How to Survive the End of the World as We Know It

by James Wesley, Rawles

  Chronic Care

  It may be difficult for us to confront the issue of care for the chronically ill, because it can seem so overwhelming. These issues demand our attention, our concerted planning, and considerable financial commitment. There is such a wide range of chronic illnesses and disabilities, and it is impossible to address them all, but I will mention a few of the most common disorders that will require advance planning:

  Kidney Disease

  In a grid-down situation, dialysis patients will be in trouble once the hospital backup generators run out of fuel. To see a loved one slowly dying because their blood is turning toxic would be absolutely heartbreaking. The best solution might seem extreme, but it might be your only option: Move to the Big Island of Hawaii, or to a natural-gas-producing region, or near a refinery in an oil-producing state. There are any number of different circumstances, including an EMP attack, wherein the continental-U.S. power grids will go down, but the lights will stay on in Hawaii. In Hawaii, each island has its own independent power-generation infrastructure.

  Moving to a natural-gas-producing region (such as parts of Oklahoma, Arkansas, Texas, New Mexico, and several other states) would require considerable research. You would have to find a community adjacent to natural-gas fields with a kidney dialysis center that has a natural-gas-fired backup generator and that is in an area with sufficient wellhead pressure to pressurize local lines.

  Another option might be to find a dialysis center with a diesel-powered backup generator that is within twenty-five miles of a refinery that is also in oil country. The keyword to watch for in your Web searches is cogeneration. A plant that has cogeneration capability is likely one that could operate without the power grid.

  Diabetes

  Relatively small and inexpensive (less than $3,000) packaged photovoltaic power systems with inverters (such as those sold by Ready Made Resources) can be used to operate a compact refrigerator such as the Engel compact refrigerator/freezers sold by Safecastle. A system of this size could also be used to run a CPAP machine or other AC-powered medical equipment with similar amperage demands.

  I strongly suggest that any readers who are diabetic or who have diabetic relatives look into the Weimar Institute’s NEWSTART nutritional and behavioral program. There are also some herbal alternatives for diabetics who are not fully insulin dependent.

  For those who are indeed insulin dependent regardless of dietary changes, I recommend that you stock up on enough injectable insulin for its full potential shelf life.

  Postsurgical

  Another category of chronic illness to consider is the care of postsurgical ostomy patients—folks who have had a colostomy, ileostomy, urostomy, or similar procedure. These often require keeping on hand a large supply of medical appliances, bags, catheters, and so forth. Thankfully, most of these items have fairly long shelf lives and are not too expensive to stock up on.

  Lung Ailments

  There are some lung ailments that can be relieved (at least to an extent) by relocating. Getting to a more suitable elevation, moving to avoid pollen or fungi, and so on can make a considerable difference. If this is your situation, then I suggest that you make the move soon.

  If you are asthmatic, you can get a prescription for a handheld nebulizer that has both AC and DC car-adapter capabilities as well as a rechargeable, gel-cell battery. Thankfully, most nebulizers have fairly modest current requirements.

  Buying a woodstove—a key preparedness measure—is not good for someone who has an asthmatic in their family. If that is your case, then consider moving to the southwest, where passive-solar heating is an option, or moving to an area where you can use geothermal heating.

  For the many folks who now depend on medical oxygen cylinders, stock up on extras. One alternative suitable for long-term scenarios is to buy a medical oxygen concentrator. High-volume units are fairly expensive, but owning your own would be an incredible resource for charity or barter as well as for your own family ’s use.

  Medication

  The high cost of some medicines makes storing a two-year supply difficult. And the policies of most insurance companies—often refusing to pay for more than a month’s worth of medication in advance—only exacerbates the problem. In these cases, I suggest 1) reprioritizing your budget to provide the funds needed to stock up, and 2) if possible, looking at alternative treatments, including herbs that you can grow in your own garden or greenhouse.

  If you decide to stockpile—all the way to their expiration dates—this will require not only lots of cash but also very conscientious FIFO rotation of your supplies. To buy your medications safely and legally from a pharmacy, have your doctor write you a prescription for the generic version of your medications. If you pay for the prescriptions yourself, without relying on insurance, it will be more expensive, but you will be able to stockpile without a hassle.

  As for using meds beyond their expiration dates, this requires some careful study. Some medications have listed expiries that are overly conservative. A few drugs, however, are downright dangerous to use past their expiration dates. Consult your local pharmacist with questions about any particular drug. (I lack an “R.Ph.” or a “Pharm.D.” after my name, so I am not qualified to give such advice.)

  In my opinion, it would be better to err on the side of caution. To be absolutely safe, I recommend that you avoid both overdosing and out-of-date or otherwise deteriorated antibiotics. As a prepper who anticipates the possibility of infrastructure breakdown and widespread power failures, the last thing that I want is to see anyone become dependent on scheduled kidney dialysis because they saved money on antibiotics.

