Flu: Deadly Lessons Learned

Sorry I haven't posted in awhile. I contracted [lab confirmed] swine flu (I have asthma) . Within 22 hours of onset of symptoms, I was unable to stand, moving less than half the air I normally can, high fever with confusion, in shock, and with a low oxygen level. I was brought to the ER by my wife and admitted to hospital. If I had not gotten to the ER that night and had instead gone the next day, I would be in ICU right now instead of writing these words.

I made mistakes in my prepping plan. Some of these mistakes could have cost me my life. I want you to learn from my mistakes. I list what went wrong, what went right, cover home care, and then list some advice I got from the hospital staff to help you all keep from ending up a statistic.

What Went Wrong
Too many trips outside the home. We live about six miles outside of town in a sparsely populated area. So limiting exposure to the "herd" is easy for us. But I did not plan trips to town efficiently, making about 60% more trips than actually needed, thus increasing my exposure to potential infection. Worst of all, I visited a house where a child had been recently ill with a respiratory infection without masking up while I was there. Even though I was there only a few minutes, it would have been enough to expose me to a disease.

I didn't pay attention to good hydration. When the disease manifested,, it came on with bad nausea and severe coughing. Initially, I could replace the fluid lost by drinking some water. But as the severity of the coughing itself induced vomiting, I stopped drinking water completely. Within a few short hours I began to show the symptoms of dehydration as I lost ever more water through coughing, sweating, tears, and vomiting. With the high fever, my falling oxygen saturation, and confusion I was soon beyond being able to save myself by drinking water. My wife should have forced me to take small sips of water as often as possible, but her concern for not causing me further suffering won out. In the event, the ER staff had to run 3l of IV fluids into me before the shock lifted. Dehydration can be a killer, get water into the patient as often as you can, even if it is only a tablespoon at a time.

No oxygen available in my house. I have asthma and used to have a home oxygen unit. But I never replaced it when we moved to Montana. I required oxygen in hospital for about 20 hours off and on. If I had oxygen available in my home, I would not have arrived at the ER in such desperate shape. Maybe it might have even given me the edge to be able to realize that I was getting shocky from fluid loss and got me drinking water again. Having a pulse oximeter available would have allowed us to monitor how well the bronchodialators and oxygen were working for me.

A decent oxygen rig can be assembled for about $220 that will allow about 2 hours+ at 3l/minute flow rate, enough to help a flu patient. Aviation oxygen is "OTC", medical oxygen (100% rather than 99%+) is by prescription.


What Went Right
Our IC plan works. We have a good supply of earloop medical masks and some N95 "rubber banded" masks available as well as ample supplies of gloves, disinfectants, paper towels, etc. So my wife was able to disinfect the house after I was admitted to hospital and I was masked when I was taken to the ER, thus cutting the chances of me infecting others.

I am in strict quarantine for 10 days; it was an easy matter for us to turn the master bedroom suite into our "prepper quarantine ward". I only need to leave it to eat, having masked, washed my hands, and gloved up. I spend only the minimum time outside the isolation room and wipe down everything I touched/handled with disinfectant before I return to my room. My wife is masked when she is in our home and we keep the CDC recommended distance of six feet apart at all times.

Could This Have Been Handled at Home?
I have a rescue inhaler with a spacer. In hospital, and for the next week or so, I require frequent nebulizer "breathing treatments". Using the puffer inhaler instead of a nebulizer would be less efficient and deliver much less medication than the nebulizer would. So it might have taken two days to even start to improve my breathing capacity. Plus, my puffers would have run out within a day and a half at the heroic dosing levels that would have been necessary. I might have been able to do it if my wife could have gotten more inhalers.

Without an oxygen tank, the shock would have worsened some more , I would have been unable to help myself for a longer period of time, and the risk of death would have increased. If I had just a little D cylinder with a nasal cannula, I would have improved some and the real risk of death would have been lower.

