At 36READY we are thankful to have a team of volunteers that are medical doctors and emergency medical care specialists.  We are using this opportunity to highlight the top-10 medical preparedness questions that we receive from those who are preparing for, “When there is no doctor” and “When there is no medical care” situations.  

This article is not medical advice, it is solely to help you prepare your own questions for your personal physician.

 

Question #1:  

What can the responsible individual do to minimize the adverse impact of no modern medical care for himself and his family?

Doctor:  In my research I came to realize that there are numerous medical conditions and events that we can avoid or mitigate with the proper preparation NOW.  Even those without any medical training can learn enough first aid and rudimentary health and sanitation principles to make a life or death difference for their loved ones.  This preparation will require the same diligence that we use in any other area of preparedness.

 

Question #2:

I have no medical knowledge or background, so what can I do to prepare medically for me and my loved ones?

Doctor:  Let’s be clear.  It will take diligence and a serious commitment of time and effort to be an effective caregiver for your nuclear group.  Set realistic goals for yourself.  Unless you decide to go to medical or nursing school you won’t get that level of knowledge and experience.  However, basic and advanced first aid can be learned by almost anyone and can be a lifesaver.  But to be proficient you will have to read, study, take courses and gather materials.

 

Question #3:

In addition to gaining knowledge, what practical things can me and my loved ones do now to begin to prepare for a medical emergency?

Doctor:  Start today, and begin the process of assembling three (or four) medical kits.  Though we often own many first-aid products, very often we can’t quickly find what is needed.  Change that today.

First, develop a small first aid kit that can be carried on your belt (or in your GO-Bag).  After you’re satisfied with the contents of this first small kit, make a duplicate for each family member’s GO-Bag.  Second, pull together a more complete medical bag to keep at home.  You can use this at home if needed, but it is designed as a self-contained multipurpose kit to grab if you ever need to evacuate (bug-out).  Design your third kit to be routinely carried in your vehicle.  The contents of this shoulder-bag size kit should be oriented toward traffic accidents and other serious injuries.

Fourth, if you are preparing a ‘safe haven’ retreat as a destination for evacuation, you will want to have heavy-duty plastic bins filled with all sorts of first aid and medical supplies.  In addition to quantities of first aid bandages and related gear, these bins of supplies should also include prescription drugs needed for you and your family, and nonprescription medicines for routine ailments.  In addition, these bins should have sanitation gear and other health care goods that might be needed for your family / community.

For the first three types of kits, use soft-sided bags.  This makes them easier to carry, transport, and easier to cram into limited space.  If you don’t currently have something suitable, don’t let that stall your implementation.  A cardboard box works fine as a container to start the process. 

Inventory what you already have, and make a list of what you need.  To save money, basic bandages can be obtained at a Dollar Store or Wal-Mart, while other items can be purchased online or at a medical supply store.  If you are planning for a protracted emergency situation, you will want a lot more in the way of medical supplies. 

At the very least, you and each adult and teen in your family should obtain formal first aid training.  The American Red Cross and other organizations offer courses such as, ‘Wilderness and Remote First Aid.’ This particular class was developed cooperatively between the Red Cross and the Boy Scouts, so you will probably find this type of medical training more helpful than just a basic first aid course.  Though not as practical as the hands-on classroom version of this course, this class is also offered as an online 16-hour course. 

The “Emergency Reference Guide” for this Wilderness and Remote First Aid class can be downloaded for free from the Red Cross website.  Print or buy a copy of this 121-page handbook and keep it in your larger medical kits.  Inside this Guide you will also find a list of items to include in your first aid kits.  In my view these lists are far from complete, but it is a good place to start.  Also, if you have a smart phone or tablet device, purchase a first-aid app or an e-book on wilderness medicine and emergency first aid.  That way you’ll have these reference materials handy.

In addition to these medical kits, review my responses to the below questions.  This should spark other thoughts regarding what you can do to prepare for a medical emergency. 

  

Question #4:

My doctor recently talked to me about having elective surgery.  I’m not sure I want to do it, but I realize that this could become a problem, especially during a protracted emergency situation when there is limited (or no) access to competent medical care.  

