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July 17, 2007

Index to Medical Posts
Posted by Jim Macdonald at 02:12 PM *

Emergency Medicine entries I’ve posted so far:

Emergency Preparedness:

Related interest:

Some of Teresa’s emergency posts:

Abi’s emergency posts

Copyright © 2007-2009 by James D. Macdonald

I am not a physician. I can neither diagnose nor prescribe. These posts are presented for entertainment purposes only. Nothing here is meant to be advice for your particular condition or situation.

Creative Commons License
Index to Medical Posts by James D. Macdonald is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 License.

(Attribution URL:

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Comments on Index to Medical Posts:
#1 ::: Madeleine Robins ::: (view all by) ::: July 17, 2007, 02:42 PM:

Jim--question. Just re-read your Heart Attack post, and noted the instruction to chew four baby aspirin. What is that equivalent to in standard aspirin, just in case that's all you have to hand?

#2 ::: James D. Macdonald ::: (view all by) ::: July 17, 2007, 02:54 PM:

Four baby aspirin (81 mg each, 324 mg total) is the equivalent to one standard aspirin (325 mg).

The difference is that the baby aspirin are flavored (orange or cherry, usually) and so are a trifle less yucky.

If it happens that you get "Funny Tummy" from taking an aspirin a day, you can get "enteric coated" 81 mg aspirin which have a coating that keeps 'em from dissolving in the stomach.

Naturally, you don't want to have those as your chewing aspirin.

#3 ::: Jeff Orth ::: (view all by) ::: July 17, 2007, 03:17 PM:


I work in medium sized lab and I am involved in the Safety, Chemical hygiene end of things. I would like permission to pass this on to the Committee members here and a nudge towards corporate.

Text books fine, but, this is much more likely to stick.



#4 ::: Josh Jasper ::: (view all by) ::: July 17, 2007, 03:24 PM:

I keep waiting for the "In case of Zombie Apocalypse" entry...

#5 ::: Betsey Langan ::: (view all by) ::: July 17, 2007, 03:33 PM:

Jim, thank you for posting this. I was just thinking I'd like an index of your medical posts.

#6 ::: Jen Roth ::: (view all by) ::: July 17, 2007, 03:34 PM:

Is this entry going to be updated with links to future posts, so that one might bookmark it as an index?

#7 ::: David Moles ::: (view all by) ::: July 17, 2007, 03:35 PM:

How about a heroin overdose? I need to write a fatal heroin overdose scene.

#8 ::: James D. Macdonald ::: (view all by) ::: July 17, 2007, 03:36 PM:

JeffO -- go for it. Permission granted. Just keep my name on 'em and remember the copyright notice. A link back is always appropriate.

Before going much further: I am not a physician. I can neither diagnose nor prescribe. These posts are presented for entertainment purposes only. Nothing here is meant to be advice for your particular condition or situation.

#9 ::: linnen ::: (view all by) ::: July 17, 2007, 03:45 PM:

Very interesting reads, these articles.

A quick note, if I might. An addendum to your 'Flu Pre-Pack' should be considered with respect to medication. (I read your diabetes article yesterday. Doesn't insulin require refrigeration?)

I would do a write up myself, but am not a doctor and don't have training in this outside of Boys Scouts years back.

#10 ::: James D. Macdonald ::: (view all by) ::: July 17, 2007, 03:46 PM:

Yes, I do intend to update this as time goes on.

For heroin overdose: Whack 'em up with Narcan (naloxone). 2-8 mg, IV, SQ, IM, nasal spray or down the ET tube.

Narcan is an opiate antagonist. Be careful with this, though. Since it turns off the opiates, the person who paid good money for that dose is gonna be pissed at you if you take it away. So just push enough to get 'em breathing again.

(The most common variety of opiate overdose I personally see around here is a little old lady who puts on a Duragesic patch, then, without taking that one off, puts on another, then another ... or the little old ladies who take their OxyContin, forget they took it, and take it again....)

More on that when I do Poison: It's Not Just For Breakfast Any More.

#11 ::: James D. Macdonald ::: (view all by) ::: July 17, 2007, 03:49 PM:

Does insulin need to be refrigerated? Beats heck out of me. Consult your doctor.

As to medication for flu -- I think there was some discussion in the comment thread. Might be best to re-open the conversation there.

