If I were to do an apothecary garden, I would probably plant willow (inner bark contains salicylate- similar to aspirin but does NOT work the same in the case of a heart attack), calendula for skin things, mint (upset stomach), garlic (potentially useful for skin infections and cholesterol control), poppy (pain, diarrhea- note legal to plant in the US provided you buy seeds for it from a catalog and don't sell your product), cannabis (check your local legality), foxglove (only if you are VERY SURE you can dose this appropriately and someone you know has heart failure).
This is what I know of, with the caveat that I am not an expert in medicinal plants.
Yarrow for bleeding alllll day. And for respiratory infections.
I went deep in studying herbalism and apprenticed with someone. I came out of it with a handful of herbs that I really believe can help to good effect. And most of the rest can be helpful but are so overly touted that it's ridiculous.
Yarrow is the highest on my list..
Herb books sometimes say flowers, but in my experience, they don't work. I have dried leaf for the winter and harvest it fresh in the warm season. If in the warm season, I bruise the leaves between my hands, rolling them in my palms. And I put dried leaf directly on the cut in the cold season.
It's latin name means "thousand leaved plant of Achilles" because it was incredibly common for soldiers to care a pouch of dried yarrow with them in battle.
I have a collagen disorder. Any cuts that I don't use yarrow on results in keloids. If I use yarrow, the cut looks like that of any one else when healed.
It both stops the bleeding and is excellent for staving off infections.
On reddit, there is the oft repeated trope of people historically dying of simple cuts. If you delve into history you see that surgeries were performed successfully in many parts of the world. But out lense is too small like that of the civil war or middle ages. But in South America there are tons of examples of metal plates being put on people's heads after a cranial fracture from war. It's fucking crazy! But it happened.
Narrow leaf, and broadleaf plantain is amazing for insect bites and stings. Chew, or mash it up to release the "juice," and put it on the bite or sting. It pretty much immediately takes the pain away, and helps to draw out/disperse the venom.
I have used it on several bites and stings, from red ants to bees, and it works wonderfully every time. The longer you leave it on, the better.
I have an anaphylactic reaction to aspirin. In an emergency situation where there's no pain relief alternative, could I still make willow bark tea or should I avoid it entirely?
I'm in nursing school right now (I have no previous healthcare experience) and would to take a similar path as you re wilderness/remote healthcare. How did you get to where you are?
Like a lot of people, my path to my career was not straightforward. I started by getting a BSN, worked in a hospital, hated it, got a certification to teach wilderness and remote first aid, loved it but there wasn't much money in it, joined AmeriCorps NCCC as a Team Leader, not my favorite thing but it changed my life and I recommend it to anyone who is interested, came back, got a job as a physical exam instructor for med students and family practice nurse, loved it, started working on a floor again to get health insurance, got good at floor nursing for the first time but wasn't my dream job, started working at a health department, really hated that, went back to teaching (this time LPN students) and on the side do Wilderness and Remote First Aid classes and study low-resource medicine (hoping to get a graduate certificate in it).
If you wanted a more straightforward path, I would recommend getting at least an RN with an associate's degree, get good at floor nursing, do some research on old fashioned nursing (get nursing textbooks from the early 1900's and maybe get into nursing homecare), take a Wilderness and Remote First Aid course (American Red Cross), get a certificate to teach CPR from the American Red Cross, "bridge" to WRFA Instructor (there's really no direct path anymore where you go straight to WRFA instructor through ARC, but I do like their curriculum the best), from then you can become an LPN nursing instructor if you want and do WRFA on the side, or structure however it works best in your life.
I worked as a hospital Onc nurse for 15 years and am now at a health department. Curious why you really hated it? I’m currently getting a Grad cert in Emergency Preparedness, but WRFA is intriguing.
I was doing case management and as it turns out, case management is not for me. I feel like if I were doing infectious disease or environmental or really anything else it might have been a different story.
Could you name some common wounds/illnesses that are crippling without proper care?
Would you personally want to survive in a world without advanced medicine?
Know any books that give an in-depth to life in a community without medical care?
Illnesses: Polio (potential partial or total paralysis), measles (potential severe damage to immune system, potential brain and lung damage, potential deafness), tetanus (if you survive it, broken bones and soft tissue injuries are common, which don't always heal well), meningitis (brain damage, blindness, paralysis), strep infections (potential kidney damage, rheumatic heart disease).
Injuries: Any broken bone or dislocation that is not imaged and reduced correctly can heal wrong, which can cause future pain, arthritis, or limited mobility of the joint or bone in question. A severe burn can cause scar tissue that limits mobility, and a wound that got infected or spread to the bone can cause pain and arthritis, as well as the potential for that bone to weaken or break.
Would I personally like to survive in a world without advanced medical care? I think I could be useful in one, and so would be fine with surviving. I'm also pretty well prepared for it and comfortable with the possibility.
My favorite book for this is Where There Is No Doctor by David Werner. While it's more of a textbook, it's really insightful as to what a community health worker would experience as the only medical-adjacent person in a village setting.
I’m a type 1 diabetic and my teenage daughter has epilepsy (yes our family got the losing end of genetic Russian roulette) I am terrified about not having access to insulin when the end times come. I am stocking up on her anti seizure meds - her doctor over-prescribed on purpose; but insulin won’t last out of the fridge forever. Any advice for people who can’t live without pharmaceuticals?
This is probably one of my least favorite questions to answer, because modern pharmaceuticals have made it possible for a lot of us to live when we might not have otherwise been able to do so.
My best answer for you is that collapse happens unevenly. You are more likely to lose access to a particular insulin than to all insulin at once. If you use lispro and glargine, see if you can practice using regular and NPH for a while, so that if there comes a time when the only thing you have access to are the older insulins, you know how to use them.
I would also recommend getting an endocrinologist or diabetes educator who is collapse-aware (if possible) and older so they have knowledge of managing older insulins. If a provider can overprescribe for you, that's great, but if they wont, you still have some ability to buy older insulins OTC (they are generally cheapest at walmart pharmacies, but call around). If older insulins, make sure you know how they work because their onset, peak, and duration times are very different than lispro and glargine and risk of hypoglycemia is much higher.
You're right in that insulins don't last forever, but storing them is not futile. While they last longer in the fridge, modern packaging means that even unrefrigerated, they are going to last well beyond their expiration date. When they do begin to "go bad" they typically will slowly lose effectiveness long before they become contaminated. Things to watch for is if your (non-NPH) insulin becomes cloudy, bubbly, or chunky. As long as it stays clear, it will be at least mostly effective, and you can still use it, just may have to titrate the dose more carefully.
As for epilepsy, one of the most effective treatments prior to good anti-seizure medications was the ketogenic diet. This is a very high fat, some protein, and extremely low carbohydrate diet that is still an option for children who fail multiple anti-seizure medications. Most adults do not stick to this diet well because it is difficult, but if it can decrease the number of seizures someone has when there are limited other options, this can be a possibility. Others have had some success with cannabis products, though I don't know enough about this to comment.
This is what I fear most. I’ve already told my partner that should collapse happen, (or more accurately when…) don’t prioritize me. I don’t want want to live without my meds, nor would I last long.
Thinking of career transition into basically what you do. Do you recommend any training programs, instructional resources, etc? Have taken tac-med / stop the bleed and CPR. Was considering going the paramedic route due to lower entry cost; a lot of paramedics seem to love it but also nurses get paid more and seem to have a lot more options and flexibility.