  Alternative treatment, such as using herbs or acupuncture, is a touchy subject. Again, it is something that will take considerable research and qualified consultation, and in effect making yourself your own guinea pig. If you decide to use this approach, I recommend that you make any transition gradually, with plenty of qualified supervision. If it takes a lot of extra visits to your doctor for tests, then so be it. Just do your best to make the transition, before everything hits the fan.

  I have seen some folks in preparedness circles on the Internet recommend stockpiling low-cost veterinary medications, but I advise using such medications only in extremis (when your only other option is certain death).

  Elective Surgery

  If you have an existing problem that could be cured with elective surgery, then I strongly recommend that you go do so if you have the means. If your condition worsens after medical facilities become unavailable, it could turn a simple inconvenience into something life threatening.

  I’ve heard of several wealthy preppers who have had their nearsightedness cured by LASIK or PRK, just for the sake of being better prepared for a foreseen new era that will not have the benefit of ophthalmologists and a handy shopping mall “eyeglasses in about an hour” shop. Living free of eyeglasses or contact lenses also makes wearing night-vision goggles and protective masks much easier, and makes shooting—particularly at long range—more accurate.

  Buy a Food Grinder

  Many injuries and illnesses cause difficulty chewing and digesting solid foods, because of the patients’ weakness, dental problems, or jaw/palate/throat trauma. It is important to have a hand-cranked food grinder available so that you can accommodate the needs of these patients. Old-fashioned grinders (the type that clamp onto the edge of a kitchen table) can often be found used for just a few dollars at yard sales. If you want to buy a new one, they are available from both Ready Made Resources and Lehmans.

  Survival Dentistry

  The most important dental resource that I can recommend is the book Where There Is No Dentist, available for free download from the Hesperian Foundation (snipurl.com/hrpdg). (But I recommend getting a bound hard copy. Ditto for their book Where There Is No Doctor. Used copies can be found on Amazon.com for little more than the cost of shipping.)

  Dental instruments may be bought through online auctions. It would also be wise to stock up
on other dentistry supplies such as gauze, oil of cloves, and so forth. Unless you are stranded in the backcountry, I do not recommend that you put in temporary fillings under present-day circumstances. If a filling leaks, it could cause an infection. However, in a genuine TEOTWAWKI situation, temporary fillings may be your only alternative to suffice for weeks or even months until you can get to a qualified dentist. For this reason, you should stock up on temporary-filling material such as Cimpat, Tempanol, or Cavit. There are also temporary-filling materials packaged for the consumer market that contain very small quantities (under brand names such as DenTek and Temparin), but the per-unit cost is relatively high. With those, you are mostly paying for the packaging.

  I do not recommend do-it-yourself tooth extraction, except, again, in extremis. Without the support of a crown or bridge, the gap left by an extraction can cause a chain reaction, as other teeth shift to compensate for the missing tooth. This can lead to a series of complications, which are best avoided.

  SurvivalBlog contributor The Army Dentist wrote the following piece:

  Dentistry may be one of the least exciting topics under preparedness. But a dental emergency can quickly complicate or even bring to a standstill daily living and tasks. In a WTSHTF scenario this is not something you want to deal with.

  I would like to present a summary of the caries process and the best way to prevent dental pathology in the first place, a simple way to recognize and/or loosely categorize dental symptoms, and some simple treatment alternatives until definitive care can be obtained.

  Start by going to your dentist and having everything taken care of immediately. After all existing problems have been addressed, begin and maintain a preventive dental program—make it a habit. It is not a very difficult thing to do, and you can save thousands of dollars and a lot of pain by doing it.

  Brush your teeth and limit your sugar intake. It really does work. If you can remove the bacteria, which predominantly resides in plaque, from your mouth, you will limit its ability to create acid. The sugar-intake frequency is more important than the amount of sugar. Every time you put sugar in your mouth, the bacteria will create acid for thirty minutes. If you drink one soda in ten minutes, and then consume no more sugar the rest of the day, then you will have acid in your mouth for only about 40 minutes. If you take the same soda and sip on it all day long, then you will have acid in your mouth all day long. Certainly limit the amount of sugar you ingest, but more important, limit the frequency with which you ingest it. Also, use a fluoride rinse every night. You should brush your teeth, rinse your mouth, drink water if you want, and then rinse with the fluoride. Then don’t put anything else in your mouth, and go to bed. The fluoride will sit on your teeth and make the enamel less soluble.

  Toothpaste is good but not necessary in this regimen. Toothpaste is nothing more than a mild abrasive, flavoring, and fluoride. If you want to make your own, you can use fluoride rinse and baking soda, although baking soda is much more abrasive than commercially made toothpaste and can irritate your tissues.

  If you do develop a carious lesion (a cavity), do not leave your tooth untreated. You will eventually end up with an abscess and the tooth will be extremely painful to the touch. You may begin to run a fever and experience swelling. Some people say it feels like the tooth has “raised up.” It has. The infection is pushing it up. If the infection, however, travels toward the tongue, neck, or sinuses, to name a few places, it can become very dangerous, very quickly. Possible complications include septicemia, airway obstruction, and pericardial infections. These are not common but are dangerous and need to be treated by a medical professional. Some of the symptoms of these serious infections include increased temperature, swelling under your jaw, under your tongue and around your chin, swelling extending toward your neck, swelling in your throat that may begin to push your uvula aside, and difficulty swallowing and/or breathing. Do not ignore these! Seek medical care immediately.

