Treating Chronic Illness Post-SHTF - Chapter 1 - COPD (and introduction to the series)
Hey everyone!
I'm a American Registered Nurse and prepper enthusiast who takes an interest in survival medicine, firearms, and preps. Today I want to introduce a new series I've been working on. I've noticed that there are hundreds of books on the market talking about treating acute illness (bone breaks, cuts, trauma, chest wounds, swamp feet) but there are not a lot of resources for chronic illness. According to the AHA, nearly half of the population (133 million) people suffer from a chronic illness.
Disclaimer: I'm not writing these for money, I don't have advertisers or a website or any ulterior motives. I don't want you to click on any weird links or buy anything. I might make these into a book someday, but for now, I'm just going to stick to posting on reddit. Also, this isn't medical advice and I'm not a physician. Depending on how these go I may make more for other chronic conditions. My goal is 50-100 chronic conditions before I turn it into a book.
The goal of these articles is to provide you with:
An overview of a disease
A list of common medications used with the disease
A scavengers list (what to stock up on and look out for as it relates to this disease, especially if you are scavenging a pharmacy or trading for medications)
A list of helpful equipment to have in your preps
Alternatives, if they exist (I don't share pseudo-medicine and my knowledge does not expand into herbals or alternative medicines. If that's your thing, there's plenty of books about that)
Tips, tricks, and things to avoid as they relate to this disease and SHTF
Anyways, here we go. Chapter 1 - COPD
Treating Chronic Illness Post-SHTF - Chapter 1
COPD/Emphysema
Chronic Obstructive Pulmonary Disease
Description: A chronic disease that affects the ability of the lungs to bring oxygen into the bloodstream, most often caused by a lifetime of smoke exposure (including cigarettes). Permanently damaged air sacs in the lungs have difficulty exchanging oxygen and co2. COPD (both diagnosed and undiagnosed) affects millions of Americans every year. Different stages of COPD exist, from mild to severe. COPD is irreversible due to damage to the air sacs (called alveoli) that are responsible for the exchange of oxygen and co2 (a byproduct of metabolism) in the body. Depending on the severity, COPD may be treated with daily short-acting steroids, long-acting steroids, inhalers, supplemental oxygen, and antibiotics.
COPD exacerbation is often due to respiratory infection (even a simple cold can be problematic for patients with lung disease) or airway irritants like smoke. COPD exacerbation can result in insufficient oxygen exchange and result in hypoxia (low oxygen content in the blood) and hypoxemia (low oxygen supply to muscles and organs, including the heart and brain).
Typical presentation:
Shortness of breath
Rapid breathing
Pale skin, blue (looks more pale purple IRL) lips and areas around the eyes
As blood oxygen levels trend down: confusion or altered mental status
Cough and mucous production can also be a sign of oncoming COPD flair-up or respiratory infection.
Medications: Common medications used to treat COPD are:
Inhalers – fast-acting inhalers like albuterol relax the muscles in the airway to ease breathing and increase airflow. Used for wheezing and sudden breathing tightness/difficulty.
Steroids – both inhalable and oral steroids are used to control airway inflammation during times of COPD exacerbation, or for routine daily use to keep COPD symptoms controlled.
Antibiotics – COPD flair up is commonly caused by respiratory tract infections treatable with oral antibiotics.
Scavenge list (keep any eye out for these medications when scavenging or trading):
Short-acting Inhalers: albuterol (Proair HFA, Ventolin HFA), levalbuterol (Xopenex), ipratropium (Atrovent HFA)
Long-acting or short/long combo Inhalers: tiotropium (Spiriva), budesonide/formoterol (Symbicort), fluticasone/salmeterol (Advair), fluticasone/vilanterol (Breo Ellipta)
Oral Steroids: Methylprednisolone, prednisolone, prednisone, dexamethasone (decadron)
Oral Antibiotics: Doxycycline, Trimethoprim-sulfamethoxazole (Bactrim), Azithromycin (Zithromax), Levofloxacin (Levaquin)
Tips/Avoid
Avoid exposure to lung irritants like smoke, including cigarette smoke and wood-fire, charcoal, generator exhaust or other sources of smoke.
Remain in areas of adequate airflow. Avoid dust, mold, pollutants, and chemical fumes.
Some sufferers are sensitive to extreme changes in temperature, and should limit their exposure to extreme cold or heat. This may be unavoidable if SHTF.
Physical exercise can strengthen respiratory muscles and improve oxygenation in those with COPD. In SHTF, most of us will be significantly increasing the amount of physical activity we perform on a daily basis, but it's important for those with COPD to start slow.
Stay hydrated. COPD can contribute to thick/sticky mucous formation in the airway. This mucous is only made thicker and stickier with dehydration.
Anyone who relies on medical equipment should have a multi-point backup power plan in place, including generators, solar, wind, and other sources of energy.
Recommended Equipment:
In addition to any general medical prep, be sure you have:
One or multiple pulse oximetry meters. They are inexpensive and can be purchased at Walmart for $20-$30. The pulse oximetry meter (or "pulse ox") is used to measure the oxygen content in the blood. The meter is placed on the finger and light beams detect what percentage of blood cells are carrying oxygen.
Healthy adults and children will read 95-100%. Typically adults with begin to feel short of breath in the low-90's.
Adults with COPD should know their baseline, but it is generally 88% or better. Some COPD patients can experience levels in the low-80's without the feeling of shortness of breath.
Cold fingers or poor blood flow may artificially skew the pulse ox reading. Try multiple fingers, try warming up the fingers, and if that doesn't work try the lobe or top of the ear.
A special note for COPD patients needing supplemental oxygen:
Unfortunately, the outlook is not good for those dependent on supplemental oxygen during the apocalypse. Oxygen is measured in liters per minute and typically ranges from 1-5 LPM of flow. Those who use 1-2LPM of oxygen may be able to ween themselves off, but those using 3-4L of oxygen will likely face serious repercussions if their oxygen machine (concentrator) fails or no electricity is available.
Additional oxygen tanks are not easy to come by, and even so, they don't last very long. Your typical small oxygen tank (M9 tank) lasts only 2-3 hours at 2 liters per minute. A larger tank may last 4-8 hours, but it's not really feasible to gather enough oxygen tanks to ride out a long grid-down situation.
If faced with the inevitability of losing oxygen supply, I recommend weaning the oxygen slowly. Decrease by 1LPM every hour. Start the weaning process early and adjust activity to compensate. Track the pulse oximetry reading as you adjust the flow, and track the reading during any subsequent activity.
This article may be edited as I discover new and useful information that I may not have initially thought of.