Doctor:  If you or your physician know that an “elective” procedure will need to be done at some point—do it now!

Doctors use the word ”elective” in two entirely different ways.  A truly elective procedure is one which is not essential to good health but is desired by the patient.  Examples of truly elective procedures might be plastic surgery for breast implants or a face lift.  These are certainly worthwhile procedures if they are important to the patient but they will have little or no impact on enhancing survival.

Doctors also use the term “elective” to describe medical abnormalities that do not have to be fixed right now but should be taken care sometime in the future.  These medical abnormalities will likely cause a problem at some point.  I strongly urge you to get these procedures done now!  Right now modern medical treatment is available. Safe, effective anesthesia can be administered by experts.  This ideal situation will not be available in a meltdown scenario.

 

Question #5:

What are the medical procedures that are important to deal with right away?

Doctor:  Repair of hernia (herniorraphy), removal of the gallbladder (cholecystectomy) if it has ever been symptomatic, removal of hemorrhoids (hemorrhoidectomy), sinus surgery for serious recurrent sinus infections, knee or hip replacement, herniated disk surgery, carpal tunnel release and removal of tonsils (tonsillectomy) for recurrent serious throat infections.  If you have decided that you don’t want children then you might consider a vasectomy (males) or women might consider having their fallopian tubes tied now.

One additional comment is needed regarding gallbladder removal.  At the present time just the presence of gallstones is not considered justification for removal.  At the present time and with the medical resources currently available I concur with that guideline.  However, the question is will your gallstones at some future time (when modern medicine may not be available) cause a blockage of the duct?  I can’t answer that and neither can anyone else.  Gallbladder “attacks” are painful, accompanied by nausea with or without vomiting and may produce a serious condition called pancreatitis (inflammation and damage of the pancreas).  The pancreas secretes the enzymes we need to normally digest food. It is also the organ that manufactures insulin for control of our blood sugar levels.  Another consideration– if you have gallstones and have never had symptoms from them it is likely that your medical insurance will not want to pay for the surgery.  It’s an issue that you will have to decide for yourself with the input of a trusted personal physician.

 

Question #6:

My best friend visits her demonologist twice a year.  Is this really necessary?  What is the likelihood that a skin problem would develop so quickly, that it would become a problem during an emergency situation?

Doctor:  I think it would be prudent to have a competent dermatologist perform a careful examination of your skin to identify any premalignant or cancerous skin lesions.  The vast majority of these skin cancers are basal cell carcinoma (BCC) or squamous cell carcinoma (SCC).  If caught early they are easily treated and completely curable.  These two skin cancers almost never spread to other areas of the body but if left untreated they can become very destructive leading to open wounds that are disfiguring and subject to secondary infection.

 

Question #7:

I’m a father of adult children, and am wondering if there are any special medical tests I should undergo as part of being prepared for an emergency situation?

Doctor:  Is it time for your colonoscopy?  I urge you to get it done so that any benign polyps, precancerous lesions or other abnormalities can be dealt with now.

Chronic Conditions:  If you or your loved ones have any chronic diseases you will need to prepare for their long term care.  This will require careful thought and planning.

Start by making a list of every disease or condition currently affecting each individual. If a medical person is available in a societal collapse environment, just having this information could be lifesaving.  By having a detailed list of medical problems, the medic can do a brief survey physical exam and probably be able to quickly determine the cause of the current acute problem and deal with it.

You also need to have a complete list of all vitamins, supplements and medications being taken by each individual to provide to the medic.  Be sure to include the dose (amount), the frequency with which the medicine is taken and how it is taken (by mouth, by suppository, etc.).  Drug interactions can mimic medical conditions and complicate diagnosis.

 

Question #8:

Obviously we may not have access to medical clinics, medical tests, and hospitals during a serious disaster.  Should I somehow get some antibiotics or other prescription medicines in case they are needed?

Doctor:  If possible, start to accumulate “extra” medications that are needed for each individual.  This is going to be hard to do because most medications are now fully or partially paid for by insurance companies.  Understandably, these companies are unwilling to pay for more than is needed for a given period of time (usually a 30 or 90 day supply).  So try to always get a 90 day prescription from your physician, so that if the “balloon goes up” tomorrow you will have that three month supply instead of just one month. 

