Thanks for these posts, Jim.

(Electrolyte imbalance can kill you.)

Which I suppose is why Making Light now incorporates Electrolite: for balance.

Posted January 11, 2006 1:05 AM by Bob Oldendorf

I read (a bit ago) that the Koreans cured chickens with the avian flu by serving them extract of kimchee.

I don't doubt that those of you who have less sensitive palettes than my own will be a bit taken aback by this, but I rarely have good medical reasons to do things I'd rather do anyway (like keep kimchee in the refrigerator, although HM sternly informs me that if we do have it in the house, I have to let daddy have some...)

Posted January 11, 2006 1:12 AM by julia

I live in California, and usually file "prepare for disaster" warnings under "make sure earthquake preparedness kit is up to date". Some of the items on that list are more specialized than the usual "survive while waiting for services to be restored", but well worth keeping on hand.

Posted January 11, 2006 1:41 AM by Max Kaehn

Ditto on the particle filters. There's a certain specification for masks used to limit the spread of infection (I don't remember it offhand and my First Responder manual's at school, perhaps someone else with emergency medical training knows) which is better suited than most masks. Also, the first mask should go on the patient, especially if its the only mask, since it'll cut down the number of pathogens significantly for the most amount of people.

Posted January 11, 2006 2:15 AM by TheSquire

Oddly enough, at some point yesterday and perhaps for reasons relating to Alec Rawls, I stumbled across a long rant attributing the deadliness of the Spanish Flu pandemic to poor telephone sanitation. Or something.

Posted January 11, 2006 3:31 AM by Julie L.

I read (a bit ago) that the Koreans cured chickens with the avian flu by serving them extract of kimchee.

That reminds me, I must put up a new batch of kimchee - we're fresh out. Salt-fermented pickles are fantastic if you like Microbiology In Your Own Home - watching Lactobacillus at work is a beautiful thing.

However, I think that the main anti-flu effect you'd get from eating kimchee would be the kimchee breath that deters everybody from coming within touching or droplet-spreading range of you. While I don't have any proof of this, I'm convinced that the masks work in much the same way for people who aren't actually providing patient care, especially on public transport.

Another thing that is worth keeping around for when you're sick (I doubt I could stomach kimchee once the flu kicks in) is candied ginger. Great stuff - sugar for energy and ginger to quell nausea and vomiting. It comes from healthfood stores.

Posted January 11, 2006 4:23 AM by Fernmonkey

What is a good cough expectorant? Is that like Mucinex?

My greatest weakness is keeping food/drink proper for sickness in the house. I'm constantly dieting, and I've found the best way not to overeat is to have only the foods I intende to eat in the next two days in my house.

Posted January 11, 2006 5:26 AM by Leah Miller

New Scientist had an article on possible preparations for bird flu.
Some of the suggestions weren't very helpful ("Be wealthy"), but one was to look into antibiotics for bacterial infections that may attack your lungs while you are weakened by the flu, since in a pandemic they might be harder to get hold of when they are needed. I'll check the paper copy when I get home.
This doesn't, of course, invalidate the "antibiotics do nothing for viruses and insisting your doctor give you some when you don't need them will just encourage more things to develop resistance to more antibiotics" message.

Posted January 11, 2006 6:42 AM by Alan Braggins

Just delurking to add:

If there's a pandemic you're going to have problems even if you don't get it yourself. No staff for shops, no drivers for public transport or food distribution. You need 30days+ food supplies in stock cos you may not be able to buy anything once it hits.

And what about drinking water? If the staff shortages bring widespread power cuts then pumping stations could be hit. If you have a house then a rain barrel (fits on the downpipe from your guttering and stores rain water - do you have them over there?) could save your life.
Not sure what you do if you have an apartment though.

Oh yes, and most infection is spread through the hands touching the mouth - the main advantage of the mask is it stops you absent-mindingly wiping your lips. So wear gloves when your out.

Posted January 11, 2006 6:44 AM by Andy Brazil

Masks don't really stop viral capsids spraying everywhere when you sneeze, unless they're really heavy-duty ones with filters. What they accomplish is to stop uninfected folks touching their face with hands that have been in contact with someone who's infected. You touch your face more often than you think -- several times per hour -- and if your hands have been in contact with a patient, your fingers are probably going to be carrying flu virus particles. Rubbing them off on a paper mask means not rubbing them off on a mucous membrane.

On the subject of oral rehydration, here in the UK there's a product called Dioralyte -- sachets which, when dissolved in the correct volume of water (typically 500ml) produces an isotonic solution (and pleasant flavouring -- orange, blackcurrant, whatever). If you're ill, you won't be functioning properly: make life easy on yourself, use pre-mixed stuff rather than trying to remember 5g salt/40g sugar/litre while you're running a fever.

Assume the worst: you'll be dealing with the flu on your own, or everyone in your household will come down with it simultaneously. With any luck it won't happen that way and there'll be someone about who can think clearly and manage the patient, but planning for the worst always pays dividends.

What's bad flu like? It starts with irritation and lack of ability to focus, and mild cold-like symptoms. Your brain turns to mush and you can't concentrate on anything. You may have a runny nose. Then you'll feel achy and run down. By the time you take to your bed you can expect to be feverish. You'll be alternating between shivering under three duvets and a hot water bottle, and unbearably hot. (Getting out of bed will be a daunting prospect.) You may have difficulty breathing (which is scary as hell) and have to force yourself to stay awake in order to keep your lungs moving. You will feel extremely weak and everything will ache as if you've just done a really hard work-out. And you may well be experiencing mild hallucinations along with everything else -- mind wandering, weird thoughts, imaginary conversations. After the fever breaks it may take you a day before you feel well enough to get out of bed and move around the house; you may feel drained and weak for a week or more.

That's ordinary flu. H5N1, if it crosses the species barrier, will look like this -- except when it looks a whole lot worse and the victims start burning up or stop breathing.

Posted January 11, 2006 6:54 AM by Charlie Stross

Conventional wisdom has it that proper electolite balance consists of having the right amount of sodium and postassium ions floating around in one's synapses, keeping the whole mechanism of neural transmission going. In other words befuddlement, passing out, etc. can be the result of getting that screwed up.

Sodium isn't a problem for most Americans under most circumstances, (this group may be more health conscious, but I doubt it), but potassium is, since it's not present in every single processed food we come across. (Allegedly, a single bananna has enough potassium to keep you going for a day or more. Very popular amongst the bicycling crowd.)

