What I Did This Week To Prep

and Storm After Action Review

Anytime you use your preps–after you neatly put them away for the next time–it’s important to review how things went. What went well? What needs to be changed or improved? And what did you learn? We were pleased with how our preps worked during the storm, and because of them the power outage was only a minor inconvenience.

However, there were a couple of things I needed to follow-up on. I checked the generator to see why it had stopped running. As stated, I assumed it had stopped because it ran out of gasoline. I looked in the tank, it still had plenty of fuel left, and it started just fine. I let it run for about 20 minutes and there were no issues. I don’t know why it had stopped. My only concern was the age of the gasoline in it. When we bought it a year ago the tank was full and we still had that same fuel. The previous owner had added Sta-Bil, but I don’t know when. I decided to drain the tank and fill it with fresh gasoline. I siphoned as much as I could into the Jeep, then let the generator run until it was empty (it ran for over an hour before it stopped – an inadvertent but useful test). Then I added new gasoline and Sta-Bil, started it up to double-check, and put it away.

While working with the generator, Sarah, Ryan and I all practiced starting it.  It’s important that all adults (and as many of the kids as possible) in the home know how to run the critical prepper equipment. We had been concerned that Sarah wouldn’t have the ‘bulk’ to pull-start the generator, but she was able to do it without much trouble.

Next, when the battery bank was in use it had shut off earlier than I expected; I thought it was because of some kind of a surge. But my understanding may have been flawed. Fellow prepping blogger Homestead Fritz send me a link to The 12volt Side of Life; a 12-volt battery information site. I’m going to do some additional research on that topic. I’ve said before, I have a decent amount of knowledge about a variety of topics – but electricity is not one of them (though I’m learning).

Finally, I went by the hardware store and bought an 8-foot, 14-gauge extension cord that will be dedicated to use with the furnace. During the power outage I realized I was one cord short, so we had to shuffle cords around. The battery bank and the furnace are only about six feet apart so it seemed like a waste to use a 25-foot cord, but the smaller ones I own were only 2-prong household types and I needed a heavier duty 3-prong one.

Also this week, I found out my favorite collapse medicine experts, Doctor Bones and Nurse Amy of the Doom & Bloom Hour, had written a book. The Doom and Bloom Survival Medicine Handbook was published last week. I immediately ordered one and just received it in the mail. I’m very excited to have what I believe will be a fantastic medical reference. I’ll post a review on it soon.

I’ve started posting more to the TraceMyPreps Facebook page. I’d encourage you to “like” it and join our budding community; use that forum to comment, ask questions, and give advice. To make it easier I’ve added a ‘TraceMyPreps on Facebook’ like button on the top of the right side of my blog page. Also, right below that is a ‘Follow Blog Via Email’ box, if you sign up there each post I write will be automatically sent to you as soon as I publish it – this is an easy way to keep up on the posts as they come out.

What did you do?

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What I Did This Week To Prep

We planted our winter compost crop seed mix this week. The seeds arrived last week (from Bountiful Gardens), but because the ground was frozen we had to wait for warmer weather. There is a mixture of vetch, wheat, and rye, and then the fava beans are planted separately. We’ve never done this before and are not exactly sure what to expect. Will it look like just a bunch of weeds growing? And it seems strange to plan to grow stuff, just to cut it down and leave it in the dirt. I understand the concept and the experts say it’s a good idea, so the only way to fully understand it is to do it. We also sprinkled Dutch White Clover seeds on the backyard areas with less grass which, hopefully, will expand throughout the yard.

Shooting real firearms in suburbia isn’t very convenient, plus winter is frequently cold and wet when you go to the range, and ammunition quickly gets expensive. So I’m going to try using airsoft guns as an alternative way to practice and teach shooting skills. I got the idea from listening to Jack Spirko’s TSP, Becoming a Better Shooter and Trainer with Airsoft Guns (Episode 671). Last week Ryan and I went and bought a Crossman Air Mag C11 CO2 pistol, a box of CO2 cartridges, and a 2000 pellets (total cost less than $100). We came home and built a frame (8 1/2 by 11 inches), with a plywood back, lined the inside with a towel (to absorb the impact and prevent ricochet), and tacked up a normal piece of paper with a target drawn on it. We hung it on the wall and paced off ten feet. Sarah, Ryan, Alison, Emily and I took turns shooting in our custom indoor-range. I think it will be a good cost and time-saving, teaching and practice tool. Of course it’s not the real thing, but it’s the right weight and size and it allows you to practice: stance, grip/hand placement, sight alignment and sight picture, and trigger control. About the only thing missing is the loud “bang” and recoil. I’m excited about this new training venue. Once we get our skills up to a good level, we can–since it’s not a real gun and can be shot in the house–practice some “what if a stranger breaks into the house” scenarios. I think this will be a good winter activity that will allow any and all of us, who want to shoot, to have almost unlimited practice.