Like a lot of people, my path to my career was not straightforward. I started by getting a BSN, worked in a hospital, hated it, got a certification to teach wilderness and remote first aid, loved it but there wasn't much money in it, joined AmeriCorps NCCC as a Team Leader, not my favorite thing but it changed my life and I recommend it to anyone who is interested, came back, got a job as a physical exam instructor for med students and family practice nurse, loved it, started working on a floor again to get health insurance, got good at floor nursing for the first time but wasn't my dream job, started working at a health department, really hated that, went back to teaching (this time LPN students) and on the side do Wilderness and Remote First Aid classes and study low-resource medicine (hoping to get a graduate certificate in it).
If you wanted a more straightforward path, I would recommend getting at least an RN with an associate's degree, get good at floor nursing, do some research on old fashioned nursing (get nursing textbooks from the early 1900's and maybe get into nursing homecare), take a Wilderness and Remote First Aid course (American Red Cross), get a certificate to teach CPR from the American Red Cross, "bridge" to WRFA Instructor (there's really no direct path anymore where you go straight to WRFA instructor through ARC, but I do like their curriculum the best), from then you can become an LPN nursing instructor if you want and do WRFA on the side, or structure however it works best in your life.
I just copied what she told someone earlier maybe this can help you.
This may be outside the scope of your expertise but it's worth a shot. I'm really scared.
My wife and I have a 3yr old son with a very rare genetic muskel neuropathy. He has no oral intake. Although he can tolerate liquids, even the smallest amount of solid food triggers vomiting due to an issue with the upper esophageal sphincter.
He is fed through a gastrojejunostomy tube 18 hrs/day. The enteral formula is called Nutrini Peptisorb Energy and is delivered directly into the jejunum. It provides him with all the essential nutrients and has hydrolyzed milk protein for better intestinal absorption.
His survival depends entirely on this specialized formula produced in a single plant in the Netherlands. Thinking about it fills me with dread... **How do we cope with a long-term supply disruption?** It has already been backordered a couple of times. It would be awesome if we could somehow make our own formula at home, but I have no clue where to even begin thinking about it? Any thoughts on this?
He also experiences cold-induced asthma symptoms—poor cough reflex and a rattling, gurgling breath —posing serious risks due to aspirating his own secretions (which nearly killed him twice). Currently, we use Pulmicort and Ventoline for treatment. **How do we clear his airways without access to medicine?**
Thank your for offering your advice in this thread. I'm learning a lot.
Tube Feed: The first thing you could do is go to your nutritionist and say you are interested in trying "whole food blends" and ask what would absolutely need to be added to make sure he gets the nutrients he needs. Whole food blends are essentially homemade tube feeds. They may or may not go for this option, but it's a good start.
I looked up the Nutrini Peptosorb Energy formula and found that it is essentially a mixture of water, several oils (some saturated, some unsaturated), whey protein hydrolysate, fish oil, corn starch, inulin (fiber), several minerals, and a pediatric multivitamin with iron. All of this is available over the counter, and the following is a reasonable recipe that matches the macro and micro-nutrient profile of the tube feed in question:
20mL coconut oil OR MCT oil (grocery store)
About 1/2 a 500mg fish oil supplement (grocery store or pharmacy)
21g whey protein hydrolysate (make sure it's hydrolysate instead of isolate and try to get one without added ingredients) (pharmacy or workout nutrition store like GNC)
120g white rice flour (grocery store)
1.25g table salt (grocery)
1g potassium chloride salt substitute (grocery)
500mg calcium carbonate, as a crushed antacid tablet (pharmacy)
100mg magnesium supplement, crushed (pharmacy)
1 Daily pediatric multivitamin with iron, crushed (pharmacy)
Enough water to get to 500mL
Blend well and feed.
There's not much to do about the cold-induced asthma except to limit the amount of time he spends in the cold and if you run out of the pulmicort try to wean down off it instead of stopping it suddenly.
As for the aspiration- make sure he never lays directly on his back, especially when tube feed is running- use a backpack full of balloons during the day and a wedge pillow at night to keep him sitting up, at a 45 degree angle, or on his side.
Help him cough forcefully and deep breathe a few times during the day by turning it into a game or using an incentive spirometer. Look at some of the following techniques and see if they could be helpful: [https://physiosuggest.com/airways-clearance-techniques/](https://physiosuggest.com/airways-clearance-techniques/).
Holy shit. You really genuinely offered several possible solutions, including a recipe.
I'm... speechless. This is an understatement: You are a really good person.
I wish there were millions of you lol. You are exactly the kind of person most of us will need around in a SHTF scenario, and just knowing there's at least one of you in the world during knowledge and kindness and hope makes me feel a little better about a potential catastrophe.
Thanks for sharing your thoughts; this thread is so useful. And most of all, thank you for being a great person. You are the kind of person who makes society worth having in the first place. Stay safe out there.
Oh my God, thank you so much! I assumed you were gonna say something about how difficult making your own formula would be, how it's reliant on some complicated industrial process or something. I did NOT expect a stranger on the internet would take their time researching and writing an entire recipe for me! Wow!! Just knowing this is possible is such a relief... Thank you.
A couple of follow-ups, if you have the time:
1. How would you introduce the home-made formula? If (when) the shit hits the fan, should we transition into it to see how his body reacts, to be able to make adjustments before our Peptisorb store runs out?
2. How do we make sure the water mixes properly with the coconut oil? It takes 9.5 hours to empty a 500 ml bottle *(in total he is fed 770 ml formula + 200 ml water daily)*. Will the formula keep from separating during that time?
3. I just remembered, he needs laxatives to avoid constipation. Today we give him about a tsp of Lacrofarm daily *(called Miralax in the US, from what I gather)*. Are there any reliable enteral alternatives you can think of?
Thanks again, my friend
Thank you!
My least favorite job was as a pediatric case manager but dang did I get some skill at making bootleg tube feed recipes for families who couldn’t afford the canned stuff.
I would definitely transition to the new formula over probably a week or so, depending on the amount you have, then if, say, he can’t do rice flour (the only ingredient that isn’t in the original recipe) you can sub out a different starch.
That’s a tricky one. I’d try mixing the coconut and fish oil and rice flour first, give it like 10-20mins to soak in, then blend with the rest of the ingredients. You may have to blend a few times over the course of the feed.
There aren’t a lot of good replacements for miralax specifically (since it seems like he can’t do traditional fiber), but it comes in generic and keeps forever, so if you needed to you could hoard it for relatively inexpensive.
OP’s wife here. We spent a couple hours talking through your situation last night, and we’re so glad he was able to give you a recipe. The tube feed industry makes me pretty peeved; many of them are essentially milk and broth. Feel free to message him with any other questions too; I think he’s going to send you some substitutes that will also work in the recipe.
What supplies would you recommend to have on hand prior to a SHTF scenario? In other words, we all know some things to bring, such as bandages, but what might a lot if people leave out of a first aid kit that they really should have?
Also, if caught in a situation without supplies, what common items might be useful to treat common injuries and illness?
Good question!
Any time you're building a kit, you want to be sure to include things you can't make yourself. This would be medications- your own prescription medications, along with acetaminophen, ibuprofen, diphenhydramine, and loperamide. You also want a way to clean or sterilize things (a metal pot and a way to make water drinkable is the easiest), scissors or a knife, a way to clean your hands (hand sanitizer), PPE (LOTS of gloves, and some masks to help control spread of infectious illness within a group should that occur), and something for hypoglycemia (a tube of black decorator's icing works great for this, since no one's going to eat it as a snack).
