" A Time--Perhaps--For Some Honest Revelations "

04/28/12

Since beginning my 'Blog' in late march, 2011--while I knew little about the genre, or what would consist of content, or, of how to attract (and keep) readers--I nonetheless wanted a forum in which to share with you my deepest thoughts, problems, life experiences, short vignettes of various kind, as well as the occasional poem, I found that my biography did not nearly exlain my situation, nor my desires.

These, I found, were two-fold: one, to bring to you expostion of a non-specific kind that you might find to be of some help, or interest, and, to also--in time--increase my readership base; the very notion of having loyal readers world-wide intrigued me, and--frankly--in time--I hoped to maybe monetize the Blog to help me with a dificient income.

While trying to find one's Voice, I had notable problems with sustainable content, as so, alowed the enrties to lapse for some four months; this effectively destroyed any readership I might have hoped to have, but--yet--I somehow, wanted to continue.

I happened to join a site called, 'MDJunction.com', which is an enormous member-based, clearing house for individuals with all manner of physical, and/or psychiatric conditions who were looking for support, caring, information, and understanding; one of the features of MDJunction was that members could write 'diary entries' on really, anything they liked, and the diary space allowed for member comment.

And so, I began, with some hesitancy, to write diary entries, there, in hope to prove to be of some, small possible help as a thanks for all who willingly befriended me, and for their kindness, caring, and non-judgemental support.

Slowly, I found it easier to write entries in that format.  And when--since late July of 2011--I found that I had written some 180 entries, I thought--perhaps--to begin to transfer them to my Blog.  These entries to MDJunction were almost all positive, urging me to cast wider my nets; and it remains a thrilling possibility of taking my MDJ entries to the next level...that of my Blog.  To keep MDJ's membership of some 60,000 persons, to that of my Blog, which, in being world-wide, might attract more, and more regular readers.

Please forgive me, if I indulge in some vain, self-promotion, but, what do I have to say, that is not already being said somewhere amid a billion, other blogs?

1) I try to write about problems that we all have in common, perhaps, regretably, in a style of writing not seen for a hundred years.

2) And while, my friends, I freely admit to using punctuation as I may feel, I do try to write concise sentences, not given to slang, or to the current (and, to my mind, most annoying) tendency to 'text speak', nor, exposition that is 'emoticon heavy'.

3) I seriously promised, both at MDJunction and here, to never knowingly lie to you.  I realize that such a promise is itself, open to suspicion; but one I hoped would be made manefest in the content of my entries.

To give you--perhaps--a better glimpse of who I am, beyond a bundle of likes and dislikes is my profile at MDJ., which I will attempt to share with you now.

'Zahc'
57 yr. old male.
Lives alone with 14 yr old Border collie mix.
Disabled since 2002. effective 2005.
Dx's: since 2002:
1)Acute Anxiety with Panic attacks; Severe Depression with Agoraphobia.
2)Numerous fractured ribs, and vertebral compression fractures at T-3-5, from frequent falls.
3)COPD; Orthostatic Hypertension: Migraines.
4)Apnea; RLS.
5)Slight episodes of CHF.
6)Diabetes.
7)Fibromyalgia; Lupus; connective tissue disorder.
8)Diabetic retinopathy.
9)Diabetic Neuropathy.
10)1-3+ edema in feet/legs to knees.
11) Possible RA
12) Chronic fatigue; Chronic pain Syndrome.
Hx. of asthema; bronchitis; pneumonia
13) Apparent Hx. of PTSD from childhood.
Am now on a bucket-load of medications which I detest.
Am housebound 98% of time, except for visits to doctor's offices.
Am on pain medication.
Have friends 38 miles away who never visit me, 'tho they telephone once or twice a week.
My dog is my best friend.
I now have the attention span of a gnat; I no longer watch television.
Sitting or standing for any length of time just about paralyzes me, and I then feel as if I am losing consciousness.
Am on oxygen 24/7, and can only walk with cane. I no longer can drive a car.
And live in a rural area with no one to talk with. And, often feel trapped and alone.
Though I am grateful for it, I have to live on a disability income that's at least a third of what I once earned.
I have NO family to speak of.
I live in Florida; its too hot and humid to get out, and require assistance with bathing, or getting in or out of a car.
I am on medicare, since 2005; Medicaid is a laugh.
And I am always broke by the 10th of the month.
However, any time I need an extra shower, or my lawn mowed, or my house tidied up, or my laundry done, or groceries bought & prescriptions picked up, I have to pay for these 'services' out of pocket.
And while I no longer moan, "Why me ?". I am bitter, and in almost constant pain.
My sleep is erratic with pain, and several bathroom calls, so am almost always tired.
I used to be an artist, wrote poetry, made books for friends, composed music, took photographs, wrote plays, and short stories...now...nothing.
I now need naps in the afternoon to survive the evenings.
Have gained 80 pounds, and am up to 3XL.
Have been trying to fix/repair/remodel my home on the cheap.
Often, I don't even feel well enough to become bored. One day is about like the next.
And, as I age, my symptoms just get worse.
When I was younger, I got a B.A. in Social & Behavioral Sciences, and Psychology, and have spent most of my working life in the health care field.
I still consider myself to be a good listener, and always enjoyed it if I could help others.
I now do nothing to earn my keep as an human being. And I hate it.
Sometimes, I wish I came equipped with an 'off' button.
If the Past was awful, the Present almost unbearable, I cannot even begin to imagine a Future that is not dismal in the extreme.
Oh, I used to enjoy gardening, but now, can no longer reach down, or get down on my knees as I need help getting up.
And I have great difficulty holding and using a pen as the entire right half of my right hand is completely numb; as it--too--is a numbness that causes pain. Go figure.
I really do not need 'hand holding', nor do I wish to be read stories to.
In fact, I have really NO idea what I think I want or need.
I do believe that I am more nice than nasty, and that I would--again--like to be of some help to someone in the same boat as am I.
Coping skills would be nice. Funny news, good news, anything. Your first grandchild; your new puppy ( or kitten ); your favorite receipe; your fondest hope; your mortal fear; what you think of during long nights of pain when sleep will not come, and is not restorative when it does.
I once had a fine mind that my body is now destoying bit by bit.
But then, most of you will know exactly what I mean.
Thanks for time at the podium.
Please take care all.
'Zahc'