#12 ::: Betsey Langan ::: (view all by) ::: July 17, 2007, 04:08 PM:

The feature I wanted, when I was looking for the posts now indexed here, is a way to search for posts (not comments) by a particular poster. (The old ML search, where you could use ticky-boxen to search one or more of [ML, Sidelights, Particles, Comments] could do this, by searching ML posts only. The new Google one doesn't.)

If this can be added a) without too much trouble and b) without breaking stuff (as I have no wish to re-inflict this weekend's deprivation), it would be lovely.

#13 ::: Matt ::: (view all by) ::: July 17, 2007, 04:24 PM:

RE: #4

I believe first you'd want to set up a zombie triage:

Category 1: People not likely to become a zombie
Category 2: People who will become a zombie, unless you do the right thing, right now.
Category 3: People who will become a zombie no matter what you do.

Example of a catergory 3: You ask the patient his name and he responds, "BRaaaaaaaaains." Definetly a red tag there.

#14 ::: Todd Larason ::: (view all by) ::: July 17, 2007, 04:46 PM:

My understanding is that insulin needs to be refrigerated for long-term storage, but in the short term (a few days to a week or so) just needs to be kept 'cool'. I'm not a doctor either, though, just a guy with a diabetic cat.

#15 ::: ethan ::: (view all by) ::: July 17, 2007, 04:48 PM:

Hooray! Thanks for this, Jim!

Matt #13: Unfortunately, most experts agree that, once bitten by a zombie, you will become one eventually, one way or another. Some accounts differ (the 30th anniversary "improved" version of Night of the Living Dead, for example, includes a zombie-bite survivor), but they're unreliable at best, and probably outright lies. So really your categories should be:

Category 1: The uninjured.
Category 2: Those about to be zombies.
Category 3: Those who are actually trying to eat the flesh of the living right now.

#16 ::: Greg London ::: (view all by) ::: July 17, 2007, 04:50 PM:

Jim@8: Permission granted. Just keep my name on 'em and remember the copyright notice. A link back is always appropriate.

Jim, if you were so inclined, you could select a Creative Commons license here that would make the licensing show up on google searches. (i.e. someone could search for CC licensed first aid info and should be able to find your post)

The most restrictive version would be Attribution, NonCommercial, NoDerivatives, as described here.

The license requires that all copyright notices remain in place, and Attribution requires the author's name and the title of the work to be listed. Attribution can also require a URL be part of the attribution if the URL points to the license info for the work, which you do by marking the post with the CC license.

Not a guarantee to cause a surge in the number of hits, but if you're going to allow certain uses, wouldn't hurt anything.

#17 ::: Mez ::: (view all by) ::: July 17, 2007, 04:53 PM:

New! The approved Official Sydney City go-bag.

#18 ::: Matt ::: (view all by) ::: July 17, 2007, 05:09 PM:

ethan #13:

You raise a good point. In case of a #2, or a #3, the precedure ought be the same though, and it can be remembered by the acronym:

A, a shotgun.
B, barricade.
C, constant firepower.

#19 ::: Teresa Nielsen Hayden ::: (view all by) ::: July 17, 2007, 05:26 PM:

Jim, you should link to your own jump bag posts from the main post.

#20 ::: Zack Weinberg ::: (view all by) ::: July 17, 2007, 06:55 PM:

I had a Type I diabetic housemate for two years; he kept his currently active bottles of insulin in the refrigerator, or an insulated bag with a pack of Blue Ice, at all times. There was an additional several weeks' supply in the freezer.

I understand from him that there are a whole bunch of different formulations of insulin, some of them more heat-tolerant than others; also that it matters more if you're doing aggressive management (lots of small tailored doses, to try to keep the blood sugar level as even as possible).

#21 ::: Dolloch ::: (view all by) ::: July 17, 2007, 08:05 PM:


Thank you so much, this is excellent info! At our theatre yesterday, we had one case of shock and another of heat exhaustion. I was wondering if I could quote you liberally and put this advice into our theatre handbook?

#22 ::: Torie ::: (view all by) ::: July 17, 2007, 08:44 PM:

Re: insulin

Yes, it needs to be refrigerated. Type I diabetes usually has two kinds of insulin: fast-acting insulin, the kind you take before meals/throughout the day; and slow-release insulin, for overnight.

The slow-release one has to be kept in the freezer and is injected with a normal syringe and the fast-acting one should be refrigerated, especially if you don't plan on using it for several days, and nowadays is more commonly injected with a metered pen. You can of course take the fast-acting stuff with you throughout the day and it will be fine for quite a while.