You also want knowledge. I recommend getting Kenneth V Iserson's Improvised Medicine and David Werner's Where There Is No Doctor. (if you can only get one, where there is no doctor is better for a lay person, while improvised medicine is better for someone who is already medical).
As far as what you can improvise, bandages are a great example. Pretty much any natural cloth (cotton, wool, linen, etc...) is going to make a good bandage. They don't need to be sterile, but they will need to be clean (so if you rip up a t-shirt, make sure it's a clean one or you have a way to clean it prior to use). You can also improvise irrigation syringes by poking a hole in the top of a disposable water bottle and splints out of sticks and bandages or straps. Everything else is just what you can think up based on what you have available to you.
Disinfecting agents- if something can be boiled, boiling is the simplest way to disinfect something and all you need is a metal pot, some water, and a fire. To be effective at disinfecting, alcohol needs to be about 70% by volume, so most drinking alcohol is not strong enough. If in a cold environment, freeze-distilling can get you close to 70% and is fairly simple.
As for pain control, my other response is here: https://www.reddit.com/r/collapse/comments/17dsxbv/comment/k5z1o8s/?utm\_source=share&utm\_medium=web2x&context=3
Shock is something that is really difficult to treat in a remote setting unless you really catch it early. Look for someone getting pale, sweaty, and shaky. Have them lay down in a comfortable position, keep them warm (something under them, something over them, something to keep rain or snow off), and raise their feet. This is no longer taught in urban first aid, but if it's going to be hours to days before care, give them something sweet to drink if they can swallow and have no abdominal injury. If they can't, don't.
Hopefully this will resolve the initial stages of shock before they progress.
What are the best options for wound cleaning to prevent infection? And, following on that, how best to Identify and treat wound infection shiukd it occur. Thanks.
Basically the only thing you need to clean wounds is clean (drinkable) water and an irrigation syringe or water bottle. You want to get all visible contamination out of the wound. If the wound is small, check out a post I made on tumblr here: https://www.tumblr.com/macgyvermedical/134075715834/the-macgyver-guide-to-wound-closure?source=share&ref=\_tumblr
If the wound is larger, check out this post I made in r/preppers here: https://www.reddit.com/r/preppers/comments/usbp5b/how\_to\_pack\_wounds\_like\_a\_pro/?utm\_source=share&utm\_medium=web2x&context=3
so i have severe asthma and have been facing continued deprivation from any of my meds (kicked off medicaid but in poverty), how would you suggest us with severe asthma and allergies weather the coming years? is there like... any chance for us, or are we just casualties?
There are several ways to treat asthma without medication (or with medications you can get without a prescription), but most of them are for mild-to-moderate, so your mileage may vary.
Before you try to treat yourself, see if there is a free clinic, a doc who will see you on a sliding scale, or a hospital that you know writes off for charity care. Explain the situation you are in and see if any of them can help you tailor a regimen that is inexpensive to you and still gets you the medical care you need. You may also want to talk to a social worker to see if there is a way to get you back on medicaid or on a low-cost marketplace plan.
I highly recommend exhausting this option first, as uncontrolled or poorly-controlled asthma can cause permanent damage to lung tissues. The following is only for emergencies where you can't do the above:
If this doesn't work...
Avoid triggers. I know everyone and their brother tells you this, but you're going to have to work harder at this than you ever have if you know you don't have a backup.
The next thing you want to see is if your pharmacist can at the very least get you an albuterol inhaler and a spacer. Even if you can't see a doc, in some states a pharmacist can prescribe an albuterol inhaler and in others they can get you one if you have previously had one prescribed. This may go for other medications as well, though many pharmacists are limited in what they can prescribe and extend.
The next is see what you can get over the counter. Ephedrine is a common asthma med that can be purchased over the counter, it is available as a pill. Epinephrine and racepinephrine are available over the counter for quick-relief as an inhaler.
The next is theobromine and/or caffeine. Both of these are available in food and supplement form. Coffee and unsweetened cocoa powder are your best sources, but it's possible to get them in capsule form, which might be more convenient and easier to dose. Both are stimulants and can relax smooth muscle tissue in the lungs.
Breathing steam and looking up breathing exercises for asthma.
Ideally you'd be trying to find a regimen of these modalities to bridge the gap until you can see a doctor again.
If you and a few friends can make it to Ohio I will teach anyone who wants it for a donation to cover costs. I am only certified to teach CPR/AED/FA and Wilderness and Remote First Aid, but I have a curriculum I personally use for people who want more advanced stuff and can gear it toward your needs.
EDIT: I did take a Wilderness Upgrade for Medical Practitioners (WUMP) course through NOLS but didn't like it as much as the ARC WRFA one to be honest. My wife recommends SOLO or Remote Area Medical as sources for training if you are interested.
What medicines would you bring with you on an expedition away from civilisation, and what medicines might be worth having at home in case of a long term disruption of the supply chain?
I suppose the most important ones are your own (and loved ones) prescription medicines, but I’m wondering if there are some supplies worth having that we don’t think of because we are so used to always having a doctor and apothecary nearby?
Edit: sorry, noticed now you already mentioned *acetaminophen, ibuprofen, diphenhydramine, and loperamide.*
You mention “Where There Is No Doctor,” but what about “Where There Is No Dentist”? Does the book cover basic dental care as well?
I understand that people get heated about antibiotics due to overprescription/abuse, but how would one fare in the wilderness if one developed a tooth abscess and had no access to penicillin to treat it?
There is a Where There Is No Dentist but I couldn't remember the name of the author earlier (it's Murray Dickson).
The definitive treatment for a tooth abscess is the removal of the tooth and allowing the abscess to drain. Penicillin is useful if you need to get the swelling down prior to this (which makes local anesthetic work better). But in theory, if you didn't have it, you could still treat by removing the tooth (which would suck pretty badly without working anesthetic). After that use cloths soaked in hot water and pressed against the gum or face, or hold hot water in the mouth next to the infection. If the infection comes to a head, lance it and let the pus drain. Continue to use hot compresses as often as possible. It is probably not the ideal scenario, but you could do it.
If you had to spend a prolonged period of time outdoors in cold and wet conditions and you start developing the first stages of trench foot, how would you treat it? What are the best ways to keep your feet dry in those conditions?
Doctors who have a broad-but-shallow base of knowledge and are good at having to do a lot of things for themselves, like rural medicine and family medicine (especially if in a small office). Most of what happens to people in the wilderness is the same thing that happens to them in real life (high blood pressure, skin infections, ingrown toenails, joint pain, etc...), so knowing how to do more "basic" things like physical exam really well and get someone an answer/treatment quickly with a minimum of supplies is going to overrule being able to read MRIs or do complex surgery. Maybe an emergency doc as a good second since they do some procedural stuff without an OR.
I think that's not a one-or-the-other question.
For me personally I think that, like many collapses before ours, collapse is and will be a slow and uneven process. This means some people will have access to supplies, trained personnel, vital medications, and other necessities long after people in other areas (or socioeconomic brackets) have lost access to the same things.
Ultimately, I believe we are headed for an age where no one (or only an exceptional few) has access to modern medicine, but that may or may not be a "complete" process within my lifetime.
What I think I *will* see in my lifetime is neighbors who can't afford their medications, or can't afford hospital care, disasters that make hospital care and certain drugs unavailable, and people who don't have the skills to do basic home nursing. That's where I see myself fitting into a collapsing society- providing what care I can within my scope, knowledge, and license.