The truth is that I am presently, very ill, and should you have read my blog entries, you will know that I am often in unbearable pain; both my diary entries to MDJ., and here, have proven to be of immeasurable help, in that, no matter how I may be feeling, my writing is often an anodyne to pain, and loneliness.  And one of my few, remaing delights is to be read, and commented on.

I am NOT asking for pity, or for 'pity points', as--while the state of my health was never sought, nor desired--yet--it remains an integral part of my life.

I would like for whatever 'Voice' I do have to find sympathetic ears, it is rather the context of the entries that I would glady wish might form some kind readership, among you.

I most sincerely hope that what I have to say may prove to be of interest, as it mimics my regular diary entries, and--therefore--the 'adventures', and progress of a life...my life.

I would urge--should you 'accidentally stumble-across' this blog-- to kindly stay a while, and, if you have the time, to go back, and read my older posts.

To clear up some possible confusion, under MDJ., I post under the name of 'Zahc', though my name is Charles.

It is my continued hope that you may find my 'vision', and my 'views', to be contemporary, and germane to an everyday life, that we all share.

I welcome you to my Blog, and hope you will return again, and again.  Should you ever have problems, questions, doubts, even, your comments would be most welcome !

And, as always, I wish you and yours well; may you never know want; may you be surrounded by the ones who love you, and care for you.  I wish you quiet and untroubled days, and nights of blissful rest, kept always safe and secure.

I thank you for your most kind, and wonderful patience, and loyal reading.

Please take care,

Charles/'Zahc'

" An 'A-B-C-' Of Home Health Care...Part IV of IV "

 “ An ‘A-B-C ‘ Of Home Health Care: A List Of Things You NEED To Know (Which Might Just Save Your Life, Or The Life Of Someone You Love), Incomplete As It May Be…Still  “

Part IV of IV

04/30/12

To my ever dearest, loyal friends, and constant readers, I remain ever grateful to you for your caring, and support; in my attempt to somehow repay that debt of absolute gratitude to you for your kindness, and love, and of accepting me as I am, it is my goal to try to prove to maybe be of some help to you; to maybe make your lives better and more secure.

I delight in your wonderful company, and even as I fully know that you have both mental and health issues, yet, you have somehow made room for me.  Never once have you been unfriendly, or unkind, nor ever wavering in your support.   You have made me feel welcome here, at MDjunction, and yet, you have never been judgmental, or censorious, which is so often so counter to those I meet in real life, that I count you among my blessings, and, many times, I cannot believe my good fortune in having stumbled-across MDJ, where I have made both wonderful, and lasting friendships, so many I hope will be long and thoroughly enjoyable.

There seems to be too frequent times, during which I am lost in pain and depression, unable to find but errant, short, or unreliable relief; I know that many of you feel the same, yet, in being my dear friends, and pausing to read my diary entries, and with your comments, and criticisms, you bring to me a singular joy I thought I had lost; it is YOU who have been as stalwart, always being ‘there’ for me, when my massed complaints would otherwise wear me down and out, and, in utter hopelessness, I would be alone, and full-given into my depression, my agoraphobia, panic, and a general fearfulness of a Future without change, without cure, without refuge, and quite without any sense of happiness.

And while I write these many diary entries to try to regain some sharpness and clarity of old, I dedicate them to YOU, my dear, sweet friends, in expectant hope that even some little bits will prove to be of help to you. It remains among my fondest hope that—in them—you may find both comfort, and direction that may further your own goals and aspirations, and the successful intervention of illness, accident, or injury in perfecting your own, ‘First Aid Kit’; which, while it may appear long, unnecessary, tedious, maybe…it is my offering to you to help keep you or a loved one safe, often until an ambulance arrives.

And when I happen to receive a hug, or PM, or diary comment that I have helped you, then, my heart is truly happy.  And I thank you for all these things, and more.

I realize that I tend to run overlong, but ask of you to stay the course, and then make up your own minds.  What matters is that I think of you so very often, and want you to be well. With ALL the happiness that you most kind hearts can hold.