(My roommate was diabetic and had to give us all the what-to-do-if-I'm-in-a-coma speech.)

#23 ::: James D. Macdonald ::: (view all by) ::: July 17, 2007, 10:40 PM:

#21: At our theatre yesterday, we had one case of shock and another of heat exhaustion.

My golly! What was going on at your theatre? Permission granted to quote liberally (with credit and a link back).

#19: Jim, you should link to your own jump bag posts from the main post.

I'm thinking of doing a post which is just my first aid bag, with an explanation of what everything is and why it's there.

#16: Creative Commons license

Like the little do-funny that's currently on this entry, above?

I do want people to be able to use the information to create their own works. (I certainly don't want to claim that I'm the one who invented Class I Shock, and folks will write their own articles, or use excerpts and such.) Thus I selected the "Share Alike." If I'm wrong in this, let me know. If I'm right, I'll put similar do-funnies on all the other first-aid articles of mine.

How will this show up for "first aid" though? I don't always use that phrase. Is there some master index somewhere?

#24 ::: Zeke ::: (view all by) ::: July 17, 2007, 11:06 PM:

Jim, thanks for all of these posts.

I'm thinking of doing a post which is just my first aid bag, with an explanation of what everything is and why it's there.

I hope you do write a post of this sort; I'd be very interested in reading it.

#25 ::: Greg London ::: (view all by) ::: July 17, 2007, 11:08 PM:

Jim@23:I do want people to be able to use the information to create their own works. ... Thus I selected the "Share Alike." If I'm wrong in this, let me know.

You are correct. ShareAlike is the one to use to allow others to make derivatives and have all those derivatives are also under a ShareAlike license, with attribution going all the way back to here.

If I'm right, I'll put similar do-funnies on all the other first-aid articles of mine.

Yeah, you'd need to apply it to the individual articles/works, probably with each URL pointing to that specific work.

How will this show up for "first aid" though? I don't always use that phrase. Is there some master index somewhere?

Er, well, that was an example. There used to be a master index where you could list your CC works, but after the search engines added the ability to look for specific CC licenses, a master index became redundant, and was usually out of date.

#26 ::: Greg London ::: (view all by) ::: July 17, 2007, 11:20 PM:

also, to cover all bases, if you want URL attribution, you might want to add it explicitely, as well as embedding it in the link underneath your name. i.e.

Index to Medical Posts by James D. Macdonald is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 License.
(Attribution URL:

That's if you want to be absolutely clear that you want other people to point back to the original here. Having it as a link under your name is legally sufficient, but explicitely listing it removes any misunderstandings.

#27 ::: Greg London ::: (view all by) ::: July 17, 2007, 11:21 PM:

ianal, tinla, yada, yada....

#28 ::: Rachel Brown ::: (view all by) ::: July 18, 2007, 02:36 AM:

Thank you very much!

#29 ::: Dolloch ::: (view all by) ::: July 18, 2007, 01:34 PM:


Thank you very much! Done and done.

#23 - Tech week is the short answer. Our booth op/stage manager/sound designer/doing-too-much-for-one-person person has been stubbornly refusing all offers of water even though the booth is much hotter than the rest of the theatre despite the fans. After feeling ill and headachy, she's hopefully cured of that.

The shock was an actress who thought it'd be a good idea to move around in black out with her eyes closed (because, hey, what's the difference) and stumbled off the stage. She banged her knee (slight abrasion of the boo-boo variety) and seemed okay, but then got dizzy, nauseous, and passed out.

The EMTs think she hit some sort of nerve there which freaked out the rest of the system. They came, checked her out, then left declaring her okay. IMHO, she seemed to respond well to built men in tight uniforms. She's a naturally rail-thin person who's been working hard, so maybe blood sugar was a factor?

#30 ::: Caroline ::: (view all by) ::: July 18, 2007, 02:40 PM:

Dolloch -- oh, tech week.

I haven't done tech theater since high school...I miss it. I overcome this feeling by putting things together in the lab (and with my current plan to add bookshelves and a window seat to the front room of my house).

This has been a completely off-topic moment of nostalgia. (It should also be noted that in high school, we had the benefit of lots of people, so no one had to be totally overworked, and an air-conditioned theater.)

And I respond well to built men in tight uniforms, too. Yum!

#31 ::: Lila ::: (view all by) ::: July 18, 2007, 03:24 PM:

Teresa's Weird Nursing Tales link (not the one on this page, the one on the page it leads to) appears to have been taken over by a bunch of ads. Excuse me, "sponsored results".

