Your Survival Blog
“No other medicine / but only hope”
After Hurricane Katrina, the chronically ill who’d escaped without their medications were among the first survivors to die.
Many evacuees had high blood pressure or asthma with no way to control their disease. Kidney recipients escaped without their antirejection medications, and lost function in their transplanted organs. Type I diabetics were stranded without insulin. By some estimates, six percent of the people of New Orleans had some form of diabetes, and a medical professor was quoted as saying that if fifty thousand people were crammed into shelters, that was three thousand diabetics “with no medication and no testing supplies.”
Which made me wonder: what would happen to my friends and neighbors in a similar disaster?
“The miserable have no other medicine/ But only hope: ” —Shakespeare (Measure for Measure, Act III, Scene 1)
My dear friend Colin (all names have been changed to protect identities) has Addison’s disease. It’s an adrenal-gland insufficiency which (like HIV infection) used to be a death sentence, but now is a perfectly manageable chronic illness — providing a patient takes meds on a daily basis. He takes dexamethasone (or prednisone) and fludrocortisone every morning; without them he’d be dead in three days. I asked him his plans in the event of a disaster. “I have a month’s worth of prednisone,” he said, shrugging. Fludrocortisone? Nope. He talked to his doctor about stockpiling it once, but was told insurance wouldn’t pay for it.
Kerry and Aidan carry EpiPens (epinephrine injectors) — Kerry’s due to unfortunate experiences with stinging insects, Aidan’s because of a dangerous food allergy. Last summer Kerry discovered the EpiPen in her purse had expired two years earlier, which might have been a tragic oversight if the dive-bombers at her picnic had been a tad more aggressive. Aidan, a second-grader, has already gone into anaphylactic shock during his short career at school. Yet Melanie, a school nurse in Washington, notes that because EpiPens are specifically prescribed for certain children, her school could not keep extras on hand: “If a kid was dying of a bee sting and they had a different kid’s EpiPen in the cupboard it would be against the law to use it.”
Melanie also told me about a child she’d encountered with adrenal hyperplasia syndrome: “She was too young (or the dosage was wrong) for pills, so she had to have a liquid form that needed replacing constantly. They wanted to keep a backup amount but it was very expensive, so they always had to remember to put the new medicine in the ‘backup’ spot and use the former backup medicine up. It was doable, just something they had to constantly do properly.”
James and Robert are young cousins with moderately severe ADHD, and both take stimulants based on methylphenidate. While their parents are able to cope (with gritted teeth) on days they don’t take their meds, the need to focus on tasks in hand in a real emergency might make a difference in their risk of serious injury or death. While stimulants are tightly controlled by the United States government — it’s not even possible, in many cases, to replace a prescription that’s been lost or damaged — James’s mother has carefully saved enough pills over the months they’ve been filling prescriptions (by not always giving meds on weekends and holidays) that she’s squirreled away an entire month’s backup supply, ready to go in case of emergency evacuation.
Ann has epilepsy. After years of experimentation, she hit upon a drug which works very well for her, carbamazepine; without it she’d be “a complete mess.” But she lost her job and has lived without health insurance for a long time, surviving partly on the contributions of relatives toward her medications. The drug used to cost over $100 a month without insurance coverage; she considers herself lucky right now, because a big-box retailer offers a special discount program on certain selected medications, and she can now buy carbamazepine for $17/month. It prevents her from having grand mal seizures, leaving only myoclonic jerks. Another drug she takes daily, clonazepam, smooths out the “kinda twitchy” aspects; she says she wouldn’t function well without it, but at least she’s able to obtain it at reasonably low cost from warehouse-store pharmacies. She hasn’t tried to stockpile either drug, however, and is now curious about how to do that; she gets a month’s worth at a time, and is often down to a four-day supply before replenishing.
She points out that epilepsy, like many illnesses, is made worse by stress and lack of sleep; with exhaustion and anxiety, seizures become difficult to control. And if her illness is not controlled, she cannot live an independent life. But she wonders how people on limited incomes, without access to extremely discounted drugs, can manage their illnesses on a regular basis — much less in an emergency?
Doreen has a thyroid disorder, which she takes pills for. “I am pretty sure I wouldn’t die without it,” she says, “but it is fairly essential to proper metabolic function.” Her mother, in an independent-living retirement community, has Parkinson’s, Crohn’s, and major depression, and is on “a boatload of drugs” for these and other chronic conditions. “We normally all have at least a week’s supply, maybe two, extra,” says Doreen. “I don’t think we can make any plans to stockpile, because the pharmacy won’t let you renew beyond 15 days out by mail order, one week out in person.”
“How do each of you plan to make sure you have your meds with you in case of emergency evacuation — earthquake, wildfire, hurricane, flood, that sort of thing?” I inquired. “Have you talked to your doctors about emergency backup plans?” No, she admits: “That’s a good thought; I’m realizing just how unprepared we are. You’re right, we all need a disaster plan, especially with ill parents, pets, kids, spouses that work in different directions, and so on.”
And hers is an excellent summary. We all need a disaster plan — and if we take essential prescription medications, we need to be prepared to manage for days or even weeks without a pharmacy.
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