A GI Doctor Speaks Out

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I am a long time lurker on this board (about 1-1/2 years). I take care of patients with chronic illnesses, most of whom would die or be severely impaired without their medications. On an average day I see 20-25 patients in the office. In the last year only 5 ( yes five) have expressed their concerns about y2k and medication. I am amazed at the total lack of concern. Over the last several months I have tried to drop hints such as "don't wait to the last minute to fill that script", or "here's an extra script for a rainy day", or even more blunt "are you putting away a few extra pills for the new year?". I usually get responses such as "I hadn't even thought about it" or "it's all a bunch of hype, those people are going to take all of their money out of the bank and cause bank runs". One of the first GI patients started off her appointment with a cautious, but blunt "I need extra pills for y2k", and then started asking me about my children, mentioned powdered milk, etc. I told her with a wink that this was already taken care of, then we discussed my batteries, inverter, generator, and "RGI engineer husband". After I told her about our petromax latern she seemed quite relieved that her doctor would survive.

A lot of these patients clearly can afford a couple months (or even longer) worth of meds, yet complain that their prescription plan won't cover these. We also have a limited supply of certain drug samples, which I always give to the patients that are on very limited income. I've also asked the absolute denialist/"hype" patients if there drugstore always has their refills in stock. They usually say "no, I frequently make extra trips, they don't always have them in stock". One family member then asked "Well, don't you keep extra pills here in the office?".

Some thoughts:

1. Your doctor may be a GI or a DGI. Don't confront your doctor threatening to sue him/her if they don't give you extra scripts. First ask for extra refills (3 month quantity with refills). Try to be honest. Patients frequently ask for extra prescriptions because they are going out of the country/the insurance plan just changed/are going to Florida for the winter/leaving town for a couple months to take care of a sick relative.

2. Internet based pharmacies such as drugstore.com or mail order programs through AARP are available. Don't try to get your insurance plan to pay for the extra--they won't.

3. Ask for samples

4. Don't forget important over-the-counter medications and supplies, such as:

A good basic first aid kit and manual Monostat if you get yeast infections, anti-fungal cream if you tend to get athletes foot Silver sulfadine cream for burns--particularly if you are using wood stoves Multivitamins Pediatric tyelenol/motrin for children Adult aspirin, tyelenol, motrin Sterile saline Alcohol and peroxide Oral re-hydration solution in those square bottles (children hate it but can be life saving for a child or adult with diarrhea) Antacids Anti-diarrheals such as lomotil, Kaopectate Bacitracin ointment Eye wash bottle and solution Extra rectal and oral thermometer Extra Bandaids, 4X4 gauze pads, ace bandages Hot water bottle Merck manual PDR

5. Be careful with antibiotics that you've never taken before-you could be allergic. Ten percent of patients allergic to penicillin are also allergic to the cephalosporins (i.e. Keflex). Antibiotics also may interact with certain blood thinners, some heart medications, and some seizure medications, with dangerous consequences.

6. Avoid unproven/controversial treatments based on testimonials.

7. Make friends with a paramedic, nurse, or doctor in your neighborhood. Some one in your family knows one.

Sorry about email address, but I must remain anonymous for obvious reasons. Will respond to follow-up posts when I have time.

P.S. I do not mud wrestle

-- Gidoc (gidoc@lurking&now.out), October 12, 1999

Answers

Thanks for the post, Gidoc. Good luck and God bless...

-- Nabi (nabi7@yahoo.com), October 12, 1999.

Terrific post. Thanks.

-- Dog Gone (layinglow@rollover.now), October 12, 1999.

Hi Doc,I just ordered some antibiotics from Foster and Smith,for animals. Are they safe for humans? I figure if you need them for an emergency what the heck I'll take my chances,what do you think? Thanks ,Daryll

-- Daryll (twincrk@hotmail.com), October 12, 1999.

Sorry you don't mudwrestle. But come back and see us anyway. You've given some valuable advice and I hope you post more.

-- Old Git (anon@spamproblems.com), October 12, 1999.

Fantastic!A physician specializing in GI.I appreciate your post.I wish you lived in my county.You are a valuable asset which will increase far more than gold as we roll into the future.Please post any additional prep info you think is prudent.

-- Rocco (rdimm@anskis.com), October 12, 1999.


Got a question for you, please.

We're hearing a lot about the possibility of bioterrorist attacks on major cities - particularly anthrax as recently highlighted on Nightline. Is it wise to keep a stash of antibiotics on hand, in the event that you know you have been exposed? What type of antibiotic is recommended - and what amount for an adult? Does it go by body weight or ??? This assumes, as you say, that you are not allergic to that antibiotic.

Thanks

-- Fiver2000 (fiver2000@yahoo.com), October 12, 1999.


GIDoc,

Excellent advice. You sound like a damn good doctor. These days it seems your breed are becoming am endangered species because of HMO's and lawsuits. Glad that you remind us of some of the most critical supplies that many of us have overlooked, while we still have a little time left. A couple of months ago I asked my pharmacist if they had any plan for letting people get their scripts filled for 60- 90 days advance if the doctor would write them. They looked at me like I was crazy. She said "we've got our computers fixed for Y2K", so I said "but what about the Meds companies like Merck and Pfizer", and she said "oh, those are big companies, they won't have any problems". I was going to ask "well what about the shipping companies and all the other things along the way that could go wrong", but there was no point...she was obviously a DGI. Thanks for reminding me Doc, there are some things I still need to get. Best wishes.

-- @ (@@@.@), October 12, 1999.


Thanks, doc. Thou art a credit to thine oath.

Night Train

-- jes an ol achy footballer (nighttr@in.lane), October 13, 1999.


Gooood Morning, Doc. 'Bout time you came out of the bunker! Wish ***** a happy birthday from me. Later...

