anything foreign to your body. If it sees a protein or a virus or a bacteria or anything that it doesn’t recognize, it launches an attack.

— WheatNOil (@WheatNOil) December 17, 2020

4: 

Once it fights off the virus, though, it remembers it. You’ve got memory cells in your immune system and if you run into that virus again, your memory cells say “I’ve seen this asshole before”. Your body uses it’s past experience to demolish the virus before it can make you sick.

— WheatNOil (@WheatNOil) December 17, 2020

5:  

So, with that in mind, we return to the vaccine. Scientists looked at the COVID virus and saw a protein on the outside of the virus that looked like a good candidate to launch an immune attack against.

— WheatNOil (@WheatNOil) December 17, 2020

6:  

That protein, by the way, is an important one for the virus. It uses that protein to get into your cells. That protein makes the virus more infectious. In short, that protein makes the virus more of an asshole.

— WheatNOil (@WheatNOil) December 17, 2020

7:  

Now COVID has DNA in it that codes for all of its parts. So scientists looked at the entire DNA sequence of virus and found the sequence of DNA that is the blueprints for that protein. The asshole protein.

— WheatNOil (@WheatNOil) December 17, 2020

NOTE: This is where the typographical error lies. "COVID carries its genetic material as RNA, not DNA," says my friend the Doctor of Microbiology.  I asked if this changed the information at all, or if it was simply a case of strike the word DNA in this Tweet and replace it with RNA? "Strike and replace," she says.

In fact, the person who originally tweeted this admitted and apologized for the typographical error as well.
 

8:  

Side note: DNA is the blueprint to make things in a cell. Cells take the DNA and transcribe it into RNA. The RNA is the instructions that tell the cell what to make. mRNA (literally messenger-RNA) literally just gives instructions to the cell to make something.

— WheatNOil (@WheatNOil) December 17, 2020

9:  

So scientists took the blueprint for the asshole protein on COVID and made an mRNA version of it. Literally just the instructions on how to make that protein.

These instructions “are” the vaccine.

Let me explain.

— WheatNOil (@WheatNOil) December 17, 2020

10:  

The vaccine contains no actual part of the virus. It has only the instructions on how to make the asshole protein. So, you can’t get infected with COVID from the vaccine. You just get these instructions.

— WheatNOil (@WheatNOil) December 17, 2020

11:

Your cells see these instructions and say “sure, I’ll make this”. So your cells make a bunch of the asshole protein.

You immune system sees this new protein you’re producing and immediately says “what... the fuck... is this?” And it starts attacking the protein.

— WheatNOil (@WheatNOil) December 17, 2020

12: 

Remember it hasn’t seen this protein before. It takes awhile to ramp up production. Then it launches an all out war against the asshole protein. The fevers, chills, muscle soreness, etc you might get as vaccine side effects is your body bombing the hell out of the asshole protein

— WheatNOil (@WheatNOil) December 17, 2020

13: 

So you destroy the asshole protein (which in and of itself can’t infect you, it’s just a protein, not the virus).

Now here’s the important part. Your memory cells ‘remember’ the asshole protein. They remember exactly how to destroy it.

— WheatNOil (@WheatNOil) December 17, 2020

14: 

By the way, your body breaks down the mRNA instructions that you got with the vaccine pretty quickly too. That’s normal. You don’t need a bunch of instructions hanging around forever. Your body breaks those down and gets rid of them.

— WheatNOil (@WheatNOil) December 17, 2020

15: 

So you’ve broken down the mRNA instructions. You’ve destroyed asshole proteins. Everything from the vaccine is gone.

Except for those memory cells who remember that protein very well.

— WheatNOil (@WheatNOil) December 17, 2020

16: 

So then, a COVID virus enters your body. Your body has never seen the virus before.

BUT it’s seen that protein that’s on the outside of the virus. Your memory cells say “you’ve got to be kidding me, THIS asshole again? Get the fuck out of here!”

— WheatNOil (@WheatNOil) December 17, 2020

17: 

Your body’s own ‘natural immune system’ quickly and efficiently launches an all out war, using the template it has from when it destroyed the asshole protein last time. It destroys the virus before it can take hold, replicate, and make you sick.

— WheatNOil (@WheatNOil) December 17, 2020

18: 

Congratulations! Now, you’re immune to COVID! You’ve got the blueprints to defeat it as soon as it enters your body.

— WheatNOil (@WheatNOil) December 17, 2020

19: 

What if the virus mutates so it doesn’t produce the asshole protein any more? Well, since it uses the asshole protein to get into your cells, if it mutates away from the asshole protein, it’ll probably also be less infectious. That’s what makes the vaccine low-key brilliant.

— WheatNOil (@WheatNOil) December 17, 2020

The Technical Explanation

The more in-depth and less colloquial version is too large to post here.  Cedar Sanderson, author and scientist, explains it in this post on her blog. 

Now You Know

And now you can make an informed decision whether or not to get vaccinated

The ER Bag

Not actually Erin.

