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. 

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. 

Chronic Headache Pain

Not actually Erin.

Picture by KJ Photography

& is used with permission.

As I write this, I am in pain.

It's not big, bold pain, the kind that gets me in the hospital on the good drugs. It's about a 4 on the pain scale listed below -- I'm constantly aware of it, and I can't ignore it, but I can function with it so long as you don't ask me to do something super-physical or mentally intensive, and I can probably fall asleep tonight even with it hurting. After a lifetime of chronic sinus and migraine headaches, I've found that the best anesthetic is unconsciousness, and so I've learned to sleep through pain up to a level 7 or 8.

I remember what a shock it was when I realized in high school that people didn't carry painkillers with them because -- surprise! -- they didn't get headaches on a weekly basis. I marveled at what it must be like to go weeks, maybe even months, without their head hurting.

I have never had level 10 pain. I've had level 9 pain, but that was from kidney stones. The worst migraine I've ever had was an 8, and many of my sinus headaches are in the 5-6 range.

What a lot of people don't realize, however, is that a low but constant pain can wear you down over time. Sure, it may only be a 3 or a 4 when it starts, but after 8-12 hours of it, my pain tolerance recedes and takes with it my patience, good humor and willpower. Eventually that 3-4 feels like a 5-6, and not only do I hurt but I also feel like a wimp because something that shouldn't be able to take me down has done so.

Here's how I cope with chronic headache pain. I make no guarantees that these will work for you.

Sleep
Anesthesia works by putting the body into a sleep so deep that the body can't feel pain, and so as far as I'm concerned sleep is the best way to get rid of pain.

When possible, a nap in a quiet, dark room (possibly with a cold compress over my eyes or forehead) will work wonders. However, it's often not possible to take a 4+ hour nap because of where I am or what I must get done.

Painkillers
Good old NSAIDs, Nonsteroidal Anti-inflammatory Drugs. They usually work, but I've taken so many of them over my lifetime (I was getting migraines before I was 10) that I've built up a tolerance to them. In a very real way, I suffer from the Ramp Effect, whereby I've developed a resistance to painkillers and therefore require and increasingly larger dose to achieve the same effect.

To prevent this, I frequently switch between types of painkillers (ibuprofen, acetaminophen, naproxen, etc) in the hopes that my tolerance to a particular type will decline as I take the others.

Alcohol
Let me be very clear on this:  I am not suggesting that someone drink alcohol until they are unconscious.

I am simply stating that, based on my observations, a drink of liquor (in my case, a shot of rum) helps take the edge off a lot of vascular headaches. It also helps increase the efficacy of painkillers. Yes, I know, medicine says not to mix painkillers and alcohol; I don't do this if I plan to drive or use machinery (mainly because if I'm hurting this much it's not safe for me to drive anyway) and I never consume so much that I become inebriated.

It works for me. It might work for you. Use caution and common sense.

Scalp Stimulation
Despite how weird this sounds,  having the top of my head scratched for 20-30 minutes is practically guaranteed to make me feel better. While it won't completely cure a headache, it will grant me enough relief that it knocks the pain down by 1-2 levels and makes other treatments more effective.

I don't know why it works. Maybe because there are nerve clusters on the top of my head and being scratched stimulates them to produce endorphins (pain-killing hormones). Maybe it just feels good and the pleasure creates dopamine within my body, overwriting some of the pain. All I know is that it works, and if I ever get married that person has to be willing to scratch my head whenever my head hurts.


These are what work for me. What works for you?

Dealing with Pain in Others

A lot of prepper articles are written about first aid because injuries tend to happen with any situation that rises to the level of an emergency. First aid generally means treating injuries when professional medical help is not available to stop further damage and prevent loss of life, with the goal being to get the patient to better care as soon and as safely as possible. The patient is going to experience pain both before and after seeing a physician, and the field of treating pain is complicated and controversial, but there are secondary issues that we should all be ready to address.

I'm learning to deal with chronic (long-term, unending) pain in someone I know. The day-to-day stress of having pain that won't go away has emotional and mental effects that drugs don't treat. Acute pain (short-term, may go away eventually) is normally the result of injuries and tends to be more unsettling to the patient because it is out of their normal experience. Both types of pain cause changes in the person suffering them that will affect how they deal with the world and people around them. Don't expect a person dealing with pain to act or react normally; you may have known them for years, but they can turn into a completely different person once they're in pain.

Physical Effects of Pain

• Loss of appetite and weight. Plan your meals accordingly and do what you can to make sure they get the calories and nutrients that their bodies need, especially if they're healing.
• Fatigue and sleeplessness. Pain will interrupt their normal sleep cycles, which will prevent deep, restful sleep. This will eventually cause fatigue and the other effects of sleep deprivation.
• Decreased movement. The risks of pneumonia and blood clots rise with the lack of mobility caused by injury and pain. Internal movements will also be slowed down, so watch for constipation and fluid retention if they aren't eliminating wastes as they should. Diuretics and laxatives are a subject for a separate article.
• Weakened immune system. Dealing with the source of the pain will focus the body's attention away from general immune response, so watch for infections in areas that weren't injured.

