Surviving the Medical Meltdown (17 page)

Suzanne Somers is a breast cancer survivor, and she is currently taking the same Wiley hormone replacement I use. Before starting that program I contacted the cancer specialist following her and about fifty others on the Wiley program who also have had breast cancer. As it turns out, although this data is unpublished to my knowledge, the rate of cancer recurrence in the treated group was far below the rate of recurrence in people not on the program. For my money this makes sense because one of the many benefits of hormone replacement is an improvement in immune function.

BIOIDENTICAL HORMONE THERAPY (BHT)

For women this is somewhat complicated because normally we have hormones that wax and wane with the moon cycle. Men are simpler and have less cyclic variation and fewer hormones to worry about. For men, replacing testosterone to normal ranges is usually all that is required; albeit some men, like women, need thyroid and adrenal assistance. Generally, oral therapy would not be used for sex hormones because of its effect on the liver. So we use patches or rub-on creams or injections. For most men, I find a simple rub-on cream dispensed via a pump is fine. They push the pump and it gives a measured dose, which they rub on some part of the body that won’t
come into contact with other people. (Women partners don’t need much testosterone and can get overdosed from a man if he does not take precautions: wash hands, use under clothing when going to work, and avoid the buttocks, where it can transfer via toilet seat.)

In my female program I replace thyroid and adrenal hormones orally and then use rub-on creams to replace estrogen, progesterone, and testosterone. There are several things that all anti-aging doctors agree on: (1) these hormones do not cause cancer, (2) there is no anti-aging benefit to being without hormones, and (3) oral sex hormones are bad. But we do not all agree on the way to dose and monitor hormone supplementation. There are those who give women the lowest dose possible to prevent symptoms such as hot flashes. Then there are those who give a higher, steady state dose. And finally, there are those who replicate the hormone levels of youth by giving high-dose hormones cyclically. For myself I use the higher-dose cycling hormones – I re-create the environment for my cells that I had in my youth. I very much believe the philosophy of T. S. Wiley in her book
Sex, Lies, and Menopause
, that our bodies were made to cycle. And in addition to the voluminous literature debunking the idea that cancer is produced from bioidentical hormones, I try to think about this logically. Who gets cancer? Women in their twenties whose estrogen and other hormones are sky-high? Or women in their fifties with declining hormones in abnormal proportions? We know the answer is the latter. In my own experience, I feel the best, look good, and have normal menstrual cycles when using the cycling youthful level of hormones. At sixty-one I actually feel better and am in better shape than when I was forty-five. And whereas I once hated having my menstrual period, now I celebrate the monthly blood flow as biofeedback that my cells are normal again!

To get on a program of hormone optimization, you will need to find a doctor or nurse practitioner who specializes in this field of medicine. You may find one by word of mouth or the Internet. But if needed, I have listed resources for finding a practitioner.

PART III
LIVING THROUGH THE MELTDOWN

13
BE YOUR OWN CORPSMAN:
INTRODUCTION TO PERSONAL SURVIVAL

H
aving been a Navy medical officer for ten years, I have a great affinity for Navy corpsmen. At the battle of Iwo Jima, Navy corpsmen and surgeons landed with and were everywhere tending to wounded Marines. After that historic fight, four Congressional Medals of Honor were awarded to Navy corpsmen, two posthumously. John Bradley, one of the flag raisers at Mount Suribachi, was, in fact, a Navy corpsman. In Vietnam, 620 Navy corpsmen were killed, more than three thousand were injured, and four corpsmen earned the Congressional Medal of Honor.

Independent duty corpsmen, or IDCs, are the highest level of medical care aboard many submarines and surface ships. They also supply medical care for the forward-based Navy and Marine Corps Special Forces teams. Through multiple conflicts, on land and on sea, in remote areas, in inclement regions, clever Navy corpsmen have learned how to survive and how to medically assist those around them – often with little in the way of supplies or oversight. We have much to learn from their experience, so I am using them as a model of independent medical care when higher-level medical help is either absent or far away.

INFORMATION IS KEY

Because the future is always uncertain and you never know what medical crisis may come your way – or if help will be help available in such a crisis – it is probably a good idea to get a military field medical reference, such as the
Special Operations Forces Reference Manual
(see
appendix A
). It is wise to print out pertinent sections to keep in case of emergency. I’m not confident about our ability to have complete access to the Internet in the future, so I keep very important information backed up by paper. Also, a plethora of self-help, home-care manuals are available at major bookstores. Some may be better than others, but definitely purchase something and keep it handy. As much as I disagree politically with the AMA, they put out a great home book for emergency care, the
American Medical Association Handbook of First Aid and Emergency Care
. The more portable, the better. The U.S. Army
First Aid Manual
is an excellent small book of the nuts and bolts of first aid care that can easily fit into a backpack or your seventy-two-hour bag. This book is intended to be a quick reference for many things. For in-depth assistance, the
American College of Physicians Complete Home Medical Guide
gets high praise from laypeople for its thoroughness, good illustrations, and general helpfulness in understanding all sorts of diseases.

BUDDY CARE

One of the principles of military medicine is buddy care. It is important that family members be organized and that everyone understand how to help others in certain emergencies. If one family member has periodic, severe asthma attacks, all able members should be trained to assist if needed, including knowing where important medicines are stocked. Everyone should take a CPR course and should understand basic first aid. All the principles of evacuation and emergency meeting areas should be part of a family’s planning.

ORGANIZING SUPPLIES

Navy corpsmen know that it’s prudent to distribute supplies among many users. Of course, in a combat situation this is done for many reasons, not the least of which is to camouflage the corpsman, who otherwise is one of the prime targets. But it is also done so that no one ends up carrying too much and so that if one bag gets left behind or lost, you are not totally without medicine and supplies.