Picture by KJ Photography

& is used with permission.

Over the past few months, my 81 year old mother has had increasing pain in her hip and leg. Now, when I say pain, I don't mean discomfort; I mean PAIN, the kind where all she can do is whimper and it tears my heart out to hear because I can't do anything about it. Last Wednesday night it got so bad that it woke her up around midnight and I had to take her to the ER. 

Because I have elderly parents and late-night ER trips like this are common, I have what I call an "ER Bag", which is a backpack filled with things that make spending interminable hours in hospital chairs a bit more tolerable. 

My bag contains the following:

• A bottle of Gatorade and a granola bar
• Pocket change for vending machines
• Baseball cap 
• Spare face mask
• Earplugs
• Hoodie
• Small fleece blanket
• Klymit Cush 
• Power Bank
• Wall Charger
• 3 USB cords
• Tablet computer with bluetooth mouse & keyboard
• Ear buds

I'm probably forgetting something I will need in the future, but each time I go to the ER I add to this based upon what I wish I had with me to make me more comfortable. 

Because the backpack isn't full, I can also stuff things into it, like my mother's coat after she takes it off, or bottles of medicine that she's taking, or even her medical records if that's necessary. 

If you end up going to the ER a lot, I recommend you set up a go bag so that you can just "grab it and go" rather than having to take time to get stuff. 

As for my mom, first they gave her morphine which dropped her pain from an 8 to a 1. Then they did x-rays which determined nothing was broken (good) but couldn't account for the pain (bad). Finally they did a CT scan, which detected that something was encroaching upon her lower spine and that was causing the pain. The doctor felt she would probably need an MRI to determine exactly what it was (although she suspect spinal stenosis) but that would have to be scheduled through mom's primary care physician. 

We arrived at the hospital at 12:30. We didn't get home until well after 5 am. I'm mostly back to normal but I'm still not at my best mentally, which is why this post is shorter on meat than most. 

Potassium Iodine

Not actually Erin.

Picture by KJ Photography

& is used with permission.

Every prepper needs a supply of Potassium Iodine (KI) in their supplies or Get Home Bag in the event of a nuclear incident such as an accident at a nuclear power plant or the detonation of a nuclear warhead. While it is not proof against all forms of radiation poisoning, it is an affordable, lightweight prep that is better to have and not need than to need and not have.

Rather than attempt to use my layman skills to explain to you why this is, I will quote freely from various authorities. Any emphasis is mine.

From the Nuclear Regulatory Commission's webpage on KI:

What is potassium iodide? 

Potassium iodide is a salt, similar to table salt. Its chemical symbol is KI. It is routinely added to table salt to make it "iodized." Potassium iodide, if taken in time and at the appropriate dosage, blocks the thyroid gland's uptake of radioactive iodine and thus could reduce the risk of thyroid cancers and other diseases that might otherwise be caused by exposure to radioactive iodine that could be dispersed in a severe nuclear accident.

What is the role of potassium iodide in radiological emergency preparedness?

Potassium iodide is a special kind of protective measure in that it offers very specialized protection. Potassium iodide protects the thyroid gland against internal uptake of radioiodines that may be released in the unlikely event of a nuclear reactor accident.

The purpose of radiological emergency preparedness is to protect people from the effects of radiation exposure after an accident at a nuclear power plant. Evacuation is the most effective protective measure in the event of a radiological emergency because it protects the whole body (including the thyroid gland and other organs) from all radionuclides and all exposure pathways. Administering KI can be a reasonable, prudent, and inexpensive supplement to in-place sheltering and evacuation.

What is the benefit of taking potassium iodide during a radiological accident?

When potassium iodide is ingested, it is taken up by the thyroid gland. In the proper dosage, and taken at the appropriate time, it will effectively saturate the thyroid gland in such a way that inhaled or ingested radioactive iodines will not be accumulated in the thyroid gland. The risk of thyroid effects is reduced. Such thyroid effects resulting from radioiodine uptakes due to inhalation or ingestion, or both, could result in acute, chronic, and delayed effects. Acute effects from high doses include thyroiditis, while chronic and delayed effects include hypothyroidism, thyroid nodules, and thyroid cancer.

Supplementary note from HealthPhysicsSociety.org:
The only possible sources of large radioiodine releases are from a nuclear weapons denotation and a catastrophic accident in an operating nuclear reactor. Therefore, KI has no protective value from a "dirty bomb" or a dispersion of spent nuclear fuel.

Can individual members of the public obtain potassium iodide?

The FDA has approved potassium iodide as an over-the-counter medication. As with any medication, individuals should check with their doctor or pharmacist before using it.

Erin says: You can buy packs of 14 KI tablets from Amazon for $10 with Prime shipping. 

Is it safe to take KI tablets with an expired shelf-life?

Yes, potassium iodide tablets are inherently stable and do not lose their effectiveness over time. Manufacturers must label their products with a shelf-life to ensure that consumers purchase safe and useful products.

