Helpful OTC Meds & Supplements

These are what I brought in...assume generic if one was available

Electrolyte replacer(s)

Aspirin, Tylenol, Advil, Alive - I have bottles of each as each has there best usages.

Benadryl - unexpected minor allergic reactions

Antidiarrheal - self explanatory

NyQuil  & DayQuil  - allows patient restful sleep

Cough syrup

Maalox - For sour stomach & also suggested as a salve for extreme irritation from diarrhea, neutralizes acidity, etc.

Ensure - liquid diet for ill patient who can't manage/want solids.

Sinus medication

PROPHYLACTIC SUPPLIMENTS - assume 1 years supply per person.

Vitamins: A, B-COMPLEX, C, Calcium w/D, E, ZINC.  I chose individuals as opposed to a multi vitamin because this way I can tailor the dosage in shifting circumstances.

Supplements: Fish Oil, Curcumin (anti-inflammatories); Co-Q10, Cranberry extract; Green Tea Extract; Resveratrol; N-Acetyl Cysteine (NAC has been shown to have anti-inflammatory properties in lungs, as has Resveratrol)

Of the above, I have copious amounts (read: higher than normal dosage planned) of C, E, Fish Oil, Green Tea, Co-Q10.

For the vitamins & supplements I bought the best quality I could find from a supplier that guarantees standardized doses. www.lef.org (just who I trust, I have no affiliation beyond standard membership with this website/organization).  Off-brand & discount vitamins & supplements are notorious for not having the % listed on the label, some have been found to contain NONE of the active ingredient(s).

I did not buy these all at once...it represents a huge investment and only what I determined met my needs.  YMMV.

 

 

 

 

 

Pardon my ignorance, but how do you wash your nostrils? -Libby

Idaho, I DIDN'T know that Tylenol had suppositories!!!  Where would I find these???  You bet, that would be right at the top of my list, thanks so much for mentioning it.

Speaking of dehydration...yes I brought in IV set-ups and several cases of ringers, but then I found some info from another RN about hydration of an incapacitated patient via the use of an enema bag and a slow introduction of water.  It was also mentioned that if a person was that incapacitated that maybe this would be the best way to get medicine into them.  I didn't post it here because I didn't have a nurse to back-stop my less than perfect memory of the technicals here.

And guys, I know this may sound wacked and OMG, NOT ME!  But life and death is life and death and if I run out of IV drips I wouldn't hesitate to resort to this, or use this method to administer meds.  And to be truthful, if my ex medic is not able to handle the IV, being one of the incapacitated I may forgo the IV.  I have all the instructions and supplies but when it comes down to brass tacks...will I be able to do it?  If I had no other options I would of course give it all I had, but the hydrating enema seems so much more manageable to me.

I will fight this with every thing I have.

And what about respiratory therapy?  Years ago, I had a med prof suggest that a standard child's balloon makes a wonderful at home, no cost, no tech, respiratory therapy tool.  Just have (flu) patient blow the balloon up several times, several times a day.  Wonder if this would be of any use????

PLEASE NOTE THIS:   ALL MEDICAL DISCUSSIONS ARE FOR DISCUSSION PURPOSES ONLY, NOTHING HERE IS MEANT AS MEDICAL ADVISE. IF YOU FEEL YOU NEED MEDICAL ADVISE PLEASE SEE YOUR LOCAL MEDICAL PRACTITIONER.

 

Here is a web site with a number of nasal irrigation products:

nationallaergy.com

 

Two comments:
1. nasal irrigation may well shoot the virus higher into the sinus cavity, not good. An antibacterial soap will kill it.
2. I would think twice about using an extreme measure of an enema to increase fluids. We need to question how much and how often, to guard from deleting electrolytes. What if you perforate the colon and the person starts bleeding, then what? You may stimulate the vagus nerve which can cause a sudden drop in blood pressure and cause fainting. No offense to your mom, but let's check with our doctor before advocating introducing fluids in this manner.

Mary Kay RN

MaryKay, you give me a couple of points that will have me googling for several hours I'm afraid.