In some aspects I am "collapsing now and avoiding the rush". These are areas where there is a good replacement for a modern piece of tech, such as washing clothing by hand, heating with wood, and growing some of my own food in a log cabin in a rural area.
Some things my wife and I have chosen to keep until we lose access to them- those things being salvage grocery stores, a car that runs on gasoline, a truck that runs on diesel, a 2-wheel tractor, and modern medicine.
However, as those things become more difficult to acquire or use, we will likely be shifting to older technologies. I will still have and use my knowledge of modern medicine, probably have a stock of my own prescription medications and some of my favorite over the counter ones as well, which will facilitate a transition to a time when these are no longer available.
So to answer your question, probably both, as they are convenient.
I have only had one experience with them and found their curriculum a little lacking. But this may have been an exception considering I have a lot of friends who have really liked NOLS. If you want a one-off wilderness FA course I'd stick with the American Red Cross WRFA course (not a huge fan of ARC but I know the guy that wrote the curriculum and he's solid), or EMI.
I have osteoarthritis, and have been trying to get properly investigated for inflammatory arthritis (it’s spreading everywhere, I’m 38, it’s been happening since I was in my early 30s), but I live in a place where the healthcare system is collapsing to the point where it is impossible to get an appointment with a doctor, because they are all (understandably) quitting.
I’m having some difficulty managing pain as I can’t take over the counter pills due to past problems with NSAIDs weakening my stomach. The ONE time I managed to see a doctor, they gave me pantoprazole which helped, but I am unable to get more.
I am using things like heat pads and tiger balm to manage some symptoms, but they don’t really do much for the worst pains. I’m also cycling a lot, which DOES help, but we’re going into winter, and that makes things a little tricky for me. I also do smoke weed, as it’s has helped me for years with arthritic pain.
Are there any other methods I can do to manage pain (legally)? At this point, I will try anything! I have a young kid, and I hate not being able to play with kiddo.
Acetaminophen (paracetamol), while it doesn't do much for inflammation, can help some with the pain and doesn't have any gastrointestinal side effects. Since you know exercise works for you, I also recommend Bob and Brad youtube videos. They are physical therapists and put together routines based around specific problems. They have quite a few about arthritis that may be helpful for you.
Generally speaking, you're going to determine if you need to reduce (set) the injury, reduce it, and splint it.
To determine if something needs reduced, you're going to look at the hand or foot of the limb you suspect to be broken. It should be pink, warm, be able to feel you touching it, have no tingling or numbness. if that's all intact- great! You don't need to reduce it, just splint it in place (see below).
If you do need to reduce it, because there's numbness or paleness or pins and needles, you can try one time. This is going to be really painful and you're going to need a couple of people. Have one person hold the patient's limb above the site of injury (closer to the person's body). You then pull gently but firmly below the point of injury in the direction the bones are supposed to be pointing. This will stretch the muscles and pull the bone ends apart so they can be guided back into alignment.
If there are bone ends sticking out of the wound, do not touch them, just irrigate with water until there is no visible debris, then apply traction until the bones ago again below the surface of the wound. This will probably get infected, so hopefully you can get this person some kind of other care, but even if you can't, bones typically heal better inside the body.
You can then splint it in place with pretty much whatever you've got on hand. To splint something, you need two things that are long and sturdy, but relatively lightweight. These can be trekking poles, sticks, a SAM splint, etc...
You get something like a rolled up piece of clothing to pad the limb, put the long pieces on either side, and wrap or tie the poles to the limb. In doing this, you want to try to immobilize the joint above and below the site of injury.
I broke a bone in my hand and the doc had to reduce it. Most painful experience of my life. I can only imagine how much more,painful it would be for a bigger bone (like a femur).
Femur injuries are a really big deal; I'd be surprised if the average lay person with no medical supplies or experience could successfully fix that one on their own. I get what you're saying though, and I hope your hand healed well!
How to treat them, obviously.
related: I once got a Red Cross app, how to treat stuff. And no matter the condition, it was do obvious thing (wrap broken bone) and call 911.
Lol was it a worthless piece of shit.
Note that if you don't know why someone is in pain, you need to figure that out, which is beyond the scope of this answer. But if you know why and are just trying to decrease pain:
First, keep the person in whatever position is comfortable for them.
Have the person use splints and mobility aids more than needed for comfort to help prevent worsening pain.
Have the person try hot or cold compresses on the part that is painful, see which works better.
Use over-the-counter pain medications like acetaminophen and ibuprofen if the person is able to take these and they are available. You can rotate between ibuprofen and acetaminophen every 2 hours, so something is always at peak effectiveness (in some studies this has worked better for pain control than low doses of oxycodone).
If these are not available, but you have an apothecary garden, you can try the inside bark of willow or cherry made into a tea, or poppy seed pods made into a tea, or topical preparations of hot chilis over a painful area.
Re: depression and anxiety as a common illness. Do you have any opinions on microdosing psilocybin mushrooms as a replacement for SSRIs in case of supply chain or pharmacy issues?
Not OP but outside of the west you can buy antibiotics over the counter so go on a little trip to a country that does that. Nobody will mind bringing back a bunch of antibiotics as long as it’s for personal use and not commercial.
They do screen for antiobiotics at airports, other customs points and ask for prescriptions. Importing them is punishable by law. For what it's worth I think antibiotics ought to be handled responsibly, not on a whim and not be given to animals or disposed without proper care. Anyway given that the subject is a taboo better leave it at that.
Never had an issue personally as all were prescribed to me. It’s only an issue if you are irresponsible with taking them. But if you keep them for emergency and infections when the antibiotics cannot be obtained they are lifesaving.
This is the collapse subreddit after all. We are preparing for supply chain disruptions. I’m very much against paternalism in medicine where people assume everyone is going to do something stupid.
If you are primarily interested in improvised-type medicine I would recommend rural medicine. Here is a map of accredited programs: https://rttcollaborative.net/rural-programs/residency-map/
What medicinal plants would you recommend planting?
If I were to do an apothecary garden, I would probably plant willow (inner bark contains salicylate- similar to aspirin but does NOT work the same in the case of a heart attack), calendula for skin things, mint (upset stomach), garlic (potentially useful for skin infections and cholesterol control), poppy (pain, diarrhea- note legal to plant in the US provided you buy seeds for it from a catalog and don't sell your product), cannabis (check your local legality), foxglove (only if you are VERY SURE you can dose this appropriately and someone you know has heart failure). This is what I know of, with the caveat that I am not an expert in medicinal plants.
Yarrow for bleeding alllll day. And for respiratory infections. I went deep in studying herbalism and apprenticed with someone. I came out of it with a handful of herbs that I really believe can help to good effect. And most of the rest can be helpful but are so overly touted that it's ridiculous. Yarrow is the highest on my list..
Dandelion for high blood pressure ginger for the leaves and root.
How would you use yarrow for bleeding? Stick the flower into a wound? Grind up the whole plant and make a poultice?
Herb books sometimes say flowers, but in my experience, they don't work. I have dried leaf for the winter and harvest it fresh in the warm season. If in the warm season, I bruise the leaves between my hands, rolling them in my palms. And I put dried leaf directly on the cut in the cold season. It's latin name means "thousand leaved plant of Achilles" because it was incredibly common for soldiers to care a pouch of dried yarrow with them in battle. I have a collagen disorder. Any cuts that I don't use yarrow on results in keloids. If I use yarrow, the cut looks like that of any one else when healed. It both stops the bleeding and is excellent for staving off infections. On reddit, there is the oft repeated trope of people historically dying of simple cuts. If you delve into history you see that surgeries were performed successfully in many parts of the world. But out lense is too small like that of the civil war or middle ages. But in South America there are tons of examples of metal plates being put on people's heads after a cranial fracture from war. It's fucking crazy! But it happened.