December 1st was yesterday. 2011 is almost over. Now is the time to reflect on our 2011 goals and either hurry up and finish, or revise as necessary. My post the last Friday of this month/year will be: What I Did This Year To Prep. Then, in early January, I’ll write: Goals For 2012. I’d encourage you to reflect back on this year and start thinking about your goals for next year.

Lastly, I wanted to link to some follow-up information regarding antibiotics in our long-term preps. From The Doom and Bloom Hour blog with Dr. Bones, a medical doctor, and his wife Nurse Amy, a Nurse Practitioner: Antibiotics And Their Use In Collapse Medicine, Part 1 and Antibiotics And Their Use In Collapse Medicine, Part 2. I applaud this couple for their diligence and determination to share life-saving material about collapse medicine. It is difficult to get good information on this topic and they are my top resource.

What did you do?

Expired, or Not Expired… That is the Question

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

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

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

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

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

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

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

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

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

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

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

(Friday: What I Did This Week To Prep)

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

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

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

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

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

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

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

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

Antibiotics In Your Preps?

“The first rule of antibiotics is try not to use them, and the second rule is try not to use too many of them.” – Paul Marino The ICU Book 2007

Cellulitis

Last week in Soap and Water I posted about the risk, in a collapse situation, of an infection–from minor cuts and scrapes–known as cellulitis. I linked to Dr. Bones Doom and Bloom blog post, Cellulitis: An Epidemic in a Collapse. Here’s another good article by Dr. Bones, A Doctor’s Thoughts on Antibiotics, Expiration Dates, and TEOTWAWKI. For additional perspective about antibiotics before and during a collapse I recommend comments by Dr. ‘Walker’ on TSP forum. Additional, non-prepper/collapse, antibiotic information can be found at eMedicineHealth.com.

I need to state, though I was previously certified and worked as a paramedic for almost ten years, I am currently not a medical professional of any type; thus I am not giving any professional medical advice. All the information in this post is from open internet sources. As Dr. Bones states “. . . [these] are hypothetical strategies for a post-apocalyptic setting. They are not meant to replace standard care and advice when modern medical technology and resources are available.” And always remember, the practice of medicine or dentistry without a license is illegal and punishable by law.

So with all the caveats stated:

Antibiotics refer to a substance that kills, slows or disrupts the growth of:

  • bacterial infections: caused by a pathogenic (a ‘germ’/microorganism that causes disease) bacteria
  • protozoan infections: caused by a parasitic disease, i.e. giardia which occurs through ingestion of infected fecal contaminated water or food

Antibiotics do not fight infections caused by viruses, such as: colds, flu, most coughs, and most sore throats (unless caused by strep).

Much of my information comes from Dr. Bones. I trust his advice. I applaud him; he is a medical doctor who is willing to say what he believes will save lives in a collapse situation. But as he clearly states, “[This] advice is contrary to standard medical practice, and is a strategy that is appropriate only in the event of societal collapse. If there are modern medical resources available to you, seek them out.”

As discussed in Soap and Water, describing a collapse situation, there are several things that will aggravate the chances of getting an infection: 1) We will be doing more ‘dirty’ jobs, 2) We will be doing a lot more manual labor and other activities that can easily lead to cuts and scrapes, and 3) Clean water and basic hygiene will not be as accessible or convenient. So a relatively minor wound that is ignored while you continue working gets more contaminated; then the wound isn’t thoroughly washed out because clean water is saved for drinking. In a short period of time that wound can develop a serious infection.

Dr. Bones states in Fish Antibiotics in a Collapse, “These injuries can begin to show infection, in the form of redness, heat and swelling, within a relatively short time. Treatment of such infections, called “cellulitis”, at an early stage improves the chance that they will heal quickly and completely.  However, many rugged individualists are most likely to “tough it out” until their condition worsens and spreads to their blood.  This causes a condition known as sepsis; fever ensues as well as other problems that could eventually be life-threatening. The availability of antibiotics would allow the possibility of dealing with the issue safely and effectively.”

Having antibiotics available in a collapse situation will be very important, even lifesaving. The question is how can we as preppers obtain a stockpile to be used if other ‘medical resources’ are no longer available?

Dr. Bones continues, “After years of using [antibiotics] on fish, I decided to evaluate these drugs for their potential use in collapse situations. A close inspection of the bottles revealed that the only ingredient was the drug itself, identical to those obtained by prescription at the local pharmacy. If the bottle says FISH-MOX, for example, the sole ingredient is Amoxicillin, which is an antibiotic commonly used in humans.  There are no additional chemicals . . .”