I had some prednisone on hand, though at a lower dose than used at hospital, so I was covered on this. I have a penicillin and a macrolide antibiotic on hand so I might have been able to treat the bacterial pneumonia that started up, though the hospital used a quinilone antibiotic. So I had a chance of treating the incipient, potentially deadly complication of bacterial pneumonia. I had a small supply of antiemetics to treat the nausea so I had a chance to slow the deadly fluid loss that would have killed me.

If my wife had forced fluids on me, an ounce or so at a time, I would have had a small chance of recovering from the developing shock. I was down nearly three quarts of water so it would have required round the clock intensive nursing care on her part and a lot of luck to correct the deadly fluid deficit. Between the shock, the low blood oxygen/seriously impaired respiration, and incipient bacterial pneumonia, I probably had about a 65% chance of surviving this flu with home care only.

Notes on the Disease
First, in our area of SouthWest Montana, there have been no cases of the seasonal flu at all, only H1N1 (swine flu) to date. Silver Bow and Lewis and Clark Counties lead the state in case reports, for week ending 17oct09, (1,501-3,000 cases each), with Galatin County close behind (751-1,500 cases). Generally, Eastern and Western Montana counties are reporting between 1-250 cases. Central Montana counties and Broadwater County are reporting 0-0.9 cases.

Montana's Department of Public Health has received the first shipment of H1N1 vaccine, they are deciding which groups to offer it to first. Watch your local newspaper and TV for further news. So get your regular flu shot but exercise meticulous infection control behavior in your family to avoid H1N1 infection. I had had the regular flu shot 8 days before I came down with the swine flu, maybe I became lax in my precautions? Here is the flu information page for our State.

The doctor told me that the H1N1 virus is transmissible by indirect means (infected person touches object, you touch object with germ and then touch your eyes or nose) also, not just by the infected person coughing or sneezing droplets that you inhale. As an added note, pets should be excluded from the infected person's room as their fur can serve as a "fomite" to carry the virus between people. The infected person could pet the cat or dog if the person washes their hands thoroughly before hand or wears gloves. But no nuzzling by the animal or kissing by the human. Imagine trying to sanitize a cat after the patient coughed and then pet it!

The virus is shed for up to 10 days after the patient's fever breaks. This means the patient is still highly infectious even after they feel fine again. So wearing a mask when out in public and using hand sanitizer or gloves frequently is not only common courtesy for the recovering H1N1 patient, it is sound public health policy. All door handles, light switches, etc. need to be disinfected regularly during the course of the patient's illness and the whole area given a thorough cleaning and disinfection after the disease has passed.

This strain of flu is highly infectious; consider it as infectious as measles or tularemia if that helps give you the mental image that this is not a trivial disease. Pregnant women, young adults, and those with chronic diseases (diabetes, heart disease, chronic respiratory disease) are at real risk of death from this flu strain.

Use masks! Sure it looks funny in the USA but in Asia it is a social custom to wear a mask when you are ill with the cold or flu as a courtesy to others and as a good public health practice.

N95 masks tend to have higher breathing resistance and be less comfortable to wear than procedure masks. But they offer a slight edge in risk reduction. Earloop masks are the easiest masks to wear for long periods of time, just remember to form it to your face carefully. Traditional string-tied masks tend to have more "breathing room" so they would be a good choice for the patient as they have low breathing resistance. There downside is that they take more time to don and doff and tend to shift position easily.

That's all for today. I'm glad I'm still alive and I hope you can learn from my mistakes so you don't end up in serious crisis due to the H1N1 flu.

Airguns

Today's post is about a great tool for the well heeled prepper, airguns. Today's post is by a long term prepper and former Army officer from SW Montana. I've seen him demonstrate what these guns can do. Trust me, get one they're very useful and fun!




While most 'preppers' include a firearm in their preparedness plan, one weapon that is frequently overlooked is the air rifle. The air rifle can make an excellent addition to any prepper's battery and is probably more useful in anything short of a TEOTWAWKI situation, particularly for the suburban survivor. The Air rifle is useful for training, pest control and even hunting small game, while having a low report and limited range that makes it well suited for more built up area. Ammunition is widely available and relatively inexpensive. A can containing 500 rounds is the size of a chewing tobacco tin and can be purchased for less than $8. Also, because air guns are not firearms, there are few regulation regarding their purchase, ownership and even use (as always, check your local laws). This article will cover the various types of air rifles, discuss their utility and give some tips on selecting an air rifle for you personal battery.