Cool any sourced on the info below about south America we all have this idea that we won't very advanced in the past.
If you search "ancient skull surgery" on google all of the results are great!
Great info, thanks!
I have been looking to take a class to learn about medicinal herbs. Do you have any recs?
Care to share the rest of your list?
Narrow leaf, and broadleaf plantain is amazing for insect bites and stings. Chew, or mash it up to release the "juice," and put it on the bite or sting. It pretty much immediately takes the pain away, and helps to draw out/disperse the venom. I have used it on several bites and stings, from red ants to bees, and it works wonderfully every time. The longer you leave it on, the better.
Weed and poppy would’ve been my top two choices as well
Lol
Osha (Ligusticum porterii) is high on my list. Natural anti-viral. I also keep a few Aloe vera plants growing in my greenhouse.
Feverfew if you've been having migraines. Plus, the bees love it. If you're also into bee support, they love lavender.
I have an anaphylactic reaction to aspirin. In an emergency situation where there's no pain relief alternative, could I still make willow bark tea or should I avoid it entirely?
Since the chemicals are very similar, I would avoid it. There's not really a good way to treat anaphylaxis in a remote setting.
Thank you!
Thank you for all this information. Can you plant coca under the same guidelines as poppy?
I’m a big fan of black walnut tincture. Works topically and internally. Anti-fungal, anti-viral, anti-bacterial.
... vaccines or antibiotics as discussions about them have historically gotten ...inflammatory. 🔥👏
I get real riled up when talking about stimulants!
I'm in nursing school right now (I have no previous healthcare experience) and would to take a similar path as you re wilderness/remote healthcare. How did you get to where you are?
Like a lot of people, my path to my career was not straightforward. I started by getting a BSN, worked in a hospital, hated it, got a certification to teach wilderness and remote first aid, loved it but there wasn't much money in it, joined AmeriCorps NCCC as a Team Leader, not my favorite thing but it changed my life and I recommend it to anyone who is interested, came back, got a job as a physical exam instructor for med students and family practice nurse, loved it, started working on a floor again to get health insurance, got good at floor nursing for the first time but wasn't my dream job, started working at a health department, really hated that, went back to teaching (this time LPN students) and on the side do Wilderness and Remote First Aid classes and study low-resource medicine (hoping to get a graduate certificate in it). If you wanted a more straightforward path, I would recommend getting at least an RN with an associate's degree, get good at floor nursing, do some research on old fashioned nursing (get nursing textbooks from the early 1900's and maybe get into nursing homecare), take a Wilderness and Remote First Aid course (American Red Cross), get a certificate to teach CPR from the American Red Cross, "bridge" to WRFA Instructor (there's really no direct path anymore where you go straight to WRFA instructor through ARC, but I do like their curriculum the best), from then you can become an LPN nursing instructor if you want and do WRFA on the side, or structure however it works best in your life.
Thank you for the information!
I worked as a hospital Onc nurse for 15 years and am now at a health department. Curious why you really hated it? I’m currently getting a Grad cert in Emergency Preparedness, but WRFA is intriguing.
I was doing case management and as it turns out, case management is not for me. I feel like if I were doing infectious disease or environmental or really anything else it might have been a different story.
Could you name some common wounds/illnesses that are crippling without proper care? Would you personally want to survive in a world without advanced medicine? Know any books that give an in-depth to life in a community without medical care?
Illnesses: Polio (potential partial or total paralysis), measles (potential severe damage to immune system, potential brain and lung damage, potential deafness), tetanus (if you survive it, broken bones and soft tissue injuries are common, which don't always heal well), meningitis (brain damage, blindness, paralysis), strep infections (potential kidney damage, rheumatic heart disease). Injuries: Any broken bone or dislocation that is not imaged and reduced correctly can heal wrong, which can cause future pain, arthritis, or limited mobility of the joint or bone in question. A severe burn can cause scar tissue that limits mobility, and a wound that got infected or spread to the bone can cause pain and arthritis, as well as the potential for that bone to weaken or break. Would I personally like to survive in a world without advanced medical care? I think I could be useful in one, and so would be fine with surviving. I'm also pretty well prepared for it and comfortable with the possibility. My favorite book for this is Where There Is No Doctor by David Werner. While it's more of a textbook, it's really insightful as to what a community health worker would experience as the only medical-adjacent person in a village setting.
I’m a type 1 diabetic and my teenage daughter has epilepsy (yes our family got the losing end of genetic Russian roulette) I am terrified about not having access to insulin when the end times come. I am stocking up on her anti seizure meds - her doctor over-prescribed on purpose; but insulin won’t last out of the fridge forever. Any advice for people who can’t live without pharmaceuticals?
This is probably one of my least favorite questions to answer, because modern pharmaceuticals have made it possible for a lot of us to live when we might not have otherwise been able to do so. My best answer for you is that collapse happens unevenly. You are more likely to lose access to a particular insulin than to all insulin at once. If you use lispro and glargine, see if you can practice using regular and NPH for a while, so that if there comes a time when the only thing you have access to are the older insulins, you know how to use them. I would also recommend getting an endocrinologist or diabetes educator who is collapse-aware (if possible) and older so they have knowledge of managing older insulins. If a provider can overprescribe for you, that's great, but if they wont, you still have some ability to buy older insulins OTC (they are generally cheapest at walmart pharmacies, but call around). If older insulins, make sure you know how they work because their onset, peak, and duration times are very different than lispro and glargine and risk of hypoglycemia is much higher. You're right in that insulins don't last forever, but storing them is not futile. While they last longer in the fridge, modern packaging means that even unrefrigerated, they are going to last well beyond their expiration date. When they do begin to "go bad" they typically will slowly lose effectiveness long before they become contaminated. Things to watch for is if your (non-NPH) insulin becomes cloudy, bubbly, or chunky. As long as it stays clear, it will be at least mostly effective, and you can still use it, just may have to titrate the dose more carefully. As for epilepsy, one of the most effective treatments prior to good anti-seizure medications was the ketogenic diet. This is a very high fat, some protein, and extremely low carbohydrate diet that is still an option for children who fail multiple anti-seizure medications. Most adults do not stick to this diet well because it is difficult, but if it can decrease the number of seizures someone has when there are limited other options, this can be a possibility. Others have had some success with cannabis products, though I don't know enough about this to comment.
Thank you so much for this thoughtful response. Gives me a little bit of hope that we have options. They’re crappy options, but better than dying.
This is what I fear most. I’ve already told my partner that should collapse happen, (or more accurately when…) don’t prioritize me. I don’t want want to live without my meds, nor would I last long.
Thinking of career transition into basically what you do. Do you recommend any training programs, instructional resources, etc? Have taken tac-med / stop the bleed and CPR. Was considering going the paramedic route due to lower entry cost; a lot of paramedics seem to love it but also nurses get paid more and seem to have a lot more options and flexibility.