#32 ::: Dolloch ::: (view all by) ::: July 18, 2007, 06:44 PM:

#30 Caroline,


That seemed to be the consensus amongst the male-liking part of the cast! It being a... sexually orientated play helped along too.

#33 ::: Meg Thornton ::: (view all by) ::: July 18, 2007, 08:05 PM:

Just letting folks know I'm linking to the hypothermia post on my LiveJournal (things are getting a tad brisk over in the Eastern states of Australia, and I figure any information about how to cope with the cold will help).

Thanks very much to Jim for putting all of these posts in a single index.

#34 ::: A.J. Luxton ::: (view all by) ::: July 18, 2007, 10:37 PM:

These posts all make me want to become an EMT.

#35 ::: P J Evans ::: (view all by) ::: July 18, 2007, 10:44 PM:

Dolloch @ 29

Knees and shoulder blades both have a location very much like the 'funny bone' in the elbow. Harder to hit, but not impossible. I got a shoulder one, once; ISTR it's almost under the bottom point of the shoulder blade - I was leaning on a chain-link wall and 'caught' it when I straightened up. The one in the knee is kind of under the kneecap, so banging it hard might be enough.

#36 ::: Mat Herford ::: (view all by) ::: July 19, 2007, 01:32 AM:

I just want to say thank you, Mr. Macdonald, for the your Health related posts. I'm hesitant to call them "medicinal" posts, or any variation thereof, because you spread personal experience throughout the postings. I appreciate that, and the posts overall, a great deal.

Again, thank you very much.

#37 ::: Lila ::: (view all by) ::: July 19, 2007, 08:53 AM:

The EMT simulator is a lot of fun, especially if you have no idea what the hell you're doing. My best feat so far is to set the patient and 2 bystanders on fire.

#38 ::: Greg London ::: (view all by) ::: July 19, 2007, 10:47 AM:

Really dumb question.
What's a good substitute for a wool blanket?

#39 ::: Lori Coulson ::: (view all by) ::: July 19, 2007, 11:20 AM:

Greg London @38:

If you're not allergic to down, a down comforter will work in place of a wool blanket.

Hypoallergenic alternative is a polar fleece blanket. They're also lighter than the comforter in cases where weight is an issue. (And less expensive too.)

#40 ::: Greg London ::: (view all by) ::: July 19, 2007, 11:53 AM:

Lori, from Jim's "go bag" list:

Wool is light, fire-resistant, and maintains its insulating properties when wet.

I thought down was useless once it got wet, and doesn't most of the synthetic fleeces melt when exposed to fire? Or is polar fleece something else?

#41 ::: Adrian ::: (view all by) ::: July 19, 2007, 12:12 PM:

Wool is warm, even when wet. Polar fleece is light and warm, even when wet. I think it's a good substitute for a wool blanket in a car kit, for someone who is allergic to wool (or can't afford it.) You just need to remember it's NOT fire-resistant, and not go dashing through flames when wrapped in it. Then again, it's not a great idea to go dashing through flames even when wrapped in a wool blanket. A person can usually avoid fire, if they're enough in control of the situation to be getting their emergency kit out of the trunk. It's much harder to avoid getting wet, and wet cotton is worse than useless.

#42 ::: Teresa Nielsen Hayden ::: (view all by) ::: July 19, 2007, 12:16 PM:

Lila (37): Dang! I never managed to do that. Which scenario was it?

Greg (38): There is no substitute for a wool blanket, except possibly a blanket that's a mixture of wool plus (pick one) alpaca, cashmere, guanaco, mohair, angora, camel, vicuña, qiviut, or llama.

#43 ::: Dolloch ::: (view all by) ::: July 19, 2007, 12:44 PM:

#35 PJ,

Judging by the wound location, I bet that's it exactly. Right on the kneecap. Would that be the same as a peroneal strike?

#44 ::: Greg London ::: (view all by) ::: July 19, 2007, 12:47 PM:

There is no substitute for a wool blanket

Some items made from wool make me break out all bright red, even some wool blends.

I did happen to find a nomex blanket, but at $60 a pop, it is a bit steep.

Oh well. looks like fleece and a frankensteinian fear of fire for me.

#45 ::: A.J. Luxton ::: (view all by) ::: July 19, 2007, 12:59 PM:


Book ad for Nefertiti in the body of comment immediately upthread: intentional?