According to FDA guidance on Shelf-life Extension, studies over many years have confirmed that none of the components of KI tablets, including the active ingredient, has any significant potential for chemical degradation or interaction with other components or with components of the container closure system when stored according to labeled directions. To date, the only observed changes during stability (shelf-life) testing have been the failure of some batches of KI tablets to meet dissolution specifications. Some tablets tested required slightly longer than the specified time to achieve dissolution. Even in the case of a failure of this sort, the product remains usable. In such cases, instructions can be provided to crush the tablets and mix them with a juice or other liquid prior to administration as suggested for emergency pediatric dosing.

From the CDC webpage on KI:

How often should KI be taken? 

Taking a stronger dose of KI (potassium iodide), or taking KI more often than recommended, does not offer more protection and can cause severe illness or death.

A single dose of KI (potassium iodide) protects the thyroid gland for 24 hours. A one-time dose at recommended levels is usually all that is needed to protect the thyroid gland.

In some cases, people can be exposed to radioactive iodine for more than 24 hours. If that happens, public health or emergency management officials may tell you to take one dose of KI (potassium iodide) every 24 hours for a few days.

Avoid repeat dosing with KI (potassium iodide) for pregnant and breastfeeding women and newborn infants.

What are the side effects of KI?

Side effects of KI (potassium iodide) may include stomach or gastro-intestinal upset, allergic reactions, rashes, and inflammation of the salivary glands.

When taken as recommended, KI (potassium iodide) can cause rare adverse health effects related to the thyroid gland. These rare adverse effects are more likely if a person:

• Takes a higher than recommended dose of KI
• Takes the drug for several days
• Has a pre-existing thyroid disease.

Newborn infants (less than 1 month old) who receive more than one dose of KI (potassium iodide) are at risk for developing a condition known as hypothyroidism (thyroid hormone levels that are too low). If not treated, hypothyroidism can cause brain damage.

• Infants who receive more than a single dose of KI should have their thyroid hormone levels checked and monitored by a doctor.
• Avoid repeat dosing of KI to newborns.

How is KI given? 

The FDA has approved two different forms of KI (potassium iodide), tablets and liquid, that people can take by mouth after a radiation emergency involving radioactive iodine.

Tablets come in two strengths, 130 milligram (mg) and 65 mg. The tablets have lines on them so that they may be cut into smaller pieces for lower doses. For the oral liquid solution, each milliliter (mL) contains 65 mg of KI (potassium iodide).

According to the FDA, the following doses are appropriate to take after internal contamination with (or likely internal contamination with) radioactive iodine:

• Newborns from birth to 1 month of age should be given 16 mg (¼ of a 65 mg tablet or ¼ mL of solution). This dose is for both nursing and non-nursing newborn infants.
• Infants and children between 1 month and 3 years of age should take 32 mg (½ of a 65 mg tablet OR ½ mL of solution). This dose is for both nursing and non-nursing infants and children.
• Children between 3 and 18 years of age should take 65 mg (one 65 mg tablet OR 1 mL of solution). Children who are adult size (greater than or equal to 150 pounds) should take the full adult dose, regardless of their age.
• Adults should take 130 mg (one 130 mg tablet OR two 65 mg tablets OR two mL of solution).
• Women who are breastfeeding should take the adult dose of 130 mg.

In Conclusion 
While Potassium Iodine will not protect you from every nuclear event, it is lightweight, portable, affordable, is shelf-stable indefinitely, and fits easily into any first aid kit. I recommend every prepper who lives in a big city or within range of a nuclear power plant stock up on KI. 

More Reading

• HPS Fact Sheet on KI (pdf)

The Return of Norovirus

Not actually Erin.

Picture by KJ Photography

& is used with permission.

David is out sick today. Based on the symptoms he describes, it sounds like he has a case of Norovirus, which I had the "pleasure" of encountering in February 2017.

The good news for David is that it ought to have run its course by now, or at the latest tomorrow morning.

The bad news is that he's going to be absolutely miserable until then.

Posted here is a recap of my experience, as well as some advice on recovery afterwards.



As I mentioned in earlier, I came down with a stomach bug the last day of MAG40 that left me dehydrated and going at both ends -- often simultaneously.

While I don’t know what it was that I have, my best guess is Norovirus, aka the “Winter Vomiting Bug”. It’s commonly caused by fecal contamination of food, touching a contaminated surface and then your mouth, or directly from another sick person.

Norovirus is a viral buzzsaw that rips through close collections of people, like classrooms or people on cruise ships.

Based on my close, intimate relationship with Norovirus, the biggest problem with it is dehydration. I was desperately thirsty and my mouth was full of cotton, but I couldn’t take more than a few swallows without upsetting my stomach and triggering another vomiting session.

Worse, diarrhea causes an electrolyte imbalance within the body, which in turn creates more diarrhea. In other words, diarrhea is self-perpetuating, so for those who are curious, you can indeed shit yourself to death.