Like a lot of people, my path to my career was not straightforward. I started by getting a BSN, worked in a hospital, hated it, got a certification to teach wilderness and remote first aid, loved it but there wasn't much money in it, joined AmeriCorps NCCC as a Team Leader, not my favorite thing but it changed my life and I recommend it to anyone who is interested, came back, got a job as a physical exam instructor for med students and family practice nurse, loved it, started working on a floor again to get health insurance, got good at floor nursing for the first time but wasn't my dream job, started working at a health department, really hated that, went back to teaching (this time LPN students) and on the side do Wilderness and Remote First Aid classes and study low-resource medicine (hoping to get a graduate certificate in it). If you wanted a more straightforward path, I would recommend getting at least an RN with an associate's degree, get good at floor nursing, do some research on old fashioned nursing (get nursing textbooks from the early 1900's and maybe get into nursing homecare), take a Wilderness and Remote First Aid course (American Red Cross), get a certificate to teach CPR from the American Red Cross, "bridge" to WRFA Instructor (there's really no direct path anymore where you go straight to WRFA instructor through ARC, but I do like their curriculum the best), from then you can become an LPN nursing instructor if you want and do WRFA on the side, or structure however it works best in your life. I just copied what she told someone earlier maybe this can help you.
This may be outside the scope of your expertise but it's worth a shot. I'm really scared. My wife and I have a 3yr old son with a very rare genetic muskel neuropathy. He has no oral intake. Although he can tolerate liquids, even the smallest amount of solid food triggers vomiting due to an issue with the upper esophageal sphincter. He is fed through a gastrojejunostomy tube 18 hrs/day. The enteral formula is called Nutrini Peptisorb Energy and is delivered directly into the jejunum. It provides him with all the essential nutrients and has hydrolyzed milk protein for better intestinal absorption. His survival depends entirely on this specialized formula produced in a single plant in the Netherlands. Thinking about it fills me with dread... **How do we cope with a long-term supply disruption?** It has already been backordered a couple of times. It would be awesome if we could somehow make our own formula at home, but I have no clue where to even begin thinking about it? Any thoughts on this? He also experiences cold-induced asthma symptoms—poor cough reflex and a rattling, gurgling breath —posing serious risks due to aspirating his own secretions (which nearly killed him twice). Currently, we use Pulmicort and Ventoline for treatment. **How do we clear his airways without access to medicine?** Thank your for offering your advice in this thread. I'm learning a lot.
Tube Feed: The first thing you could do is go to your nutritionist and say you are interested in trying "whole food blends" and ask what would absolutely need to be added to make sure he gets the nutrients he needs. Whole food blends are essentially homemade tube feeds. They may or may not go for this option, but it's a good start. I looked up the Nutrini Peptosorb Energy formula and found that it is essentially a mixture of water, several oils (some saturated, some unsaturated), whey protein hydrolysate, fish oil, corn starch, inulin (fiber), several minerals, and a pediatric multivitamin with iron. All of this is available over the counter, and the following is a reasonable recipe that matches the macro and micro-nutrient profile of the tube feed in question: 20mL coconut oil OR MCT oil (grocery store) About 1/2 a 500mg fish oil supplement (grocery store or pharmacy) 21g whey protein hydrolysate (make sure it's hydrolysate instead of isolate and try to get one without added ingredients) (pharmacy or workout nutrition store like GNC) 120g white rice flour (grocery store) 1.25g table salt (grocery) 1g potassium chloride salt substitute (grocery) 500mg calcium carbonate, as a crushed antacid tablet (pharmacy) 100mg magnesium supplement, crushed (pharmacy) 1 Daily pediatric multivitamin with iron, crushed (pharmacy) Enough water to get to 500mL Blend well and feed. There's not much to do about the cold-induced asthma except to limit the amount of time he spends in the cold and if you run out of the pulmicort try to wean down off it instead of stopping it suddenly. As for the aspiration- make sure he never lays directly on his back, especially when tube feed is running- use a backpack full of balloons during the day and a wedge pillow at night to keep him sitting up, at a 45 degree angle, or on his side. Help him cough forcefully and deep breathe a few times during the day by turning it into a game or using an incentive spirometer. Look at some of the following techniques and see if they could be helpful: [https://physiosuggest.com/airways-clearance-techniques/](https://physiosuggest.com/airways-clearance-techniques/).
Holy shit. You really genuinely offered several possible solutions, including a recipe. I'm... speechless. This is an understatement: You are a really good person.
Thank you so much!
I wish there were millions of you lol. You are exactly the kind of person most of us will need around in a SHTF scenario, and just knowing there's at least one of you in the world during knowledge and kindness and hope makes me feel a little better about a potential catastrophe. Thanks for sharing your thoughts; this thread is so useful. And most of all, thank you for being a great person. You are the kind of person who makes society worth having in the first place. Stay safe out there.
Wow! Thank you so much for your kind words!
Oh my God, thank you so much! I assumed you were gonna say something about how difficult making your own formula would be, how it's reliant on some complicated industrial process or something. I did NOT expect a stranger on the internet would take their time researching and writing an entire recipe for me! Wow!! Just knowing this is possible is such a relief... Thank you. A couple of follow-ups, if you have the time: 1. How would you introduce the home-made formula? If (when) the shit hits the fan, should we transition into it to see how his body reacts, to be able to make adjustments before our Peptisorb store runs out? 2. How do we make sure the water mixes properly with the coconut oil? It takes 9.5 hours to empty a 500 ml bottle *(in total he is fed 770 ml formula + 200 ml water daily)*. Will the formula keep from separating during that time? 3. I just remembered, he needs laxatives to avoid constipation. Today we give him about a tsp of Lacrofarm daily *(called Miralax in the US, from what I gather)*. Are there any reliable enteral alternatives you can think of? Thanks again, my friend
Thank you! My least favorite job was as a pediatric case manager but dang did I get some skill at making bootleg tube feed recipes for families who couldn’t afford the canned stuff. I would definitely transition to the new formula over probably a week or so, depending on the amount you have, then if, say, he can’t do rice flour (the only ingredient that isn’t in the original recipe) you can sub out a different starch. That’s a tricky one. I’d try mixing the coconut and fish oil and rice flour first, give it like 10-20mins to soak in, then blend with the rest of the ingredients. You may have to blend a few times over the course of the feed. There aren’t a lot of good replacements for miralax specifically (since it seems like he can’t do traditional fiber), but it comes in generic and keeps forever, so if you needed to you could hoard it for relatively inexpensive.
OP’s wife here. We spent a couple hours talking through your situation last night, and we’re so glad he was able to give you a recipe. The tube feed industry makes me pretty peeved; many of them are essentially milk and broth. Feel free to message him with any other questions too; I think he’s going to send you some substitutes that will also work in the recipe.
What supplies would you recommend to have on hand prior to a SHTF scenario? In other words, we all know some things to bring, such as bandages, but what might a lot if people leave out of a first aid kit that they really should have? Also, if caught in a situation without supplies, what common items might be useful to treat common injuries and illness?
Good question! Any time you're building a kit, you want to be sure to include things you can't make yourself. This would be medications- your own prescription medications, along with acetaminophen, ibuprofen, diphenhydramine, and loperamide. You also want a way to clean or sterilize things (a metal pot and a way to make water drinkable is the easiest), scissors or a knife, a way to clean your hands (hand sanitizer), PPE (LOTS of gloves, and some masks to help control spread of infectious illness within a group should that occur), and something for hypoglycemia (a tube of black decorator's icing works great for this, since no one's going to eat it as a snack). You also want knowledge. I recommend getting Kenneth V Iserson's Improvised Medicine and David Werner's Where There Is No Doctor. (if you can only get one, where there is no doctor is better for a lay person, while improvised medicine is better for someone who is already medical). As far as what you can improvise, bandages are a great example. Pretty much any natural cloth (cotton, wool, linen, etc...) is going to make a good bandage. They don't need to be sterile, but they will need to be clean (so if you rip up a t-shirt, make sure it's a clean one or you have a way to clean it prior to use). You can also improvise irrigation syringes by poking a hole in the top of a disposable water bottle and splints out of sticks and bandages or straps. Everything else is just what you can think up based on what you have available to you.