But, right off the top of my head these struck me:

1) "using an extreme measure of an enema to increase fluids" Well I don't think it could get any more extreme than trying to keep a dying patient alive.  Let's face it, if we have someone in the condition that requires hydration by this method chances aren't very danged good, but I would give it every bit of effort I could muster.  I have seen some quoted observations from doctors with hands-on experience in treating H5N1 patients that state "hydration is the number 1 key to survival", "if the patient comes in already dehydrated there's not much we can do."  I tried to look this up the other night when I brought up keeping a patient hydrated but I couldn't find the article.  Now his position and statement can be taken a face value; it sounds reasonable to me, a layman.  Or he could be making this statement because of "Don't blame me they  all died, they were dehydrated blah blah blah..."  Don't know.  Best guess, it's a bit of both.

2) "to guard from deleting electrolytes"  Electrolyte depletion, while serious and can cause heart attack at the extreme (my understanding anyway) is a "less critical" issue than a fevered dehydrated patient.  You have more time to fudge the electrolyte issue than the hydration issue, again, my understanding.

3) "What if you perforate the colon and the person starts bleeding" We're not talking a high colonic (?) here, and proper equipment used by even someone without professional medical training shouldn't be too difficult.  This one truly confused me...Does this happen a lot?  I have never heard of it happening, doesn't mean anything I know, but still.

4) "You may stimulate the vagus nerve which can cause a sudden drop in blood pressure and cause fainting." We are referring to an unconscious, incapacitated patient...how much more "faint" can they get?  But since I know nothing about the vagus nerve (will look up) I can't really counter this with any intelligence.

Confused here and just wanting to work through this as it may turn out to be important.

TIA,

Debi

Mary Kays Info is pretty accurate.
What most people do not get is: your mucose membranes serve a purpose and protect you quite good so nasal cleaning is not advisable for most people thats just an option for some special allergy situation, if in doubt do not.

Enema and fluid is utmost stupid. You will just torture that unconcious dehydrated human, have pleasure with a dying dehydrated person lying in sh*t. You will dehydrate the person by this method more than giving them fluid.

i.v fluids is not really an option for home therapy for most and can be very dangerous in inesperienced hands, you just lack the capacity to monitor an electrolytes are a big big issue there. No, you do not alway have "time" with the electrolytes, that depends on the patient and situation and is much to complicated to explain and can hardly be mastered without medical knowledge, worst it cannot be dealt with in a home care situation its al guessing and can be dead wrong.

If you are looking for a way to instill fluid in a patient thats unresponsive or just too sick think about it early and insert a nasogastrial tube (with proper librication while the person is still conscious and can help you and swallow ! unless you are a registered nurse or doctor you should not try that on an unconscious patient good chance you get that into the lungs or the patient vomits and gets stomach fluid into the lungs and that still has a 30% death rate even with intensive care under normal circumstances - so dont play and try hero-rescuer. you are likely to do more harm than good. Actually reading some of this I would rather be in the hands of an experienced mother that cared for sick children so knows basics and these very well than be in the hands of paramedics/google educated selfmade nurses/rescue workers they all tend to trust their skills to much and come up with pretty risky ideas.

Anyway, think about the nasogastrial tube, normally not used for feeding rather the oposite but you can theoreically install fluids as well and do not have to care about sterile solutions, not so much about electrolytes and so on. Dont forget to educate yourself about it!
There is one good alternative to i.v fluids but you cannot do that in a home care environment so I will not go into that, too dangerous.

Enema is a very stupid idea specially for fighting dehydration, let alone for other health reasons.

Dear SophiaZoe
"While it may seem reasonable and aceptable to you to simply sit by, doing nothing and watch a loved one die, it doesn't to me."

LOL, how come you think a medical doctor could do that to his or her loved ones? They are better off than most because they have got available what is within my capabilities and a doctor at home is a lot better than average chances, does not get much better doesn´t it? With some of the ideas people come up it would indeed be better they do nothing because all they do is aditional harm.
Treating flu and dehydration, better preventing dehydration is not the main issue in the whole story, definitely not for medical professionals and also not for laymen. I am much more worried about many other routine medical illnesses that can come up in a quarantine situation of a years time and there lies the problem: no big deal in a normal situation or in a hospital (take appendicitis or similar things that need surgery, good luck!)but a live threatening situation in a home care situation. Indeed most people are all to focused on BF, if you stay in strict quarantine thats not your problem, everything else will become a problem.