Most Americans think of air guns as toy suitable for older children rather than as a serious tool. Many of us owned 'BB' or 'pellet' guns when younger, and look at these weapons as a sort of 'junior' firearm until we are old enough to get a 'real' gun. However, in countries with restrictive gun laws, the air gun is often the only gun one can obtain, and air guns in these countries (Germany, England, etc) are as refined as any American made firearm. The higher end 'adult' air guns are accurate, powerful and extremely well made guns that can last a lifetime or more.

Adult air guns were relatively unknown in this country until recently thanks to Dr. Robert Beeman, who began importing high powered air rifles into the US to be sold under the Beeman name. There are now a variety of importers, and literally dozens of high quality air gun from scores of sellers. One can buy air guns from hundred to thousands of dollars, and from small caliber precision plinkers to .50 caliber plus air guns capable of taking some of the largest game in North America.

Modern air guns are typically divided into three types: pneumatics, gas guns and spring guns. Pneumatics are further divided into single pump, multi-pump and PCP (Pre-charged pneumatics). Most common 'BB' and pellet guns fall into one of the first two categories. Benjamin and Crossman are well know for their 'pump up' pellet guns. The last type, PCP, utilize a built in air tank that is charged from a high pressure source like a SCUBA tank or via several hundred cycles of a special high pressure hand pump.

Most of the American made pump pneumatics are inexpensive and fair quality, with barely adequate accuracy and no provision for scope mounting, and are relatively limited in their usefulness. PCP guns are typically higher end guns that are very powerful and accurate, but require a high pressure air source that makes them less than ideal for anyone beyond the dedicated air gunner. Gas gun are familiar to most in the form of CO2 guns. While convenient, they rely on CO2 cartridges and their accuracy and velocity is also less than optimal.

This bring us to the spring guns, which make up the majority of the 'adult' air guns available. In a spring gun, there is a large compression chamber much like a doctor's syringe. A spring is held under pressure by the trigger, and when the trigger is released, the spring presses the 'plunger' forward, compressing the air and forcing it through a small port into the rifled barrel where a pellet is waiting. The compressed air launches the pellet out the barrel. The gun is then re-cocked, compressing the spring and another pellet is loaded into the barrel. This relatively simple system results in a uniform volume of air each time the gun is fire, leading to consistent velocity and good accuracy. It is also capable of producing fairly high velocities. Some of the higher powered 22 caliber spring guns can launch a pellet at or over 1,000fps. These guns can place 5 shots within a 1 inch circle at 50 yards and humanely kill small pests and game at 30-50 yards with little noise. The air gun can also be used to 'discourage' larger animals like feral cats and dogs from intruding into your yard or garden . And thanks to the light weight of the pellet and it's low ballistic coefficient, the same pellet is relative 'harmless' at 100 yards. Unlike firearms, a air rifle can be fired relatively safely even in a small suburban backyard, and few neighbors are likely to complain about you shooting your 'BB' gun.

Adult air guns are like conventional firearms in that you typically get what you pay for. The cheapest spring guns available are often of inferior quality and not worth consideration. Spring guns actually require as much or more precision manufacture than firearms, so you should expect to pay a minimum of about $150 for a decent spring gun. There are a variety of cocking systems used for spring guns – break barrel, under lever and side lever – with break barrel being the most common. In a break barrel air rifle, a linkage is attached to a hinged barrel. To cock the rifle, one breaks the barrel until the piston is captured by the trigger mechanism. A pellet is then fed into the open breech, and the barrel is hinged closed until it locks into place. Typically, the safety is automatically activated so that the cocked and ready to fire rifle is already on safe. Break barrels are easy to operate and understand, and it is easy to check to see if the rifle is loaded with a pellet by simply opening the action. In the case of under lever and side lever gun, cocking the lever opens a port into which the pellet is loaded. Because the lever is under spring tension, these guns are equipped with an 'anti-bear trap' mechanism to keep from smashing your fingers while loading. For this reason, the break barrel is usually recommended as a first air gun.