#46 ::: Xopher ::: (view all by) ::: July 19, 2007, 01:02 PM:

Down is useless when wet. There's this thing that used to be called something like HollowFill; I have a sleeping bag filled with it. It's puffy like down, compresses as well or better, and (I'm told) is still warm when wet.

Same person who told me that said "The best you can say for a wet down sleeping bag is that it's not dramatically worse than being naked."

#47 ::: Lizzy L ::: (view all by) ::: July 19, 2007, 01:27 PM:

Regarding aspirin: About 3 years ago I suddenly developed an allergy to ibuprofen. Up to that moment I had been taking it regularly. Now, if I take even one ibuprofen, my throat closes. I can still breathe but I cannot eat, and drinking is difficult. Scary. Since people who are allergic to ibuprofen often get the same reaction to naprosyn (Aleve) and aspirin, I can't take those, either. For pain meds I take Tylenol -- and if I need an anti-inflammatory I'm out of luck, unless I want to go straight to cortisone.

When I had a heart attack back in 2006, they put me on Plavix. I tolerate it and it works, though it's expensive and it leaves me spotted with bruises. (It was generic for a while and now it's non-generic. It will be non-generic until 2011. How expensive? If I were not a Kaiser patient with drug coverage, a three month supply would cost me $315, for a drug my doctor tells me I will take for the rest of my life. I hate Big Pharma.) So my warning is -- if you are allergic to aspirin, or might be allergic to aspirin, perhaps you shouldn't take it. There are some alternatives.

#48 ::: TChem ::: (view all by) ::: July 19, 2007, 02:14 PM:

Greg@44: If you've got room, maybe have a fleece one (better when wet) and a cotton one (better with fire), so you can choose depending on the circumstances? Or, as TNH says, other animal fibers are a possibility, though pretty expensive if it's something that will be sitting in your trunk.

#49 ::: Harry Connolly ::: (view all by) ::: July 19, 2007, 02:25 PM:

Thank you for this.

#50 ::: Lila ::: (view all by) ::: July 19, 2007, 02:56 PM:

Teresa @ #42: I don't remember the scenario number, but it involved flammable liquid and an AED. (Rumor has it that topical nitroglycerin cream can be fun too, but I've had trouble confirming that.)

#43 dolloch, no--a peroneal strike is on the side of the knee (the side facing away from the other leg). The common peroneal nerve runs between surface and bone there. Same nerve, same location can be a problem if you break your leg and they put the cast on too tight.

#46 Xopher (and anyone trying to do a web search), it's spelled 'Hollofil' (registered trademark).

Army surplus stores and thrift stores are potential sources of cheap (though ugly and scratchy) wool blankets.

#51 ::: Lexica ::: (view all by) ::: July 19, 2007, 03:06 PM:

My experience with buying wool blankets from army surplus stores is that different countries use wool of differing quality. We have a couple of Swedish blankets that are fairly non-scratchy, but IIRC all the US-surplus blankets we felt were awful.

#52 ::: TexAnne ::: (view all by) ::: July 19, 2007, 03:48 PM:

Scratchy wool may sometimes be improved by a trip through the washing machine, in cold water with Orvus horse soap (or quilt soap--same stuff, but cheaper in horse-sized quantities). Don't put it in the dryer if you don't want felt.

#53 ::: Charlie Stross ::: (view all by) ::: July 19, 2007, 09:27 PM:

Speaking of these medical posts Jim .... good job.

It's currently 2am in Edinburgh. As of 1am, I'd needed to dial the emergency services twice in my whole life. As of now, the number is four times.

Feorag and I headed out for a drink at a pub in Edinburgh this evening around 10pm. Three pints later, at closing time, we (and a couple of friends) headed for a different bar, with food service -- to find it was closed. So we decided to walk home. On our way, at about 1:10am we spotted a road junction with something odd in the road, and a car stopped in front of it with hazard warning lights flashing.

So we went up to see what was going on.

There's a guy lying in the road. This car didn't hit him, and the driver is trying to help -- but someone else had hit him. His mouth's bloody and he's missing some teeth and he's trying to speak, but incoherent. A friend who was walking with us spotted him a few minutes earlier, staggering around drunkenly and wandering into the road. It's not that unusual in Scotland (people get drunk: idiots get so drunk they end up as traffic hazards) but the point is, he looks to have been hit by a car that didn't stop, and he's a bit angry and very wobbly.

