What’s a Walipini and Why Do You Want One?

A walipini is an underground greenhouse.  It was first conceived and constructed by the good folks at the Benson Institute of Brigham Young University who were looking for a way for people living high in the Andes Mountains to be able to grow fresh produce year-round.  And one of the requirements was that the solution had to be relatively inexpensive.  The walipini as built in the guide provided by the Benson Institute costs about $250-300.  (Not sure how much that works out to now with inflation.)  Using the dimensions provided in the guide, the walipini can grow vegetables to feed seven adults. 

What the walipini lacks in expense it makes up for in labor.  Yes, it takes work, mainly in excavating the pit, but once that part is accomplished it’s pretty smooth sailing.  Whether I ever get one of these remains to be seen.  Aaron and KOTPE started excavation on one at our last place.  Our mountain was mainly sand and with a bobcat it didn’t take much time at all.  And then dating and school took up KOTPE’s time and Aaron found his job was coming to an end.  So that walipini was never finished.  And now our mountain is nothing but solid rock.  They say it isn’t quite so easy to excavate.

Anyway, one of the most significant advantages of the walipini is that, in contrast to regular greenhouses, it does not require any electricity to heat it.  The earth several feet below the soil surface remains at a constant 50°F so that the sun’s rays only need to raise the air temperature about 30°F.  The sun’s rays penetrate and warm the soil during the day and then the soil releases the heat at night to keep the ambient temperature inside above 45°F.   

Aaron, KOTPE, and I got to tour a walipini about 45 minutes from here.  It worked very well to grow all the vegetables for a couple of large families.  I have wanted a walipini for years.  Unfortunately, just because I want something doesn’t necessarily mean that I get it.  And instead of waiting any longer to get it before telling you about it, I figure I just better share the info now so that those of you who want one can start working on it.

The address below is to a 29-page instruction manual put out by the Benson Institute for building a walipini.  As noted in the comments below, the address I provided several years back is no longer good.  And when I went looking for another address, I found a plethora of options, some of which I considered pasting in here.  And then I quickly realized that at least one of them as AI-generated.  I've read horror stories about the AI-generated knitting patterns.  An AI-generated walipini plan could be a whole lot worse.  So keep that in mind as you peruse walipini plans.  

References:

https://archive.org/details/WalipiniConstructionTheUndergroundGreenhouse/page/n1/mode/2up

 

Identifying and Managing Pneumonia Post-Collapse

Disclaimer.  I am not a licensed health practitioner.  This is just another post on knowledge and understanding you might wish to acquire in advance of a disaster in case no higher care is available.  As long as our society is functioning, you should leave anything more substantial than applying a Band-Aid to the professionals.  No medication, including those available over the counter, should be taken without consulting a physician.  Information shared here is for educational and entertainment purposes only.  It is not medical advice nor a substitute for licensed medical care. 


Checking all my medical resources, Armageddon Medicine is the book to have if pneumonia is a concern.  The others barely address it at all.

Without a laboratory for testing specimens, there is no way you'll be able to definitively determine whether a patient has viral pneumonia or bacterial pneumonia.  It is an acute infection of the lungs that often develops after another respiratory illness, like influenza, bronchitis, or asthma.  However, it may also occur following measles, whooping cough, or any other very serious illness, especially in the very young and very old.  You're going to have to make an educated guess so that you can decide whether you want to use the precious supply of antibiotics.

Babies and the elderly (or anyone who seems a bit feeble) are at greater risk for unilateral pneumonia, meaning that the pneumonia is only in one lung.  It can be due either to aspirated food or microbes that get trapped in one lung and cause a localized infection.  Left unchecked, the fluids accumulate in the lung, preventing gas transfer--no oxygen in and no carbon dioxide out.  The patient literally drowns in his own fluids.  However, the infection can also enter the bloodstream, causing sepsis and death.  Listening to the lungs will reveal that the affected side rattles or wheezes, while the unaffected lung is clear without any sounds.  But if the respiration is very shallow, you may not be able to detect a difference between the two sides.  The nostrils may flare with each breath.  The patient may complain of one-sided chest pain, particularly when coughing or inhaling deeply.  Or there may be no respiratory symptoms at all and the patient may simply feel weak or sick.  There may be sudden chills and then a high fever.  For these patients, a doctor will want to use antibiotics.