And so to that end, if I may be allowed to present you with Part V of V, on;

“ An ‘A-B-C’ Of Home Health Care : A List Of Things You NEED To Know…”

My dearest friends, EVEYONE needs to assemble a fairly simple, yet fairly comprehensive First Aid Kit to have with you at home; granted, this is—for me—an ideal, wish list, some of which you might never need, but I nonetheless desire to provide you with various things that may—in fact—save lives, and that will also buy you time until ‘911’ has been called, and the ambulance arrives.

The list—as such—is not alphabetical, to lessen the chance that in doing so, potentially valuable items might  accidentally be forgotten, and unfortunately left off the list. I am also thinking as I write. Frankly, the only time an alphabetized list would come in handy, is to—at an eye-glance—tell you what you have, and possibly, what you will need.

The Container:

You will want to make a First Aid Kit that is accessible, but one not underfoot.  An empty 2-litre soda box with handles will suffice, but you want your supplies to remain dry, and free from getting wet; equally, an old suitcase can be used (just be sure that if you lock it, you will have the key on hand, which wastes valuable time!). What you don’t want, is to have your supplies jostling-about, and lose, as you want to be able to lay ready hand to whatever you may need with as little delay as possible.

After careful consideration, what I would recommend is one of those large, plastic tackle boxes that fishermen use, with the fold-out drawers.  These boxes close compactly, and can be snapped shut in the front; further, they have carrying handles on them, are fairly inexpensive, and are available in bright colors to be more quickly and easily seen.  The many fold-out compartments help keep your supplies separated, and, if the top of the box is white, you can take a magic marker, and boldly write upon it, “First Aid”.  This box should contain your first aid supplies….and nothing else.

A continued list of ‘What You Will Want To Get:

PLEASE note that to be on the ‘safe side’, regarding ANY O.T C. (over the counter) preparations that I may recommend, I will always err on the side of prudence and caution in their use; I urge you to do the same.  Not all directions to these ‘medications’ should even be followed by the directions on the box, but—rather—to be used more sparingly, enough to help you, as I’ve seen a tendency, especially in America, an attitude that, “If one pill works, two will work better and faster…and so on.”  This may pose a decided problem for you, among two more concerns: when it is time to call ‘911’, or take the ill person to a Primary physician; hence, ALL my recommendations—as may be necessary—will be as general guides, only. And then, to be used sparingly, for my conscience dictates that—in any help to you—too much of anything is never good, nor wise.

In order to save time, and to marshal my thoughts, I have ‘listed’ what you may need, with any, necessary explanation for these items as we go along.  Doubtlessly, some of the things will make more sense than others; should you have further suggestions, remarks, questions, or criticisms, I would most kindly ask you to leave them in comment section, or in PM’s, or even ‘hugs’ to me, and I will be more than happy to reply.  And if—in still natural, further doubt—I would urge you to speak to your Primary, or Pain Management Physician.  Thank you. ‘Zahc’

1)           Aspirin.     Discovered in 1890, and one of the class of drugs called ‘NSAIDs’, such as Tylenol, Motrin, Aleve, etc., which stands for, “Non-Steroidal, anti-inflammatory drug”, which means that they do not contain steroids such as cortisone, or prednisone.  Aspirin comes in many brands, and strengths, from ‘baby aspirin; to regular aspirin (326 mg. tabs); to extra-strength aspirin (500 mg. tabs); to now, ‘adult-strength’ aspirin (81-83 mg. tabs).  Aspirin is cheap, and performs a variety of uses.  It is an ‘anti-inflammatory’, to reduce swelling; an ‘analgesic’, to reduce pain; and an, ‘anti-pyretic’, to reduce elevated temperatures. 

Further, The American Heart Association recommends that—as may be tolerated, adults should take an 81-83 mg. dose, daily, to help prevent, or lessen the severity of heart attacks.  Since aspirin can upset your stomach, these adult doses should be coated (enteric coating), so that the aspirin will dissolve in the intestines, rather than in the stomach; further reading has suggested that in doubling the dose, to one in the morning, one at night, may slow the onset of Alzheimer’s disease.  And as with all, O.T.C preparations always look for the ‘sell buy’ date to ensure freshness and efficacy. To many, partially dissolved aspirin tastes very bitter.

2)           Tylenol.  An ‘NSAID’ to be used, in lieu of aspirin, for those for whom aspirin upsets their stomachs, or, who are allergic to aspirin.

3)           Imodium.  An O.T.C. preparation that is used to slow, and stop diarrhea.  However, as nasty as it is to have diarrhea, where possible, it should be allowed to continue at least two to three days, untreated, as diarrhea is the body’s way of rapidly removing toxins from the system, such as those in flu; some types of food poisoning, etc. However, you want to keep in mind two things: that unchecked diarrhea can rapidly lead to dehydration, which is why you want to continue to ‘push’ fluids and soup.  As important is: that over-use, can cause the stool to ‘concretize’ in the bowel, resulting in severe constipation, or ‘impaction’, which, if left untreated, can be life-threatening.  Constipation that lasts for more than four days should require a trip to the emergency room; and, should I not have previously mentioned it, one of the signs of an impaction is ‘fullness, the inability to express stool, except for slight diarrhea that is forced around the impaction, and out.

