Saturday, 22 March 2014

10:19 – It’s to be a nice day today, sunny and with a high around 73F (23C). Alas, the next several days are to be much colder, with highs in the 40’s (~ 5 to 8C), lows near or below freezing, and snow forecast for Tuesday.

Amidst laundry and other normal weekend tasks, Barbara and I will be working on kit stuff today.


11:05 – I’m thinking about what to include in the medical kit, and I’ve decided to include a heat-sealed ziplock bag of oral rehydration salts sufficient to make 20 liters. That may seem an obscure choice, but serious diarrhea can kill in very short order. The contents needed to make up 20 liters are:

sodium chloride – 52 g
dextrose – 270 g
potassium chloride – 30 g
trisodium citrate dihydrate – 58 g
zinc sulfate (150 mg of zinc)

Actually, zinc sulfate isn’t included in the standard ORS formula, but zinc at 10 to 20 mg/day is recommended in conjunction with ORS therapy, so I decided to include it.

20 thoughts on “Saturday, 22 March 2014”

  1. For the rehydration mix, why not just buy packets of Gatorade powder? I don’t know how long the small, sealed packets are good for, but the big cans of powder last for at least a year before the humidity gets to them. (In upstate NY weather with air conditioning used very seldom.)

  2. Gatorade is better than nothing, but it’s not intended for oral rehydration therapy. The mix and concentrations of the ORS components are very finely tuned to optimize them. Too high a concentration is actually dangerous. It’s better to err on the side of too low a concentration.

    Severe diarrhea is an emergent situation, particularly when skilled medical care is not available. That’s true even if it’s not caused by dysentery or cholera. It’s dangerous enough that WHO actually recommends using known-contaminated water for oral rehydration if safe water is not available. And in some situations, such as dangerous E. coli strains or Clostridium difficile, it’s actually dangerous to use Imodium/loperamide and similar antidiarrheals because they keep the toxin-producing bacteria in the gut longer.

  3. BTW, my 81 year old FIL is still in ICU in Carrollton, Texas. They removed his gall bladder yesterday so he had a combination of pneumonia and gall bladder infection. They are still pouring IV antibiotics into him (a week now). He actually had active E. Coli in his blood, presumably from the infected gall bladder.

  4. 33 here today; we was sposed to git 3-6″ of snow but nary a flake (except me) here yet. It was allegedly to kick off around 04:00 but all I got here is the usual wind, with gusts, again per usual, at 40-50 MPH. Radar shows a system rolling toward us that stretches from Montreal down to Utica, NY but no sign of it doing anything here. The NWS winter storm advisory is still in effect until 4 PM, but why?

    In other nooz, the Mooch and her entourage impress the Red Chinese with their brilliance and charm:

    “The best quote last night came from one of the hotel staffers, “We can’t wait for this to be over, to tell you the truth.”

    “Brother, the American people feel your pain. We can’t wait for it to be over either, to tell you the truth.”

    And the sad thing is, we’ll probably get even worse when the time comes, if that is possible, which I guess it is.

    http://bostonherald.com/news_opinion/columnists/howie_carr/2014/03/carr_last_place_to_send_first_lady

  5. I forget, is there a one link limit. I tried posting with two links and it doesn’t show up.

  6. Can’t post with even on link, so:

    A comment on the medical kit:

    I’ve been reading up on the use of pet antibiotics for human use. From what I read, the drugs are the same, just approved by the USDA for animal use, not human use. Some of the reviews indicate people are buying them for human use when they can’t get to a doctor for a prescription in a reasonable time, no insurance, etc.

    Any comments? The site below has amox, ampi, cepha, cipro and others in 250-500mg

    Would these cover most needs?

    calvetsupply

  7. Michelle will come home when the negotiating over ICANN is done. Just wait until fall when the DemocRats lose the Senate. Then Obummer will be a loose cannon and making that pen go amuk.

  8. Yes. They don’t have special production lines for animal antibiotics. The amoxicillin (for example) that you buy from a vet supplier is the same amoxicillin used for humans.