So you want to give water via the mouth to an unconscious person or not? Read my post and inform yourself about the relfex mechanisms with swallowing and breathing. Inform yourself of the mental effects of dehydration, you can simple not let a drip of some sort deliver water or whatever into the motuh of a serously deterioated person that is either coughin up blood and secretions or lying still hardly breathing or vomit or just let you pipe drip to the bed, you have to be present!!!!!!! Or take the route I gave you. To bad for your loved ones that you dont take valuable advice and rather go for disagreeing on no grounds of knwolegde or imagination. THINK AND START READING or bying medical students books as long as you can.
Or do you want to give fluid via rectum? Than, well, pleasure with a corpse lying in that what came out in the agony state - fluid and sh*t.

Well I feel sorry for you, do you really expect me to agree to disagree with a layman? Agressive, oh well yes and so be it, take it or ignore it or throug me out I do not mind.
I do care about stupidity but I do not care wether people are washed or ointed, LOL. Patients normally dont smell good and do not have a chance to wash, get real!

To bad that you waste my and your time with the interpersonal issue and tone and so on. It helps a lot more if we stay focused on facts and it would have done you, me and others a better service to ask questions as long as I am present. You want to survive? You got a chance to learn from a medical doctor, and you care wether he/she ist polite? I am not really polite when it comes to bogus healing, I am not polite to people who promise more than they can deliver (naturo-somebogus-healers) and I will stronlgy oppose and with my choice of wording - even agressive - to what I consider dangerous.
Choose your priorities wisely. I chose mine: I do not care wether anyone likes my tone or me or what I have to say and how I say it, this is a cute playground, I vent about things here instead of in real life and also try to give some medical hints and prevent the worst (with some help from other well informed posters), thats the deal from my side.

Concerned, in case it has escaped your notice, I am here BEGGING for information, ideas, and options.

And yes, I am the first to admit that ignorance and idiocy IS difficult to suffer with grace.  Our styles are just different and I accept that.  If you feel it's necessary to berate and belittle me(us) that would be a fine with me, BUT JUST PLEASE, PLEASE HELP US!

PLEASE share any and all information you think would be pertinent to help us deal with an H5N1 patient.  I will get down on my knees, bowing and begging, if that's what it takes.

Debi

OK, Concerned, if you haven't given up on us, please explain, in as plain a language as possible, the procedure for nasogastrial tube insertion.

Diameter of tubing?

What type of lubricant?  Water-based?  Oil-based?  Does it matter?

What volume of fluid to administer?  How rapidly?  How ofter?

Will the fact that this is a flu patient, quite possibly with an extreme and violent cough be an issue?

Should we lay a person flat?  Elevate?  Sit up?

Is there a length of time the tube should not remain in place in a home setting?

Edited by SophiaZoe

Hey
please accept my apology for communication style, as usual its not realy personal. Don´t beg, that makes me feel even worse about the whole issue.

Lets just forgive eaach other as good as we can and be helpful as good as we can.
I will be back to you about the nasogastic tube as soon as possible, I do have to translate. It has been quite a while since I was working in Anaestesia and it was for most part in Germany but I find my english notes and books and be more precise.
From the back of my head:
Diameter of tubing?
- there will only be a few availble, for infants some sizes and for grown ups only one size (as I remember, I dont use these any more and when I did, the nurses inserted them)
(could be a mixup of feeding tube or tube for anaesthesia whrer yxou just want to drain the stomach from extra gas or fluid before intubating, thats the one I meant because it is small so risk and damage is smaller. Feeding via nasogastric tube is done but Ive not used it so I have to check weather they are different, I suppose so.

What type of lubricant? Water-based? Oil-based? Does it matter?: does not matter, since these a routine procedures before operations I ve not seen the package really its standard lubricant (not sterile but better be very clean)sometimes it comes with a local anaestetic in very low dose - its not painful but the nose mucose membranes are very sensitive and delicate - just be slow gentle and turn it (nasopharyngeal tubes are much bigger - Ive done that but also jgentle turning never anything if there is resistance you dont want to push into the brain - skull is hard but not at the end of nose theres a sensitive more brittle area and it can bleed profoundly so just be extra slow and let the tube find its way.
Lubrication should not make a difference if you handle it careful and keep it clean, my guess is water based as a principle is less risk. I check for a brand name in the next days.