4)           Laxatives.  These, too, should be used with prudence; pain medication can often be very constipating. So ‘stool softeners’ (generic name: docusate sodium, or docusate potassium), gently help to encourage the production of stool.  These—too—should be used, with caution, as the ‘docusate sodium’ contains salt, for those who have hypertension.  Perhaps, the powdered versions mixed with either water, or fruit juice, taken daily, should provide necessary bulk, and ease of passing stool.  Plus, the too-frequent use of laxatives may contribute to one becoming, ‘laxative dependent’, especially in the elderly, where normal bowel motion may be lost, until one cannot go to the bathroom without laxatives.

5)           Oil of Clove, or ground, powdered Clove.  This is an absolute, non-habit forming, nor potentially dangerous Godsend for tooth and/or gum pain.

While nothing—of course—will take the place of regular, dental hygiene, or visits to the dentist, often, toothaches occur at all the wrong times, and can be severe, and these days, few can afford to visit a dentist regularly, or at all.

Add a little water to the ground cloves to make a paste that will adhere better to teeth and gums, or directly apply the oil to the toothache with—of course—washed hands, or with a palette made or a tongue depressor; rub it thoroughly into the top of the tooth that hurts, and massage it into the sides, and gums.  Since it is a ‘natural’ product, without noted side-effects, it can be used repeatedly to buy you time, or to just temporarily eliminate toothache pain, which can be so severe, it can be applied as often as you may need.

While this is a wonderful approach, it does NOT replace dentist visits in case of abscess, or infection.  It is—however—safe-enough to use in moderation on small children who may be ‘teething’.

6)           ‘Burn Cream’, or—where possible—silver sulphathiazide cream, in the treatment of minor burns, to help reduce the pain, and encourage healing.  Please note that severe burns ( ones that cause blistering, or lack of pain sensation, or ones that cover larger areas of skin, should immediately necessitate a call to ‘911’, and an ambulance trip to an emergency room, or nearest burn center).

7)           Flashlights.  For the ‘Home First Aid Kit’, I would recommend having two: one regular one for illumination in dark settings, and one, ‘pen light’, smaller flashlight that may be held in the ‘on’ position in the mouth, to free-up use of both your hands.  Always keep on hand a pack of fresh, unopened, and unused batteries.

8)           Thermometers.  For years, we have become accustomed to the old, triangular, glass thermometer which contains mercury, and requires keeping sterile in alcohol, or with alcohol-based wipes; these must be ‘shaken down’, by several, quick, ‘whip’ motions, while holding the top.  These came in two types: blue at top for oral thermometers, and red, for anal use.

These thermometers can break easily, especially when attempting to ‘take’ the temperature of one who is ill, and may have chills.  In addition, old, glass thermometers contain mercury, which is very poisonous.  I would not recommend their use.  Instead, I would suggest that you purchase a plastic, disposable, digital thermometer (along with end-covering sleeves, to help keep them sterile), that is light-weight, and ‘beeps’ when the correct temperature is arrived at.  Since the end of a digital thermometer is lightly weighted, it still may prove difficult to keep it in the mouth of those who are ill, children, and the elderly, or those who lack the teeth to hold it in their mouths.  There are two, other ways in which a temperature may be reached, and these you need to know.  First, in babies, the temperature should be taken rectally.  To the value that you receive, deduce one point.  Thus, if your young child (or, grandchild’s rectal temperature is, say, 103.0, deduce one point, to make it now, 102.0, a proper reading.  For those who simply cannot keep a thermometer in the mouth, any value—there obtained—will be useless.  Instead—where possible—place the thermometer securely under the arm pit, and make sure the thermometer is held tightly there; this is referred to as an ‘axillary temperature’, whose value you will need to add one point.  While ‘oral’ temperatures are supposed to be more accurate, what good is it if the person cannot keep it in the mouth, under the tongue.  However, should you use either of these alternative ways, and subsequently need to report them, always designate whether taken rectally, or axillary

9)             Every Home First Kit should have a bottle of peroxide; allow to dribble over wounds, or apply—carefully—with sterile cotton balls, before bandaging.

10)   One bag of sterile, cotton balls.

11)   One package of sterile Q-tips, to use in dabbing ointment to a wound; NEVER use them in your ears to clean them, as you will probably compact the wax that is there, which may lead to ear pain, or ear ache, or infection!

12)   Traditional, metal boxes of band aids usually offer different sizes, many of which you may never, ever have a use for.  Look—instead—for a box of band aids that are at least 3/4ths inches wide, or one inch wide.  Those tiny lengths, and little, round spot band aids are useless, do not cover the wound, and never stay in place.  If—for example—one has a fairly simple finger cut, drape one band aid over the wound, and secure it in place, by wrapping another one around it.  Band aids should be changed regularly, about every day, or, every other day.  We all have had experience with band aids that have been left on too long; the skin—beneath—is always super white, mottled with blue, and feels odd to the touch.  While you want the wound to heal, you do not want to compromise the blood circulation in the fingertip, or, indeed, anywhere else on the surface of the body.

13)    Blood Pressure Cuffs.  For general ease of use, portability, and convenience, I would fully recommend a Velcro, wrist blood pressure cuff; these are fairly inexpensive, and are very accurate.  And, they stay in place, better, being held in place by Velcro.

So many accidents happen at home, many of which go way beyond any treatment that little, rusted, box of band aids in your medicine cabinet can provide.