Perhaps Mr. Macdonald can help me fact check that last bit.

I haven't looked at the oral rehydration stuff in a long, long time, but I understand that chicken noodle/with rice type soup is pretty good, having the necessary sodium, potassium and starch dissolved in it, and being innocuous enough to be less likely to be vomited up. I think it was being reccomended for use in 3rd world countries as a more practical solution than telling people to wait for packets that are designed to dissolve in cold water.

-r.

Posted January 11, 2006 7:51 AM by rhandir

(Allegedly, a single bananna has enough potassium to keep you going for a day or more. Very popular amongst the bicycling crowd.)

Where does one get potassium if one hates bananas, nasty slimy things that they are?

Posted January 11, 2006 8:28 AM by Carrie S.

What Carrie just said. Also, your formula for 5cc of salt and 40cc of sugar to a litre of water sounds instantly and violently emetic. Can you add anything else to keep it down? Or would "sports drinks" do?

Posted January 11, 2006 8:33 AM by chris

You can get liquid pre-mixed rehydration salts; I get mine at MEC, but they ought to be available in any backpacker store. No banana.

Don't forget to put protein in your food stash, even if it's -- baring allergies -- five two kilo bags of peanuts. You're going to need it.

Posted January 11, 2006 9:13 AM by Graydon

On the expectorant question: I personally love guaifenesine, which can be had in Robitussin/Pay-Less-Tussin form if you read the bottles to find whichever variety it is that has guaifenesine only. (And if you're like me and can't take pseudoephedrine for allergies and such, it's the next best sinus-clearing thing I've found.)

I also like Emergen-C, which has the vitamin C and potassium and so on without the artificial sweeteners and nasty taste of AirBorne.

Posted January 11, 2006 9:28 AM by G. Jules

Japanese markets in NYC (and most other places) have a beverage called 'Pocari Sweat' which is isotonic and has (IIRC) potasium. I think it's superior to gatoraide.

In Singapore, dehydration is a fairly serious problem, as working in the hot sun has killed people stupid enough to just use Red Bull for energy and not hydrate while exerting a lot. Isotonic beverages were extremley popular there, coming in several differnt brands.

If you can get to a doctor, an IV with an IV drip bag may be better than a drink if you're vomiting on a frequent basis.

If anyone has EMT training and wants to know what's in my stepfather's magick IV blend, email me and I'll ask him. He treats people with bad food reactions, etc... on a regular basis, and works in an area where Avian Flu will probably hit before it gets to the US. They've got rehydrating patients to an art form out there.

Potassium

AHA Recommendation

Potassium is an element (and an electrolyte) that's essential for the body's growth and maintenance. It's necessary to keep a normal water balance between the cells and body fluids. Potassium also plays an essential role in the response of nerves to stimulation and in the contraction of muscles. Cellular enzymes need potassium to work properly.

A potassium deficiency due to increased urinary loss often occurs when medication for certain heart diseases is used to prevent sodium and water retention. To overcome this loss, physicians often suggest eating more foods high in potassium. More potassium may be prescribed as a medicine.

Foods high in potassium include bananas, cantaloupe, grapefruit, oranges, tomato or prune juice, honeydew melons, prunes, molasses and potatoes. Some foods high in potassium are also high in calories. When weight control is important, eat more low-calorie foods. Foods such as fruits, vegetables and low-fat dairy products that are high in potassium and calcium, when incorporated in the DASH Diet Study, helped to significantly lower blood pressure.

Posted January 11, 2006 9:31 AM by Josh Jasper

My experience has been that electrolyte concoctions, including sports drinks, are "instantly and violently emetic" unless I'm out of balance enough to genuinely need them, at which point they taste like nectar.

Dietary potassium sources other than bananas tend to be more work than I'm willing/able to do when sick. I keep a bottle of multivitamins in my sick kit to cover anything I'm not up to eating.

Posted January 11, 2006 9:41 AM by OG

Leah, the active ingredient in Mucinex is the guaifenesine that's in cough syrups--the pills have the advantage of blocking the taste of the drug, which, even palliated by cough-syrup flavorings, is one of the foulest things I can think of.

A cough suppressant is something else altogether--you want the guaifenesine (in whatever form you choose it) to break up mucous, so that your body can get rid of it--you want a cough suppressant when you get to the stage of the irritating cough that does nothing except drive you nuts and wear you out. Combining the guaifenesine with a cough supressant is a bad plan, because when you've loosened up the mucous in your lungs, you want to be able to cough it loose.

I bring all this up because I'm constantly amazed by how many people don't understand coughing. Having spent much of my childhood attempting to qualify for the All-American Bronchial Infection Team, I speak as a grizzled veteran: there are different coughs, and some of them are coughs you need to cough.

Posted January 11, 2006 10:14 AM by fidelio

You can buy guaifenesin (sp?) in pill form, which has a longer shelf-life (about 2 years to the ex-date).

What I don't see on the list is some sort of anti-diarrhea (again sp?) agent, such as immodium. Even though I pretty much never need the stuff, I keep it around, JIC. That said, when I had really nasty food poisoning last spring (campylobacter) NOTHING worked until I got the second full round of antibiotics, without which I may actually have died. :-o

When you've got a fever of 104, cognitive abilities are not at their peak, so it's important to remind yourself how sick you really are before you go and do something foolish (like try to drive) and get yourself or someone else hurt. Yet another reason to lay in a sick-period pantry.

Posted January 11, 2006 10:33 AM by Larry Brennan

speaking of guaifenesin... i have asthma and when i was young, and was having breathing trouble, the school nurse would always give me some horrible acrid yellow syrup called "Quibron".

it's a blend of guaifenesin and theophylline and tastes like Robitussin triple-distilled over a tire fire then aged for 12 years in casks of piss oak.

Posted January 11, 2006 10:39 AM by cleek

I haven't looked at the oral rehydration stuff in a long, long time, but I understand that chicken noodle/with rice type soup is pretty good, having the necessary sodium, potassium and starch dissolved in it, and being innocuous enough to be less likely to be vomited up.

Agreed - it's the perfect food.

Posted January 11, 2006 10:50 AM by Eve Bloom (was Fernmonkey)

Potassium is a good excuse for eating fries (and baked potatoes). Orange juice is also good (better than unjuiced oranges!)