What’s more, after a case of Norovirus the gastrointestinal tract may be severely inflamed, or not used to digesting food, and may need to be re-started. So what’s a prepper to do?

Obligatory disclaimer: I am not a trained health professional, do not take this as strict medical advice, consult your doctor if you have an erection for more than four hours.

First, always have an antidiarrheal medicine, like Immodium AD, in both your bug-out and get-home bags. Heck, after this weekend I’m keeping several doses in my every day carry kit. Oof.

Second, have a way to get electrolytes back into your system. Since you’re trying to prevent dehydration at the same time, the best way to do that is through liquids. I’m a big fan of Gatorade, but any sport drink will do, as will Pedialyte for children and of course regular old water. You can also buy packages of oral rehydration salts from Amazon -- just mix them with clean water and you’re good to go. They’re light enough that you could fit them into any bug out or get home bag.

There are however some liquids to avoid:

• Milk, because while you may not normally be lactose intolerant, your digestive tract may not be able to process milk in your weakened state.
• Alcohol and caffeine, because both of these substances also contribute to dehydration and would only make things worse.
• Excessively sugary drinks like soda and fruit juices, because while sugar is important in electrolyte solutions, too much has the opposite effect. Avoid any liquid that has more than 3% sugar in it.
• Don’t use artificial sweeteners, either, as those often have a laxative effect.

Third, when it comes time to eat -- and it may be days before you want to think about food -- it’s best to start small. There’s something called the BRAT diet - Bananas, rice, applesauce, toast - which is supposed to be easy on sensitive guts. Other foods which are good for recovering digestive tracts are oatmeal, boiled potatoes, plain crackers, and baked chicken without skin or fat. You’ll notice that a lot of these ingredients are in that universal antidote, chicken soup.

Preppers ought to consider adding some packages of oatmeal and chicken broth to their bug-out bags, and perhaps some dehydrated bananas as well.

Finally, keep a dark-colored washcloth in your various bags. Don’t use it for regular hygiene of the hands or face; use it just for cleaning “down there.” When the S hits the F, it’s good to have a soft, absorbent, dark-so-it-won’t-stain cloth to clean that S from your body.

• Norovirus - https://en.wikipedia.org/wiki/Norovirus
• Treating diarrhea - http://www.webmd.com/first-aid/diarrhea-treatment
• Oral Rehydration Salts - http://amzn.to/2mxD12X
• What to Eat When You Have Diarrhea - http://www.everydayhealth.com/digestive-awareness/what-to-eat-when-you-have-diarrhea.aspx
• The Many Uses of a Washcloth - http://bluecollarprepping.blogspot.com/2016/06/the-many-uses-of-washcloth.html

Soft Tissue Injuries

Getting old sucks. I know the rest of the family here will give me grief, seeing as I'm the youngest of the regulars, but it's true. What I lack in age I make up for in mileage, and with that mileage (or just age) come aches and pains and a tendency to get hurt more easily.

One of the most insidious types of injuries are soft tissue injuries which include things like strains, sprains, and pulled muscles. As we age, flexibility decreases and recovery time from strenuous activity increases, both of which contribute to soft tissue injuries. While these are often dismissed as "aches and pains," they can be quite serious and need treatment to heal properly.

The best way to deal with soft tissue injuries is to prevent them entirely:

• Stretch before any kind of strenuous work. 
• Don't work in stressful positions and avoid twisting and bending awkwardly. 
• Take care when lifting items, and carry items close to the body instead of at arm's length.
• Take time during work to stretch and flex, especially when changing positions or if you feel sore.
• Remain properly hydrated while working.
• Keep yourself in as good of physical condition as possible. Healthy bodies get hurt less.

When (not if) you suffer a soft tissue injury, the proper treatment is RICE:

• Rest: Allow your body the time it needs to heal. Avoid activity that could aggravate the injury.
• Ice: Apply ice packs to the injured area if possible in 20 minute intervals, 20 minutes of ice and 20 minutes without. Never apply ice packs directly to the skin! I like to wrap them in hand towels, but a shirt or other cloth works just as well.
• Compression: Use an elastic bandage or a joint brace to support the affected area, which will keep things from moving in ways that will cause further injury. Don't apply an elastic bandage too tightly, or you risk cutting off circulation and causing far more severe injury. Monitor the area while the bandage is on, and if you start to lose feeling or see a limb turn purple, remove the bandage, rest the area, and then reapply the bandage more loosely.
• Elevation: Elevate the injured area if possible and allow joints to rest in a natural, semi-flexed position. Usually this will be the most comfortable position, which will encourage rest and speed healing. It will also limit bruising and any minor internal bleeding.

In addition to RICE, use your favorite over-the-counter pain medication as directed on the label. If this method doesn't provide substantial relief within 48-72 hours, you may need professional intervention. If you feel a pop or crack when the injury occurs, or lose major function in a limb for even a few minutes, this is not a soft tissue injury and needs treatment by a physician.

Getting old and working hard may hurt, but you can limit a lot of that.