What volume of fluid to administer? How rapidly? How ofter?
Thats to complicated because it depends on the patient situation. If you (resp-. the patient is not severely dehydrated) have time take everything slowly like you would give him a cup of soup an he/she sips so you just give what it needed just through the tube, the tube is small in diameter so water with a little salt and sugar or tea everything just normal temperature (like you could drink it). If in doubt take it slowly as a general rule, slowly but continuously.
Another rule of thumb: check urine output and check bladder tension (carfully) if there isn´t any urine output (otherwise the patient will tell you or just have the urge to pee). If the person urinates and tha urine has a normal light yellow color thats fine. Everything orange or no urine in let me say 6-8 hours should make you really nervous

Will the fact that this is a flu patient, quite possibly with an extreme and violent cough be an issue?
Yes, but that can also happen in a non flu patient. Its not the rule so just be gentle. coughing should make you stop anyway that could mean you went for the vocal cords and that leads directly into the lungs, you do not want to go there!

So you only try that if the patient is at least somewhat responsive (and can cough and does have reflexes), best if they are still able to swallow.
Sit patient upright put lubricate on tip, gently very gently and slowly go through one nostril (after checking that it is not congested) and then just feed it very slowly into the nose (there are two parts where it is difficult and you have to be extra slow: when it has to curve down - like end of nose beginning of brain - and when it passes the tracheal/laryngeal area (where the tongue kind of starts you cannot see that area, kind of middle of neck or "deep throat"- there the patient should swallow). You know you are right when stomach fluid comes back (ly patient down)

Patient has nothing to do than breath normal mouth closed and swallow a few times.
Really it sounds more complicated than it is so easy that I´ve never taken real care or attention and not done it too often (nurses did it in operation theater). Its easy with not to much risk and might help in the special situation.

Should we lay a person flat? Elevate? Sit up?
Preferably sitting up while inserting, just easier for patient and you, second choice elevate, third flat. All is possible.

Is there a length of time the tube should not remain in place in a home setting?
After a day or so the nostril/nose will start getting irritated (and it is bothersome to a patient that does have breathing problems anyway) - so do not keep it in longer than absolutely necessary - if you cannot rehydrate in a day /24 hours than either your diagnosis is wrong or something else.
Even in a hospital setting the tube is changed every second day (change nostrils as well).



Do not forget to fix it with tape!!!!! Fix it well!! The better it is taped the less hassel and risk, if the patient is really dehydrated than they can become kind of disturbed, restless, mentally disturbed let alone the effect of fever so you make sure its not pulled out by the patient.

Its not for regular feeding. Its not for days, its for a crisis situation like a day or two. Can you get yourself a good Anaesthesia Book/Emergency Medicine? Just to look at the pictures and some explain the procedures pretty well.

Concerned.  You have now been promoted as this forum's  medical advisor lol.   Thank you for helping all of us.  Having an M.D on hand to give us all medical advice is extremely valuable.  You are already putting your skills to use by helping (advising) all of us.  I wish the rest of the med community was like you.   Thank you.

Dehydration is very risky. Preventing that or minimising it is very important so the issue is important.
Just imagine that dehydration influences many important functions:
- brain (severy dehydration can lead to a delir state), you can get swelling, fluid retention in the brain
- lungs (coughing up secretions is a lot harder if dehydrated so it directly influences outcome)
- fever (specially children develop high temperatures if dehydrated, adults as well just not so fast so you are adding to the fever by the infection - whatever it is - and cannot distinguish
- electrolytes - there you end up with brain functioning, heart as the most serious and it is difficult or nearly impossible to really monitor at home
- do not forget kidneys, they might be fighting with virus and medicine already and dehydration does add the rest

So - just to keep it short: good hydration is a very good idea!

Concerned are you really a doctor?
I find that hard to believe after reading your directions on inserting a nasogastric tube.
You said several things that are definately not a good idea, i.e. an oil based lubricant,......no way!
Keep it in two days? I have have patients in the hospital with a tube for weeks. C'mon, are you really an MD?

You gave no directions to see if the person placed it in the lungs instead of the stomach. You can drown someone if it's in the lungs, suffocate them to death with the fluids or give them pneumonia!

Inserting a nasogastric tube:

You will need:

A gastric tube, water based lubricant, a stethoscope, a 50cc syringe, paper tape, non sterile gloves, small container of warm water, cup of water with straw, and 30cc's of sterile water for testing.