Dressing equipment (bandaging), and other needed supplies:

14)   At least two boxes of gauze pads, 4 inches X 4 inches.  Use it to apply to wounds; but please keep in mind that plain gauze can sometimes stick to an open wound, and so;

15)   At least two boxes of “Telfa”, 4 X 4 inch pads; these do not stick to wounds.

16)   Several, packaged lengths of elastic, netting, often called ‘Curlex’.  This is used to wind-around a wound, to help keep the pads in place; they also promote air to reach the wound, to help in healing.  Always remember that dressings should be changed every day, and kept as dirt-free as possible.

17)   Now, you will need some kind of tape to use to secure the Curlex; basically, there are two types: A) Paper tape, and; B) Cloth tape.  While cloth tape may prove to better hold a dressing shut, you will need a set of scissors to cut it, as it is difficult to tear into desired lengths.  Paper tape is much easier to tear, but may require more of it to be effective.  Also, some individuals are allergic to paper tape, so it would be most wise to keep both kinds on hand.

18)   Where possible, it is always best to first wipe the wound or affected area to remove from it any dirt present.  Then use a couple sterile, gauze pads to clean the wound with peroxide, stop the bleeding, and apply with clean Q-tip, antibiotic cream, and bandage gently.

19)   Remember, please, to always keep your First Aid Kit in some semblance of order, so you won’t have to repeatedly dig-around, or look for the supplies that you may need, which wastes time, is frustrating, and postpones intervention and treatment.

My friends, this series has been of some difficulty to write, as I knew it would run long, yet, I did not want to miss more than I probably did miss.

One often thinks something as prosaic as a ‘First Aid Kit’ to be of little importance, or use, in day-to-day living.  From past experience, I feel quite the contrary, that your home First Aid Kit—when equipped, and maintained properly, is nothing less than your first line of defense, in the treatment of even simple wounds, to conditions that will require you telephone ‘911’ to summon an ambulance to your home.

It is at least a partial measure of my love and regard for you that you and yours be kept as well, and as safe as possible. Those were my only motives.  And in wracking my poor and tired brain to point of headache, I have tried to share with you things that I had experienced over the years. I still think the points are valid, and may prove to be of some possible help to you, whenever you most need it.  Remember—always—that you are special and unique to all the world.

As always—my most dear, and treasured friends—I wish so much for you days of much lessened, or of ‘no pain’; quiet, contemplative days, recalling dreams; afternoons, surrounded by both friends, and family members who love and care for you; happiness unbounded; pantries full, with no thought of need, or want; peaceful evenings, leading to nights of natural tiredness—looking forward to climbing into a cool and crisp bed; and blissful and untroubled sleep combining comfort, and pleasant dreams, protected—ever—by gentle angels, ‘to lead thee to thy wondrous rest’.

Please always know I love you dearly,

‘Zahc’/Charles

" An 'A-B-C' Of Home Health Care...Part III of IV "

“ An ‘A-B-C ‘ Of Home Health Care: A List Of Things You NEED To Know (Which Might Just Save Your Life, Or The Life Of Someone You Love), Incomplete As It May Be…Still  “

Part III of IV

04/28/12

My most dear, and wonderful friends, and ever-loyal readers, there will inevitably be a time, following illness or accident at home, that will necessitate calling ‘911’ for assistance, or intervention, or transport to a Hospital emergency room; as I may have mentioned before, trauma centers refer to a term called; “The Golden Hour”, during which there still remains a good chance that the person will survive after intervention and treatment.   This refers to major accidents at home, or while driving, whether they are serious injuries, strokes, or heart attacks, to name but a few.

And even though many of you have cell telephones that you take with you everywhere, nevertheless, this, “Golden Hour”, is precious, and any extra time you can contribute for intervention and treatment to be given soon enough, can only help increase one’s odds of survival.

Too often—though—valuable minutes are wasted from the time the ‘incident’ is discovered, to ‘911’ being called, to the arrival of the ambulance, by otherwise caring individuals, standing-around, looking either dazed, or confused, not knowing what to do, to even, where to begin. Or when, the incident—itself—is discovered late.  You must intervene as soon as possible.

Depending upon the severity of the illness or injury, a person may not have a “Golden Hour”, when just five minutes could—if correctly acted upon—help a person to survive.  Of course accidents and injuries can happen anywhere, any time, to anyone: family member, friend, neighbor, acquaintance, or even casual strangers. 

So many times—especially in the case of those unknown to us—we hesitate to become involved.  Only YOU can listen to your heart’s voice in deciding the extent of your interaction.  However, situations differ so much that, while you may be reluctant to begin C.P.R. on a complete stranger, you might not hesitate a second to remove someone away from fire, or a burning car spotted along the road.

There are two things to always keep in mind, whenever someone has fallen, or must be removed from harm; that is, unless absolutely necessary, never move a person who may have sustained back injuries.  Make the person comfortable of course, with a flat pillow to facilitate their breathing, and—when necessary, ever so slightly elevate the feet, and provide a blanket, to ward off potential shock.

These days, this reluctance is quite understandable, what with AIDS, Hepatitis C, other, blood-borne diseases, and a few air-borne ones like Tuberculosis.  Without proper precautions, the ‘helper’ places him or herself at risk, especially when potentially; massive quantities of body fluid are either directly observed, or discovered.