    I should probably let a physician comment, but amoxicillin is very useful (particularly in combination with clavulanic acid as Amoxiclav, Augmentin, etc.). Ampicillin doesn’t do much for you that amoxicillin doesn’t do better. Cephalexin is useful, as is ciprofloxacin. I’d want a sulfa drug such as sulfamethoxazole/trimethoprin. (I actually use sulfadimethoxine, which I buy by the kilo.) Finally, I’d want metronidazole (Flagyl).

    Obviously, you have to be very careful about allergies, particularly to penicillins (amoxicillin) and sulfas. You can easily kill someone quickly. Anaphylactic shock is not a pretty sight.

  9. Yesterday afternoon, the nursing home called to tell me my mom’s condition had changed. She had some bleeding from the lower end of her gi tract. I told them to do whatever they needed to make her comfortable. At 11:30 she stopped breathing for three minutes, and then started breathing again on her own. At noon she stopped breathing for the third and final time.

    I’d like to thank Ray T. for sharing his experiences with his aunt. It helped me a lot these last 18 months. Of course I’d also like to thank our host for sharing his experiences with his mother and in laws as well.

  10. Dave, my condolences on your mom’s passing. It’s never easy.

    Thanks, Bill. It isn’t easy, but at least now I don’t have to make life and death decisions. And within reason she was comfortable, and didn’t turn out like a friend of my whose dad who has been in a nursing home for years. For an entire year the nursing home staff had to tell him that his wife was at the grocery store and had to be back soon, when she had died a couple of years earlier. Now he can’t remember anything.

  11. Sorry, Dave. Many of us here know what you’re going through. It’s never easy.

  12. ” For an entire year the nursing home staff had to tell him that his wife was at the grocery store and had to be back soon, when she had died a couple of years earlier. Now he can’t remember anything.”

    This is currently happening to a friend of mine’s mother. She either can’t remember her own daughter, or forgets that her husband passed away ten years ago, or has no clue where she is. Sometimes a combination of two or all of those things in a single visit. My friend at first tried to explain that her father had died, but was told that she should just go along with the charade of “gone shopping” as the mother would panic realizing her husband was gone for ever. Sadly for my friend, her mother’s body is as healthy as a 92 year old can be.

    It’s never easy, but sometimes it can be much, much worse. There is solace in there, somewhere.

    My own mother never ended up in an care home, she chose to take chemo treatments for her stomach cancer over the objections of her oncologist by quoting Nietzsche’s “That which does not kill us makes us stronger.” My sister and I both concurred when we were approached by the doctor, so I guess that was an early form of doctor assisted suicide, which is still very illegal in Canada. We took solace in knowing that our mom was no longer in pain, and had lived her life fully, and on her own terms. I took the same solace when my wife passed in 2010 of her cancer. I know just how easy it isn’t.

  13. I could not say it any better than Bill just did, so I will only add my condolences.

  14. I’d like to thank Ray T. for sharing his experiences with his aunt.

    Sorry for your loss Dave. Pleased that my trials may have helped with the experience.

    My mother passed in December of 2013, suddenly. I was very much thankful that she went quickly. She entered the hospital on Thursday (did not tell anyone). We found out by accident late Sunday night, she passed on Monday night while I was in transit to California. Since dementia was present in her father, brother and her sister it was good that she did not go through the same situation her sister went through.

    The only reason we found out she was in the hospital is that she did not show up for church on Sunday. A couple of members went to her apartment to see if she was OK. These church members were informed that my mother had gone to the hospital. They went to the hospital and asked why family was not there. The hospital said they could not contact anyone as they had no contact information. The church members said they knew someone in another church who might know someone. Through this method the church finally contacted my older brother who then contacted me at 11:30P. I was not able to get a flight until Tuesday which turned out to be too late.

    Death is a part of life that cannot be escaped, albeit the final phase of life. We can only look back on their life, consider their accomplishments, the legacy they left.

  15. My condolences Mr. Dave. My own Mom turns 89 in June. Two time cancer survivor. Sharp mind, but the body won’t last much longer.

  16. Mine’s 82 with Pick’s Disease (variant of Alzeheimer’s) and steadily failing on all cylinders, like my dad sixteen years ago at only 71. I’m keeping what’s left of my own brain cells humming with new stuff to learn and do, plus more exercise outdoors, in perhaps vain hopes of staving off a similar end.

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