So it seems that fish antibiotics are the same drugs as used in human antibiotics. I believe that adding fish antibiotics to my preps is a sound strategy. They are available, without a prescription, through many fish supply websites. I have purchased, or plan to purchase, the following:

  • Fish-Mox Forte (amoxicillin 500mg): used to treat infections of the ears, nose, throat, urinary tract, skin, pneumonia, and gonorrhea
  • Fish-Flex Forte (cephalexin 500mg): used to treat infections of the bone, ear, skin, urinary tract, and pneumonia; it has very low side effects, (it is typically safe for those with penicillin allergies)
  • Fish-Flox Forte (ciprofloxacin 500mg): used to treat infections of bones and joints, sinuses, skin, urinary tract, gastroenteritis (stomach ‘flu’), typhoid, plague, and anthrax
  • Aqua-Doxy (doxycycline 100mg): used to treat infections of the sinus and respiratory tract, skin (staph), urinary tract, intestines, chlamydia, anthrax, Rickettsia, Lyme disease, plague, and cholera
  • *Fish-Zole (metronidazole (Flagyl) 250mg): as an antiprotozoal, used to treat giardia and dysentery

For any medication you choose to stock (antibiotics or otherwise) print out the entire drug card and keep that information stored with the drug; a good online source of drug information is the U.S. National Library of Medicine. Also it’s always best to store them in the original package and, like food storage, keep in a dry, dark, cool place.

If you choose to add antibiotics to your preps it is your responsibility to be thoroughly educated about their usages, contradictions, doses, and side effects. This is something you can’t just buy and figure you have it if you need it. Obtain additional medical publications such as the Physicians Desk Reference (PDR) or Delmar Nurse’s Drug Handbook*. Antibiotics are drugs, taking an antibiotic is a medical treatment, do not take this lightly. When I was going through my Army medic training one of my instructors said, “Every medicine you put into the body is a toxin, be sure the benefits outweigh the risks.”

(Wednesday: Expired, or Not Expired; That Is The Question)

* There are many other good references available, these are just two examples. There is no reason to buy a current edition; older editions are much cheaper and have essentially all the information a layperson would ever need. 

Soap and Water

Minor cuts and scrapes happen from time to time. Though any open wound is a potential site for infection, we really don’t think much about the small ones other than their initial pain and the inconveniences they cause us as they heal. Most of us live in a world that is relatively safe and even minor wounds don’t happen very often. When they do, the simple steps we take to care for them plus our daily hygiene practices prevent most infections. In rare situations, when the injury becomes infected often the biggest hassle is finding the time to get to the doctor’s office for prescribed antibiotics.

But in a long-term disaster/collapse situation, a minor wound–if neglected–could become deadly. In that scenario, there are several things that will aggravate the chances of getting an infection: 1) We will be doing more ‘dirty’ jobs, i.e. working outside, building fires, handling animals; 2) We will be doing a lot more manual labor, i.e. cutting wood, cooking over a fire, building and repairing, and other activities that can easily lead to cuts and scrapes; and 3) Clean water and basic hygiene will not be as accessible or convenient, i.e. no running water in the house. So a relatively minor wound that is ignored while you continue working gets more contaminated; then the wound isn’t thoroughly washed out because clean water is saved for drinking. In a short period of time that wound can develop a serious infection.

What is the best way to clean and care for a minor wound? Common answers frequently include hydrogen peroxide or alcohol, but not only do both of these harm the healthy tissue they can also delay wound healing. I’ve even heard someone say that ‘alcohol must be the best because it burns the most when you apply it’ – it burns because you are killing the exposed healthy tissue.

The best way to clean a minor wound, and prevent infection, is to remove all debris from the wound with cool, clean running water (this could also be poured or squirted from a container) and a mild soap. Then prior to bandaging it, lightly apply (think chapstick application) petroleum jelly on the wound. This will help the healing process by keeping the wound moist and clean and stop the bandage from sticking. Using antibiotic ointments is unnecessary, they add unneeded cost and may help create more antibiotic resistant bacteria; their main benefit is the same as the petroleum jelly.

Remember there’s a fine line between tough and stupid. The only medical aid available might be from your own group. So plan ahead to minimize injury: wear protective gloves, long pants and long sleeves, and, if appropriate, a helmet and/or goggles. When you do get a minor wound (and you will), make it a priority to clean and dress it as soon as possible. Be sure to know where the nearest first aid kit is kept, have water available for washing, and keep soap in your preps.

Even if you’ve done everything right, there’s a chance infection will occur. The type of infection common in these type wounds is cellulitis. Cellulitis, if not treated by antibiotics, “can cause a life-threatening condition known as sepsis”. This is described by Dr. Bones on his Doom and Bloom blog post, Cellulitis: An Epidemic in a Collapse. I recommend reading it. Next Monday I’ll explain what I’ve learned, and recently done myself, to acquire a stockpile of ‘collapse medicine’ antibiotics.

(Friday: What I Did This Week To Prep)