Now here's the fun bit. I immediately pulled out my phone to dial 999 -- the UK emergency number -- because that's what you're meant to do if you think someone's been hit by a car. The bit that's off the cognitive map is what you do next, unless you've practiced it. Especially if you, yourself, are drunk (not legless, but drunk enough you wouldn't be driving). First mistake I made: having difficulty hearing where the earpiece on my phone was. Second mistake: asking for "police and ambulance" when asked which service I needed. Third and real mistake: getting distracted. The victim was up, walking, and remonstrating with Feorag. At that point, my brain went "sproing" and I said, "sorry, the guy's on his feet, don't need you", or words to that effect, and hung up.

A couple of minutes of trying to get sense out of him convinces me of the error of my ways. He's talking, but he's not lucid and can't remember where "home" is, or point to a direction. A couple of times he walks into a pavement bollard, so my friends get him to sit down. And then he wants to lie down. At this point my alarm bells begin going off again, and I'm calmed down -- the situation is normalized -- so I dial 999 again. "Ambulance, Edinburgh, corner of XXX and YYY, male, age 20 to 30, has been struck by a car." I wait on the line and answer questions (no major bleeding but bleeding around mouth and has lost teeth; conscious, breathing, talking but incoherent and appears drunk) and stay on the line. He's lying down on his back but still breathing. By now he's unconscious. When the dispatcher says "help is on its way, call back if you need help or advice" I hang up and go roll him over into recovery position so he doesn't aspirate, then realize he's wearing a t-shirt and it's 1am and there's a wind blowing so I stick my jacket over him.

While we're waiting for help, a taxi driver pulls up and asks if everything's okay. We tell him we've called an ambulance, and he says he saw the guy fighting earlier. (Big surprise.) We thank him and he heads off.

Five minutes later a paramedic arrives on scene and takes over. We answer questions, ask if he needs anything else, then reclaim my coat and head for home.

The point of this?

I screwed up, the first time round. Luckily he wasn't spouting from a femoral artery or aspirating his vomit, and I got a second chance to get things right. I'm assuming that what he looked like was what he was -- your typical Thursday evening Edinburgh drunken ned -- in which case, he's probably sleeping it off in A&E by now. (I'm just hoping he didn't have a cerebral haemorrhage while I was pissing around trying to remember what to say on the phone.)

Remember: practice makes perfect.

(And thanks for the refresher course!)

#54 ::: Charlie Stross ::: (view all by) ::: July 19, 2007, 10:01 PM:

Update (from the friend who stayed behind to watch the whole circus unfold): our drunken first aid victim was finally taken away in an ambulance, protesting incoherently, with no less than three police cars in attendance (not helping or anything, just watching the show).

Cars don't tend to hit people in the mouth and knock their front teeth out while leaving the rest of their faces intact. I suspect the taxi driver was telling the truth ...

#55 ::: Faren Miller ::: (view all by) ::: July 20, 2007, 10:58 AM:

Lizzie (#47): Sorry to hear about your med problems (I've got a couple of take-for-life prescriptions myself, and from what others have said in various threads it sounds like a lot of the "Making Light" regulars are only hanging on via the [mostly expensive] wonders of modern medicine.)

A year ago I developed a terrible case of hives that lasted all summer. The original trigger might have been some kind of pollen allergy, but I'm sure my regular use of ibuprophen made it worse. I went off the stuff and haven't gone back, too paranoid to return; for a while, aspirin seemed to make things worse as well (along with mint tea), but now that the hives are gone I can tolerate both of those just fine -- luckily, since Tylenol doesn't help much with sinus headaches.

The only allergy I have to report to each new doctor is to penicillin, but I must say that even the mention of wool makes my skin want to break out!

#56 ::: James D. Macdonald ::: (view all by) ::: July 20, 2007, 04:55 PM:

You can set the bystanders on fire in this scenario, but you can also burn yourself down in this one.

#57 ::: DavidS ::: (view all by) ::: July 22, 2007, 12:17 AM:

Hey, I'm posting in order to decompress.

About an hour ago, my wife Lark and I were driving home when we passed a man leaning up against a telephone pole and just looking -- wrong somehow. By time I'd processed what I'd seen, I was already a block from home so Lark and I decided to park at home and walk back the few blocks to see if something was wrong. When we got there we found a man in his mid seventies with short cut hair, dressed in a white T-shirt and grey sweatpants and carrying a plastic bag with the emblem of the local hospital, about 1/2 a mile away. He was leaning against the pole and breathing a bit heavily.