In children, pneumonia is more likely to be viral.  No antibiotics.  In adults, pneumonia is more likely to be bacterial.  But that doesn't necessarily mean antibiotics are needed.

The next factor a physician looks at is whether the patient "looks" well or not.  In a patient that looks well, the pneumonia is more likely to be viral or the very early stages of bacterial.  And by "looking well" a doctor means that the patient is physiologically stable.  S/he can still be quite miserable, but the vital signs are normal, respiration is normal, the patient is eating and drinking and not confined to bed.  These patients should continue eating and drinking and be given fever reducers and pain relievers to be kept comfortable.  Antibiotics are not warranted, but the patients should be carefully observed for any changes.

Patients that do not "look well" display abnormal physiological reactions, including:

• elevated heart rate, 
• rapid breathing, 
• labored breathing, 
• vomiting, 
• inability to take food and drink.  

A sick child who takes more than fifty shallow breaths per minute likely has pneumonia.  These patients must be observed more carefully.  If they cannot maintain fluid intake, they must get it through an intravenous, subcutaneous, or rectal administration.  Acetaminophen can be used for reducing fever.

So when will a doctor want to use antibiotics?  They are most likely needed with:

• one-sided, or unilateral, pneumonia;
• a sick-looking patient, baby, or feeble adult;
• when a patient has other respiratory conditions such as asthma and COPD;
• in any patient that does not improve or gets worse after 3-4 days.

If an infection develops, most doctors would prescribe cephalexin, Augmentin, or erythromycin as first choices.  Second-line options would be doxycycline, ciprofloxacin, or levofloxacin.  Treatment would be continued for two days beyond the resolution of the infection.  In order to conserve the supply of antibiotics, bacitracin, silver sulfadiazine, and/or honey might also be recommended.

After two to three days on antibiotics, the patient should be improving.  If he is not improving by day three or four, or if he is worsening, the doctor will switch antibiotic classes.  Antibiotics will usually do the job in five days in an otherwise healthy adult; it may take seven to ten days for those who are older or chronically ill.  The cough may linger for weeks but is not a cause for concern.  

Regardless of whether the pneumonia is bacterial or viral, there are a few other measures that can be taken.  The patient should take several deep breaths every hour.  In addition, the head of the patient's bed should be elevated 30-45 degrees.  Warming and humidifying the air will help loosen mucus secretions in the lungs.  The patient can be given a balloon to blow up, or he can blow bubbles through a straw into a cup of water.  Both of these methods provide some back pressure when exhaling to prevent lung collapse.  The vibrations from the bubbles also help loosen the mucus.  Or the patient can yell.  These measures are better than nothing, but unfortunately, not as effective as antibiotics.

In the days before antibiotics, physicians used a stethoscope to determine where the pneumonia was concentrated and then had the patient lie on the affected side to facilitate drainage.  The caregiver then cupped his hand and clapped it against the affected area on the back rapidly and firmly enough to loosen the mucus, but not so hard as to cause pain or bruising.  This was performed several times each day.  Patients today will not be any more happy than patients of previous generations were.

Herbs that may help manage pneumonia include Usnea, oregano, rosemary, Japanese honeysuckle, and lomatium.  Some of these will be more effective against bacteria and others will be better for viruses.

Links to related posts:
Usnea  
Oregano
Rosemary
Japanese honeysuckle 
Lomatium 

For further information:
Armageddon Medicine, pp 123-129.

Hemostatic Agents to Stop Bleeding

Disclaimer.  I am not a licensed health practitioner.  This is just another post on knowledge and understanding you might wish to acquire in advance of a disaster in case no higher care is available.  As long as our society is functioning, you should leave anything more substantial than applying a Band-Aid to the professionals.  No medication, including those available over the counter, should be taken without consulting a physician.  Information shared here is for educational and entertainment purposes only.  It is not medical advice nor a substitute for licensed medical care. 

When faced with treating life-threatening bleeding, military medics have turned to hemostatic agents for years. In conjunction with direct pressure, they stop bleeding in places where tourniquets cannot be used, especially the head, neck, abdomen and pelvic area. Celox and Quikclot have been around for years; X-Gauze is the new kid on the block.  

