Surviving the Medical Meltdown (30 page)

Food poisoning:
Since food poisoning can be misunderstood to be flu, we will address the symptoms here. True influenza with gastrointestinal symptoms lasts for more than a few days, generally causes diarrhea, but rarely causes a sudden onset of vomiting and diarrhea all at once. Sudden onset of abdominal bloating, diarrhea, nausea, and vomiting that lasts a day or less is generally food poisoning. Depending on the bacteria involved, it may start two to sixteen hours or more after ingestion of the contaminated food. You can look for a source – my husband was clearly poisoned by an egg salad sandwich in an airport once – but usually the source is unclear. In the absence of dysentery (bloody diarrhea), you just keep replacing fluids and let it resolve. If you have true dysentery, seek help and be cautious not to contaminate others. Scrupulous hand washing and isolation from family members, if possible, may prevent its spreading.

*
For infants, adequate intake is 400 IU/day for 0 to 6 months of age and 400 IU/day for 6 to 12 months of age.
¹

As a cynical observation, I have noted in medicine that the more treatments we have for a problem, the less successful any of the treatments are in actually solving the problem. In the past we had 105 procedures to correct bunion deformity of the feet. (I think – I hope – we are doing better in the past twenty years.) Jesus said, “You will always have the poor among you” (John 12:8
NIV
). Hippocrates should have said, “You will always get colds; just live with it.” You will not avoid colds, and it is probably beneficial to get the occasional flu or flu-like illness, as it keeps your immune system in shape.

The question is what can we do to alleviate the misery from these colds that always hit at the worst possible time? Well, it is always good to get advice from a doctor who has your disease. I have had a lot of colds in my life, and I’ve told you all I know to do for my family and myself. I cannot emphasize enough the benefit of vitamin D
₃
. This vitamin is one of the most powerful anti-aging and disease-protecting substances we have in our medical arsenal. Take it. Take it in big doses. Do not believe the government doses, which are based on no evidence. (In the anti-aging world we refer to the RDA as the “Recommended Death Allowance.”) And take vitamin C. Eat a good diet, get enough sleep, and exercise as outlined in
chapter 8
. Taken together, all of this will cut down – but not eliminate – the episodes of colds and flu you experience.

21
BITES

W
e talked about bites briefly in previous chapters, but in this chapter we will cover them in more depth. Bite wounds are pretty straightforward. One thing, however, is unique and should be kept in mind. Bites cause swelling. It is tempting to apply ice to a bite wound to prevent swelling, but DON’T APPLY ICE. It turns out that cold activates many venoms and quite probably will make the situation worse. If you lump all kinds of bites together, there are only three treatment types:
symptomatic therapy, surgery and antibiotics
, or
antivenom
.

Common insect bites:
Most insect bites require only symptomatic treatment. Use calamine lotion for itching, keeping the area clean and moisturizing as needed. Dry skin is always more susceptible to itching and scaling, and dry skin generally worsens any problem.

Tick bites:
Ticks are annoying and are becoming more of a problem because of Lyme disease. Most ticks that get on people are “wood ticks,” or the American dog tick – the flat, brown bug with black highlights that is generally about two to four millimeters in size. These do not generally carry Lyme disease, but all ticks can carry some type
of a tick-borne illness, such as Rocky Mountain spotted fever. The classic wood tick is easily visible, whereas the deer tick, most classically associated with Lyme disease, may be so small it is missed.

If you have a tick attached to you, the classic removal technique is to heat the tick’s body with a hot pin or other source of focal heat. This causes the tick to start backing out or releasing its grip, and you can then remove it without losing the head within the skin.

The most important point is to monitor for any symptoms that occur after the bite: a round, red rash, flu-like illness, joint aches and pains, or any systemic illness occurring within weeks of the bite should receive prompt treatment. Classically, doxycycline 100 milligrams twice a day for ten to twenty-one days is prescribed. It is important not to let your doctor minimize the symptoms as unrelated because, if the doctor is wrong, long-term arthritic symptoms can set in. It is better to be overcautious and treat rather than withhold treatment for absolute proof – which is never available because lab studies are notorious for missing the early disease.

Spider bites:
Most spider bites just need local care and time to go away – they are simply annoying. If you see the spider, capture it and hold it in a container in case you develop symptoms. Symptoms of a black widow spider bite begin within an hour and are systemic – nausea, shaking, numbness, pain, and flu-like illness: muscle cramps, abdominal pain, and so forth. A brown recluse bite may go unnoticed at first because the bites are not always painful. But over hours the wound becomes painful and red, and over days, death of the tissue around the bite may occur. In short, if you suspect either of these bites, go to an emergency room. These need aggressive medical care. There is no home treatment. Do not apply ice. Support the victim with hydration and protection and warmth if needed.

These venomous species – black widows and brown recluse spiders – are not aggressive. They hide in warm, dry places. They are very prevalent in the desert areas of America and love things such as cardboard boxes.
¹
During my many military moves, I lived in the
desert and had partially unpacked cardboard boxes in the garage, which had been colonized by black widows. I occasionally found black widows taking up residence in some of my houseplants. When I found them in the house, I removed them. But I know that we didn’t find them all, and we lived for years in a communal arrangement where I instructed my children not to reach into dark places or into my houseplants without observing for spiders. (In those days we also had a house gecko living in our couch, and he only came out during spring cleaning!)