1. Measure the tubing from nose, down neck, to stomach area. This will tell you how far to go down with the tube. Note this line.{Tubing will have several lines on it.} This is not a sterile procedure, but should be as clean as possible. There are two basic tube sizes, child's and adult. Prepare two pieces of tape, 1 1/2 inches long.
2. Sit patient in an upright position only, tilt head back very slightly, 5 degrees.
3.With gloves on, warm tube in warm water so it is pliable. You don't want it stiff as this will make insertion more difficult, and painful.
4. Using a water based lubricant, or if none is available use water, lubricate the first 8 or 9 inches well so it will slide in easily, bend the tubing so it has a curve.
5.Give the patient the cup of water with a straw and tell them that they are to sip through the straw when you tell them.
6. Hold the tube at the first three inches, insert straight about an inch, then immediately bend downward, as that goes down about three inches, then ask the patient to start drinking the water through the straw, proceed in passing the tube, about two inches at a time per second. You will feel a SLIGHT resistance,keep going, then it should go right down without further difficulty. If the patient starts gagging, stop.Open mouth and see if the tube detoured through mouth. Remove tube, try again in a few minutes. The patient may be anxious so be patient. This is not rocket science. Anyone can do this so be confident and patient.
7. When the line of measurement is at the nose, stop. Then you can have someone hold the tube at the nose or tape it while you check for placement.
8.Take the syringe, draw back on the stopper and fill syringe with air. Place syringe over the end of tube, place stethoscope over the stomach, inject air quickly. If the tube is properly placed you will hear a "swissssh" of air, absolutely. It will be loud and distinct. If you do not hear this, try again, if no sound, remove tube. Never introduce fluids if you fail to hear this as it may be in the lungs.
9. After you are certain of it's placement you can introduce the warm sterile water, 30cc's, wait a minute. Then pull back to remove the fluid. If the fluid is yellowish, gastric fluids, then you know it's for sure in. {If patient should start coughing, lip color is cynotic/bluish, remove tube, it's not in the stomach but the lungs.}
10. Secure with tape.
11. Introduce sterile water only at first to be on the safe side, in case it's in the lungs. Then give food, ensure or whatever fluids your DOCTOR recommends.Fluids may be given via slow drip/ 60 cc's per hour,per bag or "bolus" with syringe, 240 cc's over five minutes. Patients {adult}are usually fed four/five times a day, with 120/150cc water with each feeding. If patient is a diabetic, you must check blood sugar and feed appropriately according to blood sugar levels.
12. NEVER, ever, feed a patient while they are lying flat. There is the chance of aspiration into the lungs.
Always keep bed up, at least a 40 degree angle during feeding time and for the following 45 minutes post feeding.
13. Follow feeding with 30cc's of water to flush tubing.
14. Start every feeding with 30cc's of water to clear the tubing.
15. Most meds may be crushed and given with fluids.Check before crushing any med. Heart and narcotic meds usually can not be crushed.
Tube may remain for several days/weeks.
16. Check for proper placement each and every time you introduce fluids.
17. Remember electrolytes are important.

Mary Kay RN

Edited by Mary Kay

TO Mary Kay:
"Concerned are you really a doctor?"

Oh yes, and you are not experienced enough and smart enough to distinguish. And you have not read the other posts and my post obviously not at all. As I pointed out thats a job that nurses do so they know better. And more important: you did not understand the difference of a nasogastric tube during an operation to the procedure you decribed (feeding on a ward) and I did make clear that I am talking about the perioperative (before during and after the operation) procedure, the only one I ve seen a thousand times, on the ward its slightly different. And if you have that periopertive its taken out after a few hours. Smarten up on the surgical and intensive care, you semm sto either come from a textbook background or purely internal ward.
So you are just proving that you did not read my post or did not understand it and that you might be very skilled in nursing care but have not spent much time in emergency medicine or operating theater.
You are talking about the procedure to feed a patient, slightly diffent issue. You are definitely not a registered nurse that is specialised in anaestesia, diffent area. There you just slide it down often after the patient is intubated so take that, the patient is lying flat - oh yes airways are secured when done in that order there are many variations to the subject thats the difference.

I find that hard to believe after reading your directions on inserting a nasogastric tube.
You said several things that are definately not a good idea, i.e. an oil based lubricant,......no way!

WHO SAID THAT? I DID NOT !I DID SAY BETTER WATER BASED BUT WHO CARES IF SHE CANNOT GET THE RIGTH ONE.


"Keep it in two days? I have have patients in the hospital with a tube for weeks. C'mon, are you really an MD?"