Lokidude

Guest Post: First Aid and Embarrassing Situations

by Wolfman

When I was in middle school, we had an outside teacher brought in to teach Health class because
the teacher was embarrassed. It was just as well, because that gym teacher had to put up with us for 5
more years, and he knew he would never live down the embarrassing things he tried to teach 13 year-old kids.

And so I find myself embarrassed about doing a guest post about things that nobody ever really wants to talk about. We’ve all got them, of course; one or another, we all have a thing that we have to deal with which we hope nobody else needs to know about. My wife and I have been married for a decade, she’s borne two children, and so I've had a chance to learn a lot more about female anatomy than the practical bits that I had studied earlier. She, on the other hand, has gotten surprisingly sharp on the subject of hereditary gastrointestinal disorders.

In the best of times, of course, these are things that we just don't talk about in polite society. They are subjects that don’t often come up, because nobody wants to admit that they are problems. So we do our own things, and hope for the best, and nobody is the wiser (if we’re lucky). However, this community is not for The Lucky; this community is for The Prepared, and in the worst of times, the things that we don’t want to talk about can absolutely kill us.

Sometimes, it's the thing we don’t want to admit is our fault. Recently, Lokidude was at an event with some other people and myself where circumstances -- partially of his own making, partially of some very entertaining friends -- caused him to require burn cream. Bear in mind that this wasn't a life-threatening injury, but rest assured that he did need burn cream. He could’ve shrugged it off, taken the injury stoically… and it could’ve gotten infected over the next few days, and caused a much larger problem when he got home. He didn’t do that. Instead, he looked at his injury, discussed it with a few others, and sought out a reasonable treatment. Don’t let relatively small problems become larger ones because you don’t want to admit the root causes! 

Sometimes, we think the thing is a sign of weakness. For example, I have terrible knees. Some of it is probably genetic and some of it is wear and tear from being a carpenter and taking terrible care of myself. I’m not proud of it, and it hurts. It’s not fun to deal with, nor to live with. At that same event with Lokidude there was a person who suffered an acute knee injury and who needed a medical brace, but the event was remote enough to require driving several hours round trip to obtain one. I, however, travel with multiple knee braces. I could have kept that to myself; nobody wants to admit weakness. But that would have been my selfishness being a direct cause of someone else’s extreme discomfort and considerable expense. I was happy to help out by donating my brace, and the other person was happy to not have to drive several hours. As it turns out, I didn’t need that brace anyhow, and even if I did, I had a spare. Keep in mind that it might not be you that you hurt with your hubris.

Sometimes, the thing that you are avoiding talking about is extremely personal. Remember that discussion of female anatomy? Trust me when I say that I have had plenty of conversations that went above and beyond the level of information that I once thought sufficient. Guys, ever bought tampons at the store? I guarantee the gals have had to ask a stranger for one. These are things that take up very little space but are extremely critical in certain situations, and when they are most critical is when the subject is most delicate. Under normal circumstances, their lack can be an inconvenience; in extreme, or even nominally difficult circumstances, failure to properly address the situation can lead to Toxic
Shock Syndrome and death. Men probably don’t want to think about or deal with this. Too bad! This is a subject that women have to deal with on a very regular basis. Be candid, be honest, and be attentive. There is no time for embarrassment.

What about things that aren't so common but are still personal? I’ll throw this one out there to the world: I have hemorrhoids. Yes, before you ask, they are a pain in the rear. They're extremely common in my family, and I’m given to understand they aren't unknown to others. In the best of times, of course, they are briskly unpleasant, and even then they require some very specific preparations. Chief among these are medicated wipes, which are kept 100% of the time in my vehicle and refit points. Is it embarrassing? Yes, but since I’m talking about it on the internet, I can’t say that I’m too terribly embarrassed. 

(A word to the wise: Spend the extra money on the good ones. Cheap store-brand wipes are honestly a bit lackluster, and when you need them most, you don’t want something that will let you down.) 

Secondary to those, but far more useful across the board, are the various anti-irritation creams and treatments. It may interest people to know that hemorrhoid creams use the same active ingredients as many insect bite creams: hydrocortisone, the H in Preparation H). This helps alleviate shame a couple different ways. First off, it is perfectly reasonable to have hydrocortisone cream for insect bites and rashes. Nobody will ever bat an eye at this, and if anyone ever finds themselves in a very specific need, it may be easier to ask for that in particular rather than ask for hemorrhoid treatments. Conversely, the properly prepared will be able to easily treat insect bites with hemorrhoid preps, and one can reasonably play that as the original goal, if needed. 

Another note: I strongly recommend the application of creams and similar to be executed by applying the cream to a square of clean toilet paper. This obviously prevents any unseemly cross-contamination.