While initially designed for military use, all three products are available to civilians without restriction. Celox and Quikclot can be found in stores and online, but for X-Gauze, you've got to go to their website.  

These clotting agents are sold as granules, z-pack gauze, and sponges. The granules are poured onto or into a wound. But if that wound is still spurting blood, the granules are going to be washed away. The clotting agent must be exactly where the blood is coming from to be of any use.  

Z-pack gauze is favored for most applications. The gauze is impregnated with the clotting agent and can be packed very tightly against an internal wound. The clotting agent cannot be washed away. And the medic using this product does not have to bother with packing the wound while simultaneously sprinkling in the clotting agent. 

All three products differ in their mechanism of action. QuikClot uses kaolin, a natural clotting agent that accelerates the body's natural clotting abilities. When used in conjunction with direct pressure, it stops life-threatening bleeding within five minutes. It has a five-year shelf-life from the date of manufacture. QuikClot and the kaolin and gauze must be completely removed from the body before the wound is closed.

Celox uses chitosan, a clotting agent derived from shrimp. Throughout extensive clinical trials and field use, there have been no reports of any allergic reactions, even among individuals allergic to shellfish or iodine. Like QuikClot, Celox stops severe bleeding within five minutes when used together with direct pressure. Unlike the kaolin in Quikclot, the chitosan in Celox can be broken down by the body. So while it should be thoroughly washed away before the wound is closed, chitosan is less likely to cause a problem if small amounts are not removed. Celox granules have a four-year shelf-life. Like QuikClot, Celox gauze has a five-year shelf-life from the date of manufacture.  

Both of these products work to clot blood even in patients taking blood thinners, as well as in cases where hypothermia is an issue.  

X-Gauze, in contrast, does not use a hemostatic clotting agent. Instead, it is gauze impregnated with miniature sponges that expand to ten times their size on contact with fluids to stop bleeding by direct pressure. It is ideal in that it conforms to the wound perfectly and exerts pressure everywhere. As of this writing, it is not available on Amazon; you have to go to their website. Because it is new, it does not have extensive field testing, but clinical trials have shown that it is a very promising technology. Unfortunately, at $50 each, they're a little expensive right now.  

It must be emphasized that none of these clotting agents substitute for direct pressure. Direct pressure will stop the vast majority of bleeding within thirty minutes. If direct pressure fails to stop bleeding after thirty minutes (without peeking every five minutes to check, which may interrupt any clotting that started), then a clotting agent and/or tourniquet may be required. 

Links to related posts:
Bleeding
Tourniquets 

For further reading:
https://pdfs.semanticscholar.org/5742/31fb7a3bb1fa973113958a9de48a4a6a8f9b.pdf
https://www.celoxmedical.com/eur/eurfaq/
https://quikclot.com/QuikClot/Clinical-Evidence
https://www.revmedx.com/xgauze/

 14 january 2020

The Best Medical Tapes and Wraps for TEOTWAWKI

One of the things that I have found intimidating about learning about medicine and the essential medical supplies is simply not knowing anything. See, medical personnel know their stuff pretty well, but they then talk about it as if we completely understand all their jargon. And the rest of us laypeople don't even know what we don't know, so we can't ask intelligent questions. And if you don't have a lot of experience with illnesses and injuries, you've had even less exposure than others and are at more of a loss. Did that make any sense?

I was raised in a family of rather non-adventurous girls. We never broke a bone or needed stitches. My kindergarten-aged sister did a faceplant into the side of a sandbox that caused a massive bruise and swelling on her forehead. That's about the extent of our injuries. I had never even heard of triple antibiotic--or any antibiotic--cream until I was married. I'd never heard of Coban or Vet-Wrap until our dog needed it about five years ago. And yet, both of these are items we should have in any basic first-aid kit. So I figured today I'd cover medical tapes and wraps to consider adding to your supplies.