"Are you alright sir?"
"Can we do anything for you?"
"I'm going to XXXX YYYYY street."
"This is YYYYY street sir, you're about two blocks away from XXXX. Can you walk two blocks, sir?"
"No, I can't."

We offered the man a ride, which he accepted, and walked back to get the car. As he tried to get into the car, the man stumbled, falling like a rigid tree against the side of the car. Once we helped him up though, he was able to stand and get into the car seat OK. He spoke perfectly coherently, if slowly, saying he had just gotten out of the hospital and repeatedly telling us we were really nice people.

It took some driving around looking for street addresses in the dark, but we finally found XXXX. Our passenger spotted it before we were able to make the number out, and it indeed was XXXX. He stumbled again as we got him out of the car, but then walked to the back door under his own power. He seemed at home around the house, relaxing in a way that suggested this was his space.

The gentleman had told us that there would be people waiting for him, but in fact the house was dark and silent, with no cars in the driveway. We pounded on the door, and nobody answered. The man leaned up against a wall of the back porch and looked to be near falling asleep. We asked if there was anyone we could call for him, or if we should bring him back to the hospital, or do anything else, but he told us that he was as well as he could be. He said he was very grateful to us and would be fine; he'd just wait where he was. We were very uncomfortable with this; I wondered whether he was secretly hoping to die on these people's porch and be found in the morning. On the other hand, we had neither the power nor the right to force him to come with us. The temperature was in the eighties and the night was calm, so I thought it was unlikely something would go wrong immediately. We helped the gentleman into a lawn chair and drove off.

We discussed options with each other in the car and decided to call the 911 operator and ask his advice. The operator said he would send a police car by to see if they could offer any better help.

That was the point when I started writing this post, and I was on tenterhooks hoping that the man's condition hadn't worsened while we left him. In the time that it has taken me to type all of this out, we got a call back from the police. The fellow accepted an offer of a ride to a local hotel with which they have an arrangement, and he doesn't seem in any urgent medical danger.

My apologies for the length of this message. Before we got the call back, I needed someplace to dump all this stress and, afterwards, it seemed that I might as well post it

#58 ::: Lizzy L ::: (view all by) ::: July 22, 2007, 12:49 AM:

DavidS, it's really hard to know what and how much you can do for someone in the situation you describe. It sounds like you made compassionate, respectful, and clear decisions. Calling 911 resulted in the gentleman getting attention and shelter for the night. All good.

Faren at 55, thank you for your kind thoughts -- but given the shit that other people have to go through with medication, (getting it, taking it, reacting to it, etc.) I don't have med problems, at least, not at the moment. All of what I wrote at 47 is a mild inconvenience. And while I do hate some of the ways Big Pharma behaves, I am very grateful that the various medications I take exist. Statins, blood thinners, beta blockers -- good stuff.

Tomorrow I'm getting together with a group of friends to talk. We call it a "salon," and we do it about once a month. (Kind of like a blog, except we are all physically present in the same room, with beverages and snacks. You never know, it might catch on...) Tomorrow's topic is Sicko, which I haven't seen but most of the other folks have, and more generally medical care in the U.S., which we've all had ample experience of. I'm thinking of going to the (Democratic) candidates' websites and printing stuff about their health care proposals to bring with me.

#59 ::: Edward Oleander, RN ::: (view all by) ::: July 24, 2007, 06:02 PM:

My apologies to anybody who posted regarding insulin, but much of the information posted so far has been incorrect. Here are some clarifications on insulin:

Do NOT freeze insulin suspensions (any of the cloudy insulins), EVER. In fact, just don't freeze any of it. Insulin that has been frozen may not resuspend correctly which can easily lead to incorrect dosing. Also, the glass vials and pens are NOT designed to withstand freezing and are prone to developing microscopic (non-leaking) cracks, which can admit bacteria and contaminate the insulin.

Refrigerated UNBROACHED glass vials (bottles) and cartridges/pens (3ml size) will last out to and even a little beyond their expiration date.

BROACHED bottles of insulin will be good for 28 days WHETHER OR NOT they are refrigerated. Insulin that goes above 86 deg. Fahrenheit is only good for about 24 hours afterwards.

Broached insulin PENS are good 10-28 days, depending on the flavor of insulin contained. The fast-acting (15 minute) Humalog (or it's Novolog cousin) will last 28 days, while the long-acting flavors last 10-14 days. Read the directions carefully.