  Eye Protection and Flushing

  Eye protection is crucial. When anyone in my family shoots, we always wear eye and ear protection. Ditto whenever we use a chain saw. I use a Stihl brand “forestry” helmet with built-in earmuffs and a full-face mesh screen, although I’ve read that the Peltor brand may be superior. We now store our workshop face goggles right on top of our bench grinder, where we can’t forget to use them. This is a good practice for all safety gear. Store it alongside your tools—otherwise it will be “out of sight, out of mind.”

  We don’t drink alcohol at the Rawles Ranch but we keep a shot glass handy, since they make an ideal eyecup for irrigating foreign matter out of an eye. I plan to add a mini-eye-wash station to our workshop. That is cheap insurance.

  It is important to have safety goggles with side protection for everyone in your home. Also, lay in a supply of ophthalmic saline solution that can be used as an emergency eyewash.

  Stabilizing an Injured Person

  As always, the best treatment for an injury is not to be injured in the first place, but if someone in your group suffers a fall and twists an ankle or fractures a forearm, you will need to stabilize them to prevent further injury. Michelle, an EMT, submitted this piece:

  You should always consult qualified medical advice on an injury that requires splinting, crutches, or any kind of assistance. In a post-TEOTWAWKI situation, that may be the medical person in your group, or Where There Is No Doctor, but unless you have a serious fracture that is apparent (i.e., bone sticking out of flesh, deformity, or immediate inability to move the extremity), you should make every effort to get help from a medical professional. Splinting in order to get to a facility is fine, but you really should have an injury looked at by a medical professional.

  SPLINTING

  We splint to immobilize an extremity. This is achieved by keeping the joints above and below the injury from moving. If it’s a knee, splint the injury so the ankle can’t move and the hip can move only in a forward-and-backward motion—so you can move the entire leg without bending the knee. For wrist or elbow sprains, bend the elbow ninety degrees and hold it to the chest. Apply the splint “in place”—before moving the patient. A critical assessment to make prior to and after splinting is to see if you can feel a pulse and whether the victim can feel sensation, as well as their degree of mobility. This allows you to loosen, tighten, or change the splint as needed if any of those three factors change during or after splinting.

  Splinting is more about technique than the materials on hand. Anything hard and straight can be used—from tree branches and long wooden spoons to a piece of stiff plastic. You can also buy commercial splinting supplies. There are wire-mesh types, cardboard cutouts, and, of course, the simple ACE bandage. I also highly recommend taking a basic first-aid course that will help you with splinting and immobilizing.

  For treatment of sprains and twists use the RICE acronym: Rest, Ice, Compress, and Elevate.

  STRETCHERS AND BACKBOARDS

  While stretchers are durable and rugged, they have some serious faults. A better option for prepared families is simply to buy a backboard and put the injured person on a cart or simply carry him or her. Backboards run about one hundred dollars, and the straps (spider straps) are about fifty dollars and are easy to use.

  Backboards have slots at the top and sides for handling and you can easily secure the board via hooks, ropes, or seat belts to the top and rear of a garden cart. Boards can be made out of wood but are nowadays largely made out of plastic. Backboards should be used only to move a person and not to prevent any head or neck injury (their primary design in modern medicine), unless you are trained for that level of care. Another benefit of using a backboard is that by strapping a person down you are in effect temporarily splinting the arms and legs.

  Another good idea is to secure all of your first-response medical gear to the board. For about 150 to 200 dollars and a cart used for other purposes, you have a heavy-duty stretcher to get an injured person back to your retreat.

  In my experience as an EM
T, I have discovered that some great places to find emergency gear are SaveLives .com and Galls.com.

  Transportation for the Disabled in the Event of TEOTWAWKI

  As you should know by now, I strongly suggest that if it is at all practicable you make arrangements to live with your family at your retreat year-round. If you have a disabled person in your party, the habitation should be a single-story structure, on level or nearly level ground, with an easy retrofit for a wheelchair ramp to the main door. Also, if anyone in your party currently uses an electric wheelchair, get an old-fashioned wheelchair for backup in the event of a long-term power failure. And don’t forget to buy crutches and canes for anyone who might end up with a sprained ankle or twisted knee down the road.

  For transportation over longer distances, plan ahead for providing for your disabled family members. One great option, in my opinion, is a four-wheel-drive, full-size van conversion. Beware of buying an older 4WD conversion: Some of the 4WD van conversions that were done back in the 1970s and 1980s were plagued by reliability problems—mainly involving differential linkage and other power-train problems. But in more recent years the conversion companies seem to have gotten it down to a science. Just be sure to get a written warranty.

  Vans can be “dual converted” for both 4WD and a wheelchair lift apparatus. See vantagemobility.com.