Posted January 11, 2006 10:55 AM by P J Evans

For protein sources, I like the PowerBar Protein Plus bars that are often available in stores of various types (I can get them locally at Osco, GNC, etc.). Depending on variety, they have about 3 - 3.5g of saturated fat versus about 24-25g of protein. You can also get the in a reduced sugar formula, although the fat content is higher and lowers the SF:Protein ratio. Most of the bars have about 290 calories.

They keep pretty well unopened. You can even eat half, fold it up, and save the rest for another meal. Nice to have the protein source if other sources are scarce or you just aren't up to preparing them.

Golfers use the generic (non-protein-loaded version) while playing. It does give a nice energy source without loading up the fat...

Posted January 11, 2006 11:08 AM by Scott

Potassium chloride is also available as "salt substitute" at your local supermarket. Use it with caution, especially on small children whose electrolyte balance can be shoved too far in the other direction.

Presumably, it is possible to split up your electrolyte requirements into salty soup-like liquids and sweetened (perhaps acidic) tea/juice-like liquids. Under the indirect inspiration of prepackaged bottles of "cranberry tea" (iced tea madewith cranberry juice cocktail), I have found grape juice cocktail a surprisingly comforting combination with tea of various temperatures.

Posted January 11, 2006 11:45 AM by Julie L.

Lemon Gatorade is probably one of the least disgusting ways of restoring electrolites. Either that or chips, gummi bears and juice, depending on how very sick you are.

Can't imagine doing salt and sugar except in some recreational form. Pumpkin seeds. Life Savers.

Posted January 11, 2006 11:58 AM by Scorpio

OK, they changed the nutritional labelling so the facts are not out in sight any more, but Cool Ranch Doritos have 95 mg of potassium per serving, and jalapeno potato chips have about 495 mg.

So choose your snack foods and drink calcium fortified orange juice, because the balance is supposed to be among sodium, calcium and potassium.

Posted January 11, 2006 12:09 PM by Scorpio

One caveat about the protein bars, for the uninitiated: they should be consumed with plenty of water. If not, the gaseous by-product of that much protein hitting your digestive system at once is, um. You become unfit for human company. I suspect that if you're eating one while simultaneously pounding fluids due to flu infection, you'll probably be okay. But you really don't want to do more than absolutely necessary to drive away whatever caretakers you may have around.

Posted January 11, 2006 12:22 PM by Andrew Willett

For some people, an expectorant alone is not enough. I have chronic sinus problems, so I have to take Zyrtec-D along with Mucinex when I am severly congested. My doc tells me it's not mucus- it's hard rubber cement- and somehow it got in my head. Eew. I assume any good decongestant in concert with an expectorant will work fine, assuming one drinks plenty of fluids.

Posted January 11, 2006 12:29 PM by LeeAnn

One thing to keep in mind about the electrolyte replacement issue--people who are really, really sick may not be feel like eating solid food. In fact, they may not be cognizant enough to eat solid food. In which case, fluids by mouth are the only hope for home care, unless you have the very rare home set up to rig an IV hookup.

Not to be an alarmist, but the possibility exists that in the case of a flu pandemic, some of us will either be dealing with people who are too sick to cooperate much in their own care, or be too sick ourselves to handle anything very complicated.

Posted January 11, 2006 12:34 PM by fidelio

For those of us who keep the graduated cylinders and volumetric flasks in the lab,

5 cc of salt plus 40 cc of sugar to one liter of clean drinking water...

is one teaspoon of salt and two tablespoons + two teaspoons (or three tablespoons, if you are not finicky) in four cups of water.

Also, YMMV, but multivitamins on an empty stomach make some people (eg me) throw up, I imagine that if I am not eating, I am also not going to be taking multivitamins.

The other important insight I can add - regardless of what you choose to drink to rehydrate/rebalance your electrolytes - you want to be sipping it slowly! I nearly sent myself to the ER once with a stomach flu, since I was so dehydrated from vomiting: I was really thirsty, of course, and I would glug down a pint of water, throw it up (losing additional water in the process), rinse, repeat (yeah, not exactly at my cognitive best when I'm sick). My doctor suggested apple juice, instead of water, so I'd at least get some calories and electrolytes, and that I should drink it slowly - which worked much better.

Posted January 11, 2006 1:39 PM by debcha

debcha wrote:
Also, YMMV, but multivitamins on an empty stomach make some people (eg me) throw up, I imagine that if I am not eating, I am also not going to be taking multivitamins.
I take children's chewable multivitamins. Vile, chalky aftertaste, but not as bad as pills.* I have heard it said that the iron in multivitamins can induce nausea. Anyone know for certain about that?
-r.

*now available in SuperFriends, RugRats, and something else shapes. Not just Flintstones anymore. I'm still holding out hope for Naruto ones, though. (I wonder if you can get those in .jp?)

Posted January 11, 2006 1:49 PM by rhandir

Somewhat brainless practical question. I was raised by a family firmly entrenched in that sort of Midwest Great Depression Survivor mentality of waste nothing, throw nothing away, use everything. The thing that has always struck me about these survival kit plans (car kits, earthquake kits, flu kits, etc.), is they involve buying lots of things with expiration dates (medication, food, even bottled water), then sticking them in your trunk or closet until they expire, then tossing them out and buying new ones.

Anybody have strategies for avoiding that sort of thing? Is it possible to actually use the stuff in your kit before it expires, then simply remember to keep it stocked?

Am I crazy to be worrying about this sort of thing?

Posted January 11, 2006 2:03 PM by Carrie V.

Also, YMMV, but multivitamins on an empty stomach make some people (eg me) throw up, I imagine that if I am not eating, I am also not going to be taking multivitamins.
Well, yeah. The multivitamin is for the frequent circumstance where I can eat but can't stay on my feet long enough to cook something moderately healthy, a boost during the initial slump down to being really sick and extra support during recovery. Generally speaking, if I can't keep a multivitamin down, I won't keep Gatorade or juice down, even in small sips.

Posted January 11, 2006 2:07 PM by OG

Curious...
Any reason not to use Pedialite to replace electrolytes and fluid? I'm not sure I'd be aware/awake/energetic enough to mix a cocktail of sugar, salt, water, etc.

Posted January 11, 2006 2:23 PM by ElizabethVomMarlowe

Is it possible to actually use the stuff in your kit before it expires, then simply remember to keep it stocked?