Most survival handbooks recommend that every family member be responsible for a pack. From a medical perspective, this pack should carry that person’s prescription meds, over-the-counter meds, and supplements for at least a week. You can possibly replace food and water, but you may not be able to quickly make up prescription meds.

I also recommend having a more extensive first aid pack that can be hand carried. In that pack I would put basic supplies, splints, and more medications. Suggested contents are outlined in
appendix B
.

And it is probably a good idea to have a true first aid emergency backpack for grab-and-go. There are few areas of America without some realistic disaster potential that might necessitate emergency evacuation – forest fires, tornados, floods, earthquakes, to name a few. And then there are gas leaks, toxic spills, and industrial accidents. Don’t be complacent about organizing for an eventuality you hope never occurs.

Being a physician, I have organized my packs around specific problems. You could use various-sized backpacks or plastic storage boxes for your packs. I have one box of wound care supplies; another for advanced wound care that includes minor surgery sets; one box for respiratory problems; one for medications; and my father’s black bag, which contains examination equipment – a stethoscope, some old-fashioned mercury thermometers and a new one that does not require a battery, a blood pressure cuff, and so forth. I also have several boxes of supplements and hormones. Finally, I have a pack of splints, slings, and orthopaedic equipment that I keep – for obvious reasons – next to my snowboard bag. I have a second, tiny house that is my peripheral office. It is eighty miles away, and I
keep there a seventy-two-hour medical kit. If for some reason I had to bolt out of my regular home, I would go with my family there. It is probably a good idea to distribute survival medical supplies among family members’ seventy-two-hour kits, and each member should carry a kit. In the military, corpsmen do carry some things, but every ground combat unit distributes medical supplies among
all
its members.

COMMUNITY SUPPORT

Consider, too, that in an emergency, most of your neighbors will be less prepared than you. I have participated in a group that has given preparedness talks to our community because we do not want to be surrounded by desperate, unprepared people. Consider organizing your community for a general catastrophe, and then get a medical provider to help with this piece of the preparation.

It is the principle of the Mormon Church and of the Jews at Passover (and probably at other times) to prepare for one’s own family plus one other person. I would think that way about supplies in general. When it comes to medical preparedness, depending on the catastrophe, you may want or need to render first aid to others. The level of preparation depends on how you see your role in this eventuality. As a surgeon, I am now the repository of all out-of-date wound care articles from my hospital. I am preparing to be the community medical clinic in a pinch.

In the next few chapters, I will outline in detail what to stock in your packs, but the first thing you need to know is where real emergency and nonemergency medical care can be found. That’s what we’ll discuss next.

14
FINDING A PHYSICIAN WHEN PHYSICIANS ARE SCARCE

Y
ears ago, I read an article in the
American Journal of Medicine
that said that 90 percent of the time people go to a doctor, they don’t really need a doctor. But that other 10 percent of the time, they need a damn good doctor. I believe that to be true. Of course, the key is knowing whether you are in the 90 percent or the 10 percent. A good Navy corpsman knows where his resources are for that 10 percent.

It will become important for you to have a relationship with some higher-level medical provider – a physician, nurse practitioner, nurse, or physician’s assistant. You need to assess the resources you have and keep that information updated and handy. Think of it as you would your will and testament. You try to keep a list of people who need to be contacted for quick access by your heirs. Of course, the best insurance is to do what I did: I sent my son to medical school! (Actually he went of his own volition in spite of my telling him to be a lawyer.) But since everyone can’t do that, you need a list of all medical personnel you can access in an emergency.

As stated in previous chapters, those people most likely to be left out in the cold in the coming medical meltdown are those of or near Medicare age, the disabled, and those with chronic disease
or potentially terminal illness, such as prostate cancer or myeloma, with which you may live for many years but whose treatment may be deemed “futile.”

Ultimately, if things become as grave as I believe they will, we will all be in trouble finding the medical care we need, either because an economic collapse impacts our ability to trade goods and services – including medical care – or because there simply won’t be a doctor or a clinic for miles and miles.

As an aside, but in confirmation of this fear, I recently attended a mandatory training session for EPIC. EPIC is the most common electronic medical records (EMR) system being forced upon hospitals and physicians’ offices. Nothing in my career has proven so devastating to quality health care as the implementation of EMR. As it turns out, the CEO of EPIC was a huge financial backer of Obama – big surprise? But the upshot is this: all four of us at the training were surgeons in different specialties and from different hospitals, and we all discussed how we could retire rather than deal with this awful nightmare.

I am going to assume that the government in this scenario has not made cash payment for medical care illegal. If, however, the government outlaws cash practice (as was done in Cuba, Canada, the Soviet Union, and North Korea), then most of this chapter still applies to getting care in the black-market economy that will surely develop.

FIND A CASH PHYSICIAN

Most doctors today don’t work for you – they ultimately work for those who pay them – in other words, insurance companies and the government, via Medicare and Medicaid. Having said that, it is also true that most physicians are true professionals, and they do try to keep your needs at the forefront of their consideration. But ultimately, let’s face it – they run a business, and if they lose money on a treatment, they can’t continue to offer you that service. (This is a basic business concept that seems not to be understood by policy
makers in DC). And when the system collapses, those dependent on government fees being paid by Medicare will collapse with it and not be available – at least for a while – to help you.

Thankfully, a growing number of physicians are running cash practices. They do not take any government money, so they don’t have to follow government rules and are not dependent on a functioning government system to stay in business. Because a cash practice requires far less staff, their overhead is low. They are usually very cost-effective, charging a fraction of what is charged through insurance. And in any case, they spend time with you, not with your records, so you get more for your money.