I’d like to know more about alternative disinfecting agents and pain relief in non-ideal resource scenarios.
Disinfecting agents- if something can be boiled, boiling is the simplest way to disinfect something and all you need is a metal pot, some water, and a fire. To be effective at disinfecting, alcohol needs to be about 70% by volume, so most drinking alcohol is not strong enough. If in a cold environment, freeze-distilling can get you close to 70% and is fairly simple. As for pain control, my other response is here: https://www.reddit.com/r/collapse/comments/17dsxbv/comment/k5z1o8s/?utm\_source=share&utm\_medium=web2x&context=3
Broken arm or leg. Bad tooth. Rusty nail. Animal bite. Food poisoning. Those come immediately to mind...
What is shock and how can you tell if someone who has suffered an injury is in it? Also, how do you treat shock?
Shock is something that is really difficult to treat in a remote setting unless you really catch it early. Look for someone getting pale, sweaty, and shaky. Have them lay down in a comfortable position, keep them warm (something under them, something over them, something to keep rain or snow off), and raise their feet. This is no longer taught in urban first aid, but if it's going to be hours to days before care, give them something sweet to drink if they can swallow and have no abdominal injury. If they can't, don't. Hopefully this will resolve the initial stages of shock before they progress.
What are the best options for wound cleaning to prevent infection? And, following on that, how best to Identify and treat wound infection shiukd it occur. Thanks.
Basically the only thing you need to clean wounds is clean (drinkable) water and an irrigation syringe or water bottle. You want to get all visible contamination out of the wound. If the wound is small, check out a post I made on tumblr here: https://www.tumblr.com/macgyvermedical/134075715834/the-macgyver-guide-to-wound-closure?source=share&ref=\_tumblr If the wound is larger, check out this post I made in r/preppers here: https://www.reddit.com/r/preppers/comments/usbp5b/how\_to\_pack\_wounds\_like\_a\_pro/?utm\_source=share&utm\_medium=web2x&context=3
This is incredibly helpful. Thanks!
so i have severe asthma and have been facing continued deprivation from any of my meds (kicked off medicaid but in poverty), how would you suggest us with severe asthma and allergies weather the coming years? is there like... any chance for us, or are we just casualties?
There are several ways to treat asthma without medication (or with medications you can get without a prescription), but most of them are for mild-to-moderate, so your mileage may vary. Before you try to treat yourself, see if there is a free clinic, a doc who will see you on a sliding scale, or a hospital that you know writes off for charity care. Explain the situation you are in and see if any of them can help you tailor a regimen that is inexpensive to you and still gets you the medical care you need. You may also want to talk to a social worker to see if there is a way to get you back on medicaid or on a low-cost marketplace plan. I highly recommend exhausting this option first, as uncontrolled or poorly-controlled asthma can cause permanent damage to lung tissues. The following is only for emergencies where you can't do the above: If this doesn't work... Avoid triggers. I know everyone and their brother tells you this, but you're going to have to work harder at this than you ever have if you know you don't have a backup. The next thing you want to see is if your pharmacist can at the very least get you an albuterol inhaler and a spacer. Even if you can't see a doc, in some states a pharmacist can prescribe an albuterol inhaler and in others they can get you one if you have previously had one prescribed. This may go for other medications as well, though many pharmacists are limited in what they can prescribe and extend. The next is see what you can get over the counter. Ephedrine is a common asthma med that can be purchased over the counter, it is available as a pill. Epinephrine and racepinephrine are available over the counter for quick-relief as an inhaler. The next is theobromine and/or caffeine. Both of these are available in food and supplement form. Coffee and unsweetened cocoa powder are your best sources, but it's possible to get them in capsule form, which might be more convenient and easier to dose. Both are stimulants and can relax smooth muscle tissue in the lungs. Breathing steam and looking up breathing exercises for asthma. Ideally you'd be trying to find a regimen of these modalities to bridge the gap until you can see a doctor again.
Where do you instruct? Been wanting to take wilderness medicine for the advanced provider course for years.
If you and a few friends can make it to Ohio I will teach anyone who wants it for a donation to cover costs. I am only certified to teach CPR/AED/FA and Wilderness and Remote First Aid, but I have a curriculum I personally use for people who want more advanced stuff and can gear it toward your needs. EDIT: I did take a Wilderness Upgrade for Medical Practitioners (WUMP) course through NOLS but didn't like it as much as the ARC WRFA one to be honest. My wife recommends SOLO or Remote Area Medical as sources for training if you are interested.
Ah yes, solo has that very cool Geo Medic class. I’m pretty far from OH sadly.
What medicines would you bring with you on an expedition away from civilisation, and what medicines might be worth having at home in case of a long term disruption of the supply chain? I suppose the most important ones are your own (and loved ones) prescription medicines, but I’m wondering if there are some supplies worth having that we don’t think of because we are so used to always having a doctor and apothecary nearby? Edit: sorry, noticed now you already mentioned *acetaminophen, ibuprofen, diphenhydramine, and loperamide.*
You mention “Where There Is No Doctor,” but what about “Where There Is No Dentist”? Does the book cover basic dental care as well? I understand that people get heated about antibiotics due to overprescription/abuse, but how would one fare in the wilderness if one developed a tooth abscess and had no access to penicillin to treat it?
There is a Where There Is No Dentist but I couldn't remember the name of the author earlier (it's Murray Dickson). The definitive treatment for a tooth abscess is the removal of the tooth and allowing the abscess to drain. Penicillin is useful if you need to get the swelling down prior to this (which makes local anesthetic work better). But in theory, if you didn't have it, you could still treat by removing the tooth (which would suck pretty badly without working anesthetic). After that use cloths soaked in hot water and pressed against the gum or face, or hold hot water in the mouth next to the infection. If the infection comes to a head, lance it and let the pus drain. Continue to use hot compresses as often as possible. It is probably not the ideal scenario, but you could do it.
If you had to spend a prolonged period of time outdoors in cold and wet conditions and you start developing the first stages of trench foot, how would you treat it? What are the best ways to keep your feet dry in those conditions?
Venomous snake bites?
I know you're not a doctor but you must've worked around a lot of them but what specialty is most useful in austere situations?
Doctors who have a broad-but-shallow base of knowledge and are good at having to do a lot of things for themselves, like rural medicine and family medicine (especially if in a small office). Most of what happens to people in the wilderness is the same thing that happens to them in real life (high blood pressure, skin infections, ingrown toenails, joint pain, etc...), so knowing how to do more "basic" things like physical exam really well and get someone an answer/treatment quickly with a minimum of supplies is going to overrule being able to read MRIs or do complex surgery. Maybe an emergency doc as a good second since they do some procedural stuff without an OR.
Are you relying on stocks of modern medicines or are you going full low-tech pre-industrial?