-- Sam Mcgee (weissacre@gwtc.net), October 13, 1999.

Hello Doc,

What a coincidence - my intent when logging on tonight was to search out a good text/guide book for physicians/PA's for basic procedures, suturing, abcesses/cysts, etc. What would you recommend?

I just finished "mucking out" a 1/2 inch deep encapsulated cyst-like wound on the bottom of my chicken's foot (from roosting and having an opposing toe nail dig in long term) - pulled out "lining/sac", flushed with hyd. peroxide and swabbed w/7% iodine. Then packed open/gaping hole with dry gauze, will remove tomorrow, blah, blah, blah - sure would be nice to have a manual for that type of stuff - people medicine preferred - already have Merck's new manual for medical info - need actual technique manual. Grew up on a ranch, horse doctoring was a must - definitely do not plan on abusing the information. Just would like it on hand for worst case scenario and to do a better job on minor problems for my critters. Thanks in advance!

Kristi

-- Kristi (securxsys@cs.com), October 13, 1999.



Flushing a chickens' cyst? Ooh I am so glad I could not have a chicken because I had wanted one. I didn't think of stuff like that. I recently had a female cat with an abscessed chest wound and I had to watch the vet flush it out. I thought I was going to faint.

-- Paula (chowbabe@pacbell.net), October 13, 1999.

Thanks, Doc. Glad you un-lurked yourself with this great information. My baby sister is a pharmacist with 20 years experience. She is now working at company that fills scrips for more than 3000 convalescent and nursing care facilities. She remains concerned about inventory and supply lines, and of course, in a time of intermittant and/or extended power problems their highly computerized/phone dependent company will be out of business in no time flat.

Be well and safe.

-- Donna (moment@pacbell.net), October 13, 1999.


A GI doctor is one of the greatest assets his/her patients can have.

My doc is GI, we've discussed his preps, his neighbors, etc. Last time I saw him for a scrip, he said matter-of-factly that I could fill the whole year's worth at once, the way he wrote it. No big deal, just totally GI. Fantastic.

-- bw (home@puget.sound), October 13, 1999.


Here are some good titles that I've found. I'm recalling them from memory because I'm not near my library right now. These are all available from Amazon.com. Just do a title search.

1. NATO emergency war surgery 2. Ditch medicine 3. Where there is no Doctor 4. Where there is no Dentist 5. U.S. Army Special Forces Emergency Medical Handbook 6. Wilderness Survival

Ditch Medicine and Where there is no Doctor have lots of gruesome pictures showing how to handle wounds, injuries, and various ailments. Good reading, all.

-- rob minor (rbminor@hotmail.com), October 13, 1999.


Thank you, Gidoc!

Now... do you recommend growing any medicinal herbs... for the long term? In case.

;-D

Diane

-- Diane J. Squire (sacredspaces@yahoo.com), October 13, 1999.



GI doc, would you check in on the KI03/birth defect thread on the Prep Forum if you have any information? Thanks!

-- Mumsie (Shezdremn@aol.com), October 13, 1999.

So glad to hear you're thinking of your patients for longer than it takes to see the back of their head heading for the parking lot. I took a close friend of mine for a first visit to a new doc yesterday. She has so many things wrong, lupus and diabetes being two of the biggies. While on the drive to the dr. office I suggested she ask where she should be at rollover time. I told her not to let the doc pat her hand and say, "Everything's going to be just fine." She asked and he told her I want you in the hospital. I had been prepping for both she and her son who are on limited income, but until last week hadn't considered her extensive medical needs. He told her he wants to admit her on Dec. 31 and I was thoroughly impressed. At least she'll stand a better chance of surviving a heart attack or seizure there.

Looks like there's at least TWO good docs who GI.

beej

-- beej (beej@ppbbs.com), October 13, 1999.


Thank you so much, GI Doc! How good it is to know that some people are in such good hands, ones which are looking ahead to their needs at Y2K. I brought printouts from two doctors I found on Y2K prep sites in a neat pocket folder to my doctor a few months ago, and introduced the subject in a very non-threatening manner. He knew I was coming in for a tetanus booster, and that I wanted to start a Hepatitis series, but he not only discouraged the series, like I was very strange to want it, he refused the folder! I have had to resort to getting info on obtaining prescriptions ahead from overseas, since he and my health plan are not about to see to it that I have meds ahead, without which I am in deep trouble. Through my health plan I could have six months of meds at a cost of only $250. Via overseas, that will be (even at their cheaper prices, since there is no coverage for this) more than double that.

Got my flu shot yesterday, and was too hesitant to ask for a rabies innoculation, for fear he'd call the men with the white coats! But I've read how people turn out their pets when there is no food, and how we should prepare for rabid feral packs by having a rabies shot.

My question to a GI Doc would be: HOW can one help one's physician to GI if he DWGI, so that his other DGI patients will get help? Is there not something for the medical profession such as the FEMA/Red Cross stuff the public receives, which will/can alert them?

-- Elaine Seavey (Gods1sheep@aol.com), October 13, 1999.


Elaine -

Re Rabies Shots --

There are two different series of shots, pre-exposure and post-exposure. Most people who work with animals on a daily basis (such as myself) get pre-exposure shots. This is a series of 3 or 4 shots. Then, if they have exposure to a possibly or definitely rabid animal, they get another 4 shots. Post-exposure, which I am lucky enough to have had, is a series of 7 shots over a 28-day period. These shots cost somewhere between $300 -$600. The full 7-shot series is thought to last about 10 years. I get my titer checked every 2 years to make sure I still have immunity. It's uncomfortable and expensive but I do have a nice sense of security.

-- dakota (none@thistime.com), October 13, 1999.


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