TAPES

Transpore medical tape. I absolutely love this tape. Read the reviews on Amazon to get more information from medical personnel, but for starters, this tape is the best. It adheres very well, it's clear, and it tears so easily in both directions, even for me with diminished finger strength. We've been using this with the rabbit and 1/2" is way too wide for what we need to do. But those strips can cleanly be torn into four or five strips. It's waterproof, yet it also breathes to let sweat out and air in. It is the strongest for adhering to skin. It can be used to prevent chafing and as a butterfly stitch to close minor cuts. I love this tape so much that I was afraid to check what it would cost, sure that the price would be outrageous. (Supplies for diabetes management usually are, and this was something my husband was no longer using.) I was thrilled to find it on Amazon, one of the few items I've found that is substantially cheaper there than at ShopMedVet.com. Transpore does leave a sticky residue and can irritate sensitive skin. You wouldn't want to use this for daily bandage changes. And I wouldn't use it for securing a SAM splint unless you had no alternative, because it will rip the foam off the splint. Number of rolls to stockpile (for a family of four): four.

Nexcare waterproof tape. This absolutely waterproof tape adheres very well to the skin. It's very flexible, making it the tape of choice for areas like under armpits and between fingers and toes. It doesn't stick well to hair, which is good for sensitive skin or daily bandage changes, but not so good if it needs to stick to hairy skin. It is easy to tear across, but not into lengthwise strips, and it leaves no sticky residue behind. Number of rolls to stockpile: one.

Paper tape is gentle on the skin. It is not as sticky as the previous two and is inexpensive, so it's what you want for daily dressing changes and sensitive skin. It will not work for situations involving heavy exercise, irregular areas of the body, or blisters or chafing. Number of rolls to stockpile: two.

Cloth tape (I prefer silk), 2-3" wide, has a lot of applications, but the most critical, especially for our purposes, is for taping sprained ankles. A badly sprained ankle can be taped so well and so securely that the patient will be able to walk if necessary. Of course, it is far, far better to rest that ankle and let others do the work, but in some situations, that may not be an option. Ace bandages absolutely will not substitute for good cloth tape and a good taping job. Number of rolls to stockpile: three.

Duct tape is obviously not designed for medical applications, but it's a favorite for emergency medical kits. Wider rolls are used in splinting limbs and wrapping bandages in place when other tapes just won't work. You can also get mini rolls of duct tape (Duck Tape brand "ducklings") for smaller applications and smaller kits. Number of regular duct tape rolls to stockpile for the emergency kit: one.

 WRAPS

Coban is used for wrapping fingers and limbs and holding bandages in place. Because it is self-adherent, no pins are needed. It is made of non-woven polyester so that it is elastic and conforms well to the body and lets the skin breathe. 

Vet-Wrap is designed for animals, but there's no good reason not to use it for people, especially when it's so much cheaper. It's the same stuff as Coban. Number of rolls to stockpile: five. 

The self-adherent wraps are nice because they don't require pins and do a pretty good job staying in place. I've never used Coban, but we have used Vet-Wrap on the dogs and one rabbit. Of course, on the animals we are concerned about them being active, so we also use a little duct tape just to be sure. Lately, at the grocery outlet stores around here, they've had their own cheap knock-off version of Coban. I bought several rolls--you can't go too far wrong at 99 cents--and put them in with the other supplies.

We decided to try it out on the rabbit. And initially, I was not at all impressed. Actually, I was more irritated to think I had wasted some money. It wasn't very sticky, but we used it on the rabbit anyway. And when we removed that knock-off Coban at the next dressing change, my attitude towards it did a one-eighty. Why? Because it wasn't as sticky. It was so much easier to change that dressing. I think this is because the rabbit is active and jumping around and using his foot all the time, and the Vet Wrap gradually compresses and becomes more adhered to itself. Because the knock-off isn't as sticky to begin with, it is easier to remove. I think the same might be true with active children. So now I'm happy that I got it and plan to get a few more rolls. I wouldn't plan on it as a substitute for Coban or Vet-Wrap, but more as a supplement for situations where stickiness is not essential.

Ace bandages, one each of 2", 3", and 4", provide support for joints, reduce swelling, and comfortably hold dressings in place. These are for your family, nobody else. 

To go along with these, you'll also want bandage scissors for removing bandages. These have a curved tip on the bottom so that you don't risk injuring your patient. I also have a Klever Kutter (actually ten, they were pretty cheap that way). I have really loved this. It was a lifesaver in trying to remove the bunny's bandages without hurting him. I would rather have this for dealing with a wiggly child or other difficult-to-manage patient. In case you're interested, click on the link below for the review.