On those few occasions when I was there, observed the incident, and took action, it was my choice to do so; but then…neither did I rush in, and do it foolishly.  I took what precautions that I needed to ensure my own survival; which is why it is of vital importance that you remain calm so you can think, even if the scene is one of nightmare.

But, even if the circumstances may make you afraid, legitimately or not, taking NO action should leave you with a bruised conscience.  At very LEAST—should you come upon an injury or an accident, or abuse….too many carry cell telephones these days, to simply not use them, to call ‘911’.  You must make up your own minds, and often, very quickly, too.  And in regards to helping a complete stranger, even one whose aspects you might find distasteful, I will only list two things:

1)           As a Director Of Nurses once told me, “…whether you may like or dislike a person, doesn’t matter, if you but consider all to be ‘God-made’ souls.

2)           I consider the prudent intervention on behalf of even strangers to be but part of the price that I must morally pay to assert my claim to being human.

However, it must be mentioned, that since—perhaps—something like 80-90% of all injuries, and accidents occur at home, you will then be—of course—more likely to on an ascending scale to help neighbors, friends, relatives, to direct family members such as a spouse, or child.  And in being more informed in how to give such care, it may eventually prove to be of help to you.

Few homes—if any—have on hand, a usable, and reliable ‘First Aid Kit’, beyond—perhaps—a rusted box of band aids, or some peroxide, or Q-tips, which will NOT be of any help to you in a ‘real’ emergency.  And so, after having given the matter much thought, I am going to list what I think every family should have on hand, in case of an emergency, and how to use them properly, and to best effect.

While ‘my’ “First Aid Kit’, consists of things you may NEVER need, needless to say, all of the items do have a valued place, kept in a resealable, cardboard box, placed, so that it will not get wet—in every home, thus enabling you to prepare for accident, or injuries, and to follow some basic tips, while waiting for the ambulance to arrive.  Thus, you may have helped provide that “Golden Hour” for you, or someone you love, when—on occasion—there may be NO “Golden Hour”, but only scant minutes.  Nevertheless, it can be YOUR calm intervention that may well prove to save a life.

All of the items in ‘my’ dream “First Aid Kit”, are readily obtainable in drug stores, or near the pharmacy in grocery stores.  You do not have to go to a medical supply house; all you need—to begin—is a list of things to get.

And…I will—where necessary—explain:

1)           Why you may need it.

2)            When to use it

3)           And importantly, when to NOT use it

4)           Remember, please, that I may inadvertently either list too much, or miss an item or two; so, I will err on the side of caution, in listing too much, even though, ALL items might prove to be of life-saving value.

Above all...try ever to remain calm; there will be occasions when—perhaps—you might be the ONLY calm person in the room; it is vital that you be so, to better access the situation, and to take prompt action.  Save your nerves for later.  Only after, when the ambulance is on its way to a hospital, do you have the ability and time to scream, yell, cry, or otherwise, ‘break-down’.  Often—for example—while you are intervening, you may need someone to bring things to you such as blankets, or, someone to telephone ‘911’; assume that you are the only one capable of successful intervention (with the possible exception of C.P.R., which CAN be done alone, if you must, but is better done by two ‘first responders’, and anyone else nearby, who can relieve you, as it is VERY tiring to do alone, or to be done properly).

Please know that not every injury or accident will require such drastic intervention, or call to ‘911’.  Accidents include slips, falls, cuts, burns, insect bites, allergies, headaches, bruises, that run the gamut from, ‘boo-boos’, to that which may prove catastrophic.  It is, of course, up to your powers of observation while inspecting, and treating.  However, the decision may not be yours to make. 

If that small voice inside says that something is very, very wrong, or, should it say that it is beyond your capabilities, play it safe, and call ‘911’. Some conditions warrant always calling ‘911’, to have an ambulance take the injured or the ailing to a hospital’s emergency room.

Some of these ‘situations’ demand that you leave the evaluation of, and treatment of to professionals; at best—then—your involvement should be limited to some required stabilization, in attempting to lessen the severity of symptoms, or of preparing the individual for transport—by ambulance—to an emergency room; or, to simply make the person more comfortable, and less likely to go into shock before the ambulance arrives.

There are so many ‘if/thens’ that happen that will necessitate an ambulance trip to the emergency room; and while there are a few palliative measures that you can take, putting off dialing ‘911’, and summoning help may be foolhardy, wrong, and may—in fact—lessen that person’s chance of survival.

As I have mentioned, before, I am NOT licensed, nor am I a professional, so that anything I may say is—in fact—my own opinion, no matter how well read, or assumed experienced; and, I always try to err on the side of caution.  I do feel that the majority of my suggestions are based on personal experience, to, ‘help, do no harm’, but some of these measures should be read, not so much with skepticism, but always with the knowledge that I love you, and want you and yours to be ever safe and well.

You will—from time to time, however rarely, experience events that require calling ‘911’ for an ambulance, without delay.  I list some of them, in no particular order of magnitude; as I consider each, in its own way to be seriously sufficient to warrant immediate action by professionals:

1)           Any slip or fall, that results in unconsciousness.

2)           Any suspected fractured, or broken bone, especially, if there is bone protruding and visible.

3)           Any injury to the eye.