Almost all spring guns are equipped with a 2 stage trigger. This type of trigger is favored by Europeans and is generally unfamiliar to American shooters. The trigger has a long, relatively light first stage (take up) followed by a shorter, crisp second stage which fired the gun. On firing, the piston is released forward, and a spring gun will often have a noticeable, but not uncomfortable recoil. Because spring guns use a forward moving piston, they actually have recoil in both direction, and the forward recoil can destroy scopes not rated for air guns, so you will need an air gun rated scope. In addition, air gun scope have their parallax set for 20-25 yards, rather than 100 yards on a conventional scope. Adjustable Objective air gun scopes will generally focus as close as 7 yards.

When selecting an air gun, even after determining type, there will be a a number things to consider. The two main thing to keep in mind are intended use and the user. While spring gun can generate a significant amount of power, to do this means using heavy springs which require some upper body strength to cock. Also, intended use will dictate caliber. The four most popular air gun calibers, in order, are 0.177, 0.22, 0.20 and 0.25. Of these four, only 0.177 and 0.22 should be considered by the 'prepper'. The other calibers are often difficult to find, and so unless you plan on keeping a large store of ammunition, stay with the common calibers which can be found at almost any sporting goods store.

The general rule of thumb is that 0.177 is meant for target shooting and practice, and 0.22 is for pests and hunting. This is mostly true, but small animals can be dispatched with 0.177 if you restrict your targets to small game (birds and rodent) at short distances. The best all around performer is a powerful spring gun in 0.22, but such a rifle may be too hard to operate for older children or even some adults. If the air gun will be used by teens or a person with limited upper body strength, you will need to select a spring gun with a cocking effort of less than 25 pounds. This will generally limit you to lower velocity 0.177 air gun. However, these gun can still function very well in the pest control and hunting role if you understand their limitations.

Rather than cover every possible gun on the market, I'll list a few of the 'classics' that most experienced air gunners consider good guns and good values.

Light weight air guns with moderate cocking effort. These rifles are suitable for older children, men and women. These also tend to be lighter that 'full power' air rifles, and much easier to carry around.

RWS Schutze – This basic training rifle will deliver a 0.177 pellet at about 580 fps and costs about $200. It is marginal for game but only requires 19 pounds of cocking effort. Equipped with iron sights, it has an 11mm dovetail for scope mounting.

Beeman HW30S – Another easy cocking 0.177 caliber rifle from Germany, it features the famous Rekord trigger, iron sites and 11mm dovetail. 675 fps. About $300

Beeman R-7 – A highly refined version of the HW30S with an American style stock and 700 fps. Weighs in at about 6 pounds and sells for around $400

Classic 'work horse' guns. These are proven and well regarded designs that will last for years, are accurate and powerful. They require a cocking effort of around 40 pounds.

RWS34 – this basic gun start at around $225 and goes up depending on options. Just shy of 8 pounds in weight, the 0.22 version will launch a pellet at 800 fps.

RWS 350 magnum – This is a true magnum air rifle, capable of 1000 fps in the 0.22 version. The basic model starts at just under $400 and weighs in at 8 pounds.

Beeman R-9 – Available in 0.177 and 0.22 caliber, this is one of the most popular air rifles among US air gunners. It's equipped with the excellent Rekord trigger and weighs only 7 pounds. The 0.177 version fires a pellet at just under 1000 fps and the gun has a deserved reputation for superb accuracy. Fit and finish is first rate, as you would expect from an air gun that starts at $500.

Beeman R-1 – This was the first air rifle to break the speed of sound. Also equipped with the Rekord trigger, dovetail for scope and superb fit and finish, this rifle is a burly 9 pounds and starts at $600.

In addition, there are a number of other quality guns, both break barrel, under lever and side lever not mentioned here like the 'classic' RWS 48 and 52.