Since we’ve come this far together, I may as well finish with one of the most common and easily treatable acute conditions: gastrointestinal distress. This also happens to be common in my family, but there are many acute conditions that contribute to it as well. Again, it's not a fun subject to broach with friends and acquaintances, but the consequences of avoiding it can be incredibly serious. Untreated, diarrhea can lead to dehydration, malnutrition, and death. In normal times, not to mention survival or prep-consumption situations, gastrointestinal disorders can be rapidly life-threatening. Is it uncomfortable to admit to your friends that you are in gastric distress? Oh yes, it certainly can be, but not quite as uncomfortable as failing to properly address that distress. Towards that end, there are some easily maintained solutions, and some slightly more esoteric ones.

• The most easily stowed, for those that only need to treat this as a mild likelihood, is in the form of loperamide tablets under brand names such as Imodium or Maalox AD. 
• The most rapidly effective solutions are suspensions, usually of bismuth subsalicylate, which take up more space but work very quickly. You can find them under brand names like Pepto-Bismol or Kaopectate. 
• Incidentally, bismuth subsalicylate suspensions are also safe for dogs with the same problems. They don’t care much for the taste, though. 
• In a pinch (and there's an unfortunate idiom), dietary additions such as pumpkin or similar starchy fiber sources can help to regulate these issues. 
• When dealing with diarrhea, the immediate concern is generally dehydration, which can lead very quickly to serious illness and death. In such situations, treatment with a rehydrating solution such as Gatorade or Pedialyte is critical to maintain hydration and electrolyte balance.

Now you know a considerable amount more about me than you ever needed to know. 

In an emergent or prep-consumption environment such as we prepare for, there will be many threats. Some of them are obvious, some are not. Some of them are extremely uncomfortable to deal with, and those ones can be just as deadly as the others. When it comes to survival, modesty and embarrassment must take a back seat to honesty and openness. Don’t let embarrassment, which is inherently survivable, make a bad situation worse.

Magnesium Citrate: the Prime Mover

Not actually Erin.

Picture by KJ Photography

& is used with permission.

If you've used opioids at all (or if you've seen the movie Trainspotting), you know that they cause terrible constipation.

How terrible? A few years back my mother had neck surgery and was given a small supply of oxycodone for the pain. She was constipated (and in extreme discomfort) for ten days. I eventually called her doctor, made an appointment, and took her to the appointment myself; mom is stubborn and doesn't want to spend money if she doesn't have to, but I was worried her intestine would rupture and she'd go septic.

Her doctor didn't write us a prescription. Instead, we were told to buy a bottle of magnesium citrate at the nearest supermarket and to follow its directions. We did, and the results were phenomenal: within 4-6 hours of ingestion, a 10 day streak of constipation ended.

WARNING: The results of magnesium citrate can be dramatic. And potentially messy. And sometimes even explosive. What I'm saying is this: Clear your calendar, don't stay too far from the bathroom, wear easily removable clothes, and maybe put down some drop cloths in case you don't make it to the toilet in time. 

Frightening, yes, but also frighteningly effective.  There's a reason I call magnesium citrate the "prime mover", and that reason is it will move anything in your colon. In extreme cases, you may need to take a dose of Miralax alongside it. If you are still constipated after that, you're going to need surgery.

In less extreme circumstances, smaller doses of Mag C will prevent such blockage in the first place. To use my mother as another example, after coming home from the hospital she has taken a drink from the bottle every time she takes an oxy. So far, this has succeeded in keeping her regular.

Every prepper needs a bottle of Mag C in their cupboard.

• Available: You can find it in every drug store and supermarket in the country. 
• Affordable: A store/generic brand costs about a dollar for a 10 ounce bottle. 
• Stable: It's shelf-stable for at least 2 years (and you're all familiar with my rants about expiration dates), so long as you don't open the bottle it doesn't require refrigeration; if you don't drink it all at once, then screw the lid on tightly and refrigerate it to reduce its interaction with oxygen. Dispose of it after a week past opening. 
• Effective: Read the reviews; you'll find comments like "the bottom fell out of me", "colonoscopy prep" and... well... this: 

Buy a bottle of Mag C, put it in your medicine cabinet and forget about it. At worst, you're out a dollar. But if you have a stubborn blockage that you need removed, then just drink the Prime Mover and wait.


Disclaimer: Anyone with irritable bowel syndrome, ulcerative colitis, or other diseases of the intestine shouldn't use magnesium citrate as it will trigger a bad IBS/UC attack. Consult your physician for other options.

A Few Thoughts

Not actually Erin.

Picture by KJ Photography

& is used with permission.

My mother had knee replacement surgery 2 weeks ago, and so I've been helping take care of her and also doing a lot of her chores around the house while she recovers. Therefore, this post will not have a single topic; instead, it's what David calls a "buffet post".


Save Your Post-Surgery Medication
This advice does not apply to antibiotics; if you are prescribed an antibiotic then you must finish your entire course of medication unless your doctor says otherwise.