That's what they recommend you do around here. You store the survival stuff in your pantry and rotate it to keep it fresh.

Our earthquake survival kit is merely keeping enough food in the house to live off for a week. (The assumption I have made is that the house will be damaged by not collapse in a quake, and we will be able to go in and remove items from it relatively safely, even if we end up sleeping in the yard. This is supported by analysis by an engineer.) We have an on-site fresh water supply from the groundwater under our house that can support five to ten people with drinking and washing water depending on the time of year, so we don't stock water.

For illness, we keep a month's supply of prescription medications as a matter of course. When we get a flu or cold, we restock what we used in the medicine cabinet. We keep things like immodium around even though we don't use them all that often, because when you need it you NEED IT NOW, ditto for pink bismuth or whatever Pepto-Bismol is. We always have a store of salt and sugar around, and tissues as well, and my compulsive toilet paper purchases ensure that even if every member of the household has a violent case of the trots, we don't have to resort to leaves for a few weeks. These are all supplies we always have on hand, not gathered in a kit but stored in their usual places in the house. (I don't know where I'd put such a kit, anyway.)

We live on an island, so I keep planning to buy a couple of emergency rubber boats (and paddles, of course), in case we desperately need to get to the mainland (it's a swimmable distance, but swimming might not be an option depending on the emergency). I also have fallen down on keeping cash on hand -- after an earthquake, credit cards are not much use without the phone lines and computers and such.

These plans would be different if I lived in a concrete or masonry building, or if I lived in an apartment building, or if we didn't have fresh water bubbling out of a hole in the basement floor year round. Planning for disasters is highly context dependent.

Posted January 11, 2006 2:26 PM by Ayse Sercan

Carrie, my emergency kit doubles as my backup stash, so I'm always pulling stuff out and replacing it. Need batteries? Raid the hurricane kit and put them on the shopping list. OTC medication and food/rations, the same. Water I filter, refill and rotate as I empty a jug.

The important thing about a kit is having it organized and easy to get to when it's really needed. That doesn't necessarily mean that it has to be in a duffel hidden away until the emergency strikes. My hurricane kit, with its batteries and mini flashlights and mini TV, is in a series of plastic bins beneath my kitchen bar. My flu kit is just a list of things I make sure to keep stocked up: vitamins, sports drinks, chicken soup, pseudoephedrine and guafenesin, etc.

Posted January 11, 2006 2:37 PM by OG

Yes, I try to keep things stocked around the house anyway--it's common sense, really! But harder to do, I've noticed, when you live alone, like me. No one is depending on me and I'm used to being able to just run out to the store two blocks away whenever.

I need to be better about this sort of thing--especially living alone, since no one is on hand to look after me. I tend to be a little blase, which I think comes from living in a region with too many survivalist types who take the whole emergency kit thing to an extreme. You know, keeping a small army's worth of ammo with their bottled water...

Posted January 11, 2006 2:49 PM by Carrie V.

Carrie V, we use a system I'm told is used in both the US Navy and Seventh Day Adventist households: minimum quantity on hand. That is, each item has a minimum quantity that's always stocked in the pantry/first aid kit/closet/whatever. If our MQ for canned black beans is 5, then when I see 6 cans in the pantry as I'm pulling one out to use, "canned beans" goes on the shopping list. This only sounds complicated. It's basically a matter of replacing things before you're out of them.

Posted January 11, 2006 2:54 PM by Aconite

You'll be alternating between shivering under three duvets and a hot water bottle, and unbearably hot.
Sounds like hot flashes.

Cleek: it's a blend of guaifenesin and theophylline and tastes like Robitussin triple-distilled over a tire fire then aged for 12 years in casks of piss oak.
Thank you for the perfect description of some single malt scotch I had once. Altho maybe not the Robitussin part.

There's a company I'm a distributor for that sells isotonic vitamin/mineral stuff. I think my name link will send you there, or try www.j4l.com. Menu on left side, "Health & Nutrition": Several products that start "Isotonix..." are available. They all come in a potassium base, which gives them a foamy head (a friend said delightedly, "a vitamin that gives head"). I got into them because I have great difficulty taking pills and the last set of powdered supplements I tried started at $200/month and went up.

Carrie V: Is it possible to actually use the stuff in your kit before it expires, then simply remember to keep it stocked?

I go thru my earthquake kit twice a year. I take out all meds, batteries, and similar things. I put in brand new meds, batteries, etc., and put the just removed stuff into active use. Those will be the next meds I take, the next batteries I use. So at most, they're six months old, which is well within expiration dates. It's also a good time to check the elastic on your longer-term sox, undies, and elastic bandages as it will die after a while.

Posted January 11, 2006 3:00 PM by Lin Daniel

survivalist types who take the whole emergency kit thing to an extreme. You know, keeping a small army's worth of ammo with their bottled water...

I have a friend who's emergency kit list starts with "hand weapon of choice."

Posted January 11, 2006 3:03 PM by Lin Daniel

chris - I find that the homemade rehydration drink is undrinkable when I'm well, but as desirable as the waters of the Nimrodel when I'm sick.

Posted January 11, 2006 3:05 PM by clew

Aconite -- similar to what I do, which is "If you didn't put it on the shopping list when you took the next-to-last one, then it's not MY fault we're out, YOU go to the store." Sigh. Now I feel guilty and will vow to be a Better Wife and Mother.

Posted January 11, 2006 3:25 PM by Janet Croft

There isn’t much you can do about viruses. Antibiotics won’t touch them, since they aren’t alive to start with. There are some anti-viral agents, but they’re not 100% even if you can get them and get them in time.

One thing I have heard of from a couple of sources as a potential combattent against the avian flu is colloidal silver, with the caveat that it is to be used during infection ONLY and is NOT to be used on a long-term basis (or else you turn into a Smurf.)

Posted January 11, 2006 3:49 PM by Rachel Heslin

Upthread, Fernmonkey said: Another thing that is worth keeping around for when you're sick (I doubt I could stomach kimchee once the flu kicks in) is candied ginger. Great stuff - sugar for energy and ginger to quell nausea and vomiting.

Seconded - I suffer fairly badly from low blood sugar, and this is one of the things I keep around to deal with that and get me to real food, along with almonds and dried banana chips. I make my own using this recipe. Much recommended. It's also good for clearing out a mildly blocked nose, and - which I find just as important - it's a good strong taste even when you're fluey and miserable and everything you normally like to eat tastes like thick cardboard dampened with first pressing of pre-Cambrian mud.

