Practical Care for the ill by Fishsurfer

[pamela]

this is basic common sense care tips for you if you are caring for someone with the flu. Swine or otherwise.

thanks Fishsurfer!

If no one minds, I'll sticky this for a few days so that everyone who wants to can copy this.


Btw, id just throw this out real quick.  Since Respiratory failure is the most common cause of death, if you find yourself isolated and caring for someone because all hell has broken loose, you need to make sure and remember a few things. 

-Dont let the person your caring for lie in bed, it will only help fluids build up on the lungs. 
-Do make them cough and/or use spirometer devices (the little thing with the ball you try and hold in the air inside a clear tube at the hospital), get the fluids out of the lungs..its feeding the bacteria.
-Make them get up and walk around, even if they hate you for it.
-Make them sit up in bed to sleep or rest as much as possible (everyone used to do that in the old days every night)
-Provide supportive care for their fevers, dont let it get out of control but dont let it go away imho (the higher temps can help fight the lung infection somewhat), its probably better to have a rough few days followed by shedding than weeks of continuous pounding that may seem minor but bites you in the ass. 
-Provide "chest pt" by pounding on the back and front of chest for at least a few minutes a couple of times a day, followed by purposeful coughing.  The pounding loosens up the crap, you cough it out.  Hard enough to make them bounce a bit, but dont leave massive bruises or break ribs for christs sake.
-Fluids, give them enough to make their urine at least yellow if not clear. 


it came from here.
http://www.doomers.us/forum2/index.php/topic,44751.msg647223.html#msg647223

[Fishsurfer]

This is just covering one aspect, and i could add more, and i will tonight probably.  I was going to put it into one of my medical "best of" of threads, but maybe more people will see it if its in here. 

[slow_dazzle]

Good info' - thanks.

[Fishsurfer]

Famous quote describing Pneumonia by Hippocrates:

"Peripneumonia, and pleuritic affections, are to be thus observed: If the fever be acute, and if there be pains on either side, or in both, and if expiration be if cough be present, and the sputa expectorated be of a blond or livid color, or likewise thin, frothy, and florid, or having any other character different from the common... When pneumonia is at its height, the case is beyond remedy if he is not purged, and it is bad if he has dyspnoea, and urine that is thin and acrid, and if sweats come out about the neck and head, for such sweats are bad, as proceeding from the suffocation, rales, and the violence of the disease which is obtaining the upper hand"

Actually a pretty damn accurate account, very astute observations.  And thats exactly what your going to need to make in a world without access to medical care or drugs, good observations.  Prevention...of illness in itself or worsening of the condition...is the name of the game.  The body can do an awful lot of things to fight illness, and it will keep at it for as long as your fed, hydrated, and motivated enough to keep on living. 

Pneumonia in a non-medical environment is a very exhaustive and lengthy fight.  It could easily go on for months.  Some weeks may be difficult, others may be easier.  Regardless, if H1N1 hits hard this fall or even this summer (unlikely), be prepared for a battle.  Hospitals will be overrun, the economy will be in the process of collapse, social unrest is likely, you will rely on family or they may rely on you. There will be no ambulance coming to get you, the EMT's and Medics will be at home themselves.


continued........page is screwed up. 

[Fishsurfer]

In Pneumonia, the normal exchange of gases in the alveoli (air sacs) are interupted by the presence of fluid, mucous, etc...  There are many types of it, and underlying conditions greatly affect the outcomes. 

Three types: Bacterial, Viral, and Atypical Bacteria (walking pneumonia). 

There are many other underlying types as well, although a bit more uncommon, fungi etc...

Risk Factors:

Age: 65 or older
Flu or other respiratory illness
Chronic illness, such as heart or lung disease
Stroke (aspiration pneumonia due to difficult swallowing)
Weakened immune system caused by AIDS or chemotherapy treatment
Chronic bronchitis
Malnutrition
Pregnancy
Infants and very young children
Alcohol or drug abuse
Smoking
Chronic exposure to certain chemicals (eg, work in construction or agriculture)


Continued....

