DIY Medicine

[The Old Man]

I recently sustained a medical emergency that required me to contact the EMTs who took me to the hospital. Recently, I received the bill of nearly $90K; my health insurance is covering most of it, but I am liable for the deductible and out of pocket maximum which will be paid through my Health Savings Account. I don’t consider the medical issue to have been that complicated, so I find the bill to be shockingly high.

So, since this is ERE, how feasible is DIY Medicine?

In my case, I sustained severe dehydration. While my boat has air conditioning, it only operates on shore power; I have no air conditioning when I am on anchor. In Florida, I was dealing with 70-80% humidity and a temperature of 95°F. I sustained severe dehydration and as I was rectifying this problem I developed side effects of a major infection of my urinary tract, kidney, and blood. Whereupon when I made it back to shore, I contacted the EMTs.

A google indicated that severe dehydration meant a risk of developing a urinary tract and kidney infection which is what happened. Since the kidney infection was massive it also affected the blood, which Google did not indicate.

DIY Medicine: In addition to having a first aid kit it is also possible to obtain prescription medicines for prepping purposes. Several companies in the USA sell prescription medicine kits. Usually, a doctor’s authorization is necessary, but the companies provide that as well.

First Aid Training
https://www.wildmed.com

Prescription Medicine Kit (as an example)
Jase Medical Antibiotics Emergency Kit Review (and how weirdly easy it was to get)
https://youtu.be/p6fzOFWAijE?si=e1H9eSQav3gTqlg5

The links above pertain to first aid training and prescription medicines that are geared towards people traveling in remote locations but could also be used at home.

I think if I was properly prepared, I could have treated myself and avoided a trip to the hospital (and the huge bill).

So, back to the question: With proper training, first aid kit, and prescription medicine kit, how feasible is DIY Medicine as a first step? Remember, if the EMTs are available in a timely fashion, then since you don’t have a medical license, you can’t treat others – only yourself.

[7Wannabe5]

Since urinary tract infections are a frequent and not-easy-to-ignore problem for many women*, it is a known hack to hold some antibiotics in reserve and/or chug concentrated cranberry juice while taking OTC oral anesthetic tablets. I'm not especially prone to them, but BTDT out of frugality and/or not wanting the bother of doctor appointment.

I used to be generally quite DIY on medicine, but then I got Crohn's Disease, and I gave up, because human immune system second most complex thing in the known universe; the first most complex being human brain. So, now I am tethered to IV infusion treatment with extremely expensive advanced biologic medication every 8 weeks. However, mini lightbulb moment, it might come to happen that an AI mini-chem lab could be helpful in this realm in the future. Anybody with the skillz to currently do something like 3-D printing could manufacture their own customized phamaceuticals!



*Also why some women develop the practice of jumping right out of bed after sex to urinate as preventative measure. My current partner has a bidet installed, and I would highly recommend this as an addition to any even moderately active heterosexual bachelor pad.

[theanimal]

Medical skills are a key skill for the aspiring renaissance individual. Even if you are not going into remote locales, the knowledge may help serve you or your loved ones when you need it most. Mrs. Animal and I have taken and been certfied in the wilderness first aid (WFA) and wilderness first responder (WFR) courses multiple times. We also once took an EMT course and were certified until we let that lapse. I've used my skills to help an elderly women who rolled her car off the side of the road in winter as I was driving by, and also in the backcountry when Mrs. Animal went into a severe state of anaphylaxis.

Both of us came to the conclusion that the Wilderness First Responder course is the best course you can take, even though it's technically lower than an EMT. The built in assumption within each course reflects the material and depth to which you are taught (at least in our experience). For the WFR, the assumption is you are far from services with limited supplies. You are forced to use the limited resources you have and deal with the possible harsh nature of the surrounding environment. If you are an EMT, you are presumably within a city and are relatively close to a hospital, leading to an environment where you're more likely to punt on certain problems. There also isn't that much difference in terms of material covered. The EMT course covers emergency childbirth and the administration of a limited amount of drugs, like narcan. Factoring in the (often significant) additional time and cost for the EMT course than with a WFR, my $0.02 are that a WFR offers a superior education for medical skills. You can find courses through NOLS, Wild Med, and SOLO schools.