Posted January 11, 2006 6:03 PM by Sam Kelly

we use a system I'm told is used in both the US Navy and Seventh Day Adventist households: minimum quantity on hand.

Yes, exactly. This works much better, of course, when all members of the household participate. In my case, I come home from trips to find that all supplies have been depleted by the other two inhabitants of the household, who think that "we don't need black beans: we have five cans on the shelf still."

Another thing to consider is, if you have the space and climate, growing some of your emergency supplies in the garden, rather than storing them all as canned goods. For one thing, you're always sure that the supplies you have are fresh, and you get new ones automatically. For another, after a week or so of canned beans, you will miss fresh vegetables and fruit. Fruit on the tree doesn't need refrigeration, and you can eat it unripe if you're really hungry. I'm planting a high density orchard this winter, with varieties timed to ripen sequentially all year rather than all at once in July. In case of disaster, we'll have fresh fruit in every month of the year (winter months are pretty much citrus, but you take what you can get). Of course, this assumes we don't get a mandatory evacuation order as a result of the disaster.

Posted January 11, 2006 7:00 PM by Ayse Sercan

My understanding of a good stash is that it's not an isolated thing-- it's the cupboard where you put extras you picked up along the way. I have extra bathroom stuff under my bed, and when I run out of what I'm using now, I pull out the whatever from under the bed and buy another one next shopping trip. You shouldn't keep your stash isolated-- just keep it full.

Posted January 11, 2006 8:19 PM by Cassie

One of the good things about being really sick and living alone is that I have a lot of this stuff already. I'm chronically dehydrated so the primary makes me drink 32oz of Gatorade every day (I just finished today's, when I drink it while I'm online, it's not so icky). I have a method of stocking canned things so the oldest is what I take, and so forth.

But on other bits here:

The last time I had a 105.3 fever, the Kaiserdoc stayed in the room with me all night. It was probably a good idea -- they had this plastic thing under me that was circulating cold water and it was very painful.

The last time I had a TIA was in the midst of a heavy flu season, and the ER couldn't find anywhere in Northern Virginia to admit me, so they just watched me in the ER until they were sure I was okay.

Julia, the WashPost Home section last week did an article on kitchen appliances designed for certain ethnicities and religions and one of them was a kimchee fridge so your regular fridge doesn't stink.

Carrie S, there's a lot of potassium in prunes. If you hate the taste, some manufacturer is flavoring them with citrus now.

Elizabeth VM, Pedialyte is designed for kids. Adults need a different recipe for rehydration. The company that makes Pedialyte also makes an adult drink, but I can't remember its name. It's more expensive than Gatorade.

Posted January 11, 2006 8:32 PM by Marilee

Rachel, I would hold off on the collodial silver. Argyria is a well established side effect (as you put it, becoming a smurf) and any theraputic effects of colloidial silver are hard to establish, at best.

External applications are something else. Good luck getting my big jar of Silvadene away from me.

Posted January 11, 2006 8:33 PM by Claude Muncey

As other people said: You use the stuff from your kit(s) day-to-day, and replace into your kit when you go to the store.

Posted January 11, 2006 8:41 PM by James D. Macdonald

"a kimchee fridge

I recognize the desirability of this, but...

(I'm visualizing the McMansion which has designated fridges for the colas, the beer, the kimchee...)

Posted January 11, 2006 9:14 PM by Linkmeister

Carrie,

My low maintenance, low cost, reliable method for extra food storage:

1. Have reasonable supplies of spices and vitamins on hand.

2. Buy 120,000 kcalories [60k kcal/ person/ month] of inexpensive, bulk-priced, low-volume, easy-to-sauce foods *that will expire in no less than 18 months.*

3. Store food well, in a safe place (or two), away from regular food storage.

4. In 6-9 months, buy the identical 120k kcalories of food. Donate the first set to a food bank.

5. Repeat.

The benefits are... you only have to plan the foods once, you only need to follow up twice a year (and buffer time is built into the system), the foods aren't wasted or thrown out, and both you and the donation recipients are getting good (not stale) foods. I focus on high calorie per volume foods (pasta, not canned soups) so the storage space isn't much.

Even if you completely forget to donate at other times, you'll always be reminded come winter.

Before my current system, my 'emergency shopping method' included the assumption that I'd be wanting a giant variety of many different foods during the duration. I no longer believe that. Under the stress of an emergency, food has to be good enough so that its easy to eat (so no novel tastes or textures in my supplies), but not much more than that. Food is worth satisficing on. [Making sure I have an extra 2 month's worth of medications and the like? Those were worth the time and money not spend on shopping]

If I'm getting enough calories and my personal RDA of nutrients (through vitamins), then spices and sauces make for most of the necessary tastiness and variety. I'll always be able to mix in my regular foods (which could represent a week or two's worth of food anyways, not counting the fridge and freezer) without having to think about food backups every time I shop.

My extra 120k kcals cost about $50 to $70: far less than a few days of retail MREs or dehydrated meals for camping. Much but not all purchased at warehouse stores (Costco- membership required. Smart and Final- open to the public), but also at 'ethnic' grocery stores.

Posted January 11, 2006 9:21 PM by kathryn from Sunnyvale

Sugar and salt in water work. Something else might work better.

It's for restoring hydration. When you're dehydrated with diarrhea and/or vomiting, it's hard to absorb plain water. A little salt and a little sugar lets you absorb it. It doesn't restore your salt balance, but if you can stay hydrated for a few days until the worst is over, then you can do something else to restore your salt balances.

It's OK to store ten pounds of sugar and a pound of salt someplace out of the way and not bother to cycle them, provided they don't get damp enough to cake. Enough for 20 gallons. Including other salts may be better for you. But getting the balance just right is tricky, it depends on how unabalanced everything else you consume is. When you're healthy you don't have to worry about getting the balance just right, your body will preferentially dump whatever you have in excess into your urine and sweat. (And probably tears, for what that's worth.) If you're sick enough you need the ion balance just right then you'll probably die, but stuff that's supposed to get it right might possibly save you.

Sure, keep gatorade and chicken rice soup, and everything else that seems possibly palatable. Your best judge whether it's what you need is likely to be whether it feels wonderful when you taste it. But if you aren't sure how much rehydration fluid you'll need, having an extra ten pounds of sugar and a pound of salt in addition won't hurt. And remember, once you get through the disease cycle you might have neighbors who started later and need help. No telling how many. A minimal expense now might save lives.