However, for everything else that is prescribed on an as-needed basis -- anti-nausea, anti-inflammatory, pain killers, etc -- keep them in your preps to have on hand for an emergency. For example, I am prone to kidney stones, and in 99% of all such cases the best treatment is to wait for the stone to pass into the bladder. However, the act of passage hurts immensely; my mother, who has had three children and one kidney stone, said that her stone hurt worse than any of her deliveries. The next time I have another kidney stone, instead of going to the ER I'll just take one of the oxycodones I was prescribed in 2017 after the dog attack and then try to sleep through the pain until it passes.

Don't throw your medication away once it's past its expiration date, either! That date simply means "After this point the medicine is no longer 100% effective." I don't know about you, but I'm just fine taking medicine with a 99% effectiveness. See this post for more details, but the short version is that you can easily get four or more years worth of storage out of medications.


Cultivate Additional Food Sources
Our back yard butts up against a forest, and my mother enjoys feeding the squirrels, raccoons and deer which live there. Not only are we encouraging the growth of an animal population which could feed us in an emergency, but we are also conditioning them to not fear humans.


Have a Plan to Move Disabled Family Members
If we had to evacuate right now, it would be a lot more complicated than normal. Not only is mom moving much more slowly, but she needs a walker. That factors into my bug out plans, because it means that any evacuation will take longer and will require space for her walker (thankfully, it's collapsible) in the car.

If we have to walk?  Well, I have a deer cart and a chaise lounge cushion. It won't be fun for either of us, but if it'll cart a 500 lb deer out of the forest, it will easily carry a 120 pound woman and her BOB.


That's all for now. Hopefully I've have a more coherent post next week!

Medications

There's more than one reason to prepare. Yes, we spend a lot of time getting ready for disasters and emergencies, but there are several things which don't quite reach that level that still need to be on your radar. Having a stockpile of your daily medications is one of those oft-neglected preps that I think should be kicked up a notch or two on your priority list. While not as important as air or water, a lot of the medications we take on a daily basis are life-saving.

A Little Background
My wife is disabled due to some serious damage to her spine. Surgery is not an option that any doctor we've seen is willing to attempt, so she lives with a lot of pain. As a way to manage that pain, she has taken legal opiate-based pain killers for over a decade.

About four years ago, the Drug Enforcement Agency (DEA) started threatening small-town doctors who were prescribing opiate-based pain medications with “Stop writing prescriptions (Rx) or face the wrath of the federal government.” They swooped in and made examples of a couple of known pill-pusher doctors, which scared the rest into submission -- which isn't really hard to do when there are three corporations that run every hospital and clinic within 75 miles. Instead of a 15 minute drive to our local clinic, we had to find a pain specialist and the nearest is an hour away.

The DEA also changed the prescription rules: No more than a 30 day supply on a single Rx, and opiates require a paper Rx (no faxing or emailing), so every month we have to drive to the city to pick up a piece of paper.

Three weeks ago, the DEA led a “raid” on the pain management clinic we've used for those four years. They gathered up all of the patient charts (records) and computers and took them away, effectively shutting down a clinic that has been running for 25 years without a problem. No arrests, no indictments, no reason given; they just shut the clinic down without having to go through the hassle of pulling licenses. This is a form of “lawfare” that is being used to fight the “war on drugs” and battle the “opiate epidemic”. The process becomes the punishment, without any need for frivolous things like actual evidence of a crime. These imaginary wars and epidemics are great for funding and time in the spotlight, so I don't expect them to ever be won or cured, but that's getting close to our self-imposed prohibition on politics so I'll leave it alone.

This is an emergency on several levels for us:

• Without any control of her pain and the likely withdrawal symptoms from running out of a very addictive medication, her life becomes torture.
• We're looking into other local options as there are a few other pain clinics around, but the DEA still has all of her charts. This means that any new doctor has to start from scratch, something which isn't going to be pleasant.
• Being a bit pig-headed, my wife has not been listening to me and only had about a week's worth of pain meds left, so it's been a scramble to find another doctor.
• The DEA now has my wife's medical records and that doesn't fill me with joy. No politics, I know.

The same thing could happen to anyone who takes a life-saving medication. Blood pressure meds, diabetes supplies, anti-rejection drugs for transplants, and the like are all things that you don't want to run out of. Certain common anti-depressants come with a warning that you should never stop taking them abruptly, as the withdrawal effects can be deadly. It might not be a federal agent cutting off your source of the medications you need to get by (or stay alive); disruptions caused by any major disaster would have the same effect. Losing your job and/or health insurance will also put a crimp in your medications (been there, done that for two years.)

How to Prepare

• Have a stockpile if at all possible. If you take a medication on an “as needed” basis, it's possible to set aside a few doses every month until you have a safe stockpile. I like 30 days, but you need to decide for yourself.
• Talk to your doctor, see if they will write your Rx for several months at a time. Many insurance companies require mail-order Rx service and they like to deliver several months worth in one box.
• Renew your Rx as soon as they will let you, and you should gain a few days each time. For example, my insurance will let me renew a 30 day RX after 28 days
• Look into alternative sources for your meds. I did an article a long time ago about mail-order meds. The information is still valid, even if the names have changed over the years. 
• Look into alternative medications. Not every ailment is treatable by herbal or alternative medicine, but some are. Medical marijuana and derivatives are spreading, so check their many uses. Don't forget the less-than-legal options; what they may lack in quality control they can make up for in lack of records. Getting meds from someone who no longer needs them may be possible as well.This is generally illegal, but you have to be alive for them to charge you.