I believe @Ego has mentioned the book "Where there is No Doctor" and the accompanying "Where There is No Dentist" on here before. Those are supposedly very highly regarded and older versions of the PDF are available online. There may also be a thread on those books somewhere on here.

ETA: Here's the thread on the Hesperian Health Guides by @NewBlood, my apologies! viewtopic.php?t=12323 Looks like I said much of the same I said above.

[The Old Man]

@theanimal

Thanks for your detailed response.

[jacob]

I'll +1 the two "Where there is no doctors/dentist" books. Go get them if you don't already own them:
https://www.amazon.com/Where-There-No-D ... 942364155/
https://www.amazon.com/Where-There-Dent ... 942364058/
(I recommend the paper versions. Because when you need a doctor it's also likely that you won't have internet, especially where you're going---out on a boat in the middle of nowhere, far harder to reach than a regional mountain top. Also, I presume you're already looking into offshore medicine, which is another thing entirely. Doctoring is the third most important skill on a boat right after sailing and engine mechanics!).

Those two books will provide a different and reality-based perspective on both what can go wrong and what it takes it "fix" it compared to how these things are commonly approached on a street level in the US. Growing up in Europe in the 1980s/1990s I find myself somewhere in the middle between US2020 and Wherethereisnodoctor. So let's contrast and compare ...

In the US, there's definitely the belief that medicine (a product that you can buy if you ask your doctor, just watch this ad) can fix any and all problems. It's possible for anyone to buy a much wider assortment of medicines in the US than are generally available elsewhere (whether by law or availability). However, this also means that people can go out and buy a pill or salve and proceed to misapply it and suffer the consequences. There's also the belief that a doctor will know exactly what's wrong and exactly how to fix it.

First, going anywhere within 10ft of a doctor in the US often requires you to seriously rearrange your financial budget (something most doctors don't see and few ask about) to the point of bankruptcy. More importantly, they'll apply "tests" and "medicine" to figure it out, much like a science experiment. This might not always be for the better. As such people go to the ER for a simple throat infection and proceed to get financially slammed paying for a full spectrum test or they go to a corner drugstore and pop pills every single time (ending up with kidney issues 30 years later) ... when they could have boiled a pan of water and inhaled the steam for relief and solved the problem in 1-2 days.

As such, I'm learning more towards DIY diagnostics. Learn what can go wrong and how likely it is and how likely the body is to self-repair. It's unfortunate it has to be this way but showing up uninformed whether at the doctor's office or IRL in general all comes with risk. Just like going to the auto-mechanic, they might take you for a ride. This, however, also means knowing enough to know to distinguish between when you have a serious problem that requires intervention and when you just have a problem that'll clear up on its own.

[Bonde]

Im glad you are OK. The treatment probably saved your life. You had sepsis (bacteria in blood) which has an around 30% mortality rate and requires Iv antibiotics and fluid/electrolytes.
Prevention is key. Do everything possible to avoid severe dehydration.
Concerning med kit I recommend a few different antibiotics, painkillers (pcm, ibuprofen), pcm also lowers fever, different bandages, torque, suture kit. I think that covers the most practicalities and you og course need toknow your gear eg. Which infection an antibiotic usually treats.

[Sclass]

I personally don’t know much about this stuff.

My dad however really liked to play doctor on himself. While cleaning out his house this summer I found multiple copies and editions of the Merck Manual. He’d refer to this a lot. I also found stashes of all kinds of drugs. Mostly antibiotics he bought in Mexico over the counter. There must have been half a dozen kinds of Penicillin there…N,G etc. It looked like it could give you serious diarrhea issues if taken but I suspect he hoarded the stuff as a last resort.

While he did save himself a few times this way I look at it more like postponing his eventual trip to the ER. He ended up in the hospital multiple times with confused doctors looking at his imaging wondering how long he’d been suffering. That is, he would stave off disease up to a point then he’d finally break down and go in.

I guess on your boat it is a really good idea to have some meds and the know how to put yourself back together. I had a friend who superglued a guy together after a vicious fight. My friend was a med school dropout who happened to have a bottle of superglue handy when this guy stumbled in covered in blood. It worked out pretty well.