This info is the result of being a nurse as well as an insulin-dependent diabetic for the last 12 years. I also teach diabetic basics to my street population. This info can be confirmed at the Eli Lilly website:

Jim, THANK YOU for your ongoing health series... Your index will let me fill in gaps I didn't know existed (from before I joined the board). I have always found your info to be accurate and user-friendly. Since my own writing skills are somewhat (admit it, Ed, there is no "somewhat" about it) lacking, I also ask for permission to use your articles as part of an informal reference library I keep for my street peeps (complete with copyright info, of course)...

Disclaimer: I too am not a doctor, and may neither diagnose nor prescribe. Nothing contained herein is intended to replace or supplant information gained from your doctor. Close cover before striking. Sale is by weight not volume and some settling during shipment may occur. Contents under pressure. No lifeguard on duty.

#60 ::: James D. Macdonald ::: (view all by) ::: July 28, 2007, 06:50 PM:

Edward, permission granted.

My purpose is to make peoples' lives better, not to advance myself. I'm a volunteer--I do all this for love, not money.

Anything I say here is, of course, my own opinion and not the Gospel according to Luke. I'm always eager to learn more. Anything I say could be wrong, it's just the best I know.


Q. Okay, Uncle Jim, what do you carry on your belt every day?

A. I carry a Leatherman multitool, a mini-mag flashlight, a Buck folding Hunter, and a glove case.*

Q. What's a Leatherman?

A. It's named after a guy named "Leatherman" who designed it. The one I carry is the bog-standard version with the file, and the screwdrivers, and the ruler, and so on. Not very expensive. Lots of imitators.

Q. Where can I get one?

A. Your local sporting-goods store, or

Q. How about those Buck knives?

A. Named for a guy named "Buck" who made them.

Q. Isn't the knife in the Leatherman good enough?

A. No.

Q. Do I want a Buck Folding Hunter or a Buck Folding Ranger?

A. Depends on your hand size. Small hands, get the Ranger. Big hands, get the Hunter. To see if your hands are "small" or "big" put the knife blade across your palm from little finger side to first-finger side. The blade that is closest to matching the distance is the blade for you.

Q. Anything else I should know about Buck knives?

A. They used to include a Bible verse with every one. Also, they have a lifetime guarantee. Also, if you play with them enough, you can get 'em to open one-handed as fast, as reliably, and far more legally than a switchblade.

Q. Where can I get one?

A. At your local sporting goods store, or right here:

Q. A Mini-mag flashlight? Why?

A. Because it's hard to do EMS by Braille.

Q. Is a Mini-Mag that good?

A. Yes.

Q. Okay, you convinced me! Where can I get one?

A. At your local sporting goods store, or right here:

Q. Anything else?

A. You can get third-party devices that will allow you to use the Mini-Mag as a headlamp so you can keep both hands free.

Q. A glove case?

A. Yeah. For nitrile exam gloves. But then I do this every day. You may not need it. For the day you're face with an arterial bleed, though (or any of those other neat body-fluid situations), you'll wish you had it.


*Actually, my glove case is part of my radio holster, and has slots for a pair of trauma shears and a flashlight.

#61 ::: Emily H. ::: (view all by) ::: August 10, 2007, 04:13 PM:

Jim Macdonald, I wanted to thank you for these posts.

I was working alone in the library when I saw a guy slumped over a desk. "He's hung over," I thought, "Or really sleepy." First dumb mistake. I went to help someone make a copy and returned to find the guy unconscious on the floor. Started to call 911. Saw the guy start to get up, and nearly hung up on them--but stopped myself and asked, "Do you need help?" He did. And I stayed on the line and tried to keep a cool head as the paramedics came. (Embarrassing thought: "What if my boss comes in while the library is full of paramedics?")

I made a number of mistakes. I should've acted quicker. Should've done what I could to help the guy while someone else called 911. I knew this stuff. But I shudder at how badly I would've done if I hadn't read these posts...

At least the guy is okay.

#62 ::: James D. Macdonald ::: (view all by) ::: June 14, 2009, 05:11 PM:

Have we adjusted the filters?

#63 ::: abi ::: (view all by) ::: June 14, 2009, 05:16 PM:

Yes, to the extent possible. I've blocked the IP addresses, but these ones didn't have any payload I could add to the regex.

#64 ::: Lee sees spam ::: (view all by) ::: January 27, 2011, 01:05 PM:

@ #70

#65 ::: James D. Macdonald ::: (view all by) ::: January 27, 2011, 02:43 PM:

There's no need for comments on this post. Shutting 'em down.

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