If you want more of a medication than your medical insurance allows, then you will have to pay for it.  There are ways to get around medical insurers’ limitations but to do so is dishonest.  Don’t go there; honesty is important.  Cheating a medical service provider or an insurance company is not just illegal, it’s dishonest and unethical.  If you want more than your insurance company will provide, pay for it yourself out of your own pocket.

There are other, honest and legal, ways to accumulate prescription medications.  For example,  Do not discard old medications that weren’t completely used.  Pain pills that were prescribed for treatment of pain after a dental or surgical procedure, can be used by that individual in the future.  But be sure you know what you are doing.  Improper treatment can create more problems than they solve, and even be life threatening.  A doctor spends years in school to make sure he prescribes the appropriate treatment, don’t assume that you can do this with no training. 

In any case, if you were given a five day supply of pain killers but you only used it for two days, you have the option to save the extra.  Many preppers are doing this to make sure they have it available during an extended emergency situation. 

* If this is what you choose to do, be sure these medications are stored in a safe place, where children and unauthorized people can’t access them. 

 

Question #9:

What about the expiration date on medications?  Can they be used safely after that date has passed?

Doctor:  Although every medication has an expiration date, it has been scientifically proven that most medications (if stored correctly) are still effective for years (in some cases even decades) after that date.  Besides, even if an expired medication isn’t at full strength, in a situation where no medical care is available and you won’t have access to care for a long time, past-date medicines may be far better than nothing. 

 

Question #10:

I’ve heard that it’s possible to order medications online, from other countries, without a prescription.  Is this true?  Is it legal?

Doctor:  In some locales, another way to legitimately accumulate your prescription medications is to ask your care provider to write an identical, additional 90 day prescription for you. These patients don’t turn this second prescription in to their local pharmacy.  They use the first prescription to legitimately obtain their medications locally, using their medical insurance pharmacy plan.  The second prescription is used to order additional medication online, at their own expense. 

If this is what you would like to do, you will need to see if this is legal in your location.  If it is legal, be sure to ask friends for reliable vendors, and undertake your own online research.  Many people have successfully used Canadian mail-order pharmacies as well as those based in other countries.  However, there are multitudes of scammers and unethical vendors who are taking advantage of those who seek offshore medical supplies.  So, use caution.

 

DISCLAIMER ON CONTENT AND THIS DOCTOR’S VIEWPOINT

This is only a conversation; we are not providing medical advice in this article.  We are only sharing general information to help you develop questions to ask your own doctor, so that you can better prepare for a situation when you cannot get medical care.  It is essential that you seek advice on these issues from your personal health care provider.  DO NOT act on this information without the corroboration of that licensed medical professional.

Doctor:  Although I am a physician, I am (obviously) not your personal or family physician.  So please understand, the purpose of this article is to respond to general questions, and share my thoughts and personal opinions.

As I consider the needs of my family and friends who are preparing for a “When there is no hospital or clinic” situation, I feel compelled to offer my opinions.  None of this should be considered a treatment plan, or medically directed advice.  It is solely for a “When there is no medical care for months” circumstance.

To be clear:  These responses are provided solely for those individuals who do not have access to medical care, and circumstances in which you have no choice but to handle medical care situations on your own.  Since I don’t want to leave you stranded, I have responded to these questions with the specific understanding that your circumstance is that no medical care will be available to you for many months.

Post Script:  I must confess that initially I was discouraged thinking about all the medications and technology I won’t have available to me in a societal meltdown situation.  But as I continue to study what can be done in such a situation, I became excited about the very real difference that we can make in the lives of others during a time such as this.  What an incredible opportunity to show the love of Jesus to those who will be desperate for help.

 

THIS ARTICLE SHOULD NOT BE CONSIDERED MEDICAL ADVICE.  CONSULT YOUR FAMILY DOCTOR BEFORE YOU MAKE DECISIONS REGARDING ANYTHING CONTAINED IN THIS ARTICLE.