Posted January 11, 2006 10:17 PM by J Thomas

With regard to normal flu, not pandemic apocalypse, I think it's wise to keep personal remedies as necessary. A lot of the planning I've seen is for times without any resources rather than the week spent off work because you're just not willing to ride the subway in your condition. Little things, like pudding for sore throats or other comfort food, don't make a lot of a difference at the end of the world, but at the start of another day of feeling off and trying not to spread it, they help.

Posted January 11, 2006 11:47 PM by Cassie

As much as I normally hate Gatorade, when you NEED it it tastes like honey. I work at a local Ren Faire and have discovered this need a few times. Enough that I store some in our booth if it's hot (I work for a jewelry crafter).

Posted January 12, 2006 12:23 AM by Paula Helm Murray

All I can guess is that I have never NEEDED Gatorade, because the stuff has always been something I need to choke down. Yeah, I drink it, but I don't like it.

Posted January 12, 2006 1:11 AM by Ayse Sercan

Julia, the WashPost Home section last week did an article on kitchen appliances designed for certain ethnicities and religions and one of them was a kimchee fridge so your regular fridge doesn't stink.

Hey, that could be pretty nifty! We just close the lids really tightly and we're good to go, but it would be nice to have somewhere to seal the kimchee off while making it.

Your best judge whether it's what you need is likely to be whether it feels wonderful when you taste it.

Very true. Normally, I hate soda and am pretty indifferent to bananas. However, when I had a terrible stomach flu a month or so back, the Coke-with-a-big-pinch-of-salt tasted like ambrosia, and the banana actually made me whimper with happiness.

Posted January 12, 2006 4:36 AM by Eve Bloom

Bulk foods: Given that you have to have oil or a hot-air popper to cook it, I don't know how well popcorn would hold up in a real emergency...but when you're just poor, you can't beat it for dollar-to-calorie; a $3 bag of yellow popcorn makes several tens of thousands of calories, especially if you pop in oil. (Remember to drink milk with it if you can tolerate milk.)

Posted January 12, 2006 8:25 AM by Carrie S.

Re the home-made electrolyte recipe: consider mixing it in zip-top snack bags, one liter's worth of mix per bag. If you have lots of small pill bottles or spice bottles, they'd work also.

Posted January 12, 2006 10:49 AM by P J Evans

Back during my food-poisoning incident, my MD told me to try the Pedialyte popsicles. They were way way too sweet for me to choke down, so I stuck to my regime of half-strength Gatorade and multivitamins. (Thankfully, despite it all, everything went in and came out where it was supposed to.) Still, these pops may be a good thing to have on hand - they have a long shelf life melted, and I imagine they could survive an ice age frozen.

Once I was ready to eat again, freshly made white rice with (tetra-pack) chicken broth suddenly became the food of the gods. Once I was able to add an egg white to the broth, I knew I was on the road to recovery. My biggest lesson from the whole incident was that I'm a poor judge of exactly how sick I am.

Given that on the whole, I'm pretty healthy, I had the stuffing knocked out of me for a week. I don't event like to think of what a pandemic bird flu could do to those of less sound health.

My electrolyte replacement prep now consists of keeping a can of Gatorade powder on hand. It's easier than trying to roll my own when sick, and I know I'd get angry at a bunch of ziplock bags full of sugar and salt and eventually pitch them.

Posted January 12, 2006 12:14 PM by Larry Brennan

Re: Adults not using Pedialyte.

My Mom is an RN. When she travels, she packs the powder version of Pedialyte just in case she gets Traveler's Tummy (Immodium too, for that matter.)

When I mentioned that someone here said that Pedialyte should not be used for rehydration for adults, she said:

"It tastes better than Gatorade. When rehydration is necessary, you take what will stay down. When my gut's in an uproar last thing I want is something that will have an emetic effect..."

So at least one person with some medical training says you can use Pedialyte!

Oh, and for something that will ease the burning sensation in the mouth and throat after too much vomiting, 1/2 teaspoon of baking soda in 8 ounces of water. Stop drinking this mix when it no longer tastes good.

Caveat with regard to Immodium -- do not use during vomiting/purging phase of some viruses. It slows down the process, but keeps it going longer. I speak from personal experience...

Posted January 12, 2006 12:24 PM by Lori Coulson

re: popcorn

Kettle corn (sugar & salt) popcorn might work for some of the people who can't stomach the sugar & salt drink mix. Google for more info.

Posted January 12, 2006 12:35 PM by Adam Ek

Lori, the baking-soda-in-water is our preferred tummy-settling medicine--so not only will it sooth your throat after vomiting, it might stop you from vomiting again. We find it even helps settle doggie tummies. And it's a heck of a lot cheaper than Alka-Seltzer!

Posted January 12, 2006 1:16 PM by Janet Croft

No more flintstones? I took a couple of (large) bottles of those with me to Iraq. Came in real handy.

Sigh.

Posted January 12, 2006 1:24 PM by Terry Karney

Two yummy, restorative soups that are easy to make are:

Okayu (Japanese) which is basically overcooked rice, cooked in a broth made from bonito flakes (maybe 1-2 teaspoons of it/serving), and a bit of soy sauce for taste. It's highly digestible and yummy. I used to make it for my first husband when he felt sick.

Avgolemono-Cook rice until it's nice and mushy in chicken broth, take off the heat add equal parts egg yolk and milk to thicken (1 egg yolk/serving). You will want to put the mixture back on the heat, and heat it a while without boiling to kill any stray bacteria in the egg yolk. Then add lemon juice to taste, and eat.

Of the two the Okayu is probably best if the patient is weak. You'll want to start with lots of broth and relatively little rice at first, until they're strong and hydrated enough to handle more rice.

Posted January 12, 2006 1:40 PM by Amy Thomson

Re: Popcorn. The sugar and salt and carbos are great, but make sure you keep the fluids up. Drink lots and lots of water.

Posted January 12, 2006 1:42 PM by James D. Macdonald

I think that was "not JUST Flintstones."

As in, you have your choice of Hannah-Barbara character you can chomp on.

But not Harvey Birdman, damnit.

Posted January 12, 2006 1:48 PM by Stefan Jones

I currently have a bad cold (not the flu, I hope*). I have been drinking water constantly - just added one tsp. of salt and 3 tbl. sugar to my water bottle and I have to say it tastes really good right now.