4)           Any fall by an elderly person, that might indicate a fractured or broken hip.

5)           An adult, sustained, elevated temperature of 103.0. WARNING: should this temperature not respond to aspirin or Tylenol, or, continues to rise, call ‘911’ immediately.  The general purpose of an elevated temperature is to an attempt by the body to create an inimicable climate for bacteria or viruses to live.  However, sometimes the body—in response to the pathogen—will continue to rise.  At around 105.0, there is a decided danger that the person may begin to have seizures; unchecked, the person may go into a state called, ‘status epilepticus’, or non-stop seizures, that prevent oxygen from reaching the brain; it WILL either result in a vegetative state, or, most likely be fatal !  In the old days, that person would be placed in a bath tub, and covered with ice.

My advice is to always keep four or five packages of frozen peas in the freezer.  They not only conform better to an inflamed area, such as a sprained ankle, but they can be quickly refrozen, again, for future use. And since the packages are not compromised, the peas can still be eaten later!

In finding someone with an elevated temperature of 103.0 of higher, while waiting for the ambulance, place these bags under each armpit, and on each interior side of the groin, where the leg joins the torso…near the genitals. Until proper help can arrive, what you are doing is trying to lower the temperature a little, by ‘chilling’ the blood.  This is nothing to play around with, and should only be used while waiting for an ambulance to arrive.  They then, can try to stabilize the temperature with special ice packs, until they can arrive to the emergency room.

6)           Should that person be on a ‘blood thinner’ such as Coumadin, or warfarin, it works to prevent clots by lubricating the arteries and veins.  However, its action also makes it extremely difficult to clot at the site of a cut.  A surprising amount of blood can be lost in this fashion.  A band aid will not help, nor will a hundred band aids.  What you can do in this situation, AND, for sustained cuts that run deep, and  produce copious amounts of blood, is to apply a ‘pressure dressing’, by covering the open area, and then grabbing it, or, pressing down upon it with great force, holding tightly to it; in this way, you literally mash the cut closed. Your goal—while waiting for help—is to momentarily stop, or slow don blood loss, that, unchecked will render the person unconscious; there is also the risk of ‘exsanguination’ , or, bleeding to death. A significant, and deep, arterial cut can shoot blood thirty feet into the air, and ‘bleed-out’ happens rapidly.

7)           Unless diagnosed with a history of Migraines, a head-pounding, blinding headache that—despite home treatment—lasts longer than two or three days.

8)           Any burn, beyond that which causes redness, and can be attended to by burn cream; this would include burns that raise the skin with blisters, and may or may not ‘hurt’, depending if nerve cells are damaged, or not.

9)           A resting ( at rest ) radial (wrist) pulse above 120.  Please note that ‘100’ is high, as damage to the heart could follow. As important, is if the sustained pulse is 50 or less. Which could imply cardiac arrest.

10)   A blood pressure whose top number is greater than 150, and whose bottom number is greater than 110. While both have names: systolic, and diastolic, the top number represents the heart in action, while the bottom number represents the heart ‘at rest’.  Both values are important, but the higher the bottom number is of somewhat more importance, and if it is inordinately high, together, may bode signs of heart attack, or stroke.

11)    For confirmed diabetics, both very high numbers or low numbers are critical.  A blood glucose of 60 or lower needs to be raised immediately, lest the person go into insulin shock.  Look for signs of diaphoresis (profuse sweating), redness of face, unsteady gait, incoherency, and/or tremors.  Former wisdom warranted giving the person orange juice to bring up the low blood glucose.  But what if they are semi-conscious, and cannot swallow?  Several packs or a teaspoonful of regular white, table sugar should be placed in the person’s mouth, under their tongues (sublingually), as the glucose in the sugar will then pass directly from under the back of the tongue, to the palette, and into the limbic system of the brain.  Don’t overload the person, but the administration of the equivalent of three or four packs of sugar should help stabilize them until the ambulance arrives.

12)   Nausea and vomiting, with or without elevated temperature, with or without lower abdominal pain, that lasts over two days. This might be evidence of a number of conditions such as food poisoning; however, sustained nausea and vomiting will swiftly dehydrate an individual, and deplete them of necessary electrolytes; meanwhile, try to administer sips of either power aid or gator aid, as these drinks contain valuable electrolytes—besides hydration—that help keep the heart running, and other body functions.

13)   Constipation that lasts longer than a week, which does not respond to laxatives (which should always be given prudently).  Pain medications are notorious for their constipating effects, and—with the guidance of your Provider-- usually, a stool softener is concurrently prescribed.  However, constipation that lasts a week (or longer) may indicate the presence of an impaction, wherein the stool has hardened, and cannot pass normally through the intestines. The person may feel uncomfortably ‘full’, but may only produce mucous and a little diarrhea as normal stool tries to pass around the impaction.  Untended, constipation may prove fatal, as stool continues to back up the digestive system, into the stomach.  Only in an emergency room can it safely be physically removed, difficult, if the impaction is ‘high’, or at the start of the intestines. In extreme cases, surgery may be advised.  And, please, please remember, to NEVER sit there and strain and strain with all one’s might; this stimulates the Vegas nerve that runs up past the heart; such straining can precipitate heart attacks, especially those with a prior history of heart problems.