[Fishsurfer]

Symptoms specific to H1N1:

Fever
Shakes and Chills
Green Yellow Mucous or Rust colored
Profuse sweating (diaphoresis)
Bluish nail color, lips, due to lack of oxygen...(hypoxia)
Altered mental status (related to massive infection including sepsis, oxygen levels, organ failure, or all of the above. 

You see how it starts out?  Fever, then shakes and chills, etc... Dont let it get passed shakes and chills and your fine.  If you start letting fluids and secretions accumulate in the lungs, you could be in real trouble. 

The biggest problem with this condition is accumulating fluid and  mucous in the lungs, which can even get into pleural spaces surrounding the lungs, called effusions; then a spiraling inffective respiratory exchange and potentially sepsis sum total.   

One of my favorite methods besides deep breathing to get fluid and mucous out of the lungs is to do some Chest Physical Therapy.  It has some contraindications however, if the person is so ill they are at the point of bronchospams, sudden constriction of the muscles in the walls of the airways bronchioles (the two little branches leading to your lungs); then its a bad idea to start doing this (you should have been doing it well before this stage) doing so now may cause spasms and increase their severity.  Let them rest and fight it off a bit more, continue doing deep breathing though, you can always do that. 

The important thing to note though is that if you do this as mentioned in the begining of the thread, make sure you cough afterwards.  There is a right way to cough, sit up on a chair.  Take a deep breathe for about two seconds and exhale for about two seconds.  Then make two sharp coughs, rinse and repeat. 

Continued.....

[Fishsurfer]

How do you know its happening, beyond the fever, H1N1 condition, etc...?

If you have a stethoscope, you can listen for diminished lung sounds in the lower bases of the lungs.  Listen every few hours, and over time you'll notice the trend quickly.  Of course, if you own a stethoscope, you probably already know this.  So what if you dont?  Well, you should get a cheap one even, for under 20 bucks you can easily get a model suitable for basic listening needs of the lungs (and heart somewhat).  But if you still dont buy one, then you can use percussion techniques, although its highly not as reliable as actually listening with a scope. 

To do that, you basically take two fingers placed together, and tap on the spaces around the lungs, basically at the base of the rib cage (although your lungs go all the way up to your clavicle region and then some.  Tap on it, listen for the tones it makes.  If your a musician, you may be able to recognize what a hollow sound is, and what a more solid (fluid filled) sound is.  Tap on a wall, where there is no stud its a hollow sound, where there is a stud, is somewhat muted and diminished.  Same with the lungs.  Remember what the person your helping sounds like, write it down, track it for a few hours to days and even weeks or months.  It could be your first indication something is happening, beyond the obvious fever and malaise that occurs with the Flu. 

The kind of lung sounds you'll find in Pneumonia are loud low pitched bubbly gurgles, or high pitched low intensity sound that last beyond exhalation.  You may also just hear diminished sounds in the begining.  You can listen to them here:

http://mtsu32.mtsu.edu:11259/abnormal_breath_sounds.htm

[Fishsurfer]

Think of your lungs like a sponge.  It has air exchange sacs all over it, trading away CO2 for Oxygen, grabbing Oxygen from air while discarding Nitrogen, CO2, etc... sending it to your Heart to be distributed through your bodies circulatory system before it comes back to the lungs.  F'ng awesome interaction imho. 

But, when liquids,mucous, and fluids settle on the base of the lungs, sides of the lungs, etc... it can create a cascade of interactions that eventually cause your condition to worsen, your fluids to increase, and your temperature to rise among many other things. 

So, its important to move around, shift those fluids around a bit, shake the mucous around, let the unaffected portions of your lungs absorb some of the crap that has saturated the other part of your lungs because you were lying in bed for days.  If you move around, sit up in bed often, and generally avoid a flat position thats unchanged, you can do a great deal to relieve your lungs and give yourself a fighting chance.