This morning, I had an almost-empty bottle of blueberry juice - filled that up with water and it tasted pretty good too. I mention that because according to the label, 240ml of blueberry juice contains 35 mg of sodium. Not sure how that compares to the sugar-salt mixture, but it seems interesting.

*My test for "is it the flu?" is that flu gives me the sensation of shooting pains in the marrow of my bones, different from cold-like feverish aches and pains.

Posted January 12, 2006 2:25 PM by Laura Roberts

If the iron in muti vitamins is a problem, Nature Made makes a chewable muli vitamin with no iron. It tastes like the kids orange chewables too!

After half a bottle of the Centrum chewables I was getting queasy just looking at them, and that was when I was perfectly healthy.

Posted January 12, 2006 2:58 PM by Cindy L

I've never had the flu but I'm highly prone to sinus infections and suffer from nearly-chronic congestion. My brother and my son are the same way, as was my husband. A fellow I work with says his wife is the same way--never had the flu, frequent sinus infections. He claims it's related to the immune system; you either get one or the other. Have any of you ever heard of this?

Posted January 12, 2006 7:51 PM by mary

New Scientist advice: consider a pneumococcus vaccination (protects for five years, pneumococcus causes pneumonia when it infects flu damaged lungs), and "You could also stock up on antibiotics for treating other kinds of bacterial pneumonia. Half the victims of 1918 died of such secondary infections. Ask your doctor which antibiotics work against the most common infections in your area".

Posted January 13, 2006 4:41 AM by Alan Braggins

I first had pneumovax about 18 years ago. Back then, they thought one was all you needed, but I've had two more since because they figured out they only lasted five years. The really weird thing is that just about any other kind of injection is free from Kaiser, but I have to pay for pneumovax.

Posted January 13, 2006 7:21 PM by Marilee

My plans for surviving avian flu are not to get it. If a pandemic happens, I have a bug out location in mind -- a remote mountain cabin.

Though for what it's worth, it sounds like the fatality rate isn't nearly as high as initially reported -- also, it IS easily caught from poultry by people. Because it infects the lower reaches of human lungs, we don't transmit it from person to person easily. It's not infecting the upper respiratory tract, therefore, we don't hack the virus up and infect each other easily. If it mutates to infect the human sinuses, we're in trouble. Also -- apparently MANY people in areas with H5N1 have antiobodies; there's also some fairly compelling evidence that H5N1 readily infects human who are exposed to it by bird feces but only causes regular-to-severe flu symptoms, enough to cause lost work, not enough to kill, in most people. It may be we're looking at something on par with the Spanish Flu, which would be bad enough, and not something like Stephen King's "the Stand", which would be catastrophic and civilization ending.

As far as food goes, I do the "first in -- first out" thing too, with mostly bulk foods. My stock includes (or should include, I'm running low at the moment):

Pinto beans -- note, at my bug-out place, I have access to unlimited wood for cooking them. If you don't have a way to cook them without gas/electric (they need 24 hours cooking) substitute some other source of protein that's easier to cook.

Flour, water, lard, yeast, for basic bread. (keep a bottle of yeast in fridge, replace every few months -- make sourdough starter in emergency, so you don't need to stock much, as it DOES go bad)

Flour can be frozen to kill the buggies (it's generally pre-infested with weevil eggs when you buy it.) Then seal it airtight.

Cooking oil

SPICES, which can solve a multitude of food evils.

Dried fruit, nuts, chocolate, etc.

Dried noodles.

Canned tomato sauce.

Canned meats & fish (tuna, salmon, etc)

High-calorie canned soups & stews -- cream-of whatever, dinty moore, etc.

Rice.

Condiments -- ketchup, mustard, mayo, etc. Small bottles or fast-food packets. Canned chilis.

Yummy stuff that makes life better ... pickles, pickled peppers, canned fruit, etc. All the stuff that you don't NEED, but sure tastes dang good, and which I eat anyway and might as well add an extra can to the store ....

If you're living out in the country and plan to supplement your food with hunting, raising livestock, or gardening, also make sure you've got a way to preserve food. And a stockpile of salt might not be a bad idea.

As far as shelf life goes on canned goods -- most canned food has a half life roughly equivalent to plutonium. They put expiration dates on commercially canned foot to keep the insurance companies and the gubmint happy, but realistically, a can of soup isn't going to go bad unless the seal's broken. It may taste funny. I wouldn't want to test it unless I had to, but I would (with only a few qualms) eat that ten year old can of soup from the back of the pantry if that was all that was left ...

Leva

Posted January 14, 2006 4:44 PM by Cygnet

Useful stocking technique: we keep a black wax pencil handy in the kitchen, and put a checkmark on the lid (of spices, ketchup, vitamins, whatever) to indicate "There is already another of this On Deck. Do not keep buying." (Experience born of having five containers of ground coriander.) It's simple enough to track down the existing peanut-butter jar and "check it off" when you put the newly purchased jar on the shelf.

I haven't figured how to make this work for something of which one WANTS multiples, like canned chicken broth.

Kathryn from Sunnyvale: I REALLY like your idea of clearing the decks for fresher food by donating the existing emergency supply to food banks. Win-win.

Posted January 14, 2006 9:56 PM by Kate Yule

I put grease pencil dates on the tops of my cans o'stuff, as sometimes the stuff in back doesn't get shifted to the front when the next batch of new stuff gets added. It answers the question "good lord, how long has this stuff been in here?"

Posted January 15, 2006 1:35 AM by Lin Daniel

Lin - I have some old "Ann Page" spice tins from A&P, with some presumably dead vegetable matter inside. No longer food, just collectors items. To me. And probably to nobody else. They'd have to date from when I was little and the local A&P closed forever. Probably around 1972 or so.

Until I became more serious about tending my pantry, I'd sometimes find things like Waldbaum's pineapple spears (one of the few stores where that form factor could be found) that were three label designs old. When the new packaging is totally different from the old, it's time to dump or rotate.

FWIW, this doesn't happen to me anymore, since rotation and shallow safety stocks have become a religion. (Moving too much does that.)

Posted January 15, 2006 2:59 AM by Larry Brennan

buy tamiflu

Posted January 19, 2006 6:25 AM by Flu_Cures

'Spose that was inevitable.