14)   Persistent, achy to sharp lower middle abdominal pains, or similar pains more to each side, towards the back, under the ribs.  The pain may become unbearable, with or without elevated temperature. Only a trip to the emergency room can rule out appendicitis; pancreatitis; urinary tract infections (which are sometimes accompanied by dark, cloudy, painful urination; gall stones; or, kidney stones). A perforated appendix sprays the interior body cavity with infections and poisons, can result in unconsciousness, and—if untreated—IS fatal. Do not wait for the appendix to rupture.  It must be surgically removed.

15)   Painful urination, that may look dark, cloudy, or be odiferous (awful smelling); it pain may be present all along the urinary tract, can produce ‘flu-like’ symptoms, and an elevated white cell blood count, which would indicate infection; this may be a urinary tract infection, or U.T.I.  Treatment involves antibiotics, along with extra hydration.  Cranberry juice is recommended for women, apple juice for men, to help create a hostile environment for the pathogens, but, please also note, that apple juice—taken in great quantities—also can act like a laxative.

16)   Should you ever find that a person has become unconscious, and is NOT breathing, nor has any determinable heart beat, then--until the ambulance arrives--you should begin C.P.R. (cardio-respiratory-resuscitation).  Often referred to as, ‘the breath of life’, it involves a concerted attempt to blow into a person’s open airway (mouth and throat), and push down upon the person’s chest, both at regular intervals, which if memory serves is about one breath to every four compressions.  The goal is to provide oxygen to the lungs, to the brain, while compressing the heart to facilitate blood flow throughout the body.  While individuals differ—of course—it is a rough estimate that—without C.P.R. being performed, a person has about nine minutes, until becoming oxygen brain starved; except in rare cases—particularly in children who have been rescued from icy waters at bear-freezing temperatures—death will result.  And even if C.P. R.—begun too late, restarts breathing and heat beat, the person will be in a vegetative state, with a so-called, ‘flat-line E.E.G.’ 

My very, very dearest, and precious friends, while I do not mean to fuss at you, I must in all candor say that there is no such thing as ‘half-ass’ C.P.R.  If you want to learn how to perform it (and I recommend that everyone does), learn to perform it properly.  Your local County Health Department should be able to tell you when and where classes in C.P.R. and First Aid may be given, as well as your local Fire Station.

If you learn it, learn it well; and when you commit to using it, commit fully, with no reservations.  Now I completely understand why the notion of your putting your mouth over the mouth of a stranger—after first clearing the airway—might repulse you, and make you want to gag, especially these days with so much drug use and STD’s and illnesses, at least, learn it for your friend’s and family’s sake.  Mouth pieces or guards can be purchased, as can little, portable machines to, ‘jump start’ a heart. But I would not recommend your buying one.

17)   Insect bites.   We all are familiar with ant bites (at a picnic), or mosquito bites, where insect bites become serious, or potentially deadly, is when the person bitten has an demonstrated allergy to such bites, such as; spiders, snakes, scorpions, or ticks.  These bites warrant treatment at a hospital emergency room, but there are a few things you can do; keep on hand a bottle of Benadryl 50 mg. tablets, as well as Benadryl cream in tubes; Benadryl is also known as diphenhydramine.  Also wise, in the treatment of even minor injuries, would be to have several tubes of Triple antibiotic cream to apply to the site to facilitate healing; When doing so, NEVER squeeze the contents onto your bare finger.  Neither touch the tube end directly to the wound, as it is very easy to contaminate those creams, and if so, they will be counterproductive, and too dirty to use.  Instead, apply all creams with Q-tips, using more than one should you need to apply more cream.

18)   For those who have definitive allergic reactions to any bites, having one, or two, ‘Epipens’ on hand is wise; these are syringes that contain epinephrine to help minimize the reaction.  These ‘pens’ are obtained by prescription, only, and be sure to always look at the expiration date.

19)   Benadryl tabs are also of great help—until the ambulance arrives—to slow the effects of a medication allergy. An allergy may demonstrate the following symptoms: itching; a red face, and body that feels swollen and ‘cracked’, changes in respirations, foggy, or loss of consciousness; and falling blood pressure.  Where available, Benadryl liquid is also helpful.  But please, for a severe allergic reaction of ANY kind, call ‘911’ immediately.

20)   Since hands, even if washed, are particularly dirty, you do not want to inadvertently infect a wound by touching it with bare hands.  And so, the purchase of rubber, or latex gloves, in a size comfortable to you is extremely important.  Please also know that some individuals are allergic to latex products, so be prudent—please—in your purchase; one disaster at a time is more than enough!

I realize, my very dearest friends that this entry has been very, very long, I nevertheless would urge you to please make, and keep a copy of it as a reminder, even if you do not care to read it in full now.

There are yet a few things that I’d like you to purchase in the making of your own First Aid Kit, and these, I will attempt to elaborate on, in part IV of this series.

As always, your feedback and comments are vitally important to me, for they help guide me to better help you if I can.  Please ever feel free to give you criticisms and your suggestions to me anytime.

But, please, my dearest, dearest friends, and gentle readers, I am ever motivated to try to be of some help to you, being—as I am—so grateful to you for your kind friendships, and your caring, and support.

This concludes Part III of IV; Part IV to follow.

And, please know I love you dearly,

‘Zahc'/Charles