Equally important, if someone is so out of it, nearly delusional or non-compliant with your demands; at least rotate them in their bed.  Much like they do at a nursing home for bed sores and other things, they also do it for patients with lung issues in an ICU or Pallative care facility.  You can also do it when death is not imminent, and i would highly suggest it even when your healthy trying to recover without meds.  Its always good to change positions, move around, change rooms your in (mental aid), or even take them outside for fresh air.  Switch it up, keep them moving if possible.  But recognize when someone just needs to rest.  You dont want to over exert someone. 

[Fishsurfer]

The other thing to mention here is that with this strain of flu, the onset of symptoms and the time you have to use "Treatments" may be extremely extremely short. 

You need a mercury thermometer.  Old school bulb style.  With a Flu strain, your fever will show up slowly over a day or two, if you take your temp twice a day at the very least during a Pandemic, you may catch the onset of illness before you actually would have noticed it.  Get a thermometer! 

Seriously though, treating Pneumonia is a bitch, you've got bacteria stuck inside your lungs, edema potentially occurring as a side effect, and no anti-biotics to treat the underlying causes of inflammation and fluid build up, the bacterial infection itself. 

If you've got Pneumonia to the point your lungs are full of fluid, your in a world of hurt. 

If you know of some good immune boosting treatments that are readily available outside of the hospital, then do it.  If you have left over anti-biotics, give it a shot.    Even if its meant for a dog, or an aquarium, whatever.  Worst case scenario, humility and quality doesnt matter anymore. Something is probably going to be better than nothing. If its from the Amoxil family of drugs definately do take it.   

[msegk]

FS, Curious for your take on something.

I get acute bronchitis every few years.  Usually I throw it off using common sense and natural remedies but not this time.  Doc claimed Levaquin is the best antibiotic for this, administered a shot and sent me home w/ a week's prescription but there is no improvement at all. 

[pamela]

Fishy, I just know that this excellent, well worded information will save lives!
thank you so much for taking the time to write this up and post it for people.
Again, I'm printing this out and putting it on the wall!

[wiccawench]

thanks fishsurfer !

ps you realise you might want to correct the title (spelling police) PRACTICAL 

VERY USEFUL information...... when my kids were small i always used the back pounding to remove phlegm from their lungs as they were pretty bad asthmatics.... its VERY effective. Thanks for reminding us all of the actions within our own grasp.

[Fishsurfer]

thanks fishsurfer !

ps you realise you might want to correct the title (spelling police) PRACTICAL 

VERY USEFUL information...... when my kids were small i always used the back pounding to remove phlegm from their lungs as they were pretty bad asthmatics.... its VERY effective. Thanks for reminding us all of the actions within our own grasp.

I cant!  Pamela did it 

[Fishsurfer]

FS, Curious for your take on something.

I get acute bronchitis every few years.  Usually I throw it off using common sense and natural remedies but not this time.  Doc claimed Levaquin is the best antibiotic for this, administered a shot and sent me home w/ a week's prescription but there is no improvement at all. 

Levaquin is one of the best options, there are several others. If the mirco organism causing the problem is really bacterial.  Sounds to me that it might have been Viral.  That can go on for awhile and you need anti-virals, and its the most common form.  Im guessing your Doc thought it was bacterial though.  If its bacterial you usually get a high grade fever and a darker colored mucous.  If its viral, your coughs wont be productive, your fever will probably be lower but the rest of the symptoms will probably be the same.  Do you smoke? Have allergies?  Did the Doc take anything to the lab to verify for sure?  I know sometimes people get in a hurry and just dont get to follow up on lab results, but they also at the same time want to get you on some meds.  So they send you out the door with something, but maybe it wasnt the right something.

[msegk]

Fishsurfer, I sure didn't mind my manners when I failed to thank you FIRST for all your helpful information!

And thanks for replying.  You nailed my situation perfectly.  Ignorant smoker, got a cold I think.  Low fever, intense sore throat, burning chest, runny nose, morphed into productive cough.  No sample taken, no antiviral given.  In spite of my nasty habit, I rarely get sick but the way this hangs on (three weeks already) is creepy.  I take precautions and avoid crowds but scared a few folks last week.  Think I'll immerse in more alternative antivirals, borrow a few of your ideas and see how it goes this week.