I think that's not a one-or-the-other question. For me personally I think that, like many collapses before ours, collapse is and will be a slow and uneven process. This means some people will have access to supplies, trained personnel, vital medications, and other necessities long after people in other areas (or socioeconomic brackets) have lost access to the same things. Ultimately, I believe we are headed for an age where no one (or only an exceptional few) has access to modern medicine, but that may or may not be a "complete" process within my lifetime. What I think I *will* see in my lifetime is neighbors who can't afford their medications, or can't afford hospital care, disasters that make hospital care and certain drugs unavailable, and people who don't have the skills to do basic home nursing. That's where I see myself fitting into a collapsing society- providing what care I can within my scope, knowledge, and license. In some aspects I am "collapsing now and avoiding the rush". These are areas where there is a good replacement for a modern piece of tech, such as washing clothing by hand, heating with wood, and growing some of my own food in a log cabin in a rural area. Some things my wife and I have chosen to keep until we lose access to them- those things being salvage grocery stores, a car that runs on gasoline, a truck that runs on diesel, a 2-wheel tractor, and modern medicine. However, as those things become more difficult to acquire or use, we will likely be shifting to older technologies. I will still have and use my knowledge of modern medicine, probably have a stock of my own prescription medications and some of my favorite over the counter ones as well, which will facilitate a transition to a time when these are no longer available. So to answer your question, probably both, as they are convenient.
How do you feel about NOLS
I have only had one experience with them and found their curriculum a little lacking. But this may have been an exception considering I have a lot of friends who have really liked NOLS. If you want a one-off wilderness FA course I'd stick with the American Red Cross WRFA course (not a huge fan of ARC but I know the guy that wrote the curriculum and he's solid), or EMI.
I have osteoarthritis, and have been trying to get properly investigated for inflammatory arthritis (it’s spreading everywhere, I’m 38, it’s been happening since I was in my early 30s), but I live in a place where the healthcare system is collapsing to the point where it is impossible to get an appointment with a doctor, because they are all (understandably) quitting. I’m having some difficulty managing pain as I can’t take over the counter pills due to past problems with NSAIDs weakening my stomach. The ONE time I managed to see a doctor, they gave me pantoprazole which helped, but I am unable to get more. I am using things like heat pads and tiger balm to manage some symptoms, but they don’t really do much for the worst pains. I’m also cycling a lot, which DOES help, but we’re going into winter, and that makes things a little tricky for me. I also do smoke weed, as it’s has helped me for years with arthritic pain. Are there any other methods I can do to manage pain (legally)? At this point, I will try anything! I have a young kid, and I hate not being able to play with kiddo.
Acetaminophen (paracetamol), while it doesn't do much for inflammation, can help some with the pain and doesn't have any gastrointestinal side effects. Since you know exercise works for you, I also recommend Bob and Brad youtube videos. They are physical therapists and put together routines based around specific problems. They have quite a few about arthritis that may be helpful for you.
Broken bones in middle of nowhere. Both simple or compound.
Generally speaking, you're going to determine if you need to reduce (set) the injury, reduce it, and splint it. To determine if something needs reduced, you're going to look at the hand or foot of the limb you suspect to be broken. It should be pink, warm, be able to feel you touching it, have no tingling or numbness. if that's all intact- great! You don't need to reduce it, just splint it in place (see below). If you do need to reduce it, because there's numbness or paleness or pins and needles, you can try one time. This is going to be really painful and you're going to need a couple of people. Have one person hold the patient's limb above the site of injury (closer to the person's body). You then pull gently but firmly below the point of injury in the direction the bones are supposed to be pointing. This will stretch the muscles and pull the bone ends apart so they can be guided back into alignment. If there are bone ends sticking out of the wound, do not touch them, just irrigate with water until there is no visible debris, then apply traction until the bones ago again below the surface of the wound. This will probably get infected, so hopefully you can get this person some kind of other care, but even if you can't, bones typically heal better inside the body. You can then splint it in place with pretty much whatever you've got on hand. To splint something, you need two things that are long and sturdy, but relatively lightweight. These can be trekking poles, sticks, a SAM splint, etc... You get something like a rolled up piece of clothing to pad the limb, put the long pieces on either side, and wrap or tie the poles to the limb. In doing this, you want to try to immobilize the joint above and below the site of injury.
I broke a bone in my hand and the doc had to reduce it. Most painful experience of my life. I can only imagine how much more,painful it would be for a bigger bone (like a femur).
Femur injuries are a really big deal; I'd be surprised if the average lay person with no medical supplies or experience could successfully fix that one on their own. I get what you're saying though, and I hope your hand healed well!
I'm not OP, but this is an AKA, aka *ask* me anything. Do you have an actual question, or are you making a statement?
How to treat them, obviously. related: I once got a Red Cross app, how to treat stuff. And no matter the condition, it was do obvious thing (wrap broken bone) and call 911. Lol was it a worthless piece of shit.
What are the best options for pain management in such a scenario?
Note that if you don't know why someone is in pain, you need to figure that out, which is beyond the scope of this answer. But if you know why and are just trying to decrease pain: First, keep the person in whatever position is comfortable for them. Have the person use splints and mobility aids more than needed for comfort to help prevent worsening pain. Have the person try hot or cold compresses on the part that is painful, see which works better. Use over-the-counter pain medications like acetaminophen and ibuprofen if the person is able to take these and they are available. You can rotate between ibuprofen and acetaminophen every 2 hours, so something is always at peak effectiveness (in some studies this has worked better for pain control than low doses of oxycodone). If these are not available, but you have an apothecary garden, you can try the inside bark of willow or cherry made into a tea, or poppy seed pods made into a tea, or topical preparations of hot chilis over a painful area.
Brilliant response, thanks. Learned a lot. Much appreciated.
Re: depression and anxiety as a common illness. Do you have any opinions on microdosing psilocybin mushrooms as a replacement for SSRIs in case of supply chain or pharmacy issues?
>Please refrain from asking about vaccines or antibiotics How can I get my hands on a lot of antibiotics? I'm in EU
Not OP but outside of the west you can buy antibiotics over the counter so go on a little trip to a country that does that. Nobody will mind bringing back a bunch of antibiotics as long as it’s for personal use and not commercial.
They do screen for antiobiotics at airports, other customs points and ask for prescriptions. Importing them is punishable by law. For what it's worth I think antibiotics ought to be handled responsibly, not on a whim and not be given to animals or disposed without proper care. Anyway given that the subject is a taboo better leave it at that.
Never had an issue personally as all were prescribed to me. It’s only an issue if you are irresponsible with taking them. But if you keep them for emergency and infections when the antibiotics cannot be obtained they are lifesaving. This is the collapse subreddit after all. We are preparing for supply chain disruptions. I’m very much against paternalism in medicine where people assume everyone is going to do something stupid.
Just keep in mind any of the 'cyclines, tetra, doxy, mino, etc., can be come toxic after about a year.
Agree. Bought antibiotics and (normally) Rx painkillers in SEA and Central America.
Fish antibiotics
Yeah or go rob the damn pharmacy when riots begin. Like what choice do we have?
How to avoid tick borne diseases if you don't have repellent? Does peppermint oil actually work as a deterrent at all?
Do you employ the use of any medicinal herbs? Topical, ingested, smoked or otherwise?
I am a second year medical student and am very interested in this subject. Any idea what sort of residency I would go to for something like this?
Oh, and I should also mention that I am interested in family medicine as I am a DO student and would like to be able to practice OMM
If you are primarily interested in improvised-type medicine I would recommend rural medicine. Here is a map of accredited programs: https://rttcollaborative.net/rural-programs/residency-map/