I AM NOT A NURSE THATS FOR SURE AND YOU OBVIOUSLY DONT READ AND UNDERSTAND. You show a good example of the difference between doctors and nurses, you are giving a precise (and unnecessarily and not under all conditions working way) textbook nurses way to to it, I just gave an anaethetists view form the back of my head describing your job, not mine, since this procedure is hardly ever done by doctors, got it? You also show that you cannot read what I posted and cannot imagine how an emergency situation look like and thats different from planned feeding on a ward.
I SAID CLEARLY THAT I AM WRITING ABOUT THE PERSPECTIVE FROM AN ANAESTHETIST that thats nurses work so I have not done it too often and in an emergency setting everything goes a lot different from the textbook text yxou wrote, we never give a glass of water and all this extra brimborium in the operating room or emergency. No you don´t have it in for weeks, not even in the situation you are talking about - long term care on a ward and feeding (as opposed to the procedure I meant where we are talking purely about releiving gases and stomach fluid). They have the tube in but it is exchanged frequently and the nostrils must be alternated otherwise you get nasty infections and lacerations, but that did the other shift or yxou are just reading citing textbooks and have to little practical or no experience.

And I would not advice layman in a home setting to keep it in for too long, they cannot deal with arising problems like ulcerations, infections and dislocation of the tube and so on, so in home care environment you have to advise much mor cautious. Thats another diffence between us, you are clear and brilliant in textbook copying but cannot tailor your advice for a real live situation of layman homecare.

"You gave no directions to see if the person placed it in the stomach instead of the lungs! "
I did, you obviously did not understand. Would be better if you just add instead of contradicting where there is´nt any.

"You can drown someone if it's in the lungs, suffocate them to death with the fluids or give them pneumonia!"

As I wrote, again, you obviously did not read my post.

Its on the other side I show you in a new post. What a waste of time...

For the other issues of Mary Kay:

my guess is water based as a principle is less risk. I check for a brand name in the next days.

Oh, by the way since you are american can you please check the lubricant brand name that you use in your country and your hospital, its too much hassle for me... smilie

So, now I got an old book out "Current Emergency Diagnosis and Treatment"

"Nasogastric Intubation"
(For Gastric Evacuation or Lavage)

We are not talking about feeding
That cannot be done in home care sufficiently
Feeding via nasogastric tube for weeks (exchanged or not)is torture for all involved and not done in Germany, may be US differs in this respect as countries do differ in procedures sometimes.

"Positioning the Patient
The patient should be in a comfortable, supported sitting position.
Unconscious patients should either be supine and flat or supine with head slightly elevated. Children or unusually overreactive adults may be asked to sit on their hands as a reminder to keep them away from the nose and the tube as it is being passed into the stomach."

Original idea was a severely dehydrated patient at home. And that is very likely not a very cooperative patient any more. If the patient is still able to drink from a straw one would not try theses tricks on them and just sit by and feed them drinks the natural way gulp by gulp.

The idea of giving sterile water first sounds plausible but is rather useless because you will not be able to tell the difference, there will simply be not reaction eihter way (lung or stomach) with a small amount of water like 10-30 ml, and a larger amount forbids itself. The only true way (which you do if you are in a hospital)to distinguish is an x-ray which you dont have.

So my humble suggestion to ly the person flat and check for stomach fluid running out of the tube has some merit because the other method is pretty useless at home. Checking the air movement is useful and I did not elaborate on that since I did not look it up in a book.

The straw and glas is textbook and not the situation when a layman should try that method (my opinion) a person that can drink from a glass with straw or without does not need a nasogastric tube in a homecare situation!

You forgot that most people that are fed with a nasogastric tube in a hospital situation also are not really that wonderfully cooperative most of them have had a stroke and are partially paralyzed so not able to sit or swallow correctly so your textbook version does not work exactly.
By the way, there are more than two sizes of tubes but as has been said before, it was my idea of a last resort if i.v fluid is not an option and oral hydration (normal drinking) is not either.

I leave it at that, pictures and different descriptions and thinking it through for different situations is the only way to deal with it.

Thanks Concerned for the compliment, but I didn't copy my NG tube instructions from a textbook, just a late night note. Over the past ten years, I have inserted many nasogastric/gastric tubes........can do it in my sleep. : )

Hope it helps.
God's blessings!

MK

Some tips to pass on:

Forcing yourself to sneeze every night is a great way to keep your nasal passages virus free.