Mental/Emotional Effects of Pain

• Stress. Pain causes a lot of different stresses on the body and mind, so expect anyone who is not a hard-core stoic to show signs of stress. Dealing with stress varies from person to person, so investigate the patient normally deals with stress and find ways for them to do it.
• Depression/anxiety/panic/fear. Chronic or acute, pain tends to kick us out of our comfort zones. From what I've experienced, the severity of the pain is less of a factor than the personality of the patient. Drugs can help with these effects, but they tend to cause problems of their own that you then have to deal with. A calm environment and slow, quiet movements may help reduce these effects by eliminating any new emotional stresses.
• Anger/resentment. This one I know well. Pain, especially chronic pain, tends to cause outbursts of anger and resentment over little things, and big things lead to full tirades and melt-downs. Patience, prayer, and a thick skin are your only defenses. Being able to take a break and letting someone else handle the person in pain will help with your mental state.
• Disconnection from other people. Pain centers the mind on itself, leading to a loss of concern for others and difficulty relating to them. This means more conflict and less enjoyment for everyone around. This can be really hard on a marriage or other long-term relationship.

Pain is Part of Life
Humans have been dealing with pain longer than we've been able to talk, so it shouldn't be something arcane or mysterious. Our society has tried to ignore or sometimes punish those in pain for several centuries, which is so fundamentally wrong to my mind that I have a hard time grasping the concept. Most of the natural drugs we have stumbled across, even the discovery and development of things like alcohol and narcotics, have been in search of at least a temporary respite from the pains of life. The addictive properties of some of these drugs get blown out of proportion by those who think they know how to live our lives for us, and I'm sure some of that is based on their desire to control as much of the world as they can.

Those of you who are young and healthy should enjoy life as much as you can and give thanks to whichever deity you prefer. As we age, we collect injuries and ailments that cause pain and this impacts our lives and the lives of those around us. Be aware of those impacts and take them into consideration when dealing with others.

Gun Blog Variety Podcast #72

Come ring in the New Year with the crew of The GunBlog VarietyCast Episode 72!

• Erin Palette gives us some strategies on managing chronic pain during a disaster.
• In our Foreign Policy for Grownups segment, Nicki Kenyon tells us why she thinks that Russia is becoming more like the old Soviet Union.
• Our Special Guest, Benjamin Turner of the Personal Defense Talk podcast, explains to us how to avoid a fight in the first place.
• In his triumphant return, Barron B explains how $100 worth of dash camera can make the difference when a bad driver claims an accident is all your fault.
• And in another Patented Weer'd Audio Fisk™, Weer'd watches the Democrat debate so that you don't have to.

Thanks for downloading, listening, and subscribing. Please like and share The GunBlog VarietyCast on Facebook, and if you use iTunes, give us a review!

Listen to the podcast here.

Read the show notes here.

A special thanks both to Firearms Policy Coalition for their support and to our sponsor, Law of Self Defense. Use discount code "Variety" at checkout and get 10% off.

Headaches

Not actually Erin.

Picture by KJ Photography

& is used with permission.

I believe I've mentioned that I suffer from chronic, severe allergies. Imagine living with a cold for most of your life, where you are constantly blowing and wiping your nose, or where you are struggling to breathe because your sinuses are plugged, and you get an idea of what I live with daily. Some days are better, some are worse, but nearly all of them contain some sort of nose-related activity.

One of the more delightful side effects of these allergies is that I have frequent headaches. This is because the mucous in my sinuses prevents the pressure inside my head from equalizing with the outside world, so any time the weather changes -- high pressure front, low pressure front, rain, storm front, etc etc -- my head hurts as the pressure inside my skull tries to equalize with the pressure outside.

Some days I can handle the pain with simple over the counter medications. Other days, the pain is so horrible that the only thing I can do is crawl into bed and hope to pass out into the perfect painkiller than is unconsciousness.

In a SHTF scenario, neither of these options are likely to be available to me. But there is one pain easement technique (not a cure, mind you -- it soothes but doesn't solve) I know which works on every headache I've had:  Having the top of my head scratched with fingernails.

I'm not entirely sure why this works. I believe there's a nerve cluster there, and stimulating it with vigorous fingernail scratching helps me relax. All I know is that it works, and it can make a terrible headache into a tolerable one, or help destroy one when combined with painkillers.

If you have a headache that won't go away, give this a try. In my experience it requires actual scratchiness, so if you don't have any fingernails then you may have to substitute something stimulating, like a brush with stiff bristles.

Let me know if this works, and if you have any other sure-fire headache solutions that can be used post-SHTF, please list them in the comments below.

And now I'm off to bed, as my head has been aching all afternoon.