Posted January 19, 2006 6:32 AM by John M. Ford notes viral marketing

I was about one second away from pressing the button on that "buy tamiflu" post when I went to look at it, and discovered that it's an actual site with real information. The only mention of tamiflu is a warning from Health Canada not to buy tamiflu on the 'net.

Whoever posted that link should work on their presentation.

Posted January 19, 2006 11:22 AM by James D. Macdonald

Saw a brief bit on the local news this morning RE the fact that one of the main ingredients in tamiflu is an acid derived from star anise.

Alternative source: Pine needles!

Posted January 19, 2006 12:47 PM by Stefan Jones

You mean Euell Gibbons was right aout eating pine trees?

Posted January 19, 2006 5:04 PM by Janet Croft

See also:

http://www.pandemicflu.gov/

Posted March 22, 2006 3:39 PM by James D. Macdonald

Hi

Thanks for your interesting explanations of the flu, i am happy you mention dehydration and you sites, i will study them carefully.

Thanks

http://www.pandemic.nu

Posted June 20, 2006 5:02 PM by Pater

Here's the flu pre-pack inventory list from the LiveJournal linked to above.

What you want to have in your flu kit are ample supplies, for each person in your household, of
1. pain and fever reducer of your choice -- ibuprofen is generally well-tolerated, while aspirin is more likely to cause stomach upset
2. decongestant (pseudoephedrine-based)
3. antihistamine (like Bendadryl -- in case you get some whacked-out allergic reaction while your immune system is in a tizzy)
4. cough suppressant
5. cough expectorant
6. long-keeping juices, clear soups/consommes
7. easily-digestible, easily-prepared, long-keeping staple foods (you'd be surprised how good Cream of Rice can taste)
8. bottled water
9. a basic clean-up kit for infectious spills/vomit, etc.: bleach, a few sponges, some small plastic bin liners, a roll or two of paper towels, and a small bucket (in fact, everything may fit inside the bucket, how convenient!)
10. plain old table salt (to mix with water to help keep your electrolytes up)
11. plain old table sugar (see above)
12. vitamin C in some readily-available form -- a jar of chewable vitamins is fine (see above)
13. some extra boxes of tissues
14. some extra rolls of toilet paper / l00 paper / bog roll
15. a thermometer that you know how to use and read -- one that you can't is not going to be so useful to you. (Wee digital thermometers are easy to find, btw., and no mercury and glass waiting to break and so on.)
16. a ballpoint pen and a small notebook, for keeping track of vital signs and symptoms in case you need the reference
17. backup/reserve supplies of any medications you take on a regular basis, on the theory that you may be too ill to get to a pharmacy to get a refill when you need one; a great many disaster preparedness folks generally recommend that people keep a one-month backup supply of meds around anyway Just In Case
18. stomach-settlers of your choice: if you like Rolaids or Pepto-Bismol, great, but you might also think about things like dried peppermint (peppermint tea), candied or dried ginger, and dried catnip (catnip tea)
19. rubbing alcohol and gauze pads or cotton balls/cotton wool -- can be useful in reducing fevers
20. a copy of the Merck Manual of Medical Information (Home Edition) -- one of the single most useful books any household can own, can help you know the difference between, say, "just a cough" and pneumonia
21. a copy of Where There Is No Doctor: A Village Health Care Handbook -- an unbelievably useful basic diagnosis, treatment, and prevention handbook for common health care issues

I put it here because -- well, no on-line site is forever. Please, go read the original post -- there's much other goodness and more advice and discussion there.

Posted December 28, 2006 11:53 AM by James D. Macdonald

From The top ten underreported news stories of 2006

9. What’s Worse Than Bird Flu? The Cure: There were no confirmed deaths in developed countries from bird flu; but the alarm, fueled by Western media reports, did real damage. A rash of abnormal behavior, hallucinations, and even deaths was attributed to Tamiflu, the medicine marketed as a key drug capable of fighting the disease. Ten Canadians taking the drug died suspiciously. The FDA received more than 100 reports of injury and delirium among Tamiflu takers, nearly as many cases as were logged over the drug’s five-year trial period.

Oh -- and the number one non-pharmacological way to lower deaths during a pandemic flu? Close the schools. If there's a flu pandemic and the local schools aren't closed, keep your kids home anyway.

Posted December 28, 2006 12:17 PM by James D. Macdonald

There is an especially nasty flu going around Israel (January to the present - 2007). A 12-year old girl came down sick with the flu, and ONE HOUR later, she had pneumonia!

I came down with this same flu in early January, and I was out of work for 6 weeks. Bear in mind that I never took more than 2 weeks off work in the past. This super flu is extremely prolific, and produces so much phlegm so fast, you nearly drown in your own body fluids. I thought I was past getting the flu, as I hadn't gotten one for three years prior to January, 2007. I am also quite knowledgeable about handling flus in the past, as I used the amino acids L-glutamine, L-lysine, and L-cysteine, along with selenium, vitamin C (1 mg) and elderberry. For extra protection, I used 10 ppm colloidal silver as a nose spray. Incidentally, to get the condition where your skin turns grey, you must use at least 100 ppm or greater concentrations for long periods of time. Nevertheless, the 10 ppm colloidal silver was unsuccessful in clearing my sinuses for this very different super flu. It bears a close resemblence to H5N1, or even the 1918 flu, in that it rapidly attacks the respiratory system, and your body responds with an over-abundance of cykotines. I never saw so much mucous in my life - and it nearly killed my wife. Some of the mucous would not come up, even with expectorants, as it was quite hard. Robotussin expectorant did a fair job in helping the situation when all natural alternatives, such as licorice, failed.

The reason I am still able to post, and still have a living wife, is because she brain-stormed and came up with two novel solutions to our deadly dilemna. The first novel solution was to use ozonated water as a nose spray. This was a fantastic breakthrough - it actually cleared out all mucous. The drawback is that one needs to continually apply it once per hour. With the ozonated nose spray, the flu was completely held in check - sort of a stalemate. What we need was to checkmate this thing, and that's when my wife came up with the idea of trying fresh aloe vera gel - straight from the plant. This slimy gel was up to the task - and met the slimy mucuous problem head-on, enabling us to get a good night's sleep, plus a little brandy for good measure (the alcoholic drink helped dry up some of the mucuous as well). I am now 100%, and my wife is now 80% better. I hope someone else can benefit from our near brush with death.

Posted March 5, 2007 12:53 PM by Yochanan, Israel