Do not clean out too much of your ear wax, as it is a natural barrier

Place a drop of hydrogen peroxide in your ears daily to help kill any virus that may try to come in through the ear passage. Some scientists think that you are more liekly to receive the flu virus via the ear canal than the mouth or nostrils; mainly because the mucus of the nose and mouth helps kill the virus or bacteria better than the ear will.

Thoughts... Hope this helps, let me know!

 

In the list of medications (I may have missed it) I did not see any expectorant for helping move congested mucus out of the lungs.  It's probably contained in some of the multi-ingredient concoctions like NyQuil, but it can be bought as a stand-alone med also.  I prefer stand-alone varieties for the most part, because it helps me be more flexible with the dosages of each individual ingredient.

I bought two big bottles of generic guaifenesin (400mg) tablets at Costco.  It's an expectorant, I believe the same ingredient as in the OTC "Mucinex".  It helps thin and loosen congestion so it can be coughed up more easily, help keep things clear.  Plus I imagine stagnant mucus would quickly become a breeding ground for secondary infections, as well as clogging otherwise-useful alveoli in the lungs.  That's why I thought having some on hand might be a wise investment. 

Rather than buy and store something like "Pedialyte" electrolyte replenisher, we simply got cans of powdered Gatorade.  It'll keep well, we only have to mix it on demand, and darn it, I enjoy the taste.  Any drawbacks to this approach that anyone is aware of?

Bruss,

Thanks for the quaifenesin explanation...it's going on my list for next pick-up!!!

Re: Gatoraide...I read many times that Gatorade & the like contains too much sugar and that will exacerbate diarrhea, thus speeding electrolyte loss and dehydration.

MK, this is from CIDRAP, please note that diarrhea is a dominate symptom.

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/ biofacts/avflu_human.html

Clinical and Treatment Considerations

The incubation period for most patients with H5N1 influenza is 2 to 4 days; however, the range appears to be as long as 8 days. A recent report summarized the clinical presentations for different groups of patients in Asia; the information is presented in the table below (see References: WHO Writing Committee of the WHO Consultation on Human Influenza A/H5).

Clinical Presentation for Different Groups of Patients in Asia
	Hong Kong (N=18)	Thailand, 2004 (N=17)	Vietnam, 2004 (N=10)	Ho Chi Minh City, 2005 (N=10)	Cambodia, 2005 (N=4)
Outcome or Measure	No./Total No. (%)	No./Total No. (%)	No./Total No. (%)	No./Total No. (%)	No./Total No. (%)
Fever (>38ºC)	17/18 (94)	17/17 (100)	10/10 (100)	10/10 (100)	4/4 (100)
Headache	4/18 (22)	NS	NS	1/10 (10)	4/4 (100)
Myalgia	2/18 (11)	9/17 (53)	0	2/10 (20)	NS
Diarrhea	3/18 (17)	7/17 (41)	7/10 (70)	NS	2/4 (50)
Abdominal pain	3/18 (17)	4/17 (24)	NS	NS	2/4 (50)
Vomiting	6/18 (33)	4/17 (24)	NS	1/10 (10)	0
Cough	12/18 (67)	16/17 (94)	10/10 (70)	10/10 (100)	4/4 (100)
Sputum	NS	13/17 (76)	5/10 (50)	3/10 (30)	NS
Sore throat	4/12 (33)	12/17 (71)	0	0	¼ (25)
Rhinorrhea	7/12 (58)	9/17 (53)	0	0	NS
Shortness of breath	1/18 (6)	13/17 (76)	10/10 (100)	10/10 (100)	NS
Pulmonary infiltrates	11/18 (61)	17/17 (100)	10/10 (100)	10/10 (100)	4/4 (100)
Lymphopenia	11/18 (61)	7/12 (58)	NS	8/10 (80)	½ (50)
Thrombocytopenia	NS	4/12 (33)	NS	8/10 (80)	½ (50)
Increased aminotransferase levels	11/18 (61)	8/12 (67)	5/6 (83)	7/10 (70)	NS
Development of respiratory failure (usually with ARDS)*	8/19 (44)	13/17 (76)	9/10 (90)	7/10 (70)	4/4 (100)
Abbreviations: ARDS: Acute respiratory distress syndrome; NS: Not stated. *High levels of inflammatory mediators may contribute to ARDS and multiorgan failure. Data were obtained from a recent WHO report and are derived primarily from several separate studies (see References: WHO Writing Committee of the WHO Consultation on Human Influenza A/H5; Chan