Recently, an number of excellent Chinese made air gun have been imported in the US. While fit and finish are not up to the standards of the European made guns, they represent a good value for the cash strapped buyer. In the past, quality was spotty, but the latest Chinese made guns are very much improved. In particular, there are are several models that are virtual clones of much more expensive European guns that sell for half or even one third the price. The Chinese XS-26 is a copy of the Beeman R-9, the XS-28 is a duplicate of the RWS 350 magnum and the XS-B30 is a copy of the RWS 48. A little research on the web will turn up numerous reviews on these and other air guns.

Once you have selected and received your air gun, here are a few things you need to know.

1.Treat your air gun just like any other gun. Adult air guns are not toys and can kill. Follow the basic rules of gun safety.

2.Wear eye protection. Pellets can ricochet and you are generally much closer to your target with an air gun

3.Never fire a spring gun without a pellet. When the piston is released, it is cushioned by a column of air behind the pellet. Without a pellet, the piston slams into the front of the cylinder which can damage the piston and piston seal

4.Use only air gun oil, and only oil as recommended. The pressure and temperature of the cylinder get high enough to detonate petroleum oil, just like in a diesel engine. Smoke and noise from you spring gun is a sign of 'dieseling', and is bad for the gun. Many new guns will diesel for the first few shots. Don't amplify the problem by adding 'fuel'. Use only approved oil as recommended by the manufacturer.

5.Air guns require a break in period before they reach full accuracy and velocity. This is typically 500-1000 rounds before the gun 'settles in'. Give the gun time to break in.

6.Air guns will often show a preference for certain pellets. Try a variety to find out which shoot best.

7.Have fun. Use your air gun to practice your shooting skills in the back yard, barn or even basement. Dispatch those pesky garden pests without using poisons, bothering with traps, or disturbing your neighbors.

Useful air gun web sites:

http://www.airguns.net/ - Air gun reviews and other helpful information
http://www.pyramidair.com – Customer reviews of a huge variety of air guns, air gun sales.
http://www.beeman.com – The original importer of adult air guns. Lots of useful air gun info.
http://www.arld1.com/images/swfs/tx200whole.swf – Great illustration of how a spring gun works
http://www.xisicousa.com/airguns.html – Importer of Chinese made air guns
http://www.compasseco.com – Chinese air gun sales, under their own 'Tech Force' brand as well as other makers.

NRA Refuse To Be A Victim Class Change

RTBAV class will be held at Lewis and Clark County Library (120 S. Last Chance Gulch, Helena in the large meeting room) this Tuesday, the 21st from 615PM-830PM rather than on Wednesday, the 22nd.

Sorry about the change; room was not scheduled, luckily I checked. No publicity done either. So if you are in the Helena, Deer Lodge, or Butte area, come on down for this class which deals with security issues related to survival. Network, exchange tips with each other, learn from the experiences of those who have faced living in high crime areas and learn some opsec tips for SHTF.

Again, class is free of charge. You get a good student book too.

For those outside SouthWest Montana, try these websites for tips on surviving the coming "Change and Hope":

http://www.corneredcat.com/TOC.aspx#FirstGun A site for women, authored by a woman, on armed self defense. Very good on the mental aspects of surviving violence, light on technical minutae of bullet weight and esoterica of powder choice.

http://www.abovetopsecret.com/forum/thread237760/pg1 Blog article on defending your supplies from looters and the State. Ignore this aspect of survivalism at your peril.

http://www.defendu.com/articles.htm Defend University. Great name, great articles on crucial aspects of self defense and situational awareness.

http://www.selfsecure.co.za/html/making_your_home_risky_for_cri.html Site has a few good articles on crime prevention from a country which made our recent mistakes, from 1994 on; so read this material to prepare for our descent into the abyss when SHTF here. Solid advice from a place which makes Oakland or Detroit look like heaven.

http://www.tactical-life.com/online/category/tactical-medicine/ A few good, brief, articles on what to do when SHTF and your side has WIAs! Practical articles that will appeal to the survivalist medic looking for ways to prepare for beyond Check Call Care first aid.

http://www.opfors.net/forums/viewtopic.php?f=58&t=41 100 things that you need to be prepared. The comments at the end from a survivor of Sarajevo are both instructive and chilling when you read them.

Be safe. Be prepared, be strong in faith (of your choice).