Links to related posts:
Wound Dressings
Sutures
Klever Kutter  

For more information on tapes:
https://insidefirstaid.com/first-aid-kit/medical-tape-buy-the-right-kind

More Uses for the Basic White Sauce

Yesterday’s article covered the basic white sauce—bechamel—and various ways to prepare it to add variety to our dishes.  Essentially it combines butter, flour, and milk to produce a cooked sauce. 

However, you can produce a lot of other sauce options by changing out the liquid.  Instead of using milk, try water, fruit juice, or broth. 

Teriyaki Sauce

Begin with a thin white sauce (1 tablespoon each butter and flour, ¼ teaspoon salt, 1 cup water) and then stir in the following:

½ cup soy sauce

½ cup sugar

1 tablespoon cornstarch

2 tablespoons vinegar

¾ teaspoon ginger

1/8 teaspoon red pepper flakes

 

Cook and stir until smooth.

 

Sweet and Sour Sauce

1 onion, sliced

1 tablespoon oil

½ cup pineapple juice

½ cup vinegar

½ cup sugar

1 tablespoon cornstarch

1 teaspoon ginger

½ teaspoon garlic powder

¼ cup ketchup

 

In a saucepan over medium-low heat, sauté the onion in oil.  Add the pineapple juice and vinegar.  In a small bowl, combine the sugar, cornstarch, ginger, and garlic, and then add to the saucepan.  Stir in the ketchup.  Cook and stir until smooth.

 

Lemon Chicken Sauce

¾ cup lemon juice

¼ cup vinegar

½ cup sugar

1 tablespoon cornstarch

1 teaspoon ginger

½ teaspoon garlic powder

¼ cup toasted sesame seeds

 

In a small saucepan over medium heat, combine the lemon juice and vinegar.  In a small bowl, combine the sugar, cornstarch, ginger, and garlic powder and then add it to the juice mixture.  Cook and stir until smooth.  Stir in the sesame seeds. 

Substitute orange juice for the lemon juice to make Orange Chicken.

 

Stir-fry Sauce
1/2 cup water
1 tablespoon cornstarch
2/3 cup soy sauce
1/2 cup sugar
1/2 cup vinegar
2 tablespoons oil
1 tablespoon sesame seeds
2 teaspoons red pepper flakes
2 teaspoons chili oil
1 teaspoon minced ginger

Combine water and cornstarch and stir until cornstarch is dissolved.  Add this to the other ingredients in a small saucepan over medium heat.  Bring to a boil, then reduce heat and simmer until thickened. 

 

Apple Cider Syrup

2 tablespoons butter

½ cup sugar

1 tablespoon cornstarch

½ teaspoon cinnamon

1 cup apple juice

1 tablespoon lemon juice

Melt butter in a small saucepan over medium low heat.  Combine the sugar, cornstarch, and cinnamon in a small bowl and then stir into the melted butter.  Add the apple and lemon juices.  Cook and stir until thickened and bubbly.  

Fruit Pie and Dessert Filling

2 tablespoons butter

1 cup sugar

1 tablespoon cornstarch

3/4 cup water

1/4 cup lemon juice 

2 cups fruit

In a medium saucepan over medium-low heat, melt the butter.  In a small bowl, combine the sugar and cornstarch and stir into the melted butter.  Immediately add the water and lemon juice and stir until thickened.  Stir in the fruit and continue to cook an additional 1-2 minutes.

Note that this recipe will make about 1 pint of fruit pie filling.  To fill a pie, you will probably want to double or triple this recipe.  Also note that most commercial pie fillings, especially blueberry and cherry, have food coloring added to the liquid.

Bacon Syrup

2 tablespoons bacon grease

1 tablespoon cornstarch

1 cup water

2 cups brown sugar

Melt bacon grease in a small saucepan over medium low heat.  Combine the sugar and cornstarch and stir into the bacon grease until smooth.  Add the water and cook and stir until thickened and bubbly.

Vanilla Syrup

2 tablespoons butter

1 tablespoon cornstarch

1 cup water

½ cup sugar

1 ½ teaspoons vanilla extract

Dash salt

Dash nutmeg

In a small saucepan over medium-low heat, melt the butter.  In a small bowl, combine the sugar and cornstarch and stir into the butter.  Add the water, salt, and nutmeg and cook over low heat until thickened and clear.  Remove from heat and stir in the vanilla extract.