Snake Bites:
North Carolina has every species of poisonous snake, and there are by far more envenomations in North Carolina than in any other state in the union. As a surgeon, I took care of United States Marine Corps members for years in North Carolina. These Marines made a living snooping and crawling through hot, humid forests. Nevertheless, most snake bites were the result of doing something demonstrably (and sometimes catastrophically) stupid. In short, if you don’t reach blindly into your woodpile or other areas where snakes go to get out of the sun, if you don’t try to be Bear Grylls by capturing a snake and biting its head off (yes, young men really do that), if you wear tall boots through the brush, and if you learn to make noise before going through grasslands and other areas where snakes live – you probably won’t get bitten. If you do, and you can observe the snake, do so. Don’t try to capture a snake. Venomous snakes in the United States have triangular heads and either diamond patterns or bright rings (coral snake) and often rattles.

Not all snakebites are envenomations, but don’t take chances. If bitten, don’t ice the wound, and don’t cut and suck the wound. Head to the nearest emergency room. You cannot take a chance on waiting. Go immediately. (See
chapter 17
, “Real Emergencies That Can’t Wait.”) Unfortunately, the treatment for envenomation is – as we say in orthopaedics – “antivenom, antivenom, antivenom.” If Obamacare pushes us to single-party payer or we experience overall system collapse, antivenom may not be available everywhere, and in these cases we may be simply out of luck.

Bee/Wasp Stings:
Bees can sting you only once, and then they die. In the absence of an allergy to bee stings, this is annoying but not life-threatening. The stinger gets deposited in your skin and is generally easily removed by carefully scratching it with your nail or a knife. Do not attempt to grasp the stinger, as that may inject more poison into you. An exception would be a mass stinging because bee venom is toxic to the heart in big enough doses. If you experience a mass stinging, get professional help.

I used to be a beekeeper. One day I failed to secure my bee helmet and netting, and there was a small hole where the net contacted the chest. As I was working the hive, a single bee penetrated my hood and began to sting me on the inside of my left nostril. Now, had I simply reflected upon the fact that the bee could sting me only once and had I quietly walked away, all would have been well. But to be honest, it is hard to be calm and collected when a bee is in your nose. So I reflexively lunged for my face and knocked the whole hood apparatus off. Sensing opportunity, hundreds of bees swarmed out to defend the hive, bearing down on my face and long hair, which had come tumbling out. I ran into the dark basement, screaming as my husband laughed himself silly. (Running into the dark works for the average Italian honeybee, but an Africanized bee may chase you for miles through dark and light.) In the basement, my head was abuzz with bees trapped in my hair. My husband finally collected himself enough to help me by getting a hairbrush and getting rid of the bees. By that time, of course, I probably had been stung more than fifteen times. Initially, I experienced stinging and some facial swelling, but the excitement came twelve hours later as I lay in bed and became lightheaded. I felt more and more as if I would black out, and I could not detect my own pulse. I took deep breaths and raised my legs above my heart. But, nothing changed. My husband tried to call an ambulance, but in those days there was no 911 where we lived and the phone line was busy. Fortunately, I just had a touch of asthma – probably from being allergic to the many flowers in my yard – and I kept an Alupent inhaler at the bedside. The drug in the
inhaler causes the heart to speed up, and after I took a few puffs, my heart rate recovered, and I felt fine. I called my friendly cardiologist, and he had no clue about this phenomenon after bee stings. But my friend who was both an anesthesiologist and a beekeeper knew about the slowing of the heart that can occur with a large injection of bee venom. In fact, this is what can kill you when swarms of Africanized bees attack you – even if you are not allergic to bee stings.

If you are allergic to bee stings, of course, keep an EpiPen on you or nearby at all times, and know how to use it.

Everything we just covered also applies to wasp stings – except that these little guys can sting you and sting you again! Wasps don’t lose their stingers in you so the right response is to get the heck out of their nest area.

Human and animal bites:
See the chapter on “Real Emergencies That Can’t Wait” for more information, but in general, you treat these with cleansing, antibiotic ointment, and observation. But be aware that human and animal bites can become infected with exotic bad germs. At the first sign of trouble, seek medical attention. Generally, it is safer not to close these wounds. If a human bite starts looking red, hot, and swollen and you have no immediate medical assistance available, make sure the wound can drain. If necessary, remove any scabbing or reopen the skin margins. Soak the affected area in a warm sink or tub of water, or by placing a moist warm towel on the area. It is even possible to apply a moist cloth and cover it with a heating pad. The point is to keep moisture on the wound and to keep the blood flow stimulated with warmth. Apply an antibiotic ointment and alternate with ¼ percent acetic acid wet-to-dry dressing changes as outlined on
page 185
. Clean daily with soap and water as well. Take 750 milligram cipro every twelve hours and 300 milligram clindamycin by mouth three times a day. For children use Clindamicin 30 mg/kg per day, divided into three doses. (See sidebar on
page 168
.)

Bite wounds are like the practice of anesthesia – usually boring,
but occasionally things happen to set your hair on fire, and you have to act quickly and appropriately. I hope medical care will always be available, but sadly, the first things to become scarce in a socialist health care model like Obamacare are expensive medications and those items used only occasionally. Antivenom is one such item. Jeffrey Tucker of the Mises Institute gives a very funny talk about our current regulatory environment. He points out that the sanitation of flushing away human waste has been improving for nearly five hundred years since the first flushing systems. But the government, via the EPA, has managed in five years to give us toilets that don’t succeed at their primary function – flushing away human waste. In medicine, the more serious consequences of our overregulation will be unnecessary death as antivenom, trauma surgeons, and emergency rooms are in shorter and shorter supply.