If you take any medication on a daily basis, you should know as much as possible about what it is, how it works on your body, how it's made, what can be used as a substitute, and where to get it. Supplies and gear aren't going to do you any good if you're not around to use them.

Prepping for Asthma

As any prepper knows, preparedness is key.

And as anyone with chronic health conditions knows, emergency preparedness for those conditions can be nearly impossible at times.

I have lived with chronic, severe allergies for the last 20 years plus, but they have only notably impacted my life over the last 10. The most significant day to day impact of this has been asthma, specifically allergy-induced asthma that has made interacting with the general public difficult... such as when I have an allergic reaction to most kinds of soap. In addition to soap, I am badly allergic to mold, such as orange mold, various plants, and dust mites.

(I am aware that there will are those of you who claim that it is impossible to be allergic to soap. Feel free to convince my allergist, and my body, of that. When the in double-blind testing I have the same reaction, I promise you that it is not “attention seeking”).

Non-Medicinal Preps
In an emergency, I don't expect frequent access to allergy medication so I can restock what I typically keep on hand. This means that for whatever emergency I am planning against, I have to keep enough on hand to last me for quite some time. To that end, I specifically look for things that will last for a long time.

• Instead of just getting medication, I try to control the environment. Medication tends to expire much more quickly then filters for your furnace or a facemask.
• When I do get medication, I try to keep a stock of individually foil packed pills, so that if there is an emergency, I don’t have to open an entire container of them and risk contamination or expiration.
• When I do stock up on medication, it's easier to do it in stages. The rule that I have is one – two – five. I try to get a one month supply, and then a two month supply, and then a five month supply, and then a year's supply, and so on. If I cannot afford a month's supply at a time of whatever it may be, I start with a day or week.

Over the Counter Preps
As to the specifics of what preps I keep on hand:

• I keep a year's supply in bottles of three different over-the-counter allergy medications. I buy mine from Costco, but it does not especially matter where you purchase yours from as long as they work and have a basic minimum level quality packaging. I use, sometimes more than one at once, generic/store brand versions of Allegra, Claritin, and Zyrtec. 
• I also keep a two-week supply of each of these in foil-wrapped packets. I actually buy name brand for these, because in my experience the packaging tends to be more waterproof. The Claritin and Zyrtec are even available as a dissolving tablet, which means you don't need water to take them. 
• I keep a two week supply of Mucinex on hand. I'm still working up to a full year's supply, but the supply that I do have is all foil wrapped.
• I keep chlorpheniramine (an alternative to benadryl) on hand. I buy this in bulk, since it is cheap, and I know people who are allergic to Benadryl.
• As far as controlling the environment, I use a good spray sanitizer when I clean, and then I use a power fan style HEPA filter.
• To supplement that, I use a box fan with a 20” x 20”  filter on it.
• I even use a face-mask respirator on occasion. It has excellent filtration, and on days like today (where the air smells like barbecue) it ends up being a practical method to be able to breathe outside. I tried to keep between four and six filter replacements for it on hand, because I occasionally use the respirator for work reasons.

Prescription Preps
Everything I have mentioned so far is not a controlled substance, requires no prescription, and can be purchased over-the-counter at any drugstore with no problem. Everything else on my list is still legal, but may be more difficult to obtain in case of power outages or loss of infrastructure.

• Sudafed and other decongestant medications require identification (such as a driver's license) to purchase in the USA. Pharmacies scan your ID, and to enssure that you’re not making methamphetamine with it they monitor and restrict how much you're allowed to purchase in a given month. I try to keep a one-month supply on hand, which is thankfully not very much. I do not use it often, but when I need it, I have to have some on hand.
• I try to keep an inhaler on hand in my backpack, in my desk, and on my person. When I am in public a lot I end up going through an inhaler every 3 to 4 months, averaged over the several that I keep on hand. I also try to keep a foil-wrapped inhaler in my bug out bag, my roadside emergency kit, my primary toolbox, and one to three in the long term food storage. I know that sounds like a lot, but inhalers are inexpensive, (less than $10 each at Walmart without insurance), will be very difficult to get a hold of in a real emergency, and are something I will quite literally die without. I feel that overkill is a far smarter way to go then underkill.
• Finally there is the EpiPen. I've never had to use one, and I hope I never do, but if I have to it will be there. I keep one in my backpack and my first aid kit. I would like to keep one in several other places, but they are quite expensive. I hope to remedy this with an EpiPencil.

It's possible to prep for asthma. I did it, so you can do it too. I know it sounds like a lot, and in some ways it is, but it's entirely doable.

Good luck, and don’t forget to practice.