[ertyu]

i've been superglued by an actual doctor. works well when the cut has clean edges and you're reasonably confident it's clean and shallow enough not to be infected.

[Frita]

My dad was a Vietnam-era medic, doctored our animals and us. Butterfly clips seem to work similarly to superglue without the stuck fingers. I have used this myself while skiing and not wanting to drive into whatever closest town to get in the Instacare/ERE queue (and possibly listen to someone tell me about their sexually-transmitted disease symptoms, true risk from my experience).

Thumbing through the no-doctor manual, I found the healing with water section fascinating.

[chenda]

I wonder how much veterinary medicine is analogous to human medicine, and vice versa. I imagine a vet could effectively treat humans in an emergency.

[Ego]

I would think that when you are far from help, having the right diagnostic tools, instruments and drugs on hand is critical. I assume you will have some sort of communication method that can link you to your doctor, GlobalRescue or some other emergency service.

Every so often military medic kits show up on ebay. Search "North American Rescue" or "Phokus Research Group". If you look at the photos closely you may find that they are packed with useful doodads that are impossible to get over the counter. Some come with small waterproof spiral guides that are pretty good at explaining in layman's terms the field treatment of various traumas and even some non-trauma medical emergencies like the one you experienced.

That said, chances are the condition that will cause you trouble when you are far from help is one that you already know about. If you have heart problems, diabetes or some other condition, run through some scenarios of what could happen and how you would handle them. I find flow charts helpful.

[thef0x]

Interesting thread. I think a better title would be "DIY Acute Medical Diagnosis" because systemic, slow moving problems are not identifiable nor well treated with these suggestions (think cancer).

I am excited about tech here as many new companies are offering full body MRI diagnostics for more and more reasonable prices. Eventually, I hope, this kind of tool will become standardized for preventative medicine.

As a note related to the acute diagnostics: interestingly chatGPT / big data meets AI may unlock huge cost savings for DIY medicine. While potentially wrong, honing in on the appropriate diagnostics to pursue without a doctor's first pass may save quite a bit of money from our bloated healthcare system.

I'm optimistic about the intersection of tech and personalized medicine in general.

[jacob]

As a note related to the acute diagnostics: interestingly chatGPT / big data meets AI may unlock huge cost savings for DIY medicine. While potentially wrong, honing in on the appropriate diagnostics to pursue without a doctor's first pass may save quite a bit of money from our bloated healthcare system.

It's possible to get pretty far in self-diagnosing even with the Merck manual (book), common sense, and an understanding of baseline probabilities(*). "Where there is no doctor" is a good starting point. Overall, health care is more of a "culture" than a service. What I mean with that is that people have certain expectations of what can be done and who should do it. Even moving from Denmark to the US, I still find myself struggling to deal with the US healthcare system because the expectations are simply different that what I "culturally absorbed" growing up. In many way, I'm closer to the "Where there is no doctor", because I simply wouldn't go to the ER if I had a fever with the flu or seek out a pharmacy for some pill as seen on TV if I had a sore throat... rather I'd be sitting with a towel over my head staring at a steaming pot of water. The difference in how DW and I approach our health is worth an anthropological study on its own.

(*) Math, bodily wisdom, AND the propensity to read being required is why this is not a universal recommendation. It's possible that AI can make a substitution suitable for the masses who "get their informations" from tiktok. Technically, as far as I understand, doctors do much of the same thing... essentially running through a decision tree while knowing what to look for and how probable a given branch is. It's the "knowing what to look for" that's the hard part, because to do this yourself requires a good sense of the physiological sensations in the body itself which apparently many humans lack.

[Henry]

... rather I'd be sitting with a towel over my head staring at a steaming pot of water.

Out of curiosity, were you birthed by a mid-wife.

[jacob]

Out of curiosity, were you birthed by a mid-wife.

The working hypothesis is that I was beamed down to the surface by space aliens. AskyourdoctorifgettingbeameddownisrightforyouIfyouexperiencenausevommitingheadachesorimaginarydeathortoomuchgooglingtalktoyourdoctoraboutotheroptionsaftermakingoursalespitchforus.

[Henry]

The working hypothesis is that I was beamed down to the surface by space aliens.

Nothing personal, but I wouldn't object to that idea if it was floated.